Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.1 Health Promotion in Child Care

3.1.1 Daily Health Check Conduct of Daily Health Check

COVID-19 modification as of July 28, 2023.

After reading the CFOC standard, see COVID-19 modification below (Also consult applicable state licensure and public health requirements).

Every day, a trained staff member should conduct a health check of each child. This health check should be conducted as soon as possible after the child enters the child care facility and whenever a change in the child’s behavior or appearance is noted while that child is in care. The health check should address:

  1. Reported or observed illness or injury affecting the child or family members since the last date of attendance;
  2. Reported or observed changes in behavior of the child (such as lethargy or irritability) or in the appearance (e.g., sad) of the child from the previous day at home or the previous day’s attendance at child care;
  3. Skin rashes, impetigo, itching or scratching of the skin, itching or scratching of the scalp, or the presence of one or more live crawling lice;
  4. A temperature check if the child appears ill (a daily screening temperature check is not recommended);
  5. Other signs or symptoms of illness and injury (such as drainage from eyes, vomiting, diarrhea, cuts/lacerations, pain, or feeling ill).

The caregiver/teacher should gain information necessary to complete the daily health check by direct observation of the child, by querying the parent/guardian, and, where applicable, by conversation with the child.

COVID-19 modification as of July 28, 2023: 


Children who are experiencing any of the symptoms listed below should stay home and get tested for COVID-19

  • COVID-19 symptoms most likely seen in children:
    • Fever (100.4F/38C or higher) or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscles and body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea
    • Refer to the complete list Symptoms of COVID-19 | CDC

Children that are waiting for results of a COVID-19 test or have been recently diagnosed with COVID-19 should not enter the program. Children with a positive COVID-19 test should stay home for five days and wear a well-fitting mask for five days when they return to their program. Children may return if they received a negative test or their isolation period has ended.

Children or staff who arrive in the program with symptoms or develop symptoms while in care should wear a well-fitting mask while in the building, be sent home and get tested. Children or staff exposed to COVID-19 who develop symptoms, should be tested. 

There is overlap between COVID-19 symptoms and other common infectious childhood illnesses. Programs should follow their illness exclusion guidelines and refer to COVID-19 modification for Standard Inclusion/Exclusion/Dismissal of Children.


Daily health checks seek to identify potential concerns about a child’s health including recent illness or injury in the child and the family. Health checks may serve to reduce the transmission of infectious diseases in child care settings by identifying children who should be excluded, and enable the caregivers/teachers to plan for necessary care while the child is in care at the facility.
The daily health check should be performed in a relaxed and comfortable manner that respects the family’s culture as well as the child’s body and feelings. The child care health consultant should train the caregiver/teacher(s) in conducting a health check. The items in the standard can serve as a checklist to guide learning the procedure until it becomes routine.

The obtaining of information from the parent/guardian should take place at the time of transfer of care from the parent/guardian to the staff of the child care facility. If this exchange of information happens outside the facility (e.g., when the child is put on a bus), the facility should use an alternative means to accurately convey important information. Handwritten notes, electronic communications, health checklists, and/or daily logs are examples of how parents/guardians and staff can exchange information when face-to-face is not possible.

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Child Care Health Consultants Inclusion/Exclusion/Dismissal of Ill Children
Appendix F: Enrollment/Attendance/Symptom Record

COVID-19 modification as of July 28, 2023. Documentation of the Daily Health Check

The caregiver/teacher should conduct and document a daily health check of each child upon arrival. The daily health check documentation should be kept for one month.
The vast majority of infectious diseases of concern in child care have incubation periods of less than twenty-one days (1). This information may be helpful to public health authorities investigating occasional outbreaks.
The documentation should note that the daily health check was done and any deviation from the usual status of the child and family.
Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Records of Injury Documentation of Parent/Guardian Notification of Injury, Illness, or Death in Program Review and Accessibility of Injury and Illness Reports Contents of Child’s Records Pre-Admission Enrollment Information for Each Child Contents of Admission Agreement Between Child Care Program and Parent/Guardian Contents of Child’s Primary Care Provider’s Assessment Health History Contents of Medication Record Contents of Facility Health Log for Each Child Release of Child’s Records
  1. California Childcare Health Program. CCHP health and safety checklist. Rev. ed.