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Child Illness Policy

Keeping our Children Healthy

Hildebrandt Medication Policy

Hildebrandt Learning Centers and the child care staff entrusted to care for your child, are concerned with your child's health. In spite of everyone's efforts, children do get sick. Young children, in particular, get sick more often because:

  1. their immune systems do not fight illness as well as an adult's and

  2. they have not been exposed to many of the germs (viruses, bacterial, fungi, or parasites) that cause infections.

Contagious diseases spread from one person to another. Often, people who spread disease do not look or feel sick. The germs spread by direct contact (touching), by coughing or sneezing, or by germs from the stool (bowel movement) or by blood getting on surfaces.

Maintaining health and preventing the spread of contagious diseases are responsibilities shared by parents, our staff, and Hildebrandt Learning Centers. Our staff is training in illness-prevention practices that limit spread of infections. The use of gloves during diaper changing and the employment of the proper cleansing agents, help in reducing the spread of infections Parents must have their children immunized against major diseases, including but not limited to: diphtheria, tetanus, pertussis, Haemophilus influenzae type b disease (HIB), polio-myelitis, measles, mumps, reubella and chicken pox according to the latest recommendation of the American Academy of Pediatrics and the United States Public Health Service (unless exempted for religious or medical reasons). If you have any questions, you should call the Pennsylvania Chapter of the American Academy of pediatrics (ECELS) at (800) 243-2357 and they will contact your family physician to review the requirements.

Hildebrandt Learning Centers employs procedures for reporting exposures, identifying an ill child, and informing the parent of a child's illness. Parents are responsible for providing up-to-date emergency phone numbers, promptly picking up their ill child, and consulting with their child's doctor about diagnosis and care. Parents must inform the center when their child is ill with a contagious disease and should request their pediatrician's cooperation in consulting with the center if the illness has implications for the entire child care program.

Recognizing Ill Children

The child care staff and parents need to recognize the signs and symptoms of illness in children. Fever is a well known symptom that the parent or our staff use to identify a child who may be ill. Fever (a rise in the body temperature above normal) is common in young children and is rarely harmful. There are many causes of fever other than illness. Exercise, environmental conditions, individual variation and teething may raise the body temperature.

However, fever may be a symptom of a contagious or serious illness. Some children with fever will not be admitted to the program until the child is examined by a health professional. Such children include those who fit the following description.

A child with:

  • an oral temperature of 101°F or greater, or

  • a rectal temperature of 102°F or greater (Hildebrandt Learning Centers staff will not take a rectal temperature at the child care center), or

  • an axillary (armpit) temperature of 100°F or greater, who also has behavior changes or other signs or symptoms of illness

Have a doctor check babies immediately with fever of 101°F axillary who are less than 4 months of age or any age child with fever higher than 105°F. Parents will be notified promptly when their child is found to have a fever while at the center and must pick up their child within thirty (30) minutes of notification. Failure to do so will require the center director to contact another emergency contact person or transport your child to an emergency room.

The child's response to fever-reducing medicines (e.g., acetaminophen) is not helpful in deciding how wick the child is. Regardless of the presence or height of fever, it is how sick a child looks or acts that is important. Have your doctor check your child with symptoms or signs of a possibly serious illness (unusual drowsiness, fussiness, persistent or excessive crying, wheezing, uncontrolled coughing, difficulty breathing) or who refuses to play or complains of severe pain.

Inclusion/Exclusion from the Child Care Center

Most children with mild contagious illness do not need to stay home from child care. Usually the child has already exposed others before seeming sick. Other illnesses (e.g., impetigo, conjunctivitis) stop being contagious shortly after treatment is started. Guidelines depend on the specific diagnosis or symptom (see tables). Therefore, there is no reason to exclude mildly ill children or those being treated unless:

  1. The child does not feel well enough to participate comfortably in the usual activities. The child care center staff and/or the center director will make the decision as to whether to exclude your child from the center.

  2. The staff cannot care for the sick child without interfering with the care of other children. Again, the decision to exclude your child from the program will be at the discretion of the child care staff and/or center director.

  3. The child has any of the following:

    • fever and behavior changes or other signs or symptoms of illness as defined under "Recognizing Ill Children" until the child's inclusion is checked with a health professional who determines that the child may be in child care;

    • the child has signs of symptoms of a possible serious illness as defined under "Recognizing Ill Children" until the child is checked by a health professional who determines that the child may be in child care;

    • uncontrolled diarrhea (stool runs out of the diaper or the child can't get to the toilet in time);

    • vomiting in the previous 24 hours until the vomiting stops or a health professional determines that the child may be in child care;

    • mouth sores with drooling, unless a health professional determines the child's illness is not from communicable illness;

    • rash with fever or behavior change until a health professional determines that the child may be in child care;

    • pink eye with white or yellow discharge until 24 hours after treatment is started;

    • scabies, head lice or other infestation until 24 hours after treatment is started and the child is nit-free;

    • these contagious diseases, until the child meets the requirements listed in the tables in this child sick policy:

 

tuberculosis mumps
impetigo

hepatitis A

chicken pox measles
pertussis (whooping cough) rubella
herpetic gingivostomatitis shingles
strep throat or other streptococcal infections

 

In the event antibiotic treatment is required, the child must have received the treatment for 24 hours before returning to the center.

Inclusion or exclusion of children with non-contagious conditions such as a disabling injury or illness, asthma, or failure to thrive will be determined by the center's and staff's capacity to provide proper care for the child's special needs. Each case must be considered individually.

However, the final decision whether to exclude a child from the center will be made by the center director and/or center staff caring for your child. In addition, a doctor's excuse or plan of care may be required by the center director prior to allowing your child to return to the center.

Your child may be excluded from participating at the center if the required immunizations, as recommended by the American Academy of Pediatrics (AAP), are not current. The recommendations of the AAP are on page 2 of the Child Health Appraisal or may be obtained from your center director.

Your child will be excluded from participating at the center if a Child Health Appraisal (HA-120) is not provided to the center within sixty (60) days of enrollment. Hildebrandt Learning Centers requests that all infants, (age 6 weeks to 12 months), enrolled at the center have a current Child Health Appraisal on file at the center, the first day of attendance. In addition, your child will be excluded from the center if the Child Health Appraisal is not current with the standards promulgated by the AAP. The frequency of a child health appraisal is detailed on page 2 of the HA-120 or a copy may be obtained from your center director. There will be no exceptions to the policy of maintaining a current Child Health Appraisal on file at the center. Failure to do so will result in the termination of the Parent Contract between Hildebrandt Learning Centers andyour family.

A Reminder

It is usually a good idea to call or consult a pediatric health provider early in the course of an illness. The pediatric health provider will help you determine how sick the child is and what treatment can be given.

For specific symptoms and conditions, these tables will give you detailed information. Use the tables to look up what you know: symptoms or specific condition. The table tells you the cause, when to exclude your child from the child care center, when to ask for medical advice, and when to re-admit a child to care. Remember . . . use your good judgment in dealing with your sick child.

All policies and procedures listed in this Child Illness Policy must be adhered to by all parents. Failure to do so may cause an interruption in your child care services or termination of your Parent Contract. All parents are required to sign and date the Acknowledgment of Receipt of the Child Illness Policy, a copy of which will be maintained in your child's file.

**Disclaimer**

The major of the information detailed above and all the information supplied in the tables on symptoms and conditions were prepared by the Early Childhood Committee of the Pennsylvania Chapter of the American Academy of Pediatrics.

For additional information on any illness listed in this Child Illness Policy, you may contact the Pennsylvania Chapter of the American Academy of Pediatrics at 1-800-24-ECELS.

Why Children Would be Excluded from the Program Review

  1. The child does not feel well enough to participate comfortably in the usual activities. The child care staff and/or center director will make the decision.

  2. The staff cannot care for the sick child without interfering with the care of the other children. Again the decision to exclude your child from the program will be at the discretion of the child care staff and/or center director.

  3. An axillary (armpit) temperature of 100°F or greater, who also has behavior changes or other signs and symptoms.

  4. Uncontrolled diarrhea (stool runs out of the diaper, child can't get to the toilet in time, or 3 or more bouts of diarrhea in one day).

  5. Vomiting in the previous 24 hours until the vomiting stops or a health professional determines that the child may be in child care.

  6. Pink eye with white or yellow discharge until 24 hours after treatment is started.

  7. Scabies, head lice or other infestation until 24 hours after treatment is started and the child is nit-free.

Remember, use your good judgment in dealing with your sick child.