Child Care Infrastructure and COVID-19: A New Reality

Safe, resilient, and developmentally appropriate child care facilities are essential to an early childhood system that promotes the health and well-being of the nation’s children and families. Yet facility infrastructure has been long neglected and many child care facilities around the country are in substandard condition. While there has been a longstanding need to invest in facility improvements, the pandemic has shown a need to prioritize these investments so programs can effectively implement guidance that may mitigate the risk of virus exposure. With these investments, we can move toward ensuring children and providers stay safe and healthy in child care settings, and that the nation builds back a stronger and more resilient child care system.

In April 2020, the Centers for Disease Control and Prevention issued guidance for child care that has remained open during the pandemic. Following this, in May 2020, the CDC released guidance to help providers reopen. For child care to reopen during this time, programs must take steps to reduce the risk of transmission, such as reducing class sizes, implementing enhanced sanitation and hygiene protocol, and introducing additional health checks. To do so effectively, however, may require facility upgrades and modifications that will lead to improved facility conditions as the nation recovers.

Based on available guidance from the CDC, the following features of child care facilities should be considered as programs reopen:

Self-contained classrooms to support social distancing. The CDC provides social distancing strategies for child care settings, which include reducing class group sizes, having children remain in the same class groups each day with the same providers, and limiting the use of communal space, such as cafeterias and large play areas. While social distancing is not developmentally appropriate for young children, efforts to limit interactions between children and providers can help reduce the risk of virus transmission.

Self-contained classrooms, or classrooms with furnishings, equipment, and appliances located directly within the enclosed space—including toilet and diaper-changing areas and child-sized bathroom and activity sinks—are helpful in reducing viral transmission by keeping children and providers in the classroom throughout the day. These classrooms should include sufficient space for individually storing children’s belongings and bedding materials, a teacher resource station, and a meal preparation area that includes an adult-sized sink and dishwasher for sanitation purposes. The classroom size should also accommodate sufficient space for children to remain six feet apart during naptime. Other features of child care classrooms that are beneficial to children’s development, such as access to natural light and appropriate acoustic levels, should also be included in facility design.

Additional classroom space to accommodate small group sizes. With guidance promoting small group sizes in child care settings, programs may be required to reduce the number of children served, which impacts both the business model and working parents’ access to child care. Child care programs can also construct additional self-contained classrooms, as described above, to accommodate a greater number of small class groups. Separate classrooms can be used to serve children of health care providers and other essential personnel who are at greater risk of exposure. Providers may consider temporary partitions to divide existing classrooms if the space is large enough and each classroom contains amenities, furnishings, and equipment needed to keep children and providers safe, in addition to ample room for gross motor play and socially distanced nap space. However, as providers begin to rebuild their businesses, they should look to long-term sustainable solutions.

Enhanced plumbing for additional sinks and bathrooms. Child-sized bathrooms and sinks in classrooms promote independence and help instill strong hygienic practices in young children, which is particularly important amid the pandemic. When classrooms are designed or retrofitted to meet advanced health and safety guidance, child-sized fixtures should include both sinks and toilets, in addition to separate adult-sized sinks for meal preparation. Adding these fixtures into classrooms may require new plumbing and draining throughout the facility. While portable sinks are available for classrooms, this is a temporary solution and may not be cost effective over a long period of time or be advisable for future needs.

Upgraded ventilation systems to improve air quality. Ventilation and air circulation is critical to improving air quality by clearing the air of toxic substances, infectious disease agents, and odors, which is important to keeping both children and adults healthy. Many child care programs, however, are located in older facilities that were not originally constructed to house child care programs and may have ventilation systems that are not appropriate for the space. Prior to child care reopening, ventilation systems should be inspected by an engineer qualified by the American Society of Heating, Refrigerating, and Air-Conditioning Engineers. Programs should also change the air filters monthly to improve air flow throughout the facility.

Improved entry ways to meet new screening protocol upon arrival. The CDC provides guidance for child care providers to implement new protocols for facility entry. At drop-off, programs should screen both children and providers for symptoms and conduct temperature checks at curbside prior to entry. While screenings can be conducted with support from parents while incorporating social distancing, physical barriers and safety equipment can be used to protect the provider from exposure. Child- and adult-sized sinks should be available within the entry area so both children and providers can wash their hands as they enter the facility. In addition, the entry areas should have sufficient storage area for safety equipment, cleaning supplies, and thermometers.

Other facility improvements may need to be considered during this time to improve health outcomes and reduce the risks of exposure. These include removing carpeting to reduce allergens; installing washers, dryers, and dishwashers to conveniently sanitize beddings, toys, and equipment; adjusting drinking fountains to reduce the risk of contamination and promote more hygienic use; and creating extra isolation spaces for children who may experience symptoms throughout the day. Facilities should also have adequate storage space for cleaning supplies and other safety materials that are out of children’s reach.

Child care programs already face challenges with their physical infrastructure, and the nation should prioritize investments to create a stronger and more resilient child care system that keeps children and providers safe and healthy. As the nation prepares its recovery from the COVID-19 pandemic, so too must the child care industry.