Know

每个孩子的日常访问您的计划都应该以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，以便在学龄和青少年方案中。大多数孩子偶尔会鼻涕，咳嗽或轻度发烧。这通常会对教师，工作人员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。课程在处理生病儿童时有政策。因为你对你的节目中的孩子们很好地了解，你很可能会告诉你的小孩在你的护理时足以参加活动，并识别孩子当孩子过于恶心，无法留在学龄计划中。您的计划可能有指导方针可以帮助您做出这一决定。美国的儿科学院（2011）提供了三个关键因素，决定儿童是否对育儿感到恶心：

• 孩子不能参加活动
• 孩子的疾病对其他孩子或员工带来了风险
• You cannot care for the child while maintaining appropriate care for the other children

如果您认为孩子符合这些标准中的任何一个，那么他可能会被送回家。查看下面的学习活动部分的资源，了解有或不利用儿童保育的完整疾病列表。

Daily health checks are a good time to evaluate a child's health to make these decisions. Remember, it is up to your program -not the family-to decide whether a child is healthy enough to stay in child care. You must consider the health of the other children and staff in your program.

Daily health checks also provide a record of any changes in the child's appearance or behavior, which can be important if you suspect 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. They provide an opportunity for you to spot signs of common infectious diseases, which helps prevent the spread of illness in your program. This lesson will answer questions many school-age staff members may have about health checks.

What Is a Health Check?

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，您还可以收集家庭的信息。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，“今天每个人都感觉好吗？”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。学龄儿童通常能够在进行健康检查时传达任何不适，疼痛或症状，这是有用的。一定要倾听每个孩子，请他们在家里或在学校的日子问他们。

When Should I Do a Health Check?

You should do a health check each time a child or youth arrives in your program (e.g., if children comes to your program before and after school, a quick health check should happen at both time points). Ideally, in instances when a family member drops off the child, health checks should be completed before the parent or guardian leaves the building. 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.

See

健康检查是什么样的？

The exact procedures for doing a daily health check may vary. Watch this video to see an example of school-age staff members checking a child's health.

每日健康检查s

What Should I Look For?

您的计划可以为您提供每日健康检查表格。如果没有，本课程的应用活动部分有样品，您可以适应自己的使用。在进行健康检查时，请务必使用所有的感官。

• 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)?
• Listen for a cough, wheezing, or a stuffy nose.
• 如果出现生病，感觉孩子的皮肤会发烧或脱水的迹象。
• Use your sense of smell to check for any unusual odors.

不要忘记谈话是一个强大的学龄儿童工具。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关注。您还可以通过向您提出问题，如下问题

• How are you doing today?
• How was your day at school?
• How was your night?

这些问题的答案为您提供有价值的信息，帮助您确保您的护理中儿童和青少年的健康和安全。

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 alternate plans.

Whether or not you see a problem, it is important to document daily health checks. Use a form provided by your program or use the one provided in the Apply Activities section below. 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 your program and public health officials.

排除和再入院政策

您的计划的排除和入院政策考虑到儿童，其他儿童，员工以及家庭需求的健康状况。重要的是，您遵守您的计划的政策，帮助家庭了解您的计划与健康有关的预期和要求。

Your administrator is responsible for determining whether or not a child needs to be excluded from child care for health reasons and for how long. It's your responsibility to know:

• The conditions and symptoms that do not require exclusion
• The criteria for the exclusion of ill children
• The procedures for a child who requires exclusion

Contrary to popular belief, excluding a child with a mild illness is unlikely to reduce the spread of germs, as most children spread germs before or after their illness or don't exhibit any symptoms. However, if a child is sick and the decision is made for them to be sent home, remember to respond sensitively to the child and family. Contact the family right away, and ask them to pick up their ill child. When a family member or guardian arrives, describe the symptoms and provide any documentation the family might need to give a doctor. Include when you noticed the illness, a description of symptoms, any vital signs (like temperature), and any medications you provided that were prescribed by a physician and approved in writing by the family, or other actions you took. Also remind the family about your program's policies and when the child can return.

您的计划旨在帮助促进健康的实践。花些时间了解您的计划对生病儿童的政策和设施。观看此视频以了解更多信息。

规划疾病

您的计划应通知与患有以下条件之一的儿童接触的儿童的员工和家庭通知：

• 脑膜炎
• Pertussis (whooping cough)
• Invasive infections such as strep
• Chickenpox
• 皮肤感染或侵扰（头虱，疥疮和癣）
• Infections of the gastrointestinal tract (often with diarrhea) and hepatitis A virus (HAV)
• Haemophilus influenzaeb型（hib）
• 第五病（Parvovirus B19）
• 麻疹
• Tuberculosis

Families and staff should also be notified if two or more unrelated persons affiliated with the facility are infected with a vaccine-preventable or infectious disease.

If one of these diseases or conditions is suspected in your school-age program, your program will need to notify all families and staff who have come in contact with the child or children. This notification should include (Caring for our Children, 2015):

• 儿童暴露的诊断疾病的常见疾病的名称和医学名称，是否有一种案例或爆发，以及曝光的性质（例如共享房间中的儿童或工作人员或设施）
• Signs and symptoms of the disease for which the parent/guardian should observe
• 疾病的传播方式
• Period of communicability and how long to watch for signs and symptoms of the disease
• 卫生部门推荐的疾病预防措施（如果是合适的话）
• Control measures implemented at the facility
• Pictures of skin lesions or skin condition may be helpful to parents or guardians (e.g., chicken pox, spots on tonsils, etc.)

通知应该是不识别有传染病的孩子。

In some cases, your program may need to contact medical professionals or public health officials. There are certain illnesses that are considered "reportable illnesses." Your program will need to follow health guidelines to notify families and staff 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 athttp://wwwn.cdc.gov/nndss/downloads.html.

To make illness less stressful, you should work with families to make sure a plan is in place for an ill child. Families, staff, and programs should make sure:

• 家庭有一个候补儿童保育安排，暂时生病了
• Programs have a safe place for sick children to wait until families can pick them up; this space should be supervised by an adult that the child knows
• 疾病后的排除和再次入院是一项书面政策;此政策与家庭共享
• 通信线路是开放的;员工与有关孩子的健康的家庭分享信息，家庭与员工与员工有关儿童健康的信息。这包括当孩子被诊断出存在传染病时与该程序进行通信。

最后，请记住，您作为工作人员也能够传播疾病。如果你生病了，留在家里。如果您在排除列表中列出的任何疾病，您应该在工作中留在家中，直到您符合回归的标准。

免疫

免疫help prevent serious diseases. For immunizations to be effective, they must be given as scheduled. Researchers regularly discover new information concerning immunizations, such as who should receive them and when, so it might be helpful for you to 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/index.html.

虽然有助于了解免疫接种，但您的经理有责任从家庭获取免疫信息，以确保您的计划符合所有与健康相关的法规。对于要免疫的教师和护理人员来说，也很重要，因此确保您在工作人员的推荐免疫方面遵循您的计划的指导方针。