A Child Care Center Followed The COVID Safety Guidelines. It Still Had An Outbreak
The coronavirus pandemic caused more than half of Los Angeles day care centers to close by April. Among those that stayed open was Centro Alegria, a child care facility in Boyle Heights run by the nonprofit group Proyecto Pastoral.
"We rose to the responsibility and the commitment that we've made to our families," said Executive Director Cynthia Sanchez. "The staff, every day that they came in, put their fears aside."
They followed all of the state and local safety guidelines for child care, Sanchez said — no parents were allowed inside the center, staff ramped up the cleaning and started wearing masks, groups of kids were limited to 10 or fewer.
But despite all of their best efforts, five teachers at Centro Alegria have tested positive for coronavirus in recent weeks. And while the center's prevention efforts meant it didn't have to shut down entirely, it was left scrambling to figure out how to continue to operate safely.
The outbreak illustrates the difficulties child care providers face in interpreting and implementing differing guidelines from state and local agencies that they often find confusing. Providers say they're overwhelmed by the amount of information out there.
"When everything got shut down, I had a lot of providers calling me. And they were like, 'so what are we supposed to do?'" said longtime child care provider and union organizer Tonia McMillian. "And I told them I don't know."
CORONAVIRUS CHILD CARE CASES RISING
For starters, it's tricky to figure out exactly just how many coronavirus cases are linked to child care.
The California Department of Social Services, which licenses child care facilities, reports that there have been 302 coronavirus cases linked to child care in Los Angeles County as of Aug. 5.
But as of July 30, the L.A. County Public Health Department had confirmed just 52 coronavirus cases associated with 35 different child care facilities, including the outbreak at Centro Alegria.
Officials at neither agency were able to directly explain the discrepancy — they say it could be because they gather information differently.
Both are relying on direct reports from providers — but it's not clear how many providers are actually filing reports with both the county and state. The L.A. County Department of Public Health said it also finds out about cases linked to child care through contact tracing.
"Given this, the number of cases associated with child care facilities that DPH is aware of would not match up with the numbers of cases that day care facilities report to (the) California Department of Social Services, simply because the source and system of reporting for the two groups are different," an L.A. County Department of Public Health spokesperson said in an email.
It may be that some L.A. County providers aren't aware that they are supposed to file reports of COVID-19 cases to both the state licensing agency and county health officials.
According to the statewide figures, the number of coronavirus cases in child care staff, children attending centers and their parents increased nearly 71% in July. There are now 1,709 cases that have been reported statewide with 33,469 licensed child cares open.
Michael Smit, a pediatric infectious diseases physician at Children's Hospital Los Angeles, said it's likely the coronavirus cases in child care are not a result of children spreading the virus, but rather a reflection of the transmission happening in the larger community. But the data-gathering discrepancy makes it difficult to track potential sources of outbreaks in local communities.
"That's a little bit difficult to interpret without having the more granular data to be able to analyze," he said.
OUTBREAK AT PROYECTO PASTORAL
In Boyle Heights, where Proyecto Pastoral is located, there have been 3,380 COVID-19 cases as of Aug. 5, according to the county Department of Public Health. The agency also categorized East Los Angeles as an area with a high need for more testing. The county's infection rates in the Latino community spiked in April and the virus is disproportionately affecting people of color overall.
Between March and June, an average of 10 kids a day came to Proyecto. Among them was the 4-year-old daughter of Stephanie Trujillo, a behavior specialist who was happy that her child had a place to go after LAUSD campuses closed in March.
"I see so many people struggling right now and I'm just grateful that I still got to continue my normal routine," she said.
As more L.A. businesses reopened, more families needed child care, and by mid-June Centro Alegria was seeing daily about 30 children separated into small groups.
Proyecto staff notified the L.A. County Department of Public Health that one teacher, who'd recently been out sick, tested positive for the coronavirus on June 27.
"They shared that, because of that person having been out, that they really hadn't put anyone else at risk, right? So that there was no need, they said, to test anyone else," Sanchez said. "But we did have people get tested anyway."
Within a few weeks, four more teachers reported they had tested positive for COVID-19. Trujillo's daughter came into contact with one of them.
"My first instant reaction was scared," Trujillo said, but she was reassured by phone calls from the center staff sharing updates and information from the health department.
She and her daughter quarantined for two weeks before returning to the center. "Coming back, I felt safe," Trujillo said.
After the fifth case was confirmed on July 17, Sanchez said the health department told Proyecto to conduct a deep cleaning before reopening the following Monday, but did not provide any specific guidelines for how to conduct the cleaning.
The child care center's director instructed the cleaning company based on information from the state's Department of Social Services and the Department of Education. Every single thing a child might come into contact with — toys, furniture, floors — was disinfected, along with the center's computers, walls and countertops.
Proyecto provided LAist with a copy of the county's inspection report from July 23. The health department made a few recommendations, including logging temperature checks and updating the HVAC filters, and concluded the center's procedures "meet or exceed guidelines issued by Los Angeles County to reduce the risk of spread of COVID-19."
"We did everything we were told to do and then some, but my realization is [that] in the future we will do more," Sanchez said. For example, were the center to ever reach three cases of coronavirus again, she'd close and reevaluate.
"We're reflecting on what our responsibility is to ensure safety of the community of the staff and the children," Sanchez said.
'EVEN THOUGH I CLEAN EVERY DAY, IT STILL SCARES ME'
Since the beginning of the coronavirus pandemic, it's been up to each California child care provider, whether they watch kids in their home or at a center, to decide whether to continue operating.
Providers have maxed out informational conference calls and there are daily discussions on social media on navigating the changing guidelines from state and local agencies, where to find supplies and how to entertain kids in new socially distanced ways.
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"I had to resort to alcohol — like buying a gallon of alcohol from a dental supply place and breaking it down to where it would meet the qualifications to be a disinfectant," Muhammad said. She's also paid up to $20 a can for Lysol spray.
A recent survey from The Center for the Study of Child Care Employment found 38% of California child care providers say they still don't have sufficient cleaning supplies and worry about exposure to COVID-19.
Recently, when a parent arrived to pick up their child from Tameika Lackey's home child care in Long Beach, she mentioned she'd just come from the emergency room after exhibiting symptoms of COVID-19.
"I start(ed) spraying the door, mopping the floors, just sanitizing because I still had kids here," Lackey said.
Lackey said the Long Beach Health Department advised her to wait until the test results came back before deciding to close. After a week, she still hadn't heard anything from the parent and the child had not returned.
"I'm still scared to keep continuing and I don't know what's going on inside my home. Even though I clean every day, it still scares me," Lackey said.
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