Rule 37.96.505 - MANAGEMENT OF ILLNESS(1) All licensed and registered child care providers must designate a staff member to check daily the health status of each child immediately upon that child's entry into the child care facility.(2) All licensed and registered child care providers must exclude any child or staff member with an illness until symptoms have resolved, adequate treatment has been received, or a health care provider states that the person is noninfectious. The following symptoms or illnesses require exclusion: (a) a fever of 100.4°F that is accompanied by behavior change or other symptoms;(c) vomiting more than two times in the previous 24 hours;(d) mouth sores with drooling, if unable to contain drool, unless a health care provider states that it is a noninfectious condition;(e) a rash with fever or behavioral change or a rash that is quickly spreading, unless a health care provider states that it is a noninfectious condition;(f) active tuberculosis, until a health care provider states that the person is noninfectious and can return;(g) group A strep pharyngitis (strep throat) until the person appears well and at least 12 hours after beginning appropriate antimicrobial therapy;(h) impetigo, until treatment is initiated and if lesions on exposed skin are covered with a waterproof dressing;(i) head lice, scabies, or ringworm, until treatment is started. Children and staff can remain in the child care setting until the end of the day;(j) chickenpox (varicella), until sores have dried or crusted. Child care providers must not purposefully expose susceptible children to chickenpox, even with the permission of the susceptible child's parents/guardians;(k) rubella, until seven days after the rash appears;(l) pertussis, until five days after antibiotic treatment was initiated;(m) mumps, until five days after onset of parotid gland swelling;(n) measles, until four days after onset of rash;(o) hepatitis A, until one week after onset of illness or as directed by the local health authority;(p) shigellosis, salmonella, or E. coli, until a local health authority clears the person for readmission; or(q) if the child is unable to participate in activities or needs care from staff that compromises the health or safety of other children.(3) Children and staff must be excluded from all child care facilities, and a health care provider must evaluate the conditions to ensure the person's return will not harm that person or the other people, when a child or staff: (a) has symptoms of severe illness, such as fever with behavior change, lethargy, uncontrolled coughing, breathing difficulty or wheezing, stiff neck, irritability, persistent crying, poor food or fluid intake, progressive rash with any other symptoms, or a seizure; or(b) has persistent abdominal pain for two or more hours, or intermittent abdominal pain associated with fever, dehydration, or other signs or symptoms of illness.(4) A child or staff member does not need to be excluded, but a child's parents/guardians should be notified of new onset, for minor illnesses or symptoms including:(a) a runny nose or cough not accompanied by a fever;(b) pinkeye or other eye discharge not accompanied by fever;(c) fever without behavior change for people aged four months and older, including children with immunization-related fevers; or(d) rash without behavior change or fever and that is not quickly spreading.(5) If a child develops symptoms of any illness other than those included in (2) or (3) while at the child care facility and after the parents/guardians have left, the child care provider must:(a) isolate the child immediately from other children in a room or area segregated for that purpose; and(b) contact and inform the parents/guardians as soon as possible about the illness and request they pick up the child.(6) Disease charts that identify reportable diseases are available from the department. A child care provider must notify the local health authority, on the same day or as soon as possible if no contact can be made the same day, if: (a) a child becomes ill or is suspected of having a communicable disease reportable to the health department while in care;(b) a child is absent and a reportable communicable disease is suspected; or(c) there is an outbreak of any reportable communicable disease detected in a child care facility.Mont. Admin. R. 37.96.505
NEW, 2024 MAR p. 738, Eff. 4/13/2024AUTH: 52-2-704, 52-2-735, MCA; IMP: 52-2-702, 52-2-704, 52-2-713, 52-2-721, 52-2-722, 52-2-723, 52-2-724, 52-2-731, 52-2-735, MCA