Temporary Exclusion for Health Reasons (Including Medications and Special Diets) Policy Rationale: Head Start Performance Standard 45 CFR Section 1302.42 (b)(4), 1302.47(b)(7)(iii), and 1302.47(b)(7)(vi). Policy: To ensure the health and safety of our children, staff and volunteers, children with a short-term injury, an acute, contagious illness, or any condition diagnosed after enrollment requiring a Head Start care plan (i.e. asthma), will be excluded from center-based activities and socialization. This exclusion is for a short-term period during which the child in care poses a significant risk to the health or safety of the affected child and/or anyone in contact with the child.
Temporary Exclusion for Health Reasons (Including Medications and Special Diets) Procedure Guidance: To ensure the health and safety of our children, staff and volunteers, children with a short-term injury, an acute, contagious illness, or any condition diagnosed after enrollment requiring a Head Start care plan (i.e. asthma), will be excluded from center-based activities and socialization. This exclusion is for a short-term period during which the child in care poses a significant risk to the health or safety of the affected child and/or anyone in contact with the child. Procedure: 1. Children suspected of having a communicable condition must be sent home and are to be immediately excluded. Until the parent/guardian arrives, the child shall be removed from direct contact with other children and monitored and supervised by a staff person known to the child until dismissed to the appropriate person. 2. If the child is diagnosed with a communicable disease by a healthcare provider contact, see Exposure Notice Procedure. 3. Before returning to school, the parent/guardian must present written documentation from a healthcare provider stating that the child is healthy enough to return to school. Note: If the condition requires a care plan, a care plan must be received prior to the reentry of the child.
4. All notes regarding the child s health check, condition, and interaction with the family will be documented in the child s file. Temporary Exclusion for Illness (Including Medications and Special Diets) Guidelines: A child is to be temporarily excluded if any of the following situations apply: The illness prevents the child from participating comfortably in program/classroom activities. The sick child needs more care than center staff can provide without affecting the health and safety of the other children. If necessary, center staff must seek consultation with the Health Manager before making this determination. The child has any of the following conditions: fever of 101 F; unusual lethargy; irritability; persistent crying; difficulty breathing; or other signs of severe illness. Fever is defined as a temperature equal to or greater than 101 F (oral) or 100 F (axillary/underarms). Any infant younger than 2 months with fever should get immediate medical attention. Diarrhea (defined as an increased number of stools compared with the child s normal pattern). Vomiting. Mouth sores with uncontrolled drooling, unless the child s healthcare provider or local health department authority states the child is non-infectious.
Rash, or unusual spots, with fever or behavior change, until a healthcare provider has determined the illness is not a communicable disease. Skin sores with drainage that cannot be contained in a bandage. Sore throat/severe coughing and/or dry mouth with trouble swallowing, Dental pain (swollen mouth, foul smells, etc.) Headache or any other body pain. Yellowish skin or eyes. Gray/white stool or unusually dark urine. Abdominal pain that continues for more than 2 hours or intermittent abdominal pain with fever or other signs and symptoms. Children identified as having a possible communicable disease (see Exposure Notice Procedure), until cleared by primary health care provider or local health department. If a vaccine preventable disease to which a child is not fully vaccinated occurs, even if the child does not have any symptoms; the health department should be notified and will provide guidelines for exclusion. Note: If a child is diagnosed after enrollment or it is not disclosed to center staff before enrollment that a child has any of the following diagnoses, a temporary exclusion will be warranted and readmission will be granted upon receipt of a care plan. A temporary exclusion may be
warranted if a child is diagnosed with or requires a care plan for the following: Asthma History of seizures Severe allergies Special diet Other conditions that require care beyond that required by children generally
Temporary Exclusion for Illness Re-admission Guidelines The following are recommendations for re-entry into school following exclusion: Exclusion for fever, vomiting, and diarrhea will be for the day the child is sent home and the following full day, at a minimum. Children should be excluded until symptoms have been resolved for at least 24 hours, without the use of medication. The child will be readmitted following the exclusion period. Significant improvement in overall health status has been made, as agreed by both the parent/guardian and center staff. The child s physician provides written documentation stating that the child is not contagious, or re-entry is safe for the child, classmates, and staff. If a care plan is required, the necessary information is completed and returned to center in the form of a referral package- please refer to the Request for Follow-Up Services: Health/Nutrition policy and procedure for additional guidance. The child is not to return to school until the care plan is complete and returned to the center. Report ANY possible communicable diseases to the Health and Nutrition Services Unit immediately and follow the Exposure Notice Procedure. If the illness is part of an epidemic, state and local guidelines regarding testing and treatment must be followed. The Health/Nutrition Services Unit and local health department must be informed of any such case immediately.