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Daycare Center and Family Home Forum>Help with Sick Child Policies - Re: Runny Noses and Coughing?
pip 03:38 PM 03-05-2019
Hi all,

I'm writing a sick child policy for our church nursery and need some advice. Could somebody help me out with what your policies say regarding runny noses and coughing, specifically? Do you write in something regarding the kids' ability to blow their nose, wash hands, cover their cough? How much extra work is reasonable for the daycare provider to take on for a sick child?

Our situation, if it helps and you want to offer any advice: we have a few families consistently bringing kids that look sick (productive cough, runny nose that drips onto toys, etc), that nursery staff believe are sick and would like to send home. The families of these kids are aggressively pushing back that the children aren't sick and that the nursery staff just need to wipe their noses more or cover their mouths when they cough.

How do we write a reasonable policy here? Is something like we'll send kids home if they need their nose wiped more than once every 10/15/20 minutes to keep snot from dripping on toys/tables/etc reasonable? What about for coughs? We would like to put something in writing so that the nursery staff aren't needing to defend their judgement on whether a kid is sick so often.
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Cat Herder 03:41 PM 03-05-2019
https://ncchildcare.ncdhhs.gov/Porta...-12-103308-310

This should help.
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Blackcat31 07:23 AM 03-06-2019
I would exclude children with excessive runny noses. By excessive I mean needing to wipe it more than once in a 30 minute period.

However, if the child is younger and has difficulty keeping their hands out of their mouths, I'd probably be more strict.

As for coughing, IF the child is old enough to cover their mouth, great! If not, exclude. Coughing is one of THE most common ways to spread viruses.

I state in my policies that ANY child that requires MORE care and attention than normal or care that takes away from my ability to maintain a clean, healthy environment while providing the same level of care and supervision to other children will be excluded.

It's also important for parents to understand "sick at home" is vastly different than "sick at daycare". I usually follow that up with something like "Imagine feeling under the weather and having to go lie down in the toy section at Walmart and rest/get better."

Most my parents have an "Ah-ha!" moment and totally understand what I mean.
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Ariana 07:28 AM 03-06-2019
My illness policy states “I am a WELL daycare, meaning I can only care for children who are either well or with mild cold symptoms who are otherwise acting fine. Mild cold symptoms are slight runny nose that is clear and/or slight cough with no fever and is acting otherwise fine. Unusual lethargy or crankiness accompanying the above mild symptoms is cause for exclusion.”

Unfortunately you are going to have to put up with some runny noses and you will have to wash toys a lot. I think wiping noses is also expected BUT constant runny nose is exclusion here.
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LittleExplorers 07:55 AM 03-06-2019
Is this a church nursery where care is offered just during church functions or all the time? If it's during church functions I would be super strict. If it's not, I exclude for fevers, frequent coughs, loose stools, vomit or the inability to participate in activity. It goes more in depth, but that's the basics of it. If I excluded for every runny nose, I would not have clients. I use my judgement.

It also states it is my decision on when they can return, not a physician's.
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Snowmom 11:04 AM 03-06-2019
Originally Posted by pip:
The families of these kids are aggressively pushing back that the children aren't sick and that the nursery staff just need to wipe their noses more or cover their mouths when they cough.
Are these parents seriously expecting staff to catch a child's cough? For real? I can't even see that being a plausible request.

Here are the highlights of my policy:

Exclusion Symptoms:

If your child has displayed any of the following symptoms within the last 24 hours, they will not, under any circumstances, be admitted into care.
• A fever (99° under arm; 100° oral, temporal or rectally)
• Diarrhea
• Vomiting (one or more times)
• Undiagnosed Skin Rash
• Eye Discharge or Pink Eye
• Constant/uncontrollable runny nose or cough
• If the child is unable to participate in normal activities, continuously crying or requires more attention than I can provide without endangering the health and safety of the other children in my care
• Or been given any fever masking medication, such as Tylenol or Advil, in the last 24 hours.

Children that are displaying the above symptoms are excluded from attending daycare regardless of the cause. A doctor’s note or diagnosis is not considered an automatic clearance to return to daycare; it is ultimately up to the provider to determine as I am responsible for the well-being of the group as a whole, not just one individual.
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kendallina 11:23 AM 03-06-2019
Originally Posted by Snowmom:
Are these parents seriously expecting staff to catch a child's cough? For real? I can't even see that being a plausible request.

Here are the highlights of my policy:

Exclusion Symptoms:

If your child has displayed any of the following symptoms within the last 24 hours, they will not, under any circumstances, be admitted into care.
• A fever (99° under arm; 100° oral, temporal or rectally)
• Diarrhea
• Vomiting (one or more times)
• Undiagnosed Skin Rash
• Eye Discharge or Pink Eye
• Constant/uncontrollable runny nose or cough
• If the child is unable to participate in normal activities, continuously crying or requires more attention than I can provide without endangering the health and safety of the other children in my care
• Or been given any fever masking medication, such as Tylenol or Advil, in the last 24 hours.

Children that are displaying the above symptoms are excluded from attending daycare regardless of the cause. A doctor’s note or diagnosis is not considered an automatic clearance to return to daycare; it is ultimately up to the provider to determine as I am responsible for the well-being of the group as a whole, not just one individual.
This is very similar to my policy. I cannot imagine sending a child home who needs help wiping his nose. So, yes, unless child is excusable for above reasons OE if they 'cannot participate in the regular programming at preschool', then they're here! Boogers and all!
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