Health Programs & Requirements
Kessel Kids CcLc will work with the area nurse consultant to develop and improve policies to ensure the health and safety of the center. The nurse consultant will provide the center with guidance and suggestions on injuries and illnesses, resources available to assist with improving quality care and on-site support.
Licensing requirements state that each child admitted to a center must have a physical examination before they attend. The physical may have been attained within the last 12 months prior to enrollment. Kessel Kids CcLc encourages families to have their provider complete the enclosed physical form within the enrollment packet versus submitting the physical form utilized by the provider. Annual medical updates are required thereafter. If your child is school- age, a copy of the physical examination is accepted or a health statement provided by the parent is acceptable.
State law also requires that immunizations be recorded and put on file for each child with updates completed when necessary. It is Iowa law that each child has the chickenpox vaccine or has had chickenpox or a statement from the physician as to why the child is not to have the immunization at this time. Children will not be excluded for failure to be immunized if they have an appointment for immunizations and have their immunizations within one month. Failure to keep immunizations up to date after three written reminders to the parent(s)/ legal guardian within a three month period will result in dismissal from the child care center. Immunization records are checked annually by the Howard County Public Health Department. Immunization exemption certificates must be on file for any parent choosing not to immunize their child(ren).
***Child care services can be canceled if you fail to provide medical and/or other enrollment forms.
When the parent(s)/ legal guardian of a child identifies that a child has special needs, Kessel Kids CcLc Director and the parent(s)/ legal guardian and other interdisciplinary team members requested by parent(s)/ legal guardian will work together to formulate an Individual Family Service Plan (IFSP) or Individual Service Plan (ISP) to best meet the child’s needs. Kessel Kids CcLc does not discriminate on the basis of special needs. The program accepts children with special needs as long as a safe, supportive environment can be maintained at the center. Providers working directly with a child with special needs are responsible for the implementation of a Service Plan. If Kessel Kids CcLc is unable to accommodate the child’s needs as defined by the child’s health care provider or outlined in the Service Plan without posing an undue burden as defined by federal law, Kessel Kids CcLc will support the parent(s)/ legal guardian to find an environment suitable for the child and his or her needs. The plan for serving a child with special needs will be reviewed at least annually to see if it is in compliance with the legal requirements of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973 and is achieving the overall objectives for the agency or facility. Staff will participate in interdisciplinary team meetings with the family and other involved professionals at least annually if not additionally to review or revise the individual service plan.
Keystone Area Education Agency provides services which include hearing, speech, testing, consultation and direct therapy. Kessel Kids CcLc providers may make a referral to this agency to support children with their developmental needs with parental consent.
The child care provider, not the child’s family, will make a determination as to whether the child can receive care in the child care program. The decision to exclude a child will be based on whether there are adequate facilities and providers available to meet the needs of the child as well as the other children within the group. In addition, a child will be excluded from the program if the illness prevents a child from participating comfortably in activities, the illness requires more care than the child care staff are able to offer without compromising the needs of others in the group or if keeping this child within care would pose a risk to the other children or adults in the center coming in contact with the child. If the child care staff question whether or not the illness does pose an increased risk to others, the child will be excluded until the child is seen by a physician and it is noted the child can attend.
Illness
Kessel Kids CcLc will decide whether a child who is ill or appears ill will be permitted to remain in the center for the day. If a child appears to be ill:
- Providers will complete a Symptom/Attendance record. This record allows providers to document the date and time of an illness, the symptoms displayed by the child and or action steps taken by the staff to address the symptoms including the notification of those on the emergency contact list.
- Symptoms will be communicated in writing when the parent arrives or the parent will be contacted depending on the symptoms displayed.
- If it is determined that the child is too ill to stay at the center, families will be contacted to pick up the child. The child will be provided with a place to rest until the child’s parent, legal guardian or designated person arrives. A child with a potentially communicable illness that requires the child to be sent home will be provided care separate from other children with attention given to hygiene and sanitation until the child leaves the facility.
Kessel Kids CcLc has attached the guidelines from HHS for common illness and exclusion protocol.
Specific conditions that do not require exclusion include:
- Children who are carriers of an infectious disease agent in their bowel movement or urine that can cause serious illness, but who have no symptoms of illness themselves. Exceptions include E. coli 0157:H7, Shigella or Salmonella Typhi.
- Children with conjunctivitis (pink eye) who have a clear, watery eye discharge and do not have any fever, eye pain, or eyelid redness.
- Children with a rash, but no fever or change in behavior.
- Children with cytomegalovirus infection, Parvovirus B19, HIV or carriers of hepatitis b.
Children who carry HBV chronically and who have no behavioral or medical risk factors, such as aggressive behavior (biting and frequent scratching), generalized dermatitis (weeping skin lesions, or bleeding problems) shall be admitted to the facility without restrictions. Testing of children for HBV is not a requirement for admission to the program.
If there is an identified outbreak of any communicable illness at the facility, a child shall be excluded if the health department official or health care provider suspects that the child is contributing to transmission of the illness at the facility. The child shall be readmitted when the health department official or health care provider who made the initial determination decides that the risk of transmission is no longer present.
All communicable diseases must be reported by the center director to public health officials so control measures can be used. With respect to legal boundaries of confidentiality of medical information, communicable disease postings will notify families of any suspected or reported communicable disease among the children, providers or family members of the children or providers.
Kessel Kids CcLc will administer medications to children with written approval from the parent(s)/ legal guardian and an order from a health care provider. Whenever possible, the first dosage of medication should be given at home to see if the child would have any type of reaction. We encourage parent(s)/ legal guardians to administer medication to their own children during the child care day if possible due to the safety hazards created by having medication within the facility.
Kessel Kids CcLc providers will administer medications only if the parent(s)/ legal guardian has provided written consent. The instructions for the dose, time, and method to be used and duration of administration will be provided to the child care staff in writing.
Prescription medications must be provided in the original, child-resistant container that is labeled by a pharmacist with the child’s name, the name and strength of the medication; the date of the prescription; the medication’s expiration date; and administration, storage and disposal instructions.
For over the counter medications, parent(s)/ legal guardians will provide the medication in a child-resistant container. The medication will be labeled with the child’s first and last names; specific, legible instructions for administration and storage supplied by the manufacturer and the name of the health care providers who recommended the medication for the child (if applicable).
A physician may state a certain medication may be given for a recurring problem, emergency situation or chronic condition. A child may only receive medication with the permission of the child’s parent(s)/ legal guardian and when the staff person who will give the medication has demonstrated to a licensed health professional the skills required to do so.
All medications will be stored out of the reach of children and at the recommended temperature. Medications will not be used beyond the date of expiration on the container or beyond the prescription guidelines.
Kessel Kids CcLc also requests that parents supply a medicine dropper, measuring cup etc. for dispensing medications if needed. The measuring device needs to be placed in an enclosed bag and labeled with the child’s name.
Medication errors will be controlled by checking the following items each time a medication is given:
- Right child
- Right medicine
- Right dose
- Right time
- Right route of administration
Medication logs will be completed by the provider administering the medications. The documentation will be kept on file as well as recorded for the parent(s)/ legal guardian’s reference. Spills, reactions, and refusal to take medication will be noted in this log. If a medication error occurs, the Poison Control Center and the child's parents will be contacted immediately.
Weather permitting, all children, including infants, are encouraged to spend time outdoors to allow for exploration and development of large motor skills. Kessel Kids CcLc encourages parents to dress their child in weather appropriate clothing. Layering clothing can support the child with remaining comfortable. In the summer months, we encourage parents to send children in tennis shoes. Sandals with straps on the back are suitable for walking/outdoor play, however, tennis shoes provide additional means of support for walking and foot protection. Parents are also encouraged to bring sun hats or visors if desired to protect a child from the sun. A sun hat is especially encouraged for children under 6 months as sunscreen is not yet recommended. It will be requested that parent(s)/ legal guardians bring in sunscreen for their child(ren) during the summer months. During the winter, children will need appropriate outdoor attire including snow pants, hats, gloves and a winter coat. Parents are encouraged to take winter gear home periodically to wash. Classrooms will provide extra gear for outdoors if and when a child does not have the appropriate outdoor attire.
Children will go outdoors on a regular basis with exception to extreme weather conditions. Parent(s)/ legal guardians are encouraged to bring an extra change of clothing labeled with the child’s name to have on hand in the case a child’s clothing would need to be changed. Children are encouraged to be hands-on and explore which at times may lead to dirty clothing. Please dress your child in attire that can withstand developmentally appropriate hands-on play.
Infants younger than six months should be kept out of the direct sunlight and be kept within the shade. Children should be encouraged to wear a hat or cap with a brim that shields the face from the sun. Between the hours of 10AM and 2 PM, when UV rays are the strongest, sun exposure will be limited. Parents will be required to supply sunscreen for their child. Sunscreen does not require written authorization from a primary care physician but does require written permission by the parent(s)/ legal guardian. As with any prescribed medication, a medication log will be completed. If an allergic reaction is observed, caregivers will discontinue use and notify the parent(s)/ legal guardian.
When given permission to apply sunscreen, sunscreen should be applied to all exposed areas including the face, nose, ears, feet and hands. Sunscreen is applied on cloudy days as well. “Broad Spectrum” sunscreen with an SPF of 15 or higher should be utilized. Sunscreen is applied thirty minutes before going outdoors as it needs time to absorb within the skin. Sunscreen will be applied every two hours. Protective clothing as well as shade should also be used to protect children from the sun. Sunscreen should be applied at least once by the parent before application in the child care setting.
All providers, volunteers and children will wash their hands as follows: upon arrival, when moving from one classroom to another, when coming in from outdoors, before and after handling food and feeding a child, before and after giving medication, after diapering and toileting, handling bodily fluids, cleaning/handling garbage, handling pets and playing in sandboxes. Hand washing procedures will be posted near each sink.
Diapering will be done in a designated area. There will be no food handling in this area. Providers will follow diapering procedures and proper cleaning and sanitizing practices. Toilets in rooms will be kept separate from activity areas. Children less than five years of age and older who require assistance will be accompanied by an adult. Toilets are adapted to encourage independent use by children.
The facility will be maintained by center staff. Surfaces and toys will be disinfected using a (non-toxic) solution of household bleach and water mixed fresh daily. The solution will be left on for at least two minutes before it is wiped off with a clean towel or be allowed to air dry.
Pets will be kept in clean and enclosed cages or separated by some other means from children. Any pet or animal present at the center must be in good health and show no evidence of carrying any disease. Children will not be able to access the pet’s food or excrement and will be under the supervision of staff at all times. Children and staff will follow proper hand washing procedures when in contact with pets.
If cloth diapers are used, the diaper should have an absorbent inner lining completely contained within an outer covering made of waterproof material that prevents the escape of feces and urine. An alternative is the use of cloth diapers that contain a waterproof cover that is adherent to the cloth material. If cloth diapers with a separate lining are used, the outer covering and inner lining should be changed together as the unit should be reused in the child care center. No rinsing or dumping of the contents of cloth diapers should be performed at the center. Soiled cloth diapers should be completely wrapped in a non-permeable material, stored in a location inaccessible to children and given directly to the parent(s)/ legal guardian upon discharge of the child.
Each crib, cot or mat is to be labeled with the name of the child who uses the equipment. All surfaces need to be cleaned and disinfected before use by another child. Bedding will be washed one time per week. Cribs, cots and mats will be placed 3 feet apart from where any other child sleeps. Bedding will be stored so there is no contact between sleeping surfaces of another child.
Caregivers and teachers promote regular tooth brushing. Children will brush their teeth at least once during the hours they are in childcare. Children under the age of two will utilize only a smear of fluoride toothpaste (rice grain) on the brush when brushing. Those over two years of age should use a pea-sized amount of fluoride toothpaste. Caregivers are encouraged to model brushing activity at the same time the children are brushing their teeth. Fluoride is the single most effective way to prevent tooth decay. Brushing of teeth with fluoridated toothpaste is the most efficient way to apply fluoride to the teeth.
Additional Health Policies
Kessel Kids CcLc will administer medications to children with written approval from the parent(s)/ legal guardian and an order from a health care provider. Whenever possible, the first dosage of medication should be given at home to see if the child would have any type of reaction. We encourage parent(s)/ legal guardians to administer medication to their own children during the child care day if possible due to the safety hazards created by having medication within the facility.
Kessel Kids CcLc providers will administer medications only if the parent(s)/ legal guardian has provided written consent. The instructions for the dose, time, and method to be used and duration of administration will be provided to the child care staff in writing.
Prescription medications must be provided in the original, child-resistant container that is labeled by a pharmacist with the child’s name, the name and strength of the medication; the date of the prescription; the medication’s expiration date; and administration, storage and disposal instructions.
For over the counter medications, parent(s)/ legal guardians will provide the medication in a child-resistant container. The medication will be labeled with the child’s first and last names; specific, legible instructions for administration and storage supplied by the manufacturer and the name of the health care providers who recommended the medication for the child (if applicable).
A physician may state a certain medication may be given for a recurring problem, emergency situation or chronic condition. A child may only receive medication with the permission of the child’s parent(s)/ legal guardian and when the staff person who will give the medication has demonstrated to a licensed health professional the skills required to do so.
All medications will be stored out of the reach of children and at the recommended temperature. Medications will not be used beyond the date of expiration on the container or beyond the prescription guidelines.
Kessel Kids CcLc also requests that parents supply a medicine dropper, measuring cup etc. for dispensing medications if needed. The measuring device needs to be placed in an enclosed bag and labeled with the child’s name.
Medication errors will be controlled by checking the following items each time a medication is given:
- Right child
- Right medicine
- Right dose
- Right time
- Right route of administration
Medication logs will be completed by the provider administering the medications. The documentation will be kept on file as well as recorded for the parent(s)/ legal guardian’s reference. Spills, reactions, and refusal to take medication will be noted in this log. If a medication error occurs, the Poison Control Center and the child's parents will be contacted immediately.
Weather permitting, all children, including infants, are encouraged to spend time outdoors to allow for exploration and development of large motor skills. Kessel Kids CcLc encourages parents to dress their child in weather appropriate clothing. Layering clothing can support the child with remaining comfortable. In the summer months, we encourage parents to send children in tennis shoes. Sandals with straps on the back are suitable for walking/outdoor play, however, tennis shoes provide additional means of support for walking and foot protection. Parents are also encouraged to bring sun hats or visors if desired to protect a child from the sun. A sun hat is especially encouraged for children under 6 months as sunscreen is not yet recommended. It will be requested that parent(s)/ legal guardians bring in sunscreen for their child(ren) during the summer months. During the winter, children will need appropriate outdoor attire including snow pants, hats, gloves and a winter coat. Parents are encouraged to take winter gear home periodically to wash. Classrooms will provide extra gear for outdoors if and when a child does not have the appropriate outdoor attire.
Children will go outdoors on a regular basis with exception to extreme weather conditions. Parent(s)/ legal guardians are encouraged to bring an extra change of clothing labeled with the child’s name to have on hand in the case a child’s clothing would need to be changed. Children are encouraged to be hands-on and explore which at times may lead to dirty clothing. Please dress your child in attire that can withstand developmentally appropriate hands-on play.
Infants younger than six months should be kept out of the direct sunlight and be kept within the shade. Children should be encouraged to wear a hat or cap with a brim that shields the face from the sun. Between the hours of 10AM and 2 PM, when UV rays are the strongest, sun exposure will be limited. Parents will be required to supply sunscreen for their child. Sunscreen does not require written authorization from a primary care physician but does require written permission by the parent(s)/ legal guardian. As with any prescribed medication, a medication log will be completed. If an allergic reaction is observed, caregivers will discontinue use and notify the parent(s)/ legal guardian.
When given permission to apply sunscreen, sunscreen should be applied to all exposed areas including the face, nose, ears, feet and hands. Sunscreen is applied on cloudy days as well. “Broad Spectrum” sunscreen with an SPF of 15 or higher should be utilized. Sunscreen is applied thirty minutes before going outdoors as it needs time to absorb within the skin. Sunscreen will be applied every two hours. Protective clothing as well as shade should also be used to protect children from the sun. Sunscreen should be applied at least once by the parent before application in the child care setting.
All providers, volunteers and children will wash their hands as follows: upon arrival, when moving from one classroom to another, when coming in from outdoors, before and after handling food and feeding a child, before and after giving medication, after diapering and toileting, handling bodily fluids, cleaning/handling garbage, handling pets and playing in sandboxes. Hand washing procedures will be posted near each sink.
Diapering will be done in a designated area. There will be no food handling in this area. Providers will follow diapering procedures and proper cleaning and sanitizing practices. Toilets in rooms will be kept separate from activity areas. Children less than five years of age and older who require assistance will be accompanied by an adult. Toilets are adapted to encourage independent use by children.
The facility will be maintained by center staff. Surfaces and toys will be disinfected using a (non-toxic) solution of household bleach and water mixed fresh daily. The solution will be left on for at least two minutes before it is wiped off with a clean towel or be allowed to air dry.
Pets will be kept in clean and enclosed cages or separated by some other means from children. Any pet or animal present at the center must be in good health and show no evidence of carrying any disease. Children will not be able to access the pet’s food or excrement and will be under the supervision of staff at all times. Children and staff will follow proper hand washing procedures when in contact with pets.
If cloth diapers are used, the diaper should have an absorbent inner lining completely contained within an outer covering made of waterproof material that prevents the escape of feces and urine. An alternative is the use of cloth diapers that contain a waterproof cover that is adherent to the cloth material. If cloth diapers with a separate lining are used, the outer covering and inner lining should be changed together as the unit should be reused in the child care center. No rinsing or dumping of the contents of cloth diapers should be performed at the center. Soiled cloth diapers should be completely wrapped in a non-permeable material, stored in a location inaccessible to children and given directly to the parent(s)/ legal guardian upon discharge of the child.
Each crib, cot or mat is to be labeled with the name of the child who uses the equipment. All surfaces need to be cleaned and disinfected before use by another child. Bedding will be washed one time per week. Cribs, cots and mats will be placed 3 feet apart from where any other child sleeps. Bedding will be stored so there is no contact between sleeping surfaces of another child.
Caregivers and teachers promote regular tooth brushing. Children will brush their teeth at least once during the hours they are in childcare. Children under the age of two will utilize only a smear of fluoride toothpaste (rice grain) on the brush when brushing. Those over two years of age should use a pea-sized amount of fluoride toothpaste. Caregivers are encouraged to model brushing activity at the same time the children are brushing their teeth. Fluoride is the single most effective way to prevent tooth decay. Brushing of teeth with fluoridated toothpaste is the most efficient way to apply fluoride to the teeth.