Child Care Policy & Procedure _____________________ Child Care Provider Policy Manual Child Care Policy & Procedure TABLE OF CONTENTS HANDWASHING .............................................................................................................................. 2 How Germs Spread .................................................................................................................................. 2 Key Times to Wash Hands ....................................................................................................................... 2 Steps to Wash Your Hands the Right Way ................................................................................................. 2 HEALTH CARE POLICY AND PROCEDURES ................................................................................. 3 Ill or Infected Caregiver ........................................................................................................................... 3 Ill or Infected Children ............................................................................................................................. 3 Parent/Guardian Notification Plan ............................................................................................................. 3 Emergencies ............................................................................................................................................ 4 Exposure to Blood or Other Potentially Infectious Materials ....................................................................... 4 Reduce the Spread of Illness through Direct Contact ............................................................................. 4 Reduce the Spread of Respiratory Illnesses ........................................................................................... 4 Infant Sleeping Position Practices ............................................................................................................. 5 MEDICATION POLICY .................................................................................................................... 5 FOOD AND NUTRITION................................................................................................................... 6 BEHAVIOR MANAGEMENT AND GUIDANCE ................................................................................ 6 SUSPECTED CHILD ABUSE OR NEGLECT ..................................................................................... 6 Mandated Reporter .................................................................................................................................. 6 Shaken Baby Syndrome and Abusive Head Trauma ................................................................................... 7 Recognizing .............................................................................................................................................. 7 Reporting ................................................................................................................................................. 7 Prevention Strategies ................................................................................................................................. 7 Prohibited Behaviors ................................................................................................................................. 7 EMERGENCY PLANNING ................................................................................................................ 7 PHYSICAL CHILD CARE AREA ...................................................................................................... 8 Cleaning ................................................................................................................................................. 8 Disposal of Garbage and Biological Contaminants ................................................................................... 10 Hazards ................................................................................................................................................ 10 Community Assessment ......................................................................................................................... 10 Toys and Play Equipment ....................................................................................................................... 10 TRANSPORTATION ....................................................................................................................... 10 Parental Notification .............................................................................................................................. 11 Drop Off/Pick Up Times ........................................................................................................................ 11 Child Passenger Safety ........................................................................................................................... 11 ACKNOWLEDGEMENTS .................................................................................................................... 11 1 HANDWASHING For the health and safety of myself and the children in my care, we will follow handwashing procedures outlined by the U.S. Centers for Disease Control and Prevention (CDC) at all times which is reviewed below. HOW GERMS SPREAD Washing hands can keep you healthy and prevent the spread of respiratory and diarrheal infections from one person to the next. Germs can spread from other people or surfaces when you:  Touch your eyes, nose, and mouth with unwashed hands.  Prepare or eat food and drinks with unwashed hands  Touch a contaminated surface or objects  Blow your nose, cough, or sneeze into your hands and then touch other people’s hands or common objects. Wash Your Hands! g · 2 3 Soap Wash for 20 seconds 4 5 6 Rinse Dry Turn Off Water with Paper Towel KEY TIMES TO WASH HANDS We keep ourselves healthy by washing our hands often, especially during these key times when it one is likely to get and spread germs:  Before, during, and after preparing food  Before eating foods  Before and after caring for someone who is sick  Before and after treating a cut or wound  After toileting  After changing diapers or cleaning up a child who has used the toilet  After blowing our nose, coughing, or sneezing  After touching an animal, animal feed, or animal waste  After touching garbage STEPS TO WASH YOUR HANDS THE RIGHT WAY Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community – from your home and workplace to childcare facilities and hospitals. 2 HEALTH CARE POLICY AND PROCEDURES For the safety of your child and all children in our care, please do not bring your child to daycare sick. ILL OR INFECTED CAREGIVER I will not accept children in care when I am sick and potentially can spread illness that may endanger the health or well-being of any child in my care. I will monitor myself against signs of illness that may include fever, coughing, upper respiratory infection, vomiting, or diarrhea. If there is a time, I am unable to provide child care services due to illness, I will notify the parent/guardian as soon as possible so alternative arrangements can be made. If possible, I will notify the parent/guardian the night before, however, should I awake ill, I will notify the parent/guardian as early as possible in the morning. Should I become sick during the course of the day, I will notify parent/guardian for immediate pick-up of the child(ren) in care. ILL OR INFECTED CHILDREN A child with any of the following illnesses must be completely free of any symptoms before returning to daycare. If the child is taking antibiotics for an illness, the child may return after the initial 24 hours of beginning antibiotics as long as (s)he has a temperature below 100.4 degrees, no longer contagious, and is otherwise feeling well enough to participate in our daily schedule. Signs of illness may include the following: unusual lethargy, irritability, persistent crying for no reason, runny nose (more than clear), cough (more than slight), difficulty breathing, diarrhea, vomiting, mouth sores, rash, pink-eye, chicken pox, mumps, measles, roseola, hepatitis A, impetigo, lice, ringworm, scabies, strep throat, scarlet fever, tuberculosis, shingles, and any other contagious rash or disease. Any child with a fever of 100.4 degrees or above, orally or axillary, may not attend daycare. I will monitor each child in my care throughout the day for signs or symptoms of illness or contagious diseases. A parent/guardian will be contacted with the contact recorded and filed in the child’s record, and the child sent home for symptoms outlined in Missouri regulations. PARENT/GUARDIAN NOTIFICATION PLAN Parent/guardian will be notified if I observe changes in the child’s health, child experiences accidents, injuries, incidents, or if a child becomes ill. Each of the following notifications will occur:  Accident, Injury, or Incident – parent/guardian will receive a written report that includes the time, date, nature of the incident/accident, and first aid or action taken. Staff will discuss with the parent/guardian at pick up and I, along with the parent/guardian will sign the report.  Accident, Injury, or Incident (Serious) – parent/guardian will receive a phone call as well as the written report discussing the accident injury or incident. o Parent/guardian will automatically receive a phone call if the injury occurs above the shoulders as well as the written report.  Illness – parent/guardian will receive a phone call if a child becomes ill. The parent/guardian will be required to pick up the child within one hour of notification. If the child becomes ill while in care, (s)he will be comfortable cared for separately from the other children until the parent/guardian can arrive to take them home. The child must be free of symptoms, eating a regular diet, and free of fever for 24 hours before returning. 3 EMERGENCIES I make every effort to provide the children with a safe environment through ,I,lql\ CALL' supervision and childproofing of the child care area. However, minor bumps, If you have an scrapes, and cuts are inevitable. If something should happen, the appropriate first aid will be given, and accident forms will be filled out and signed. I maintain 9-1-1 current First Aid and CPR Training. If any major injury or medical problem occurs, the parent/guardian will be contacted immediately. If I cannot contact the parent/guardian, I will contact the emergency contact numbers supplied to me. If necessary, I will contact 9-1-1 or the poison control center prior to contacting the parent/guardian. If necessary, the injured or ill child will be transported to the hospital at the parent’s expense. EXPOSURE TO BLOOD OR OTHER POTENTIALLY INFECTIOUS MATERIALS As a child care provider, I will likely be exposed to blood or bodily fluids at some point as children are likely to get bloody noses and suffer a cut or scrape. For this reason, I am aware of the risks of blood-borne pathogens and how to protect myself from infection. If I believe there has been exposure to a bloodborne pathogen, I will immediately wash the affected area with soap and water; report the incident to the appropriate agency if necessary and proceed immediately to a physician or emergency room. Guidance from the Centers for Disease Control and Prevention (CDC) provides the following guidelines for me to follow to assure the health and safety of myself and any child in my care. Reduce the Spread of Illness through Direct Contact  Make sure the provider, and any children in care, wash their hands after contact with any body fluids.  Wear disposable gloves when touching body fluids or objects and surfaces contaminated with body fluids  Use running water for handwashing. Do not use basins or stopped sinks, which can become contaminated with the germs.  Use plain liquid soap and single-use disposable paper towels or single-use cloth towels.  Always use single-use disposable tissues wiping noses. Never use the same tissue for more than one child.  Dispose of used tissues and paper towels in a disposal container which is kept away from food and supplies.  Follow recommended procedures for cleaning, sanitizing, and disinfecting toys and surfaces.  Wash and cover sores, boils, blisters, cuts, or scrapes promptly and wash away eye discharge.  Report rashes, sores, eye discharge, and severe itching to the parent/guardian so they contact the child’s health care provider(s). Reduce the Spread of Respiratory Illnesses  Provide ventilation, including airing out the child care area daily and encouraging outdoor play.  Teach children to cough or sneeze into their elbow or sleeve. If they sneeze or cough into a hand or tissue, they must properly dispose of the tissue and wash their hands.  Ensure hands are washed after wiping or blowing a nose, after contact with any fluids from the nose, throat, or eye, and before preparing or eating food.  Don’t allow food or eating utensils to be shared.  Clean and sanitize mouthed toys.  Clean eating utensils carefully in soapy water; then rinse, sanitize, and air dry or use a dishwasher to sanitize dishes and utensils. 4  Use single-use disposable cups, or reusable cups that are cleaned and sanitized after each use What does a safe sleep INFANT SLEEPING POSITION PRACTICES environment look like? Based on the risk factors of Sudden Infant Death Syndrome (SIDS) Reduce the R1!:J< of Suddm Infant Death Syndrome (SIDS) and Other Sleep-Related Cw.sas of Infant Death all infants will be placed to sleep on the infant’s back unless the Us-eafirmslffp home has been provided a physician’s written statement authorizing surface.,uctias ama1trtsS1ru uftc.y-appioved• another sleep position for that particular infant. All infants will be cfibrov«edb',' afittedshee:. placed to sleep on a firm, tight-fitting mattress in a sturdy and safe crib with no pillows, quilts, blankets, comforters, bumper pads, sheepskins, stuffed toys, or other soft items in the crib. For the safety of any infant in my care, I will ensure that no infant will nap or sleep in any furniture or equipment that is not an approved crib, including, but not limited to, car seats, bouncy seats, Babvstwuldnot deep~~~iJt infant seats, swings, jumping chair, or similar items. I further bed.onacooch. Ofonachair alonewJth)')u.or acknowledge that if an infant should fall asleep in any of these .,,il:h•ntoneeke. unapproved items, I will move them from said location and place 'For more .,formatrc:n en c;nb s,lrty gudd....,,. ,;ont&ct the Consume, Product S1tfetyCommlmon111-l00-6ll·2772orhtlp,tlwww.cptc.go,,. them on their back in an approved crib. MEDICATION POLICY NH Safe Sleep Campaign NH Divlslm or Public Bea Ith Sen•k:l'S NH Department~ Heath &Human Sen-Ices When a parent/guardian requests that the care provider administer 800-852...'.3.345,x4517/603-271-4517 http:llwww.dhhs.nh.gov/dphsibchstmchfslds.htm medication, the following provisions, based on requirements of state standards shall apply:  Medication, including prescription drugs or individual special medical procedures, will be given or applied only with prior written permission from the parent/guardian. o I will not honor any instruction from a parent/guardian which contradicts the instructions of the physician (for prescription drugs) or the instructions on the label (for over the counter drugs).  I will maintain a record as to the time and the amount of any medication given or applied.  The medication shall be in the original container, stored according to the instructions, and must have the original pharmacy label indicating the physician’s name, child’s name, instructions, and name and strength of the medication and shall be given in accordance with those instructions.  I will keep the medication out of the reach of children.  I will return the medication to the parent/guardian when it is no longer needed.  No medication prescribed to one child will ever be administered to another child at any time. 5 FOOD AND NUTRITION The parent/guardian is responsible for providing me with a list of each child’s known food allergies. The parent/guardian should provide a care plan prepared by the child’s primary health care provider with a list of the food(s) the child is allergic and instructions for steps to avoid that food; as well as a detailed plan to be implemented in the event of an allergic reaction including specific symptoms which indicate the need to administer medication. With the parent/guardian’s permission, I will post the food allergies in the food preparation area; otherwise those allergy records shall be maintained in each child’s enrollment form and food allergy plan. I will have a plan for each child with a food allergy developed with the parent/guardian that includes:  Instructions regarding the food(s) to which the child is allergic and steps to take to avoid that food  A detailed treatment plan to implement in the event of an allergic reaction, including the names, doses, and methods of prompt administration of any medications o The plan, reviewed and signed by parent/guardian, includes specific symptoms that indicate a need to administer one or more medications, the process to notify the parent/guardian of any suspected or known ingestion of or contact with the problem food even if a reaction did not occur, and the process to contact emergency medical services immediately if epinephrine is administered. BEHAVIOR MANAGEMENT AND GUIDANCE My goal is to provide safe care for your child and to ensure that I correct inappropriate behavior in a manner that shows love and respect. Under no circumstances should discipline occur with shame, humiliation, sarcasm, or physical punishment. If your child’s behavior becomes unmanageable, you will be notified to come pick him/her up. In addition, we will document all behavior problems and any conversations with the parent/guardian. When a child’s behavior is disruptive (i.e. biting, hitting, throwing objects or using “bad” language), the parent/guardian will be notified. If the child continues a disruptive behavior, a parent/guardian conference will be held to discuss reasonable solutions to the situation. The discussion will include a consideration of any disability, which affects the child’s behavior and a reasonable accommodation to meet the child’s need and eliminate the disruptive behavior. SUSPECTED CHILD ABUSE OR NEGLECT MANDATED REPORTER ~porting child As a registered child care provider, I am required by state law abuse is to report any instances of child abuse or neglect to the e's appropriate authorities. I must all report any instances in . . . which there is a “reasonable suspicion” that abuse or neglect may have occurred. I take these responsibilities seriously and will report any actual or reasonable suspicions of abuse or neglect. I have completed training required of all registered child care providers which educated me on the signs and symptoms often associated with child abuse and neglect regarding 6 physical indicators on the child, child behavioral indicators, and characteristics of the parent/guardian. I will use these guidelines to help me determine if I feel “reasonable suspicion” exists with each child in care. SHAKEN BABY SYNDROME AND ABUSIVE HEAD TRAUMA I believe that preventing, recognizing, responding to, and reporting shaken baby syndrome and abusive head trauma is an important function of keeping children safe, protecting their healthy development, providing quality child care, and educating families. Recognizing Each child is observed for signs of abusive head trauma including irritability and/or high pitched crying, difficulty staying awake/lethargy or loss of consciousness, difficulty breathing, inability to lift the head, seizures, lack of appetite, vomiting, bruises, poor feeding/sucking, no smiling or vocalization, inability of the eyes to track and/or decreased muscle tone. Bruises may be found on the upper arms, rib cage, or head resulting from gripping or from hitting the head. Reporting If shaken baby syndrome or abusive head trauma is suspected, I will:  Call 9-1-1 immediately  Contact the parent/guardian  If the child has stopped breathing, I will immediately begin pediatric CPR Prevention Strategies To assist in coping with a crying, fussing, or distraught child, I will first determine if the child has any physical needs such as being hungry, tired, sick, or in need of a diaper change. If no physical need identified, I would attempt one or more of the following strategies:  Rock the child, hold the child close, or walk with the child  Sing or talk to the child in a soothing voice  Gently rub or stroke the child’s back, chest, or tummy  Offer a pacifier or try to distract the child with a rattle or toy  Take the child for a ride in a stroller  Turn on music or white noise Prohibited Behaviors Behaviors that are prohibited for children in my care include, but are not limited to:  Shaking or jerking a child  Tossing a child into the air or into a crib, chair, or car seat  Pushing a child into walls, door, or furniture EMERGENCY PLANNING An Emergency Action Plan has been developed to be implemented in the event of an emergency situation. The plan has been designed to provide a plan of action in the event of a natural or man-made disaster. While developing this plan, consideration of each child’s development and ability was considered to ensure the plan is effective to keep them safe. In the event of an actual emergency, we will follow the instructions of the local authorities and I will continue to monitor your child to observe any behavior(s) that will help avoid danger. The instructions may be to stay in the 7 child care area and shelter-in-place, or to evacuate. If we are instructed by authorities to evacuate to a specific location, the children will be taken to the location identified by the authorities. If no specific location is provided, parents will be notified where the children are taken based on the circumstances. As part of our Emergency Action Plan, we ask that you update your contact information including current telephone numbers (home, work, and cell, as appropriate) and addressed for yourself and any emergency contact persons as soon as changes are made. PHYSICAL CHILD CARE AREA As part of my requirements for being registered with the State of Missouri to care for your child, I follow all local ordinances which pertain to my geographical location, including requirements of business licenses, permits or waivers, as well as meeting codes and regulations for construction standards, fire safety rules, health stipulations, animal control, or other similar considerations. CLEANING I take the well-being of every child in care very seriously and work hard to provide an environment that is healthy as possible. I am committed to keeping my child care area and the children in care as clean as possible, in order to help minimize and/or prevent the spread of germs. My child care area is kept clean and disinfected at all times. I thoroughly clean surfaces that children come in close contact with using soap and water, or Lysol, etc. As appropriate, high chairs, diaper changing tables, etc. are cleaned and disinfected between each use. Toys are cleaned and disinfected often. To help eliminate the spread of germs, I will wash and disinfect toys regularly. In the instance where a child had an illness, toys will be washed on a more regular basis. When cleaning, disinfecting, and sanitizing, I will ensure that all products used for the health and safety of the child care area, myself, and the children in care will be used as directed by the manufacturer’s or health department guidelines. I will also ensure that when cleaning and disinfecting I will keep the children away from the area to ensure they do not have access to chemicals and that adequate ventilation is maintained in the child care area to prevent children and myself from inhaling potentially toxic fumes. In addition to ensuring items, such as cleaning materials, laundry detergents (including pods), automatic dishwasher detergent (in liquid or solid form, including pods), aerosol cans, pesticides, health and beauty aids, medications, lawn care chemicals, liquid nicotine and tobacco products, or other toxic materials remain inaccessible to children in care at all times, I also recognize that these products should only be used as recommended by the manufacturer and stored in their originally labeled containers. 8 CLEANING SCHEDULE After Each Daily Weekly Monthly Notes Use Changing Tables Food prep area & sinks Dining table or high chairs Cribs, playpens, swings, or other similar furniture Dishes & utensils Vacuum, sweep, and/or mop floors Change garbage cans Diaper Pails Return all toys to storage bins Art supplies used Hand towels & bibs Bedding Doorknobs, light switches, and cabinet handles Pretend play items (clothing, etc.) Sanitize toys Oven, Refrigerator, Microwave, and other kitchen appliances 9