Know

每个孩子的一天都应该从简单的健康检查开始。这是一种快速的方法，以确保孩子健康足够健康，以便在您的家庭儿童保育计划中。万博体育下载官方网站大多数孩子偶尔会鼻涕，咳嗽或轻度发烧。这通常会对提供者和家庭造成很少的担忧。然而，有时候，孩子的疾病变得更加严重。您需要建立在处理生病儿童时指导决策的政策。因为你认识你的照顾中的孩子们，你可能会告诉孩子何时足够好参加活动，当孩子过于留下你的计划时。您需要概述准则，以帮助您完成此决定并与家庭共享这些指南。美国的儿科学会（2011）提供了三个关键因素，帮助您决定一个孩子是否对育儿感到恶心：

• 孩子不能参加活动
• The child’s illness presents a risk to other children or adults
• You cannot care for the child while maintaining appropriate care for the other children

如果孩子符合任何这些标准，那么他们很可能会被送回家。查看本节中的附件，以获取或不从托儿所享受排除的疾病列表。每日健康检查是评估孩子帮助做出这些决定的一种方式。这取决于你 - 不是家庭 - 决定孩子是否足够健康，无法留在育儿。您必须考虑特定许可机构的指导方针，以及其他儿童的健康，您的计划中的任何其他人。

Daily health checks also can offer a record of changes in a child’s appearance or behavior, which can be important in cases of child abuse or neglect. This information can also be very useful for families if the child is suspected of having a long-term physical- or mental-health need. Health checks, if conducted sensitively and documented thoroughly, can help you build relationships with children and families. This lesson will answer questions many family child care providers may have about health checks.

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？

每当儿童或青年到达您的计划时，您应该进行健康检查（如果孩子在学校之前和之后的课程上，则应在两次发生快速健康检查）。理想情况下，在一个家庭成员下降时，在父母或监护人离开家之前应该完成健康检查。如果您怀疑孩子生病或者您对孩子的外表或行为的任何变化有疑问，这将使您有机会与父母或监护人交谈。您还应该在任何时候注意到孩子的外表或行为的变化，那么健康检查。如果您怀疑一个孩子感觉不舒服，您可能会在当天进行一系列健康检查。

看

健康检查是什么样的？

The procedures for doing a daily health check may vary. Watch this video to see an example of family child care providers checking a child’s health.

每日健康检查

What Should I Look For?

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。
• Feel the child’s skin for a fever or signs of dehydration if he or she appears ill.
• Use your sense of smell to check for any unusual odors.

谈话是具有学龄儿童的强大工具。与年幼的孩子相比，学龄儿童能够更好地传达他们的感受和经验。如果您有疑虑，请记住将儿童和青少年询问他们是如何感受的，并将您的担忧引起他们的注意（例如，“你看起来真的脸红了，你觉得很热吗？”）。您还可以通过向您提出问题，如下问题

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

这些问题的答案提供了有价值的信息，并帮助您确保您的护理中儿童和青少年的健康状况。

Do

Document 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.

Whether or not you see a problem, it is important to document your daily health check. Record that you did a health check each day, and mark anything unusual for the child or family. Be sure to save this documentation for at least 30 days. In the event of a disease outbreak, these records can be very useful to public health officials.

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：

• The conditions and symptoms that do not require exclusion
• 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。

Planning for Illness

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

• 脑膜炎
• Pertussis (whooping cough)
• 侵入性感染如腕表
• Chickenpox
• Skin infections or infestations (head lice, scabies, and ringworm)
• 胃肠道（通常与腹泻）和甲型肝炎（HAV）感染
• 嗜血杆菌流感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):

• The names, both the common and medical, of the diagnosed disease to which the child was exposed, whether there is one case or an outbreak
• Signs and symptoms of the disease for which the parent or guardian should observe
• Mode of transmission of the disease
• 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
• 可能是皮肤病变或皮肤状况的照片（例如，鸡痘，扁桃体上的斑点等）

通知应该是notidentify the child who has the infectious disease.

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/notified/2020/。Contact you trainer, coach or family child care administrator if you have questions or concerns about reporting illnesses.

为了使疾病减轻压力，您应该与家人合作，以确保计划是不生病的孩子。您和/或您的家人应该确保：

• 家庭有候补儿童保育安排，他们孩子生病了
• 生病的孩子们等待一个安全的地方，直到家人可以接他们
• 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
• 确定何时需要健康访问
• 确定何时何时向家庭育儿管理或许可报告万博体育下载官方网站
• signs and symptoms of illness

参见关怀为我们的孩子（2019年）附录A，标志和症状图表可用作下面的学习活动资源和http://nrckids.org/files/appendix/appendixa.pdf.

Immunizations

Immunizations help prevent serious disease. For immunizations to be effective, they must be given as scheduled. Researchers regularly discover new information concerning immunizations, including who should receive them and when, so you must stay up-to-date on the latest recommendations. You can learn more about immunization on the Centers for Disease Control and Preventions website athttp://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html。你作为一个家庭的一部分儿童保健提供万博体育下载官方网站r is to get immunization information from families to ensure that your program is in compliance with all health-related regulations. Work with your licensing agency to ensure you have the necessary health-related forms. It is equally important for providers to be immunized, so be sure to follow your licensing agency’s guidelines.