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Old 05-30-2013, 09:21 AM
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Default The Plague! WWYD

So last week I posted a few questions regarding sickness... quick blurb... last week one family graced us with an icky cold... that has a lingering cough... both DCG's from said family had to pick up early 2 of the 3 days they were here. Illness spread to myself and my 4 month old son. Then my other DCBs mom informed me he had spiked a 103 temp the last of his three days.

Enter the holiday weekend... DCB was still sick... mom took him to Dr, and Dx with an ear infection and put on Z-Pak on Tuesday... he was out Wednesday and is back today. Upon drop off mom stated he was feeling better, his temp had gone away but he was being super clingy and wasn't himself... not to mention nasty nose. Anyways... my policy states child has to be fever free without antipyretics for 24 hrs before returning.. which technically he met this criteria.

This boy is being totally whiney and defiant... WAY more so than usual... I informed mom he has been crying relentlessly for an hour and is in fact not himself... she stated she has a call into the Dr.

What would you do?
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Old 05-30-2013, 09:26 AM
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Originally Posted by lflick View Post
So last week I posted a few questions regarding sickness... quick blurb... last week one family graced us with an icky cold... that has a lingering cough... both DCG's from said family had to pick up early 2 of the 3 days they were here. Illness spread to myself and my 4 month old son. Then my other DCBs mom informed me he had spiked a 103 temp the last of his three days.

Enter the holiday weekend... DCB was still sick... mom took him to Dr, and Dx with an ear infection and put on Z-Pak on Tuesday... he was out Wednesday and is back today. Upon drop off mom stated he was feeling better, his temp had gone away but he was being super clingy and wasn't himself... not to mention nasty nose. Anyways... my policy states child has to be fever free without antipyretics for 24 hrs before returning.. which technically he met this criteria.

This boy is being totally whiney and defiant... WAY more so than usual... I informed mom he has been crying relentlessly for an hour and is in fact not himself... she stated she has a call into the Dr.

What would you do?

Call for pick up. My policy states fever free without meds, and able to participate in the activities of daycare.
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Old 05-30-2013, 09:29 AM
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Call for pick up. My policy states fever free without meds, and able to participate in the activities of daycare.
Okay. Mom says let him nap Dr said he needs rest... well IMO that drew a red flag as well he shouldn't be here as I can't sit and tend to his "extra" needs when I have 5 others today! It's disruptive to our routine... nap time isn't generally until about 11 but I am trying it now because he is sooooo ready.
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Old 05-30-2013, 09:33 AM
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Okay. Mom says let him nap Dr said he needs rest... well IMO that drew a red flag as well he shouldn't be here as I can't sit and tend to his "extra" needs when I have 5 others today! It's disruptive to our routine... nap time isn't generally until about 11 but I am trying it now because he is sooooo ready.
The dr. Answered it for you. He needs rest. At home. Under the watchful one on one eye of mom.

Or mom can have the option of one on one rest from you for an extra fee??
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Old 05-30-2013, 09:37 AM
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The dr. Answered it for you. He needs rest. At home. Under the watchful one on one eye of mom.

Or mom can have the option of one on one rest from you for an extra fee??
She has already paid for today, the normal rate. I honestly don't know how I could even offer that as an option. He isn't one to just sit either he just wonders around trying to plop on my lap everywhere I am... he got mad at me as I was using the restroom earlier and he threw my iPad on the hardwood floor!
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Old 05-30-2013, 09:37 AM
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Kids can't get the rest they need to recoup from illness at daycare.

It's noisy, you are busy, there is loads of additional germs etc.


I'd let her know you just cannot offer him what he needs there at this point. If you don't put your foot down it will keep right on cycling through everyone.
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Old 05-30-2013, 09:39 AM
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She has already paid for today, the normal rate. I honestly don't know how I could even offer that as an option. He isn't one to just sit either he just wonders around trying to plop on my lap everywhere I am... he got mad at me as I was using the restroom earlier and he threw my iPad on the hardwood floor!
Your parents don't pay when they aren't there due to illness etc??

I'd call the mom for pick up immediately. If you don't, then she will continue to send not up to par sickly kid to you expecting you to allow him extra rest periods and extra care.
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Old 05-30-2013, 09:41 AM
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They do pay when they are out due to illness. She paid for yesterday as well and he wasn't here.
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Old 05-30-2013, 09:50 AM
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They do pay when they are out due to illness. She paid for yesterday as well and he wasn't here.
Oh ok. Definitely what willow said. At this point he is extremely susceptible to catching additional germs due to his weakened immune system. Explain to mom you are protecting HIM as we'll as everyone else.
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Old 05-30-2013, 09:58 AM
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Argh... so now I had everyone napping and he starts screaming again... I pull him out of the nap area he shares with another young child so he didnt wake him up and perpetuate crabbiness... he felt warm so I took his temp and he's at 100.6 again... mom was told to p/u.
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Old 05-30-2013, 10:28 AM
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Sounds like mom doped and dropped. I would have had her pick up as soon as I realized he needed special.
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Old 05-30-2013, 10:34 AM
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I think when mom picked up I would tell her I needed a doctor's note that it is okay for him to return to daycare.

Laurel
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Old 05-30-2013, 10:36 AM
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Nows the perfect time for you to add a dope and drop policy to your handbook...

Great timing actually.

Require 48 hours exclusion if dope and drop is suspected. Should stop it pretty quick.
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Old 05-30-2013, 10:39 AM
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This is my policy. Note the last part. I would call and send home and make sure this additional part is in your policy as well. You cannot reasonably meet the needs of the other children in your care if he is so unwell that he can't let go of you or stop crying.

**Sick Child. Maryland law prohibits me from caring for sick children. Therefore, you may NOT bring your sick child to my Home for care. If you give your Child medication to reduce a fever or mask symptoms of illness and bring the sick Child to my Home without telling me about the medication, you will be violating this Agreement, and I will have the right to terminate it immediately. If your child becomes sick while in my care, I will call you, and you must pick up your child promptly. I will keep your sick Child separated from the other children in my care until you arrive. After any illness, your Child must be free of all symptoms (not just fever and vomiting) for at least twenty-four (24) hours before returning to my Home. After a serious illness, your Child will be allowed to return to my Home only with written permission from the Childs’ physician. If your child is put on antibiotics they must wait 24 hours before returning to care. It is your responsibility to find alternate care for your sick Child and to notify me when your sick Child will not be present in my Home on a scheduled Child Care Day. Please inform me of any contagious illness so I may alert the parents of other children exposed to you Child. The definition of a sick child for the purpose of this Agreement shall be a child who has a fever (100 degrees F. or above), vomiting, diarrhea, a runny nose with thick, discolored discharge, a rash of unknown cause, severe pain, extreme listlessness or other dramatic personality change indicating the child is not well, or any other symptom of acute illness, serious transmissible infection or communicable disease.
Your Child should be able to participate in the normal activities of the day. When having to care for sick children, it keeps me from providing quality care to the other children in my Child Care Home. Therefore, you will have one (1) hour to pick up your sick child/ren.
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Old 05-30-2013, 10:40 AM
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Originally Posted by Laurel View Post
I think when mom picked up I would tell her I needed a doctor's note that it is okay for him to return to daycare.

Laurel
Yes, but be careful how you word this. The Dr. doesn't get the final ok, YOU do.
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Old 05-30-2013, 10:44 AM
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Yes, but be careful how you word this. The Dr. doesn't get the final ok, YOU do.


I once had a parent get a doctor to write a return to care note with a diagnosis of strep after receiving a whopping penicillin shot, with a fever, and lethargic.

He actually wrote...X CHILD MAY RETURN TO CHILDCARE ON SAME DAY OF VISIT. DIAGNOSIS POSITIVE STREP, X UNITS OF PENICILLIN GIVEN IM. ALLOW PLENTY OF REST AND LOTS OF FLUIDS. ADMINISTER X AMOUNT OF TYLENOL OR X AMOUNT OF IBUPROFEN ALTERNATIVE FOR FEVER OR PAIN"
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Old 05-30-2013, 10:45 AM
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Originally Posted by Brooksie View Post
This is my policy. Note the last part. I would call and send home and make sure this additional part is in your policy as well. You cannot reasonably meet the needs of the other children in your care if he is so unwell that he can't let go of you or stop crying.

**Sick Child. Maryland law prohibits me from caring for sick children. Therefore, you may NOT bring your sick child to my Home for care. If you give your Child medication to reduce a fever or mask symptoms of illness and bring the sick Child to my Home without telling me about the medication, you will be violating this Agreement, and I will have the right to terminate it immediately. If your child becomes sick while in my care, I will call you, and you must pick up your child promptly. I will keep your sick Child separated from the other children in my care until you arrive. After any illness, your Child must be free of all symptoms (not just fever and vomiting) for at least twenty-four (24) hours before returning to my Home. After a serious illness, your Child will be allowed to return to my Home only with written permission from the Childs’ physician. If your child is put on antibiotics they must wait 24 hours before returning to care. It is your responsibility to find alternate care for your sick Child and to notify me when your sick Child will not be present in my Home on a scheduled Child Care Day. Please inform me of any contagious illness so I may alert the parents of other children exposed to you Child. The definition of a sick child for the purpose of this Agreement shall be a child who has a fever (100 degrees F. or above), vomiting, diarrhea, a runny nose with thick, discolored discharge, a rash of unknown cause, severe pain, extreme listlessness or other dramatic personality change indicating the child is not well, or any other symptom of acute illness, serious transmissible infection or communicable disease.
Your Child should be able to participate in the normal activities of the day. When having to care for sick children, it keeps me from providing quality care to the other children in my Child Care Home. Therefore, you will have one (1) hour to pick up your sick child/ren.
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Old 05-30-2013, 10:52 AM
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Originally Posted by lflick View Post
Okay. Mom says let him nap Dr said he needs rest... well IMO that drew a red flag as well he shouldn't be here as I can't sit and tend to his "extra" needs when I have 5 others today! It's disruptive to our routine... nap time isn't generally until about 11 but I am trying it now because he is sooooo ready.
She's lying.

She doped him this morning and she didn't call the dr. She's just giving you what words it takes to get him to nap time on your clock. Everything she has said to you has been a marker to get more time.

She knew he was too sick to come and she knew you would call. She just wants him there so she can be at work and you can do what she believes she pays you to do. She paid yesterday for your "day off" so she wants some service. She doesn't have ANY problem with him being at your house sick. She knows it's better for her if you care for him sick.
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Old 05-30-2013, 10:58 AM
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She's lying.

She doped him this morning and she didn't call the dr. She's just giving you what words it takes to get him to nap time on your clock. Everything she has said to you has been a marker to get more time.

She knew he was too sick to come and she knew you would call. She just wants him there so she can be at work and you can do what she believes she pays you to do. She paid yesterday for your "day off" so she wants some service. She doesn't have ANY problem with him being at your house sick. She knows it's better for her if you care for him sick.
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Old 05-30-2013, 10:59 AM
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Originally Posted by Cradle2crayons View Post



He actually wrote...X CHILD MAY RETURN TO CHILDCARE ON SAME DAY OF VISIT. DIAGNOSIS POSITIVE STREP, X UNITS OF PENICILLIN GIVEN IM. ALLOW PLENTY OF REST AND LOTS OF FLUIDS. ADMINISTER X AMOUNT OF TYLENOL OR X AMOUNT OF IBUPROFEN ALTERNATIVE FOR FEVER OR PAIN"
Never allow a doctor to decide readmission to child care. The Doctor's client is the parents not you. They make money when they do what their client wants them to do.

A Doctors note should just say
day seen
diagnosis
treatment
is child contagious?

That's it. You don't need anything else but that. Do NOT accept a treatment plan that includes good handwashing and sanitation to halt spread. That line of use good handwashing is the docs get out of jail free card if an epidemic hits.
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Old 05-30-2013, 11:01 AM
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Never allow a doctor to decide readmission to child care. The Doctor's client is the parents not you. They make money when they do what their client wants them to do.

A Doctors note should just say
day seen
diagnosis
treatment
is child contagious?

That's it. You don't need anything else but that. Do NOT accept a treatment plan that includes good handwashing and sanitation to halt spread. That line of use good handwashing is the docs get out of jail free card if an epidemic hits.
Amen lol.... I didn't allow it and I have a specific policy. When mom read that note to me on the phone after the md visit, I laughed at her and told her see you in 48 hours lol.
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Old 05-30-2013, 11:06 AM
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Yes, but be careful how you word this. The Dr. doesn't get the final ok, YOU do.
Very good point. I agree.

I don't have a policy per se about this. I just decide and they can take it or leave it. My whole contract is only 2 pages and I don't have a handbook. I don't feel I need it. I try to choose good parents and I am reasonable with what I will and won't accept and if they don't like it they can leave. No one ever has left because they were upset about something. The only time they leave is if they are moving out of town or going to kindergarten.

But you are definitely right. The doctor doesn't know my exact situation. I guess I could say "I will 'consider' taking him back tomorrow if you bring a doctor's note." That way I'm covered. But in some ways not having a handbook really gives me more leeway in all my decisions. I don't have them coming back to me saying "Well that isn't what your handbook says...."

I feel I'm flexible and reasonable and if they need to know how I handle every little thing that hasn't actually happened yet then they can hit the road.

Laurel

Last edited by Laurel; 05-30-2013 at 11:13 AM. Reason: lots of typos
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Old 05-30-2013, 11:10 AM
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Originally Posted by Cradle2crayons View Post


I once had a parent get a doctor to write a return to care note with a diagnosis of strep after receiving a whopping penicillin shot, with a fever, and lethargic.

He actually wrote...X CHILD MAY RETURN TO CHILDCARE ON SAME DAY OF VISIT. DIAGNOSIS POSITIVE STREP, X UNITS OF PENICILLIN GIVEN IM. ALLOW PLENTY OF REST AND LOTS OF FLUIDS. ADMINISTER X AMOUNT OF TYLENOL OR X AMOUNT OF IBUPROFEN ALTERNATIVE FOR FEVER OR PAIN"
Wow, just wow!

Laurel
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Old 05-30-2013, 11:11 AM
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I've had a mom who has been in my program for years laugh as she handed me the note saying: yes I know it means nothing! They know what I except- but are ok with it most times because I say: well... Would you like someone else's kid here w the same symptoms next to your healthy kid?!
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Old 05-30-2013, 12:18 PM
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I was starting to think it was a dope and drop... he was here 4 hrs so it would make sense.... either that or the mom is just oblivious to how illnesses work!
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Old 05-30-2013, 12:25 PM
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I was starting to think it was a dope and drop... he was here 4 hrs so it would make sense.... either that or the mom is just oblivious to how illnesses work!
Give Mom more credit than not knowing how illnesses work.
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Old 05-30-2013, 02:31 PM
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Give Mom more credit than not knowing how illnesses work.
I meant that in the manner he hasn't been ill much and she is a first time parent and very diligent. I think perhaps she is not as seasoned in how illness runs its nasty course in children... I have 5 of my own and have seen it all haha.
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Old 05-30-2013, 04:41 PM
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I have something like this...

regardless of doctors note of diagnosis, it is at the sole discretion of the provider to determine if she can still provide adequate care for every child in the daycare.

Parents must understand that the care of one CHILD can not take away the providers ability to be able to care for all children in attendance.


THe other thing that I have is symptom exclusion statement.

Please understand that because I do not have a degree in medicine, I cannot diagnose any child with any illness. It is for this reason that if your child displays any of the following symptoms, they must be excluded from care.
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