(a) Communicable diseases - (i) No person with a communicable disease, or being a carrier of such, that is listed on the Wyoming Department of Health (WDH) Reportable Disease and Condition List shall work in a childcare facility, unless:
- (A) They have been declared non-infectious to others by a licensed physician, physician assistant (PA), or nurse practitioner (NP); or
- (B) Approval has been given by the local or State Department of Health; or
- (I) In the case of Hepatitis B, Hepatitis C, or HIV the infected individual has received bloodborne pathogen training and has been determined to be of negligible risk to other persons during the routine care of children by a licensed physician and the facility director; or
- (II) In the case of a sexually transmitted disease the infected individual has been determined to be of negligible risk to other persons during the routine care of children by a licensed physician, physician assistant, or nurse practitioner.
- (ii) No person shall work in a child care facility while they are experiencing any of the following:
- (A) Skin infection or rash unless the lesion can be completely covered and drainage contained by an impervious dressing, all other persons are prevented from having contact with the lesion, and the affected person can practice adequate hand hygiene; or the condition is due to a non-infectious condition as verified by a licensed physician, PA, or NP.
- (B) Jaundice unless due to a non-infectious condition as verified by a licensed physician, PA, or NP.
- (C) Purulent conjunctivitis
- (D) Head lice, until after first treatment.
- (E) Scabies, until treatment is completed.
- (iii) No person shall work in a child care facility if exclusion is directed by state or local public health officials.
- (iv) Exclusion of children:
- (A) Any child who cannot participate in a regular child care program due to discomfort, injury or other symptoms of illness may be refused for care by the facility staff.
- (B) A facility serving well children may not admit a child who has any of the illnesses/symptoms of illness specified below:
- (I) A communicable disease, or being a carrier of such, that is listed on the Wyoming Department of Health (WDH) Reportable Disease and Condition List, unless:
- (1.) They have been declared non-infectious to others by a licensed physician, physician assistant (PA), or nurse practitioner (NP); or
- (2.) Approval has been given by the local or state department of health; or
- (3.) In the case of Hepatitis B, Hepatitis C, or HIV the infected individual has been determined to be of negligible risk to other persons in routine childcare settings by a licensed physician and the facility director.
- (II) Diarrhea, when it is:
- (1.) Due to disease spread by fecal contamination as verified by a licensed physician, PA, or NP; or
- (2.) Accompanied by evidence of dehydration or fluid loss, identified by sunken eyes or poor skin elasticity; or
- (3.) Accompanied by a history of poor fluid intake or unusual drowsiness; or
- (4.) Continued beyond four (4) days unless a physician provides written documentation that it is safe to readmit the child for care.
- (III) Severe pain or discomfort;
- (IV) Two (2) or more episodes of acute vomiting within a period of twenty-four (24) hours;
- (V) Difficult or rapid breathing;
- (VI) Yellowish eyes or skin unless due to a non-infectious condition as verified by a licensed physician, PA, or NP;
- (VII) Sore throat with a fever over 101 degrees or severe coughing;
- (VIII) Head lice, until after first treatment;
- (IX) Scabies, until treatment is completed;
- (X) Children suspected of being in contagious stages of hepatitis A, chicken pox, pertussis, measles, mumps, rubella or diphtheria;
- (XI) Skin infection or rash, excluding diaper rash, unless under the care of a licensed physician, PA, or NP, and the licensed healthcare provider has approved in writing their return to child care;
- (XII) Purulent conjunctivitis;
- (XIII) Swollen joints or visibly enlarged lymph nodes, unless under the care of a licensed physician, PA, or NP, and the licensed healthcare provider has approved in writing their return to child care;
- (XIV) Elevated oral temperature of 101 degrees or over, unless under the care of a licensed physician, PA, or NP, and the licensed healthcare provider has approved in writing their return to child care;
- (XV) Blood in urine, unless under the care of a licensed physician, PA, or NP, and the licensed healthcare provider has approved in writing their return to child care;
- (XVI) Mouth sores associated with drooling, unless under the care of a licensed physician, PA, or NP, and the licensed healthcare provider has approved in writing their return to child care;
- (XVII) Other conditions as may be determined by the health consultant or provider on an individual basis.
- (C) The parent shall be notified immediately when a child has symptoms requiring exclusion from care. The child care facility must provide adequate separation and direct supervision of a sick child until he/she can be removed from the facility.
- (D) If a child or employee becomes seriously or suspiciously ill with a communicable disease during the hours of operation of the facility, he/she shall be separated, and children shall be supervised, from the rest of the children until he/she can be removed from care and/or examined or treated by a licensed physician, PA, or NP and verified to be non-infectious to others.
- (E) A room or other area that can be used for separation shall be provided at each facility for persons becoming ill or suspected of being ill with a communicable disease, and it shall be equipped with a cot or bed and bedding material that can be easily sanitized.
- (F) When communicable diseases occur and attendees or other staff have been exposed, all staff members shall be advised and all parents or guardians of exposed children shall be immediately notified by the provider to observe for symptoms; the specific identity of the persons infected with a communicable disease shall not be revealed except to authorized health authorities.
- (G) Facilities shall report any communicable disease listed on the Wyoming Department of Health Reportable Diseases and Conditions list occurring to the children to the local public health office and to licensing.
- (H) Facilities shall obtain the current list of reportable diseases and conditions from the office of the State Epidemiologist, Wyoming Department of Health.
- (I) Chronic upper respiratory problems, except common allergies, shall require annual examinations by a physician.
- (J) Deteriorating health conditions shall be brought to the attention of the certifying authority.