Anspayaxw School Society: Kispiox Community School, Anspayaxw Aboriginal Headstart Daily Health Check:

The following tool is to be used by parents and caregivers to complete prior to their child coming to school.

Daily Health Check for:

1. Symptoms of Illness: Does your child have any of the following symptoms?

CIRCLE ONE

Fever YES NO
Chills YES NO
Cough or worsening of chronic cough YES NO
Shortness of breath YES NO
Sore throat YES NO
Runny nose / stuffy nose YES NO
Loss of sense of smell or taste YES NO
Headache YES NO
Fatigue YES NO
Diarrhea YES NO
Loss of appetite YES NO
Nausea and vomiting YES NO
Muscle aches YES NO
Conjunctivitis (pink eye) YES NO
Dizziness, confusion YES NO
Abdominal pain YES NO
Skin rashes or discoloration of fingers or toes YES NO
2. International Travel Have you or anyone in your household returned from travel outside Canada in the

last 14 days?

YES NO
3. Confirmed Contact Are you or is anyone in your household a confirmed contact of a person confirmed to

have COVID-19?

YES NO
4. “Travel Zone”. Kispiox Band Council has identified travel zones. Call the band office to find current travel zone Have you or anyone in your household returned from travel outside of the “safe zone” in the last 14 days? YES NO

If you answered “YES” to any of the questions and the symptoms are not related to a pre-existing condition (e.g. allergies) your child should NOT come to school. Please inform the school.

If they are experiencing any symptoms of illness, contact a health-care provider for further assessment. This includes 8-1-1, or a primary care provider like a physician or nurse practitioner.

If you answered “YES” to questions 2, 3, or 4 use the COVID-19 Self-Assessment Tool to determine if you should be tested for COVID-19.