Download Temporary Exclusion Policy

Southern Kennebec Child Development Corporation
Communicable Disease & Vaccine Preventable Illness
Temporary Exclusion Policy
Rationale:
1). Effective procedures prevent and reduce the spread of a communicable disease to other
children, adults, and their families throughout the program and community.
2). Infants and young preschool children, due to their very age, are highly susceptible to
contagious disease. They have not yet built up resistance or completed immunizations for
protection against communicable disease. Also young children have many habits that promote
the spread of germs such as putting fingers and other objects in their mouths or not washing their
hands frequently or effectively. In this way, germs enter and leave the body and then infect the
child or are passed on to others.
3). This policy is consistent with Federal, State and SKCDC Child Care guidelines and
standards, as well as the American Academy of Pediatrics, The Centers for Disease Control and
the Advisory Committee of Immunization Practices. (See Maine Rules for the Licensing of
Child Care Facilities attached).
4). Staff will do all they can to support a child and family through any illness or injury in order
for a child to quickly return to his/her normal daily routines.
5). Staff are NOT health care professionals or substitute-parents. They are not qualified,
licensed, or permitted to act outside of their qualifications or position descriptions. Therefore
Staff have the obligation to follow this policy by assessing and acting on the side of caution.
Policy:
Note: It is to be understood that when this policy makes reference to child/children it will
also be inclusive for adults and staff, even if not stated but if appropriate to the situation.
Children and Staff will be temporarily excluded from the center if:
1) The child’s illness prevents the child from participating comfortably in activities that the
facility routinely offers for well children.
2) The illness requires more care than the child care staff is able to provide without
compromising the needs of the other children in the group.
3) Keeping the child in care poses an increased risk to the child or to other children or adults
with whom the child will come in contact
If any of these criteria are met, the child should be excluded, regardless of the type of illness.
SKCDC Employed Staff/Volunteers or Enrolled Children who may be excluded are:
 Those who have no immunization certificate of vaccination on file for the specific
communicable disease or are too young to have received the vaccine.
 Those who have a waiver of Immunization Exemption Form (Attachments A & B) on
file documenting a sincere religious or philosophical belief or a medical reason against
the immunization.
M:\Plans, Policies, Procedures\Temporary Exclusion Policy
Revised 6/1/13


Those who do not have a documented history (by a health care provider) of a vaccine
preventable illness.
Those who have an illness that requires temporary exclusion as defined by the Maine
Center for Disease Control (CDC) and/or Managing Infectious Diseases in Child Care
and Schools, 2nd Ed., 2009 (Attachment C).
Procedure:
In the event that one of our enrolled children, or employed staff, is diagnosed with a
communicable or vaccine preventable disease that requires immediate temporary exclusion, the
following steps shall be taken:
1). Site Center Supervisor, Site Program Manager, and the Health/NutritionManager shall be
notified immediately.
2). The parent/guardian or emergency contact of the child will be notified immediately, and will
be asked to pick up the child within one hour. The staff person will be expected to leave the
center ASAP.
3). The child will be isolated from the other children as much as possible, until the parent arrives.
4). Parents/Guardians and Staff will be notified in a timely manner with a Parent Notification
Letter (Attachment D). Printed notification will also include a health related fact sheet
recommendations for home care. (See Quick Reference Sheets in Managing Infectious
Diseases).
5). In the event of a disease outbreak, children/staff who have an Immunization Exemption form
on file or who do not have the documentation of vaccination or disease, will be excluded from
the program until the threat from exposure no longer exists, or until the child/ staff has been
vaccinated, which ever comes first. The actual length of the exclusion will be determined by the
Maine CDC.
6). Children/Staff who have been ill with a communicable disease or illness may return to the
center if the exclusion criteria are resolved, the child is able to participate, and the staff
determine that they can care for the child without compromising their ability to care for the
health and safety of the other children in the group. There may be additional return criteria for
specific conditions as determined by specific SKCDC policies (e.g. head lice policy), the Maine
CDC, the child’s health care provider, and recommendations in Managing Infectious Diseases.
Note: If there is a conflict between SKCDC policies and the recommendations of others,
the Health/Nutrition Manager should be consulted.
M:\Plans, Policies, Procedures\Temporary Exclusion Policy
Revised 6/1/13
Recommendations for Inclusion or Exclusion (Attachment C)
Mild illness is common among children. Most children will not need to be excluded from
childcare for mild respiratory illnesses, because transmission is likely to have occurred before
symptoms developed in the child. Disease may occur as a result of contact with children with no
symptoms of infection. The risk of illness is decreased by following proper hygiene, such as
hand washing.
Recognizing & Managing Communicable Diseases
When a Child Is Too Sick to Attend
Most children with mild illnesses can safely attend child care. But, a child may be too sick to
attend if:
1) The child does not feel well enough to participate comfortably in the program's activities.
2) The staff cannot adequately care for the sick child without compromising the care of the other children.
3) The child has any of the following symptoms unless a Primary Care Provider determines that the child
is well enough to attend and that the illness is not contagious (infectious):
-Fever (101° F. orally, or above 100 ° F. axillary) accompanied by behavior change
and other signs or symptoms of illness (i.e. the child looks and acts sick)
-Signs or symptoms of possible severe illness (e.g. persistent crying, extreme irritability, uncontrolled
coughing, difficulty breathing, wheezing, lethargy (very tired)
-Diarrhea: Changes from the child's usual bowel movements (stool pattern)--increased frequency of
stools, looser/watery stools, stool runs out of the diaper, or child can't get to the bathroom in time.
-Vomiting more than twice in the previous 24 hours
-Mouth sores with drooling
-Rash with a fever or behavior change
4) The child has any of the following diagnoses from a Primary Care Provider (until treated and/or no
longer contagious):
-Chicken pox-until six days after start of rash or all sores have crusted over
-Hepatitis A-until seven days after start of symptoms (e.g., jaundice)
-Impetigo-when topical, oral or other systemic antibiotics are started if the sores can be covered and kept
dry
-Measles-until four days after onset of rash
-Mumps-until five days after onset of swelling
-Oral herpes (if child is drooling or lesions cannot be covered)-until lesions heal
-Pertussis (Whooping Cough) until five days after appropriate antibiotic treatment started
-Rubella (German measles)-until seven days after onset of rash
-Scabies or other infestation-until after treatment is completed
-Shingles (if lesions cannot be covered)-until lesions are dry
-Strep throat, scarlet fever, or other strep infection-until 24 hours after antibiotic treatment started
-Tuberculosis (TB)-until a health care provider determines that the disease is not contagious
Adapted from: Managing Infectious Diseases in Child Care and Schools, American Academy of Pediatrics,
2nd Ed. 2009. A copy is available at each SKCDC site.
M:\Plans, Policies, Procedures\Temporary Exclusion Policy
Revised 6/1/13
M:\Plans, Policies, Procedures\Temporary Exclusion Policy
Revised 6/1/13