Health Policies

The purpose of the health policies is to provide a healthy environment as well as predictability and consistency in the care of children at the Center. Our goal is to appropriately refer infectious and serious illness to parents and their health care provider. The health policies are based on and will be revised in accordance with the recommendations of Caring for Our Children, American Academy of Pediatrics and the Center for Disease Control recommendations for group day care.

Notification Responsibility:
Parents are requested to notify the Center any time that a child is ill. If your child has had a medical assessment and a diagnosis has been made, please let us know what type of illness and the diagnosis so that we can notify other families in compliance with state licensing regulations.

Immunizations:
Children must be up to date with recommended immunizations prior to starting. Children who are medically exempt from one or more immunizations must have documentation of the exemption from their health care provider. Families who choose not to immunize or to follow a delayed schedule must sign a personal belief exemption prior to starting school. Children who are not fully immunized may be excluded in the case of an outbreak.
It is a requirement that our immunization records be updated yearly. We will give you periodic notices that follow the well child immunization schedule for your child's age.

Daily Health Assessment:
Your child’s teacher will, as required by law (SDSS 101326.1), perform a daily health assessment. After the assessment, the child is to be signed in so that an accurate count can be obtained rapidly in the event of an emergency. It is preferable that a child showing signs of illness not be brought to school. However, many symptoms may not be clearly developed at drop-off time. If your child becomes ill during the day, we will be in touch with you. If your child's symptoms fall within our exclusion criteria, you will need to remove him/her from the Center within two hours.

Exclusion:
Exclusion from the center is based on current clinical assessment of the risk of contagion, the care needs of the child, and the care needs of the other children in the center. Children with signs /symptoms of an excludable contagious disease will be excluded from the center. The child may return upon diagnosis and medical clearance. The CPSC Health Consultant is available for consultation on exclusion diseases and accompanying issues.

Health History Standard:
It is our goal to keep an accurate record of your child's day in school and to notify you of any accident or signs of illness that may occur throughout the day.

Exposure notices:
The county public health department requires that exposure notices be posted following potential exposures to specific illnesses or outbreaks. These will be distributed via the website and a copy will be placed in the affected classroom(s). Exposure notices will not contain identifying information about children or teachers affected.

Exclusion Criteria:
The following list of excludable symptoms was developed in accordance with guidelines from Caring for Our Children 2011, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics.
If a child develops symptoms of an excludable illness during his/her attendance at the center, parents will be asked to pick up the child within two hours.

Fever:
The child has a fever with additional signs of illness.
A fever is an elevation of a child's body temperature above normal. A fever may be treated with medications upon written parental permission.
A fever is a temperature at or above 101.0 F taken by any thermometer measurement.
The presence of fever alone has little relevance to the spread of disease and should not disallow a child's participation in childcare. Except for very young infants, serious illnesses with fever are associated with recognizable behavior changes. Children will be excluded whenever fever is accompanied by behavior changes, and/or signs or symptoms of illness that require parental evaluation of their illness. It is recommended that all infants under 4 months of age with an unexplained fever have a medical evaluation.

Diarrhea:
Diarrhea is stool that is not formed, has water loss and mucus. The presence of diarrhea in diapered children increases the likelihood of exposing other children to the infectious agents that cause these illnesses. Three or more diarrhea stools in a day that does not have a clearly non-contagious origin require exclusion from school for all age groups. Every attempt will be made to provide parents with a “warning call” after the first episode.

Vomiting:
Vomiting with symptoms such as lethargy and or/dry skin or mouth, or reduced urine output may indicate dehydration. A child with these symptoms will be excluded and should have a medical evaluation.
Vomiting which has a clear, non-contagious origin (e.g. too much spinning around on the playground.) will be assessed by the caregiver and the parent notified upon pick up time.
If your child vomits once and has other symptoms of illness, you will be notified and you child will be excluded from the center. Children will also be excluded after two episodes of vomiting in the absence of other symptoms or a clear non-contagious origin.

Abdominal Pain:
Abdominal pain is consistent complaint of belly pain accompanied by behavioral changes in school. Children with complaints of abdominal pain with symptoms of drowsiness, irritability, or no appetite or who are unable to participate in usual activities will be excluded. Children with non-specific and intermittent belly pain will be assessed and parents will be informed of these complaints. Medical assessment will at the parents’ discretion.

Rash:
Rashes can be localized or generalized to the whole body. Rashes that are generalized and appear at school accompanied by other symptoms such as fever, change in behavior or nausea/vomiting will be excluded. Any rash localized or generalized that has open, weeping lesions and/or is not healing will be excluded.
Chronic or intermittent rashes your child may have will not result in exclusion as long as the center is kept informed of the condition.
A child with a small-localized rash without other symptoms will be observed.

A child with diagnosed fifth's disease will not be excluded.

A child with symptoms of head lice will not be excluded but the family will be notified upon pick up. A child with head lice may return after treatment.

Children with suspected scabies will be excluded and may return after treatment.
Children with suspected ringworm will have the lesion(s) covered and parents will be notified upon pick up. A child with ringworm may return with treatment started.

Mouth Sores:
Children with multiple lesions in their mouth accompanied by drooling and difficult eating and drinking will be excluded and will need medical clearance to return.

Eye Discharge:
All eye drainage is not the same. Some eye drainage is caused by non-infectious reasons including allergy or irritation.
Eye symptoms that include yellow, green, or white discharge, pink or red conjunctiva, and eye pain will be excluded. Children may return after starting treatment and when drainage has stopped or with a doctor’s note saying they may return.
Eye symptoms that include clear, watery eye discharge without fever, eye pain, or redness of eyelid is typically not infectious and will not be excluded. The center may recommend parents contact their child’s health care provider for advice.

Behavior:
The child feels too poorly to participate in normal center activities. Every effort is made to address each family's unique needs within the limits of our resources. A child made irritable by illness is not only uncomfortable but also takes an inordinate portion of attention from staff, thus decreasing our ability to care for other children.

Other:
In situations not specifically addressed in these criteria, we will follow recommendations from Caring for Our Children, the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the Santa Clara County Public Health Department.

Non-Excludable Conditions:
The following list of non-excludable conditions was developed in accordance with guidelines from Caring for Our Children 2011, the Center for Disease Control, and the American Academy of Pediatrics. In addition to the criteria discussed above, the center will not exclude children diagnosed with the following conditions:

Common cold or runny nose
Cough not associated with an infectious disease or fever
Rash without fever or behavioral change
Molluscum contagiosum
Thrush
MRSA carrier state
Bacteria or virus in urine or stool without illness symptoms
Watery, clear eye discharge
CMV infection
Hepatitis B carrier state
HIV infection
Fifths Disease (parvovirus B19)
Children with chronic infectious conditions that can be accommodated by our program

Return Policies:
A child may return to the center from an excludable illness when:
1. The child feels and acts well and is able to participate in the center activities.
2. Temperature is normal for 24 hours: 99.2 or less taken by any thermometer measurement.
3. No vomiting or diarrhea for 24 hours. When a child returns after a diarrhea illness, it is a provisional acceptance. The first diarrheal stool after the child returns will mean immediate re-exclusion.
4. Rash or skin infection is no longer draining and are under treatment as indicated.
5. Medical clearance has been received for excludable serious illness or treatment for minor illness has been started.