PLAY IS THE WORK OF CHILDHOOD. We ask that you dress your child in comfortable, washable clothes that are marked with their name. A second set of clothes is required daily, year-round, to contend with all eventualities. Please check your child’s bag routinely to make sure clothes are appropriate for the weather and still fit! Appropriate play shoes are required. We respectfully request that your child’s daily personal hygiene requirements be met. Overly tired children find it difficult to negotiate the demands of the day. Parents are asked to be sure that their child has a reasonable bedtime.

HEALTH CARE CONSULTANT
Dana Goldsmith, M.D., a pediatrician and VP of Medical Affairs at Penobscot Bay Medical Center, is available to the Childcare Center for consultations on general health issues. We will work with parents on an individual basis regarding your child’s health. Please call the Center with concerns you may have about an illness and we will discuss your situation with Dr. Goldsmith.

HEALTH CARE PREVENTION
As childcare providers, we play a very important roll in protecting and promoting the health and well being of the young children in our care. PBMC Creative Learning and Childcare Center achieves major health gains by taking several simple steps.

• Handwashing is the simplest and best thing we can do prevent the spread of disease.
• Safety checks, on a regular basis, prevent a tragic injury.
• Annual in-service training in CPR, first aid, and updates on common childhood illnesses keep the staff informed and current.
• Ongoing observation of children may reveal health problems that can respond to early treatment.
• An Immunization Record is filled out and signed by the child’s physician within 30 days of the child’s enrollment.

Staff who greet children upon arrival will visually screen each child, noticing specifically:

• Overall physical appearance - Is the child pale, atypically tired or overactive, appropriately clothed?
• Do the child’s eyes look matted with discharge? Are the child’s eyes unusually irritated or red?
• Does the child’s exposed skin appear to have a rash, red spots, discharging sores, or pimples of any kind?
• Does the child’s hair have any evidence of nits or head lice?

BACK UP CHILDCARE and REPORTING AN ABSENCE
There are times when children are not well enough to attend school. Please have a back up childcare plan for when your child is ill and needs one-on-one care. If your child will not be attending school because of an illness, or for any other reason, kindly call the Center at 596-8700 or your child’s classroom directly to report the absence. Because of the danger of contagion, all instances of communicable disease must be reported immediately to the Center so other parents, and the Center for Disease Control, if applicable, can be notified.

HEALTH POLICY
If your child shows signs of illness, please keep him or her home. If signs of illness become apparent during the day, a childcare staff member may call you to pick up your child. Children will be excluded if:

• A child’s illness prevents him or her from fully participating in daily scheduled activities
• The illness requires more care than the childcare staff is able to provide without compromising the needs of the other children in our care.
• Keeping the child in care poses an increased risk to the child or other children or adults with whom the child will come in contact.

A Notice of Temporary Dismissal from Childcare (blue paper) will be sent home with ill children. This form outlines the suspected illness and our policy regarding that illness, including when the child can return to childcare. In the event that a physician’s diagnosis is needed, this form should be taken to the appointment with you, completed, and signed by your child’s physician. Please do not give your child fever reducing or cough medication prior to childcare, if they meet the requirements to stay home.

We understand it is difficult when your child is too sick for childcare. However, if everyone sticks to the policy, it should make for less illness; therefore, less inconvenience overall!

Following are the guidelines we follow for some common childhood illnesses; however, this is not an exhaustive list. We will take several things into consideration when determining whether your child is well enough to attend childcare, including your child’s age, overall health and medical conditions, and combination of symptoms. We will refer to our health care consultant and/or the American Academy of Pediatrics guidelines for additional information to guide us as situations arise.

FEVER – greater than or equal to 100.4⁰ F. Children must be fever free, without the use of a fever reducing medication, for 24 hours before returning to childcare.

PERSISTENT COUGH – that interferes with daily activities, including napping, is noticeably deep, or occurs in conjunction with difficulty breathing, fever, or other symptoms.

SEVERE COLDS, FLU, AND OTHER RESPIRATORY INFECTIONS, including RSV – Children need to be isolated and symptoms at least discussed with their family physician. They may need antibiotics. The child may return after other symptoms have subsided (24 hours) or as recommended by their physician. We may be especially cautious about these symptoms as recommended by our health care consultant, during times of anticipated epidemics (RSV – December, February, and March; influenza – January and February)

CONJUNCTIVITIS – highly contagious eye infection. Children may return after resolution of eye discharge and at least 24 hours of treatment.

DIARRHEA / VOMITING – Children will be sent home after 2 bouts of diarrhea or 1 instance of vomiting. Children may return after 24 hours free of diarrhea or vomiting.

RASH – Rashes are a sign of contagion. Children who develop a new rash may return to childcare 24 hours after the progression ceases or with the diagnosis from a physician.

CHICKEN POX – The child may return after all lesions are dry and crusted over. Typically, one week (7 days) after the rash first appears. We recommend children receive the Varicella vaccine.

HEAD LICE – The child may re-enter the childcare center after the antiparasite treatment is completed and all nits are removed.

STREP THROAT – The child may return after 24 hours of antibiotic medication and a normal temperature.

IMPETIGO – The child may re-enter the center after at least 24 hours of treatment with oral antibiotic and/or topical antibiotic. Lesions must be covered.

SCABIES – The child may re-enter the center 24 hours after antiparasitic treatment is started.

THRUSH – This is a yeast infection of the mouth. It is usually in infants or toddlers and can be passed when toys or bottles containing infected saliva are shared. While this is not a life threatening illness for healthy children, it can pose difficulties with breastfeeding or take a long time to resolve. Children with thrush will need to see their doctor and have been on medication for greater than 48-hours prior to returning to the center.

MEDICATIONS
All medication, whether prescription or over-the-counter requires written parental permission to administer. The childcare staff cannot accept or administer any form of medication without the completion of a Medication Administration Form. ALL medications need to be in the original container and stored in the lockbox in your child’s classroom. Parents are required to drop off and pick up medications with the classroom teacher. All medications must be taken home daily.

We follow the guidelines recommended by the American Academy of Pediatrics regarding the administration of medication. Per their recommendation, we cannot administer cough or cold medicine to children, even with parental permission.

ALL medications must be clearly labeled with:

• child’s name, no initials
• name of medication
• clear directions for administering
• name of the prescribing physician

MEDICAL EMERGENCIES and PROCEDURES
You, as a parent, will be notified immediately of medical emergencies. You will be given the opportunity to participate in the needed treatment. When notification and/or participation are not possible, the completed and signed Authorization for Emergency Transportation and Medical Treatment Form will facilitate quick and effective response to your child’s needs.

In the event of an emergency the staff will:

• Remain calm, and reassure the child.
• A severely injured or ill person will not be moved, except to save their life.
• A second person will be obtained to help. There are always at least two people in the building.
• Simultaneously, parents, 911, the child’s (or staff) physician, and / or poison control will be contacted.
• An accident / injury report will be filled out by the teacher with a copy for parents and one in the child’s file.

If the child’s physician is unavailable for consultation, the childcare center will rely on the advice of our consulting physician, Dr. Dana Goldsmith.

Medication (ipecac) will only be administered upon the approval / advise of the Poison Control Center. 1-800-222-1222.

EVACUATION PROCEDURE
Evacuation routes are posted in each classroom. The primary egresses are the exits onto the appropriate playgrounds. The teachers are responsible for leading the children in their classroom out of the building and assuring that the number of children in attendance equals the number of children evacuated. Staff will take their classroom attendance information with them. Additional staff will check the bathrooms and other areas for any stragglers. Fire drills are conducted on a regular basis.

Updated: 7/1/09