Know

Each child’s day should begin with a simple health check. This is a quick way to make sure the child is healthy enough to be in your family child care program. Most children occasionally get a runny nose, cough, or mild fever. This usually causes little worry for providers and families. However, sometimes, a child’s illness becomes more severe. You need to establish policies to guide decision-making when dealing with ill children. Because you know the children in your care well, you can likely tell when a child is well enough to participate in activities and when a child is too sick to stay at your program. You will need to outline guidelines to help you make this decision and share those guidelines with families. The American Academy of Pediatrics (2011) offers three key factors to help you decide whether a child is too sick for child care:

• The child cannot participate in activities
• The child’s illness presents a risk to other children or adults
• You cannot care for the child while maintaining appropriate care for the other children

If a child meets any of these criteria, it is likely that they should be sent home. See the attachments in this section for lists of illnesses that do or do not merit exclusion from child care. Daily health checks are a way to evaluate a child to help make these decisions. It is up to you—not the family—to decide whether a child is healthy enough to stay in child care. You must consider the guidelines of your specific licensing agency, as well as the health of the other children, yourself, and any other person in your program.

Daily health checks also can offer a record of changes in a child’s appearance or behavior, which can be important in cases of child abuse or neglect. This information can also be very useful for families if the child is suspected of having a long-term physical- or mental-health need. Health checks, if conducted sensitively and documented thoroughly, can help you build relationships with children and families. This lesson will answer questions many family child care providers may have about health checks.

什么是健康检查？

健康检查是对孩子的身体、情绪和行为的快速评估。作为健康检查的一部分，你还应该从家庭收集信息。你想知道是否有任何健康变化影响到孩子或家庭成员。一个简单的问题，“今天大家都感觉好吗？“可以开始对话。随着你对孩子的了解，你会很快注意到日常生活中的任何差异。健康检查的目的是发现孩子可能遇到的任何疾病或健康问题。

我应该什么时候做健康检查？

你应该做一个健康检查每次孩子或youth arrives in your program (if a child comes to your program before and after school, a quick health check should happen at both times). Ideally, in instances when a family member drops off the child, health checks should be completed before the parent or guardian leaves your home. This will give you a chance to talk with the parent or guardian if you suspect the child is ill or if you have questions about any changes in the child’s appearance or behavior. You should also do a health check any time you notice a change in the child’s appearance or behavior. You might do a series of health checks across the day if you suspect a child is not feeling well.

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What Does a Health Check Look Like?

The procedures for doing a daily health check may vary. Watch this video to see an example of family child care providers checking a child’s health.

Daily Health Checks

What Should I Look For?

你的授权机构可能为您提供每天health check form. If not, the Apply Activities section of this lesson has samples that you can adapt for your own use. When doing a health check, be sure to use all your senses.

• Look over the child’s body. Do you see any bruises, cuts, scrapes, or burns? Do you see any open sores or fluid coming from the child’s eyes or nose? Do you see any scratching of the head or body? Do you see any unusual behaviors (sad, sleepy, irritable, lack of appetite)?
• 倾听是否有咳嗽、喘息或鼻塞。
• Feel the child’s skin for a fever or signs of dehydration if he or she appears ill.
• Use your sense of smell to check for any unusual odors.

Conversation is a powerful tool with school-age children. Compared to younger children, school-agers are better able to communicate their feelings and experiences. If you have concerns, remember to ask children and youth about how they are feeling and bring your concerns to their attention (e.g., “You look really flushed, do you feel hot?”). You can also greet children as they enter the program by asking them questions such as:

• How are you doing today?
• 你在学校过得怎么样？
• 你今晚过得怎么样？

The answers to these questions provide valuable information and help you ensure the health of the children and youth in your care.

Do

Document any problems or changes on your daily health check form. If you think the child is ill and should not be in child care, talk with the parent or guardian immediately. This will allow them to make alternative plans.

Whether or not you see a problem, it is important to document your daily health check. Record that you did a health check each day, and mark anything unusual for the child or family. Be sure to save this documentation for at least 30 days. In the event of a disease outbreak, these records can be very useful to public health officials.

排除and Readmission Policies

花点时间来制定或更新您的计划的排除和重新接纳政策。与您的培训师、教练或授权代理交谈，了解他们对您的排除和再入院政策有哪些建议和建议。您也可以查看随附的样本排除和再入院政策从家庭儿童护理提供者的计划手册。确保您的政策符合儿童、家庭和提供者的安全做法。花点时间考虑一下，在你的家人或监护人到来之前，你将如何恰当地照顾生病的孩子。亚慱彩票APP

您的排斥和再接纳政策考虑到儿童、其他儿童的健康和家庭的需要。坚持这项政策并帮助家庭了解你的项目与健康相关的期望和要求是很重要的。

你有责任决定是否需要排除一个孩子以及需要多长时间。你有责任知道：

• The conditions and symptoms that do not require exclusion
• 排除患病儿童的标准
• The procedures for a child who requires exclusion

与普遍的看法相反，排除患有轻微疾病的儿童不太可能减少病菌的传播，因为大多数儿童在患病前后都会传播病菌，或者不会出现任何症状。但是，如果孩子生病了，决定送他们回家，你应该对孩子和家人做出敏感的反应。马上和家人联系，让他们去接生病的孩子。当家人或监护人到达时，描述症状并提供家人可能需要给医生的任何文件。包括你注意到疾病的时间、症状描述、任何生命体征（如体温）、你提供的任何由医生开具并经家人书面批准的药物，或你采取的任何其他行动。同时提醒你的家人你的计划的政策和孩子什么时候可以回来。

设计你的计划，以帮助促进健康的做法。花点时间制定并与家庭分享你的计划的生病政策，这应该基于你所在州的要求和建议。观看此视频了解更多信息。

Planning for Illness

Notify families when their children have come into contact with a child who is ill with one of the following conditions:

• Meningitis
• Pertussis (whooping cough)
• 侵袭性感染，如链球菌
• Chickenpox
• Skin infections or infestations (head lice, scabies, and ringworm)
• 胃肠道感染（常伴有腹泻）和甲型肝炎病毒（HAV）
• Haemophilus influenzae type B (Hib)
• Fifth disease (parvovirus B19)
• Measles
• 肺结核

如果两个或两个以上参与或访问您的家庭儿童护理计划的无关人员（例如，您的家庭成员、您护理的儿童的家庭成员、后备提供者、专家等）感染了疫苗可预防或传染病，也应通知家庭。亚慱彩票APP

If one of these diseases or conditions is suspected in your family child care home, you will need to notify all families and any other adults who have come in contact with the child or children. This notification should include (Caring for our Children, 2019):

• The names, both the common and medical, of the diagnosed disease to which the child was exposed, whether there is one case or an outbreak
• 的症状和体征disease for which the parent or guardian should observe
• Mode of transmission of the disease
• 可传播的时期以及观察疾病症状和体征的时间
• Disease-prevention measures recommended by the health department (if appropriate)
• 项目中实施的控制措施
• Possibly pictures of skin lesions or skin condition (e.g., chicken pox, spots on tonsils, etc.)

The notice shouldnotidentify the child who has the infectious disease.

In some cases, you may need to contact medical professionals or public health officials. There are certain illnesses that are considered “reportable illnesses.” You will need to follow health guidelines to notify families about the occurrence of these types of illness. A list of reportable illnesses is updated annually by the Centers for Disease Control and Prevention (CDC) and is available athttps://wwwn.cdc.gov/nndss/conditions/notifiable/2020/. Contact you trainer, coach or family child care administrator if you have questions or concerns about reporting illnesses.

To make illness less stressful, you should work with families to make sure a plan is in place for an ill child. You and/or your families should make sure:

• Families have an alternate child care arrangement for days when their child is sick
• You have a safe place for sick children to wait until families can pick them up
• 有一个书面的政策是关于疾病后的排除和再入院，这个政策是与家庭分享，当他们加入你的计划
• Lines of communication are open so that you share information with families about their child’s health and families share information with you about a child’s health; this includes communicating with you when a child has been diagnosed with an infectious disease

作为一个提供者，你也有能力传播疾病。如果你生病了，为每个孩子找其他的后备护理安排。如果您患有排除名单上列出的任何疾病，在达到返回标准之前，您不应返回提供护理。

有关详细信息：

• returning to care
• determining when a health visit is necessary
• determining when reporting to family child care administration or licensing is necessary
• signs and symptoms of illness

看到了吗Caring For Our Children (2019) Appendix A, Signs and Symptoms Chart available as a Learn Activity resource below and athttp://nrckids.org/files/appendix/appendix.pdf

Immunizations

Immunizations help prevent serious disease. For immunizations to be effective, they must be given as scheduled. Researchers regularly discover new information concerning immunizations, including who should receive them and when, so you must stay up-to-date on the latest recommendations. You can learn more about immunization on the Centers for Disease Control and Preventions website athttp://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html. 作为家庭儿童护理提供者，您的部分职责是从家庭获亚慱彩票APP得免疫信息，以确保您的计划符合所有与健康相关的法规。与您的许可机构合作，确保您拥有必要的健康相关表格。对提供疫苗的人来说，接种疫苗同样重要，所以一定要遵循你的许可机构的指导方针。