Daily Health Check Name of Child * First Name Last Name Name of Parent/Guardian * First Name Last Name Date * MM DD YYYY Email * Does your child have any of these symptoms (Please tick) * Fever of chills Cough Nasal congestion or runny nose Loss of taste or smell Sore throat Shortness of breath or difficulty breathing Diarrhea Nausea or vommiting Stomach ache Rash or mouth sores Tiredness Headache Muscle or body aches Poor appetite Does your child have symptoms that indicate a communicable disease or has your child been recently diagnosed with a communicable disease? * If you answered "yes", you must provide Sweet Cherry Blossom Daycare with a doctors note clearing your child for a return to daycare If your child has any of these signs and symptoms: • Please keep them at home for a period of 10 days after the onset of symptoms. Once symptoms have resolved fully your child may return to the childcare center • Please call 8-1-1 or your health provider for more information Yes No Has your child, or anyone in your household, had close contact with someone who has had possible exposure to the COVID-19 virus? * Yes No Have you or anyone in your household traveled to any countries outside of Canada, including the United States, within the last 14 days? * Yes No Thank you from all of us at Sweet Cherry Blossom Daycare!
