1. Staying Up to Date on Vaccinations

2. Optimizing Indoor Air Quality

3. Using Face Masks

4. Maintaining Good Hygiene

5. Reporting Diseases and Responding to Outbreaks

6. Cleaning Facilities

7. Getting Tested for Respiratory Infections

Please note that Cal/OSHA requires adults/employees to mask at work for 10 days after testing positive (no symptoms) – or – 10 days after symptom onset.

Protection Against Respiratory Viruses​

Masks lower a person’s exposure to respiratory infections such as COVID19, influenza, respiratory syncytial virus (RSV) and pertussis (whooping cough). 

If you test positive for COVID-19, masking is recommended. See the CDC Preventing Spread of Respiratory Viruses When You’re Sick  Respiratory Illnesses  for more details. 

If you believe you were exposed and will be in contact with someone who is higher risk, consider wearing a high-quality mask.   

If you are at higher-risk of becoming severely ill, consider wearing a high-quality mask (respirator) when you are in an indoor public setting with poor ventilation, or when you are traveling on public transportation.  

People who are at higher risk for severe respiratory infections include: 

• Older adults (aged 50 years and older)
• People with certain medical conditions such as a chronic disease or cancer
• People with weakened immune systems
• People who are pregnant or were recently pregnant
• People with disabilities
• People who live in congregate care facilities, such as a skilled nursing facility
• Children under 5, with greatest risk in infants​

Source:  CDPH - Updated July 11, 2024 (Student Guidance) & Cal/OSHA  - Updated May 22, 2024 (Employee/Adult Guidance)

SYMPTOMS |  any symptom that prevents a child from participating meaningfully in routine activities is cause to stay home.

OK TO ATTEND WITH MILD SYMPTOMS as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF  symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• Increase handwashing
• If respiratory illness (including COVID)
  • CDPH recommends students mask around others for 5 days after symptoms start 
  • Cal/OSHA requires employees/adults to mask around others for 10 days after symptoms start (if COVID)

Current guidelines are for students and staff to stay home and away from others if they have respiratory virus symptoms during the infectious period.

SYMPTOMS | may include runny/stuffy nose, sore throat, sneezing, congestion, body aches, fever, chills, fatigue, headache, and/or cough, typically lasting up to 7-10 days

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  difficulty or rapid rate of breathing - or wheezing - seek medical attention
• ^⚠  cough is severe of difficulty catching breath after coughing  - seek medical attention
• ^⚠  coughing associated with asthma that cannot be controlled by medication (like albuterol) - seek medical attention

^⚠  Seek medical attention for new symptoms such as wheezing or breathing difficulties, even if mild.​ 

STAY HOME (EMPLOYEES / ADULTS)

Per Cal/OSHA requirements,  employees/adults must stay home during the infectious period, defined as one of the following: 

1. For cases with symptoms: the infectious period is at least 24 hours from the day of symptom onset
2. For cases without symptoms: there is no infectious period. 

RETURNING TO SCHOOL  (STUDENTS) 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended
• masking for during/after respiratory illness
  • For all respiratory illnesses (including COVID) CDPH recommends students mask around others for 5 days after returning to school and resuming routine activities.

*Note: masking guidance is different for employees with COVID. Cal/OSHA requires masking around others for 10 days after symptoms start (or date of positive COVID test – if no symptoms)

RETURNING TO SCHOOL  (EMPLOYEES / ADULTS) 

Please note that Cal/OSHA  sustains certain additional requirements for employees (adults in schools).

1. Cases with symptoms may return if 24 hours have passed with no fever (without the use of fever-reducing medications) AND their symptoms are mild and improving.
2. Cases with no symptoms do not need to stay away from work. If symptoms develop, the criteria above will apply.

MASKING AT WORK  (EMPLOYEES / ADULTS) 

Per Cal/OSHA requirements,  adult/employee COVID-19 cases may return after the infectious period (see above) and must wear a mask indoors:

1. Cases with symptoms: 10 days from the start of symptoms
2. Cases without symptoms: 10 days from the first positive test

*Note that this is different from student guidance which is to mask around others for 5 days after returning to school.

SYMPTOMS |  wheezing (high-pitched sounds) that can be heard when a child breathes in or out, chest retractions (see below) OR extra effort is required to breathe

OK TO ATTEND WITH MILD SYMPTOMS as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF  symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  Wheezing that is new for the child or cannot be controlled by medications (e.g., albuterol) for known conditions (e.g., asthma)
• ^⚠  Skin or lips seem purple, blue, or grey, depending on skin tone - seek medical attention
• ^⚠  Behavior changes - seek medical attention
• ^⚠  Very rapid breathing or increased effort to breathe, such as chest retractions (space between ribs sinks with each breath), belly breathing (belly goes up and down with breathing)  - seek medical attention
• ^⚠  Breathing problem that causes child to have pursed lips, difficulty speaking, or difficulty feeding- seek medical attention

^⚠ Seek medical attention for new symptoms such as wheezing or breathing difficulties, even if mild.​

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended
• masking recommended for 5 days (students) and required for 10 days (employees/adults - if COVID per Cal/OSHA)

SYMPTOMS | pain experienced anywhere between the chest and groin; pain may be continuous or may come and go

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠ No urine for 8 hours, or upon waking up - seek medical attention
• ^⚠ Bloody or black stools - seek medical attention

^⚠ Seek medical attention for new symptoms such as wheezing or breathing difficulties, even if mild.​

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

SYMPTOMS | stools that are more frequent (typically at least two more than normal) or less formed than usual for that child AND not associated with a change in diet. 

OK TO ATTEND WITH MILD SYMPTOMS as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  Stool looks like it contains blood or mucus, or appears like sticky black tar (see medical attention) - seek medical attention
• ^⚠ Yellow skin/eyes (jaundice) - seek medical attention

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

SYMPTOMS |  pain (dull, sharp, or burning sensation) experienced inside the ear

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  Behavior changes - seek medical attention

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

SYMPTOMS | red or pink appearance to the white part of the eyeball. Child’s eye may also be itchy, have crusted/matted eyelashes, more watering than normal, or yellow/white drainage

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  problems seeing (vision changes)  - seek medical attention
• ^⚠   pain begins after an injury to the eye involving forceful impact to or penetration of the eye - seek medical attention

^⚠   - seek medical attention

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

Note:  Pink eye (i.e., conjunctivitis) is inflammation of a layer that covers much of the eyeball. It is most often caused by a virus, and children with viral pink eye typically get better after 5-6 days without antibiotics. Staying home from school or child care is not necessary. Frequent hand washing should be encouraged. Eye irritation can also result from allergies or ch​​emical exposures (e.g., air pollution, smoke, or swimming in chlorinated pool water).

SYMPTOMS |  an oral (under the tongue), temporal (forehead), rectal, or axillary (underarm) temperature above 100.4°F (38°C). Axillary (underarm) measurements should be used only if other options are not available. Follow instructions for the specific thermometer, including directions for use, cleaning and covers (if applicable). If a temperature is close to 100.4°F, repeat to confirm the result

STAY HOME  (unless otherwise directed by a healthcare provider) a child with a fever should NOT attend school or child care. 

RETURNING TO SCHOOL 

• Fever went away in the night – without using fever reducing medications, e.g., Tylenol®, Advil®, Motrin® (acetaminophen or ibuprofen) - and is still gone in the morning; AND
• child can comfortably participate in routine activities

SYMPTOMS | pain experienced in any part of the head ranging from sharp to dull; may occur along with other symptoms

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠  Concussion symptoms:  Pain occurs after a fall or other injury to the head and is severe or associated with vomiting, vision changes, behavior change, or confusion - seek medical attention
• ^⚠  Possible infection:  Stiff neck, headache and fever can be symptoms of meningitis a potentially serious infection. Meningitis can also cause sensitivity to light, vomiting, and/or confusion. A stiff neck is most concerning if the child can’t look at their belly button (putting chin to chest) due to pain or the BACK of the neck is painful (not soreness in the sides) along with the other symptoms above - seek medical attention

^⚠   - Get immediate medical attention for either of the above conditions.​​

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

SYMPTOMS | an area of the skin that has changes in color or texture and may look inflamed or irritated. The skin may be darker than or lighter than normal or red or purple; skin may be, warm, scaly, bumpy, dry, itchy, swollen, or painful; it may also crack or blister

OK TO ATTEND WITH MILD SYMPTOMS as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• fever (100.4°F or higher) - see “Fever” for return guidance
• ^⚠   rash is worsening, painful, blistering, or not healing - seek medical attention
• ^⚠   oozing, open wound or infection that cannot be covered and is in an area that might come in contact with others  - seek medical attention
• ^⚠   skin that looks bruised without a known injury or in an unusual location - seek medical attention
• ^⚠   tender, red area of skin, rapidly increasing in size or tenderness - seek medical attention
• ^⚠   rapidly spreading dark red or purple rash (may indicate a rare but severe bacterial infection; usually accompanied by fever) - seek medical attention 
• ^⚠   associated symptoms of a serious allergic reaction (rash with throat closing, abdominal pain, vomiting, or wheezing) - seek medical attention 
• ^⚠   concern for a disease like chickenpox or measles.  - seek medical attention 

^⚠   - Get immediate medical attention for either of the above conditions.​​

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• child can comfortably participate in routine activities
• frequent hand washing is recommended

Note: For diagnosed conditions, follow the advice of the healthcare provider. In general, for conditions such as lice, impetigo, ringworm, scabies, and pinworms, no waiting period is typically necessary after starting treatment and the child may return after the appropriate treatment is started.

SYMPTOMS | painful throat, or pain when swallowing

OK TO ATTEND WITH MILD SYMPTOMS  as long as both of the following are true:

• symptoms are improving & do not interfere with routine activities -  and -
• no fever has been present for at least 24 hours (without the use of fever-reducing medications)

STAY HOME IF symptoms are not improving, worsening, or severe enough that child has difficulty participating in routine activities, or if any of the following symptoms are present:

• diarrhea  - see “Diarrhea” for return guidance 
• vomiting - see “Vomiting” for return guidance
• ^⚠  fever (100.4°F or higher) - see “Fever” for return guidance - seek medical attention when present with a sore throat
• If antibiotic is prescribed, and first dose is taken within 12 hours

^⚠   - seek medical attention

RETURNING TO SCHOOL 

When going back to normal activities it is recommended that students and staff take additional precautions for the next 5-10 days such as:

• ensure symptoms continue to improve (and no fever for at least 24 hours without medication)
• frequent hand washing is recommended
• If antibiotic is prescribed, take the first dose at least 12 hours before returning 
• Consider masking around others