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How can the staff keep kids healthy:

AAP's Information and Actions Steps:

Use good hand washing practices

Regularly clean and disinfect surfaces

Children must have up-to-date immunizations

Encourage healthy eating and nutrition

Talk to a health professional about things that you can do to prevent diseases


What is the exclusion criteria?

providers connection

Provider's Connection

Children who attend child care centers have a greater risk of acquiring infections than children cared for at home. These infections are often treated with antibiotics, even when they are caused by viruses, and antibiotics are ineffective and inappropriate. Child care centers are required to follow exclusion policies to reduce infections in group care. As a result, an increase in health care visits and inappropriate antibiotic-seeking behavior is common.

How can the staff keep kids healthy? AAP's Information and Action Steps

  • Use good hand washing practices. This is easier when there are sinks with warm water, soap and alcohol-based hand cleansers, disposable towels, and easy-to-understand instructions in each room or near where the activities take place.
  • Regularly clean and disinfect surfaces available to the children including floors, equipment, toys, and objects that children might put in their mouths (thermometers, pacifiers, and teething toys).
  • Children must have up-to-date immunizations for participation in the program. The health form that you keep on file should include immunizations given. Remind parents to ask the health care provider to update the form each time their child receives a "check-up". All staff members must have up-to-date immunizations to avoid spreading infectious illnesses to the kids.
  • Encourage healthy eating and nutrition, good hand washing skills and a safe, healthy place for children to play and learn.
  • Talk to a health professional about things that you can do to prevent diseases. A child care health consultant can help you develop and carry out written policies for prevention and control of infectious diseases.

Model child care center exclusion criteria by American Academy of Pediatrics

  • The child does not feel well enough to participate comfortably in the usual activities. The child care staff and/or center director will make the decision as to whether to exclude a child from the center.
  • The staff cannot care for the sick child without interfering with the care of the other children.
  • An axillary (armpit) temperature of 100°F or greater, along with behavior changes or other signs and symptoms.
  • Uncontrolled diarrhea (stool runs out of the diaper, child can't get to the toilet in time, or 3 or more bouts of diarrhea in one day).
  • Vomiting in the previous 24 hours until the vomiting stops or a health professional determines that the child may be in child care.
  • Pink eye with white or yellow discharge until 24 hours after treatment is started.

More information on exclusion criteria can be found on our Training Resources page