Potential Client With Allergy

[Logged out for privacy]

I searched but did not find anything totally relevant to my situation.

I have an interview with a potential client who's child has allergies to 2 common foods that are frequently served here. This child has an epi pen but it is unclear if the child reacts when just ingesting allergens or will react when near them as well.

Because these foods are commonly served here I do not feel I can provide a safe environment for this child and do not want to enroll them.

How do I let mom know I can not enroll her child in an ADA compliant way?

FWIW: I am also interviewing a second family for this same position later this week.

FWIW.2: I have had children with allergies enrolled before. But never one with an epi pen (it just hasn't come up.) In the past I have parents provide all food along with utensils to prevent cross contamination.

[flying_babyb]

as long as its not a near them reaction, I would just have the parents send food. we have a Wheat allergic child who brings their own food.

[knoxmomof2]

When I looked into becoming licensed (I'm license exempt with less than 5 children), another person asked a similar question about peanut allergies. He said, "I just don't want the risk and peanuts or peanut butter would probably be a commonly used food item at our facility. What can I say that won't be considered discrimination?"

The instructor, whose own daughter had a peanut allergy, was quite offended at the question, but answered nonetheless. She said that he could indicate, when discussing the menu to a potential client, that peanut products were regularly served and that it was not a peanut free environment. It would then be up to the parent to decide that this particular environment would not be ideal for their child. I can't guarantee your "ADA safety" by going this route, it's just an answer I heard.

Instead of saying "I don't or won't do this", you're saying "here's what I do".

[lblanke]

Per ADA, you cannot chose not to enroll solely because of the allergy. Do you accept any federal funding (such as the food program)? If so and this is your basis for not enrolling, that finding could be in jeopardy.that being said, if you truly are incapable of providing a safe environment for the child, then you are not a good fit. All children deserve a safe environment of care.

[nannyde]

I would do a very short interview and tell her you are interviewing multiple families over the next few weeks. Let her know you will be making a decision in three to four weeks. If she hasn't heard from you within a month then she will know another family was chosen.

I wouldn't discuss the allergies too much. Just do your normal interviewing. If she brings it up, listen to her carefully and then move on to the next subject.

You are lucky she told you in advance. Once the allergy parents find out they can't even get interviews they wait until they have enrolled, paid for the slot, and the kid is ready to start to pop it on the provider. That's way more difficult to navigate.

[Unregistered]

License exempt and not on the food program. I have had children with allergies enrolled before and have a protocol for keeping them safe. This child's allergies were to common foods that were served weekly (not your common peanuts) and kept in the house at all times. I do agree, all children are deserving of a safe place.

I explained the food was in the childcare home and asked mom to elaborate on the severity of the child's allergies. She sad ingestion was a problem but did not know if contact was. She "recalls" the doctor saying skin contact was an issue. I found this interesting. I am NOT doubting the child has allergies, but if they were so bad to the point of an epi pen, wouldn't you know exactly what happened in the event of ingestion and contact? Or is that not how allergies go?

[Unregistered]

I would do a very short interview and tell her you are interviewing multiple families over the next few weeks. Let her know you will be making a decision in three to four weeks. If she hasn't heard from you within a month then she will know another family was chosen.

I wouldn't discuss the allergies too much. Just do your normal interviewing. If she brings it up, listen to her carefully and then move on to the next subject.

You are lucky she told you in advance. Once the allergy parents find out they can't even get interviews they wait until they have enrolled, paid for the slot, and the kid is ready to start to pop it on the provider. That's way more difficult to navigate.

One of my pre interview questions asked is if their child has any allergies or health concerns. I ask this prior to a parent stepping food in my door. Questions are always asked via email so there is a paper trail. My handbook also states that false information given written or verbally is grounds for immediate termination. In the event that a future parent would try something like this, is that enough to protect me?

[Alwaysgreener]

One provider I know post a sign stating that her home is not allergy free. She makes sure that families see the sign during tours.

[LysesKids]

License exempt and not on the food program. I have had children with allergies enrolled before and have a protocol for keeping them safe. This child's allergies were to common foods that were served weekly (not your common peanuts) and kept in the house at all times. I do agree, all children are deserving of a safe place.

I explained the food was in the childcare home and asked mom to elaborate on the severity of the child's allergies. She sad ingestion was a problem but did not know if contact was. She "recalls" the doctor saying skin contact was an issue. I found this interesting. I am NOT doubting the child has allergies, but if they were so bad to the point of an epi pen, wouldn't you know exactly what happened in the event of ingestion and contact? Or is that not how allergies go?

In cases of allergies I require a copy of the tests & what allergens were found; also what protocol to take for said allergies. An Allergy special won't test babes usually before age 2 unless there are severe issues. If an Epi pen is to be used, I would want that in writing from the DR to make sure the Epi wasn't for something (or somebody) else

I have a few very severe ingestion allergies as did one of my prior dck; I had it in writing what the allergies were & how to avoid issues, now I have her baby brother in care (she aged out).

[nannyde]

One of my pre interview questions .

ed is if their child has any allergies concerns. I ask this prior to a parent stepping food in my door. Questions are always asked via email so there is a paper trail. My handbook also states that false information given written or verbally is grounds for immediate termination. In the event that a future parent would try something like this, is that enough to protect me?

She's not required to disclose. Anything you have in your policies that state she can be termed for not divulging or omitting or answering your questions without divulging means nothing to the ADA. A parent can enroll a child with AIDS and not divulge.

Your way may deter some but the ones who have been to the rodeo many times know they don't have to tell and once they get in you must accommodate.

[Blackcat31]

She's not required to disclose. Anything you have in your policies that state she can be termed for not divulging or omitting or answering your questions without divulging means nothing to the ADA. A parent can enroll a child with AIDS and not divulge.

Your way may deter some but the ones who have been to the rodeo many times know they don't have to tell and once they get in you must accommodate.

This has been my belief/knowledge as well.

To counteract that, I instead make sure that ALL potential clients know and understand that I have a medical requirement/situation ALREADY WITHIN MY PROGRAM that may present an issue of conflict with others that also have medical requirements/situations that require special accommodations or actions.

For example I don't ask potential parents if their child has a peanut allergy but instead make sure ALL potential clients understand that we are NOT a peanut free environment due to someone else's medical situation.

So far, it's worked out just fine....

[hwichlaz]

While I can exclude the foods a child is allergic to, being ADA compliant when you're a sole proprietor with no employees isn't as hard as you may believe. You an simply say, that since you work by yourself that you are concerned that you can't supply adequate supervision at meal time to keep the child safe. I'd also be concerned about children coming in with particles of that food on their clothing from home. So even if I exclude, peanuts (an example) I can't be sure kids didn't have it for breakfast at home and don't have it on their clothing/breath/face/hands. I'd outline exactly what measures I can take, working by myself. If the parent seems okay with that...and I was also comfortable, I'd put them in writing and have both parents sign it.

[Second Home]

In cases of allergies I require a copy of the tests & what allergens were found; also what protocol to take for said allergies. An Allergy special won't test babes usually before age 2 unless there are severe issues. If an Epi pen is to be used, I would want that in writing from the DR to make sure the Epi wasn't for something (or somebody) else

I have a few very severe ingestion allergies as did one of my prior dck; I had it in writing what the allergies were & how to avoid issues, now I have her baby brother in care (she aged out).

Here in MD if a child has allergies we must have a action plan filled out by the allergist/ Dr with all information , reaction symptoms and medical instructions . It must be on the state form , no exceptions . If a parent refuses to have the form filled out and given to the provider we may terminate care due to the fact that they refuse to fill out state required forms . Any parent that says their child has allergies must have the form filled out and kept in their child's file . It also must be done every year .

[Blackcat31]

While I can exclude the foods a child is allergic to, being ADA compliant when you're a sole proprietor with no employees isn't as hard as you may believe. You an simply say, that since you work by yourself that you are concerned that you can't supply adequate supervision at meal time to keep the child safe. I'd also be concerned about children coming in with particles of that food on their clothing from home. So even if I exclude, peanuts (an example) I can't be sure kids didn't have it for breakfast at home and don't have it on their clothing/breath/face/hands. I'd outline exactly what measures I can take, working by myself. If the parent seems okay with that...and I was also comfortable, I'd put them in writing and have both parents sign it.

While this makes complete sense to me... let's say you do all that and a parent with a child that has a peanut allergy is enrolled in your program.

Fast forward a few months and a different long time enrolled child comes in with peanut butter on their clothing/hands etc... and the child with the allergy is exposed and has a reaction.

Even IF the parent of the child with the allergy signed off saying they knew that could potentially happen they could still push their child's protected right to a peanut free environment and ultimately cause you to have to term the long time enrolled child....

I understand and support ADA protected situations but sometimes some situations just go to far and the person with the protected ADA situation almost always gets priority. kwim? Sometimes that is difficult for providers working solo but the ADA doesn't really care.

It's easier to not enroll (which isn't always legal or right) than it is to deal with after the fact or use waivers...which I don't think really provide you with any legal protection anyways. *sigh*

[hwichlaz]

This can also happen at public school. Public schools cannot keep kids from eating peanut butter at home. They can have everyone wash their hands and face as they enter...which I could also do. Your public school classmates aren't unenrolled for having peanut butter on their clothing.

I can totally understand not enrolling. I've had cases where an interviewing family's allergy conflicted with the allergy of a child already enrolled and I've just explained that to them and they were disappointed but fine.