Health Requirements for Children
a) A medical report on forms prescribed by the Department shall be on file
for each child.
b) A child suspected of having or diagnosed as having a reportable infectious,
contagious, or communicable disease for which isolation is required by the Illinois
Department of Public Health's General Procedures for the Control of Communicable
Diseases (77 Ill. Adm. Code 690) shall be excluded from the center.
- The initial medical report shall be dated less than six months prior
to enrollment of infants, toddlers and preschool children. For school-age
children, a copy of the most recent regularly scheduled school physical may
be submitted (even if more than six months old) or the day care center may
require a more recent medical report by its own enrollment policy. If a health
problem is suspected, the day care center may require additional documentation
of the child's health status.
- If a child transfers from one day care center to another, the medical
report may be used at the new center if it is less than one year old. In such
a case, the center the child is leaving shall maintain a copy of the child's
medical form and return the original to the parent.
- The medical examination shall be valid for two years, except that
subsequent examinations for school-age children shall be in accordance with
the requirements of the Illinois School Code [105 ILCS 5/27-8.1] and the Child
Health Examination Code (77 Ill. Adm. Code 665), provided that copies of the
examination are on file at the day care center.
- The medical report shall indicate that the child has received the
immunizations required by the Illinois Department of Public Health in its
rules (77 Ill. Adm. Code 695, Immunization Code). These include poliomyelitis,
measles, rubella, mumps, diphtheria, pertussis, tetanus haemophilus influenzae
B, and hepatitis B.
- Unless the examining physician has made a determination that it
is unnecessary, a tuberculin skin test by the Mantoux method and the results
of that test shall be included in the initial examination for all children
who have attained one year of age, or at the age of one year for children
who are enrolled before their first birthday. The tuberculin skin test by
the Mantoux method shall be repeated when children begin elementary and secondary
- The initial examination shall show that children from the ages of
one to six years have been screened for lead poisoning (for children residing
in an area defined as high risk by the Illinois Department of Public Health
in its Lead Poisoning Prevention Code (77 Ill. Adm. Code 845)) or that a lead
risk assessment has been completed (for children residing in an area defined
as low risk by the Illinois Department of Public Health).
- In accordance with the Child Care Act of 1969, as amended, a parent
may request that immunizations, physical examinations and/or medical treatment
be waived on religious grounds. A request for such waiver shall be in writing,
signed by the parent(s), and kept in the child's record.
- Exceptions made for children who should not be subject to immunizations
or tuberculin tests for medical reasons shall be indicated by the physician
on the child's medical form.
- Day care centers shall maintain an accurate list of all children
enrolled in the center who are not immunized, as required by Illinois Department
of Public Health rules 77 Ill. Adm. Code 695.40, List of Non-Immunized Child
Care Facility Attendees or Students. The number of non-immunized children
on the list shall be available to parents who request it.
- Medical records shall be dated and signed by the examining physician
and include the name, address and telephone number of the physician responsible
for the child's health care.
c) Children shall be screened upon arrival daily for any obvious signs of
illness. If symptoms of illness are present, the child care staff shall determine
whether they are able to care for the child safely, based on the apparent degree
of illness, other children present and facilities available to care for the
e) Space shall be provided for a child who becomes ill at the center. Such space
shall be ventilated and heated, within sight and hearing of an adult and equipped
with a cot and materials that can be easily cleaned and sanitized.
- Children with diarrhea and those with a rash combined with fever
(oral temperature of 101EF or higher or under the arm temperature of 100EF
or higher) shall not be admitted to the day care center while those symptoms
persist, and shall be removed as soon as possible should these symptoms develop
while the child is in care.
- Children need not be excluded for a minor illness unless any of
the following exists, in which case exclusion from the day care center is
- a) Illness which prevents the child from participating comfortably
in program activities;
- b) Illness which calls for greater care than the staff can provide
without compromising the health and safety of other children;
- c) Rash combined with fever over 101EF (oral);
- d) Unusual lethargy, irritability, persistent crying, difficulty breathing
or other signs of possible severe illness;
- e) Diarrhea;
- f) Vomiting two or more times in the previous 24 hours, unless the
vomiting is determined to be due to a noncommunicable condition and the
child is not in danger of dehydration;
- g) Mouth sores associated with the child's inability to control his
or her saliva, until the child's physician or the local health department
states that the child is noninfectious;
- h) Rash with fever or behavior change, unless a physician has determined
the illness to be noncommunicable;
- i) Purulent conjunctivitis, until 24 hours after treatment has been
- j) Impetigo, until 24 hours after treatment has been initiated;
- k) Strep throat (streptococcal pharyngitis), until 24 hours after treatment
has been initiated and until the child has been without fever for 24 hours;
- l) Head lice, until the morning after the first treatment;
- m) Scabies, until the morning after the first treatment;
- n) Chicken pox (varicella), until at least six days after onset of
- o) Whooping cough (pertussis), until five days of antibiotic treatment
have been completed;
- p) Mumps, until nine days after onset of parotid gland swelling;
- q) Measles, until four days after disappearance of the rash; or
- r) Symptoms which may be indicative of one of the serious, communicable
diseases identified in the Illinois Department of Public Health Control
of Communicable Diseases Code (77 Ill. Adm. Code 690).
f) The center shall report any known or suspected case or carrier of communicable
disease to local health authorities and comply with the Illinois Department
of Public Health's Control of Communicable Diseases Code (77 Ill. Adm. Code
690). The center shall maintain a file of reported illnesses which may indicate
possible infectious disease.
g) If a child needs emergency care because of an accident or illness that
occurs while the child is in care, the day care center shall attempt to contact
the child's parent(s) at the phone numbers provided for that purpose. If unable
to locate the parents, the day care center's attempts to do so shall be documented
in the child's file.
h) Major and minor accidents or illnesses which happen to a child at the day
care center shall be recorded in the file, and parents shall be notified.
i) Reports of all incidents and injuries involving children shall be prepared
by the person responsible for the child at the time of the occurrence and shall
j) Employees shall wear disposable latex gloves when treating a wound. Employees
shall wash their hands, as prescribed by Section 407.320, after removing the disposable
- The time and place of the incident or injury and details about how
- When medical care is necessary, a statement signed by the physician
attending the child, describing the nature and the extent of injury.
k) When a child's medical needs require special care or accommodation, such
care shall be administered as required by a physician, subject to receipt of
appropriate releases from the parent(s). Medical consultation shall be available
to the staff as needed for the health and medical needs of the children served.
l) The facility shall make potable drinking water freely available to all
children by providing drinking fountains and/or disposable cups for individual
use. Water shall be offered to infants and toddlers at frequent intervals.
m) A child's wet or soiled clothing shall be changed immediately. Universal
precautions shall be followed when handling soiled clothing.
n) Children shall have a shower, tub or sponge bath when necessary to ensure
bodily cleanliness. Parents shall be notified when a child has received a shower
or bath. Children under the age of five shall not be left alone when bathing.
o) When used by children at the child care center, toilet articles such as
combs, brushes, toothbrushes, towels and washcloths shall be individually provided
by the parent or the center. They shall be plainly marked with the child's name
and stored individually in a sanitary manner in areas which promote drying.
Single-use and disposable articles are permitted. Toothbrushes, if used, shall
be replaced when they have lost their tone.
p) If toothpaste is used, care shall be taken to avoid cross-contamination
q) All new linens shall be laundered prior to use.
- Each child shall be given a separate tube of toothpaste labeled
with his or her name; or
- If a single tube is used, the toothpaste shall be dispensed by placing
a small amount on the rim of each child's rinsing cup or on a piece of waxed
r) Staff and children shall wash hands as required by Section 407.320.
(Source: Added at 22 Ill. Reg., effective January 1, 1998)