Hand Washing

Good hand washing can stop the spread of many illnesses and infections in a matter of minutes. Liquid hand soap is used for hand washing. Safe stepping stools are available so that children can reach sinks and taps comfortably. Hand washing sinks and the surrounding areas are cleaned and sanitized routinely to prevent cross contamination to children and adults from dirty water, soiled paper products, faucet handles, etc.

Hand Washing Steps:

1.     Wet hands with warm, running water

2.     Apply a small amount of liquid hand soap

3.     Wash the fronts, backs, and in between the fingers using gentle pressure while rubbings hands together

4.     Rinse all soap and soil from the hands with running water, allowing the used water to go down the drain

5.     Dry the hands completely with a disposable paper towel

6.     Turn off the water with the used paper towel to prevent recontaminating the clean hands with germs and soil from the faucet handles

7.     Discard paper towels immediately in the trash

Appropriate hand washing times for adults:

·      When first arriving at the program

·      Before and after giving first aid, changing bandages, or taking a temperature

·      Before and after preparing food activities, meals, or snacks

·      Before and after giving medications or treatments

·      After using the toilet or assisting a child to use the toilet

·      After diapering a child

·      After coughing, sneezing, or wiping nose/mouth

·      After caring for or handling pets or their enclosures

·      After tending to a sick child, adult, or pet

·      After handling items soiled with body fluids such as blood, urine, mucus, saliva, vomit, or drainage from infected eyes, nose, sores, etc.

Appropriate hand washing times for children:

·      When arriving at the program

·      Before eating meals or snacks

·      Before activities that can include fingers or items that can go into the mouth, such as clay, play dough, water table, etc.

·      After using the toilet or having a diaper changed

·      After playing with pets

·      After coughing, sneezing, vomiting, or wiping the nose and/or mouth

·      After outdoor play, especially before meals or nap time

·      After messy activities such as painting

Cleaning/Sanitizing/Disinfecting

Diaper Changing

Hands will be washed before and after changing diapers. The changing mat is sterilized with recommended bleach solution before and after each use. Soiled diapers will be disposed of in a closed and sanitized container.

Toys and Equipment

Toys and equipment will be sterilized daily or as needed with the recommended bleach solution.

Bedding & Soiled Clothing

Bedding will be laundered at the facility on an as needed basis. On occasion, Explore More may launder soiled clothing or clothing will be bagged and given to the parent/guardian if the laundry has been completed for that given day.

Immunizations

The State of Maine requires that a record of current immunizations be on file for each child enrolled within 30 days following admission. Immunization records shall be certified by your child’s physician or nurse practitioner and shall be updated yearly in accordance with the recommended schedule for routine health supervision of the American Academy of Pediatrics. Per State of Maine law, effective September 1, 2021, exemption from immunization requirements is limited to medical reasons.

The Family Child Care Provider must maintain a list of all unimmunized persons, regardless of age. In the event of a disease outbreak as defined by the CDC reporting standards, a child not immunized must be excluded from the Family Child Care in accordance with CDC guidance or until the child receives the necessary immunization or proof of immunity is on record.

Illness

Children will be visually screened as they arrive at the facility. In the event a child becomes ill and needs to be picked up, the child will be separated from the rest of the children until a parent/guardian arrives. For the health and safety of your child and all of the children in our daycare, please do not bring your child to daycare sick. In which case we in turn may become sick making it difficult to care from the children at the high standards that we have set for ourselves. We can only care for children with mild cold like symptoms that are otherwise feeling and acting well.

Your child may attend with the following symptoms:

·      Clear runny nose

·      Slight cough

·      Low or no fever

Your child may not attend with the following symptoms:

·      Fever of 100 or higher

·      Green or yellow runny nose

·      Persistent cough

·      Difficulty breathing

·      Diarrhea

·      Vomiting

·      Rashes

If you are no sure if your child should be brought to daycare, then please call and check with us. If a child becomes ill during daycare hours, the parent(s)/guardian(s) will be contacted to pick up the child. The child needs to be picked up within one hour of family being notified. If parent(s)/guardian(s) are not available, the emergency contact person will be notified. 

Once a child is removed from daycare due to illness, they must not return to daycare until symptoms requiring removal are no longer present. The child must also be void of any contagious disease, unless accompanied by a doctor’s note stating the illness in question is not contagious, and the child is otherwise feeling well enough to participate in our daily schedule. See the following for an in-depth list of when your child may return to care. Full childcare fees will remain due as normal regardless of how long your child is out sick. 

Please make other arrangements if your child is sick and respect my decision if I feel your child is too sick to be in childcare. I am sympathetic to the difficulties of taking time off, so discretion will be used. “Dose and Drop” where you administer fever reducing or symptom masking medication to your child at home before bringing them to childcare is strictly forbidden. Any parent(s)/guardian(s) found to be doing so to try and circumvent the illness policy will be issued an immediate termination notice for all children in care. 

Infectious Disease/Viral Outbreak Policies

Explore More will remain open during an infectious disease outbreak until and unless the CDC or Maine Child Licensing specifically instruct licensed childcare programs to shut down. I ask that parent(s)/guardian(s) take extra precautions to avoid putting our program and families at risk.

If your child is exposed to somebody who has traveled to an at-risk area where community transmission is high, please consult your pediatrician on when the child should re-enter childcare. I will ask for a doctor’s note for re-entry to childcare if I know firsthand that your child has been exposed to the illness or that you or an immediate family member has been exposed to the virus.

Should your child or anybody who lives in the same household as the child in care (to include other parent(s)/guardian(s) household if unmarried) begin to show symptoms of the virus:

1.     All symptomatic children will be asked to get tested

2.     Children may not return until negative results are received -or-

3.     Children may not return until 14 days after all symptoms are gone following a positive result

Should my children or anybody who lives in my household begin to show symptoms of the virus:

1.     The affected persons will get tested

2.     Childcare will shut down until negative results are received -or-

3.     Childcare will shut down until 14 days after all symptoms are gone following a positive result

4.     Provider may use paid sick days to cover the shut down while awaiting test results. If sick days are not used, no tuition will be due for the days the business is closed.

If your child is absent from childcare due to their illness, due to following a quarantine period, or due to waiting on test results, full tuition payments will still remain due. If childcare is shut down by the CDC or Child Care Licensing instructions, I will work with each family to ensure payment arrangements that work for all involved. 

When Can I Come Back to Daycare?

After 24 hours

·      Fever – you must be fever free without medication for 24 hours

·      Vomiting – episodes must have stopped 24 hours prior to daycare hours

·      Diarrhea – episodes must have stopped 24 hours prior to daycare hours

·      Pink eye – 24 hours after treatment has been initiated

·      Scabies, head lice, or other infestation – 24 hours after treatment has been initiated

·      Impetigo – 24 hours after treatment has been initiated

·      Strep throat – 24 hours after initial antibiotic treatment and fever free

·      Vaccinations – any vaccination requires 24-hour exclusion from childcare

·      Taking antibiotics – any illness requiring antibiotics (with the exception of those listed below) the child may return 24 hours after the first dose so long as they are fever free

Doctor’s Note Required

·      Chicken pox – at least 6 days after onset of rash or until all sores have dried and crusted AND Doctor’s Note Required

·      Pertussis – 5 days after antibiotic treatment is completed AND Doctor’s Note Required

·      Mumps – 9 days after onset of parotid gland swelling AND Doctor’s Note Required

·      Hepatitis A virus – 7 days after onset of illness AND when passive immunoprophylaxis has been administered AND Doctor’s Note Required

·      Measles – 6 days after onset of rash AND Doctor’s Note Required

·      Rubella – 6 days after onset of rash AND Doctor’s Note Required

·      Mouth sores with drooling – Doctor’s Note Required

·      Rash with fever or behavior change – Doctor’s Note Required

·      Tuberculosis – Doctor’s Note Required

·      RSV – 8 days after onset of symptoms, fever free for 24 hours, AND Doctor’s Note Required

·      COVID 19 – 10 days quarantined after onset of symptoms, fever free for 72 hours AND Doctor’s Note Required with proof of negative test

If your child visits the doctor/walk-in care/urgent care/ER for anything other than a routine well child checkup, they WILL NEED A DOCTOR’S NOTE TO RETURN TO DAYCARE. Even if it is just the sniffles. NO EXCEPTIONS. I reserve the right to deny childcare to any child appearing to be unwell for the safety of myself, my family, and other enrolled families.

If your child had an immunization update, please remember to provide me with a record of the immunization so that it can be attached to your child’s health appraisal.

Allergies

Each child with a food allergy will have a Food Allergy & Anaphylaxis Emergency Care Plan prepared by the child’s primary care provider. Parents/guardians will need to provide necessary medications such as Epinephrine Injections.

Explore More will take steps to prevent exposure to the specific food(s) to which the child is allergic, learn to recognize the symptoms of an allergic reaction and become knowledgeable in treating the allergic reaction. Should an allergic reaction occur, we will promptly and properly administer the prescribed medication and notify the parents/guardians immediately. Parents/guardians will also be notified if exposure to the allergen is suspected.

Individual child’s food allergies will be posted in the kitchen. A copy of the Food Allergy and Anaphylaxis Emergency Care Plan will be included in the Emergency Preparedness bag.

Medication Administration

In the childcare setting Explore More is justified to give medications if:

·      Dosage cannot be adjusted, so that it can be taken before and after childcare

·      A child has chronic health conditions (asthma, diabetes) which may require urgent administration of medication

·      Refusal to administer the medication would pose a significant hardship, such as requiring the child’s absence from childcare to recover from an illness, when the child is well enough to attend childcare (ear infection after the first day or so)

The administration of medications will be limited to:

·      Prescribed medications ordered by a healthcare provider for a specific child and a specific illness. Medication that is prescribed for one child in the family will not be administered to another child in the family.

·      Non-prescription medications recommended by a healthcare provider for a specific child, with written permission of a parent/guardian

·      Homeopathic and herbal medications are only given with an order from a licensed health care professional and must be properly labeled

·      Medications which Explore More have been trained to administer including oral, topic, nasal, ear and eye

·      Only after the first dose has been given at home

All medications must be handed directly to me upon arrival in the morning. Please do not level prescription or non-prescription medications in backpacks or diaper bags.

All medications will be administered following the 5 Rights:

·      Right Child

o   Match child’s name to the container

·      Right Medication

o   Read the label

o   Medication in original container

o   Check expiration date

·      Right Dose

o   Verify the dosage is correct

o   Use a proper measuring device

·      Right Time

o   Check time on permission form

o   Give within 30 minutes of prescribed time

o   Document date and time administered

o   For emergency, NOW is the right time!

·      Right Administration Procedure

o   Check instructions on label and administration form

o   Give medication using appropriate route

Parents/guardians need to provide explicit instructions on the amount of medication to be administered, the times it is to be given, and most important, what signs to watch for in the event the child suffers an allergic reaction, whether or not the medicine needs to be kept refrigerated, and so on.

The permission form to administer medication needs to be filled out and signed by the parent/guardian. Medication will only be provided with written permission from the parent/guardian. Only proper measuring utensils will be used to ensure the child receives the correct dose of their medication. The measuring utensil will be cleaned immediately after use and placed with the child’s medication.

Please ask the pharmacist to divide prescription medication into two bottles, each with its own label, so that one can be kept at home and one can be kept at Explore More.

All prescription medication must be in its original container with a prescription label that provides:

  • Pharmacy name and number

  • Prescriber’s name and number

  • Prescription number

  • Date prescription was filled

  • Child’s first and last name

  • Name of medication

  • Strength of medication

  • Number of refills

  • Quantity

  • Manufacturer

  • Expiration date

  • Legible instructions for administering, storing, and disposing of the medication

The following classifications can be given with written parent/guardian consent only as to the dose, duration, and method of administration specified on the manufacturer’s label for the age or weight of the child needing medication. These medications must also be in their original container. These medications must be accompanied by a letter from the parent/guardian stating the child’s full name, name of medication, conditions for use, dose of medication, how often the medication can be given, the manner in which ointments, lotions, repellants, creams, or powders may be applied, and any precautions to follow along with the length of time the parent/guardian authorization is valid.

The following is a list of acceptable non-prescription medication:

  • Antihistamines

  • Non-aspirin fever reducers/pain relievers

  • Decongestants

  • Anti-itch ointments or lotions, intended specifically to relieve itching

  • Diaper ointments and powders intended specifically for the use in the diaper area of the child

  • Sunscreen

  • Insect Repellent

A physician’s authorization is needed for non-prescription medication that is not included in the above list, or if it to be taken differently than indicated on the label.

A medication log will be maintained in the child’s file by the staff to record any time a prescription or non-prescription medication has been administered. The child’s full name, date, time, amount, and type of medication given plus the initials of the person administering the medication will be recorded for each administration.

All medications shall:

  • Have child protective caps

  • Be stored at the proper temperature

  • Be inaccessible to children

  • Not be used beyond the date of expiration

  • Be given only for the purpose identified in the label/description

  • Be medication for the current episode of illness

As Needed medication must be accompanied by specific, detailed information about what symptoms should trigger the need to give the medication and must state the maximum number of times the dose can be repeated before seeking further medical care.

Emergency medications will be with the provider when the child is outside or on field trips, or in the case of emergency evacuation.

No medications will be added to or administered in food, unless specifically made for food. If medication is added to food the child needs to take in all the good to get the correct dosage of medication and this cannot always be guaranteed.

If medication or order to administer is out of date, or medication is left over, the medication will be returned to the parent/guardian for disposal.

In the case of a medication error/incident poison control or 911 will be called first, if necessary, and notification of the parent/guardian will follow. If immediate contact with poison control is not warranted or the child is not in distress, parents/guardians will be notified directly.  

Medication errors include:

·      Giving medication to the wrong child

·      Giving the wrong medication

·      Giving the wrong dose (under dose, overdose, or missed dose)

·      Giving medication at the wrong time

·      Giving medication by the wrong route or using a wrong procedure

Medication incidents, but not errors include:

·      Child refusal

·      Spit out doses

·      Vomited doses

·      Spilled medication 

Incident Reporting

When a serious incident involves a child in this family childcare, an incident report is made. The information is provided to the parent/guardian, licensing board and insurance company. The purpose of this report is to inform and follow up on actions taken concerning the incident. Incident reports are made for the following incidents:

·      Injuries involving serious accidents, falls (2 feet or more) or motor vehicles

·      Unexpected illness or contagious disease

·      Poisoning or medication error

·      Aggressive or unusual behavior

·      Child death

Incident reports must be seen and signed by a parent/legal guardian within 48 hours.