知道

每个孩子的一天应该开始用一个简单的健康check. This is a quick way to make sure the child is healthy enough to be in your family child care program. Most children occasionally get a runny nose, cough, or mild fever. This usually causes little worry for providers and families. However, sometimes, a child’s illness becomes more severe. You need to establish policies to guide decision-making when dealing with ill children. Because you know the children in your care well, you can likely tell when a child is well enough to participate in activities and when a child is too sick to stay at your program. You will need to outline guidelines to help you make this decision and share those guidelines with families. The American Academy of Pediatrics (2011) offers three key factors to help you decide whether a child is too sick for child care:

• The child cannot participate in activities
• 孩子的疾病对其他孩子或成年人带来了风险
• You cannot care for the child while maintaining appropriate care for the other children

If a child meets any of these criteria, it is likely that they should be sent home. See the attachments in this section for lists of illnesses that do or do not merit exclusion from child care. Daily health checks are a way to evaluate a child to help make these decisions. It is up to you—not the family—to decide whether a child is healthy enough to stay in child care. You must consider the guidelines of your specific licensing agency, as well as the health of the other children, yourself, and any other person in your program.

每日健康检查也可以在儿童外观或行为中提供记录，这在儿童虐待或忽视的情况下可能是重要的。如果孩子怀疑具有长期的身体或心理健康的需要，这些信息对家庭也非常有用。健康检查，如果敏感和彻底记录，可以帮助您与儿童和家庭建立关系。本课程将回答问题许多家庭幼儿提供者可能会有关于健康检查的问题。万博体育下载官方网站

什么是健康检查？

健康检查是对孩子的身体，情绪和行为的快速评估。作为您的健康检查的一部分，您还应该收集家庭的信息。您想知道是否存在影响儿童或家庭成员的健康变化。一个简单的，“每个人都感觉到今天好吗？”可以开始对话。当您了解一个孩子时，您将迅速注意到日常日常的任何差异。健康检查的目的是注意到孩子可能会经历的任何疾病或健康问题。

我应该什么时候健康检查？

You should do a health check each time a child or youth arrives in your program (if a child comes to your program before and after school, a quick health check should happen at both times). Ideally, in instances when a family member drops off the child, health checks should be completed before the parent or guardian leaves your home. This will give you a chance to talk with the parent or guardian if you suspect the child is ill or if you have questions about any changes in the child’s appearance or behavior. You should also do a health check any time you notice a change in the child’s appearance or behavior. You might do a series of health checks across the day if you suspect a child is not feeling well.

看

What Does a Health Check Look Like?

每日健康检查的程序可能会有所不同。观看此视频，以查看检查孩子健康的家庭儿童护理提供者的示例。万博体育下载官方网站

每日健康检查s

我应该寻找什么？

Your licensing agency may provide you with a daily health check form. If not, the Apply Activities section of this lesson has samples that you can adapt for your own use. When doing a health check, be sure to use all your senses.

• Look over the child’s body. Do you see any bruises, cuts, scrapes, or burns? Do you see any open sores or fluid coming from the child’s eyes or nose? Do you see any scratching of the head or body? Do you see any unusual behaviors (sad, sleepy, irritable, lack of appetite)?
• 倾听咳嗽，喘息或鼻塞。
• 如果他或她出现病情，感觉孩子的皮肤发烧或脱水迹象。
• Use your sense of smell to check for any unusual odors.

Conversation is a powerful tool with school-age children. Compared to younger children, school-agers are better able to communicate their feelings and experiences. If you have concerns, remember to ask children and youth about how they are feeling and bring your concerns to their attention (e.g., “You look really flushed, do you feel hot?”). You can also greet children as they enter the program by asking them questions such as:

• How are you doing today?
• 你在学校的一天怎么样？
• 你晚上过得怎么样？

The answers to these questions provide valuable information and help you ensure the health of the children and youth in your care.

做

做cument any problems or changes on your daily health check form. If you think the child is ill and should not be in child care, talk with the parent or guardian immediately. This will allow them to make alternative plans.

无论您是否会发现问题，重要的是要记录您的日常健康检查。记录你每天都做了健康检查，并标记儿童或家庭的任何不寻常。一定要保存此文档至少30天。在疾病爆发的情况下，这些记录对公共卫生官员来说非常有用。

排除and Readmission Policies

花一些时间来开发或更新您的程序排除和入院政策。与您的培训师，教练或许可代理商交谈，以了解他们对排除和入院政策的建议和建议。您还可以查看来自家庭儿童保育提供商的程序手册附加的样本排除和入院策略。万博体育下载官方网站确保您的政策符合儿童，家庭和提供商的安全实践。需要时间考虑如何在家庭成员或监护人到达之前对您进行妥善处理生病的孩子。

您的排除和入院政策考虑到儿童，其他儿童和家庭需求的健康状况。重要的是，您坚持政策，帮助家庭了解您的计划与健康有关的预期和要求。

您有责任确定是否需要排除儿童以及多长时间。你有责任知道：

• 不需要排除的条件和症状
• 排除生病儿童的标准
• The procedures for a child who requires exclusion

与普遍的信念相反，除了一个温和的疾病的孩子不太可能降低细菌的传播，因为大多数孩子在疾病之前或之后传播细菌或不表现出任何症状。但是，如果孩子生病，决定他们被送回回家，你应该敏感地回应孩子和家庭。马上联系家庭，并要求他们拿起生病的孩子。当家庭成员或监护人到达时，描述症状并提供任何文件，家庭可能需要发出医生。包括当你注意到疾病时，症状描述，任何生命体征（如温度），您提供的任何药物由医生规定并由家庭书面批准，或者您所采取的任何其他行动。还提醒家庭关于您的计划的政策以及儿童可以返回的时候。

设计您的计划，以帮助促进健康的实践。花些时间才能与家庭进行课程的病假政策，应当基于您所在国家的要求和建议。观看此视频以了解更多信息。

规划疾病

Notify families when their children have come into contact with a child who is ill with one of the following conditions:

• Meningitis
• Pertussis（Whoping咳嗽）
• 侵入性感染如腕表
• Chickenpox
• 皮肤感染或侵扰（头虱，疥疮和癣）
• 胃肠道（通常与腹泻）和甲型肝炎（HAV）感染
• Haemophilus influenzae type B (Hib)
• Fifth disease (parvovirus B19)
• Measles
• 结核

Families should also be notified if two or more unrelated persons who are part of or visit your family child care program (e.g., your family members, family members of the children in your care, back-up providers, specialists, etc.) are infected with a vaccine-preventable or infectious disease.

If one of these diseases or conditions is suspected in your family child care home, you will need to notify all families and any other adults who have come in contact with the child or children. This notification should include (Caring for our Children, 2019):

• 儿童被暴露的诊断疾病的名称，常见和医疗，是否有一个案例或爆发
• 父母或监护人应该观察的疾病的症状和症状
• 疾病的传播方式
• 通知性，观察疾病的迹象和症状多久
• Disease-prevention measures recommended by the health department (if appropriate)
• 在您的计划中实施的控制措施
• Possibly pictures of skin lesions or skin condition (e.g., chicken pox, spots on tonsils, etc.)

The notice shouldnot识别有传染病的孩子。

在某些情况下,你可能需要联系医学专业fessionals or public health officials. There are certain illnesses that are considered “reportable illnesses.” You will need to follow health guidelines to notify families about the occurrence of these types of illness. A list of reportable illnesses is updated annually by the Centers for Disease Control and Prevention (CDC) and is available athttps://wwwn.cdc.gov/nndss/conditions/notifiable/2020/。如果您对报告疾病有任何疑问或疑虑，请与您联系培训师，教练或家万博体育下载官方网站庭儿童保育管理员。

To make illness less stressful, you should work with families to make sure a plan is in place for an ill child. You and/or your families should make sure:

• Families have an alternate child care arrangement for days when their child is sick
• You have a safe place for sick children to wait until families can pick them up
• 一份书面政策是关于排除和入住疾病后的排除和入院，并在加入您的计划时与家庭共享此政策
• Lines of communication are open so that you share information with families about their child’s health and families share information with you about a child’s health; this includes communicating with you when a child has been diagnosed with an infectious disease

作为提供者，您也能够传播疾病。如果您生病了，请为每个孩子找到替代的备用保健安排。如果您在排除列表中列出的任何疾病，则不应返回提供护理，直到您达到回归的标准。

有关：

• returning to care
• determining when a health visit is necessary
• determining when reporting to family child care administration or licensing is necessary
• signs and symptoms of illness

看Caring For Our Children (2019) Appendix A, Signs and Symptoms Chart available as a Learn Activity resource below and athttp://nrckids.org/files/appendix/appendixa.pdf.

免疫s

免疫有助于预防严重疾病。为了有效的免疫，必须按计划提供。研究人员定期发现有关免疫的新信息，包括谁应该收到它们以及何时，所以您必须保持最新的建议。您可以了解有关疾病控制和预防疾病中心的疫苗的更多信息http://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html.。您作为家庭保育提供者的一部分作用是让家庭的免疫万博体育下载官方网站信息，以确保您的计划符合所有与健康有关的法规。与您的许可机构合作，以确保您拥有必要的与健康相关形式。它对要免疫的提供商同样重要的是，因此请务必遵循您的许可机构的指导方针。