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As a child care provider, you will need a clearly written policy for excluding sick children from your child care facility. Give each parent and guardian a copy of your Exclusion for Illness Policy when each child is enrolled. Explain the policy and answer any questions that the parents or guardians have at that time. This will prevent problems later when a child is sick.

Children can become sick quickly. You should be aware of signs and symptoms of illness and know what to do if a child becomes ill. You should have a procedure for recording in writing and reporting any unusual illness or injury.

Each day when the children arrive at your facility you should:

  • Check the overall health of each child. Note any unusual symptoms and ask parents or guardians about any unusual health or behavior while the child was not in your care.
  • If a child does not appear well enough to participate in activities as usual and/or has any symptoms requiring removal from the child care setting (see below), the child should not be allowed to attend the child care facility at that time.

You should continue to watch each child's health throughout the day while in your care. Because infections spread easily among children, you should look for the symptoms requiring removal of a child from a child care setting (see below). If you see these symptoms in a child, you should:

  • Immediately separate the child from the other children.
  • Contact the parents to have the child picked up.
  • Continue to observe the child for other symptoms.
  • If the child does not respond to you, is having trouble breathing, or is having a convulsion, call 911.
Symptoms Requiring Removal of a Child from the Child Care Setting
  • Fever--AND sore throat, rash, vomiting, diarrhea, earache, irritability, or confusion. Fever is defined as having a temperature of 100F or higher taken under the arm, 101F taken orally, or 102F taken rectally. For children 4 months or younger, the lower rectal temperature of 101 is considered a fever threshold.
  • Diarrhea--runny, watery, or bloody stools
  • Vomiting--2 or more times in a 24-hour period.
  • Body rash with fever.
  • Sore throat with fever and swollen glands.
  • Severe coughing--child gets red or blue in the face or makes high-pitched whooping sound after coughing.
  • Eye discharge--thick mucus or pus draining from the eye, or pink eye.
  • Yellowish skin or eyes.
  • Child is irritable, continuously crying, or requires more attention that you can provide without hurting the health and safety of other children in your care.
Note: This information is not intended to take the place of your state's or locality's child care regulations and laws. In every case, the laws and regulations of the city, county, and state in which the child care facility is located must be carefully followed even if they differ from these recommendations.

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