13-008 Code Vt. R. 13-162-008-X
Definitions
AIDE- A volunteer or unpaid aide present in the early childhood program.
CHILD- Person who has not yet reached the age of sixteen years.
COMMISSIONER- Commissioner of the Department of Social and Rehabilitation Services or his/her designee.
CONDITIONS OF THE LICENSE- Requirements that must be met in order to retain a license.
CONFIDENTIALITY- The protection of personal information from persons who are not authorized to see or hear it.
CORPORAL PUNISHMENT- The intentional infliction of pain by any means for the purpose of punishment, correction, discipline, instruction or any other reason.
CURRICULUM- A set of activities and experiences consistent with the developmental needs of young children.
DEPARTMENT- The Vermont Department of Social and Rehabilitation Services, Agency of Human Services and/or its agents.
DEVELOPMENTALLY APPROPRIATE- Activities and interactions that recognize and address the physical, emotional, social, and cognitive stages of each child.
DIRECT SUPERVISION - Constant visual supervision, in the same room or outdoor play area, of a trainee, volunteer or person 16 and 17 years of age who assist in the program.
DISCIPLINE- A process of guiding children to develop internal pro-social behavior through supportive consistent use of the following: modeling appropriate behavior; praise, active listening, limit setting, reinvolvement and modifying the environment.
DIVISION- The Child Care Services Division of the Vermont Department of Social and Rehabilitation Services.
EARLY CHILDHOOD FACILITY- Any place, operated as a business or service on a regular or continuous basis whether for compensation or not, which provides early care and education. Used interchangeably with the term Early Childhood Program (ECP).
EARLY CHILDHOOD LICENSING REGULATIONS: Regulations pursuant to 33 V.S.A § 306(b) and 3502(d).
EARLY CHILDHOOD PROGRAM (ECP)- The developmentally appropriate care, education, protection and supervision which is designed to ensure wholesome growth and educational experiences for children outside of their home for periods of less than 24 hours a day. Preschool programs sponsored by public and private schools are also early childhood programs.
EARLY CHILDHOOD PROGRAM ASSESSMENT TEAM - A group of parents and representatives from early childhood programs and community support agencies who are brought together for the purpose of assessing and improving program quality.
GROUP- The number of children who meet together regularly and can be identified with one another as being distinct from the larger population of children present and are assigned to a specific staff person or team of staff members.
HIGHER EDUCATION COURSE- A three credit course or equivalent which could apply toward acquiring a post secondary degree in Early Childhood Education, Elementary Education, Human Development or other related field.
HUMAN SERVICES COOP STUDENT- A person 17 years of age who is (1) enrolled in a technical center approved by the State Board of Education, (2) has successfully completed at least one semester of early childhood course work or a minimum of 180 hours in a child development theory and lab school practice.
HUMAN SERVICES GRADUATE - A person who has received a certificate of completion from a technical center human services program, emphasizing child development/early childhood education and is approved by the State Board of Education.
INDIVIDUAL PROFESSIONAL DEVELOPMENT PLAN (IPDP) - A personalized plan for increasing one's knowledge and improving skills by assessing current knowledge and skills, identifying specific areas for improvement, developing strategies and resources to address those areas and providing opportunities to reflect and demonstrate personal growth.
KINDERGARTEN- A one-year educational program adapted for the needs of children who will attend first grade the following year.
LICENSE- An official document which certifies that a licensee has been granted permission by the State to operate an early childhood program in accordance with the provisions of the law and regulations of the department.
LICENSED SPACE- The indoor and outdoor space approved by the Division as usable space where children may be present.
LICENSEE- The person, corporation or other legal entity named on the license certificate as having received the license and who is responsible for maintaining compliance with the regulations.
NON-RECURRING SERVICES- Early childhood programs designed to meet the short-term needs of families arising from tourism, recreation or shopping.
PARENT - A child's parent or legal guardian.
PARENT EDUCATION PROGRAM - A program which provides an intentional level of training and supervision for parents in order for them to actively assist in the implementation of an early childhood program.
PARENTAL NOTIFICATION LETTERS - A written notification from the licensee to the parent(s), sent by mail, as required by 33 V.S.A. § 306(7) indicating that a staffing or serious health or safety violation had been identified by the Division.
PLAY GROUP- An educational and socialization opportunity for children and their parents (or caregivers). Playgroups are exempt from licensure.
PRIMARY STAFF PERSON - The staff person responsible for facilitating and nurturing a child's cognitive, social, emotional and physical growth and development and the person responsible for communicating the child's daily activities to the child's parent.
PROFESSIONAL DEVELOPMENT ACTIVITY- Interactive developmental activities in the areas of: child development, learning environments, effective teaching and nurturing, parent partnership, ethics and professional behavior, program management, child health, prevention and safety. These activities include but are not limited to workshop training sessions, course work, site visit to other programs, a mentoring session, lecture/presentation, or acting as a member of an Early Childhood Program Assessment Team assessing compliance to these regulations.
PROGRAM DIRECTOR- The person responsible for managing the program design and curriculum.
PROVISIONAL LICENSE- A non-renewable license issued by the department for a period of not more than one year to an applicant who has submitted an application for the licensure of a facility not previously licensed. A provisional license may be issued if the Department finds that an applicant's facility, staff, program, or other matter is not in full compliance with these regulations, but is likely to achieve full compliance within a pre-determined time period set by the Division, not to exceed one year.
RECREATION PROGRAMS - Programs exempt from licensure pursuant to 33 V.S.A. § 3502(b) that operate for no more than four hours one day a week or not more than two hours two days a week whose primary function is other than the care, supervision and protection of children; or operate 13 consecutive weeks or less which provide a variety of activities including, but not limited to athletics, and arts and crafts to children who have completed kindergarten or who will reach their sixth birthday by September 1st of the enrollment year; or operate part day programs less than four hours per day and thirteen weeks or less per year providing a variety of activities including but not limited to athletics, arts or crafts and socialization to children age three, four and five; or programs which provide for the development of a single skill based on activity such as skiing, pottery making, computer operation, tennis or musicianship for children ages four years and older.
REGISTERED CHILD CARE APPRENTICE - A child care employee who is formally registered with the Vermont Department of Employment and Training and Vermont Apprenticeship Program. The 4000 hour on-the-job work experience includes 6 college courses. The apprentice works in an Accredited child care program that chooses to sponsor the apprenticeship program.
REVOCATION- The formal act of removing a license to operate an Early Childhood Program or facility due to violations of these regulations or related statute. (A facility may continue to operate during a revocation action pending an appeal to the Human Services Board.)
SERIOUS VIOLATION- A violation of group size, staffing requirements or series of violations which immediately imperils the health, safety or well-being of children. Serious violations may also include corporal punishment, lack of supervision, physical or sexual abuse or health and safety requirements.
STAFF- Persons who have direct responsibilities for the operation of the program or the care and education of children.
SPECIAL NEEDS CHILD- A person under the age of nineteen (19) who is eligible for special education services in accordance with an Individualized Education Plan (IEP) or 504 Plan and who is not capable of safely caring for him/herself; or (b) A person who is age 13 or older who has a documented physical, emotional, or behavioral condition that precludes the person from providing self-care or being left unsupervised, as verified by the written report of a physician, licensed psychologist, or court records.
SUPERVISION OF CHILDREN- The knowledge of and accounting for the activity and whereabouts of each child in care and the proximity of staff to children at all times assuring immediate intervention of staff to safeguard a child from harm.
SUSPENSION- The formal act of immediately removing a license to operate due to the immediate imperilment of the health, safety or well being of a child.
TERMS OF THE LICENSE - The location, number and ages of children, hours and days of operation and expiration date listed on the license certificate issued by the Department or by subsequent Departmental action.
USEABLE SPACE- The space described by the application, which has been inspected and approved by the Division. All other space is not useable space.
VARIANCE- An exception to a regulation granted by the Commissioner in circumstances when, in his/her judgment, the literal application of a regulation would result in unnecessary hardship and when the intent of the regulation can be achieved by other means.
VERMONT FRAMEWORK OF STANDARDS AND LEARNING OPPORTUNITIES - Standards developed by the Vermont Department of Education to provide practical, useful reference points for the development of local curriculum and assessment. The Standards identify (1) essential knowledge and skills that the Vermont Department of Education expect to be taught and learned in schools and (2) behaviors and attitudes related to success in and out of schools.
Knowledge about how children learn is the foundation of program design and curriculum. A program's curriculum is developmentally appropriate when it stimulates learning at both the developmental level of the group and the stage of development of each individual child. Children should select and participate in activities that are both challenging and geared for success. Learning programs should be designed to provide a balance between individual and group needs, between teacher-directed and child-selected activities, and between active and quiet times. Program activities should include experiences designed to celebrate the diversity of all children and families.
The curriculum * shall promote:
* This may be linked to the Vermont Framework of Standards and Learning Opportunities.
Note: Considerations for computer use in early childhood programs:
-- Select programs which are developmentally appropriate, instructional and within the child's ability.
-- Develop clear and simple rules on the use of the computer, sharing and time limits.
-- Instruct children in basic use of computer including start up, shut down and running programs.
-- Provide a stable workstation that won't tip over.
-- Place computer and all electrical equipment near a power source to limit extension cord use, but away from any water source.
-- Bundle cords together so as to minimize hazards.
-- Place monitor at eye level of users. Keyboard and mouse should be easily reachable by children.
Note: Be mindful to supervise lofts, playhouses and other locations carefully when it is difficult to visually supervise children. Inadequate supervision is a leading factor contributing to accidents, injuries and inappropriate touching among children.
Children's Ages | Maximum in Group | Staff:Child |
6 weeks - 23 months | 8 | 1:4 |
24 - 35 months | 10 | 1:5 |
3 years - kindergarten | 20 | 1:10 |
1st Grade - 15 years | No Maximum | 1:13 |
Note: Public School kindergartens are exempt from licensure.
Note: Assessment helps shape teaching practice, supports children's strengths and abilities and is respectful of the many ways that children learn.
The quality of any program for young children is largely determined by the knowledge, experience, and training of it's staff. A ll program staff who work with children and families, need to have, and to continue receiving as part of their jobs, knowledge of child development and early education, supervised experience in working with young children, and continuing opportunities to improve their practice and increase their understanding of young children and families. Time to permit and invite reflection, inquiry, and self-study should be made part of every program design.
Consistency is also vital on the levels of administration and day-to-day contact with children and families. Consistency and stability are essential for every child's early learning. Children and families who are building trust in others need to have a consistent relationship with a staff member who is aware of and sensitive to the individual child's personality, interests, and needs. People who work with young children should consistently provide support for early learning and should make a steady effort to interact in positive ways with children, parents, and other staff. A dministrators must provide the consistent and appropriate leadership that is vital for their program's continuity and quality of services.
Note: The standards and practices listed here are minimum qualifications and criteria for licensing purposes. Requirements for individual programs may vary and exceed licensing requirements.
Position: Master Teacher
Qualifications: Master's degree in early childhood or in human/child development or a related field and a minimum of two years (may be school years of experience if the experience is in a school) successful experience with the ages of children specified by the terms of the license or appropriate licensure from the Vermont Department of Education.
Annual Professional Development Requirement: Minimum of 12 (clock) hours of Professional Development Activities which may be applied toward meeting the Master Teacher's Individual Professional Development Plan (IPDP), as defined by the Department of Social and Rehabilitation Services, the Local Standards Board or the Professional Standards Board of the Department of Education.
Position: Teacher
Qualifications: Bachelor's degree in early childhood or human/child development or a related field; which includes one year (may be school year of experience if the experience is in a school) of successful experience with the ages of children specified by the terms of the license or appropriate licensure from the Vermont Department of Education.
Annual Professional Development Requirement: Minimum of 12 (clock) hours of Professional Development Activities which may be applied toward meeting the Teacher's Individual Professional Development Plan (IPDP), as defined by the Department of Social and Rehabilitation Services, the Local Standards Board, or the Professional Standards Board of the Department of Education.
Position: Teaching Associate
Qualifications: Associate Degree in early childhood or human/child development or related field; or Child Development Associate (CDA); or child care certificate from Community College of Vermont and two (2) years of successful experience with groups of young children; or child care professional certification certificate of completion from a human services program emphasizing child development/early childhood education and approved by the State Board of Education; or three years of successful experience with groups of children and successful completion of four higher-education courses (minimum 12 credits) in topics related to early childhood education; or obtained a Certificate of Completion from the Registered Child Care Apprenticeship Program.
Annual Professional Development Requirement: Minimum of 12 (clock) hours of Professional Development Activities, which may be applied toward meeting the Teaching Associate's Individual Professional Development Plan (IPDP).
Position: Teaching Assistant
Qualifications: High school diploma or equivalent, at least 18 years of age and completion of a 30 hour course in child development approved by the Division, or one higher education course (minimum 3 credits) in early childhood development to be successfully completed within one year of employment.
Annual Professional Development Requirement: Minimum of 12 (clock) hours of Professional Development Activities, which may be applied toward meeting the Teaching Assistant's Individual Professional Development Plan (IPDP).
Position: Trainee
Qualifications: At least 17 years of age and enrolled in or graduated from a human services program that emphasizes child development at a technical center approved by the State Board of Education.
An effective early childhood program implements best practices through well-defined policies and procedures that guide all aspects of the program's operations. Four essential elements of leadership and organization are:
Policies and Procedures: Written policies and procedures can ensure consistency and equity in all areas of program management when they are understood by staff and families and are evaluated routinely.
Organizational Structure and Job Descriptions: An organizational chart should be accompanied by position descriptions that include supervision and evaluation responsibilities.
Staff Development: All staff should be provided with professional development activities.
Note: If municipal zoning is required and the facility site is on a state highway then an access permit may be required from the Utilities and Permit Unit, Technical Services Division of the Agency of Transportation, 828-2653.
Note: Best Practice is to encourage parents first to address concerns and/or complaints with the child's primary staff person and/or program director.
Note: The immunization form may be a photocopy of the child's original immunization record.
The immunization form must attest that the child has been immunized in accordance with the schedule of immunization determined by the Vermont Department of Health, or a statement which attests that:
Note: Programs need not have immunization records for children who are attending on a non-recurring basis.
Note: Cordless phone conversations may be overheard by third parties. The use of digital cordless phones with ratings of 900mhz or 2.4ghz minimize opportunities for calls to be overheard.
Parents play the primary, critical role in supporting their children's growth and development. Effective early childhood programs include parents as partners in the planning, implementation, and evaluation of day-to-day activities. Programs build and support this partnership. - They provide continuity and consistency with children's home lives when they offer a variety of meaningful opportunities for parents to participate and when they communicate regularly with parents and others who are significantly involved with the children.
Practices are family-centered when they show respect for the family's role in children's lives and acknowledge the impact of parents and other family members as children's first and most influential teachers.
Effective programs acknowledge and accommodate, as much as possible, the diversity in today's family structures and backgrounds. Program staff invite parents to approach them with any concerns or suggestions. Confidentiality is always respected.
For children to develop and learn, their health and safety must be protected. Any situation that is unhygienic, is physically hazardous, or exposes children to contagious illness can endanger their well-being, sometimes with permanent effect.
Self-Monitoring: All early childhood programs should check every day for health and safety hazards, taking immediate action whenever necessary.
Prevention: Programs should take a preventive approach to health and safety, emphasizing positive practices that minimize the need for intervention, treatment, or corrective action by outside agencies. Developing policies and procedures to promote positive practices, as well as outlining actions to be taken if an emergency or an unsafe situation appears, will do a great deal to prevent problems from becoming serious when they do occur. All staff should be fully informed that they share responsibility for ensuring that the children's environment is healthy and safe.
Community Services: Limited program resources make it unrealistic to expect that every program will be equipped to deal with all the needs that face today's children and families. But staff should be knowledgeable about community services and resources that can supplement those of the program. By providing resource and referral services to families in such areas as health, nutrition, social services, and transportation, programs can help knit together a unified early childhood system.
-- Fire
-- Police
-- Ambulance
-- Poison Center
-- 911, address and directions to facility
-- District Social Services office (for reporting suspected child abuse or contacting social workers serving families of children in care)
-- Parents home and work
-- Emergency contacts for each child
-- Child's heath care provider and dentist
-- Child Care Services Division 1-800-649-2642
-- wads of paper
-- push pins
-- buttons
-- crayon pieces
-- coins
-- small parts of toys
-- tiny stones
-- marbles
-- balloons
Note: National Health and Safety Performance Standards recommend minimal dimensions as 1 1/4 inch in diameter and 2 1/4 inch long. Any part smaller than this is a potential choking hazard. Children occasionally choke on toys or toy parts that meet Federal Standards. Staff should be always vigilant.
Note: On June 28, 1999, the Vermont Department of Health and the Department of Social and Rehabilitation Services issued a Model Animal Policy for Early Childhood Programs. For copies call state public health veterinarian at 1-800-640-4374
Note: Elements of loft safety
-- Enclosing the platform by solid, clear plastic sides or by vertical rails not more than 3 1/2 inches apart.
-- Children know rules for loft play.
-- A single, identified staff person is responsible for supervision of children in loft area.
-- There are no props in loft areas upon which children could stand to achieve a height whereby the top railing is below their chests.
-- Lofts do not interfere with sprinkler systems.
Safety Note: Falls from playground equipment are the leading cause of injuries to children in early childhood programs.
* U.S. Congress. Office of Technology Assessment 1995
Note: When considering a product for disinfecting, the solution must be safe for food service and children who mouth toys.
Note: Since children spend much of their time on the floor, and engage infrequent hand-to-mouth behavior, floors need to be maintained properly. Ideally vacuums with power heads and double lined paper inserts or HEPA filters should be used to get soils out.
[See graphic or tabular material in printed version]
-- easy reference first aid manual
-- adhesive tape
-- bandages
-- scissors
-- safety pins
-- sealed packets of alcohol wipes or antiseptic
-- sterile gauze
-- rolls of gauze bandages
-- thermometer
-- tweezers
-- cold pack
-- disposable nonporous gloves
-- syrup of ipecac
This kit shall be replenished as supplies are used or as expiration date(s) indicate.
-- staff member has an open cut, sore or cracked skin
-- the child has an open area on his/her skin
-- the child has a known infection that is spread through the feces
Note: Pregnant women or women considering pregnancy may want to wear gloves when changing diapers in order to minimize contact with cytomegalovirus or other germs.
-- upon arrival
-- before eating
-- after using the toilet or having their diaper changed
-- after handling animals
-- after playing outside
-- upon arrival at the facility
-- before preparation of food or bottles
-- before feeding a child
-- after diapering a child
-- after using the toilet or helping a child use the toilet
-- after cleaning up after a sick child or injured child
-- after handling items soiled with blood or body fluids
-- after handling animals
-- before and after giving medication
Note: Intact skin is the best protection against infection. Use of lotion after frequent handwashing helps protect skin from drying, chapping, and cracking. Pump-type dispensers are recommended.
Note: Universal precautions means treating all blood and other body fluids (saliva, nose and eye discharges, vomit, urine, feces) as potentially infectious.
Prescription Medications
Non Prescription Medications
Note: Chemical repellents may provide protection against ticks and insects that can transmit diseases. When used improperly, however, repellents may pose a risk of adverse health effects.
Note: The food groups are:
- milk and milk products
- fruits and vegetables
- meat and meat alternatives
- bread and bread alternatives
For Example:
- cut whole grapes in half lengthwise
- cut carrots into thin strips
- spread peanut butter thinly on crackers
The following subsection is pursuant to ACT 165 and pertains only to buildings constructed before 1978.
-- roofs
-- chimneys
-- interior and exterior walls
-- doors
-- skylights
-- windows
-- floors
-- ceilings
-- stairways
-- ramps
-- porches
-- before children arrive
-- every four hours
-- before the mixing of juices or preparing any other food or drink, and
* Flush Sampling - running the cold water wide open for a period of two minutes.
-- for non-school aged children at least 1 staff for every two children swimming.
-- for school aged children at least 1 staff for every 6 children swimming.
-- Children under one year shall face the rear in safety seats rated to at least 20 lbs.
-- Children 20-40 lbs., and over one year,_shall be secured in a 20-40 lbs. safety seat facing forward.
-- Children over 40 lbs. and under five years of age shall use a booster seat.
-- Children shall not be placed in front seat with a functioning air bag.
-- All other passengers, including the driver, shall be secured in a safety belt or lap and shoulder belts if available.
Private vehicles used to transport, to or from school, fewer than eleven persons (including the operator) for compensation are considered school buses under Vermont law and therefore must comply with operator licensing and equipment requirements of Title 23, VSA. (For more information about these requirements contact the Vermont Department of Motor Vehicles, Education and Safety Unit at 828-2053)
-- 1 - 6 children, 1 staff person
-- 6 - 12 children, 2 staff persons
Note: Program administrators should be aware of the National Highway Transit Safety Administration requirements when leasing or purchasing a new vehicle which will be used primarily for transporting children to or from school. When vehicles are primarily used to transport children to or from school dealers are required by law to sell or lease only buses that meet Federal Safety Standards for school buses.
Note: It is in everyone's best interest to reduce potential exposure of children to pesticides. Pesticides are designed to kill living organisms; therefore they pose special risks to children. Children play or sit on or near the ground and engage in hand to mouth behaviors. They also have developing organ systems that may not detoxify poisons as adults do. The best method to reduce pests and the possible need for pesticide application includes proper sanitation practices and habitat prevention steps
Note:
-- Integrated Pest Management (IPM) is an environmentally sensitive approach to pest management. IPM uses knowledge of pest life cycles and their interactions with the environment in addition to the judicious use of pesticides.
-- Risk depends upon hazard (toxicity) and exposure. A measure of hazard to humans and other mammals is provided by signal words on pesticide labels. The most toxic are labeled DANGER, followed by WARNING. The least toxic are labeled CAUTION.
A clear relationship between each early childhood program and the Child Care Services Division is important in promoting safe, quality early care and education experiences for young children. It is the Division's responsibility to put forth a set of clear rules that define minimal, acceptable standards. These standards are created collaboratively with other agencies that serve children, parents, child care providers and advocates for child health and development. It is the licensee's responsibility to meet these standards. In order for a healthy and trusting relationship to exist between the licensee and the Division, the licensee must have an understanding of the consequences when the Division believes there is noncompliance to regulations. This section sets forth these sanctions.
Appendix A
Excerpts of Vermont Statutes Annotated Relevant to the Licensing of Early Childhood Programs
*The following are incorporated here by reference only:
3 V.S.A. § 814. Licenses.
15 V.S.A., Chapter 11, § 795. Licenses or governmental contracts Child Support
18 V.S.A. § 1751. Definitions--Childhood Lead Poisoning Prevention Prevention
18 V.S.A. § 1759. Essential maintenance practices
18 V.S.A. § 1761. Duty of reasonable care; negligence; liability
21 V.S.A. § 251a. Definitions - Public Building
24 V.S.A. § 4409. Limitations - Zoning
32 V.S.A. § 3113. Requirements for obtaining license or governmental contract - Taxes
33 V.S.A. § 306. Administrative provisions Licenses Issued by SRS
33 V.S.A. § 309. Access to records - Records Checks
33 V.S.A. § 3502. Day care facilities - Exemptions
33 V.S.A. § 3503. Corporal punishment prohibited for reporting child abuse/neglect
33 V.S.A. § 4902. Definitions
33 V.S.A. § 4920. Retaliatory action by employer prohibited
Appendix B
Healthy Child Care Vermont
October 1999
Inclusion And Exclusion Of Ill Children in Child Care
Guidelines For Common Signs And Symptoms, Illnesses And Conditions related to Contagious Diseases
These guidelines have been reviewed by the American Academy of Pediatrics, Vermont Chapter and the Vermont Department of Health, however, they are not a substitute for the advice of the child's doctor. For more details about specific infections, refer to the The Red Book, Report of the Committee on Infectious Diseases by the American Academy of Pediatrics (1997) or the ABCs of Safe and Healthy Child Care: A Handbook for Child Care Providers by the Centers for Disease Control and Prevention (1996.)
Parents and child care providers share the responsibility for maintaining health and preventing the spread of contagious diseases. By including illness-prevention practices in daily routines, caring adults can limit the spread of infections. These include:
[] Parents have their children receive immunizations according to the Vermont Immunization schedule unless exempted for medical, religious or moral reasons.
[] Child care providers have clearly stated policies & procedures for:
* checking children's immunization status and helping parents know when their children need immunization;
* preventing and handling illness that includes universal precautions, hand washing, diapering, and cleaning & disinfecting;
* identifying an ill child or child care provider;
* informing parents that their child is ill; and
* routinely informing all families whenever a highly infectious condition or disease, such as head lice, measles, or chickenpox occurs in a child care program without compromising the confidentiality of the individual child(ren) with the condition or disease. This is especially important information for children or other members of families with weakened immune systems. As well some conditions or diseases are harmful to pregnant women.
[] Parents have a plan for caring for their child when he or she is ill and cannot attend child care such as providing their child care provider with up-to-date emergency phone numbers, promptly picking up their ill child and consulting with their child's doctor about diagnosis and care when the ir child is ill.
[] Child care providers keep all medical information confidential and do not disclose this information to others without written parental consent. To promote confidentiality all medical information should be kept in a locked file, never faxed, and medically related documents that are to be mailed are marked confidential.
Get Medical Help Immediately For A Child With Any Of The Following Conditions
[] Specific fevers:
. A baby less than 2 months of age has a temperature of 100.4 [degrees] (rectal)
. A temperature of 104 [degrees] F (oral) in any age child
[] For infants under 2 months, forceful vomiting with every feeding
[] Looking or acting very ill or getting worse quickly
[] Neck pain when the child's head is moved or touched
[] A stiff neck or severe headache and looking very sick
[] A seizure for the first time
[] Acting unusually confused
[] Pupils (black centers of the eyes) unequal
[] A blood-red or purple rash made up of pinhead sized spots or bruises that are not associated with injury
[] A rash of hives or welts that appears and spreads quickly
[] Breathing so fast or so hard that the child cannot play, talk, cry or drink
[] A severe stomachache that causes the child to double up and scream
[] A stomachache without vomiting or diarrhea after a recent injury, blow to the abdomen or hard fall
[] Stools that are black or have blood mixed through them
[] Not urinating at least once in 8 hours, a dry mouth, no tears or sunken eyes
[] Continuous clear drainage from the nose after a hard blow to the head
Inclusion and Exclusion of Ill Children in Child Care
Guidelines for Common Signs and Symptoms, Illnesses and Conditions related to Contagious Diseases
Signs and symptoms child care providers observe | What a child care provider should do | What needs to happen in order for a child to return to child care |
I. The ill child is unable to take part comfortably in regular activities | Exclude | The child is able to participate in activities |
II. The ill child needs care that significantly interferes with provider's ability to provide appropriate care for other children | Exclude | When the level of care needed does not interfere with the provision of appropriate care for the other children |
III. The child has signs or symptoms of a possible serious condition | Exclude | Return after seen by the child's doctor who says child may return |
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help. | ||
Get Medical Help Immediately For A Child With Any Of The Conditions Listed on Page | ||
2 | ||
IV. A child has signs or symptoms that indicates a contagious illness or condition or has a diagnosed contagious illness or condition n1 | Refer to Sections IV A through E |
n1 A child with a weakened immune system, such as a child undergoing cancer treatment or a child with HIV, may need to be excluded temporarily from child care for their own protection during an outbreak of a contagious illness or condition. They may be particularly susceptible to serious illness if infected. In this situation, the child care provider should notify the parents of the child with a weakened immune system of the occurrence of a contagious disease. The parents can then discuss with their child's doctor if it is medically appropriate to exclude their child from child care and if it is, when their child should return to child care.
IV.A. FEVER n2,n3 & BEHAVIOR CHANGE
n2 Illness is not the only cause of fever. Exercise, environmental conditions, individual variation and time of day can raise the body temperature.
n3 Doctors typically advise parents that their child can return to child care or school 24 hours after their temperature has returned to normal without the assistance of any anti-fever medication.
Signs and symptoms child care providers observe | What a child care provider should do | What needs to happen in order for a child to return to child care |
1. A child with an axillary (armpit) temperature of 100 [degrees] F; oral (mouth) temperature of 101 [degrees] F; rectal (anus) temperature of 102 [degrees] F; or greater and behavior change | Exclude | The child has been seen by or the parent has communicated with the child's doctor who says child may return |
2. Under 2 months old with temperature 100.4 [degrees] F or higher rectal (anus) | Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help. | Return after seen by the child's doctor who says child may return |
Exclude | ||
3. Over 2 months old with temperature 104 [degrees] F or higher oral (mouth) | Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help. | Return after seen by the child's doctor who says child may return |
Exclude |
Signs and symptoms child care providers observe
What a child care provider should do
What needs to happen in order for a child to return to child care
1. A child with an axillary (armpit) temperature of 100 [degrees] F; oral (mouth) temperature of 101 [degrees] F; rectal (anus) temperature of 102 [degrees] F; or greater and behavior change
Exclude
The child has been seen by or the parent has communicated with the child's doctor who says child may return
2. Under 2 months old with temperature 100.4 [degrees] F or higher rectal (anus)
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help.
Return after seen by the child's doctor who says child may return
Exclude
3. Over 2 months old with temperature 104 [degrees] F or higher oral (mouth)
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help.
Return after seen by the child's doctor who says child may return
Exclude
IV.B. RESPIRATORY SIGNS & SYMPTOMS
Signs and symptoms child care providers observe | What a child care provider should do | What needs to happen in order for a child to return to child care |
1. Watery, red eyes | Observe for other symptoms and inform parents | No action needed |
2. Thick, white or yellow/green discharge from eye(s) - once | Clean eyes (from outside corner toward the nose),observe for more discharge and inform parents | No action needed |
3. Thick, white or yellow/green discharge from eye(s) - continuing n4 | Exclude | Return 24 hours after treatment is started or if no treatment is started then return when there is no longer discharge from eye(s) or return after seen by the child's doctor who says child may return |
4. Earaches (e.g., pain, tugging at ear, grinding teeth, trouble hearing) | Observe for other symptoms and inform parent | No action needed |
5. Earaches with fever and behavior change, or pain lasting more than 3 days | Exclude | Return after seen by the child's doctor who says child may return |
6. Ear drainage (with or without tubes) | Exclude | Return after seen by the child's doctor who says child may return |
7. Runny nose | Observe for other symptoms and inform parent | No action needed |
8. Sores in mouth or nose | Exclude | Return after seen by the child's doctor who says child may return |
9. Sore throat only: first complaint | Observe for other symptoms and inform parent | No action needed |
10. Sore throat with fever and/or having difficulty swallowing | Exclude | Return after seen by the child's doctor who says child may return |
If strep is documented, return after 24 hours of antibiotics | ||
12. Coughing for more than 10 days or has severe coughing spells | Inform parent and recommend child see doctor | Return after seen by the child's doctor who says child may return |
13. Wheezing (difficulty breathing, whistling sound during breathing) | Obtain immediate medical help if having difficulty breathing | Return after seen by the child's doctor who says child may return |
Exclude if child has never wheezed before; looks or acts ill or has a fever and behavior change |
Signs and symptoms child care providers observe
What a child care provider should do
What needs to happen in order for a child to return to child care
1. Watery, red eyes
Observe for other symptoms and inform parents
No action needed
2. Thick, white or yellow/green discharge from eye(s) - once
Clean eyes (from outside corner toward the nose),observe for more discharge and inform parents
No action needed
3. Thick, white or yellow/green discharge from eye(s) - continuing n4
Exclude
Return 24 hours after treatment is started or if no treatment is started then return when there is no longer discharge from eye(s) or return after seen by the child's doctor who says child may return
4. Earaches (e.g., pain, tugging at ear, grinding teeth, trouble hearing)
Observe for other symptoms and inform parent
No action needed
5. Earaches with fever and behavior change, or pain lasting more than 3 days
Exclude
Return after seen by the child's doctor who says child may return
6. Ear drainage (with or without tubes)
Exclude
Return after seen by the child's doctor who says child may return
7. Runny nose
Observe for other symptoms and inform parent
No action needed
8. Sores in mouth or nose
Exclude
Return after seen by the child's doctor who says child may return
9. Sore throat only: first complaint
Observe for other symptoms and inform parent
No action needed
10. Sore throat with fever and/or having difficulty swallowing
Exclude
Return after seen by the child's doctor who says child may return
If strep is documented, return after 24 hours of antibiotics
12. Coughing for more than 10 days or has severe coughing spells
Inform parent and recommend child see doctor
Return after seen by the child's doctor who says child may return
13. Wheezing (difficulty breathing, whistling sound during breathing)
Obtain immediate medical help if having difficulty breathing
Return after seen by the child's doctor who says child may return
Exclude if child has never wheezed before; looks or acts ill or has a fever and behavior change
n4 Conjunctivitis (or pink eye) is an infection that causes painful or itchy, red eyes. Pinkeye can be caused by bacterial or viral infections or by allergic reactions to an irritant such as dust, pollen, or other materials. Not all pink eye infections have white or yellow/green discharge. Not all pink eye infections are contagious. Antibiotics may or may not be prescribed.
IV.C. SKIN SIGNS & SYMPTOMS
Signs and symptoms child care providers observe | What a child care provider should do | What needs to happen in order for a child to return to child care |
1. Rash - first noticed and not described below | Observe for other symptoms and inform parents | No action needed |
2. Rash with fever or behavior change | Exclude | Return after seen by the child's doctor who says child may return |
3. Rash accompanied by blood red or purple rash not associated with injury | Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help. | Return after seen by the child's doctor who says child may return |
Exclude | ||
4. Rash that is oozing or is an open wound | Exclude | Return after seen by the child's doctor who says child may return |
5. Diaper rash (simple) | Air dry and inform parents | No action needed |
6. Diaper rash (withoozing sores) | Exclude | If infected, return 24 hours after treatment has started |
7. Cold sores that are oozing sores | Exclude if the child is biting, drools uncontrollably or mouths toys which other children may put in their mouths | Return when sores are no longer oozing |
8. Hives: red blotchy, itchy, raised skin rash with no blisters | Inform parents, if accompanied by difficulty breathing obtain immediate medical attention | Return when no longer having difficulty breathing |
9. Insect bites | Obtain immediate medical help if having difficulty breathing; Exclude if bites are infected | If bites are infected, return 24 hours after treatment has started |
Signs and symptoms child care providers observe
What a child care provider should do
What needs to happen in order for a child to return to child care
1. Rash - first noticed and not described below
Observe for other symptoms and inform parents
No action needed
2. Rash with fever or behavior change
Exclude
Return after seen by the child's doctor who says child may return
3. Rash accompanied by blood red or purple rash not associated with injury
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. If the parent is not available, the child care provider should contact EMS for help.
Return after seen by the child's doctor who says child may return
Exclude
4. Rash that is oozing or is an open wound
Exclude
Return after seen by the child's doctor who says child may return
5. Diaper rash (simple)
Air dry and inform parents
No action needed
6. Diaper rash (withoozing sores)
Exclude
If infected, return 24 hours after treatment has started
7. Cold sores that are oozing sores
Exclude if the child is biting, drools uncontrollably or mouths toys which other children may put in their mouths
Return when sores are no longer oozing
8. Hives: red blotchy, itchy, raised skin rash with no blisters
Inform parents, if accompanied by difficulty breathing obtain immediate medical attention
Return when no longer having difficulty breathing
9. Insect bites
Obtain immediate medical help if having difficulty breathing; Exclude if bites are infected
If bites are infected, return 24 hours after treatment has started
IV.D. GASTROINTESTINAL SIGNS & SYMPTOMS
Signs and symptoms child care providers observe | What a child care provider should do | What needs to happen in order for a child to return to child care |
1. Stomachache with no other symptoms- first complaint | Observe for other symptoms and inform parents | No action needed |
2. Stomachache -continues or increases in severity | Exclude | Pain gone |
3. Vomiting - one time and no other symptoms | Encourage child to rest; observe for other symptoms and inform parents | No action needed |
4. Vomiting - two or more times in 24 hours | Exclude | Return when vomiting resolves. A good rule of thumb is return 12 hours after last vomiting |
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation. | ||
For infants under 4 months experiencing forceful vomiting with every feeding | ||
5. Loose or watery bowel movement that cannot be contained in diaper or toilet (uncontrolled diarrhea) or Five or more loose or watery bowel movements in an 8 hour period | Exclude and recommend child see their doctor | If not yet toilet trained: . when stool is contained within diaper,. stool frequency and consistency improves If toilet trained: . must be accident-free for one day and The child has been seen by or the parent has communicated with the child's doctor who says child may return |
6. Bloody bowel movements | Exclude and recommend child see their doctor | Return after seen by the child's doctor who says child may return |
Signs and symptoms child care providers observe
What a child care provider should do
What needs to happen in order for a child to return to child care
1. Stomachache with no other symptoms- first complaint
Observe for other symptoms and inform parents
No action needed
2. Stomachache -continues or increases in severity
Exclude
Pain gone
3. Vomiting - one time and no other symptoms
Encourage child to rest; observe for other symptoms and inform parents
No action needed
4. Vomiting - two or more times in 24 hours
Exclude
Return when vomiting resolves. A good rule of thumb is return 12 hours after last vomiting
Inform parents immediately so they can talk with their child's doctor & get an immediate medical evaluation.
For infants under 4 months experiencing forceful vomiting with every feeding
5. Loose or watery bowel movement that cannot be contained in diaper or toilet (uncontrolled diarrhea) or Five or more loose or watery bowel movements in an 8 hour period
Exclude and recommend child see their doctor
If not yet toilet trained: . when stool is contained within diaper,. stool frequency and consistency improves If toilet trained: . must be accident-free for one day and The child has been seen by or the parent has communicated with the child's doctor who says child may return
6. Bloody bowel movements
Exclude and recommend child see their doctor
Return after seen by the child's doctor who says child may return
IV.E. ILLNESSES OR CONDITIONS THAT HAVE BEEN DIAGNOSED n5
n5 Those illnesses marked with an * are diseases health officials are required to report to the Vermont Department of Health. Child care providers are not required to report these diseases, however, if you have any questions call Epidemiology, Vermont Department of Health at 1-800-463-4343.
Illnesses or Conditions That Have Been Diagnosed | What a child care provider should do | What needs to happen in order for a child to return to child care |
Diarrhea diagnosed as either E.coli:0157:H7*,campylobacter*,cryptosporidiosis*, shigella*, salmonella* or giardia* | Exclude; Notify all parents and child care providers that a case of diarrhea has occurred; Urge parents of a child who has a weakened immune system to consult with their doctor | When the Health Department says it is ok to return. In addition for E.coli:0157:H7, the child must have two negative stool tests & for shigella, one negative stool tests. If diarrhea is diagnosed but is not one of these diagnoses, call the Health Department at 1-800-463-4343 and ask for Epidemiology for more information |
Chickenpox n6 | Exclude; Notify all parents and child care providers that a case of chickenpox has occurred;Urge pregnant women and parents of children who have a weakened immune system to consult with their doctor | After no new lesions are erupting and all old lesions are crusted and dry (this typically occurs 6 days after the first pox appears) |
Fifth Disease | Notify all parents and child care providers that a case of fifth disease has occurred; Urge pregnant women and parents of children who have a weakened immune, sickle cell anemia, or other blood disorder system to consult with their doctor | No action needed. By the time the rash is evident, the child is considered no longer infectious |
Haemophilus Influenzae type b (Hib)* infections | Exclude | Return when the child is well enough to return and has been on antibiotics for 24 hours. If the Vermont Department of Health recommends giving medicine to exposed children and child care provider(s), they may return after receiving medication |
Hand, foot and mouth disease (Coxsackie Virus) | Exclude if child has fever and behavior change or unable to participate | Return after seen by the child's doctor who says child may return |
Head lice n7 | Exclude; Check all children's heads daily until head lice is gone, send a general fact sheet and notification of head lice to all families which includes asking parents to check their children's head for lice daily and assure the environment is free from head lice through such measures as vacuuming carpets & upholstered furniture, etc. | Return after receives first treatment; it is recommended that the child is retreated 7 to 10 days after the first treatment since no product is 100% effective against head lice |
Hepatitis A* | Exclude; Notify all parents and child care providers that a case of Hepatitis A has occurred | Return once the Department of Health approves; immune globulin (IG) may be given to contacts within the first 2 weeks after exposure to prevent infection from spreading |
Hepatitis B* n8 | Exclude only if the child has weeping skin lesions that cannot be covered; the child has bleeding problems; or if the child is biting or scratching | Return after seen by the child's doctor who says child may return |
HIV (AIDS virus)* n3 | Exclude only if the child has weeping skin lesions that cannot be covered; the child has bleeding problems; or if the child is biting or scratching | Return after seen by the child's doctor who says child may return |
Impetigo | Exclude; Notify all parents and child care providers that a case of impetigo has occurred | Return 24 hours after treatment has started |
Measles* | Exclude; Notify all parents and child care providers that a case of measles has occurred | Return 6 days after onset of rash |
Mumps* | Exclude; Notify all parents and child care providers that a case of mumps has occurred | Return 9 days after onset of swelling |
Ringworm | Exclude; Notify all parents and child care providers that a case of ringworm has occurred | Return 24 hours after treatment has started (oral medication to treat scalp; cream given to treat skin) |
Rubella* | Exclude; Notify all parents and child care providers that a case of rubella has occurred | Return 6 days after onset of rash |
Urge pregnant women to consult with their doctor | ||
Scabies | Exclude; Notify all parents and child care providers that a case of scabies has occurred | Return 24 hours after treatment has started |
Shingles | Exclude only if sores cannot be covered | Return when sores can be covered; if that is not possible then return after sores crust over |
Strep throat or other streptococcal infection | Exclude; Notify all parents and child care providers that a case of strep throat has occurred | Return 24 hours after antibiotics treatment has started |
Tuberculosis* | Exclude if active infection with cough, fever; Notify parents of children who have a weakened immune to consult with their doctor | Return when the Department of Health has given approval |
Whooping cough (Pertussis*) | Exclude; Notify all parents and child care providers that a case of pertussis has occurred | Return 5 days after antibiotics are started or 3 weeks after onset of cough |
Illnesses or Conditions That Have Been Diagnosed
What a child care provider should do
What needs to happen in order for a child to return to child care
Diarrhea diagnosed as either E.coli:0157:H7*,campylobacter*,cryptosporidiosis*, shigella*, salmonella* or giardia*
Exclude; Notify all parents and child care providers that a case of diarrhea has occurred; Urge parents of a child who has a weakened immune system to consult with their doctor
When the Health Department says it is ok to return. In addition for E.coli:0157:H7, the child must have two negative stool tests & for shigella, one negative stool tests. If diarrhea is diagnosed but is not one of these diagnoses, call the Health Department at 1-800-463-4343 and ask for Epidemiology for more information
Chickenpox n6
Exclude; Notify all parents and child care providers that a case of chickenpox has occurred;Urge pregnant women and parents of children who have a weakened immune system to consult with their doctor
After no new lesions are erupting and all old lesions are crusted and dry (this typically occurs 6 days after the first pox appears)
Fifth Disease
Notify all parents and child care providers that a case of fifth disease has occurred; Urge pregnant women and parents of children who have a weakened immune, sickle cell anemia, or other blood disorder system to consult with their doctor
No action needed. By the time the rash is evident, the child is considered no longer infectious
Haemophilus Influenzae type b (Hib)* infections
Exclude
Return when the child is well enough to return and has been on antibiotics for 24 hours. If the Vermont Department of Health recommends giving medicine to exposed children and child care provider(s), they may return after receiving medication
Hand, foot and mouth disease (Coxsackie Virus)
Exclude if child has fever and behavior change or unable to participate
Return after seen by the child's doctor who says child may return
Head lice n7
Exclude; Check all children's heads daily until head lice is gone, send a general fact sheet and notification of head lice to all families which includes asking parents to check their children's head for lice daily and assure the environment is free from head lice through such measures as vacuuming carpets & upholstered furniture, etc.
Return after receives first treatment; it is recommended that the child is retreated 7 to 10 days after the first treatment since no product is 100% effective against head lice
Hepatitis A*
Exclude; Notify all parents and child care providers that a case of Hepatitis A has occurred
Return once the Department of Health approves; immune globulin (IG) may be given to contacts within the first 2 weeks after exposure to prevent infection from spreading
Hepatitis B* n8
Exclude only if the child has weeping skin lesions that cannot be covered; the child has bleeding problems; or if the child is biting or scratching
Return after seen by the child's doctor who says child may return
HIV (AIDS virus)* n3
Exclude only if the child has weeping skin lesions that cannot be covered; the child has bleeding problems; or if the child is biting or scratching
Return after seen by the child's doctor who says child may return
Impetigo
Exclude; Notify all parents and child care providers that a case of impetigo has occurred
Return 24 hours after treatment has started
Measles*
Exclude; Notify all parents and child care providers that a case of measles has occurred
Return 6 days after onset of rash
Mumps*
Exclude; Notify all parents and child care providers that a case of mumps has occurred
Return 9 days after onset of swelling
Ringworm
Exclude; Notify all parents and child care providers that a case of ringworm has occurred
Return 24 hours after treatment has started (oral medication to treat scalp; cream given to treat skin)
Rubella*
Exclude; Notify all parents and child care providers that a case of rubella has occurred
Return 6 days after onset of rash
Urge pregnant women to consult with their doctor
Scabies
Exclude; Notify all parents and child care providers that a case of scabies has occurred
Return 24 hours after treatment has started
Shingles
Exclude only if sores cannot be covered
Return when sores can be covered; if that is not possible then return after sores crust over
Strep throat or other streptococcal infection
Exclude; Notify all parents and child care providers that a case of strep throat has occurred
Return 24 hours after antibiotics treatment has started
Tuberculosis*
Exclude if active infection with cough, fever; Notify parents of children who have a weakened immune to consult with their doctor
Return when the Department of Health has given approval
Whooping cough (Pertussis*)
Exclude; Notify all parents and child care providers that a case of pertussis has occurred
Return 5 days after antibiotics are started or 3 weeks after onset of cough
n3 Doctors typically advise parents that their child can return to child care or school 24 hours after their temperature has returned to normal without the assistance of any anti-fever medication.
n6 Chickenpox is usually mild, but it can be severe, especially among infants, adults and people with weak immune systems. Many people are not aware that in the U.S. every year there are approximately 100 deaths and 10,000 hospitalizations from chickenpox. The majority of deaths and complications occur in previously healthy individuals. (Dr. Bill Atkinson, CDC, 1999)
n7 The Department of Health recommends the use of a "No Nit" policy as a last resort when all other outbreak control measures have been tried.
n8 Informing child care and school personnel of a child's Hepatitis B or HIV status is not required. Because all children with Hepatitis B or HIV will not be identified, policies and procedures should be established to manage potential exposures to blood or blood-containing materials. Children with Hepatitis B or HIV should be admitted without restriction to child care facilities and schools. "Issues related to Human Immunodeficiency Virus Transmission in School, Child Care, Medical Settings, the Home, and the Community," Pediatrics, vol. 104, no.2, August 1999
References
American Academy of Pediatrics. Common Childhood Infection Guidelines for Parents. (1999.) Elk Grove, Illinois: American Academy of Pediatrics.
Centers for Disease Control and Prevention. ABCs of Safe and Healthy Child Care: A Handbook for Child Care Providers. (1996.) Washington, D.C.: Public Health Foundation.
Committee on Infectious Diseases. 1997 Red Book: Report of the Committee on Infectious Diseases. (24th ed.) (1997.) Elk Grove, Illinois: American Academy of Pediatrics.
Committee on Pediatric AIDS and Committee on Infectious Diseases. Issues Related to Human Immunodeficiency Virus Transmission in Schools, Child Care, Medical Settings, the Home, and Community. Pediatrics, vol. 104, no. 2, August 1999.
Healthy Child Care Vermont. Infection Control Practices Tipsheets. (1999.) Burlington, Vermont: Vermont Department of Health.
Pennsylvania Chapter, American Academy of Pediatrics. Model Child Care Health Policies. (3rd edition.) (June 1997.) Washington, D.C.: National Association for the Education of Young Children.
Pennsylvania Chapter, American Academy of Pediatrics. Preparing for Illness: A Joint Responsibility for Parents and Caregivers. (3rd edition.) (January 1997.) Washington, D.C.: National Association for the Education of Young Children.
Appendix C
Healthy Child Care Vermont
October 2000
Guidelines for Diapering n9
n9 Adapted from Diapering Procedure, Minnesota Child Care Health Consultants Group, 8/97
Diapering provides a wonderful opportunity to engage in special individual communication with a child and the entire process should be a positive one. Always maintain a pleasant attitude while changing a child's diaper, never show disgust or scold a child who has had a loose bowel movement.
Having the diapering area sink in the same room as the handwashing sink, close to the handwashing sink and away from where food is being prepared and eaten helps prevent the spread of infectious diseases.
Preparation | |
Assemble supplies (within reach) | * clean diaper |
* wipes or moistened paper towels | |
* gloves, when used | |
* clean clothes & child's own supply of ointment if needed | |
Diapering surface | * the diapering surface should be smooth, nonabsorbent, and easy to clean. |
Gloves may be used | * gloves should be worn if: |
Reminder: gloves are not a substitute | ==> you have open cuts, sores or cracked skin |
for handwashing and hands must be | |
washed after removing gloves | ==> if there is visible blood in the feces |
==> if you are changing the diaper of a child with diarrhea | |
or a known infection that is spread through feces | |
==> if the child has open areas on the skin | |
* pregnant women or women considering pregnancy may want to wear gloves when changing diapers | |
Dirty Phase | |
Place child on diapering surface | * keep one hand on child entire time |
* keep others away from diapering area | |
* remove child's clothing, put soiled clothing without rinsing in a plastic bag to give to parent | |
Remove soiled diaper | * roll diaper inward; place diaper directly into a waste container (used only for soiled diapers) that has a tight cover, is lined with a disposable plastic trash bag, and is within arm's reach of the diapering changing area |
*see end of tipsheet for more information on the use of cloth diapers | |
* use the child's own disposable wipes | |
Cleanse diaper area of child | * cleanse from front to back and include skin creases using a fresh wipe each time |
* place wipes in waste container or out of child's kick space/reach | |
Remove gloves if used | * place gloves in waste container or out of child's kick space/reach |
Wipe hands with a premoistened disposable wipe | * place wipe in waste container or out of child's kick space/reach |
Clean Phase | |
Put on ointment as directed by parent | * use clean glove or swab to apply, then |
take off and place glove in waste container; each child should have their own supply of ointment | |
Diaper and dress child Wash child's and your hands | * return child to activity |
Clean Up | |
Dispose of soiled items | * if not already done, put diaper, wipes, or paper towels, changing paper, gloves (if used) and cotton swab (if used) into waste container (refer to end of tipsheet for more information on the use of cloth diapers) |
Clean and disinfect | * diapering surface and all equipment or supplies touched. Allow surfaces to air-dry |
Wash hands | * thoroughly with soap and warm running water for at least 15 seconds |
Communicate | |
Record | * diaper change |
Report | * concerns to parent such as unusual color, odor, frequency or consistency of stool, rash, etc. |
Preparation
Assemble supplies (within reach)
* clean diaper
* wipes or moistened paper towels
* gloves, when used
* clean clothes & child's own supply of ointment if needed
Diapering surface
* the diapering surface should be smooth, nonabsorbent, and easy to clean.
Gloves may be used
* gloves should be worn if:
Reminder: gloves are not a substitute
==> you have open cuts, sores or cracked skin
for handwashing and hands must be
washed after removing gloves
==> if there is visible blood in the feces
==> if you are changing the diaper of a child with diarrhea
or a known infection that is spread through feces
==> if the child has open areas on the skin
* pregnant women or women considering pregnancy may want to wear gloves when changing diapers
Dirty Phase
Place child on diapering surface
* keep one hand on child entire time
* keep others away from diapering area
* remove child's clothing, put soiled clothing without rinsing in a plastic bag to give to parent
Remove soiled diaper
* roll diaper inward; place diaper directly into a waste container (used only for soiled diapers) that has a tight cover, is lined with a disposable plastic trash bag, and is within arm's reach of the diapering changing area
*see end of tipsheet for more information on the use of cloth diapers
* use the child's own disposable wipes
Cleanse diaper area of child
* cleanse from front to back and include skin creases using a fresh wipe each time
* place wipes in waste container or out of child's kick space/reach
Remove gloves if used
* place gloves in waste container or out of child's kick space/reach
Wipe hands with a premoistened disposable wipe
* place wipe in waste container or out of child's kick space/reach
Clean Phase
Put on ointment as directed by parent
* use clean glove or swab to apply, then
take off and place glove in waste container; each child should have their own supply of ointment
Diaper and dress child Wash child's and your hands
* return child to activity
Clean Up
Dispose of soiled items
* if not already done, put diaper, wipes, or paper towels, changing paper, gloves (if used) and cotton swab (if used) into waste container (refer to end of tipsheet for more information on the use of cloth diapers)
Clean and disinfect
* diapering surface and all equipment or supplies touched. Allow surfaces to air-dry
Wash hands
* thoroughly with soap and warm running water for at least 15 seconds
Communicate
Record
* diaper change
Report
* concerns to parent such as unusual color, odor, frequency or consistency of stool, rash, etc.
* --checkmark
When Using Cloth Diapers
Diaper Pails
* Each family should have their own family-labeled diaper pail that is lined with a plastic bag, can be easily cleaned and has a tight fitting lid.
* The contents of the family-labeled diaper pails are sealed at the end of the day and taken home.
* At the end of each day, all diaper pails are cleaned with soap and water, disinfected and a new plastic liner placed in the pail.
* Diaper service pick-ups can occur at the child care. This pick-up service must occur at least twice weekly.
* Common diaper receptacles for children using the same diaper service can be used as long as pick-up by the diaper service occurs at least twice weekly, the contents are sealed at the end of each day and a new or cleaned and disinfected diaper pail is used each day.
Soiled Diapers
* Change the outer diaper covering and inner lining together with each diaper change. Don't reuse outer covering till laundered.
* Place soiled diapers (with or without feces) directly into diaper pail, do not shake out or rinse feces. Urine-soiled and feces-soiled cloth diapers may be stored in the same diaper pail.
* The child care can be responsible for shaking out feces-soiled diapers if required by the diapering service. This will be done at the end of the day after all the children have left. Rubber gloves should be worn when shaking out diapers and the toilet area disinfected after finished.
Appendix D
Record of Pesticide Application
EPA Registration | Date(s) of | Location of | Pests | ||
Product Name | Number | Amount Used | Application | Application | Treated For |
EPA Registration
Date(s) of
Location of
Pests
Product Name
Number
Amount Used
Application
Application
Treated For
NOTE: These records shall be available for inspection by parents and prospective parents during operating hours.
13-008 Code Vt. R. 13-162-008-X
AMENDED: October 7, 1996 (Secretary of State Rule Log # 96-59)
February 27, 2001 (Secretary of State Rule Log # 01-7)