Questionnaire – The Think Sun Preschool

Student's Name *

Question 1

1. Has the child traveled outside Canada in the last 14 days? *

If the child answered “YES”:

The child is required to quarantine for 14 days from the last day of exposure.
If the child develops any symptoms, use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended.

If the child answered “NO”, proceed to question 2.

Question 2

2. Has the child had close contact with a case1 of COVID-19 in the last 14 days? Face-to-face contact within 2 metres for 15 minutes or longer or direct physical contact such as hugging *

If the child answered “YES”:

The child is required to quarantine for 14 days from the last day of exposure.

NOTE: Individuals who previously tested positive for COVID-19 in the 90 days before being exposed to another case of COVID-19 are not required to quarantine.

If the child answered “NO”, proceed to question 3.

Question 3

3. Does the child have any new onset (or worsening) of the following core symptoms:

Fever- Temperature of 38 degrees Celsius or higher *

Cough- Continuous, more than usual, not related to other known causes or conditions such as asthma *

Shortness of Breath / Difficulty Breathing-Continuous, out of breath, unable to breathe deeply, not related to other known causes or conditions such as asthma *

Loss of sense of taste or smell- Not related to other known causes or conditions like allergies or neurological disorders *

If the child answered “YES” to any symptom in question 3:

The child is to isolate for 10 days from onset of symptoms OR receive a negative COVID-19 test and feel better before returning to activities
Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and to receive additional information on isolation.

If the child answered “NO” to all of the symptoms in question 3, proceed to question 4.

Question 4

4. Does the child have any new onset (or worsening) of the following other symptoms:

Chills-Without fever – Not related to being outside in cold weather *
Yes
No

Sore throat/painful swallowing- Not related to other known causes/conditions, such as seasonal allergies or reflux *
Yes
No

Runny nose/congestion – Not related to other known causes/conditions, such as seasonal allergies or being outside in cold weather *
Yes
No

Feeling unwell / Fatigued – Lack of energy, poor feeding in infants, not related to other known causes or conditions, such as depression, insomnia, thyroid dysfunction or sudden injury *
Yes
No

Nausea / Vomiting / Diarrhea – Not related to other known causes or conditions, such as anxiety, medication or irritable bowel syndrome *
Yes
No

Unexplained loss of appetite- Not related to other known causes or conditions, such as anxiety or medication *
Yes
No

Muscle/ Joint aches – Not related to other known causes or conditions, such as arthritis or injury *
Yes
No

Headache – Not related to other known causes or conditions, such as tension-type headaches or chronic migraines *
Yes
No

Conjunctivitis – (commonly known as pink eye) *
Yes
No

Attention

If the child answered “YES” to ONE symptom in question 4:

Keep your child home and monitor for 24 hours.

If their symptom is improving after 24 hours, they can return to school and activities when they feel well enough to go. Testing is not necessary.

If the symptom does not improve or worsens after 24 hours (or if additional symptoms emerge), use the AHS Online Assessment Tool or call Health Link 811 to check if testing is recommended.

If the child answered “YES” to TWO OR MORE symptoms in question 4:

Keep your child home.

Use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended.

Your child can return to school and activities once their symptoms go away as long as it has been at least 24 hours since their symptoms started.

If the child answered “NO” to all questions:

Your child may attend school, childcare and/or other activities.

Please note: If your child is experiencing any symptoms from the lists above, do not bring them to visit a continuing care or acute care facility for 10 days from when symptoms started or until symptoms resolve (whichever is longer), unless they receive a negative COVID-19 test result and feel better.

Parent/ Guardian/ Staff Information

Parent Name *
First
Last

Date / Time *
Date
Time

Parent Email *

COVID-19 ALBERTA HEALTH DAILY CHECKLIST

(FOR CHILDREN UNDER 18)