A-D. Section 12/ Health and Medical

A. Immunization. Immunization records must be maintained to ensure proper medical treatment is determined and given in the event of a disease outbreak or public health emergency.

1. (NEW) All Children in care must meet the following requirements:

a. The Provider must have a current record of immunization on file for each child, which clearly documents each child’s present immunization status based on the Department’s Day Care Immunization Standards (published in September 2019), within 30 days of the child’s first admission to the child care and updated as needed thereafter or,

b. A blood test documenting immunity to measles, mumps, rubella and varicella (chickenpox), placed in the Child’s record and updated in a timely manner.

A blood test is only required when immunization records are unavailable.

c.(NEW) No Child may be required to be immunized if religious, philosophical or medical reasons are documented. Effective September 1, 2021, exemption from immunization requirements are limited to medical reasons. The Child’s physician, nurse practitioner, or physician assistant must provide documentation that immunization is medically inadvisable.

Maine Child Care Immunization Standards

Maine-AAP vaccination exemption form for child care.

2. (NEW) Unimmunized Children, Provider and Staff Members. The Family Child Care Provider must maintain a list of all unimmunized persons, regardless of age. In the event of a disease outbreak as defined by CDC reporting standards, a Child not immunized must be excluded from the Family Child Care in accordance with CDC guidance or until the Child receives the necessary immunization or proof of immunity is on record.

3. Immunization records. The Family Child Care Provider must make immunization records available to the Department of Health and Human Services, Maine Center for Disease Control and Prevention, upon request.

B. (NEW) Evaluation requirements. When the Department has reasonable cause to believe that an Applicant, Provider or Staff Member may be unable to provide safe care for Children, the Department may request a report from a qualified professional or an appropriate official that includes the evaluator’s determination of the person’s ability to safely care for Children.

Reasonable cause could include, but is not limited to, a single significant incident or chronic noncompliance with licensing rules. The provider has the right to appeal licensing action in accordance with Title 5.

1. A physical examination or other evaluation is not required if the Applicant, Provider, or Staff Member states in writing that it is contrary to the person’s religious teachings and practice.

2. If the Applicant, Provider, or Staff Member refuses to be evaluated, the Department shall determine whether sufficient evidence exists to ensure that the person can safely care for Children.

C. Health care consultation.

1. (NEW) The Provider must have a manual of written guidelines for the prevention and control of communicable diseases and other appropriate health practices for childcare.

The intent is not for Providers to create or write these guidelines. Guidelines provided by reputable sources are readily available to the public.

*FCCAM has samples from multiple states and agencies. We have pulled basic information together into “Our Booklet”.

*Purchased Manual: Managing Infectious Diseases in Child Care and Schools, 5th Edition [Paperback] A Quick Reference Guide // Susan S. Aronson, MD, FAAP, and Timothy R. Shope, MD, MPH, FAAP ( cost range $60) //Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide (2013-06-15) 3rd Edition (Spiral-bound cost range used $25 up)

2. (NEW) The Provider must ensure that the manual be available to and read by all Staff Members.

D. Health monitoring. The Provider must observe Children in care each day at the time of arrival and throughout the Child’s stay for obvious signs of illness such as fever, diarrhea, vomiting, or skin rashes. In the event of an apparent illness of a Child, the Provider must comply with the guidance in the manual described in Section 14(C)(1) above. 

When a Provider knows or suspects that a Child has contracted a notifiable disease or condition, the Provider must notify the Maine Center for Disease Control and Prevention (MECDC). The Provider must notify the MECDC immediately by phone for Category 1 conditions, and within 48 hours for Category 2 conditions. MECDC contacts: Phone: 1-800-821-5821 (24 hours a day); FAX: 1-800-293-7534 (24 hours a day); or TTY: Maine relay 711 (24 hours a day). For a list of Category 1 and 2 notifiable diseases and conditions, see 10-144 CMR Chapter 258, Rules for the Control of Notifiable Conditions, Chapter 2(I).

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