I had a little boy go home early on Monday because he had a high fever. 103 that spiked all the sudden. She took him to the doc and when she called she said he had an ear infection. I asked about his cough and she said, "Oh, just a cough." She asked if she could bring him the next morning and I said he should spend a day at home with the fever and in hopes that his cough settles down. She said ok. I then saw one of the other daycare moms and say said, "Ahhhh, poor X has RSV (Respiratory syncytial virus), huh?" WHAT?!?!?! No, *I* didn't know!!!

I called and asked the mom and she said, "Oh yeah, it's ok though because the doc gave me meds to clear his lungs." I said, no, it's not ok. He cannot come back for the rest of the week or at least until his cough, fever and runny nose have resolved! I told her that I have infants and a child with a compromised immune system and a case of RSV could be FATAL. I told her I should have been one of the first to know, and she should NOT have tried to hide it from me. She didn't have much to say, except to complain that she was going to have to miss work!!!!!! OMG!!!!!

I love the little guy, but wouldn't you say this is grounds for termination?!?!?! How dangerous and careless!!!! What would you do?! I am so livid I can barely think straight!!!

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Was that mom aware of the child at high risk?

I agree that you could terminate, but I wouldn't.

But I would definitely advise this mom that this was grounds for termination.

You have a child that has a compromised immune system, and for her lying, or purposely/consciously sending an ill child could possibly cause a fatility, the liability on HER end is great.

Maybe once you throw in there, that she could be held accountable (not sure if she could be so make sure you know that before saying it) for this child becoming hospitalized and possibly even causing a fatality she will think twice when her child has even 1 sneeze.

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Well, the mom is aware that I have infants in care, and it could be fatal to them! She also knows of my special needs little guy who is on OXYGEN!!! Regardless, isn't RSV one of those illnesses that are considered communicable?! To me she was completely and totally off base and I am so mad!!! I don't know how I am going to be able to trust her again!!!

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I would terminate. If she showed any remorse for not telling you about child's RSV after you told her about the infants and immune compromised child, then I would just give her a warning. But it sounds like all she really cared about was that she had to miss work again.

To me, she was deliberately keeping that info from you, to be able to bring him back so she didn't miss any more work. She may not have known about the immune compromised child, but she certainly should have known you have infants in your care.

You asked her straight out about the cough and she LIED to you. If she just didn't realize that RSV was a serious thing, that's one thing, but she LIED to you. I don't (wouldn't) put up with that.

Also, if I termed over this (which I already stated I would) I would definitely let her know exactly WHY I termed her - her disrespect of you and the other children and her dishonesty.

Let us know how it goes!

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Yep I changed my mind, I would term her over it, unless she was sincerely stupid about it. lol.

I totally forgot about the cough part, and you did ask her, and she completely lied about it so I definitely have changed my mind.

I think a term would be in order

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I don't think this is correct. We, as providers, are the ones who are responsible for making a safe and happy place for our dck's. That is OUR responsibility, not the other parents'. All she would have to do in that instance is say "I didn't know it was contagious" or "I didn't know it could be fatal" or "I didn't realize there was an immune compromised child" etc. It's not her responsibility to look out for the other children. It IS her responsibility to convey her child's diagnoses to the provider and keep him home when sick, but that is where her responsibility ends.

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But how can we properly do our job if the parent is not being truthful?

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Sometimes I think the doctors are the ones at fault as well. My daughter had RSV when she was 3 months old and the Dr. told me very mater-of-factly. I was a new mom and never having heard of it didn't know how dangerous it could be. Luckily I was a SAHM at the time. I would first ask the mom if the Doctor told her how serious and contagious this illness really is. There is a possibility she doesnt know. Of course there is a possibility she just tried to cover it up as well. Maybe copy an article about it and give it to her.

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True, and maybe the word "liability" is the incorrect word. But I believe she would have to live with this for the rest of her life. Whether it was LEGALLY accountable or not, she would for the rest of her life have to live with the fact that she caused a child to die, if in fact that was the outcome.

I don't agree with the fact that her liability should end with her responsibility. I'm not saying you are wrong, I'm saying the system, regulations or whatever else is wrong.

You could easily accept a child that is ill, and has been masked with some sort of medication, and by the time you realized it, it would be far too late. Would it not? It is the PARENTS responsibility to inform the provider of any and all situations whether they are in fact contagious or not. That is my opinion on that.

I don't think it's right that you are the only personal responsible for the health of all in your care. YOU can't know how the child was feeling the night before, therefore the parents are responsible for letting you know.

What if Charlie was throwing up and diarrhea all night, but no fever or anything in the am. Mom drops him off as usual and no mention of last night. You take him into care, and 2 hours later he throws up all over another child while they are playing? Gross I know, but it happens.

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How can *I* as the provider act responisibly without all the pertinent information?! I can't! I would have allowed him back into care today!!! Would have maybe been mildly annoyed by the fact that he is coughing all over the place, but not aware of the serious ramifications that could come from it! To me, it would be HER liability if she didn't tell me! She flat out LIED to me! So why would she lie to ME, but tell someone else if not to cover it up so he could come to daycare?!?! Negligent! I think I am going to have to terminate. I don't know how I could ever trust her again!! I am still so mad!!

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yep I agree.

do it now before it's too late. It'll give her enough time to find alternate care while she's home with child anyway

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I'd be livid too. OMG. It's one thing to mask a fever with tylenol, but to not mention RSV?!? Oooh. I would try to get to the bottom of why exactly she felt the need to not mention it. I try to give people the benefit of the doubt, but I don't really blame you for not trusting her now. She needs to know that the trust is gone and that what she did was NOT ok!

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I have to agree with what you said about the doctor thing. What you should do about daycare or school should be one of the FIRST THINGS out of the doctor's mouth......"You can (or can't) bring the baby back to daycare for X amount of days." Plus, she should have asked if he didn't tell her. Some of these parents are SO clueless!!!

But anyway, it seems like this mom flat out LIED. I don't know if I would terminate, but I dang sure wouldn't let the child back into my care for the rest of the week or without a doctor's note!!!

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do doctors charge for doctors notes?

I know plenty of doctors would willingly write a doctors note because it's extra money coming into their clinic. I don't always trust doctors to use best judgement. Sometimes they are just looking for turnovers, and want you in and out as fast as possible so they tell you something, write something, and kick you out.

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Oh my gosh I am so mad FOR you, I can't imagine if this was one of my families how I would feel! I almost lost my 2 year old DS when he was 3 weeks old to RSV. People are so clueless!

I would term, just because I would never be able to look at her the same.

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Thank goodness they don't charge here for doctor's notes. My son needs one written and faxed to the school nurse every year for his nebulizer medications. The office is so gracious and nice about it. They even offer to call me after it's been faxed but I don't put them through the extra trouble. I couldn't imagine them charging for that....that is so wrong!!!

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You are both absolutely right, that's why I said:

Morally she should care about the other children and care that her actions could make them ill or worse. Too many parents just don't care, unless it affects herself (unable to work) or her child (sick - so she's unable to work). There are some great parents out there, which is why I would so get rid of one who lied straight to me and was willing to bring a very contagious and dangerous (to some) illness into my daycare.

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There are two issues here:

RSV is really common, the exposure already happened, and you can't prevent anything by terming.

You have an immune compromised child in your care with other healthy kids. Send home a memo, ask that it be FWDed to the kids MD's (If they are in your contacts, send it on to the MDs). Everyone should be on the look out to reduce exposure for this child.

The Immune compromised child is not safe anywhere during RSV season.

http://www.cdc.gov/rsv/clinical/prophylaxis.html

That child should be taking preventative treatment, and if it is deemed unsafe for that child, that child should be in a private care situation.

You need to protect everyone, and you can't send all your other kids home for a week over every illness.

I would not term, or ignore a return to care note from a MD who was informed of the situation.

I Would inform icdck's parents immediately.

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If you lie to me you are outta here. Period.

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I would have said that you should maybe give her the benefit of the doubt and that maybe she didn't know how serious RSV is...but the quote above seals her fate IMO. She lied to you about the cough because she didn't want to miss work. No thought beyond that. That would be grounds for termination for me.

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Does this letter to the families sound ok? I love the little guys so much that is home with RSV, so it makes me sad to think of terming him. But how can I trust her? Unless I give her a warning and then just term the next time she doesn't follow one of my policies? Ugh, I don't know. Anyway, here is the letter I wrote. Make any suggestions you think I should make:

Dear daycare families;

I am writing this letter to make sure that everyone knows how important it is for me to be on the top of the list of people who know what is going on in your childs health. Your child is exposed to many other kids and many germs. I do my best to keep the germs to a minimum, but there is no way I can keep the germs away completely.

It is your responsibility as a parent to make sure I know the whole story when your child is sick. I cannot act in the best interest of the group and each individual child if I only know a portion of what is going on. Do you know how terrible I would feel if something were to happen to a child in my care as a result of allowing the sick child back into care without knowing that what they have? We have infants in care who are vulnerable. We have a special needs child on oxygen that is vulnerable. Your young child could be the one vulnerable. I am asking you to all act responisibly where you childs health is concerned. For your childs sake and the sake of the other children in care. The best place for a sick child is at home with mom or dad to love on them. Not in daycare.

I am now going to ask that if your child has been sick enough to take to the doctor, I will need a note from the doctor telling me what the diagnosis was and when the doctor suggests they can be safely permitted back into daycare. I will not allow your child back in without a note. At that point, depending on the diagnosis, I will then make my decision as to when I feel they can safely be admitted into care again. I have all of the kids best interest at heart here. I am not trying to be difficult. I love all of the children dearly, and would be devastated if something happened to any one of them!

Finally, if I am to find out that your child's diagnosis has been kept from me, it will be up to me whether you will be able to continue to bring your child to my daycare. It is a trust breech, I have to be able to trust you. If I give you a warning, it will be your ONE AND ONLY warning. The next breech will result in IMMEDIATE termination.

Thank you for your compliance.

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First sentence is FAR too long


Dear daycare families;

This is a reminder to all parents, that the illness policy is ALWAYS in effect. For the safety of ALL children in my care, I must be informed at all times of any illness and ALL symptoms your child has had or is currently experiencing. Your child is exposed to many other kids and many germs. I can only do my best to keep the germs to a minimum, but it is impossible to eliminate all germs completely.

I am unable to act in the best interest of the group and for each individual child if any information has been withheld. We have infants who are vulnerable. Please be considerate for all the other children. You would expect no less for your child. The best place for a sick child is at home with mom or dad to love on them. Not in daycare.

I am now requiring a note from the doctor stating the diagnosis and a suggested return date. I will not allow your child back in without a note and my approval. I only have the best interest of the entire group at heart.

Please remember, that this policy is strictly enforced at ALL TIMES. For some children, this is a matter of life and death. This is an official reminder, and moving forward, should there be any occurrences of sickly children entering my care, or any misinformation, or lack thereof, will result in IMMEDIATE TERMINATION.

Thank you for your compliance.

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That is beyond grounds for termination! It is obvious she kept it from you. The "it's only a cough" thing.......WOW. She knew exactly what she was doing. I'd be so hurt, mad, and would absolutely terminate. And I don't take terminating lightly.....when trust is gone, forget about it. Good luck!!

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Wow I cannot believe she pulled that on you! I'd be so furious right now. I do feel that it is also the parents responsibility to be aware of the other kids in the daycare. She was disregarding their best interest by saying his cough was nothing....

I would not be able to look past that, I would terminate and tell them flat out, you lied to me, you could have exposed your child to another child that has a weakened immune system, I cannot loverlook it, nor can I move forward with your family in my daycare.

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She lied about this. She WILL lie about other things.

I am so mad at this woman and I don't even know her! My own daughter had RSV at 2 months old....and she has a heart condition. I have never been so scared in my life. Just the thought that a mother could be sooooo callous about the health of other kids enrages me.

I would term her, give her a piece of my mind AND let her read all the comments here! She needs to know what she did is NOT OK.

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I ALWAYS ask when I go to the doctors "is my son contagious? I run a home daycare and need to know so I can inform my parents properly". I would also ask if he was in daycare and school. I think its only right as a parent to not pass onto another family my childs disease. Common sense tells me that and its not just because I work with kids. I did this when he was a infant and going to a home day care. I dont want my child infecting others and vice versa. I think thats the moral thing to do. My old work couldve shoved it, if my son was sick for 3 weeks I wouldve stayed home.

Why is it so difficult for parents to take care of their sick kids???

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Clearly I sympathize with parents whose children are sick and need to stay home from daycare. I understand that parents are often busy and

inconvenienced by their child’s illness. At the same time, please remember that when your child is sent to daycare sick, they put all children, their
siblings, the provider, and all other family members at risk. Please have respect for all families here in the daycare. Golden rule, if your child is too sick to play outside, they are too sick to attend daycare. Also, please don’t forget that if I should become too ill to operate the daycare, the daycare will be closed until I am healthy enough to reopen. Having to close the daycare puts every family in a bad situation in many ways. Remember that the decision about whether or not a child should not go to school should be made by the parent, NOT THE CHILD. I love that your children want to be at school but they need to be well in order to be here.

Effective Immediatley all of the above changes and additions will be made to the Safety and Health Policy of the *** Daycare.

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I TOTALLY agree that parents need to learn to take time off for their children, BUT I know a lot of employers just don't care. And they will fire you for illness etc. A lot of parents have to use up their own sick days for their children, and just have no sick days left at all, and employers couldn't give 2 poops.

I know my hubs work would fire over this. He gets paid what he does to be there on their beck and call. If he wasn't, he wouldn't make the money he has. It's a tough call.

I wish all employers were family people, so they'd have some sympathy

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Yes, it IS tough! My DH's boss could care less! Also, I was interviewing at a center last year and one of the first things that the supervisor said was, "If your child is sick, I expect your husband or other family member to take care of it. You are expected to work."

I was offered the job, but graciously let her down.

However, even if this dcm had a job like this, to me, it still wouldn't excuse her behavior. RSV is serious (my DS had it when he was 6 months old) and if she was really that worried about her job, she should have tried like crazy to find some family or friends to help her out. Not risk other children! This whole thing just makes me mad....

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No one is saying she should term over the illness, it is the fact that dcm LIED to her about something so serious that has everyone up in arms.

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The issue for me would be the fact that the parent lied to me about it in the first place. I totally understand that employers can't have employees that arr constantly home with their sick kids, but it comes with the role as a parent. Kids get sick and that means that sometimes parents miss work.

As a provider, I need to know when kids are sick and what it is that they are sick with because my obligation isn't just to the child who is sick. I am responsible for every other child in my care as well as my own family. I don't take that lightly.

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Are you kidding me?!?!? First of all, we don't need to FURTHER expose anyone to RSV. It is extremely contagious until the child isn't hacking all over the place! I SHOULD HAVE BEEN TOLD THAT THE CHILD HAD RSV!!!!! The immune compromised child IS taking prevention, but doesn't need to knowingly be exposed to it!! RSV isn't like "every other illness". I have a nephew who almost died from it! I don't take this lightly at all, and neither should the parent of this child! She has worked in a daycare setting before, she knew exactly what she was doing!

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omg it just gets worse!

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RIGHT?! She worked in a center before I started watching her son, her son was being bitten there so she requested to be put on my waiting list! She started working somewhere else and he started in my care back in October. I just wish people weren't so selfish and would think about how their actions can have some pretty serious consequences!

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Yes, I'd be livid too about the lying. That's one thing I wouldn't tolerate. It is clearly stated in my parent handbook that lying about illness is grounds for immediate termination.

For your use, I am linking you to an RSV fact sheet from the Ca. Child Care Health Program. You might want to also provide it to your families.Notice the section about Immune Compromised children, your little guy can get an immunization to help prevent him from contracting RSV. It also states that because the child was contagious prior to symptoms, that there is no reason for exclusion, however I think it would be in the best interest of the group to exclude, especially considering that some children may have not been in attendance when it was contagious prior to symptoms.

http://www.ucsfchildcarehealth.org/p...s/RSV_0910.pdf

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one other thing I have to say is...

for the parent of the immune compromised child, they probably should be available to take care of a child during times when flus and such are going around. I'm not saying they should have to do so, but I think they would probably be more than ok with keeping their child home to avoid getting ill.

I'm still think that the lying mom should be terminated, or at least STERNLY warned if you decide you don't want to term, that this will NEVER happen again.

i just feel that as a parent of a child with some disability of some sort, any sort, they probably have more flexibility with the childs care.

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I had a dcm who told me the other day "I think Billy isn't feeling very well so if he runs a temp or gets sick during the day, please call me. But if you do have to call can you use the reception desk number and NOT my private line because I want my boss to know my child is really sick because I've used that excuse so much recently that I won't be able to get away with it again unless I can prove it."

....and besides , the only thing I can think is that all those times she "pretended" to be sick, never once did she come for her child! Makes you wonder sometimes.....

So, maybe she lied because she was worried she'd already used up all her "free passes" at work and didn't want her boss to me mad. I try to recommend that all my parents have reliable back up care, but in the real world that is not always possible. I would honestly just have a very open conversation with her about this issue and tell her how betrayed you feel because of her ommision of information. Sometimes, you really have to explain things in many different ways to people for them to understand why you don't see it the same way they do.

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Okay, I agree with you that she shouldn't have lied. However, there is a lot of miscommunication about RSV. RSV can be very dangerous in infants and immune compromised patients. However, it is still considered a mild and mostly harmless virus. Most children will have RSV in their lifetime. If they are not infants, it will likely be so mild that the parent will assume it is just a cold and never seek treatment for it. It is similar to any other cold virus.

"Unregistered" is right that it is a mild illness and that the exposure has already been done. And whoever was talking about their doctor saying it nonchalantly mimics my experience exactly.

Both of my children had RSV as infants. When my oldest had it, he was fine except was wheezing which is what prompted me to bring him in. He had bronchiolitis as a result of the RSV. That was easily treated and he had a bit of a runny nose but no fever. As a new parent, I asked the doctor about daycare. She told me that it wasn't really a big deal, that all of the kids had likely been exposed, and that there was no way from letting it run rampant that time of year. She did say that it can be harmful in some infants and to keep that in mind, but she told me to call my daycare and get their policy for it. Since he didn't have a fever, she said he could go back to daycare if they were okay with it. I called the daycare and the director told me the same thing. It was a Thursday and I ended up keeping him home on Friday because the poor guy looked miserable but acted fine. All of the babies in the infant room had it (4 before he was diagnosed, 1 the same day, and the other 2 after), and no one was seriously ill. When my second son had it, I brought him in expecting it to be RSV because it was similar to when my other son had it. It was, he had a fever, and I kept him home 24 hours after the fever was gone. When I reported it to daycare (a different daycare), they told me their policy was 3 days and 24 hours fever free. So, they had a different policy. RSV is not always serious.

I understand, though, that the real problem here was the lying. It sounds like she knew she was keeping it from you, and that is a problem. I, personally, wouldn't terminate but I would send out a letter reminding parents of the illness policies (like you mentioned.) I think lying is a big problem that should be nipped in the bud, but I don't think that this incident was such a big problem. With infants and an immune comprimised child, you do need to be on alert, and I think you should remind your parents of the importance of doing this. However, I don't think RSV should be thought of as "fatal" because in most cases it is very mild. It does have the potential to be dangerous, though, and you are right to be on top of the situation. So, now you just need to decide your policy on lying/keeping the truth from you. Is that (apart from the diagnosis of RSV) grounds for termination to you? That is what you need to decide and then stick to your decision.

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The child was symptomatic on Monday morning, so it is possible that the other kids were not yet exposed since it was a weekend you know?



I ask for doctors notes, but they are not the deciding factor for me. As a previous poster stated, often a doctor will say "no big deal" or "everyone has probably been exposed", but that is not always true for every child. My entire group isn't here every single day, so they are not always exposed. I also have a mixed age group (as I'm sure most of us do). RSV might not be any more than a cold for the preschool and SA crowd, but it is dangerous for infants! A doctor seeing a 4 year old with RSV probably assumes the child's daycare consists of other 4 year olds.

Personally, I think we put entirely too much trust on what the Dr says. When the Dr comes and cares for all the kids in my house, then he can make the decision of what's best for our program. I do ask for notes, but they are for diagnostic purposes, nothing more.

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RSV can potentially be fatal. I know. My son was born 5 weeks early & got bronchiolitis when he was 5 weeks old which resulted in a 7 day stay at our local Children's Hopsital PICU. He was put on a breathing machine it was so bad (I don't mean a nebulizer I mean a breathing tube down his throat). We were told at the time that he may not make it. No, it was not RSV but 1 month later (when he was 9 weeks) he then did test positive for RSV & had pneumonia. This resulted in another almost-week long stay at the hospital. It was a very scary time for us. I guess my point is my son was healthy & just got a bad cold which resulted in these issues. I didn;t do daycare at the time. But it was a terribly scary time in our life & since then I have never taken a day for granted. Please be tough with your illness standards, you are the only one who can/will enforce them. What that mom did was unbelievable. BTW my son is a mostly-healthy 7-year-old but he does suffer with moderate asthma which more than likely was brought on by his early illnesses.

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So glad your son pulled thru! I have a nephew that almost died from it as well, and as a result, I do not take it lightly or consider it a "mild illness". I take it very seriously! If I had all 4 year olds in my care, it may not seem as huge a deal to me, but with infants in care, big deal

My special needs guy does take shots monthly I believe during RSV season. But there is NO reason to KNOWINGLY expose ANYONE to that illness. I don't take any childs life for granted!

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There are so many different vantage points when looking at RSV. It's too bad that there isn't just one authority on this subject because if everyone were given the same information, then maybe some of the conflicting data wouldn't exist.

From my perspective, RSV would be a pretty big deal more for my health than the health of the kids in my care. I'm one of the immunocompromised people that gets affected by a lot of illnesses that are minor for other people.

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So sad that some parents are so selfish and only think of missing work than harming others with their child's illness. I understand parents have to work and they have a job to do. However, I am sure they have more vacation time than we do. They can take a day or two off to deal with a sick child.

I get one week yes 5 days a year off for vacation from the center I work at. I know most parents get 2 weeks plus.

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OP - what did you decide to do?

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Where is it in the OP's post where she said the parent took the kid to an informed of the situation MD?

Are you suggesting the parent told the MD that she had an infant special needs child in the house? Did the parent know and tell the MD that there are children in the home this week that weren't in the home last week? Did the parent know if any new children were to start care this week?

This idea that everyone has already been exposed so it's okay to do future daily exposures is rediculous and shows that the average person and Doctor doesn't have a clue of how group care works.

The "kids have already been exposed" sells. It makes Doctors money because the parents keep coming back if they get that one. There is no possible way a Dr can know if the kids have already been exposed without contacting the provider and getting specific health info on the current kids, attendance during the contagious period, and info on any incoming kids to care.

There's also the issue of repeated exposures. Having a kid day after day who is contagious increases the liklihood of exposure. Nobody wants to talk about that.

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I am giving a stern warning. I am going to have a conversation with her today to tell her how wrong what she did was, tell her that it was a complete breech in trust, and I will have a hard time trusting her again. And I am giving her a written warning telling her that this is her one and only warning. If she breeches a policy again, she is gone immediately. My head wants to term, my heart wants to keep my little guy. He is one of the good ones! LOL!

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Let us know how it goes!!

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Thanks, nannyde! I don't buy the "already exposed" deal either! Why continually expose, or expose the kids that are not here every day? No need. Be responsible as a parent for petes sake!

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Good luck with your dcm. While it's true RSV is usually mild for most kids, why did she feel the need to lie about it?

There are preventative shots for RSV--but a lot of insurance companies won't pay for them.

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With no further comment on the present situation - I am assuming the RSV DCK is home and the ICDCK is in care and all moms have been warned- It is my opinion that if the FCP is going to mainstream an IC child in her care, she has a responsibility to inform everyone, MDs included.

SO - forward from this point, they should be informed. It is part of what she needs to do to offer a safe environment for an IC child.

Further, HIPPA does apply, the MD's opinion should be both final and in many cases must be accepted. FMLA does not kick in on a FCP's opinion.

If I were the parent of either of these kids, I would be frustrated, but I would be more likely to keep my IC kid home or take my RSV+, treated, returned to care child looking for new providers while we are out of care.

Even if you run a very clean house you cannot prevent every exposure. OP also can't prove the RSV wasn't contracted at her home.

If you or your child are immune compromised, the onus is on you to avoid exposures.

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Well, the infected child was out of town from Wednesday last week until Sunday. He returned to care on Monday and fell ill that day. I would assume that he was indeed infected somewhere else. Regardless of WHERE he contracted it, if the child has it, STAY HOME. I should have at the VERY LEAST been TOLD about it by the mom. As soon as I knew about the diagnosis I did contact all of the other parents and informed them. The poor little guy with RSV is still not well enough to get up off the couch, so look for other care, no daycare would have allowed this sick child to stay in their care.

Sorry, HIPAA does NOT apply. I am asking the parent for the note from the doctor, not asking the doctor directly. The parent can choose to not comply with my policy, but will be denied a return to care. I checked with my licensor today. Thanks for attempting to stir the pot though!

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ALSO, all parents are aware of the infants and the special needs kiddo in my daycare. They all think it is wonderful that I have agreed to take him. I warned the special needs foster mom and told her that I would feel better if he stayed home this week (he only comes 2 times a week). I have completely sanitized all the toys and anything else I can think of that he may have come in direct or indirect contact with.

I have done all that I can do.

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So we are responsible to notify every emergeny room, acute care clinic, walk in clinic, etc. that could possibly SEE one of our day care kids that WE have a day care kid that is immunocomprimised thus ANYTIME they HAPPEN to see one of our day care kids they ALREADY know there is an imunocomprimised kid in our care?

That's what you are saying? It's up to US to notify any possible MD that the sick kid could go to?

Sure... .that's doable.

The MD's word is his OPINION of whether or not the kid can return to care. They can't possibly know our population. They can not possibly know whether or not the other children have already been exposed. Last week I had five kids gone on spring break. On Monday I had a newborn start his very first day. If this kid came back to my house he would have exposed five kids who hadn't seen him for nine days and a brand new seven week old infant he had never met. How in the world would his Doctor know that he hadn't been around my kids or even met one of my kids? Do you think the Mother of my newborn would have been okay with him exposing her brand new baby?

Tell me specifically WHAT cases a home day care provider MUST accept a child with a definite contagious illness because of the final word of a doctor? Where is it written that WE must accomodate a FMLA law?

I decide what I will accept and what I won't. If the parent and doctor feel the child can go to daycare with the illness then the two of them can find another daycare. It doesn't have to be MY daycare.

If you have done daycare for any length of time you have been burnt on doc notes. You figure out really quickly that some parents will lie directly to a doctor to get the note. They will mask fevers with advil and tylenol to prove the kid doesn't have a fever. They will give a history that doesn't resemble in any way the child's condition in your home.

Whenever there is money attached to the note you are going to have some people cheat to save their money. Dr's notes are just one avenue for that in child care. It's just real life and in the end I am responsible for what I allow in my home.

The OP's dcp LIED to her. Do you think that same parent wouldn't lie to the Doctor?

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A parent must accept a Dr.s recommendation. A parent's employer must also respect that. No one can tell you what you must accept in your home, but not many working parents would accept a contract written on your personal opinion. Having parents fired from their jobs will not increase your business. CDC guidelines are a safe home base. Many FCPs and Centers have a clear policy on illness that keeping this RSV+ child home would violate. The conditions necessary for providing perfectly safe care for a immune compromised child can't be met in most group care settings. I don't feel, based on the OP, that this mom intentionally deceived this provider. I feel that she acted on her interpretation of the common knowledge of RSV, that it is just a cough, that it is very common, will likely make its round of every member of the community and that all of the kids are exposed.

It is practical to require contact information from all parents about pediatricians, if they frequent urgent treatment centers instead, yes, I would require that contact. If I made the decision to accept an immune compromised child into my care, I would make changes to my contracts, notify all other parents and MDs and give parents a choice as to whether they could accept a possible week home even after the MD had returned the child based on my feelings. I would also send home a note with the sick child stating that there is an immune compromised child in care and that the MD must include a statement of no risk to the other children upon returning a child to care. We caught NORO virus at our pediatrician's office on a well child visit. The world is imperfect. Germs are out there.

I do feel that many of the opinions here are hitting an extreme, and whether you choose to consider mine is really your choice, but I am stating it.

I read that you are very lucky to have perfectly well behaved and healthy children in your care. I don't think that represents the entire population of providers or children.

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