Discovery Child Care

Mandatory Pre-Screening Questions:: The following questions need to be completed, BEFORE we permit your child into the center/school.

If your child attends 4-5 days a week, the pre-screening questions need to be filled out before the first day your child attends that week. (Eg. Monday morning)

If your child attends 3 or less days a week, the pre-screening questions need to be filled out daily.
Today's Date:
Name of Parent/Guardian filling out this form:: First Name:

Last Name:
Child's Name:: First Name:

Last Name:
1. Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.:
1. Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.:
Fever and/or chills (temperature of 37.8°/100.0° or greater):: yesno
Cough (more than usual if chronic cough) including croup (barking cough, making a whistling noise when breathing):: yesno
Shortness of Breath (dyspnea, out of breath, unable to breathe deeply, wheeze, that is worse than usual if chronically short of breath) Not related to other known causes or conditions (eg., asthma):: yesno
Decrease or loss of smell or taste (new olfactory or taste disorder) Not related to other known causes or conditions (eg., nasal polyps, allergies, neurological disorders):: yesno
2. Does your child have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.:
Sore throat (painful or difficult swallowing) not related to other known causes or conditions (eg., post nasal drip, gastroesophageal reflux):: yesno
Stuffy nose and/or runny nose (nasal congestion and/or rhinorrhea) Not related to other known causes or conditions (eg., seasonal allergies, returning inside from the cold, chronic sinustis unchanged from baseline, reactive airways):: yesno
Headache that is new and persistent, unusual unexplained, or long lasting. Not related to other known causes or conditions (eg., tension-type headaches, chronic migraines):: yesno
Nausea, vomiting and/or diarrhea Not related to other known causes or conditions (eg., transient vomiting due to anxiety, chronic vestibular dysfunction, irritable bowel syndrome, inflammatory bowel disease, side effect of medication):: yesno
Fatigue, lethargy, muscle aches or malaise (general feeling of being unwell, lack of energy, extreme tiredness, poor feeding in infants) that is unusual and unexplained. Not related to (eg., depression, insomnia, thyroid dysfunction, anemia):: yesno
3. Has your child travelled outside of Canada in the past 14 days?:: yesno
4. Has your child been identified as a close contact of someone who is confirmed as having COVID-19 by your local public health unit (or from the COVID Alert app if they have their own phone)?:: yesno
5. Has your child been directed by a health care provider including public health offical to isolate?:: yesno
Results of Screening Questions:: If you answered "YES" to any of the symptoms included under question 1:

Your child should stay home to isolate immediately.

Contact your child's health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.

If you answered "YES" to only one of the symptoms included under question 2:

Your child should stay home for 24 hours from when the symptoms started.

If the symptom is improving, your child may return to school/childcare when they are feeling well enough to do so. A negative COVID-19 test is not required to return.

If the symptom persists or worsens, contact your child's health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.

If you answered "YES" to two or more symptoms included under question 2:

Your child should stay home an isolate immediately.

Contact your child's health care provider for further advice or assessment, including if your child needs a COVID-19 test or other treatment.

If the individual answers "YES" to question 3, 4 or 5

Your child should stay home to isolate immediately and follow the advice of public health.

If your child develops symptoms, you should contact your local public health unit or the health care provider for further advice.
This information is required by the Ministry of Health.:: By hitting submit, you are confirming that your child does not have any of the above symptoms nor has been in contact with someone that has travelled.

***It is your responsibility to update the Discovery Chidcare Program supervisor/designate of any changes to your above answers immediately. Serious consequences can arise from knowingly providing false information.
Spam Verification:

Queen Elizabeth Public Completed Daily COVID-19 Screening Questions

Discovery
Main Office

Jack Miner
Public School

Kingsville
Public School

St. John De Brebeuf
Catholic School

Queen Elizabeth
Public School

Gosfield North
Public School

PA DAYS, MARCH BREAK AND
SUMMER CAMP

Queen Elizabeth Public Completed Daily COVID-19 Screening Questions

Discovery Main Office

Jack Miner Public School

Kingsville Public School

St. John De Brebeuf Catholic School

Queen Elizabeth Public School

Gosfield North Public School

PA DAYS, MARCH BREAK AND SUMMER CAMP

Discovery
Main Office

Jack Miner
Public School

Kingsville
Public School

St. John De Brebeuf
Catholic School

Queen Elizabeth
Public School

Gosfield North
Public School

PA DAYS, MARCH BREAK AND
SUMMER CAMP