Required Covid-19 Screening – West Nipissing Child Care Corporation

Dear parents, guardians, employees, providers and students.

Please note that the self-screening tool has been modified.

Therefore it is very important that it be used daily.

The North Bay-Parry Sound District Health Unit has updated its “Schools/Child Care and COVID-19” information page here.

Please answer the following questions: Check the appropriate box. Thank you.

1. I am taking this screening as a:*

2. In the last 14 days, have you or anyone you live with travelled outside of Canada?*

3. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?*

4. In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?*

5. In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?*

6. Are you currently experiencing any of these symptoms?*

7. Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?*

If you have answered yes to any of the above questions or have refused to answer:

Your child will not be permitted to attend the child care center.

Please indicate which child care your child attends.*

Comments

By submitting this form I certify that the above statements are true and valid.

Name*

Date*

Phone*