St. Stephen's Community House

Part of

The Neighbourhood Group Neighbourhoods Working Together

COVID-19 - Childcare Staff Entry Form - Yonge & Sheppard

Calendar


Do you have any of the new or worsening symptoms or signs*?
Fever and/or chills; Cough; Difficulty breathing or hortness of breath; Sore throat or trouble swallowing; Runny or stuffy nose; Decrease or loss of smell or taste; Nausea, vomiting or diarrhea; Not feeling well, extreme tiredness or sore muscles.
(*If you have an existing health condition that gives you the symptoms, you should not answer YES, unless the symptom is new, different or getting worse. Look for changes from your normal symptoms.)

Does anyone in your household have any of the new or worsening symptoms?
Fever and/or chills; Cough; Difficulty breathing or hortness of breath; Sore throat or trouble swallowing; Runny or stuffy nose; Decrease or loss of smell or taste; Nausea, vomiting or diarrhea; Not feeling well, extreme tiredness or sore muscles.

Have you travelled outside of Canada within the last 14 days?

Have you been notified as a close contact of someone with COVID-19 or been told to stay at home and self-isolate?