Section Twelve- Ill Health Policy

SECTION TWELVE- ILL HEALTH POLICY

COUCHICHING CHILD CARE CENTRE ensures that when a child receiving child care appears to be ill, the child is separated from other children and the symptoms of the illness noted in the child’s records. The daily written record includes the arrangements made for a child with symptoms of ill health.

When a child is separated from other children because of a suspected illness, we ensure that,

(a) a parent of the child takes the child home; or

(b) when it is not possible for a parent of the child to take the child home or where it appears that the child requires immediate medical attention, the child is examined by a legally qualified medical practitioner or a nurse registered with the College of Nurses of Ontario. The Supervisor or Designate will call 911 in this case.

These provisions are intended to protect the interests of the sick child, and to prevent the spread of infection.

Staff will pay particular attention to:

•Elevated temperature, flushing, pallor or listlessness;

•An acute cold, nasal discharge or coughing;

•Vomiting or diarrhea;

•Red or discharging eyes or ears;

•Undiagnosed skin rashes or infections; and

•Unusual irritability, fussiness and restlessness.

Child will be sent home if:

• Temperature of 100.4
• Any Viral/bacterial infection including undiagnosed rashes of any kind
• Vomiting
• Diarrhea (2)

Children who are sent home will not be permitted to return for 24 hours from last symptom observed (eg. Fever, oozing lesions, vomiting, diarrhea)

Staff will communicate with parents at the first sign of ill health, particularly with younger children (infants and toddlers) who have developed a fever, even if the threshold for asking that the child be taken home has not yet been met. (38/100.4) Parents then have the choice to pick up their child if they are concerned.

When a child has been exposed to a communicable disease such as measles (i.e., another child attending the centre is ill), we will notify parents as soon as possible and strongly encourage parents to contact their physician. Both staff and parents should observe all children who were exposed to the communicable disease for any signs and symptoms during the incubation period.

Children suspected of having a communicable disease such as mumps or measles, should not be in the centre. Parents of children who develop symptoms during the day will be asked to pick up their child from the centre immediately. Children can return to the centre only with confirmation that they are no longer contagious.

The centre ensures that before a child who is not in attendance at a school, within the meaning of the Education Act, is admitted to a child care centre and from time to time thereafter, the child is immunized as recommended by the local medical officer of health.

This does not apply where a parent of the child objects in writing to the immunization on the ground that the immunization conflicts with the sincerely held convictions of the parent’s religion or conscience or a legally qualified medical practitioner gives medical reasons in writing to the licensee as to why the child should not be immunized.

COUCHICHING CHILD CARE RECORD OF ILLNESS REPORT

Name of Child: ______

Date: ______Onset (time): ______

Parent’s notified/time: ______

Symptoms observed (e.g., vomiting, diarrhea, pain, rash, sore throat, cough, runny nose, sore/stiff neck, trouble breathing, etc.):

______

______

______

If taken: Temperature: ______

What action was taken?

______

Comments:

______

______

Staff Signature: ______

Caregiver’s Signature: ______

Revised Oct 2016

ILLNESS LOG REPORT

PROGRAM ______LOCATION______MONTH ______

DATE / CHILD’S NAME / ILLNESS / SYMPTOM(S) / TIME CALLED / DATE RETURNED / STAFF SIGNATURE

DAILY OBSERVATION CHECK

The teacher will carry out a daily observation check of your child. As requested by the designated person in charge, the teacher has the right to refuse admittance if your child appears sick. If the child has been admitted and is showing signs of illness that may affect the health of others, he/she will be withdrawn from the program and will be placed in a separate room under the supervision of staff. Parents will be contacted immediately and will be required to pick up their child as soon as possible.

*The Daily Observation Check: In accordance with the requirements of the Child Care & Early Years Act, a daily observation check of each child is made on the child's arrival at the Centre. This check is carried out in the presence of the parent(s) by the program staff so they can exchange information about the child's health status and make decisions about the best ways to meet the needs of the child and parents and fulfill the expectation of the Centre.

The centre encourages parents to share information about their child’s restless night, lack of appetite or other atypical behaviour. This information should be recorded in the daily written record and children who have demonstrated atypical behaviour should be monitored more closely for potential signs of ill health.

In completing daily observation checks, staff is asked to observe or learn through discussion with parents whether any of the following are present:

1. elevated temperature, flushed coloring, unusual pallor;
2. nasal discharge or repeated, severe coughing;
3. stomach ache, vomiting or diarrhea;
4. red or discharging eyes or ears;
5. undiagnosed skin rashes, sores or swellings;
6. unusual activity levels, irritability, restlessness or fussy listless behavior.

By observing children at the beginning of each day, staff can identify specific signs or symptoms of illness in time to prevent the spread of infection. Staff is not expected to be able to diagnose illness but to become sensitize to a child's condition. On occasion, this examination may lead to a decision that the child is not well enough to attend the program. When there is disagreement, the Supervisor will make the final decision.

Please inform staff if the child has been given over-the-counter or prescription medication overnight. Fever control medication should not be given to your child before coming to the Centre.

Tiredness is also a health concern. A tired child is more prone to infection and communicable disease. Please ensure that your child has adequate rest and a reasonable length of day at the centre. Although, we are open from 7:45 a.m. to 4:45 p.m. we suggest that your child’s day be not much longer than your own working day.
In accordance with the Child Care & Early Years Act, a signed Emergency Consent Form must be presented on the first day of care. NO CHILD WILL BE ADMITTED WITHOUT THIS FORM. The Child Care & Early Years Act also requires all children play outdoors every day.

All children are taken outside every day, weather permitting. Children who are well enough to be at the Centre will be expected to play outdoors.

Disease or Symptom / Can student attend school/daycare​ / ​Report to NWHU if disease is on reportable disease list orif absenteeism exceeds 10%
Pinkeye / ​Should be seen by a healthcare provider*
If it isviral, YES, can attend school; lots ofhandwashingneeded!
If it isbacterial, NO. Off school until 2 days ofantibioticsare completed. /
​NO
Rash (dry)
(i.e.fifth disease, roseola) / ​YES.if the student feels well and does not have a fever, may stay at school. Lots ofhandwashingneeded!
If a student feels unwell or has a fever.NO.They should stay home until these symptoms resolve and should be seen by a healthcare provider. / ​
YES
Rash: moist, draining or oozing lesions
(i.e.hand, foot & mouth disease,impetigo,chicken pox) / ​Should be seen by a healthcare provider*
If it isviral, YES, can attend school; lots ofhandwashingneeded!
If it isbacterial(e.g. diagnosed impetigo or MRSA,NO. Should begin antibioticsbefore returning to school. Keep draining sores covered and lots ofhandwashingneeded. /
​YES
Cough, runny nose (i.e.colds,
influenza,whooping cough)​ / NO. Exclude until 24 hours without fever and well enough to participate in normal daily activities; may attend school with ongoing cough and/or runny nose. Lots of handwashingneeded and cough etiquettepracticed! /
​YES
​
Sore throat
(i.e.strep throat
colds,influenza) / ​NO. Exclude until 24-48 hours ofantibiotictreatment if prescribed (e.g. strep throat) or until 24 hours without fever and well enough to participate in normal daily activities.
Lots ofhandwashingneeded! / ​
YES
Vomiting and/or diarrhea
(i.e. norovirus,rotavirus)​ / NO. Should not attend school while symptomatic, and without symptoms for 24 hours before returning to school or daycare. /
​YES
Lice​ / ​NO. Should not attend school until treated with a lice shampoo and nit free. Treatment and instructions available at local pharmacies without prescription.
Routine checks will be given by staff. /
​NO
Scabies​ / ​NO. Exclude until 24 hours after initiation of treatment. All people in same households need to be treated also, even if they have no symptoms. /
​NO
​
Ringworm / ​NO. Exclude from school until treatment has started. No gym class or swimming until fungal infection lesions are cleared. /
​NO
Pinworm / ​YES.May attend school. Sunlight destroys eggs, so keep blinds/curtains open. Physician will prescribe treatment. Lots ofhandwashing needed. /
​NO
​
MolluscumContagiosum / YES.Exclude from close contact sports, do not share equipment. /
​NO
*Healthcare Provider means family physician/nurse practitioner (if possible), the ER, or call Telehealth at 1-866-797-0000. Those without a care provider may be able to find one atHealth Care Connect.​ ​

Not all the above illnesses require a child to be excluded. If your child is not well enough to participate in regular activities or open sores exposedfrom infection the child may be sent home.

Centre will consult with Local Health Nurse if there is a cause for concern, such as an outbreak.

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