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Health and Exclusion

Dealing with Infectious Disease

1.Purpose

The purpose of this policy and procedure is to provide guidance in the reporting and investigation of serious incidents that occur in the Childcare Services.

2.Policy

Stonnington Childcare Services has a duty of care to ensure a healthy environment for all children, carers and visitors who attend the services. The wellbeing of all children is of the highest priority to reduce the opportunity for cross infection within the service. Measures to isolate and remove the potential for illness form a part of the daily operations as well as centre management principles.

Children who are unwell, or appear to be unwell must be kept away from the service until they are no longer contagious. Stonnington Childcare Services acknowledges that child/carer ratios are not sufficient to provide the degree of individual care and comfort that an unwell child deserves. Stonnington Childcare Services believes it is in the best interests of the unwell child, as well as the other children within the group, to not attend at the service. A child who attends the centre while unwell compromises the health and well being of other children within the group.

3.Scope

This policy applies to parents/guardians with children enrolled in the service and all educators within Childcare Services, including students/volunteers and agency relief educators engaged by the City of Stonnington.

4.Responsibilities

Childcare Services Co-ordinator

Team Leaders

Educators

Occupational Health and Safety representative

  1. Procedure
  • If a child becomes unwell * whilst at the service, parents/guardians will be contacted to collect the child. If parents/guardians cannot be contacted, one of the emergency authorised nominees named on the enrolment form will be contacted to collect the child.

(* Unwell is representative of showing one or more of the following symptoms: coughing, high temperature, rash, thick discharge from nose, discharge from eyes, lethargic, blisters or open sores, vomiting, diarrhoea, excessively irritable or “not themselves”)

  • Whilst Stonnington Childcare Services acknowledges the constraints of working parents/guardians, for the safety and wellbeing of all children we must achieve adhere to a strict exclusion policy.
  • Educators/Team Leaders have discretionary authority to send a child home if she/he believes that child is unwell. This can only be disputed with a medical certificate from a medical practitioner deeming the child is no longer infectious and is fit to attend childcare.
  • The Service does not have the facilities or educator numbers to care for sick children, however effort will be made to keep a sick child comfortable until the child is collected from the service.
  • If a child becomes unwell while at the service the educator with the child must complete an illness record which details the circumstances surrounding the child becoming unwell and any apparent symptoms. The illness record should state the details of the action taken by the educator in relation to the illness.
  • Parents/guardians are required to inform the service if their child becomes unwell, this will allow educators to be alerted to symptoms in other children.
  • In the case of a serious/urgent illness or accident, an educator will, if necessary accompany the child (by ambulance) to the casualty section of a local hospital or local doctor.
  • In accordance with the Education and Care Services National Regulations 2011, parents/guardians must, on enrolment, authorise the service to seek emergency medical, hospital and ambulance services if necessary. Parents/guardians are responsible for any costs involved.
  • When a child is showing any symptoms of an infectious disease every effort will be made to keep them away from the group to prevent the spread of any infectious disease at the service. For the wellbeing of the child if parents/guardians are contacted to collect their child and have not arrived in a reasonable time (1 hour or as determined by the Team Leader) emergency authorised nominees named on the enrolment form may be contacted to collect the child.
  • Parents/guardians are requested to keep their children home if they show any signs of illness.
  • If vomiting has occurred and it is in relation to a known illnesses currently identified at the services then parent/guardians are to be contacted and the child will need to be collected from the service immediately. The child will need to stay away from the service for up to 24hrs since last vomit.This also applies if child vomits a large amount which is uncommon to the child’s normal wellness. Children with diagnosed or recorded known developmental ales may be excluded from this circumstance of needing to leave the service.
  • The Team Leader will keep parents/guardians informed about infectious disease outbreaks in either children or educators by displaying a notice in a prominent position within the service.
  • If children have an infectious disease as listed on the school exclusion table they will be excluded for the period outlined in the table. The school exclusion table indicates the minimum period of exclusion from schools and childcare services required for infectious diseases cases and contacts as described under Victorian Health Department regulations.
  • Educators will follow appropriate hygiene and food safety procedures as outlined in these policies to reduce the incidence of infectious diseases in the service.
  • It is important that parents/guardians are open with communicating to educators and advise them of any health related information about their child each day on arrival at the service.
  • Educators who are unwell will need to remain away from the service in line with requirements listed on the school exclusion table.
  1. References

Department of Health Minimum Period of Exclusion from Primary Schools and Children’s Services Centres for Infectious Diseases Cases and Contacts January 2010

Education and Care Services National Law Act 2010

Education and Care Services National Regulations 2011

National Health and Medical Research Council Staying Healthy in Childcare Fifth Edition June 2013

National Quality Standard

7.Forms/Checklists

Enrolment Form

Exclusion Table

Version Control: 2 / Date Issued; 26October 2011 / Date Reviewed: 22 February 2016

G:\Child Family Serv\Childcare\Policies & Procedures Manual\Policies and Procedures\CCS PP - Health and Exclusion (Dealing with Infectious Disease).doc

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Health and Exclusion

Dealing with Infectious Disease

School Exclusion Table

Condition / Exclusion of Cases / Exclusion of Contacts
Amoebiasis (Entamoeba histolytica) / Exclude until there has not been a loose bowel motion for 24 hours. / Not excluded.
Campylobacter / Exclude until there has not been a loose bowel motion for 24 hours. / Not excluded.
Chickenpox / Exclude until all blisters have dried. This is usually at least 5 days after the rash appears in unimmunised children, but may be less in previously immunised children. / Any child with an immune deficiency (for example, leukaemia) or receiving chemotherapy should be excluded for their own protection. Otherwise not excluded.
Conjunctivitis / Exclude until discharge from eyes has ceased. / Not excluded.
Diarrhoea / Exclude until there has not been a loose bowel motion for 24 hours. / Not excluded.
Diphtheria / Exclude until medical certificate of recovery is received following at least two negative throat swabs, the first not less than 24 hours after finishing a course of antibiotics and the other 48 hours later. / Exclude family/household contacts until cleared to return by the Secretary.
Hand, Foot and Mouth disease / Exclude until all blisters have dried. / Not excluded.
Haemophilus influenzae type b (Hib) / Exclude until at least 4 days of appropriate antibiotic treatment has been completed. / Not excluded.
Hepatitis A / Exclude until a medical certificate of recovery is received, but not before 7 days after the onset of jaundice or illness. / Not excluded.
Hepatitis B / Exclusion is not necessary. / Not excluded.
Hepatitis C / Exclusion is not necessary. / Not excluded.
Herpes ("cold sores") / Young children unable to comply with good hygiene practices should be excluded while the lesion is weeping. Lesions to be covered by dressing, where possible. / Not excluded.
Human immuno-deficiency virus infection (HIV/AIDS) / Exclusion is not necessary. / Not excluded.
Impetigo / Exclude until appropriate treatment has commenced. Sores on exposed surfaces must be covered with a watertight dressing. / Not excluded.
Influenza and influenza like illnesses / Exclude until well. / Not excluded unless considered necessary by the Secretary.
Leprosy / Exclude until approval to return has been given by the Secretary. / Not excluded.
Measles* / Exclude for at least 4 days after onset of rash. / Immunised contacts not excluded. Unimmunised contacts should be excluded until 14 days after the first day of appearance of rash in the last case. If unimmunised contacts are vaccinated within 72 hours of their first contact with the first case, or received NHIG within 144 hours of exposure, they may return to the facility.
Meningitis (bacteria - other than meningococcal meningitis) / Exclude until well. / Not excluded.
Meningococcal infection* / Exclude until adequate carrier eradication therapy has been completed. / Not excluded if receiving carrier eradication therapy.
Mumps* / Exclude for 9 days or until swelling goes down (whichever is sooner). / Not excluded.
Pertussis* (whooping cough) / Exclude the child for 21 days after the onset of cough or until they have completed 5 days of a course of antibiotic treatment. / Contacts aged less than 7 years in the same room as the case who have not received three effective doses of pertussis vaccine should be excluded for 14 days after the last exposure to the infectious case, or until they have taken 5 days of a course of effective antibiotic treatment.
Poliomyelitis* / Exclude for at least 14 days from onset. Re-admit after receiving medical certificate of recovery. / Not excluded.
Ringworm, scabies, pediculosis (head lice) / Exclude until the day after appropriate treatment has commenced. / Not excluded.
Rubella (german measles) / Exclude until fully recovered or for at least four days after the onset of rash. / Not excluded.
Salmonella, Shigella / Exclude until there has not been a loose bowel motion for 24 hours. / Not excluded.
Severe Acute Respiratory Syndrome (SARS) / Exclude until medical certificate of recovery is produced. / Not excluded unless considered necessary by the Secretary.
Streptococcal infection (including scarlet fever) / Exclude until the child has received antibiotic treatment for at least 24 hours and the child feels well. / Not excluded.
Tuberculosis / Exclude until receipt of a medical certificate from the treating physician stating that the child is not considered to be infectious. / Not excluded.
Typhoid fever (including paratyphoid fever) / Exclude until approval to return has been given by the Secretary. / Not excluded unless considered necessary by the Secretary.
Verotoxin producing Escherichia coli (VTEC) / Exclude if required by the Secretary and only for the period specified by the Secretary. / Not excluded.
Worms (Intestinal) / Exclude until there has not been a loose bowel motion for 24 hours. / Not excluded.
Version Control: 2 / Date Issued; 26October 2011 / Date Reviewed: 22 February 2016

G:\Child Family Serv\Childcare\Policies & Procedures Manual\Policies and Procedures\CCS PP - Health and Exclusion (Dealing with Infectious Disease).doc