Licensing Standards for DayCare Centers

Section L
Care of Mildly-Ill Children

L.(1) Written policies shall include information regarding the care of mildly-ill children, such as emergency procedures, inclusion and exclusion of the child from the program, separation from the group, requirements for notifying parents and health authorities and recording information regarding the illness.

L.(2) The center shall not be required to exclude from care a child with minor illness unless one or more of the following conditions exists:

L.(2)(a) The illness prevents the child from participating comfortably in program activities;

L.(2)(b) Staff is unable to provide adequate care to mildly-ill children without compromising the health and safety of the other children;

L.(2)(c) The child has any of the following conditions:

L.(2)(c)(i) Fever (until medical evaluation indicates inclusion): Temperature for children younger than four months old is greater than or equal to one hundred and one degrees Fahrenheit rectal (one hundred degrees Fahrenheit axillary). Temperature for children four months old through twenty-four months old is greater than or equal to one hundred and two degrees Fahrenheit rectal (one hundred and one degrees Fahrenheit axillary). Temperature for children twenty-four months old or older is one hundred and two degrees oral or axillary;

L.(2)(c)(ii) Symptoms of possible severe illness, such as unusual lethargy, irritability, persistent crying, difficulty breathing, or other unusual signs until medical evaluation indicates inclusion;

L.(2)(c)(iii) Uncontrolled diarrhea, increased number of stools, increased stool water and/or decreased form that is not contained by the diaper or toilet use; until diarrhea stops;

L.(2)(c)(iv) Vomiting illness, two or more episodes of vomiting in the previous twenty-four hours: until vomiting resolves or physician determines it to be non-communicable and the child is not in danger of dehydration;

L.(2)(c)(v) Mouth sores with drooling unless a physician or health official determines the condition as non-infectious;

L.(2)(c)(vi) Rash with fever or behavior change: until a physician determines that it is not a communicable disease;

L.(2)(c)(vii) Purulent conjunctivitis (pink eye): defined as pink or red conjunctiva with white or yellow eye discharge: until evaluated and treated;

L.(2)(c)(viii) Scabies, head lice or other infestation: until twenty-four hours after treatment has been initiated;

L.(2)(c)(ix) Tuberculosis: until physician or health official states child can attend facility;

L.(2)(c)(x) Impetigo: until twenty-four hours after initial treatment has been initiated;

L.(2)(c)(xi) Streptococcal pharyngitis: until twenty-four hours after initial treatment, and no fever for twenty-four hours;

L.(2)(c)(xii) Pinworm infection: until twenty-four hours after initial treatment;

L.(2)(c)(xiii) Ringworm infection: until twenty-four hours after initial treatment;

L.(2)(c)(xiv) Chicken pox: until six days after onset of rash or until all lesions have dried and crusted;

L.(2)(c)(xv) Pertusis: until five days of appropriate antibiotic medication has been completed;

L.(2)(c)(xvi) Mumps: until nine days after onset of parotid gland swelling;

L.(2)(c)(xvii) Hepatitis A virus: until one week after onset of illness or as directed by the health department when passive antibody preparation has been administered to appropriate children and staff in the program;

L.(2)(c)(xviii) Abdominal pain: persistent or intermittent.

L.(4) A child shall be excluded from the center if it has been determined by the local health official or physician that the child is contributing to the transmission of the illness during an identified outbreak of any communicable illness at the facility.

L.(5) Any child in attendance who becomes ill shall be isolated promptly from the group, but shall have continuous supervision by a staff person.

L.(6) The parent(s)/guardian(s) of the ill child shall be notified immediately when a child has a fever or other symptoms requiring exclusion from the program.

L.(7) Prior to admitting a mildly-ill child in a child day care center, a statement shall be obtained from the child's physician or health resource indicating the nature of the child's illness and whether attendance at the center is advised.

L.(8) No furniture, fixtures, equipment or supplies designated for use by mildly-ill children shall be shared with or used by children enrolled in the day care program for well children. Indoor space utilized by the mildly-ill child program shall be separate from space utilized by children enrolled in the well-child program.

L.(9) Toys, bedding, equipment and bathroom facilities used by an ill child or adult shall be cleaned and disinfected prior to use by another person.

L.(10) Children with respiratory illness shall be cared for in a space separate from children with gastrointestinal illness to reduce the likelihood of disease transmission.

L.(11) A handwashing sink shall be present in each child care room designated for mildly-ill children.

L.(12) In centers providing care for mildly-ill children, there shall be a minimum of one toilet for every ten children in the space designated for use by ill children.

L.(13) Children shall have access at all times to rest or nap areas without distraction or disturbance from other activities.

L.(14) Disposable cups and plates shall be utilized for mildly-ill children and shall be disposed of after each use.

L.(15) Meals shall be planned and prepared in accordance with the prescribed diet of the mildly-ill child.

L.(16) Staff providing care for mildly-ill children shall receive training in/have knowledge of the following areas:

L.(16)(a) First aid and Infant/Child Cardiopulmonary Resuscitation (CPR);

L.(16)(b) Temperature taking;

L.(16)(c) Nutrition of ill children;

L.(16)(d) Recognition of illness signs and symptoms;

L.(16)(e) Administration of medication(s);

L.(16)(f) Emergency medical procedures.

2-24 months	1 staff to 3 children
25-71 months	1 staff to 4 children
72 months and older	1 staff to 6 children

Fiscal Impact Statement:

The South Carolina Department of Social Services estimates that there will be no additional costs incurred by the State or its political subdivisions in complying with these regulations.

Director@Daycare.com

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