Child Illness Policy

Our Child Illness Policy is based upon the standards developed by the American Academy of Pediatrics. COA understands

that it is difficult for parents/guardian to leave or miss work; therefore, it is suggested that alternative arrangements be

made for occasions when children must remain at home or be picked up due to sickness. Exclusion from the center is sometimes necessary to reduce the transmission of illness or because the center is not able to adequately meet the needs of the child.

Mild illnesses are common among children and infections are often spread before the onset of any symptoms. In these cases,

we try to keep the children comfortable throughout the day, but will find it necessary to exclude them from the childcare

setting for the following reasons:

• Illness that prevents the child from participating comfortably in program activities.

• Illness that results in a greater need for care than our staff can provide without compromising the health and safety of other children.

• Illness that poses a risk of spreading harmful disease to others.

• Fever 100° axillary (armpit); 101º orally (mouth); 102º aural (ear)* and behavior change or other signs and symptoms such as

sore throat, rash, vomiting, diarrhea, lethargy, irritability, constant crying or difficulty breathing.

• Diarrhea — more watery stools or decreased form of stool that is not associated with change of diet.

Exclusion is required for all diapered children whose stool is not contained in the diaper, and toilet-trained children if the diarrhea

is causing “accidents.” Diapered children with diarrhea will be excluded if the stool frequency exceeds two or more stools above

normal for that child.

• Blood or mucus in the stools not explained by dietary change, medication, or hard stools, and/or uncontrolled, unformed

stools that cannot be contained in a diaper/underwear or toilet. Special circumstances that require specific exclusion criteria

include the following:

• Toxin-producing E. coli or Shigella infection, until the diarrhea resolves and the test results of two stool cultures are

negative for these organisms.

• Salmonella serotype Typhi infection, until diarrhea resolves. In children younger than 5 years with Salmonella sero

type Typhi, three negative stool cultures are required.

• Vomiting more than two times in the previous 24 hours unless the vomiting is determined to be caused by a non-communicable

condition and the child is not in danger of dehydration.

• Mouth sores with drooling unless the child’s medical provider or local health department authority states that the child is

noninfectious.

• Abdominal pain that continues for more than two hours or intermittent abdominal pain associated with fever, dehydration or

other signs of illness.

• Rash with fever or behavioral changes, until a medical provider has determined it is not a communicable disease.

• Purulent conjunctivitis (defined as pink or red conjunctiva with white or yellow eye discharge) until on antibiotics for 24 hours.

• Impetigo until 24 hours after treatment has been started.

• Strep throat (or other streptococcal infection) until 24 hours after treatment has been started.

• Head lice until after treatment and all nits are removed.

• Rubella, until six days after the rash appears.

• Scabies until 24 hours after treatment has been started.

• Chicken pox, until all lesions have dried or crusted (usually six days after onset of rash).

• Pertussis (whooping cough), until five days of appropriate antibiotics.

• Mumps, until five days after onset of parotid gland swelling.

• Measles, until four days after onset of rash.

• Hepatitis A virus, until one week after onset of illness or jaundice or as directed by the Health Department, if the child’s

symptoms are mild.

• Tuberculosis, until the child’s medical provider or local Health Department states the child is on appropriate treatment and

can return.

• Any child determined by the local Health Department to be contributing to the transmission of illness during an outbreak.

We ask that for your child’s comfort and to reduce the risk of contagion, he or she be picked up within 1.5 hours of notification.

Until then, your child will be kept comfortable and will continue to be observed for symptoms.

Children need to remain home for 24 hours without symptoms before returning to the program. This means that the child

needs to remain out of the center for the remainder of the day he or she is sent home and the following day, unless the center receives a note from the child’s medical provider stating that the child is not contagious and may return to the center. If a child is sent home on Friday, he or she may return on Monday. In the case of a (suspected) contagious disease, rash or

continuing symptoms, a note from the child’s medical provider may be required before returning.

*Infants less than 4 months of age will be excluded if they have a fever of 100° axillary (armpit) or 100.4° aural (ear) and

should receive medical attention as soon as possible.

*Any child with a fever of 104° will be excluded and should receive medical attention as soon as possible. Any infant younger

than 2 months with a fever should get urgent medical attention.

Children who have been excluded may return when:

• They are free of fever, vomiting and diarrhea for a full 24 hours.

– Readmission after diarrhea can occur when diapered children have their stool contained by the diaper (even if stools remain

loose) and when toilet-trained children do not have toileting “accidents.”

• They have been treated with an antibiotic for a full 24 hours.

• They are able to participate comfortably in all usual program activities, including outdoor time.

• They are free of open, oozing skin conditions and drooling (not related to teething) unless:

    - The child’s medical provider signs a note stating that the child’s condition is not contagious.

    - The involved areas can be covered by a bandage without seepage or drainage through the bandage.

If a child is excluded because of a reportable communicable disease, a note from the child’s medical provider stating that the

child is no longer contagious and may return is required.

The final decision whether to exclude a child from the program due to illness will be made by the childcare center.

Note: Notes allowing for a child’s return to the center after an exclusion due to illness must originate from the child’s medical provider. Unfortunately, COA cannot accept a signed doctor’s note from a physician parent/guardian