Need Advice On Illness Policies Please!

[JLH]

My husband and I run our home daycare together and we have 3 kids of our own. We have all been sick, just one person after another, for well over 2 months straight. The last straw for me was spending Saturday at the emergency room for over 3 hours to test positive for strep throat while 2 of my kids were home throwing up from a 24 hour flu bug. All thanks to our little daycare friends. No exaggeration! It's been really bad at my home with non stop illnesses every single week and weekend for months.

Here's the copy of my illness policy from my parent handbook;
We are unable to accept sick children into care, as I do not want to expose other children, myself, and my family to illnesses. I ask that you please keep your child home if he or she is not feeling well. If your child becomes ill while in care I will notify you to pick up your child and your child will be isolated from the other children until your arrival.

If your child has one or more of the following conditions I can not accept them into care:
fever of 100 degrees or higher – must remain home until fever free for 24 hours
vomiting, on 1 or more occasions in the past 24 hours
diarrhea, 3 or more times in 24 hours
draining rash – may not return until gone or cleared by a doctor
open sores, bleeding and untreated wounds
eye discharge or conjunctivitis (pink eye) – may not return until gone or cleared by a doctor
lice or nits – must remain home until nit free
fatigue that prevents participation in daily activities
Chicken-Pox – must be cleared by family physician before returning

Parents are required to notify the provider if their child contracts, or is exposed to, any communicable illness (i.e. - chicken pox, measles, lice, scabies, etc).

So, here's the problem. Several parents don't follow these policies. Several parents tylenol their kids up (some nearly every day!) before dropping them off to hide their fever. Some even tell me they give them tylenol before bringing them in. I even had a parent last week that tried to tell me their child wasn't contagious because he's on tylenol and ibuprofen. I quickly let her know that unless he has been on antibiotics for 24 hours, he is absolutely still contagious. Even after notifying parents about the strep outbreak on Saturday, I still have a child here this morning with a horrible thick, green snotty nose, a cough (he's 3 and doesn't cover his mouth), and a fever right at 99 degrees.

Now, I do understand that I have my own personality flaws, one of them being that I tend to take things a bit overboard when I get worked up over something that I'm upset about. So... what do you guys think? Am I being unreasonable? Should I just drop this and wait for the cold and flu season to pass so that I don't lose kids over this? Should I change my policies? I was thinking about making a rule that kids who have a fever of 99 or more must stay on a bed at my home and once it reaches 100 they get sent home. Is that mean? I also thought about a 3 strikes and your out rule, where over the course of a year if your child is sent home ill 3 times, you are kicked out permanently. What do you think? Too much? I just don't know what else to do. I can't keep letting my family get sick and I feel bad for the good parents that keep their kids home even for runny noses when the sick kids come in and get everyone sick.

[Blackcat31]

Please don't think I am being harsh as I am NOT trying to be, but ultimately if you are having issues with sick kids in care, it isn't that the parents are at fault for not following your policies....you are.

IF you get strict about your illness policy and refuse to care for kids who are sick then the parents can't take advantage.

I don't allow parents to medicate their child and then drop them off at care. If they do, it is grounds for IMMEDIATE termination. They ALL know this and they know I am NOT kidding.

You also need to adopt the 24/48 hour rule. It works miracles.

If a child is sick, parents keep them home until 24 hours after symptoms are gone.

If a child becomes sick in care and YOU send them home, the child cannot return until 48 hours after symptoms are gone.

That policy forces parents to do the right thing and make the right choice. 24 hrs out or 48 hrs out... their choice.

I like your policy but I also think you need to add, behavior that is out of the normal as reason to send or keep home too.

[JLH]

Re:

I do understand and agree with what you are saying. Perhaps I should elaborate on the situation a tiny bit more. We have only been open for 6 months. At first, we could not be too hard on people, as we flat out could not financially afford to lose anyone. Plus, we are located right in the middle of town, surrounded by centers who take all kids, no matter how sick they are. Now we are in a better position, with more children enrolled. So, you are right, we should have been strict from the beginning but now we are finally in a position where we can afford to be. So... where do we go from here? We sent home a newsletter a couple of weeks ago stating that we would no longer be accepting ill children and reminding everyone of our policies from our parent handbook. It has seriously done absolutely no good!

I do love all of your ideas! I love the 24/48 rule, the no medicating or it's immediate termination, and your idea about adding onto my list to include behaviors that are out of character for the child. Thanks for all of your input! I am thinking about adding these onto my illness policies asap.

Does anyone else have anything they do that has worked well?

[Blackcat31]

We sent home a newsletter a couple of weeks ago stating that we would no longer be accepting ill children and reminding everyone of our policies from our parent handbook. It has seriously done absolutely no good!

What I would do is send home a letter WITH your illness policy attached. Ask that each parent sign and date the illness policy. Set a return date for it and tell parents that after a certain date, there will be NO SERVICES until completed form is returned. Then stick to that. Even if it means turning someone away at the door.

I would let them all know that as of March xx, 2013 your illness policies will be STRICTLY enforced. and then stick to it.

Say something like:

Dear DCP

As of Monday, March 11, 2013 our illness policies will be strictly enforced. As a reminder, we are sending home a copy of the illness policy for you to look over, sign and return.

The form MUST be returned NO LATER than Friday March 8, 2013. NO services will be provided after that date without the signed form.

Please understand that illness policies are in place to protect everyone and due to the severity of this season's colds and flus, we must strictly enforce our policies in order to maintain a healthy and sanitary environment for all children attending our program.

Thank you

Provider

Add to that anything you feel needs to be added to better get your point across, such as the 24/48 hour rule and termination for medicating and dropping off.

I allow parents to medicate and drop off their child ONLY for things such as ear aches and teething but the parent MUST fill out a form stating that they gave their child Tylenol/Advil, how much, who gave it, when and why BEFORE they leave their child with me.

I can't stop parents from lying about it but it is also not really that hard to tell if parent is drugging and dropping off after you know a kid pretty well...kwim?


I personally will NOT give OTC meds. I don't even allow them to be on the property. Too much liability involved with it IMHO.

Anyways, hope that helps