Chapter 9: Administration
9.2.3 Health Policies
18.104.22.168: Content and Development of the Plan for Care of Children and Staff Who Are Ill
All child care facilities should have written policies for the management and care of children and staff who are ill. The facility’s plan for the care of children and staff who are ill should be developed in consultation with the facility’s child care health consultant and other health care professionals to address current understanding of the technical issues of contagion and other health risks. This plan should include:
- Policies and procedures for urgent and emergency care;
- Admission, inclusion/exclusion, and re-entry policies;
- A description of illnesses common to children in child care, their management, and precautions to address the needs and behavior of the child who is ill, as well as to protect the health of other children and staff;
- A procedure to obtain and maintain updated individual care plans for children and staff with special health care needs;
- A procedure for documenting the name of person affected, date and time of illness, a description of symptoms, the response of the caregiver/teacher or other staff to these symptoms, who was notified (such as a parent/guardian, primary care provider, nurse, physician, or health department), and the response;
- Medication policy;
- Seasonal and pandemic influenza policy; and
- Staff illness-guidelines for exclusion and re-entry.
In group care, the facility should address the well-being of all those affected by illness: the child, the staff, parents/guardians of the child, other children in the facility and their parents/guardians, and the community. The priority of the policy should be to meet the needs of the child who is ill and the other children in the facility. The policy should address the circumstances under which separation of the affected individual (child or staff person) from the group is required; the circumstances under which the staff, parents/guardians, or other designated persons need to be informed; and the procedures to be followed in these cases.
The policy should take into consideration:
- The physical facility;
- The number and the qualifications of the facility’s personnel;
- The fact that children do become ill frequently and at unpredictable times;
- The fact that adults may be on staff with known health problems or may develop health problems while at work;
- The fact that working parents/guardians often are not given leave for their children’s illnesses; and
- The amount of care the child who is ill requires if the child remains in the program, whether staff can devote the time for caring for a child who is ill in the classroom without leaving other children unattended, and whether the child is able to participate in any of the classroom activities (1).
RATIONALEInfectious diseases are a major concern of parents/guardians and staff. Since children, especially those in group settings, can be a reservoir for many infectious agents, and since caregivers/teachers and other staff come into close and frequent contact with children, they are at risk for developing a wide variety of infectious diseases (1). Following the infection control standards will help protect both children and staff from infectious disease. Recording the occurrence of illness in a facility and the response to the illness characterizes and defines the frequency of the illness, suggests whether an outbreak has occurred, may suggest an effective intervention, and provides documentation for administrative purposes.
COMMENTSFacilities may comply by adopting a model policy and using reference materials as authoritative resources. The current edition of Managing Infectious Diseases in Child Care and Schools, a publication of the American Academy of Pediatrics (AAP), is a reference for policies and their implementation. This publication includes detailed handouts that can be used to inform parents/guardians and outline guidelines and rationale for exclusion, return to care, and notification of public health authorities.
Other helpful references include the current edition of Model Child Care Health Policies (2), or the current edition of the Red Book (3). Caregivers/teachers can check for other materials provided by the licensing agency, resource and referral agency, or health department. Curriculum for Managing Infectious Diseases, an online training module for caregivers/teachers is available from the AAP at http://www.healthychildcare.org/ParticipantsManualID.html.
TYPE OF FACILITYCenter, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS22.214.171.124 Child Care Health Consultants
126.96.36.199 Medical Emergency Procedures
188.8.131.52 Use of Fire Extinguishers
184.108.40.206 Response to Fire and Burns
220.127.116.11 Inclusion/Exclusion/Dismissal of Children
18.104.22.168 Staff Exclusion for Illness
22.214.171.124 Medication Administration
126.96.36.199 Written Policy on Use of Medications
188.8.131.52 Disaster Planning, Training, and Communication
184.108.40.206 Written Plan for Seasonal and Pandemic Influenza
220.127.116.11 Contents of Child’s Records
Appendix A: Signs and Symptoms Chart
Appendix F: Enrollment/Attendance/Symptom Record
Appendix AA: Medication Administration Packet
Aronson, S. S., T. R. Shope, eds. 2017. Managing infectious diseases in child care and schools: A quick reference guide, 4th Edition. Elk Grove Village, IL: American Academy of Pediatrics.
Pennsylvania chapter of the American Academy of Pediatrics. Model Child Care Health Polices. Aronson SS, ed. 5th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2014.
American Academy of Pediatrics. School Health In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds.