• ---

  symptoms prevent routine activities
• occurs with fever, diarrhea, or vomiting
• 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 
• 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

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

SEEK MEDICAL ATTENTION

• ---

  symptoms prevent routine activities
• occurs with fever, diarrhea, or vomiting
• pain starts after injury
• bloody or black stools
• no urine for 8 hours

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

Frequent handwashing recommended

SEEK MEDICAL ATTENTION

• ---

  symptoms prevent participation in routine activities
• 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
• Inability to swallow
• Breathing difficulties
•  Excessive drooling or muffled voice

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

SEEK MEDICAL ATTENTION

• ---

  temperature is above 100.4°
• symptoms prevent routine activities
• occurs with diarrhea or vomiting

• ---

  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 –

• none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

• ---

  symptoms prevent routine activities
• occurs with fever,  diarrhea, or sore throat
• vomiting occurs 2 or more times in 24 hrs
• recent head injury
• looks or acts very ill
• child has not urinated in the past 8 hours
•  concern for serious allergic reaction 
•  vomit appears green or bloody 

• ---

  vomiting due to non-infectious causes;

  - OR –

• vomiting ended during the night able to hold down food or liquids in the morning;

  - AND –

• none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

 SEEK MEDICAL ATTENTION

• ---

  symptoms prevent routine activities
• occurs with fever, diarrhea, or vomiting
• stool looks like it contains blood or mucus
• stool appears like sticky black tar
• yellow skin/eyes (jaundice)
• diarrhea that occurs during an outbreak, and exclusion is recommended by the local health department

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

Frequent handwashing recommended

• ---

  symptoms are worsening or severe
• symptoms prevent routine activities
• 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
•  cough is severe of difficulty catching breath after coughing 
•  coughing associated with asthma that cannot be controlled by medication (like albuterol)
• 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 gray, depending on skin tone 
•  behavior changes 
•  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) 
•  breathing problem that causes child to have pursed lips, difficulty speaking, or difficulty feeding
•  any breathing difficulties, even if mild

• No fever has been present for at least 24 hours– without using fever reducing medications, e.g., Tylenol®, Advil®, Motrin® (acetaminophen or ibuprofen) 

  - AND –

• none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

 SEEK MEDICAL ATTENTION

Masks are no longer required, but Cal/OSHA, CDPH, and the CDC continue to recommend them indoors as follows:

• ---

  problems seeing (vision changes)
• an injury to the eye involving forceful impact to or penetration of the eye
• pain or discomfort the child cannot tolerate

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

Frequent handwashing recommended

• ---

  symptoms prevent routine activities
• occurs with fever,  diarrhea, or vomiting
• oozing, open wound
• infection that cannot be covered and is in an area that might come in contact with others
• bruised skin without a known injury or in an unusual location
• rapidly spreading dark red or purple rash (especially if accompanied by fever)
• tender, red area of skin, rapidly increasing in size or tenderness
•  associated symptoms of a serious allergic reaction (rash with throat closing, abdominal pain, vomiting, or wheezing) 
•  concern for a disease like chickenpox or measles.

• ---

  none of the symptoms above are present;

  - AND –

• symptoms are improving and the child can participate comfortably in routine activities

 SEEK MEDICAL ATTENTION