知道

Each child's daily visit to your program should begin with a simple health check. This is a quick way to make sure the child is healthy enough to be at the school-age and youth program. Most children occasionally get a runny nose, cough, or mild fever. This usually causes little worry for teachers, staff members and families. However, sometimes, a child's illness becomes more severe. Programs have policies to guide decision-making when dealing with ill children. Because you know the children in your program well, you can most likely tell when a child in your care is well enough to participate in activities, and recognize when a child is too sick to stay in the school-age program. Your program likely has guidelines to help you make this decision. The American Academy of Pediatrics (2011) offers three key factors in deciding whether a child is too sick for child care:

• 孩子不能参加活动
• 孩子的疾病对其他孩子或员工带来了风险
• You cannot care for the child while maintaining appropriate care for the other children

如果您认为孩子符合这些标准中的任何一个，那么他可能会被送回家。查看下面的学习活动部分的资源，了解有或不利用儿童保育的完整疾病列表。

每日健康检查是评估孩子健康以制定这些决定的好时机。请记住，这取决于您的计划 - 没有家庭 - 决定孩子是否足够健康以留在育儿。您必须考虑其他儿童和工作人员的健康。

每日健康检查还提供了儿童外表或行为的任何变化的记录，如果您怀疑虐待儿童或忽视，这可能是重要的。如果孩子怀疑具有长期的身体或心理健康，这些信息也非常有用。健康检查，如果敏感和彻底记录，可以帮助您与儿童和家庭建立关系。他们为您提供了占常见传染病症状的机会，这有助于防止您的计划中的疾病传播。本课程将回答有问题，许多学年工作人员可能有关于健康检查。

什么是健康检查？

A health check is a quick evaluation of a child's body, mood, and behavior. As part of your health check, you can also gather information from families. You want to know if there are any health changes that affect the child or family members. A simple, "Is everyone feeling alright today?" can start the conversation. As you get to know a child well, you will quickly notice any differences from day-to-day. The purpose of a health check is to notice any illnesses or health concerns the child might be experiencing. School-age children are typically able to communicate any discomfort, pain or symptoms, which is helpful when conducting a health check. Be sure to listen to each child, ask them about their evening at home or day at school.

我应该什么时候健康检查？

每次儿童或青年到达您的程序时，您应该进行健康检查（例如，如果孩子们在学校之前和之后提交您的计划，则应在两个时间点发生快速健康检查）。理想情况下，在一个家庭成员脱离孩子的情况下，应该在父母或监护人离开建筑物之前完成健康检查。如果您怀疑孩子生病或者您对孩子的外表或行为的任何变化有疑问，这将使您有机会与父母或监护人交谈。您还应该在任何时候注意到孩子的外表或行为的变化，那么健康检查。如果您怀疑一个孩子感觉不舒服，您可能会在当天进行一系列健康检查。

看

健康检查是什么样的？

每日健康检查的确切程序可能会有所不同。观看这段视频，看看学龄员工成员的榜样，检查孩子的健康。

Daily Health Checks

我应该寻找什么？

您的计划可以为您提供每日健康检查表格。如果没有，本课程的应用活动部分有样品，您可以适应自己的使用。在进行健康检查时，请务必使用所有的感官。

• 看看孩子的身体。您是否看到任何瘀伤，切割，刮擦或烧伤？您是否看到来自孩子的眼睛或鼻子的任何开放疮或液体？你看到头部或身体刮伤吗？你是否看到任何异常的行为（悲伤，困倦，烦躁，缺乏食欲）？
• Listen for a cough, wheezing, or a stuffy nose.
• Feel the child's skin for a fever or signs of dehydration if they appear ill.
• Use your sense of smell to check for any unusual odors.

Do not forget that conversation is a powerful tool with school-age children. Compared with 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. You can also greet children as they enter the program by asking them questions such as:

• How are you doing today?
• 你在学校的一天怎么样？
• 你晚上过得怎么样？

这些问题的答案为您提供有价值的信息，帮助您确保您的护理中儿童和青少年的健康和安全。

Do

记录日常健康检查表格的任何问题或更改。如果你认为孩子生病了，不应该在托儿所，立即与父母或监护人交谈。这将允许他们进行替代计划。

你是否看到一个问题,它是很重要的to document daily health checks. Use a form provided by your program or use the one provided in the Apply Activities section below. 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 your program and public health officials.

排除and Readmission Policies

您的计划的排除和入院政策考虑到儿童，其他儿童，员工以及家庭需求的健康状况。重要的是，您遵守您的计划的政策，帮助家庭了解您的计划与健康有关的预期和要求。

您的管理员负责确定儿童是否需要被排除在儿童保健中，以应对健康原因，并且有多长。你有责任知道：

• 不需要排除的条件和症状
• 排除生病儿童的标准
• The procedures for a child who requires exclusion

Contrary to popular belief, excluding a child with a mild illness is unlikely to reduce the spread of germs, as most children spread germs before or after their illness or don't exhibit any symptoms. However, if a child is sick and the decision is made for them to be sent home, remember to respond sensitively to the child and family. Contact the family right away, and ask them to pick up their ill child. When a family member or guardian arrives, describe the symptoms and provide any documentation the family might need to give a doctor. Include when you noticed the illness, a description of symptoms, any vital signs (like temperature), and any medications you provided that were prescribed by a physician and approved in writing by the family, or other actions you took. Also remind the family about your program's policies and when the child can return.

程序旨在帮助促进健康practices. Take some time to learn about your program's policies and facilities for sick children. Watch this video to learn more.

Planning for Illness

Your programs should notify the staff and families of children who have come into contact with a child who is ill with one of the following conditions:

• 脑膜炎
• Pertussis（Whoping咳嗽）
• 侵入性感染如腕表
• Chickenpox
• Skin infections or infestations (head lice, scabies, and ringworm)
• 胃肠道（通常与腹泻）和甲型肝炎（HAV）感染
• 嗜血杆菌流感type B (Hib)
• 第五病(parvovirus B19)
• Measles
• 结核

Families and staff should also be notified if two or more unrelated persons affiliated with the facility are infected with a vaccine-preventable or infectious disease.

如果这些疾病或条件是您的学龄计划中的一种，您的计划需要通知所有与儿童或儿童接触的家庭和工作人员。此通知应包括（照顾我们的孩子，2015）：

• 儿童暴露的诊断疾病的常见疾病的名称和医学名称，是否有一种案例或爆发，以及曝光的性质（例如共享房间中的儿童或工作人员或设施）
• Signs and symptoms of the disease for which the parent/guardian should observe
• Mode of transmission of the disease
• 通知性，观察疾病的迹象和症状多久
• Disease-prevention measures recommended by the health department (if appropriate)
• 在设施实施的控制措施
• Pictures of skin lesions or skin condition may be helpful to parents or guardians (e.g., chicken pox, spots on tonsils, etc.)

通知应该是notidentify the child who has the infectious disease.

In some cases, your program may need to contact medical professionals or public health officials. There are certain illnesses that are considered "reportable illnesses." Your program will need to follow health guidelines to notify families and staff 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 athttp://wwwn.cdc.gov/nndss/downloads.html。

为了使疾病减轻压力，您应该与家人合作，以确保计划是不生病的孩子。家庭，工作人员和计划应该确保：

• Families have an alternate child-care arrangement for days when their child is sick
• 节目有一个安全的地方为生病的孩子等待，直到家庭可以选择它们;这个空间应该由孩子知道的成年人监督
• A written policy is in place about exclusion and readmission following an illness; this policy is shared with families
• 通信线路是开放的;员工与有关孩子的健康的家庭分享信息，家庭与员工与员工有关儿童健康的信息。这包括当孩子被诊断出存在传染病时与该程序进行通信。

Finally, remember that you as a staff member are capable of spreading illnesses, too. If you are sick, stay home. If you have any of the illnesses listed on the exclusion list, you should stay home from work until you meet the criteria for returning.

Immunizations

Immunizations help prevent serious diseases. For immunizations to be effective, they must be given as scheduled. Researchers regularly discover new information concerning immunizations, such as who should receive them and when, so it might be helpful for you to 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/index.html。

Though it is helpful for you to be knowledgeable about immunizations, it is your manager's responsibility to get immunization information from families to ensure your program is in compliance with all health-related regulations. It is important for teachers and caregivers to be immunized also, so ensure that you follow your program's guidelines in terms of recommended immunizations for staff members.