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Old 11-09-2012, 07:55 AM
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Default Help!! Need My Backbone!

I have a DCB that has been sick on and off at least 3-4 times since Sept. He's brought it some nasty stuff, including a bout of strep throat and some pretty bad colds (one had him in the hospital for a week!) which for the most part, excluding one phone call to Mom when it was clear he had an ear infection (he was banging his hands over his ears), I have taken him and others have gotten sick from this child - including myself which forced me to close for 2 days due to my own high fever and in my own child.

Yesterday Mom dropped off DCB and mentioned that she thought maybe he was coming down with something since she had noticed the night prior he was starting to sound congested...fine...I don't disclude for every little sniffle and the child appeared fine and she said no fever, good.

This child is now clearly sick again, it started to appear pretty badly yesterday when he couldn't make it past 11 am and refused to eat or drink lunch (which I was serving early), so I put him down to nap. Later that afternoon DCB was worse and since this child cannot control/cover the coughs/sneezes there was a fair amount germ sharing happening. I did what I could to wipe his nose and hands as I saw it, but I can't follow one child around and even if I did it was constant. I do have an illness policy and it does say that if the cough, runny nose, fever etc. is constant they stay home - mind you Mom always seems to point out just the fever part and how DCB doesn't have one!

Now today, Dad drops him off telling me he was in bed by 6:30 up again at 11 for a couple of hours and he wasn't sure what time he was up again this morning, but it was early. He also tells me that he isn't too bad and that he's given him tylenol. RED FLAG. Seriously...am I wrong in telling this parent that they cannot continue to do this? They have told me on 3 different days in the past that they have given DCB meds before drop off. It also says in my contract that children must be symptom free for 24 hours without the aid of meds. Obviously I would not disclude for a little runny nose, but when it makes life very difficult and the child is wiping it all over, then it's an issue!

I need a backbone today!! DCB seems ok so far, a bit tired obviously, but I have him away from the others as best I can and have limited his toys to those I can wash easily and well. When Mom comes tonight I have other issues I need to bring up, she drops him off 15 mins. before I have to have my son to school causing us to practically run to the school, but now I HAVE to include the fact that she cannot drop him off like this.

How do I tell her it can't happen without telling her what to do? I want to tell her if her son has had such a difficult night, keep him home...but that to me sounds a bit offensive...but to me just common sense!? How can I tell her in a way she won't try to hide the fact that DCB is medicated when she drops him off? Do I just write a note address to DCP, not specifically her, and highlight some contract rules? I also want to point out that it's his age that adds to the issue since it can't be as well controlled.
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Old 11-09-2012, 08:00 AM
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I would not allow him to stay. If a child is sick enough to need medicine before they arrive, then they are too sick for daycare.

I have had to be very tough with my illness policy lately, as it seems no one cares if they infect the whole place (unless it is their child who gets ill from another child - then I never hear the end of it).

I would keep taking his temp, and as soon as his medicine wears off and the fever comes back, send him on his way home!!!!!
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Old 11-09-2012, 08:06 AM
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Originally Posted by bunnyslippers View Post
I would not allow him to stay. If a child is sick enough to need medicine before they arrive, then they are too sick for daycare.

I have had to be very tough with my illness policy lately, as it seems no one cares if they infect the whole place (unless it is their child who gets ill from another child - then I never hear the end of it).

I would keep taking his temp, and as soon as his medicine wears off and the fever comes back, send him on his way home!!!!!

The issue is I don't think he has a fever right now - I will check once the meds wear off anyway obviously. He didn't have one at all yesterday, it's more his symptoms that are dragging him down - he's only 1. My issue is the nose/sneezing and spreading germ everywhere. I can't stay on top of it! He's wiping it across his clothing/face before I see it and then the toys are covered - his hands were soaked yesterday at one point since he's having trouble breathing through his nose and thus drool! I guess I'm having a tough time with it since there isn't a fever...but I just don't feel it's right he's here...to me or other kids!

My thoughts were to tell them that if you feel he is unwell enough to give meds then really should he be coming? Obviously they know he isn't well, otherwise they wouldn't give him tylenol, so why don't they keep him home if they already know he isn't the best!?
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Old 11-09-2012, 08:09 AM
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I have it written in my policies that children must be fever AND medicine-free for 25 hours before returning to care. I would definitely address it with the parents and let them know it is unacceptable.
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Old 11-09-2012, 08:12 AM
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I tell my parents that if the child is sick enough to be on meds they are too sick for daycare...
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Old 11-09-2012, 08:15 AM
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Sounds to me like you were a bit flexible and relaxed about it all and now it is getting to you and you are frustrated with the whole scenario....however, mom is not seeing you as being flexible and bending your rules about illness, she just knows that it hasn't been a problem before and so it is just the way it is....kwim?

Now you will have to do some serious back-pedaling to "fix" this issue.

My advice is to have clear, FIRM illness policies and ALWAYS enforce them every.single.time. Once you let something slide, it will now become the norm in the parents eyes. It is like I have always told my children...It is easier to keep yourself out of a hole, than to have to dig yourself out later.

You need to give her a copy of your illness policies and then you need to do some serious reinforcing. I am betting she will be upset because you have been lenient before.

I have in my contract that if a parent medicates their child before dropping off, that it is grounds for immediate termination. I also have a rule that if I send your child home they must stay home for a FULL 48 hours before they can return to care but if a parent simply chooses to keep their child home, they need only stay home for 24 hours. (Thank you C-H for that )

I also send home whenever a child is unable to participate at 100%. If they are laying around being whiney or cranky, then they need to be at home. I stress to all my parents that rest is the miracle cure and sending your child to an environement that is busy and over stimulating when feeling under the weather is basically neglect in my book.

I hope you find a way to address this so the poor little one can get better.
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Old 11-09-2012, 08:23 AM
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Quote:
Originally Posted by Blackcat31 View Post
Sounds to me like you were a bit flexible and relaxed about it all and now it is getting to you and you are frustrated with the whole scenario....however, mom is not seeing you as being flexible and bending your rules about illness, she just knows that it hasn't been a problem before and so it is just the way it is....kwim?

Now you will have to do some serious back-pedaling to "fix" this issue.

My advice is to have clear, FIRM illness policies and ALWAYS enforce them every.single.time. Once you let something slide, it will now become the norm in the parents eyes. It is like I have always told my children...It is easier to keep yourself out of a hole, than to have to dig yourself out later.

You need to give her a copy of your illness policies and then you need to do some serious reinforcing. I am betting she will be upset because you have been lenient before.

I have in my contract that if a parent medicates their child before dropping off, that it is grounds for immediate termination. I also have a rule that if I send your child home they must stay home for a FULL 48 hours before they can return to care but if a parent simply chooses to keep their child home, they need only stay home for 24 hours. (Thank you C-H for that )

I also send home whenever a child is unable to participate at 100%. If they are laying around being whiney or cranky, then they need to be at home. I stress to all my parents that rest is the miracle cure and sending your child to an environement that is busy and over stimulating when feeling under the weather is basically neglect in my book.

I hope you find a way to address this so the poor little one can get better.

Yes, I have been relaxed...I have not stood up to what is in my contract...that's the issue...ME! I have to get a backbone, I've never had to before, so it makes it harder. I have an issue with being "mean", while I know sticking to my contract is not that, I just hate to have to confront someone about their child, when they should already know when their child needs something! I only have 2 families in my care, my daycare is small, but this little one has made everyone here sick at some point or another and its' wearing me down. So much illness in such a short period, yes, I am frustrated!
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Old 11-09-2012, 08:28 AM
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Quote:
Originally Posted by NeedaVaca View Post
I tell my parents that if the child is sick enough to be on meds they are too sick for daycare...
That ^. Regardless of fever. Here is my illness policy.

For the health and safety of your child, the other children in my care, myself and my family, please do not bring your child if they are sick. Children with mild cold like symptoms may attend, who are otherwise feeling and acting well. The symptoms of mild cold include; no fevers, mild runny nose, slight cough. If you are not sure if your child can attend, please contact me. If your child/ren becomes ill during daycare hours, you will be notified and expected to pick up or make emergency arrangements WITHIN 30 MINUTES. It is at my discretion when to remove a child, some of these symptoms include, but are not limited to; fever of 100.4 or greater, cough, moderate-severe runny nose, nausea and/or vomiting, diarrhea, rash or irritability that causes them to be unable to participate. Once the child is removed he/she will not be allowed back until they are symptom free for 24 hours without medication AND well enough to participate in our daily schedule. On occasion I will request a note from the pediatrician stating that they are no longer contagious and able to participate in daycare. Please remember that while stringent, these guidelines go both ways. This means that your child (and ultimately yourself and family) are not being exposed to unnecessary illnesses as well.



I would include something to them about being unable to participate. If a child is too sick to keep up, they need to go home to rest.

I just sent home a kiddo today with a mild cold who was absolutely miserable, he just wanted to lay on the floor and refused to go outside. Parents understood and Mom came to get him. Can you imagine being in the child's shoes when they are ill and all they want is home/Mom? When I called my dcm I just played on her sympathy/empathy for her own child. "Dcm little John is just miserable, he doesn't have a fever (98.9) but he is exhausted and crying and asking for you and isn't able to keep up with the kids today, I think he really needs some Mommy time right now that he feels so awful."
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Old 11-09-2012, 08:40 AM
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Quote:
Originally Posted by Mom&Provider View Post
Yes, I have been relaxed...I have not stood up to what is in my contract...that's the issue...ME! I have to get a backbone, I've never had to before, so it makes it harder. I have an issue with being "mean", while I know sticking to my contract is not that, I just hate to have to confront someone about their child, when they should already know when their child needs something! I only have 2 families in my care, my daycare is small, but this little one has made everyone here sick at some point or another and its' wearing me down. So much illness in such a short period, yes, I am frustrated!
Here is a little tip someone gave me many many moons ago and I think it really helped.

Blame licensing. Every time a parent tries to bend or break your illness policy, tell them you understand that it is hard to take a day off work and that if you could keep their child at care while they are sick, you totally would but you just can't because you could get in trouble with licensing if they made a surprise visit to you and found you caring for a sick kid.

I pretty much follow the rules for illness that the CDC uses or public schools use so it isn't unique or anything out of the ordinary. Most parents do have common sense but there are always those few who don't fit into that mold so simply blame someone they cannot argue with. If it is a licensing rule and you could get in trouble then I can't imagine why they would think it is ok for them to get special priviledges.

I would also start requiring a doctor's slip for re-entry in to care. I do this after 5 days of consecutive symptoms such as a runny nose, whiney behavior, diarrhea or anything else.

I don't just focus on the fever (or lack of fever) as the only reason for exclusion. There is more to illness than fever. I have a little guy (age 15 months) here who has just been a bit off the last few days. It has lasted more than 5 days. I had mom bring him in and sure enough...double ear infection. He had NO symptoms or signs of it other than just not being himself. No temp, no ear rubbing, no whining, etc.

So good rule of thumb is blame licensing (or whatever authority you need to follow) and require a doctor's visit after 5 days of symptoms
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Old 11-09-2012, 08:58 AM
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Sounds like you need to make a few changes to your illness policies and then need to really enforce your illness policy. Remember that you are not only caring for this one child and as inconvenient as it may be for the DCPs to stay home with him but you have the other children in your DC to think about as well. And not just in this situation with DCB that constantly gets sick but if any of the other children get sick too. It's cold and flu season and we're getting to the end of the year ... the perfect time to make changes to your illness policy.

Illness in daycare is one of my personal pet peeves so I have a very wordy illness policy. Here's what I have and yes, I enforce it.
  • I don't give/allow medication at daycare at all
  • If a parent keeps their child home sick they can return 24 hours after syptoms dissapear
  • If I send a child home sick the 24 hours exclusion turns into 48 hours
  • If a child takes any type of fever.pain reducer they MUST stay home
  • If any child shows ANY symtom of exclusion they must stay home
  • I deem whether a child is well enough to attend DC or not even if I am given a DR's note
  • I have added in my termination policy that I can term without notice if a child is brought to DC sick frequently or if they question or try to negotiate any of my policies
  • I even have a policy that I adopted from someone here on the forum about excluding for 48 hours after being immunized.

So far it seems to work but I HAD to enforce them. I had to put on my big girl pants and walk the walk. I hated any type of confrontation but I hated not being able to enjoy doing daycare because I felt like I had no control. The ladies here on this forum helped me grow, strengthen and use my backbone . I changed my policies, sent out notices highlighteing important changes, sat down with parents one on one, and then I enforced my policies. Here's my illness policy word for word: (I put in bold the important things to point out to parents)

Illness Policy
We understand that all children have minor illnesses from time to time that do not prevent them from attending daycare; however, there are certain circumstances where children cannot attend.

We are a well-child daycare and although we understand that it is an inconvenience for a client to take time off of work when a child cannot attend daycare however there are reasons for the exclusion. Any time that an ill child doesn’t feel well enough to participate comfortably in activities requires more care than the childcare provider is able to provide without compromising the health & safety of the other children. An ill child can also quickly spread illness to the other children in the group. This is group care and the needs of the group as a whole take priority.

Symptoms for Exclusion
Keep your children home if they exhibit any of the listed symptoms. Children must be excluded for 24 hours after the symptoms of the illness have subsided without the aid of medication. Do not confuse this with the onset of symptoms, meaning the 24 hours begin after the child’s symptoms disappear. If a child is sent home sick, a minimum of 48 hours exclusion will be required.

Keep in mind that fever reducers and pain relievers do not cure illnesses, they simply mask symptoms. If a child is given any form of fever reducer or pain reliever then the child is not well enough to attend daycare and is required to be kept home for a minimum of 24 hours from the time that the last dosage was given.

As per our license a child is not able to attend daycare if the child exhibits any symptoms for exclusion. Those include but are not limited to:
  • Severe sore throat/coughing/colds or strep throat.
  • Fever of 100° F or above.
  • Green/yellow discharge from nose or eyes.
  • Ear discharge.
  • Head lice, nits or scabies.
  • Three or more watery stools within 24 hours.
  • Two or more occasions of vomiting within 24 hours.
  • Severe diaper rash.
  • Chicken pox.
  • Conjunctivitis (pink eye).
  • Mumps, measles, influenza, pertussis (whooping cough), coupe, impetigo,
  • tuberculosis, rubella, rosella, etc.
  • Any type of body rash.
  • Intestinal worms, ringworms, pin worms etc.
  • Anything contagious and transmittable.
  • Any ailment that requires fever or pain medication.
  • If the child is too tired or fussy to participate in normal activities.

It is at the discretion of the childcare provider to determine whether a child can attend daycare. If the child is deemed not well enough to attend the child is to be taken home. If a child becomes ill at daycare the client will be contacted and the child will need to be picked up within one hour. During the time spent waiting the ill child will be separated from the other children and given the opportunity to rest. If a child becomes ill at home please call the childcare provider so that we can look out for signs of spreading illness.

Medication
The childcare provider will not administer any type of medication at daycare. This includes prescription and non-prescription medication. If a child needs medication of any kind a dosage schedule must be set up that does not include the hours that the child is in care. Clients are required to notify the childcare provider any time that their child is on any type of medication so that we can look out for possible reactions to the medication.

Keep in mind that fever reducers and pain relievers do not cure illnesses, they simply mask symptoms. If a child is given any form of fever reducer or pain reliever then this means that the child is not well enough to attend daycare and is required to be kept home for a minimum of 24 hours from the time that the last dosage was given.

Do not send a sick child to daycare by giving a fever/pain reducer to mask the symptom. The effects of the medication will eventually wear off (usually between 12:00 p.m. and 2:00 p.m. if given in the morning) and it will be apparent to the childcare provider that the child was given medication. Giving a child fever/pain reducer before daycare are immediate grounds for termination.

Topical products such as lotion, diaper rash ointment, sunscreen, children’s toothpaste, etc. are the only exception but require written consent. Topical products must be provided by the client in unopened and original containers and labeled with the child’s name and must remain at the daycare at all times.

Immunizations
A copy of every child’s immunization records must be kept in each child’s file. If for any reason a client chooses not to have the child immunized, a “Personal Beliefs Affidavit” must be completed and kept in the child’s file instead.

All children are required to stay home for a minimum of 48 hours after being immunized. Children exhibiting symptoms for exclusion due to immunizations must still follow the sickness policy.

We suggest that a child’s immunizations be scheduled on Friday afternoons to minimize the time that a client must take off of work. This way the child’s required recovery time can pass through the weekend.
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