9.4.1.10: Documentation of Parent/Guardian Notification of Injury, Illness, or Death in Program

The facility should document that a child’s parent/guardian was notified immediately in the event of a death of their child, of an injury or illness of their child that required professional medical attention, or if their child was lost/missing.

Documentation should also occur noting when law enforcement was notified (immediately) in the event of a death of a child or a lost/missing child.

The facility should document in accordance with state regulations, its response to any of the following events:

1. Death;
2. Serious injury or illness that required medical attention;
3. Reportable infectious disease;
4. Any other significant event relating to the health and safety of a child (such as a lost child, a fire or other structural damage, work stoppage, or closure of the facility).

The caregiver/teacher should call 9-1-1 to insure immediate emergency medical support for a death or serious injury or illness. They should follow state regulations with regard to when they should notify state agencies such as the licensing agency and the local or state health department about any of the above events.

RATIONALE

The licensing agency should be notified according to state regulations regarding any of the events listed above because each involves special action by the licensing agency to protect children, their families, and/or the community. If death, serious injury, or illness or any of the events in item d) occur due to negligence by the caregiver/teacher, immediate suspension of the license may be necessary. Public health staff can assist in stopping the spread of the infectious disease if they are notified quickly by the licensing agency or the facility (1,2). The action by the facility in response to an illness requiring medical attention is subject to licensing review.

A report form that records death, maltreatment, serious injury or illness is also necessary for providing information to the child’s parents/guardians and primary care provider, other appropriate health agencies, law enforcement agency, and the insurance companies covering the parents/guardians and the facility.

COMMENTS

Guidance on policies for parental notification of child maltreatment reports should be sought from child care health consultants or local child abuse prevention agencies. Surveillance for symptoms can be accomplished easily by using a combined attendance and symptom record. Any symptoms can be noted when the child is signed in, with added notations made during the day when additional symptoms appear. Simple forms, for a weekly or monthly period, that record data for the entire group help caregivers/teachers spot patterns of illness for an individual child or among the children in the group or center.

Multi-copy forms can be used to make copies of an injury report simultaneously for the child’s record, for the parent/guardian, for the folder that logs all injuries at the facility, and for the licensing agency. Facilities should secure the parent/guardian’s signature on the form at the time it is presented to the parent/guardian.

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

7.3.5.1 Recommended Control Measures for Invasive Meningococcal Infection in Child Care
7.3.5.2 Informing Public Health Authorities of Meningococcal Infections
7.3.7.1 Informing Public Health Authorities of Pertussis Cases
7.3.10.1 Measures for Detection, Control, and Reporting of Tuberculosis
7.4.0.1 Control of Enteric (Diarrheal) and Hepatitis A Virus (HAV) Infections
7.4.0.3 Reporting Requirements for Diarrheal Infections
7.4.0.4 Maintenance of Records on Incidents of Diarrhea
7.6.1.4 Informing Public Health Authorities of Hepatitis B Virus (HBV) Cases
9.2.4.1 Written Plan and Training for Handling Urgent Medical or Threatening Incidents
9.4.1.9 Records of Injury
9.4.1.11 Review and Accessibility of Injury and Illness Reports
Appendix F: Enrollment/Attendance/Symptom Record
Appendix DD: Injury Report Form for Indoor and Outdoor Injuries
Appendix EE: America’s Playgrounds Safety Report Card
Appendix CC: Incident Report Form

REFERENCES

1. Aguero, J., M. Ortega-Mendi, M. Eliecer Cano, A. Gonzalez de Aledo, J. Calvo, L. Viloria, P. Mellado, T. Pelayo, A. Fernandez-Rodriguez, L. Martinez-Martinez. 2008. Outbreak of invasive group A streptococcal disease among children attending a day-care center. Pediatr Infect Dis J 27:602-4.
2. Galil, K., B. Lee, T. Strine, C. Carraher, A. L. Baughman, M. Eaton, J. Montero, J. Seward. 2002. Outbreak of varicella at a day-care center despite vaccination. N Engl J Med 347:1909-15.