Our health care policy reflects the current child care licensing regulations from the NYS Office of Children and Family Services (OCFS) as well as the NYS Department of Health’s division for infectious disease control. Our administration of medication policy directly reflects the new regulations of OCFS that are now required by law for anyone administering medicine in a group or school setting. A copy of these current regulations is available in the assistant director’s office.
Planning ahead for an ill child
As a parent choosing to place your child in a group setting, it is important to realize that young children are in the process of developing their immune systems. During the first year of attending a group setting, your child will have an average of six episodes of minor illness usually associated with viruses and colds. It is important to anticipate the fact that you will need an alternate plan for childcare when your child is ill. We realize that at times parents face a conflict between going to work and staying home with a sick child. This situation will be considerably less stressful if you think ahead and consider arrangements for when your child is not well enough to be at school.
Reading a child’s behavior and symptoms
Our goal is to work with you within the framework of our health policy to determine when your child is well enough to participate in a group setting. While we try to set clear and precise guidelines for when a child is too sick to be at school and/or when s/he is well enough to return to a group setting, please keep in mind that a child’s behavior is often the key indicator of his/her health and overall ability to have a successful day at school. Like adults, each child has a unique response to illness. Mild symptoms may make some children irritable, inflexible, or dependent, while others may not complain at all. You know your child’s individual reaction to the onset of illness and we value your input.
Based on your child’s overall behavior during the past 24 hours, parents need to decide daily if their child is able to participate in a group setting. Our licensing guidelines state that parents and teachers must indicate daily (upon arrival) that each child is well and can attend school that day. Viral illnesses such as colds, coughs, and flu cannot be treated with antibiotics; they must run their course. Treatment of such illnesses consists of extra care, rest, fluids and possibly acetaminophen or ibuprofen. Generally, all children who are ill need a familiar adult close by who can give them special attention. Children seek out familiar environments: a cuddly lap, a soft pillow, or a quiet area. They prefer non-taxing activities. The normal dynamics of participating in a group, such as waiting to take a turn or negotiating over the use of a toy, become too overwhelming for a child who is not feeling well. How do we arrive at the decision to send your child home for illness?
When your child’s behavior indicates that s/he cannot be in a group setting, even if s/he is without a fever, we ask that the child go home. An unwell child can affect everyone’s day and often requires the constant attention of a teacher who, at the same time, is responsible for many other children. Please keep in mind that, although a child may play happily in the quiet of his or her own home, s/he may become uncomfortable and stressed if required to participate in an activity during a structured program. Our goal is to be sure each child is healthy and happy during school.
With this in mind, teachers are required, by OCFS, to make a daily health check of each child in their class. If during the day a teacher notices that a child is not participating in a typical fashion (e.g. not eating snack or lunch, or is tired or overly cranky), the teacher will bring the child to an administrator’s office for a temperature check and to describe their observations of the child.
At this point, if your child has any notable signs of illness such as a fever above 100.4 degrees, a rash, or appears languid, pale, or completely out of sorts, the administrator will usually decide your child should be sent home for his/her comfort and the well being of others. If you cannot be reached by telephone, the administrator will call the first medical emergency number listed on your white (and blue) cards. All parents are required to provide at least one emergency contact person and phone number in addition to themselves. Please keep all of these numbers up to date with the school secretary.
If, on the other hand, your child has none of these symptoms (but just doesn’t feel well), the administrator will probably offer a remedy such as cold water, going to the bathroom, etc; and have your child return to his/her class. The teachers will keep an eye out for further symptoms. Sometimes, at this point, we will call you to give you a heads up that your child may be getting ill and may need to be picked up early. We also make this phone call to touch base with you to see if there is something we should know about that could be causing your child to feel ill.
If you are asked to pick up your child, please respect the judgment of the Wimpfheimer staff in these situations. Remember that it is the teacher and administrator who are observing your child in the school environment and the call is motivated by wanting what is best for your child and his or her classmates.
Please remember if your child is sent home it is for everyone’s benefit and s/he may not return to school for a full 24 hours. This policy is to prevent the potential spread of disease and although your child may appear well the very next day, they may still be contagious and/or not up to a full day of school. When you pick up your child you will receive a Symptom Record, which will state our observations, their symptoms, and the soonest your child can return to school in accordance with our health policy. If your child is diagnosed with a contagious illness it must be reported to Wimpfheimer Nursery School so we can keep a record of it in our master health log and inform others that their child may have been exposed to the illness. This plan of action is required by our licensing regulations. This log also allows us to monitor the entire school and to track health patterns and follow up with any required reports to both the Dutchess County and New York State Health Departments.
Is my child well enough to go to school?
It is often not easy to decide in the early morning whether or not your child should go to school. Please remember that during the beginning stages of any illness, a child is highly contagious and is likely to infect other children and teachers. Our philosophy is proactive in the prevention of spreading illness and to provide the best possible care for each child in our program. By using the Alphabetical Guidelines For Illness & Attending School that follow, we can work together to provide a healthy environment for all children, students, and teachers in our community. Please note: all temporary illnesses require a 24-hour period without symptoms or symptom relieving medication (i.E. Fever reduction medication). This means if your child is sent home sick from school s/he may not return until s/he has been home for an entire day. (For example, if your child is sent home on a Tuesday, the earliest s/he may return to school would be Thursday.) Children may not return to school mid-day of the following day if they have been sent home with an illness.
Alphabetical Guidelines For Illness & Attending School
The following list is a helpful tool for you as a parent to know when your child should or should not come to school. Please refer to this alphabetical list of illnesses to confirm what is required for your child to return to Wimpfheimer Nursery School after an illness. If you have further questions please contact the director or the assistant director at 437-5630, or e-mail Julie Riess.
(We would like to acknowledge the program at Cornell University for permission to use portions of a similar section from their parent handbook.)
Common Childhood Illnesses Listed Alphabetically
Asthma And Breathing Distress - If your child experiences a recurring illness involving breathing distress we require medication accompanied by the proper authorization forms to be kept at school at all times. Although this medication will be kept at school, please note our approach to using such medication is conservative. We will always try several other means of relieving your child’s breathing difficulty before administering medication.
Chicken Pox - Your child may not return to school until all lesions have dried and crusted and your child has been fever-free for at least 24 hours.
Colds - If your child has a cold that persists beyond 10 days and is not getting better, s/he should be seen by a doctor. In general, colds last 7-10 days. After 5 days, secretions will be thicker and colored. A child may stay in group care if his/her activity level and behavior is normal, and s/he is without fever. If your child has any of the symptoms listed under non-specific viral illness during the course of the cold, then s/he is not ready to be in a group setting.
Conjunctivitis - Conjunctivitis is commonly known as ’pink-eye’ and is associated with white or yellow discharge, often with matted eyelids especially after sleep, eye pain, and redness of the eyelids or skin surrounding the eye. When your child is diagnosed with conjunctivitis s/he may return to group care after s/he has been on antibiotic drops for a minimum of 24 hours and shows no other symptoms of illness, or if you have a note from your child’s pediatrician on prescription letterhead stating their conjunctivitis is no longer contagious.
Coughs - A cough can spread an infection among young children faster than any other ailment. Moreover, there have been recent cases of pertussis/whooping cough in our local area. Therefore, if your child has a persistent cough the NYS Department of Health asks that the cough be evaluated by your child’s pediatrician before your child returns to a group setting. Please bring a note on prescription letterhead stating your child can return to a group setting and the cough is not contagious.
Coxsackie Virus - This virus is indicated by sores in the mouth and on the hands and feet, usually accompanied by a fever. Your child may return 24 hours after diagnosis with a doctor’s note, or if s/he is fever free and the rash has cleared. If your child has any of the symptoms listed under non-specific viral illness during the course of the virus, then s/he is not ready to be in a group setting.
Diarrhea - If your child has had two or more loose stools within a 24 hour period this needs to be treated as a potentially contagious intestinal flu. Like a cough, this type of flu spreads rapidly and therefore we are very proactive when excluding children with these symptoms. If the diarrhea is accompanied by stomach cramps, or any other symptoms your child needs to be excluded from a group setting. If the diarrhea is the result of diet or medication, the stool must be either contained within a diaper or by the child’s ability to use the toilet in order for them to participate in a group setting.
Ear Infections - Middle ear infections generally are not considered contagious. A child may return group care while being treated for an ear infection ONLY IF: s/he is fever-free for a full 24 hours and has no other symptoms including those listed under non-specific viral illness.
Fever - If your child has a fever 100.4 degrees or higher without any other symptoms, s/he needs to be excluded from a group setting until s/he has been fever-free for a full 24 hours.
Fever is defined as follows: The American Academy of Pediatrics states that a fever is a temperature of 100.4 or higher. Because fevers are typically at their lowest in the morning and rise during the day, a child may not begin their day at the nursery school with a temperature greater than 99.9. This temperature needs to be measured without fever-reduction medication.
Hepatitis - If your child is diagnosed with hepatitis, s/he may not return to a group setting until the week after the onset of illness has been diagnosed or until after immune serum globulin has been administered to appropriate children and staff in the program as directed by the NYS Department of Health. A note from your child’s pediatrician on prescription letterhead is required for your child to return to a group setting.
Immunized Diseases: Measles, Mumps, Rubella, Pertussis, And Tuberculosis - Each child in our program is required to be immunized against these illnesses. In the rare event of an outbreak of any of these diseases, the child would return to group care only when the health department has been notified and your pediatrician provides a note on prescription letterhead stating s/he is non-infectious. (Please note in this case the Department of Health supersedes your child’s pediatrician.)
Impetigo - A skin irritation with itching accompanied by red areas with pimples and yellow/brown crusts. A rash with this appearance must be diagnosed and treated for 24 hours before your child can participate in a group setting.
Infestation - (ex. Scabies, Pinworms, and Head Lice) Your child must remain home until 24 hours after treatment has been initiated.
Mouth Sores - (ex. Herpes Simplex; Hand-Foot-Mouth Disease) If your child has symptoms related to mouth sores or is diagnosed with any of these illnesses, you will need a note from your child’s pediatrician on prescription letterhead stating when your child can return to a group setting.
Non-Specific Viral Illness - If your child has a viral illness that is still running its course and s/he shows any of the following symptoms: decreased activity or appetite and/or increased need for rest, increased irritability, and the need for constant adult attention, then your child is not ready to participate in a group setting. Please remember your child must be fever-free for 24 hours to return to school.
Skin Rashes - If the rash is associated with fever and/or behavior change, your child needs to excluded from a group setting. A fungal infection of the skin (ex. Ring Worm) should be diagnosed and treated for 24 hours before your child returns. Also, if the rash covers the entire body or is specific to the mouth or hands and feet, the rash needs to be diagnosed and treated for 24 hours.
Strep - If your child is diagnosed with strep throat/scarlet fever s/he must be excluded from a group setting until 24 hours after treatment has been initiated, and your child has been without fever or fever reduction medication for a full 24 hours.
UTI - Urinary tract infection are not considered infectious and therefore your child may attend school ONLY IF s/he has no other symptoms, is not uncomfortable, is able to use the toilet prior to urinating and is able to participate in group activities.
Vomiting - If your child has thrown up within a 24 hour period please do not send them to school. Likewise, if your child throws-up at school you will be asked to pick them up immediately. Stomach flus travel rampantly through a group and therefore we need to be fully proactive on this one.
Medication Policy and New York State Laws
When your child is in the recovery stages of an illness and is well enough to return to a group setting, we will give them any necessary medications if we have your written authorization and that of your child’s pediatrician, as required by law. Please request this note from your child’s pediatrician at the time the medication is prescribed. The form must specify the amount, dosage, and time the medication should be given. State law prohibits us from administering any medication unless we have this authorization. Likewise, we may not give over-the-counter medications (acetaminophen, cough syrup, etc.) without this same authorization. We have included the necessary forms for this authorization in your parent binder and they are available in the assistant director’s and/or the secretary’s office. We suggest that you always take one with you to your pediatrician, or keep a few in the glove compartment of your car. (We provide our handy-dandy glove compartment form kits on parent orientation night.) If you forget the required form, a note from your child’s pediatrician on prescription letterhead, including the information underlined and listed above, will suffice until your child’s pediatrician can complete the required NY State form.
Please Note The Following If Your Child Requires Medication At School:
- All medication must be:
- in the original bottle
- labeled by the pharmacy
- labeled to indicate if it requires refrigeration
- labeled with the child’s first and last name (including over the counter medication)
- Indicate to the teacher in writing in the daily parent notebook (next to the sign-in sheet) the need for the medication and give the assistant director the signed authorization sheet and the medicine. If the assistant director is not available, please leave the medicine and authorization on his/her desk and tell the secretary it’s there. All medication must be stored out of the reach of children. Do not leave any medication in your child’s lunchbox, in the classroom, or with the teachers.
- You may ask your pharmacist to put half of the prescription in one bottle and half in another so that you can leave one bottle at school. Both bottles must be fully labeled by the pharmacist.
- All medication administered by the authorized staff at Wimpfheimer Nursery School will be documented in writing at the time of administration of medicine, including: date, time, dosage and observation of any side effects. Parents will be notified by phone if side effects are noted. This information is noted in our Medication Log and kept in the assistant director’s office.
- If needed, remember to take the medication home in the evening and return it the next day.
- We return all medication to the parent when no longer prescribed or needed.
- Please note the following regulation regarding administering over-counter medication: Over-the-counter medication. “If a child develops symptoms which indicate a need for over-the-counter medication, including topical ointments, while in care at the center, such medication may be given under verbal instructions from the parent for that day only. The center must document that verbal instructions and approval were given by the parent. Written instructions from the parent and, in the case of orally-administered medications, a health care provider must be obtained if the medication is to be administered on subsequent days” (section 4.18-1.11, j-4, page 18).
- E-mail instructions are strongly preferred over verbal instructions in these instances.
Child’s health records: Before a child is enrolled at Wimpfheimer Nursery School, the parent(s) must provide documentation of their child’s immunizations and physical examination on the medical form provided in the enrollment packet. This form must be completed and signed by a physician before your child begins attending our program. This includes documentation of a TB test within the past year or a written note from the doctor saying that this test is "not indicated" at this time.
Daily health information: Parents will provide daily written information on their child’s health via the sign-in sheets in the child’s classroom. Our need for this daily documentation stems not only from our professional concern for your child, but is also required to meet the New York State licensing regulations referred to as the “daily health check”, described below.
An ongoing partnership between a child’s parent(s) and teachers is important if both parties are to have a good understanding of the child’s general state of health and well being. We ask that you let us know about your child’s health each day. Is s/he taking any medications? Do you suspect s/he may have difficulty with allergies today? Is a sibling ill and you are not sure if your child might be showing early symptoms of the same illness? With this daily health information, teachers can observe your child for specific signs and symptoms of illness and can keep you informed of any significant health changes.
A simple health check (HC column preceding your sign-in signature) will be included on your child’s classroom sign-in sheet. Please be sure to complete this daily. Your checkmark indicates that your child is well enough to attend Wimpfheimer that day.
Additional daily information: Detailed health information should be provided in writing in the parent notebook next to the sign-in sheet. Parents are strongly encouraged to make verbal contact with a teacher and/or administrator as well.
Incident reports: A complete description of our incident report policy is presented under “I” in the green ABC section of this parent handbook.
Head or eye injuries: Any injury to a child’s head or near a child’s eyes will be brought to the attention of the director or the assistant director by a teacher. The director or assistant director will review the situation and contact the parent to inform them of this injury.
Clothing and bedding
Clothing: At least one extra set of clothing must be available so that we have clean clothes available for each child throughout the day. We will return children’s clothing in need of washing to parents in a plastic bag. Clothing contaminated with blood will be placed in a securely tied plastic bag and returned to the parent at the end of the day.
Bedding: Linens, blankets and bedding must be cleaned at least weekly. We will send your child’s bedding home each Friday. Please wash and heat dry over the weekend, and return all items to school in a clean plastic bag on Monday morning.
It is our policy to use pesticides on an absolute minimal basis. Consideration of any pesticide application is made in direct consultation with Julie Riess, Director. Dr. Riess has several years of experience working in an environmental toxicity laboratory at the University of Pittsburgh, funded by the National Institute of Health. Children will not be present in the area of any pesticide application and will not return to a treated area until additional time above and beyond the Environmental Protection Agency’s guidelines has passed.
The New York State day care regulations include specific instructions on parent notification when pesticides will be used on school grounds. These regulations are presented below:
“...each day care facility must send a notice home with each child or otherwise provide notification to the parent of each child not less than forty-eight hours prior to the application of pesticides.” Such notice must include:
- the location and specific date of the application of pesticides and may include two alternate dates in the event that an outdoor application cannot be made due to weather conditions;
- the pesticide product name and pesticide registration number assigned by the United States Environmental Protection Agency;
- the following statement: “This notice is to inform you of a pending pesticide application at this facility. You may wish to discuss with a representative of the day care facility what precautions are being taken to protect your child from exposure to these pesticides. Further information about the product or products being applied, including any warnings that appear on the label of the pesticide or pesticides that are pertinent to the protection of humans, animals or the environment, can be obtained by calling the National Pesticide Telecommunications Network Information Line at 1-(800) 858-7378 or the New York State Department of Health Center for Environmental Health Info Line at 1-(800) 458-1158”; and
- the name of a representative of the day care facility and contact number for additional information (section 4.18-1.11, s-4-ii, page 20).