Health Guidelines

child playing with dollThe Delhi Campus Child Care Center provides care for well children. If your child is not well enough to take part in the daily program or if he/she could jeopardize the health of others at the Center, we request that you keep your child home.

We do not diagnose diseases or conditions. The decision to exclude is based on signs and symptoms only. Key criteria for exclusion of children who are ill:

• The child is too ill to participate in program activities.
• The illness results in a need for care that is greater than the staff can provide without
compromising the health and safety of other children;
• An acute change in behavior – this could include lethargy/lack of responsiveness, irritability, persistent crying, difficult breathing or having a quickly spreading rash;
• Fever:
 Temperature above 101°F [38.3°C] orally, or 100°F [37.8°C] or higher taken axillary
(armpit) or measured by an equivalent method, AND accompanied by behavior change or other signs and symptoms (e.g., sore throat, rash, vomiting, diarrhea, breathing difficulty or cough).
 Under six-months of age: Unexplained temperature above 100°F [37.8°C] axillary (armpit) or 101°F [38.3°C] rectally (caregivers are prohibited from taking a child’s temperature rectally) should be medically evaluated.
 Under two-months of age: Any fever should get urgent medical attention.
• Diarrhea:
 Diapered children whose stool is not contained in the diaper or if the stool frequency
exceeds two or more stools above normal for the child.
 Toilet-trained children if the diarrhea is causing soiled pants or clothing.
 Blood or mucous in the stools not explained by dietary change, medication or hard
stools.
 Confirmed medical diagnosis of salmonella, E. coli or Shigella infection, until cleared by the child’s health care provider to return to the program.
• Vomiting more than two times in the previous 24-hours unless the vomiting is determined to be caused by a non-infectious condition and the child remains adequately hydrated.
• Abdominal pain that continues for more than two hours or intermittent pain associated with fever or other signs or symptoms of illness.
• Mouth sores with drooling unless the child’s health care provider states that the child is not infectious.
• Active tuberculosis, until the child’s primary care provider or local health department states child is on appropriate treatment and can return.
• Streptococcal pharyngitis (strep throat or other streptococcal infection), until 24-hours after treatment has started.
• Head lice, until after the first treatment (note: exclusion is not necessary before the end of the program day).
• Scabies, until treatment has been given.
• Chickenpox (varicella), until all lesions have dried or crusted (usually six-days after onset of rash).
• Rubella, until six-days after rash appears.
• Pertussis, until five-days of appropriate antibiotic treatment.
• Mumps, until five-days after onset of parotid gland swelling.
• Measles, until four-days after onset of rash.
• Hepatitis A virus infection, until the child is approved by the health care provider to return to the program.
• Any child determined by the local health department to be contributing to the transmission of illness during an outbreak.
• Impetigo, until treatment has been started.

Adapted from Caring for Our Children: National Health and Safety Performance Standards; Guidelines for Early Care and Education Programs, 3rd Edition. This information can also be found in our center’s Health Care Plan.

It is very important that parents inform teachers at the time of arrival if their child has been “out of sorts” (before arriving at the Center) and/or has been exposed to a communicable disease outside the Center. The Center will notify parents if their child has been exposed to a communicable disease while at the Center. Notice of confirmed diagnosis of a contagious illness or infection will be posted in the classroom.

If a child becomes ill at the Center or has an elevated temperature, the parent/guardian will be notified and is expected to pick up his/her child as soon as possible. If the parent is not located, the alternate designated on the emergency card will be contacted and expected to pick up the child. Daytime phone numbers on emergency card should be kept current be updated when changes occur.

We will not administer any fever reducing medication. This practice might mask serious illness that might otherwise be detected by a physician.

In the meantime, the sick child will be provided a place to rest quietly, away from other children, under the observation of a staff member. Until you arrive the following comfort measures will be provided for children with an elevated temperature:

  • Child will be offered additional fluids to prevent dehydration
  • Child will be kept lightly dressed with some skin exposed to help dissipate the heat unless he/she is shivering. Shivering causes the temperature to climb therefore the child should be covered.
  • Wet, room temperature washcloth to forehead and under each armpit, if child permits.

Parents are asked to make other arrangements for their child’s care while he or she is ill. A child may only return to the Center when well again.

A child returning to the Center following an illness must meet the following guidelines:

  • Diarrhea resolved with no watery stools for at least 24 hours while on normal diet
  • Normal temperature (without the use of fever reducing medication for 24 hours)
  • On an antibiotic for 24 hours
  • No vomitus for 24 hours while on a normal diet
  • Physician’s statement that the child is no longer contagious if requested by the Director. 

Your family pediatrician should be informed that the child is in a day care center, so that extra caution is used in determining when the child may return after an illness. A health provider’s release or note stating the child is not contagious and may return DOES NOT take precedence over Center’s exclusion policies.

EXCEPTIONS to above 24-hour ANTIBIOTIC policy:

  • A diagnosis of simple otitis media (ear infection) is an exception to this policy. Simple otitis media refers to an ear infection with NO OTHER SYMPTOMS such as:
    – No cough
    – No runny nose
    – No ear drainage
    – No fever
  • A diagnosis of sinusitis is an exception to the antibiotic policy.

Your physician must send written documentation of either “sinusitis” or “otitis media” with permission to return to day care prior to the 24 hour antibiotic exclusion policy.