Licensing criteria for centre-based ECE services

Criteria

Health and safety practices criterion 26

§ All practicable steps are taken to ensure that children do not come into contact with any person (adult or child) on the premises who is suffering from a disease or condition likely to be passed onto children and likely to have a detrimental effect on them.

Specifically:

• the action specified in Appendix 2 is taken for any person (adult or child) suffering from particular infectious diseases; and
• children who become unwell while attending the service are kept at a safe distance from other children (to minimise the spread of infection) and returned to the care of a parent or other person authorised to collect the child without delay.

Rationale/Intent:

The criterion aims to uphold the health and safety of children by preventing undue exposure to disease or illness while attending the service.

Guidance

Any examples in the guidance are provided as a starting point to show how services can meet (or exceed) the requirement. Services may choose to use other approaches better suited to their needs as long as they comply with the criteria.

It is very common for early childhood services to have to deal with children experiencing different forms of illness. Some will be infectious; that is, spread from person to person or from animal to person. Other forms of illness do not spread and will only affect the child or adult who has the illness.

It is not always easy to tell when a child is becoming ill. (A change in behaviour can be one indicator.) It is also quite difficult to tell what has caused the illness and whether or not it is infectious. Familiarity with the information in Appendix 2 of the criteria on infectious illnesses, incubation periods, symptoms, recommended exclusion times from attending the service etc will be helpful.

ECE services must take steps to minimise the contact of children with any person who has an infectious illness.

When a child becomes ill at a centre, the sooner they can be taken home, the better. The centre is not usually set up to deal with sick children for long periods of time, although an area away from other children at the centre where sick children can rest comfortably under supervision, while waiting to be taken home is required. For more information see PF27 - isolation area.

Services should develop a procedure with parents/whānau about what will happen when a child is ill or appears to be becoming ill. This will ensure there is common understanding about what will happen if a child is brought to the centre who is already ill or who becomes ill while there. It is vital to have up-to-date contact information for the parents on children’s enrolment records.

Having a policy and procedure to cover exclusion for general or infectious illness will assist staff to make a decision about whether or not to exclude a child on the grounds of ill health – either on the spot or when parents have a doctor’s diagnosis.

Refer to HS27 - Medical assistance for the requirement to keep records of serious illnesses.

When an illness appears to be affecting many children or adults, the service should contact their local Public Health Unit for information and advice.

Regional Public Health produce a number of fact sheets on a variety of diseases(external link).

Things to consider

When should children stay away from the service?

In general children should stay away from an early childhood service when they are ill and causing concern or:

• have no interest in activities or play
• have little energy - want or need to sleep or rest for long periods
• cry easily, are irritable or in pain
• constantly want to be held and comforted, are ‘clingy’
• have a fever
• have diarrhoea or vomiting.

What to do if children become ill while at the service

• Send them home as soon as possible. Recommend that they stay at home until well again.
• If a child cannot go home immediately, keep them away from others, stay with them at all times, and give them plenty of clear fluids to drink (water). Keep them cool if there is a fever and warm if they are cold.
• Assess the child’s illness. If a parent or caregiver is not available and the child seems to be becoming more ill, arrange for the child to be seen by a doctor.
• If you know what is causing the illness, make sure the child or staff member stays away for the recommended (or required) time.
• If you are not sure, but think the illness may be infectious, contact the Public Health Unit for information and advice.

Preventing spread of illness to others

• If the illness is infectious, contact the parents or caregivers of children with low immunity. They may want to keep their children at home until the risk of illness is over.
• If other children develop the illness, take a careful look at the hygiene and cleaning routines used at your service:
• make sure everyone is washing their hands thoroughly before eating and after using the toilet
• check the nappy changing procedure and make sure that all staff are following it carefully
• look at the cleaning programme, including the cleaning of toys, bedding, equipment, and frequently handled fixtures and fittings such as door handles, toilet flush buttons and taps and improve the programme if necessary.
• Wash children and wipe noses with disposable wipes or cloths that are used only once.
• Make sure that any sores and weeping cuts, spots and scratches are covered at all times in all environments, and encourage children not to scratch or pick at them. If these wounds cannot be covered, the child or staff member should stay at home until they have healed.
• Make sure that staff wear gloves and use disinfectant to clean up spills, or blood or other body fluids.
• Check that cups and eating utensils are washed thoroughly in hot water.
• Keep the immunisation register up to date.
• Contact your public health service for more information and advice.