In Order To Ensure That Children And Staff Are Not Unnecessarily Excluded From Head Start Activities And To Protect The Health Of The Children And Staff

Oglala Lakota College Head Start/Early Head Start Program

POLICY AND PROCEDURES

TITLE: Exclusion and Re-admission Policy

PURPOSE

In order to ensure that children and staff are not unnecessarily excluded from Head Start activities and to protect the health of the children and staff

POLICY

The OLC HS/EHS shall follow the approved policy for exclusion and send home any child if they expose other children and staff to illness listed under the policy.

PROCEDURE

a. Children Exclusion and Re-Admission

(1) The OLC Head Start and Early Head Start Centers will not deny admission nor exclude any enrolled child from program participation for long-term period solely on the basis of his or her health care needs or medication requirements unless keeping a child in care poses a significant risk to the health or safety of the child or other children, staff or visitors and the risk cannot be eliminated or reduced to acceptable levels through reasonable modifications in procedures, policies or staffing. Long-term exclusion of a child can only be approved by the Head Start Director after consultation with the child’s parent/guardian, health care provider and the appropriate Teacher.

(2) The following are conditions of short term exclusion from and for re-admission to the OLC HS/EHS Program Centers:

(a) Fever of 1010 F axillary (under arm) or higher; Meningitis may accompany a Fever greater than 1010 F with the following symptoms:

1) Diarrhea

2) Earache

3) Sore throat

4) Rash

5) Show signs of irritability or confusion

(b) Symptoms and signs of possible severe illness such as lethargy, uncontrolled coughing, irritability, persistent crying, difficulty breathing, or wheezing, until medical evaluation allows inclusion.

(c) Vomiting, on 2 or more occasions within a 24-hour period, until the vomiting resolves, or a health care provider determines the illness to be non-communicable, and the child is not in danger of dehydration.

(d) Diarrhea, that is, 3 or more stools compared to the child’s normal

pattern, increased stool water or decreased form that is not contained by a

diaper and/or clothing.

(e) Mouth sores with drooling, unless a health care provider or health official

determines the condition is noninfectious.

(f) Rash with fever or behavior change until a health care provider determines that these symptoms do not indicate a communicable disease.

(g) Eye discharge or pinkeye. Children can be readmitted after:

1) Medical diagnosis to rule out bacterial infection, or

2) 24 hours on antibiotic treatment

(h) Tuberculosis, until a health care provider or health official states that the child can attend.

(i) Impetigo, until 24 hours after treatment has been initiated.

(j) Strep throat or other streptococcal infection, until 24 hours after initial antibiotic treatment and the cessation of fever.

(k) Chicken pox, until 6 days after onset of rash or until all sores have dried and crusted, or with permission by their health care provider.

(l) Pertussis (Whooping Cough), until 10 days of appropriate antibiotic treatment to prevent and infection has been completed.

(m) Respiratory Syncytial Virus (RSV), no longer has a fever for at least 24 hours or physician statement.

(n) Mumps, until 9 days after onset of parotid gland swelling.

(o) Hepatitis-a virus, until 1 week after onset of illness or as directed by the health department when passive imunoprophylaxis has been administered to appropriate children and staff.

(p) Measles, until 6 days after onset of rash.

(q) Rubella, until 6 days after onset of rash.

(r) Shingles (herpes zoster), exclusion only on recommendation of child’s health care provider. Sores shall be covered by clothing or a dressing until the sores have crusted.

(s) Pinworm/ Ringworm, 24 hours after treatment has been initiated.

(t) Children with open oozing sores, which cannot be covered, will not be allowed to be at the center until:

1) 24 hours after starting antibiotic treatment, or

2) Sores are properly covered (e.g. bandage/clothing, staff-gloves), or

3) Sores have healed.

(u) Lice, scabies or other infestation, until 24 hours after treatment has been initiated. Center staff will conduct a recheck to insure infestation has been eliminated. Child will not be re-admitted until nit free.

(3) If a child must be sent home because of an illness, the staff will place the child in quiet isolation and attend to their needs to the extent that this attention does not compromise the care of the other children. The Teacher will designate the isolation area/room for each of the centers and a sign will be posted in this designated location.

(4) A child with uncontrolled diarrhea or vomiting shall be provided separate care in the isolation area, apart from other children until the child’s parent arrives to remove the child from the Center.

(5) If the Teacher has concerns about a child's ability to safely return to the Center they will notify the Health Coordinator to determine if a Physician statement is required, the OLC HS/EHS program reserves the right to request a note from the child's health care provider. If a child is absent 3 or more days due to illness, the staff will notify the Health Coordinator to determine if a Physician statement is required. If a child is kept home due to illness but is receiving at home treatment and doesn’t require a doctor statement from the Health Coordinator the staff will require that the parent/guardian to turn in a statement to the staff when the child returns.

Required on the statement

1. Reason for keeping the child home

2. How they were treated

3. Parent/ Guardian’s signature

Once the staff informs the Health Coordinator about an illness or health concern the Heath Coordinator will document the health or illness in the Health & Illness Trend Log which will be kept for each center.

Two forms required to excuse children for absents due to illnesses:

1. Physician statement if requested by the Health Coordinator

2. Statement from the Parent/Guardian for Home treatment

Transportation for illness; if the Health Coordinator requests a Physician statement it will be the Parent/ Guardian’s responsibility to transport the child along with the physician statement when the child is re-admitted to the center.

(6) When a child is excluded from attending our program the staff will note this in the Health Referral or Injury Report. The child’s parent will receive a copy of the report, the Health Coordinator will receive a faxed copy for review and the original copy will go in the child’s portfolio.

b. Staff Exclusion:

(1) Staff members should be excluded for the following reasons:

(a) Chicken pox, until 6 days after the onset of the rash or until all sores have dried and crusted over.

(b) Shingles (herpes zolcer), exclusion only on recommendation of an adults’ health care provider. Sores shall be covered by clothing or a dressing until the sores have crusted.

(d) Measles or Rubella until 5 days after rash onset.

(e) Vomiting, 2 or more occasions within a 24-hour period, until the vomiting resolves or is determined to be due to a non-communicable condition.

(f) Diarrheal illness, Three or more episodes of diarrhea during previous 24 hours, until diarrhea resolves and/or one episode of bloody diarrhea.

(g) Hepatitis-A virus, until 1 week after onset of illness or as directed by the health department when passive immunoprophylaxis has been administered to appropriate children and staff.

(h) Tuberculosis, until a health care provider or health official states that the child can attend.

(i) Impetigo, until 24 hours after treatment has been initiated.

(j) Strep throat or other streptococcal infection, until 24 hours after initial antibiotic treatment and the cessation of fever.

(k) Pertussis (Whooping Cough), until 10 days of appropriate antibiotic treatment to prevent and infection has been completed.

(l) Mumps, until 9 days after onset of parotid gland swelling.

c. Non-Exclusion Conditions: Certain conditions do not constitute a reason for denying admission to, or sending a child home from child care, unless the child is determined by the Health Coordinator to contribute to transmission of the illness at the facility. Exclusion of children for any of the following conditions will be decided by the Teacher with consultation of the child’s parent/guardian and the child’s health care provider

(1) Presence of germs in urine or feces in the absence of illness.

(2) Nonpurulent conjunctivitis.

(3) Cytolomegalo virus (CMV) infection.

(4) Hepatitis-B virus carrier state and have no behavioral or medical risk factors.

(5) HIV infection and have no behavioral or medical risk factors.

DOCUMENTATION

Health Referral

Physician statement for re-admittance (when requested by program)

Health & Illness Trend Log

REGULATORY REFERENCE(S):

Head Start Performance Standards 1304.20(d)

Environmental Health Standards 3-106.5

Adapted from Model Tribal Head Start Health and Safety Code-Indian Health Service/Office of Environmental Health

Revised: 03/18/09

PC Approval: 05/07/09

BOT Approval: 06/23/09