Childhood Illness Management Policy Samples

A General Illness Policy statement:

Keeping children healthy is a partnership between families, the child care provider, the children themselves and the child’s healthcare provider. Please remember the germs brought into a child care setting usually hit everyone here. If your child needs to be in bed and quiet, they need to be home.

A sick child will be turned away at the door if necessary. If you have a question, please call.

Following an illness children may not return to care until agreed to by (business name). (Business) can additionally require written clearance by child’s healthcare professional for any infectious disease before allowing the child to return to the program. This written clearance will be added to the record/file maintained by (business) on the child.

Any child who has had contact with another individual that needs to be in quarantine and/or isolated for an infectious disease will be excluded from (business) whether they are displaying symptoms or not. It is the responsibility of the child’s guardian to inform the (business) if this situation arises. Quarantine means the individual in question has been told to stay in a specific designated location (i.e., home) away from others for the purpose of observing and monitoring their health status for the development of symptoms. Quarantine is used for people who are not sick and is similar to, but not the same as, isolation, which is used when a person is sick. Returning to the program will follow the routine for any illness requiring a written clearance by child’s healthcare professional for any infectious disease before allowing the child to return to the program. This written clearance will be added to the record/file maintained by (business) on the child. Children may not return to care from quarantine/isolation until agreed to by (business name).

(business) will do their best to make guardians aware of both common and contagious illnesses that are around the community or impacting families within our child care program.

(business name)’s illness/sick care guidelines generally follow those for the local public schools.

Sick care is not provided by (business name), but this does not affect your fee.

It is the guardian’s responsibility to find alternative care for sick children.

Additional language samples to consider for a clearer childhood illness policy follow:

Illnesses requiring exclusion from care include, but are not limited to:

Fever above 100 axillary (taken under the arm) or 101 orally, when other symptoms of illness are present.

Diarrhea (where any of the following additional conditions is present):

  • stool is not contained in the diaper for diapered children or causing “accidents” for toilet-trained children
  • frequency is 2 or more above normal
  • blood/mucus in stool (need medical ok to return)
  • abnormal color (all black or very pale)
  • no urine output in 8 hrs.
  • fever with behavior changes

Vomiting:

  • more than 2 times in a 24 hour period
  • fever present
  • green or bloody vomit
  • no urine output in 8 hrs.
  • recent head injury

Severe coughing in which the child gets red or blue in the face or makes a high-pitched whooping sound after coughing or has difficulty breathing.

Head lice and ringworm: The child should be treated by healthcare professional. After initial treatment the child can return. Keep ringworm site covered will in care.

Impetigo, no return until 24 hours after treatment has been initiated.

Tuberculosis, no return until a healthcare provider states in writing that the child can return to child care.

Hepatitis A, chickenpox, mumps, measles, rubella or shingles. No return until a healthcare provider states in writing that the child can return to child care. For scabies or chicken pox the child cannot return to care until after treatment has begun and the sores have crusted over.

Certain conditions do not require exclusion unless recommended by the child’s healthcare provider or if symptoms appear.

  • CMV or HIV infection or hepatitis B and C virus carrier state.
  • Pink eye
  • Rash without temperature or behavior changes.
  • Non-contagious conditions such as chronic medical conditions or disabilities.
  • Runny nose if the child is feeling well.

What to Do If a Child Requires Exclusion While in Care:

Illnesses that occur during the day where the child is not well enough to participate means they will be excluded and guardian notification made.

  • Immediately separate the child from the other children in such a way that the child can be seen and supervised, and does not feel punished in any way.
  • Guardian will be contacted to have the child picked up as soon as possible to prevent the spread of infection to other children and staff, and to allow the child time to rest, recover, and be treated for the illness if necessary.
  • Continue to observe the child for other symptoms until picked up.

Illness Management – Exclusion: 

  • SCREENING: Children will be visually screened as they arrive at the facility. In the event a child becomes ill and needs to be picked up, the child will be separated from the rest of the children until a parent arrives.
  • NON ADMITTANCE: Your child will not be allowed to attend

(business name) if a child exhibits symptoms for exclusion within a 24 hour period prior to the child’s admittance back to school, and/or is unable to participate in the normal activities of the daily schedule, then your child must stay home.

SYMPTOMS FOR EXCLUSION:

  • Fever 
  • Diarrhea (three or more watery stools within 24 hours)
  • Vomiting on two or more occasions during the past 24 hours
  • A draining rash
  • Eye discharge or Pinkeye
  • Lice or Nits
  • Too tired or ill to participate in normal activities

In the event that a child is seen by their physician, for an illness, the parent must get a note from the physician stating it is acceptable for their child to return to childcare.

In the event that your child becomes sick while here at (business name), we will call you to come get your child; we will be expecting you to arrive as soon as possible. When we call you we will be asking your expected time of arrival so we may take precautions to keep your child away from the other children to avoid spreading the illness. If you are not able to come right away we will be expecting you to find an alternate plan for pick up in a timely manner. 

ILLNESS REPORTS: Serious illnesses will be reported to the Department of Health and Human Services (D.H.H.S). Parents will be given a copy of this report and (business) will maintain a copy.

STAFF ILLNESS: Staff members who display signs of infectious illness will not be required to be in attendance. In that event, they will be replaced by a qualified substitute until their return.

COMMUNICABLE DISEASES: We are required to report communicable diseases to Maine CDC and/or OCFS Licensing.

HEALTH CONSULTANT: (business name) utilizes the services of (health consultant name) to answer health related questions regarding the children in our care. (In no way does this mean that (health consultant name) supports our practice. They are simply a source of information regarding communicable diseases and illnesses.) We also look to the CDC (federal and state websites) to answer questions about immunization and the prevention of communicable diseases.  

Do not bring a child to (business name) if the child has had a fever, diarrhea or vomiting within 24 hours.   

General Exclusion Criteria:

Regardless of the disease, children will be excluded from (business) if they meet any of the following exclusion criteria:

  1. The provider and/or staff determines the child is unwilling or unable to participate in activities due to illness.
  2. The provider and/or staff determines that they cannot care for the sick child without compromising their ability to care for the health and safety of the other children in the group.
  3. The child has a fever (oral temperature above 101°F, axillary temperature above 100°F, rectal temperature above 102°F) along with difficulty breathing, changes in behavior, lethargy, irritability, or persistent crying.
  4. The child experiences vomiting two or more times in the preceding 24 hours, unless determined to be caused by a non-communicable condition and child is able to remain hydrated and participate in activities.
  5. The child has diarrhea and stool is not contained in diaper or if fecal accidents occur in a child who is toilet trained, or if stool frequency exceeds two or more stools above normal for that child, or if stool contains blood or mucus.
  6. Persistent abdominal pain (two or more hours) or intermittent abdominal pain associated with fever, dehydration or other systemic signs and symptoms.
  7. Oral lesions if the child is unable to contain drool or if unable to participate because of other symptoms or until the child is considered to be noninfectious.
  8. Skin lesions if they are weeping/draining/oozing and unable to be kept covered with a waterproof dressing.

Criteria for Excluding Child Care Staff:
It is important to remember that diseases are not just spread by children to other children, but from provider and/or staff to children as well as children to provider and/or staff. Staff is required to discuss their health concerns with their health care provider and inform provider of any contagious illnesses they have or have been recently exposed to.

General Health and Safety Practices

HEALTH & SAFETY PRACTICES:
  • HAND WASHING: Hands will be washed upon arrival, before and after meals, before and after bathroom use, after nose blowing or wiping, and after handling an ill child.
  • DIAPER CHANGING: Hands will be washed before and after changing diapers. The changing mat is sterilized with recommended bleach solution before and after each use.  Soiled diapers will be disposed of in a closed and sanitized container.
  • TOYS & EQUIPMENT: These will be sterilized daily or as needed with the recommended bleach solution.
  • BEDDING & SOILED CLOTHING: These items will be laundered at the facility on an as needed basis. On occasion, (business name) may launder soiled clothing or clothing will be bagged and given to the guardian if the laundry has been completed for that given day. 

Notice of Exposure to Contagious Disease Form:

Date: / /

Dear Legal Guardian:

A child in (business) has or is suspected of having:

Information about this disease-

The disease is spread by:

The symptoms are:

The disease can be prevented by:

What (business)is doing to reduce the spread:

What you can do at home to reduce the spread:

If your child has any symptoms of this disease, call your healthcare provider to find out what to do and be sure to tell them about this notice. If you do not have a regular healthcare provider to care for your child, contact your local health department for instructions on how to find one, or ask (business) for a referral. If you have any questions, please contact:

Contact:                                                            Phone:

Pandemic Response Plan / Responsibility of Licensee

  • Be aware of and review federal, state and local health department pandemic influenza plans. Incorporate appropriate actions from these plans into my disaster response plan.
  • Prepare and plan for operations with a reduced workforce, if have staff.
  • Develop a sick leave policy that does not penalize sick employees, thereby encouraging employees who have influenza-related symptoms (e.g., fever, headache, cough, sore throat, runny or stuffy nose, muscle aches, or upset stomach) to stay home so that they do not infect other employees. Recognize that employees with ill family members may need to stay home to care for them.
  • Plan for downsizing services but also anticipate any scenario which may require a surge in services.
  • Stockpile items such as soap, tissue, hand sanitizer, and cleaning supplies. Be aware of each product’s shelf life and storage conditions (e.g., avoid areas that are damp or have temperature extremes) and incorporate product rotation (e.g., consume oldest supplies first).
  • Plan how to provide staff, guardians and children with easy access to infection control supplies, such as soap, hand sanitizers, tissues and cleaning supplies for use within your facility.
  • Provide training, education and informational material about health and safety, including proper hygiene practices.
  • Assuring timely and accurate communication will also be important throughout the duration of the pandemic in decreasing fear or worry. 
  • Educate and train employees in proper hand hygiene, cough etiquette and safe cleaning techniques. 

Pandemic Response Plan (sample) to be included with your Emergency Preparedness Plan

  • Follow (business name) written illness management policy
  • Sick employees will be sent or remain at home.
  • Ratios will be maintained by substitute staff or limiting availability for care.
  • Hands will be frequently washed with soap and water. When soap and water is not readily available hand sanitizer (minimum 60% alcohol) will be used.
  • Avoid touching noses, mouths, and eyes.
  • Covering coughs and sneezes with a tissue, or to cough and sneeze into their upper sleeves if tissues are not available. Wash hands or use a hand sanitizer after they cough, sneeze or blow their noses.
  • Provide guardians with tissues and trash receptacles, and with a place to wash or disinfect their hands, upon entrance to your program.
  • Standard cleaning of surfaces. Use only disinfectants registered by the U.S. Environmental Protection Agency (EPA), and follow all directions and safety precautions indicated on the label.
  • Eliminate visiting to program by anyone other than guardian for drop-off/pick-up.
  • Follow federal/state/local requirements for a required closing of child care programs.

(Business) minimizes the spread of potential infectious diseases between
children and provider and/or staff by excluding children who may have an infectious disease or are too ill to attend the program and facilitating the prevention and effective management of acute illness in children. (business) recognizes that children might be brought to care without symptoms or signs of illness or while in care suddenly develop an illness that has not been diagnosed by a doctor, and that might be potentially infectious or potentially life threatening for the child. Symptoms may not clearly fit those listed in exclusion diseases making it difficult for (business) to decide whether to accept or exclude the child from the program. Many illnesses, while not fitting exclusion criteria, can transmit disease to others within the child care, and many non-exclusion diseases can make a child too ill to participate in normal care activities.
If an infectious disease arises at (business), we will respond to any symptoms in the following manner:

  • Isolate the child from other children.
  • Ensure the child is comfortable and appropriately supervised by staff.
  • Contact the child’s guardian. If the child’s parents are unavailable the next nominated individual will be contacted. The contact will be informed of the child’s condition and asked to collect the child from the program as soon as possible. Any individual picking the child up must be approved by the child’s guardian and be able to show identification.
  • Ensure all bedding, towels and clothing which the child has used is disinfected. These items will be washed separately and if possible, air-dried in the sun.
  • Ensure all toys used by the child are disinfected.
  • Ensure all eating utensils used by the child are separated and sterilised.
  • Provide information in the child’s home languages to the best of our ability.
  • Inform all the families with children in the program and staff of the presence of an infectious disease.
  • Ensure confidentiality of any personal health related information obtained by (business) in relation to any child or their family.
  • If a child or staff has been unable to attend the program because of an infectious illness,
  • If the individual must provide a doctor’s certificate, which specifically states the child/staff member is able to return to (business).
  • All immunocompromised children will be excluded for the recommended medically minimum periods of exclusion.