Sick But Not Too Sick For Daycare

[JLH]

"Johnny" shows up with diarrhea, AGAIN. This is 4 days in a row. My contract follows the state guidelines that say I can't send "Johnny" home unless he has diarrhea 3 or more times in 24 hours. Of course, "Johnny" only has it 1 or 2 times a day at my daycare so I can't send him home, even though it leaks through his diaper and clothing every time it happens.
I call it "the grey area". That in between area where I know he is sick and mom knows he is sick, but TECHNICALLY I can't send him home because he isn't too sick to be in daycare according to my contract. Seems everyone thinks like this: Fever of 99.8; "it's okay to go to daycare because he isn't at 100 yet". Throwing up last night;"it's okay because he only threw up once and her contract says 2 or more times in 24 hours". It's really frustrating!
What have you providers found that works? What do you guys think about separating kids that come in sick, so they don't give it to the rest of us? I'm talking about toddlers and young preschoolers that put toys in their mouth and wipe their snot everywhere because they don't yet grasp the concept of germs. Maybe keep them on their nap mat or playing quietly at the kitchen table for the day? Is this mean or is it something that you other providers do on occasion? I'm really trying to find a happy medium between keeping my family and myself healthy and not making parents mad by sending their kids home every time they have a runny nose...

[Blackcat31]

"Johnny" shows up with diarrhea, AGAIN. This is 4 days in a row. My contract follows the state guidelines that say I can't send "Johnny" home unless he has diarrhea 3 or more times in 24 hours. Of course, "Johnny" only has it 1 or 2 times a day at my daycare so I can't send him home, even though it leaks through his diaper and clothing every time it happens.
I call it "the grey area". That in between area where I know he is sick and mom knows he is sick, but TECHNICALLY I can't send him home because he isn't too sick to be in daycare according to my contract. Seems everyone thinks like this: Fever of 99.8; "it's okay to go to daycare because he isn't at 100 yet". Throwing up last night;"it's okay because he only threw up once and her contract says 2 or more times in 24 hours". It's really frustrating!
What have you providers found that works? What do you guys think about separating kids that come in sick, so they don't give it to the rest of us? I'm talking about toddlers and young preschoolers that put toys in their mouth and wipe their snot everywhere because they don't yet grasp the concept of germs. Maybe keep them on their nap mat or playing quietly at the kitchen table for the day? Is this mean or is it something that you other providers do on occasion? I'm really trying to find a happy medium between keeping my family and myself healthy and not making parents mad by sending their kids home every time they have a runny nose...

Change your contract.

Problem solved.

[JLH]

I know that is the easy answer but the problem is that I'm already stricter with my illness policy than the other daycares in my area. For instance, our state says kids can stay in care until they are 101 degrees and I changed my rules to 100. State says send home after 3 times of puking and I changed my contract to 2 or more. State says when kids are sent home they can't return for 24 hours and I changed my contract to 48. I fear if I go too strict I'll never get kids enrolled. That's why I was thinking about just separating sick kids so that way their illness doesn't spread to everyone else and that way I don't have to upset the parents by sending them home. I'm in a very competitive area and surrounded by centers that aren't supposed to, but will take sick kids.

[CraftyMom]

I would have it state your rules not the state rules and specify "This is not only for the health and well being of all children involved and their families, but also for myself and my family. We live here and confined to the germs" Or something similar. If parents give you a hard time you have the minimum set by the state. to fall back on. Not sure If it's different in your state, but my illness policies are not the same as the state's. I go above and beyond what they say because it is my home and I have the right to specify what happens in my home. For example, ANY fever, not coming back until 24 hours FEVER FREE without Tylenol. Fevers often start out low in the am and get higher as the day goes on. I have several of these that differ from the state. The state sets the minimum.

[SunnyDay]

I would not send my children to a child care that allowed children who had any episodes of diarrhea or vomiting to stay. No way. That's gross and everyone just ends up getting sick more. Change your contract and send them home!

[daycarediva]

You MAY just get good clients who don't want THEIR child exposed to illness, and in turn won't bring a sick child and expose other peoples children.

I changed the way I do interviews and specifically focus on payment and health policies. Not once, but TWICE. I TELL parents I want to work with families who don't want their child around sick children.

4 of my families are like this. If they are even UNSURE about whether to send or not, they err on the side of caution. I have kids kept home for coughing, runny nose, sore throat, being too sleepy, tummy ache/slight diarrhea, etc. These 4 kids are also the HEALTHIEST. They recover faster, are sick less often and NEVER have the continual snotty nose from September-March like the other kids do.

I have been doing a lot of parent education type things. Reminding them that the less their children are exposed to, the less they get sick. The less they expose other children to, they less THEY get sick, the less my family gets sick, the less I get sick, etc.

I had a Mom that said my health policy was harsh. (the 100 fever, home for 48 if sent home, 1x diarrhea, 1x vomiting, etc). I said that I treat the daycare kids like I would want my own children treated. I don't want my kids exposed to something potentially contagious, so I err on the side of caution. That 100 fever and sleepiness COULD be full blown H,F,M. I can't make the call, so better safe than sorry. She agreed, enrolled, and CANNOT believe how HEALTHY her child is this year vs last at their center with LOOSE guidelines.

Also, what does your local school district have as exclusionary? I would go with that before the state. The school will NOT keep a child that has vomited.

Change your contract, and change your clients or at least their mind set.

[daycare]

think about this. how are you going to meet the SPECIAL needs of one ill child and still be able to provide a safe/healthy enviornment for the others and still be able to meet the needs of all the other children.

You can NOT let one child's needs demand all of your time and attention. It is a safety issue. I am way more strict than anyone in my area and parents love me for it. We are hardly ever sick here because of it.

If johnny comes sick, there is NO way to keep him and his illness away from the other kids Now you and everyone else is going to get it more than likely. I am sure that parents will not be to happy to find out that if Johnny was just sent home to begin with or stayed home, they would not be in the position of having to take another day off of work to stay home with their kid.

what about if you get sick from the kid?? You will have to close for the day and now all parents will either scramble for back up care or will be forced to call into work.

as I always tell parents, I don't want to have to be the bad guy here, but I must do what is necessary to keep everyone safe and I offer that same respect to your child too.

I think how you deliver your policies also makes a huge difference in how parents will take it.

[CraftyMom]

You MAY just get good clients who don't want THEIR child exposed to illness, and in turn won't bring a sick child and expose other peoples children.

I changed the way I do interviews and specifically focus on payment and health policies. Not once, but TWICE. I TELL parents I want to work with families who don't want their child around sick children.

4 of my families are like this. If they are even UNSURE about whether to send or not, they err on the side of caution. I have kids kept home for coughing, runny nose, sore throat, being too sleepy, tummy ache/slight diarrhea, etc. These 4 kids are also the HEALTHIEST. They recover faster, are sick less often and NEVER have the continual snotty nose from September-March like the other kids do.

I have been doing a lot of parent education type things. Reminding them that the less their children are exposed to, the less they get sick. The less they expose other children to, they less THEY get sick, the less my family gets sick, the less I get sick, etc.

I had a Mom that said my health policy was harsh. (the 100 fever, home for 48 if sent home, 1x diarrhea, 1x vomiting, etc). I said that I treat the daycare kids like I would want my own children treated. I don't want my kids exposed to something potentially contagious, so I err on the side of caution. That 100 fever and sleepiness COULD be full blown H,F,M. I can't make the call, so better safe than sorry. She agreed, enrolled, and CANNOT believe how HEALTHY her child is this year vs last at their center with LOOSE guidelines.

Also, what does your local school district have as exclusionary? I would go with that before the state. The school will NOT keep a child that has vomited.

Change your contract, and change your clients or at least their mind set.

My policies are harsh also, much like yours. 1x diarrhea, 1x vomiting, runny nose longer that 5 days. Several situations where I need a dr note signed by the DOCTOR, not medical assistant, and it must specify the dr's knowledge of the child being in daycare and that he/she feels it is ok for this child to be around toddlers and infants

[JLH]

I love the feedback I'm getting. Thank you all! I''m looking into changing my health policy again.
What temp do you all consider a fever and send kids home for. Right now my contract says 100 but I've had kids here at 99.7 and 99.8 a lot lately that have gotten others sick.

[daycare]

I love the feedback I'm getting. Thank you all! I''m looking into changing my health policy again.
What temp do you all consider a fever and send kids home for. Right now my contract says 100 but I've had kids here at 99.7 and 99.8 a lot lately that have gotten others sick.

i send home at 100.0 and up

[KIDZRMYBIZ]

If your state says 101, tell dcm or dcd it was 101. Personally, I don't care if it 99.9 or 102.6. A sick kid is a sick kid is a sick kid...

[blandino]

I have in my contract that I can send home for loose stools that can't be contained within the diaper. That way I am covered. Of
Bivouacked I don't send home for each of the out of the diaper BMs - but I gave myself the right to.
I would much rather make my contract tight and then use my discretion - rather than loose and be stuck with a child I know is sickly but doesn't fit into the contract.

[JLH]

Again, loving the feedback! Thank you all! I've been open for nearly 5 years and parents still find new loopholes in my contract that I have to fix every year. Here's my sick policy from my contract. Any other changes you would make?

Illness Policy

We are a well child daycare only. Please keep your child home if he or she is not feeling well. As illnesses tend to spread in families, if your child has symptoms or a diagnosis of a communicable illness, please keep all siblings home as well. We have a “24/48 hour plan” in place. If your child isn't feeling well (minor cold, flu, fever, etc) you may choose to keep him/her home for 24 hours. If we must send a child home ill, the child may not return for 48 hours. We ask that you have a back-up plan in case of unexpected illness. Please understand that illness policies are in place to protect everyone and we must strictly enforce our policies in order to maintain a healthy and sanitary environment for all children attending our program.

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. Once notified that your child is ill, we ask that you arrive within 45 minutes to pick up your child. Children who must be sent home ill may not return for 48 hours.

We don't allow parents to medicate their child and then drop the child off at daycare, as this masks their symptoms while they are still contagious and can pose serious health risks. If your child needs pain relieving/fever reducing medications to get through the day, they should stay home for the day where they can be more comfortable. If your child is medicated before drop off, it is grounds for immediate termination. I do not allow children to be dropped off until they have gone 6 hours without receiving any pain relieving/fever reducing medications.

Children who appear sick, with coughing, sneezing, and runny noses may not be permitted to play in close contact with other children.

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 without the use of fever reducing medications
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 accompanied by a physician's note stating child is not contagious
open sores, bleeding and untreated wounds – depending on severity, may not return until accompanied by a physician's note stating child is not contagious
eye discharge or conjunctivitis (pink eye) – may not return until accompanied by a physician's note stating child is not contagious
lice or nits – must remain home for 72 hours and may not return until nit free
fatigue that prevents participation in daily activities, extra fussiness, and/or other behaviors that are out of the ordinary for the child or require more one on one attention
Chicken-Pox, Scabies, Impetigo, Fifth's Disease and all other communicable illnesses – may not return until accompanied by a physician's note stating child is not contagious and is safe to return to a daycare environment

Parents are required to immediately notify the provider if their child contracts, or is exposed to, any communicable illness (i.e. - chicken pox, measles, lice, scabies, impetigo, fifth's disease, etc). Failure to notify provider with all pertinent information puts other families at risk and will result in termination.

[JLH]

If your state says 101, tell dcm or dcd it was 101. Personally, I don't care if it 99.9 or 102.6. A sick kid is a sick kid is a sick kid...

Love this! happyface hahaha

[hope]

I agree with all these ladies. It's your business so make your own rules.
I would be concerned though that this child has had diarrhea for FOUR days now. I would have a serious talk with dcm. Either the child is sick or he needs a diet change or something! How can this be overlooked? I insist parents take children to the doctor if diaper rash last a few days. I want parents to take the health of their children serious. Sometimes when parents leave their children in our care they forget whose responsibility it is. This results in lingering illnesses.
If I were in your shoes I would tell mom that you need a doctors note bc this has been going on too long. If you lose her as a client you can replace her with a family that respects your daycare, your family and the other children attending.