Child Illness Management

Keeping children healthy is a partnership between the child care provider, the child themselves, their parents/legal guardians and the child’s healthcare provider. Please remember the germs brought into a child care environment usually hit everyone here. If your child needs to be in bed and quiet, they need to be home. It is the parents/legal guardians’ responsibility to find alternative care for a sick child.

Sick care is not provided by Country Fun Child Care, but this does not affect your fee.

Following an illness a child may not return to care until agreed to by me, and where noted with written clearance by child’s healthcare professional. A sick child will be turned away at the door if necessary. If you have a question, please call. 

I will do my best to make a child’s parents/legal guardians aware of both common and contagious illnesses that are around the community or impacting Country Fun Child Care.

Notice of Exposure to Contagious Disease Form:

Date: / /

Dear Legal Guardian:

A child in (business) has or is suspected of having:

Information about this disease-

The disease is spread by:

The symptoms are:

The disease can be prevented by:

What (business)is doing to reduce the spread:

What you can do at home to reduce the spread:

If your child has any symptoms of this disease, call your healthcare provider to find out what to do and be sure to tell them about this notice. If you do not have a regular healthcare provider to care for your child, contact your local health department for instructions on how to find one.

Country Fun Child Care Child Illness Management guidelines generally follow those for the local public schools. Managing Infectious Diseases in Child Care and School (a quick reference guide, 2nd edition) is also on hand and consulted.

Illnesses requiring exclusion from care include, but are not limited to:

  1. Fever above 100 axillary (taken under the arm) or 101 orally, when other symptoms of illness are present.
  2. Diarrhea (where any of the following additional conditions is present):
  • stool is not contained in the diaper for diapered children or causing “accidents” for toilet-trained children 
  • frequency is 2 or more above normal 
  • blood/mucus in stool (need medical ok to return) 
  • abnormal color (all black or very pale) 
  • no urine output in 8 hrs. 
  • fever with behavior changes 
  1. Vomiting
  • more than 2 times in a 24 hour period 
  • fever present 
  • green or bloody vomit 
  • no urine output in 8 hrs. 
  • recent head injury
  1. Severe coughing in which the child gets red or blue in the face or makes a high-pitched whooping sound after coughing or has difficulty breathing.
  2. Head lice and ringworm: The child should be treated by healthcare professional. After initial treatment the child can return.
  3. Impetigo, no return until 24 hours after treatment has been initiated.
  4. Tuberculosis, no return until a health care provider states in writing that the child can return to child care.
  5. Hepatitis A, chickenpox, mumps, measles, rubella or shingles. No return until a health care provider states in writing that the child can return to child care. For scabies or chicken pox the child cannot return to care until after treatment has begun and the sores have crusted over.

Certain conditions do not require exclusion unless recommended by the child’s healthcare provider or if additional symptoms appear.

  • CMV or HIV infection or hepatitis B and C virus carrier state.
  • Pink eye
  • Rash without temperature or behavior changes.
  • Non-contagious conditions such as chronic medical conditions or disabilities.
  • Runny nose if the child is feeling well.

What to Do If a Child Requires Exclusion While in Care:

Illnesses that occur during the day where the child is not well enough to participate means they will be excluded and the child’s parents/legal guardians will be notified. 

  • Provider will immediately separate the child from the other children in such a way that the child can be seen and supervised, and does not feel punished in any way.
  • Child’s Parents/Legal Guardians will be contacted to have the child picked up as soon as possible to prevent the spread of infection to other children, provider, and to allow the child time to rest, recover, and be treated for the illness if necessary.
  • Provider will continue to observe the child for other symptoms until picked up.

Administering Medication:

At Country Fun Child Care, the provider is justified to give medications if:

  • Dosage cannot be adjusted, so that it can be taken before and after child care.
  • A child has chronic health conditions (e.g. asthma, diabetes) which may require urgent administration of medicine.
  • Refusal to administer the medication would pose a significant hardship, such as requiring the child’s absence from child care to recover from an illness, when the child is well enough to attend child care (e.g. ear infection after the first day or so).

The administration of medications will be limited to:

  1. Prescribed medications ordered by a healthcare provider for a specific child and a specific illness. Medication that is prescribed for one child in the family will not be administered to another child in the family.
  2. Nonprescription medications recommended by a healthcare provider for a specific child, with written permission of the parent or legal guardian.
  3. Homeopathic and herbal medications are only given with an order from a licensed healthcare professional and must be properly labeled.
  4. Medications which provider and supervising staff have been trained to administer including oral, topical, nasal, ear and eye.
  5. Only after a first dose has been given at home.

All medications will be administered following the “5 RIGHTS”:

Screen Shot 2016-03-04 at 12.11.21 PM

Exception to medication policy: Nonprescription diaper ointment, sunscreen and insect repellent always require guardian consent, but do not require instructions from each child’s prescribing healthcare professional. 

A child’s parents/legal guardians need to provide explicit instructions on the amount of medicine to be administered, the times it is to be given, and most important, what signs to watch for in the event the child suffers an allergic reaction, whether or not the medicine needs to be kept refrigerated, and so on.

Permission Form to administer medication needs to be filled out and signed by the parent/legal guardian. Medication will only be provided with written permission from the parent/legal guardian.

Only proper measuring utensils will be used to ensure the child receives the correct dose of his/her medication. 

The measuring utensil will be cleaned immediately after use and placed with the child’s medication.

The permission form will be placed in the child’s record.

** Medication Tip: Two Bottles – Ask the pharmacist to divide prescription medication into two bottles, each with its own label, so that one can be kept at home and one can be kept at (business).

Medication must meet the following criteria:

Original medication packaging with a prescription label that provides:

  • Pharmacy name and number
  • Prescriber’s name and number
  • Prescription number
  • Date prescription was filled
  • Child’s first and last name
  • Name of medication
  • Strength of medication
  • Number of refills
  • Quantity (QTY)
  • Manufacturer (MFG)
  • Expiration date
  • The container has specific instructions for administering, storing and disposing of the medication. The prescription label may act as the written order.

All medications, refrigerated or unrefrigerated, shall:

  • Have child-protective caps.
  • Be stored at the proper temperature.
  • Be inaccessible to children.
  • Not be used beyond the date of expiration.
  • Be given only for the purpose identified in the label/prescription.
  • Be medication for the current episode of illness.

“As Needed” Medication Instructions (PRN):

  • Must be accompanied by specific, detailed information about what symptoms should trigger the need to give the medication.
  • Must state the maximum number of times the dose can be repeated before seeking further medical care.

Over-the-Counter Medications:

  • Make sure nothing blocks the label
  • Verify that the strength of the medication is appropriate for child’s age and weight
  • Needs to be in a child-resistant container and come with original packaging that provides:
    • Product name
    • List of active and inactive ingredients
    • Purpose
    • Uses
    • Warnings
  • Manufacturer directions
  • Expiration date
  • Specific instructions for child, dose, etc.

Unrefrigerated emergency medications will be with provider when outside.

No medications will be added to or administered in food, unless specifically made for food. If medication is added to food the child needs to take in all the food to get the correct dosage of medication.

If medication or order to administer it is out-of-date, or medication is left over, the medication will be returned to child’s parents/legal guardians for disposal.

What is a medication error?

  • Giving medication to the wrong child
  • Giving wrong medication
  • Giving the wrong dose (under dose, overdose, or missed dose)
  • Giving medication at the wrong time
  • Giving medication by the wrong route or using a wrong procedure

These are medication incidents, but not errors:

  • Child refusal
  • Spit out doses
  • Vomited doses
  • Spilled medication

In the case of a medication error/incident poison control or 911 will be called first, and notification of guardian will follow.  A Medication Incident Report will be completed. Parent/legal guardian signature is required. Report will be maintained as part of the child’s record.

Medication Incident Report

Date of report: Program: 

Name of person completing this report: 

Signature of person completing this report: 

Child’s name: Date of birth:

Date incident occurred: Time noted:

Person administering medication: 

Prescribing health care provider:

Name of medication:

Dose: Scheduled time:

Describe the incident and how it occurred (wrong child, medication, dose, time, or route?): 

Action taken/intervention: 

Name of legal guardian notified: Date: Time:

Follow-up and outcome: