14 Del. Admin. Code § 934-III-41.0

Current through Reigster Vol. 28, No. 6, December 1, 2024

Section 934-III-41.0 - Child Health Exclusions

41.1 A licensee may not permit a child who has symptoms listed below to enter or remain at the home. The child may only return when the symptoms are gone or with documentation from a health care provider stating the illness or symptoms pose no serious health risk to anyone. The documentation must be written or include a written follow-up if communicated verbally. The symptoms for exclusion must include, but not be limited to, the following:

41.1.1 Temperature of 100°F or higher without medication even if there has not been a change in behavior for infants four (4) months old and younger;

41.1.2 Temperature of 101°F or higher without medication accompanied by behavior changes or symptoms of illness for children older than four (4) months;

41.1.3 Symptoms of possible severe illness, such as unusual tiredness, uncontrolled coughing, unexplained irritability, persistent crying, difficulty breathing, wheezing, or other unusual signs;

41.1.4 Diarrhea; two (2) or more times of loose stool during the past 24 hours, or if diarrhea is accompanied by fever, exclude for 48 hours after the symptoms end;

41.1.5 Blood in stools not due to change in diet, medication, or hard stools;

41.1.6 Vomiting; two (2) or more times in the past 24 hours, or one (1) time if accompanied by a fever until 48 hours after the symptoms end or until a health care provider determines the vomiting is not contagious and the child is not in danger of dehydration;

41.1.7 Ongoing stomach pain (more than two (2) hours) or off-and-on pain due to a fever or other symptom;

41.1.8 Mouth sores with drooling;

41.1.9 Rash with fever or behavior change;

41.1.10 Purulent conjunctivitis "pink eye" (defined as pink or red conjunctiva with white or yellow eye discharge), until 24 hours after starting antibiotic treatment;

41.1.11 Scabies, until 24 hours after starting treatment;

41.1.12 Pediculosis "head lice" or nits, until 24 hours after starting treatment;

41.1.13 Tuberculosis, as directed by DPH;

41.1.14 Impetigo, until 24 hours after starting antibiotic treatment and sores are dry;

41.1.15 Strep throat or other streptococcal infection, until 24 hours after starting antibiotic treatment;

41.1.16 Varicella-Zoster "chicken pox," until all sores have crusted and are dry (usually six (6) days);

41.1.17 Shingles, only if sores cannot be covered by clothing or a bandage; if not, exclude until sores have crusted and are dry;

41.1.18 Pertussis, until completing five (5) days of antibiotic treatment;

41.1.19 Mumps, until five (5) days after onset of glandular swelling;

41.1.20 Hepatitis A virus, until one (1) week after onset of jaundice, or as directed by DPH;

41.1.21 Measles, until four (4) days after arrival of rash;

41.1.22 Rubella, until seven (7) days after arrival of rash;

41.1.23 Herpetic gingivostomatitis "cold sores," if the child is too young to have control of saliva; or

41.1.24 Unspecified short-term illness, not chronic illness if the child is unable to participate in activities or the facility cannot provide care for this child and the other children.

41.2 A licensee shall ensure temperatures for children under three (3) years old are taken with a non-glass thermometer under the arm or by forehead scan.

41.2.1 A digital oral thermometer may be used for children three (3) years and older.

41.2.2 Rectal and ear temperatures may not be taken.

41.3 A licensee shall ensure that if a child shows signs of ill health as listed above, the child's rest, comfort, food, drink, and activity needs are met until the child is picked up from the home.

41.4 A licensee shall notify a parent or guardian when their child has been exposed to a contagious disease or condition.

41.5 A licensee shall report reportable communicable diseases to DPH. For information on these diseases, a licensee shall call DPH or refer to their website (currently listed as l https://dhss.delaware.gov/dph/dpc/rptdisease.html).

41.6 A licensee may not allow a child with a reportable communicable disease to be admitted to or remain at the home unless a health care provider documents that the illness poses no serious health risk to anyone or DPH tells the licensee that the child is not a health risk to others. If the health care provider states the child may return and DPH says the child cannot return, follow DPH's instructions.

41.7 When a health care provider diagnosed a child with a reportable vaccine-preventable communicable disease, a licensee shall exclude all children who are not immunized against the disease following DPH's instructions.

14 Del. Admin. Code § 934-III-41.0

25 DE Reg. 1017 (5/1/2022) (final)