Departments » Nurse/Health Services

Nurse/Health Services

Mission Statement

The Health Services Department will commit all of its human and material resources to increase the number of students who are ready to learn, to support teachers in creating environments which sustain the learning readiness of students, and to assist all students in maximizing their personal levels of physical, social, and emotional wellness. We are partners in this most important work with families, district staff and community supporters.

Student Health Services meets this commitment by providing a comprehensive program of services that encompasses prevention, early detection, and remediation of health problems by providing health services, health education, and a healthy environment.


Sasha Stubrich, RN, BSN
Registered Nurse serving:
Chattaroy Elementary (M/F)
Riverside High School (T/Th),
Independent Scholars Program,
and Riverside Achievement Program.
Chattaroy Elementary
Riverside High School
Alma McNamee, RN, BSN, MSHCA
Certified School Nurse Services provided by NEWESD 101 School Nurse Corps schools served:
Chattaroy– day varies 
Jamie Harper, LPN
Licensed Practical Nurse serving:
Riverside Elementary and
Riverside Middle School  
Riverside Elementary:
Riverside Middle School:

Return to school during the pandemic

Physical distancing: The goal for students and adults/staff is to stay at least 6 feet apart to help prevent the spread of the virus.  Practicing physical distancing coupled with wearing cloth face coverings may significantly reduce the spread of COVID-19. Teachers and staff should stay 6 feet apart from other adults and from students when possible. Teachers and staff should also wear cloth face coverings, limit in-person meetings with other adults and avoid areas such as staff lounges where distancing is difficult.

Cloth face coverings & hand hygiene: All children over age 2 years and all adults should wear cloth face coverings that cover the nose and mouth to stop the spread of the virus. When worn correctly, cloth face coverings are safe to wear for long periods of time such as during the school day. In addition, frequent hand washing with soap and water when available, and using hand sanitizer is important for everyone.
Students at higher risk: While COVID-19 school policies can reduce risk, they will not prevent it. Some students with high-risk medical conditions​ may need other accommodations. Talk with your pediatrician and school staff (including school nurses) to see if your child needs additional solutions to help ensure safety at school.

COVID-19 Symptoms:  Parents/Guardians should monitor their child daily for developing signs of illness.  If your child develops one or more symptoms they should not go to school.  If your child is ill they will need to stay home for 10 days and be symptom free without medication for 24 hours.  Your child may return to school earlier if they receive a negative test result and are symptom free for 24 hours or you have a health care provider note stating their illness is not COVID-19 related and have been symptom free for 24 hours without medication.  Communication is necessary during this time.  If you find yourself in a unique situation, contact your school nurse for guidance.  
  • Fever (100.4) or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of smell or taste
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Immunizations & well-child exams:  It is important as students return to school that they are up to date on their immunizations. It will be critical that students and staff get their flu shot this year to reduce the spread of influenza this fall and winter.​
Life Threatening Health Conditions:  Washington State law requires children with asthma, severe allergies, seizure disorders, and diabetes to have an emergency care plan in place by the start of school each year.  Your school requires a new plan each year signed by their provider.  If your child does not have this in place (s)he will be excluded from attending school until an emergency care plan is received and medications, if needed, are checked in with office staff or school nurse.
Behavioral health/emotional support: Your child's school should anticipate and be prepared to address a wide range of mental health needs of students and staff. This includes providing mental health support for any student struggling with stress from the pandemicand recognizing students who show signs of anxiety or distress. Schools also can help students with suicidal thoughts or behavior get needed support.​

Nutrition:  Many students receive healthy meals through school meal programs. More students might be eligible for free or reduced meals than before the pandemic. Schools should provide meal programs even if the school closes or the student is sick and stays home from school.
​Remem​​ber:  Returning to school during the COVID-19 pandemic may not feel like normal – at least for a while. But whatever form school takes, it will require everyone's support to make sure that it is healthy, safe and equitable for students, teachers, staff and families.​
School Bus Safety: Review the basic bus safety rules with your youngster: Wait for the bus to stop before approaching it from the curb. Do not move around on the bus. Check to see that no other traffic is coming before crossing. Make sure to always remain in clear view of the bus driver.
(American Academy of Pediatrics, 2020)
Developing Good Homework/Study Habits: Create an environment that is conducive to doing homework. Youngsters need a permanent work space in their bedroom or another part of the home that offers privacy. Set aside ample time for homework. Establish a household rule that the TV set stays off during homework time. Be available to answer questions and offer assistance. But never do a child’s homework for her. To help alleviate eye fatigue, neck fatigue and brain fatigue while studying, it’s recommended that youngsters close the books for 10 minutes every hour and go do something else. If your child is struggling with a particular subject, and you aren’t able to help her yourself, a tutor can be a good solution. Talk it over with your child’s teacher first.
Child Care: During middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning, watch over them after school until you return home from work and be available during your child's off days. Children approaching adolescence (the 11-and 12-year olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age. If alternative adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone. When evaluating child-care options, determine whether other family members can handle these responsibilities. For example, does a grandparent or other relative live nearby, and is he or she available and willing to help? If you choose a commercial after-school program, inquire about the training of the staff. There should be a high staff-to-child ratio, and the rooms and the playground should be safe.
TV TIPS: Set limits on the amount of TV your child watches. Be firm. Limit children’s TV viewing to an hour or two daily. Hide the remote. Eliminate channel surfing which encourages passive viewing. Keep TV’s out of your youngster’s bedroom. Children should watch their favorite shows in a central area of the home. Whenever possible, record programs and watch them later. Fast forwarding through commercials will shave ten minutes off of every hour of TV viewing. Discourage repeated viewings of the same video. The graphic language, violence and sexual content of movies rated PG-13 and R can have a cumulative effect on a child if they’re watched over and over again. Harness the power of television in a positive way. TV can be a valuable tool for learning and expanding one’s awareness of the world.Make use of ratings systems to know whether or not a program or movie is appropriate for your child.
TIPS TO PREVENT ALCOHOL ABUSE: Give your child a sense of confidence. This is the best defense against peer pressure. Listen to what your child says. Pay attention and be helpful during periods of loneliness or doubt. Know who your child’s friends are and make a point to get to know them. Provide parental supervision. Don’t allow your teen to attend parties where alcohol is being served. Insist that a parent be present at parties to supervise. Offer a “free call home”. Drinking and driving may lead to death. Let him know that he can call home without fear of consequences that night. Discuss the incident the next day. Help your child learn to handle strong emotions and feelings. Talk about things that are important issues for your child, including alcohol, drugs and the need for peer-group acceptance.Join your child in learning all you can about preventing alcohol abuse. If talking with your teenager about alcohol is difficult, your pediatrician may be able to help open the lines of communication.
(American Academy of Pediatrics, 2004)

Disease and Organization Links 

There is much information available to help protect your child’s learning from being impacted by health concerns.  We want to work with you to help your child at school.  Contact your school nurse if you have any concerns that need to be addressed.
These resources are available on the internet.  Inclusion of these resources on this web page does not represent endorsement by the Riverside School District.


Medical Resources

Diseases and Prevention

Professional Organizations

National Association of School Nurses The National Association of School Nurses improves the health and educational success of children and youth by developing and providing leadership to advance school nursing practice. Position statements and links are available.

School Nurse Web Sites

Special Health Needs

General COVID-19 Questions

What is the difference between isolation and quarantine? Isolation means an individual is ill and needs to stay away from others to not expose them to the illness.Quarantine means someone is not ill, but was exposed by an ill person, needs to monitor for symptoms, and stay away from others.
What about private schools? Do they have to follow the recommendations of OSPI or DOH, or of their local health officers? Local health officers remain responsible for disease control in both public and private schools. If the local health officer determines that a school’s opening or continued operation of in-person learning poses an imminent public health threat to the community, then that local health officer has the legal power and duty to direct or order an interruption of in-person learning (WAC 246-110-020).  School administrators are obligated to cooperate with investigations, directives, and orders of the local health officer (WAC 246-101-420). 
Reporting a business in violation 
Here is the link to make a formal report for a business in violation:
Why are childcare centers/daycares still open? How are these different than schools?
As an essential service, childcare remained open through the Stay Home Stay Healthy orders. The science around children and COVID indicate young children are less likely to become infected. DOH adjusted the cohort or group size to fit the typical ratio size for childcare rooms for preschool-aged children. This is a maximum, and childcare providers may choose smaller group sizes. Childcare centers still follow DOH’s health and safety guidance, which includes symptom monitoring, distancing to the degree feasible, increased hand hygiene, cleaning, and ventilation. In addition, providers are now required to wear face coverings.

Contact your local school district for more resources.
Additional resources:
My child’s school isn’t planning to reopen and I am scrambling to figure out how to find child care. What am I supposed to do?
The Washington State Department of Children, Youth, and Families (DCYF), DOH and the Office of Superintendent of Public Instruction (OSPI) are working in lockstep to quickly and safely support access to child care to serve kids who otherwise would be in school. DCYF is working hard to create a coordinated response with state, county and city agencies, school districts and child care provider groups. Visit the COVID-19 page of their website for information and resources. 
Other child care related resources recommended by DCYF:
What numbers are you looking at in making those decisions? What rates do you need to see to reopen schools? 
Schools are not islands and what happens in the community impacts what can happen at schools. The risk of COVID-19 being introduced into the school depends on the level of COVID-19 spread in the community. Our recommended metrics are based on three COVID-19 activity levels:
  • 75 or more cases per 100,000 in 14 days is considered a high COVID-19 activity level for a community. At this level, DOH recommends distance learning with the option for limited in-person learning who need it most – such as children with disabilities.
  • 25–75 cases per 100,000 in 14 days is considered a moderate COVID-19 activity level. At this level, DOH recommends distance learning as described above, with gradual expansion of in-person education, beginning with elementary students.
  • Below 25 cases per 100,000 in 14 days is considered a low COVID-19 activity level. At this level, we recommend full-time in-person learning for all elementary students and hybrid learning for middle and high school, eventually moving to in-person for middle and high school. 
How do equity issues factor into the decision? Remote learning is easier to implement for some families than others.  Health officers and school administrators should engage staff and families of students at risk for severe COVID-19. In addition, they should engage the families of students living in poverty, students of color, English language learners, students with disabilities, and young students to determine how to best meet the health and education needs of these students and the community.  
Why does DOH feel it is safer for young students to return to school in person but not older students?  There is still a lot we do not know about transmission of COVID-19 from children, but a recent CDC study suggested young children (<10 years old) may be less likely to spread the infection than older children (10-19 years old). It is still very important for schools to ensure safety measures such as physical distancing, use of face coverings, hand-washing and small cohorts among these students. Younger children are usually in one class throughout the day and would have fewer interactions compared to middle and high school students who would be in multiple periods during a given school day.

School Related Questions

What steps are being taken to protect educators and school staff?  
This will vary district by district, but DOH and OSPI staff and leadership are working closely to develop guidance for local health officials and school superintendents. Health and safety recommendations are outlined in the following guidance documents:
Why isn’t there a statewide action on schools, similar to the order on face coverings or Safe Start?  In Washington, both education and local health decisions are made at the local level first. It’s the goal of state agencies to provide guidance to school districts and local health districts that enables them to make decisions based on the COVID-19 activity at the local level.
What about sports or other extra curricular activities?  Generally, DOH recommends that extra curricular activities, including sports, only take place once most students have access to in person learning. Ultimately, this also is a local decision. The WIAA (Washington Interscholastic Activities Association) has developed health and safety guidance for training and competitions when allowed by local districts or schools.
The CDC says we should be reopening schools. Why aren’t you following their advice?  This plan aligns with CDC guidance. DOH’s decision tree follows the similar low, medium and high risk framework described by the CDC based on rates of community transmission to inform local decision-making. The CDC says “Schools can determine, in collaboration with state and local health officials to the extent possible, whether and how to implement these considerations while adjusting to meet the unique needs and circumstances of the local community. Implementation should be guided by what is feasible, practical, acceptable, and tailored to the needs of each community.”
What will happen when a student or staff member gets COVID-19? Will I know who it was so I know if I was exposed?   School administrators will work with their local health jurisdiction to take appropriate measures to control any outbreaks and perform any necessary cleaning. Schools should notify their staff and families when there are cases or outbreaks of COVID-19 in the school and what steps the school and local health officer are taking. 
When public health learns that someone has tested positive for COVID-19, an interviewer reaches out to talk to that person, usually by phone – this is known as a case investigation. Interviewers then reach out to inform close contacts of possible exposure. This is the next step to prevent the spread of disease, known as contact tracing. Interviewers do not reveal the name of the person who tested positive for COVID-19 when speaking with close contacts. Any information collected by contact tracing staff is protected in secure systems and individual information is not shared with anyone else. Interviewers operate under strict confidentiality rules.
How will we know if there’s an outbreak at a school?  Local health jurisdictions are responsible for school follow-up and outbreak investigations and will notify close contacts of confirmed cases. Schools should inform staff and families of their students if/when there is an outbreak of COVID-19. The identity of students with confirmed cases is kept anonymous.
Does my child need a note to return to school?  Yes, the student will need a doctors note or a negative lab test result for COVID-19 or they can return at 10 days after the start of their illness providing that they have been fever free for 24 hours and their symptoms have been improving.
Will an absence affect his/her grades?  No it should not but they should double check with the school to confirm
What is chronic absence?  Chronic absence is when a student misses 10% or more of their school days, for any reason, whether the absence is excused, unexcused or non-truancy remote learning. This amounts to two days a month. Washington measures student’s regular attendance as an element of the accountability system, the Washington School Improvement Framework, in alignment with the definition of chronic absence.

Symptom Related Questions

What are the symptoms? 
Symptoms ​may appear 2-14 days after exposure to the virus. People with these symptoms or combinations of symptoms may have COVID-19:
  • Cough
  • Shortness of breath or difficulty breathing
  • Fever
  • Chills
  • Muscle pain
  • Sore throat
  • New loss of taste or smell
  • Other less common symptoms include nausea, vomiting, or diarrhea
If my kid gets sent home for fatigue, sore throat, etc. , can I send him back tomorrow after a good night’s sleep? 
Options for if they or their student is sent home sick from school or becomes sick at home:- Isolation for 10 days OR-Getting a COVID test, can come back sooner if it's negative OR-Going to the doctor to get a different diagnosis (strep throat, etc.) and a note documenting the different diagnosis.

Encourage parents to be on the alert for signs of illness in their children. Parents should keep their children home if they are sick. If the school district recommends parents check children at home in addition to screening at the school, have the parents follow a simplified screening process that includes taking the child’s temperature and observing whether they look unwell or are coughing.
*There will be new guidance coming out soon
Can my child attend school online if covid symptoms are positive? This will depend on each school, but most schools will transition a student to online instruction if sent home to isolate or quarantine.

Testing/Isolation & Quarantine Related Questions

General Testing Inquiry
Currently because of the volume of tests being performed testing facilities are screening patients and testing those who are symptomatic and/or have a known exposure or are healthcare providers.  However, here are some options you can pursue:
  1. Call your provider. If they agree to refer you for a test to the “in house clinic” you will likely get results quicker. For example, if you call Kaiser Permanente as a subscriber, you may be able to get them to test you at their own site.
  2. Airway Heights Multicare site is working with us and does testing 1-3pm W and F.
  3. Rite Aid is doing some covid testing. You can check their site at: Valley and North Division locations we believe.
  4. Walgreens on Wellesley is testing 9am-5pm by appointment only (free with insurance). Appointments can be made at their site linked below or by calling 509-483-0342.
  5. Providence is testing at select locations. To find which one works best for you visit: is an at home testing kit that is available at this link. There are other at home test kits available as well.
Ex. My cousins, sisters, husbands, aunt has COVID-19, should I isolate/get tested?  I would encourage you to review these documents and follow the guidance given there. Also, please review our website and its information on Contact Tracing and how/what that entails as well as what an “exposure” is defined as. See:
What to do if you were potentially exposed to someone with COVID-19:
What to do if you have confirmed or suspected COVID-19:
What to do if you have COVID-19 symptoms but have not been around anyone diagnosed with COVID-19:
Do I have to get a covid test? Does my whole family have to get a covid test?  If you have an exposure to a person with COVID-19 we do recommend testing 5-7 days after the exposure to see if you have an asymptomatic or pre-symptomatic infection.
My child has a tested negative for COVID can they return to school before quarantine is over? Still quarantine for 14 days
My child came in contact with someone that tested positive for COVID now what? Keep them away for 14 days from the last significant contact with that case. If the exposure occurred in the home then your child would have to quarantine for 24 days after the onset of the last person positive in the home; 10 days of that person being infectious and then 14 days of quarantine from the last infectious day.
Does my child have to see a doctor? No, but if your child has symptoms early after the exposure, a positive test may result in an earlier return to school.
Can I get a release back to school?  A staff member or student who had confirmed COVID-19 can return to the program when at least 24 hours have passed since recovery. A person is recovered when they have no fever without the use of medications and improvement in respiratory signs like cough and shortness of breath. Additionally, at least 10 days must have passed since signs first showed up.
Which testing center takes my insurance? 
Select CHAS, Providence, MultiCare (Rockwood and Indigo), Unify, Native Project, Kaiser Permanente and Franklin Park Urgent Care clinics. Testing is now also available at select Rite Aid and Walgreens pharmacies.
Who has the fastest tests?  Unify community health is doing a rapid antigen test. All of the hospitals will give results in a few hours but we don't recommend someone go to the emergency department unless they need to and CHAS has very few test kits and use them under very specific circumstances
If a child in class is positive, does everyone go home for 14 days?  Or just his class? It depends on how many cases are in the school and what is happening in the community. School closures are not usually recommended with a single case.

Mask Related Questions

How do I clean a mask? 
Wash your cloth face covering after each use, at least once per day. Use detergent and hot water. Dry the face covering completely on your dryer’s high heat setting. If you do not have a dryer, air dry the face covering in direct sunlight if possible. If you must reuse your face covering before you wash it, wash your hands after you put it back on and do not touch your face.
Throw away cloth face coverings that:
  • No longer cover your nose and mouth
  • Are stretched out or do not stay on your face
  • Have damaged ties or straps
  • Have holes or tears in the fabric
Where can I get a mask? Or a face shield with cloth barrier?  If your child is in need of a cloth face mask, the school should have some on-site. If not the school can request them free of charge through SRHD.
How do I get an exemption from wearing a mask? You must contact your healthcare provider and have a medical reason why your child cannot wear a mask. If that is the case then your child must wear a face shield with a drape.
Can my kid use lanyards?  Yes
Can my kid use a facemask instead? Face shield? My kid won’t wear a mask, what are my options? In rare circumstances when a cloth face covering cannot be worn, students and staff may use a clear face covering or a face shield with a drape as an alternative to a cloth face covering. If used, face shields should extend below the chin, to the ears, and have no gap at the forehead.
Your option is to use a face shield with a drape or consider virtual only education options.
Do kindergartners or preschoolers have to wear masks? 
All students age 5 years and older, staff, volunteers, and guests must wear cloth face coverings or acceptable alternatives in K-12 settings. Cloth face coverings should not be worn by:
  • Those with a disability that prevents them from comfortably wearing or removing a face covering.
  • Those with certain respiratory conditions or trouble breathing.
  • Those who are deaf or hard of hearing, and those who provide instruction to such people, and use facial and mouth movements as part of communication. 
  • Those advised by a medical, legal, or behavioral health professional that wearing a face covering may pose a risk to that person.
My child has a mask and is six feet away from the kid that tested positive do I need to quarantine? You may need to quarantine your child if your child was sitting adjacent to the student who was positive. The case investigator assigned to the case will be able to clarify.