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SICK CHILDREN POLICY Reference: CCB – Federal Funding Guidelines Handbook on Child Care Licensing QIAS Principle 6.6 Legislation: Child Care Act and Regulations 2003 Food Safety Legislation 2001 Workplace Health and Safety Act 1005 Workplace Health and Safety Regulation 1997 Royal Children’s Hospital Rationale: Maintaining a healthy community in child care is the responsibility of both parents and staff. Our Centre is not a place for sick children, as we cannot provide the care contagious or ill children need. Any child suffering from an infectious illness will be excluded from the Centre until they are well or no longer infectious (as may be determined by a clearance letter from a Medical Practitioner). A child requiring 1:1 care reduces the staff/child ratio and reduces the safety of the remaining children. Aim: To set guidelines for dealing with sick children for staff and parents, and maintain a safe environment for children, staff and families. Implementation: For children who become sick while at the centre staff will follow the exclusion policy and the Director will exercise discretion in individual circumstances. This discretionary note is put in place until confirmed by a Medical Practitioner or until a clearance letter is given. This is to protect the children, staff and families from any suspected outbreak of an illness or to protect the wellbeing of the child. Children suffering infectious skin disorders, conjunctivitis, head lice, and school sores (impetigo) will be excluded until treated. This policy reduces the risk of transmission. For children who are sick at home for contagious illnesses a doctor’s clearance will be needed before the child can resume attendance at the centre. A doctor’s certificate may be required for return of care when a child has had an illness or suspected illness, this will be at the request of the Director and also as per Appendix 1 so as to keep up the centre duty of care to all children, staff and families. For children with a notifiable illness, the director will contact the Department of Health as required. A notifiable illness is an illness that under the Government Regulations, requires the centre to inform the State Health Department of the illness being present at the centre. An example of such a case might be one or more cases of: H1N1 Influenza, Tuberculosis, Shigella (intestinal infection), Meningistis, Measles, Hepatitis A, B or C, Brandon Park Children’s Centre September 2009 – version 2 – approved by Parent Committee 26th August Haemophilus Influenzae Type B More than 2 cases of: Erythema Infectiosum (slapped cheek, parvovirus B19, fifth disease), More than 3 cases in one group of: Rotavirus (intestinal infection), Roseola (sixth disease), Cryptosporidiosis (vomiting and diarrhoea), Diarrhoea and Vomiting (gastroenteritis), Campylobacter (intestinal infection). In this case the family details will be given to the Department for reporting. For a list of infectious/communicable illnesses please refer to Appendix 1. Children who are hospitalised must wait 24 hours before returning to the centre. Children with temperatures above 37 degrees under the arm and 38 degrees in the ear will be required to be picked up as soon as practicable (temperatures per Paediatric guidelines on temperatures) (staff usually take temperatures in the ear at the centre). Children who are deemed too sick or unfit to participate in the daily program will be required to be picked up All cases of vomiting and diarrhoea will be excluded for 24 hours (parents are to advise the centre if children have been unwell overnight) Children who start a course of antibiotics will be excluded for 24 hours. A list of infectious diseases and exclusion periods is available at the office and are listed in the foyer. EVALUATION AND REVIEW: This policy will be reviewed at least annually. Family and staff feedback will be considered in the review process. Changes in legislation, regulations, QIAS and standards will be considered. Any changes to this policy will be communicated to families and staff verbally and in writing (Notice Boards and Newsletters) ASSOCIATED FORMS AND DOCUMENTATION: Exclusion Table Infectious Diseases Log Appendix 1: Communicable Diseases Published by the Communicable Diseases Section, Victorian Government Department of Human Services — February 2004 Minimum Period of Exclusion from Schools and Children's Services Centres for Infectious Diseases Cases and Contacts The following table indicates the minimum period of exclusion from schools and children’s service centres required for infectious diseases cases and contacts as prescribed under Regulations 13 and 14 of the Health (Infectious Diseases) Regulations 2001 — Schedule 6. In this Schedule 'medical certificate' means a certificate of a registered medical practitioner. Brandon Park Children’s Centre September 2009 – version 2 – approved by Parent Committee 26th August Conditions Amoebiasis (Entamoeba histolytica) Campylobacter Chicken pox Conjunctivitis Diarrhoea Diphtheria Haemophilus type b (Hib) Hand, Foot and Mouth disease Hepatitis A Herpes ('cold sores') Human immunodeficiency virus infection (HIV/AIDS) Impetigo (school sores) Influenza and influenza like illnesses Leprosy Measles Meningitis (bacteria) Meningococcal infection Mumps Exclusion of cases Exclude until diarrhoea has ceased Exclusion of contacts Not excluded Exclude until diarrhoea has ceased Exclude until fully recovered or for at least 5 days after the eruption first appears. Note that some remaining scabs are not a reason for continued exclusion Exclude until discharge from eyes has ceased Exclude until diarrhoea has ceased or until medical certificate of recovery is produced Exclude until medical certificate of recovery is received following at least two negative throat swabs, the first not less than 24 hours after finishing a course of antibiotics and the other 48 hours later Exclude until medical certificate of recovery is received Until all blisters have dried Not excluded Any child with an immune deficiency (for example, leukaemia) or receiving chemotherapy should be excluded for their own protection. Otherwise not excluded Exclude until a medical certificate of recovery is received, but not before 7 days after the onset of jaundice or illness Young children unable to comply with good hygiene practices should be excluded while the lesion is weeping. Lesions to be covered by dressing, where possible Exclusion is not necessary unless the child has a secondary infection Not excluded Exclude until appropriate treatment has commenced. Sores on exposed surfaces must be covered with a watertight dressing Not excluded Exclude until well Not excluded Exclude until approval to return has been given by the Secretary Exclude for at least 4 days after onset of rash Not excluded Exclude until well Exclude until adequate carrier eradication therapy has been completed Exclude for 9 days or until swelling Not excluded Not excluded Exclude family/household contacts until cleared to return by the Secretary Not excluded Not excluded Not excluded Not excluded Immunised contacts not excluded. Unimmunised contacts should be excluded until 14 days after the first day of appearance of rash in the last case. If unimmunised contacts are vaccinated within 72 hours of their first contact with the first case they may return to school Not excluded Not excluded if receiving carrier eradication therapy Not excluded Brandon Park Children’s Centre September 2009 – version 2 – approved by Parent Committee 26th August Poliomyelitis Ringworm, scabies, pediculosis (head lice) Rubella (german measles) Salmonella, Shigella Severe Acute Respiratory Syndrome (SARS) Streptococcal infection (including scarlet fever) Trachoma Tuberculosis (TB) Typhoid fever (including paratyphoid fever) Verotoxin producing Escherichia coli (VTEC) Whooping cough Worms (Intestinal) goes down (whichever is sooner) Exclude for at least 14 days from onset. Re-admit after receiving medical certificate of recovery Re-admit the day after appropriate treatment has commenced Not excluded Not excluded Exclude until fully recovered or for at least four days after the onset of rash Exclude until diarrhoea ceases Exclude until medical certificate of recovery is produced Not excluded Exclude until the child has received antibiotic treatment for at least 24 hours and the child feels well Re-admit the day after appropriate treatment has commenced Exclude until receipt of a medical certificate from the treating physician stating that the child is not considered to be infectious Exclude until approval to return has been given by the Secretary Not excluded Exclude if required by the Secretary and only for the period specified by the Secretary Exclude the child for 5 days after starting antibiotic treatment Not excluded Exclude if diarrhoea present Not excluded Not excluded unless considered necessary by the Secretary Not excluded Not excluded Not excluded unless considered necessary by the Secretary Exclude unimmunised household contacts aged less than 7 years and close child care contacts for 14 days after the last exposure to infection or until they have taken 5 days of a 10 day course of antibiotics Not excluded Exclusion of cases and contacts is NOT required for Cytomegalovirus Infection, Glandular fever (mononucleosis), Hepatitis B or C, Hookworm, Molluscum contagiosum, or, Parvovirus (erythema infectiosum fifth disease Brandon Park Children’s Centre September 2009 – version 2 – approved by Parent Committee 26th August Brandon Park Children’s Centre September 2009 – version 2 – approved by Parent Committee 26th August