| Greater Quincy Child Care Center Health Care Policy |
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Health Care Consultant Jane Maffie-Lee, Nurse Practitioner Manet Community Health Care Center 110 W. Squantum, MA. 02170 Center Location Adams Place Complex One Adams Building 859 Willard St. STE 100 Quincy , MA 02169 1st Floor in the rear of the building Hospital Used For Emergencies Quincy Medical Center 114 Whitwell St. Quincy, MA 02169 (617)-376-5533 For Emergencies Allergies For Children Parents will identify any known allergies on the child’s Enrollment Form. The Director will mark any known allergies on the child’s emergency record. This information will also be posted on the refrigerator in the kitchen and in the child’s classroom. Emergency Procedures In a life threatening situation, the staff attending the injured person will instruct another staff person to call 911 to secure emergency transportation and will also inform the Director. One staff person will stay with the child until the parent arrives. Staff will not transport children in their own vehicle. They will request an ambulance or call the State Police. The staff person will take the child’s file from the office to the hospital with them. Revised by: J. Maffie-Lee and Approved by the Board of Directors on December 17, 2003 Emergency Procedures If A Parent Cannot Be Notified Parents list an emergency person on the child’s application form. This person will be contacted if the parents cannot be reached. Staff will continue to call the parents until they are contacted. Emergency Procedure On A Field Trip A staff person going on a field trip must take a first aid kit and the emergency book of all the children on the field trip. Staff will follow the same emergency procedure as if they were at the Center. The Staff will be carrying a cell phone with them, the cell number will be posted at the time of the field trip. (Approved by the Board of Directors, Sept. 18, 2001) Evacuation Plan Evacuation plans are posted in each classroom by the door they are to exit. Who leads children out of the building? Teachers Who checks for stragglers? ead Teachers and the Director Who checks attendance to be sure all the children have been safely evacuated? The Lead Teachers bring their classroom’s attendance sheets and emergency books out with them. The teacher will do this if the Lead Teacher is not present. Infants and Toddler One (Crickets’) Classrooms will be evacuated with the help of the Director and staff members in their room. The two evacuation cribs in the Nursery will always be located on each side of the door going into the Toddler One classroom, plus they can be identified very easily by having much larger wheels on the cribs. The Asst. Director is responsible to have the Evacuation Drills every other month, and will also maintain the documentation of the date, time, and effectiveness of each drill. During inclement weather the Lead Teacher and/or Teachers will bring the children to Two Adams Place Lobby on the first floor. This building is located next door to the Center’s One Adams Place Building. The Director will follow after she/he has made a complete check of the entire Center. (Approved by the Board of Directors, September 18, 2001) First Aid Manual and Kit The First Aid Manual is kept on the bottom shelf of the book case in the Director’s office. First Aid can be administered by the Director or by the Lead Teacher/Teacher in your child’s classroom. There is one First Aid kit in the shed on the playground, and one in the Rumpus Room. A teacher is responsible to keep the First Aid Kit complete. Contents of the First Aid Kit: adhesive tape disposable latex gloves Mil band aids instant cold pack bandage compress syrup of ipecac gauze pads scissors tweezers thermometer is located in the office bottle of normal saline, to cleanse wound, to be used on field trips only First Aid for minor injuries is given at school by the staff, who are trained in first aid. Illness At The Center When a child looks or feels sick, extra attention must be paid to him/her. The staff person should look in the classroom log to see if there is any recent messages about a particular child’s health needs. If the staff thinks the child has a temperature, she should take the child’s temperature by placing the digital thermometer in the child’s underarm area or using the thermoscan. When the child’s temperature is 101 degrees or over, the parent will be called to pick up the child. If the temperature is 100 degrees, acting withdrawn, wants to be held, etc. then the parent should be called to take the child home. Children who are waiting to go home will be kept as comfortable as possible in their classroom. No medication shall be given unless we have written orders from the doctors and parents. The label on a prescription is accepted as a doctor’s note. Parents must fill out the Medication Permission Form. Medicine that does not require refrigeration should be kept in the kitchen cabinet next to the refrigerator or in the classroom(on an upper shelf). No medication should be kept on the counter areas of the classroom. All medication will be kept in one container in the refrigerator. The child should be sent home if he/she is vomiting, has a severe rash, or has other abnormal symptoms. However, it is possible for the child to stay at the Center if he/she appears listless or just not “his/her normal self.” This condition may occur just before or after an illness. The decision to send the child home should be based on how uncomfortable the child appears and how much time the child requires. The Lead Teacher or Teacher can make that decision and should consult the Director before sending the child home. See Parent Handbook for more information about our illness policy. Procedure For Exposure To Bloodborne Pathogens All Teachers will receive training in Infection Control Procedures and Bloodborne Pathogen Procedures(Universal Precautions) yearly by the Emergency Medical Specialists. Teachers will be informed of the availability of the Hepatitis B vaccine and costs incurred will be covered by the Center. Procedure: 1. Area of skin exposed to infection is washed with soap and running water. Individual disposable paper towels are used to wipe area dry. 2. A cold compress or ice pack is placed on area to control swelling. 3. An accident report shall be completed as outlined in the Injury Prevention Plan. 4. The Lead Teacher or Director shall notify the parent whose child has been exposed. 5. The Director or Lead Teacher will notify the parent(s) of the source (a case of human bite) and request that the children’s doctor be contacted. Confidentiality is observed. 6. The Director or the Lead Teacher will notify the proper Facility of a blood/fluid or exposure/spill for proper sanitizing and disposal of the contaminated waste to the Health Center. Accidents and Emergencies Any time a child has been hurt, an accident form must be completed in triplicate. These forms are located in each room and in the office. The completed form must be signed by two Teachers and the Parent. If a child has a mark that may cause a parental concern, or if you feel the parent should be notified before he/she picks up the child, call the Parent and explain the situation. It is not necessary to call Parents every time a child has a cut, but we do not want to surprise the Parents either. If the Lead Teacher is not certain about the extent of the child’s injury, the Parent should be called for consultation. In the event of an emergency, the Lead Teacher will call 911 to arrange transportation to the Quincy Medial center. If the parents have requested their child go to another hospital every effort will be made to honor their request. A staff person must accompany the child at least until the Parents arrive. In a life-threatening situation, such as a child choking or not breathing, a staff person certified in training in those emergencies, must begin assisting the victim while another person calls 911. Each classroom has a Classroom Emergency Book with all pertinent information needed for each child in the classroom. All emergency phone numbers are posted on each phone and on the classroom attendance clipboards. If the Parents cannot be reached, the emergency person will be called and requested to go to the hospital. A staff person will continue to call the parents until they are reached. A staff person must never transport a child in their own vehicle. In the event of fire, pull the fire switch located in the lobby, and evacuate the building following the standard procedure. In all cases, err on the side of caution. Injury Prevention Plan All staff must hold a current certification in basic First Aid by the American Red Cross or equivalent training. At least one staff person who is currently certified in CPR for children is available onsite whenever children are present. Accident Reports will be written for each accident or injury that occurred at the Center. A copy will be sent home with the child the day of the accident/injury, and one will be kept in the child’s file and one in the Injury Log kept in the office. These accident reports include: name of child, date, time, staff person, location, description of accident, action taken, when parent was/will be notified, follow- up staff, and Parent signatures. One Lead Teacher shall monitor the environment, indoors and outdoors on a daily basis, to immediately remove or repair any hazard which may cause injury. No smoking is allowed in the Center. The following is a list of where toxic substances are kept in the Center: First Aid Supplies-The shed on the playground, in the cabinet behind the door in the Rumpus Room. Cleaning Fluids, Bleach, and Laundry Supplies-On the shelf above the washing machine. Medications-In a tupperware box on the middle shelf in the refrigerator Sharp Scissors-On a high shelf in every classroom. These are the 10 telephones located in the Center: the offices, the Kindergarden(Tiger’s) classroom, the PreK (Chipmunk’s) classroom, the Preschool (Busy Bear’s) classroom, the Toddler/Preschool (Ladybug’s) classroom,the Toddler/Preschool (Fire Flies) classroom, the Toddler One (Cricket’s) classroom, the Infant’s classroom, and the staff room. None of these phones are coin operated. Management of Infections Diseases: Plan for the Mildly Ill Children The child will be made comfortable. If the child is running a temperature of 101 degrees, the Lead Teacher or the Teacher will call the Parent and request that the child be picked up ASAP, maximum of one hour. While the child is at the Center he/she will be removed from the other children and placed in quiet area with adult supervision. The child will be given food and drink when needed and will be given a choice of quiet activities, such as books, puzzles, coloring, etc.. He/She will also be given their cot and blanket for comfort and rest. Illness When a child is out sick, the Parent is asked to call the Center and report any pertinent information concerning the child’s illness. With a contagious illness, it is important that the Center be notified in order to prevent further spread of the illness. All Parents of children exposed to a contagious disease will be notified by a sign on the door in the lobby and one on the classroom door where the illness occurred. They will be asked to watch for symptoms. It is the responsibility of the staff to observe the children throughout the day for signs of illness. 1. Upon arrival your child will be observed. If any of the following signs are noted, he/she will be sent home with you: a. Fever of 101 degrees or higher b. Fever of 100 degrees and other signs of illness, runny nose, coughing, sleepy, etc.. c. Wheezing d. Diarrhea (2 times) e. Vomiting f. Inflammation of the eyes g. Unusual rash h. Signs of a severe cold or sore throat 2. Parents will be called during the day to take their child home if any of the above symptoms are exhibited after arrival. Parents are expected to arrive at the Center within one hour after being called. If you cannot make it to the Center within that time, you should make arrangements for another authorized pick-up person to come and get your child. A child may return to the Center only with a Doctor’s release and under the following conditions: 1. Contagious diseases: The Center’s Health Care Consultant may make the final decision regarding the child’s date of return to the Center. a. Chicken Pox: after all the spots have crusted. b. Measles: Five days after rash begins c. German Measles: Five days after rash begins d. Hepatitis: Three weeks after the onset of jaundice e. Mumps: Nine days after the onset of swelling f. Lice: After the treatment has been completed, the nits should be completely removed (Approved by the Board of Directors, September 18, 2001.) g. Monilial(yeast infection): After the medication has been applied h. Fifth’s Disease: A child may not return until the rash is completely gone, there is slight chance that fifth disease may be detrimental to an unborn fetus. (Approved by the Board of Directors) A child may return to the Center without a Doctor’s release under the following conditions: a. Fever: 24 hours fever free without fever reducing medications b. Diarrhea: When solid stools have returned c. Illness that requires antibiotics: 24 hours after first administration of medication. (conjunctivitis, strep throat, impetigo, etc.) d. Vomiting: Once solid foods have been consumed and stayed in the child’s system. Infection Control All staff and children must wash their hands with liquid soap and running water, using paper towels to dry them. All hands must be washed at the following times: a. Before eating and handling food b. After toileting and diapering c. After coming in contact with body fluids d. After handling animals or their equipment e. After cleaning f. Before using the water table and playdough g. After coming inside from the playground The following equipment must be washed with soap, water, and disinfected: 1. After each use: a. diapering surfaces b. toys mouthed by toddlers and/or infants c. mops used for cleaning body fluids d. bibs e. thermometers 2. At least daily: a. toilets and toilet seats b. containers, including lids, used for soiled diapers c. sinks and faucets d. water table and water play equipment e. play tables f. smooth surfaced non-porous floors g. mops used for cleaning h. cloth washcloths and towels 3. At least weekly, or as needed: a. sheets, blankets, and other covering 4. At least monthly, or as needed: a. cots, mats, and other sleeping equipment b. machine washable fabric toys The disinfectant solution shall be self-made solution of 1/4 cup of household bleach (EPA) to one gallon of water, which is prepared daily, labeled and placed in a bottle that is sealed with a cap. The disinfectant will be stored in a secure place and out of the reach of children. One staff person in each classroom will be in charge of changing this solution every day. If the child is displaying symptoms of illness, the toys, etc. that the child was in contact with are kept separate and washed in disinfectant in our washing machine. All of the bedding will be sent home that day with the ill child. Examinations For Children Before starting at the Center the Parent must provide the Center with a written statement from a physician indicating that your child has had a complete physical examination within the past year. A new exam must be completed yearly. Before starting at the Center, you must provide us with a physician’s certificate stating your child has been immunized in accordance with the Department of Public Health’s recommended schedules. All children must have a documented lead test once between the ages of nine months and twelve months, and again at ages two and three years of age. If the child lives in a high risk town they need an annual lead screening until they leave the Center. Please update this record anytime your child receives any new shots. (Approved by the Board of Directors, September 18, 2001.) We may request that the Parent provide a dental check-up, check for vision, or hearing when the appearance or behavior of the child indicates the need for such examination. Administrating Of Medication In order for the staff to administer prescription or non-prescription medication, we must have written orders from the child’s doctor. This may include the label on a prescription medicine. It must also indicate the child’s name, amount of dosage, and have a current date. Parents will be contacted before non-prescription medications are administered. Parents will also be required to fill out a Medication Authorization form. For non-prescription medication written orders are valid for thirty days. Staff will maintain a written log of all medications administered. This log will include the name of the child receiving the medication, time and date of each administration, the dosage, and the name of the staff person administrating the medication. The log will be posted in the classroom and placed in the child’s file when the medication is completed. No fever reducing medication will be given, such as, aspirin or Tylenol without the written consent of the child’s doctor. This consent will be valid for one year. Topical non-prescription medication, such as, sunscreen, bug spray, or a diapering ointment, such as Vaseline, which are not applied to open wounds, rashes, or broken skin, but are to be used on a babies’ unaffected area, will be administered to children with a written Parental Authorization. This statement will be valid for no more than a year from the date it was signed. For non-prescription topical medications such as diaper rash ointments, and antibacterial ointments which are applied to wounds, rashes, or broken skin, a signed statement authorizing the Center to administer this non-prescription medication in accordance with a prescription from a health care provider must accompany this non-prescription medication. The medication must be stored in the original container, and labeled with the child’s name. This statement will be valid for no more than a year from the date it was signed. (Approved by the Board of Directors, September 18, 2001) All medications must be in it’s original container, with the child’s name, the name of the drug or ointment, and the directions for it’s administration and storage. All medication shall be stored in the kitchen, either on a shelf or inside the refrigerator in the tupperware container on the bottom shelf. Any medication will be returned to the Parent when no longer needed. Medical Examinations For The Staff Each staff member employed with the Greater Quincy Child Care Center, Inc. must have the following certification: 1. Evidence of a physical examination within six(6) months prior to employment. This physical exam shall be valid for one year from the date the staff member has been examined and shall be renewed every two years. 2. Evidence of immunity for measles, mumps, rubella and chicken pox. 3. Negative Mantuox TB test. Test results has to show that they do not currently have TB. If test results are positive, staff member is required to have an x-ray as evidence of immunity. Approved by the Board of Directors on December 17, 2003) Immunizations are not required for any person who states in writing that immunizations are in conflict with their religious beliefs or for medical reasons are unable to receive the immunization. Personal Hygiene a. Each child’s face will be washed with an individual, disposable towel. b. We have extra clothing that is stored in the storage room. There is both indoor and outdoor clothing in this box. You may use this clothing to change a child whose clothes are wet or soiled. c. All children at the Center shall have at least one change of clothing including, pants, shirt, underpants, T-shirt, and socks. Children still in diapers or toilet training, should have several complete outfits. Soiled clothing shall be placed in a sealed plastic container or bag, labeled with the child’s name and given to the Parent at the end of the day. d. All children at the Center brush their teeth. Each child has an individual, labeled, toothbrush which is kept in each child’s cubby or in the Center’s bathroom. Disposable drinking cups are supplied by the Center. e. Each eating table will be disinfected before and after each meal. Toilet and Diapering Plan(7.07) Toilet: 1. Regular toileting times will be made available within each group at transition times, such as, meals, snacks, outdoor play, before and after nap. 2. In addition, any child may request to use the bathroom at any time. The child will be supervised. 3. When a toileting accident occurs, the child will be assisted in cleaning up him/herself and dressed in a dry set of clothing. Soiled clothing will be double bagged and put in the child’s cubby, apart from other items, to be taken home. Staff will monitor each child’s cubby to make sure there is always extra clothing and notify Parents if something is missing. There is also Center owned clothing in the storeroom. 4. It is recognized that children who are in the process of toilet training need extra reminders and lots of attention. Staff are prepared to work with Parents on toilet training. These children should have several changes of clothing because accidents occur more often. 5. Children and staff will wash their hands with liquid soap and running water after toileting, before and after meals, after cleaning, after handling animals or their equipment, and after having contact with bodily fluids. They will have individual paper towels available to dry their hands. No child shall be punished, verbally abused, or humiliated for soiling, wetting, or not using the toilet. Diapering: 1. Parents must keep a daily supply of diapers at the Center at all times. Staff will notify Parents when the supply runs low. 2. Steps in diapering: a. Staff will wash their hands with liquid soap and running water. Gloves are also available to staff. b. Staff will place a clean, protective covering on the diapering surface large enough to cover the surface. The diapering surface will be smooth, intact, easily cleaned, waterproof, and cushioned. c. Staff will change the child using his/her own diapers and any creams or medications as designated by the Parents. The children will be washed and dried with individual disposable wipes and/or paper towels. d. Staff will not use a child’s lotions or wipes on any other child. e. Following diapering, the staff will dispose of the soiled diapers and covering in a covered diaper bucket. Soiled diapers will be placed in a plastic bag before putting it in the covered diaper bucket. f. After changing, staff will wash and dry each child’s hands under running water with liquid soap and dry them with a individual paper towel. g. The staff will wash their hands thoroughly with liquid soap and running water. h. During the entire procedure, staff will keep one hand on the child to prevent him/her from falling and will use this to interact with the child. i. The changing table will be cleaned with soap and water and sprayed with bleach solution after each use. The bleach solution is 1/4 cup bleach to one gallon of water that will be made fresh daily. The changing surface will not be used for any other purpose. 3. One staff person from each classroom will be designated to maintain the changing area and replenish its supplies. 4. Staff will keep track of diaper changing daily. This shall be visible for Parents. Diapers shall be changed regularly when soiled or wet. Toilet training shall occur in the Toddler/Preschool classroom and occasionally in the Busy Bear classroom. Staff will work in conjunction with the Parents. Training will be viewed as simply another routine of the day and will be encouraged but not forced on the children. No reward nor punishment will be given to children for their efforts or lack there of. On occasion the staff may decide that a child needs some help with training and may start a sticker chart for encouragement. Staff must accompany children to the bathroom and stay with them until they are done. Staff must remind children to flush the toilet, wash their hands, and throw away their paper towels in the trash. Staff will also pick up any trash on the floor and check the supply of paper goods and soap. Soiled clothing from accidents or illness can not be washed at the Center. These clothes should be placed in a double plastic bag and sent home with the child. Procedure For Reporting Suspected Child Abuse or Neglect The staff who suspects abuse will report it to the Director immediately. Possible signs of abuse are bruises, welts, burns, cuts, scrapes, and head injuries. Possible signs of neglect are lack of supervision, lack of adequate clothing and good hygiene, lack of medical or dental care, lack of adequate nutrition, and lack of shelter. All of these should be considered in light of the explanation given. The staff person and Director will document these observations. The Director will talk with and examine the child and make a verbal report, within 24 hours to the Department of Social Services at 617-331-6600 (local) or at 1-800-792-5200, and follow up with a written report, within 48 hours. Should the Director not notify DSS, for any reason, the staff member should do so and then report that to the Director. Signs of abuse or neglect will be recognized by being alert to behavior different from the normal, signs of bruises, cuts, burns, etc., soiled clothing, inappropriate clothing, and/or inadequate or insufficient food. The teacher will be aware of the dynamics of the relationship when Parent(s) arrive, is the child happy, scared, etc. Or has the child been sick a lot? Is the child taken to the doctor when the need arises? Is the Parent verbally abusive or does the Parent humiliate the child, threaten or yell at the child in front of others? All staff are required to report suspected abuse or neglect to the Director, a designee, or DSS. Observations of suspected abuse will be kept in a separate locked file, dated and signed. A body sheet will be used to note which areas on a child’s body are bruised, cut, scraped, etc. and kept as well. Two signatures will be kept with the documentation to substantiate allegations. A 51A, which are kept in the file drawer, will be filled out completely. It will be signed and dated and dropped off to DSS immediately by the Director or designee. If a 51A has been filed with DSS alleging abuse or neglect of a child while in the care of the Child Care Center or in a program related activity, the Director or designee will call thThe Depratment of Early Education and Care (DEEC) immediately. Staff members involved in this situation will be kept from working with the children until the investigation is completed or as required by DEEC. If the information is warranted, the staff member will be terminated immediately as well as being reported to DEEC and DSS. The Child Care Center shall and will cooperate in all investigations of abuse and neglect. Administrative Plan For Children With Disabilities 1. Intake: The Director will be responsible for all intakes. She will report IEP/IFSP and the diagnostic information from appropriate sources. Intake will include the Parent(s), the child, the Director, and the classroom teachers to formulate a plan for appropriate care of the child. 2. Record Keeping: The Director and Lead Teacher will be responsible for all record keeping and assessment information. This will include updating all diagnostic information. No information will be released without written consent from the Parents. 3. Liaison: The Director will assign a teacher to be the Liaison for each child enrolled with special needs. This teacher will be included in initial meetings with Parents and Child. The Director will identify Community Liaison for specific disability using the Chapter 766 Handbook provided by the Massachusetts Department of Education. Parent conferences will be held quarterly. 4. Adapting Environment/Curriculum: The Director and teacher liaison will identify materials and adaptations needed for each child. The liaison will assure classroom arrangement meets the child’s physical needs. The Student Teachers will be utilized as additional resources for each child. 5. Staff Training: The Director will routinely review staff needs in regards to training for special needs. The training will include general needs as well as those specific to children enrolled. The Director will provide lists of approved training resources on a regular basis. Parents will be utilized when appropriate. 6. Screening and Identification: In routine supervision, the Director will meet with the liaison and review progress of each child. When a problem is identified, the Director will select appropriate screening too (with help of referral resource), complete screening and review for appropriate referral. 7. Resources and Referral: See Center’s Referral Plan 7.10(1). Referral sources will always be kept updated and current. Meetings with Parents will be planned as part of this process. |
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