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Health Policy

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(Revised 5/09/2022) Changes in yellow

General Information 

In order to keep our students happy and healthy and provide a safe environment for the many students who call Wing Road Farm home daily, please read the following policies regarding your child’s health. You will be asked to sign a form on your application/contract that states you have received this policy and agree to follow our protocols. If this policy is updated, you will be informed.

 

You MUST have a current physical and vaccination record on file prior to your child’s first day of attendance. Though your child does not need a lead test prior to attendance, it is highly suggested and mandated by NYS that you attain tests at age 2 and age 3 and if you have not, that you do so prior to school attendance. It requires a simple finger prick. Because we are a licensed NYS Group Family Daycare, OCFS has provided a form your doctor must fill out called the Child In Care Medical Form which can be printed from our website registration page. As per New York State Law, your child must be up to date on immunizations or you must show proof that you are attempting to immunize. The State is no longer allowing religious exemptions. There are no exceptions to this rule.

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If your child has a severe allergy or asthma, it will be necessary for you to provide us with OCFS form 6029 and/or LDSS 7002. Little Wings Farm School is an allergy aware space. We will work with parents and doctors to make sure we are fully aware of your child's treatment plan. We do not administer medicine in general, but we can administer a child's allergy medication or asthma medication. Still, there are many children who have unexpected reactions to new foods in a new environment. Teachers at Little Wings are trained to recognize anaphylaxis and we stock a non-patient specific Auvi-Q to treat any child in our program who is experiencing a severe, life threatening reaction.

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Please keep your child’s teacher informed of changes in your child's health- illnesses, allergies, injuries, etc. We do not have a nurse on staff, so do our best to observe our students and keep you informed of any illnesses passing through that may be highly contagious such as strep or flu. In the event your child is exhibiting symptoms of illness, please keep them at home in order to prevent the spread to the other participants. In the event Little Wings staff notices symptoms of illness, you will be notified and required to pick up your child within an hour. 

Please call when your child will not be attending school for any reason. When the teachers are in session, they will not be able to answer all calls, so please email or text if your child will not be able to attend that day. If an absence is preplanned, email is sufficient notification. Doctor’s notes are required to assure staff that your child has been cleared of various contagious illnesses and is fit and well enough to return to school.

 

Covid-19 Policies

It is our duty to provide a safe learning environment for our precious children. Please be aware that if a single child in our program tests positive for Covid-19, it creates a ripple that affects many families. It is our greatest wish that this never happens to any of us and that we can all stay healthy and safe during this pandemic, which is far from over. Our goal this year was zero cases and zero closures. Sadly, 5/14 of our children have tested positive for Covid during this school year. We know first hand the disruption a single quarantine causes in a family or daycare. In order to keep our children safe and stay open, please read and agree to the following policy. 

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​By sending your child to Little Wings, you attest that your household is abiding by social distancing and mask guidelines in effect in our region as required by NYS and the state and local Departments of Health until such time as it is no longer deemed necessary. All members of your household:

  1. Will abide by the current distancing recommendations of New York State and County Departments of Health when in the presence of people outside of your household or close family.

  2. Follow all and any mask wearing policies recommended by the NYS or Saratoga County Department of Health in effect as metrics change in New York State and Saratoga County.

 
Current Mask Policy

OCFS does NOT currently mandate the use of masks indoors or out for children in daycare. We do not have to follow this policy as we can choose to go beyond their precautions. We are currently still wearing masks indoors by parent vote and have voted to allow parents to choose to mask or not outdoors. We are outdoors almost 100% of the time from September - December and April-June, but we prefer each child to have a mask on a lanyard that they can wear indoors to go to the restroom or on cold and rainy days when we start indoors. I have chosen to keep masks indoors because transmission in Saratoga County is so high -  one of the highest in the nation. It is so difficult to distance children during play and we want to protect play. They regularly play face to face and cannot distance and space themselves apart yet.  All staff, students and visitors must wear masks while on Little Wings property while indoors. We believe that masks are are an important tool to stop the transmission of Covid and it is not worth losing a single life over our discomfort. If the risk diminishes and the transmission rate in Saratoga County becomes consistently "low", we will vote to give parents the choice to keep their children mask-free while indoors or outdoors. Please send your child to school with 2 clean masks in case one gets dirty. We will have extra disposables on hand. Staff are currently masking indoors and when face to face with children outdoors.

​Student Illness Policy

​Protecting the health of our students, teachers and families is our highest priority. If your child has any of the following symptoms not otherwise explained (for example, by allergies, another germ, or a recent physical injury, etc), then they may not attend the program. If they have even a single symptom listed below, please notify us after contacting your child’s pediatrician for guidance. When in doubt, keep your child home.

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  • Fever of 100F or above

  • Persistent Cough

  • Shortness of breath or difficulty breathing

  • Chills

  • Repeated shaking with chills

  • Muscle pain

  • Headache

  • Sore throat

  • Newly acquired loss of taste or smell

  • Skin rash

  • Congestion

  • Nausea, vomiting or diarrhea

 

Your child may return to preschool after having the above symptoms by following this pathway below:

  • Symptom-free for 24 hours AND Fever-free for 72 hours with either:

    • Letter from pediatrician that it is safe for the child to return to school (telehealth appointment is acceptable) OR for Covid Related Illness:

      • Proof of Negative COVID-19 test result (rapid test if active symptoms or PCR if asymptomatic)

      • AND

      • 5 days have passed since onset of symptoms

 

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Current OCFS Policy 

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We are currently following the OCFS Covid guidelines above dated February 4th, 2022. The only place we differ is that we are asking that children test negative on a PCR at day 5 of their quarantine to return to school after an exposure and we want students who are positive to test negative on a rapid test before returning after their Covid positive illness. Students with Covid symptoms may attend school with 2 negative rapid tests 36 hours apart.  

 
Drop-Off and Pick-Up

Each morning, please monitor your child's health and take note of any symptoms of illness or COVID-19.  When in doubt, please do not bring your child to school. Drop-off and pick-up will be as contact-free as possible but all parents and caregivers are allowed to enter our program at any time upon request. We ask you to follow all current mask wearing and social distancing policies in effect at Little Wings at that time. You will be asked to sanitize your hands and your childrens' hands and signing your child in implies that you have answered "no" to all the Health Screening Questions below each day on the daily sign-in form.

 
Daily Health Screening Questions

Any parent who answers YES to any of the following questions, not otherwise explained (for example, by allergies, a recent physical injury, etc) will NOT be permitted at school and will only be able to return by following the COVID-19 Illness Protocol. Please take your child’s temperature every morning before attending Little Wings. By signing your child in each day, you attest that all answers to the following screening questions are “no”. 

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  • Have a fever of 100F or above now or in the preceding 72 hours?

  • Have a cough?

  • Have a sore throat?

  • Have any muscle aches?

  • Have any difficulty breathing/shortness of breath?

  • Have recent loss of taste or smell?

  • Have you or your child taken any Tylenol, Ibuprofen or another NSAID in the last 24 hours for fever or unexplained muscle pain?

  • For the last 10 days:

    • Has anyone in your household tested positive for COVID-19?

  1. Any person with a temperature above 100 F will not be permitted at preschool for at least 72 hours following this detection of fever as a precaution. 

  2. Children will use hand sanitizer or handwashing stations immediately upon the grounds and throughout the preschool day.

 
Illness Occurring at School
​If at any time your child exhibits any of the following symptoms: 

  • Fever of 100F or above taken with an ear thermometer

  • Persistent Cough

  • Shortness of breath or difficulty breathing

  • Chills

  • Repeated shaking with chills

  • Muscle pain

  • Headache

  • Sore throat

  • Newly acquired loss of taste or smell

  • Skin rash

  • Nausea, vomiting or diarrhea

  • Constant drainage from the nose

​Teachers will isolate the child and call emergency numbers listed in the child's documents. It is imperative that all children have an adult that can be reached at any time. Child will be picked up within an hour of notification and you must follow protocols by calling the child's pediatrician immediately for an appointment to rule out Covid. See protocol above. 

 

Teachers may call you in at any time to pick up your child if:

  • The child is complaining they are unwell

  • The child is not participating in program as they usually do

  • The child has constant drainage from the nose or ears, has a persistent cough, has an unexplained rash, or has had an episode of diarrhea

 

Covid Precautions

 

  • Staff and students are required to wear masks indoors at all times except while eating. Preschoolers are required to bring at least two clean cloth face coverings. If they lose them or they become soiled, we will provide paper masks for the rest of the day.  

  • Program supplies, bathrooms, tables and any touched surfaces will be sanitized regularly according to OCFS standards.

  • We will attempt to remain outdoors as much as possible, utilizing the greenhouse in bad weather. We are asked to stay indoors only when the Wind Chill is 14 degrees F or below. In the first 4 months of our 2021-2022 program, we were only indoors 7 days but we spent over an hour outdoors each of those 7 days.

  • Children will be asked to sanitize or wash their hands upon arrival and departure as well as other times throughout the day including after bathroom use, before eating, upon entering the house from farm play and after touching shared sensory supplies.

 

COVID-19 Exposure Response

If we have a confirmed positive test of a child who has been at preschool 2 days before their positive test, we will begin the following protocol:

  1. Communicate immediately with parents and members of our staff as well as our licensor at the Office of Children and Families.

  2. Encourage families to follow our current Covid guidelines.

  3. Maintain confidentiality of the participant or staff member who tested positive as required by the Americans with Disabilities Act and the Family Education Rights and Privacy Act until they choose to share such information.

  4. Clean and disinfect all areas that could have been exposed to COVID-19.

  5. Prepare for guidance from the licensor at OCFS which could entail:

  • Closure for 24-48 hours or longer. This initial short-term dismissal allows time for the local health officials to determine the COVID-19 situation impacting our school.

  • Quarantine of all children from the positive person’s cohort for 5 days.

  • Preschool closure for a short time for cleaning

 
Environmental  Precautions
  • Use of increased ventilation by opening windows of classroom

  • Routine disinfection of high touch surfaces and bathrooms

  • Increased handwashing, use of sanitizer and gloves when handling food

  • Regular sanitizing of toys

  • A whole lot of fresh air with children primarily outside year round! :-)

 
Questions or Concerns?

We encourage you to reach out to us with your questions or concerns. We are doing our best to stay up to speed with new and changing information as quickly as possible and will do our best to keep families up to date if changes occur. Our research includes following local metrics and data, consulting the county DOH, conversations with our licensor at the state Office of Children and Families, other preschool owners, local doctors, and a public health expert. Each daycare owner can write their own Covid policy at this time. This is a challenging task and this policy may be updated many times this year as the Covid-19 Pandemic warrants. This program was designed to stay open and our policies are very strict and conservative. Even 1 case can cause a ripple effect for so many families. If you do not agree with these policies, this program may not be right for your family. We are all doing our best during an unsettling year, however there may be times you are unhappy with the current policy. Open communication with staff is best. Please feel free to share your thoughts at any time. The safety of our staff and your children is of the utmost concern to us. Writing a policy is challenging due to differences of opinion about what level of risk is acceptable to different families, so your patience and understanding is appreciated. We are all frustrated, tired and sick of living this way. Our goal is to provide the safest possible educational experience for your child, stay open, and to support one another through this time in history. 

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NY State Group Family Daycare Health Plan

 

The following information contains our Group Family Day Care specific Health Care Plan. 

  • It is the program’s responsibility to follow the health care plan and all day care regulations.

  • OCFS must review and approve the health care plan as part of the licensing/registration process.

  • OCFS must review and approve any changes or revisions to the health care plan before the program can implement the changes.

  • A healthcare consultant must approve health care plans for programs that administer medications.

  • The program’s health care plan will be given to parents at admission and whenever changes are made, and the health care plan will be made available to parents upon request.

  • The health care plan must be on site and followed by all staff/caregivers.

  • The program’s anaphylaxis policy will be reviewed annually, and parents will be notified of the policy at admission and annually after that.

  • If a conflict occurs between day care regulations and emergency health guidance promulgated by DOH in the interest of public health during a designated public health emergency, such emergency guidance must be followed.

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Section 1: Child Health and Immunizations

 

The program cares for (check all that apply; at least one MUST be selected):

  ✔Well Children

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It does not care for mildly ill or moderately ill children at this time. See examples of each below.

 

Mildly ill children who can participate in the routine program activities with minor accommodations. A child who meets any of the following criteria is defined as “mildly ill”:

  • The child has symptoms of a minor childhood illness that does not represent a significant risk of serious infection to other children.

  • The child does not feel well enough to participate comfortably in the usual activities of the program but is able to participate with minor modifications, such as more rest time.

  • The care of the child does not interfere with the care or supervision of the other children                       

 

 

Moderately ill children who require the services of a health care professional but have been approved for inclusion by a health care provider to participate in the program. A child who meets any of the following criteria is defined as “moderately ill”:

  • The child’s health status requires a level of care and attention that cannot be accommodated in a child day care setting without the specialized services of a health professional.

  • The care of the child interferes with the care of the other children and the child must be removed from the normal routine of the child care program and put in a separate designated area in the program, but has been evaluated and approved for inclusion by a health care provider to participate in the program. 

 

NOTE: The definitions above do not include children who are protected under the Americans with Disabilities Act (ADA). Programs must consider each child’s case individually and comply with the requirements of the ADA. For children with special health care needs, see Section 2.

 

Key criteria for exclusion of children who are ill:

  • The child is too ill to participate in program activities.

  • The illness results in a need for care that is greater than the staff can provide without compromising the health and safety of other children

  • An acute change in behavior – this could include lethargy/lack of responsiveness, irritability, persistent crying, difficult breathing or having a quickly spreading rash;

Fever:

  • Temperature above 101°F [38.3°C] orally, or 100°F [37.8°C] or higher taken axillary (armpit) or measured by an equivalent method (ear thermometer), AND accompanied by behavior change or other signs and symptoms (e.g., sore throat, rash, headache, vomiting, diarrhea, breathing difficulty or cough).

  • Under six-months of age: Unexplained temperature above 100°F [37.8°C] axillary (armpit) or 101°F [38.3°C] rectally (caregivers are prohibited from taking a child’s temperature rectally) should be medically evaluated.

  • Under two-months of age: Any fever should get urgent medical attention.

Diarrhea:

  • Diapered children whose stool is not contained in the diaper or if the stool frequency exceeds two or more stools above normal for the child.

  • Toilet-trained children if the diarrhea is causing soiled pants or clothing.

  • Blood or mucous in the stools not explained by dietary change, medication, or hard stools.

  • Confirmed medical diagnosis of salmonella, E. coli or Shigella infection, until cleared by the child’s health care provider to return to the program.

 

  • Vomiting more than two times in the previous 24-hours unless the vomiting is determined to be caused by a non-infectious condition and the child remains adequately hydrated.

  • Abdominal pain that continues for more than two hours or intermittent pain associated with fever or other signs or symptoms of illness.

  • Mouth sores unless the child’s health care provider states that the child is not infectious.

  • Active tuberculosis, until the child’s primary care provider or local health department states the child is on appropriate treatment and can return.

  • Streptococcal pharyngitis (strep throat or other streptococcal infection), until 24-hours after treatment has started.

  • Head lice, until after the first treatment (note: exclusion is not necessary before the end of the program day).

  • Scabies, until treatment has been given.

  • Chickenpox (varicella), until all lesions have dried or crusted (usually six-days after onset of rash).

  • Rubella, until six-days after the rash appears.

  • Pertussis, until five-days of appropriate antibiotic treatment.

  • Mumps, until five-days after onset of parotid gland swelling.

  • Measles, until four-days after onset of rash.

  • Hepatitis A virus infection, until the child is approved by the health care provider to return to the program.

  • Any child determined by the local health department to be contributing to the transmission of illness during an outbreak.

  • Impetigo until treatment has been started.

 

Medical Statements and Immunizations:

Upon enrollment, any child, except those in kindergarten or a higher grade, in the program will provide a written statement signed by a health care provider verifying that the child is able to participate in child day care and currently appears to be free from contagious or communicable diseases. A Child in Care Medical Statement for each child must have been completed within the 12-months preceding the date of enrollment. Form OCFS-LDSS-4433, Child in Care Medical Statement may be used to meet this requirement.

 

The program will accept a child who has not received all required immunizations only as allowed by regulation. The program will keep documentation that each child has received the immunizations required by New York State Public Health Law unless exempt by regulation.

 

How often are immunization records reviewed for each age group? (check all that apply; at least one MUST be selected)

six-weeks to two-years: Weekly     Monthly     ✔Quarterly     Yearly

two-years to five-years: Weekly     Monthly     ✔Quarterly     Yearly

 

Parents will be notified in the following way(s) when records indicate immunizations need to be updated: (check all that apply)

✔Written notice

✔Verbally

 

Section 2: Children with Special Health Care Needs

Children with special health care needs means children who have chronic physical, developmental, behavioral, or emotional conditions expected to last 12-months or more and who require health and related services of a type or amount beyond that required by children generally.

  • Any child identified as a child with special health care needs will have a written Individual Health Care Plan that will provide all information needed to safely care for the child. This plan will be developed with the child’s parent and health care provider.

  • Any child with a known allergy will have a written Individual Allergy and Anaphylaxis Emergency Plan attached to the Individual Health Care Plan that includes clear instructions of action when an allergic reaction occurs. Additionally, upon enrollment into the child care program, the parent/guardian will complete form OCFS-LDSS-0792, Day Care Enrollment (Blue Card) or an approved equivalent that will include information regarding the child(s) known or suspected allergies. This documentation will be reviewed and updated at least annually or more frequently as needed.

  • The program may be required, as a reasonable accommodation under the Americans with Disabilities Act, to obtain approval to administer medication if the child needs medication or medical treatment during program hours.

 

The program may use (check all that apply; at least one MUST be selected):

  ✔Form OCFS-LDSS-7006, Individual Health Care Plan for a Child with Special Health Care Needs     

 

The program may use (check all that apply; at least one MUST be selected):

 

  ✔Form OCFS-6029, Individual Allergy and Anaphylaxis Emergency Plan    

 

Section 3: Daily Health Checks

A daily health check will be done on each child when he/she arrives at the program and whenever a change in the child’s behavior and/or appearance is noted. The child must be awake when the check is done, and the following procedure will be used (check one; at least one MUST be selected):

✔Appendix A: Instructions for Daily Health Check

 

Appendix A:

Instructions for Doing a Daily Health Check

A daily health check occurs when the child arrives at the program and whenever a change in child’s behavior and/or appearance is noted. The child must be awake so an accurate assessment can be done. Check the following while at the child’s level so you can interact with the child when talking with the parent:

 

Child’s behavior: is it typical or atypical for time of day and circumstances?

 

Child’s appearance:

Skin: pale, flushed, rash (Feel the child’s skin by touching affectionately.)

Eyes, nose, and mouth: note color; are they dry or is there discharge? Is the child rubbing eye, nose, or mouth?

Hair: (In a lice outbreak, look for nits within ¼" of the scalp.)

Breathing: normal or different; cough

 

Check with the parent:

How did the child seem to feel or act at home?

Sleeping normally?

Eating/drinking normally? When was the last time a child ate or drank?

Any unusual events?

Bowels and urine normal? When was the last time a child used the toilet or was changed?

Has the child received any medication or treatment?

 

Any evidence of illness or injury since the child was last participating in child care?

 

Any indications of suspected child abuse or maltreatment?

 

Document that the daily health check has been completed. LDSS-4443, Child Care Attendance Sheet may be used to meet this requirement.

 

Any signs of illness, communicable disease, injury and/or suspected abuse and maltreatment found will be documented and kept on file for each child in accordance with Section 3: Daily Health Checks.

 

:      

 

 

The daily health check will be documented. Check the form you will use to meet this requirement:

✔Form LDSS-4443, Child Care Attendance Sheet

Other: (please attach form developed by the program- we are using our own attendance sheet)

 

Staff will be familiar with the signs and symptoms of illness, communicable disease, and injury, as well as the exclusion criteria listed in the Health Care Plan in Section 1. 

 

Staff and volunteers will be trained in preventing, recognizing, and responding to allergic reactions and anaphylaxis.

 

Staff will keep a current knowledge of the New York State Department of Health’s list of communicable diseases (DOH-389) accessible at: https://health.ny.gov/forms/instructions/doh-389_instructions.pdf

 

Children will be monitored throughout the day. Parents will be notified immediately of any change in the child’s condition or if the care of the child exceeds what the program can safely provide. If necessary, the program will make arrangements with the parents for obtaining medical treatment. If a parent cannot be reached or if the child’s condition warrants, emergency medical treatment will be obtained without delay by calling 911.

 

Any signs of illness including allergic reactions and anaphylaxis, communicable disease, injury and/or suspected abuse and maltreatment found will be documented and kept on file for each child in the following way (check all that apply; at least one MUST be selected):

✔In each child’s file

✔In a separate log- we have a student log book for abnormal health checks or incident reports

    Other:      

Explain here:      

The program will ensure that adequate staff are available to meet the needs of the ill child without compromising the care of the other children in the program.

Explain the procedures for caring for a child who develops symptoms of illness while in care.

Explain here:  The child will be isolated from other students and a call will be made to the parent or guardian to pick up their child and all attempts to comfort child will be made while they wait.    

 

 

Mandated reporters who have reasonable cause to suspect a child in care is being abused or maltreated will take the following actions:

Immediately make or cause to be made an oral report to the mandated reporter hotline (1-800-635-1522).

File a written report using Form LDSS-2221A, Report of Suspected Child Abuse or Maltreatment to the local Child Protection Services (CPS) within 48 hours of making an oral report.

After making the initial report, the reporting staff person must immediately notify the director or licensee of the center that the report was made.

The program must immediately notify the Office upon learning of a serious incident, involving a child which occurred while the child was in care at the program or was being transported by the program. 

Additional procedures (if any):      

Explain here:      

 

Section 4: Staff Health Policies

Check only one:

FDC: The program will operate in compliance with all medical statement requirements as listed in 417.11(b).

✔GFDC: The program will operate in compliance with all medical statement requirements as listed in 416.11(b).

SDCC: The program will operate in compliance with all medical statement requirements as listed in 418-2.11(b).

Any caregiver or volunteer with signs and symptoms of illness that match the exclusion criteria for children listed in this health care plan will not care for children.

If a caregiver will be unable to provide care to children due to illness and unable to obtain an appropriate substitute caregiver, the program will notify parents in the following manner:

Explain here:     A call and an email will be sent to parents to come pick up their children due to the sudden illness of a caregiver and the program will be closed for the duration of the day.  

 

 

Section 5: Infection Control Procedures

The program will use the procedures in the attached appendices to reduce the risk of infection or attach an alternate for each area (check all that apply; at least one MUST be selected for each category):

 

Hand washing

✔Appendix B:

Hand Washing

Staff and volunteers must thoroughly wash their hands with soap and running water:

At the beginning of each day.

Before and after the administration of medications.

When they are dirty.

After toileting or assisting children with toileting.

After changing a diaper.

Before and after food handling or eating.

After handling pets or other animals.

After contact with any bodily secretion or fluid.

After coming in from outdoors.

 

Staff and volunteers must ensure that children thoroughly wash their hands or assist children with thoroughly washing their hands with soap and running water:

When they are dirty.

After toileting.

Before and after food handling or eating.

After handling pets or other animals.

After contact with any bodily secretion or fluid.

After coming in from outdoors.

 

All staff, volunteers and children will wash their hands using the following steps:

Moisten hands with water and apply liquid soap.

Rub hands with soap and water for at least 30 seconds – remember to include between fingers, under and around fingernails, backs of hands, and scrub any jewelry.

Rinse hands well under running water with fingers down so water flows from wrist to fingertips.

Leave the water running.

Dry hands with a disposable paper towel or approved drying device.

Use a towel to turn off the faucet and, if inside a toilet room with a closed door, use the towel to open the door.

Discard the towel in an appropriate receptacle.

Apply hand lotion, if needed.

When soap and running water is not available and hands are visibly soiled, individual wipes may be used in combination with hand sanitizer. The use of hand sanitizers on children under the age of 2-years is prohibited.

 

 

Diapering

✔Appendix C:

Diapering

Diapering will be done only in the selected diapering area. Food handling is not permitted in diapering areas.

Surfaces in diapering areas will be kept clean, waterproof, and free of cracks, tears, and crevices. All containers of skin creams and cleaning items are labeled appropriately and stored off the diapering surface and out of reach of children.

Diapers will be changed using the following steps:

Collect all supplies but keep everything off the diapering surface except the items you will use during the diapering process. Prepare a sheet of non-absorbent paper that will cover the diaper changing surface from the child’s chest to the child’s feet. Bring a fresh diaper, as many wipes as needed for this diaper change, non-porous gloves, and a plastic bag for any soiled clothes.

Wash hands and put on gloves. Avoid contact with soiled items. Items that come in contact with items soiled with stool or urine will have to be cleaned and sanitized. Carry the baby to the changing table, keeping soiled clothing from touching the staff member’s or volunteer’s clothing. Bag soiled clothes and, later, securely tie the plastic bag to send the clothes home.

Unfasten the diaper but leave the soiled diaper under the child. Hold the child’s feet to raise the child out of the soiled diaper and use disposable wipes to clean the diaper area. Remove stool and urine from front to back and use a fresh wipe each time. Put the soiled wipes into the soiled diaper. Note and later report any skin problems.

Remove the soiled diaper. Fold the diaper over and secure it with the tabs. Put it into a lined, covered, or lidded can and then into an outdoor receptacle or one out of reach of children. If reusable diapers are being used, put the diaper into the plastic-lined covered or lidded can for those diapers or in a separate plastic bag to be sent home for laundering. Do not rinse or handle the contents of the diaper.

Check for spills under the baby. If there is visible soil, remove any large amount with a wipe, then fold the disposable paper over on itself from the end under the child’s feet so that a clean paper surface is now under the child.

Remove your gloves and put them directly into the covered or lidded can.

Slide a clean diaper under the baby. If skin products are used, put on gloves, and apply the product. Dispose of gloves properly. Fasten the diaper.

Dress the baby before removing him/her from the diapering surface.

Clean the baby’s hands, using soap and water at a sink if you can. If the child is too heavy to hold for hand washing and cannot stand at the sink, use disposable wipes or soap and water with disposable paper towels to clean the child’s hands. Take the child back to the child care area.

Clean and disinfect the diapering area:

Dispose of the table liner into the covered or lidded can.

Clean any visible soil from the changing table.

Spray or wipe the table so the entire surface is wet with an Environmental Protection Agency (EPA)-registered product, following label directions for disinfecting diapering surfaces.

Leave the product on the surface for time required on the label, then wipe the surface or allow it to air dry.

Wash hands thoroughly.

 

Safety precautions related to blood and bodily fluids

✔Appendix D:

Safety Precautions Related to Blood

All staff will follow standard precautions when handling blood or blood-contaminated body fluids. These are:

Disposable gloves must be immediately available and worn whenever there is a possibility for contact with blood or blood-contaminated body fluids.

Staff are to be careful not to get any of the blood or blood-contaminated body fluids in their eyes, nose, mouth, or any open sores.

Clean and disinfect any surfaces, such as countertops and floors, onto which blood has been spilled.

Discard blood-contaminated material and gloves in a plastic bag that has been securely sealed. Clothes contaminated with blood must be returned to the parent at the end of the day.

Wash hands using the proper hand washing procedures.

 

In an emergency, a child’s well-being takes priority. A bleeding child will not be denied care even if gloves are not immediately available.

 

 

Cleaning, disinfecting, and sanitizing of equipment and toys

Appendix E:

SPRAY BLEACH SOLUTION #1 (for food contact surfaces)

Staff will use the following procedures for cleaning and sanitizing nonporous hard surfaces such as tables, countertops, and highchair trays:

1. Wash the surface with soap and water.

2. Rinse until clear.

3. Spray the surface with a solution of ½ teaspoon of bleach to 1 quart of water until it glistens.

4. Let sit for two minutes.

5. Wipe with a paper towel or let air-dry.

SPRAY BLEACH SOLUTION #2 (for diapering surfaces or surfaces that have been contaminated by blood or bodily fluids)

Staff will use the following procedures for cleaning and disinfecting diapering surfaces or surfaces that have been contaminated by blood or bodily fluids:

1. Put on gloves.

2. Wash the surface with soap and water.

3. Rinse in running water until the water runs clear.

4. Spray the surface with a solution of 1 tablespoon of bleach to 1 quart of water until it glistens.

5. Let sit for two minutes.

6. Wipe with a paper towel or let air-dry.

7. Dispose of contaminated cleaning supplies in a plastic bag and secure.

8. Remove gloves and dispose of them in a plastic-lined receptacle.

9. Wash hands thoroughly with soap under running water.

SOAKING BLEACH SOLUTION (for sanitizing toys that have been mouthed)

Staff will use the following procedure to clean and sanitize toys that have been mouthed by children:

Wash the toys in warm soapy water, using a scrub brush to clean crevices and hard to reach places.

Rinse in running water until water runs clear.

Place toys in a soaking solution of 1 teaspoon of bleach to 1 gallon of water.

Soak for five minutes.

Rinse with cool water.

Let toys air-dry.

When sanitizing or disinfecting equipment, toys and solid surfaces, the program will use

(check all that apply; at least one MUST be selected):

EPA-registered product approved for sanitizing and disinfecting, following manufacturer instructions for mixing and application

Bleach solution made fresh each day

Spray solution #1: ½ teaspoon of bleach to 1 quart of water.

Spray solution #2: 1 tablespoon of bleach to 1 quart of water.

Soaking solution: 1 teaspoon of bleach to 1 gallon of water.

Gloving

✔Appendix F:

  1. Wash hands

  2. Put on a clean pair of gloves. Do not reuse gloves. 

Removal and Disposal

  1. Remove the first glove by pulling at the palm and stripping the glove off. The entire outside surface of the gloves is considered dirty. Have dirty surfaces touch dirty surfaces only. 

  2. Ball up the first glove in the palm of the other gloved hand.

  3. Use the non-gloved hand to strip the other glove off. Insert a finger underneath the glove at the wrist and push the glove up and over the glove in the palm. The inside surface of your glove and your ungloved hand are considered clean. Be careful to touch clean surfaces to clean surfaces only. Do not touch the outside of the glove with your ungloved hand.

  4. Drop the dirty gloves into a plastic-lined trash receptacle. 

  5. Wash hands.

Glove use does not replace hand washing. Staff must always wash their hands after removing and disposing of medical gloves.

 

Section 6: Emergency Procedures

If a child experiences a medical emergency, the program will obtain emergency medical treatment without delay by calling 911.

The director and all teachers must have knowledge of and access to children’s medical records and all emergency information.

911 and the poison control telephone numbers must be conspicuously posted on or next to the program’s telephone.

The program may use the following form to record emergency contact information for each child (check one; at least one MUST be selected):

✔OCFS form: Day Care Enrollment, OCFS-LDSS-0792 “Blue Card”

✔Other: Little Wings Application Form 

(please attach form developed by the program)

The program will keep current emergency contact information for each child in the following easily accessible location(s): (check all that apply; at least one MUST be selected):

✔The emergency bag

✔On file

Other:      

Explain here:      

In the event of a medical emergency, the program will follow (check one; at least one MUST be selected): 

Medical Emergency (Appendix G)

✔Appendix G:

Medical Emergency

 

Remain calm. Reassure the child (victim) and the other children at the scene.

If the area is unsafe, move to a safe location.

Follow first aid and/or CPR protocols.

Call for emergency medical services/911. Give all the important information slowly and clearly. To make sure that you have given all the necessary information, wait for the other party to hang up first. If an accidental poisoning is suspected, contact the National Poison Control Hotline at 1-800-222-1222 for help.

Follow instructions given by the emergency operator.

Send emergency contact information and permission to obtain emergency care when the child is transported for emergency care.

Notify parents of the emergency as soon as possible. If the parent can’t be reached, notify the child’s emergency contact person.

After the needs of the child and all others in care have been met, immediately notify OCFS if the emergency involved death, serious incident, serious injury, serious condition, communicable illness (as identified on the New York State Department of Health list [DOH-389] accessible at https://health.ny.gov/forms/instructions/doh-389_instructions.pdf) or transportation to a hospital, of a child that occurred while the child was in care at the program or was being transported by a caregiver.

   

Section 7: First Aid Kit

First aid kits will be kept out of reach of children and restocked when items are used. The program will have at least one first aid kit.

The program’s first aid kit(s) will be stored in the following area(s) in the program:

(It is recommended that a kit be taken on all trips off the program site and that a kit be kept in the emergency bag for use in the event of an emergency evacuation.)

Explain here:      

 

The following are recommended items that a first aid kit should contain, but is not limited to:

Disposable gloves, preferably vinyl

Sterile gauze pads of various sizes

Bandage tape

Roller gauze

Cold pack

List any additional items (or substitutions for the recommended items listed above) that will be stored in the first aid kit:      

Staff will check the first aid kit contents and replace any expired, worn, or damaged items:

(check all that apply)

✔After each use

✔Monthly

  Other:      

Explain here:      

 

The program will (check all that apply):

✔Keep the following non-child-specific, over-the-counter topical ointments, lotions, creams, and sprays in the first aid kit: (Programs must have parental permission to apply before using.)

Explain here: Neosporin with pain relief, Babyganics Sunscreen and Babyganics Insect Repellent      

 

Keep the following non-child-specific, over-the-counter medication in the first aid kit:

(Programs that plan to store over-the-counter medication given by any route other than topical must be approved to administer medication and have all appropriate permissions as required by regulation before administering the medication to a child.)

Explain here:      

 

    Keep non child specific epinephrine auto injector medication (e.g., EpiPen®, AquiVu) in the first aid kit:

        (Programs must be approved to stock epinephrine auto-injectors and have a staff on site who has successfully completed the Office approved training as required by regulation before storing and administering the medication to a child).

Explain here:      

 

✔Keep the following types of child-specific medication (e.g., EpiPen®, asthma inhalers) in the first aid kit: (Programs must be approved to administer medication, with the exception of epinephrine auto-injectors, diphenhydramine in combination with the epinephrine auto-injector, asthma inhalers and nebulizers, and have all appropriate permissions as required by regulation, before storing and administering the medication to a child.)

Explain here:    Only EpiPens, Benadryl and inhalers for children with medical conditions who have filled out form LDSS 7006 and OCFS 6029. 

The program must check frequently to ensure these items have not expired.

Section 8: Program Decision on the Administration of Medication

The program has made the following decision regarding the administration of medication

(check all that apply; at least one MUST be selected):

✔The program WILL administer over-the-counter topical ointments, lotions and creams, and sprays, including sunscreen products and topically applied insect repellant. *

(Complete Sections 9-12, 22)

✔The program WILL administer epinephrine patient-specific auto-injectors, diphenhydramine in combination with the epinephrine auto- injector, asthma inhalers and nebulizers. *

(Complete Sections 9-12, 22)

The program WILL administer stock non-patient-specific epinephrine auto-injectors.

(Complete Appendix J.)

The program WILL administer medications that require the program to have this health care plan approved by a healthcare consultant as described in Sections 13 and 14. * (Complete Sections 9 and 13-22)

If the program will not administer medication (other than over-the-counter topical ointments, lotions and creams, sprays, including sunscreen products and topically applied insect repellant and/or epinephrine auto-injectors, diphenhydramine in combination with the epinephrine auto-injector, asthma inhalers and nebulizers), explain how the needs of the child will be met if the child is taking medication that requires administration during program hours.

Explain here:  Parents and relatives will be required to come to the program to administer medications.     

*Parent/Relative Administration

A person who is a relative, at least 18 years of age (with the exception of the child’s parents), who is within the third degree of consanguinity of the parents or step parents of the child, even if the person is an employee or volunteer of the program, may administer medication to the child he/she is related to while the child is attending the program, even though the program is not approved to administer medication.

 

A relative within the third degree of consanguinity of the parents or step parents of the child includes: the grandparents of the child; the great-grandparents of the child; the great-great-grandparents of the child; the aunts and uncles of the child, including the spouses of the aunts and uncles; the great-aunts and great-uncles of the child, including the spouses of the great-aunts and great-uncles; the siblings of the child; and the first cousins of the child, including the spouses of the first cousins.

 

If medication is given to a child by a parent or a relative within the third degree of consanguinity of the parents or step parents of the child during program hours, the dose and time of medication administration must be documented and may be documented in the following manner (check one; at least one MUST be selected):

✔OCFS form: Log of Medication Administration, OCFS-LDSS-7004

Other: (please attach form developed by the program)

Section 9: Programs that WILL Administer OvertheCounter Topical Ointments, Lotions and Creams, and Sprays, Including Sunscreen Products and Topically Applied Insect Repellant, and/or Epinephrine Autoinjectors, Diphenhydramine in Combination with the Epinephrine Auto Injector, Asthma Inhalers and Nebulizers.

Over-the-Counter Topical Ointments, Lotions and Creams, and Sprays Including Sunscreen Products and Topically Applied Insect Repellant (TO/S/R)

The program will have parent permission to apply any TO/S/R.

 

Any over the counter TO/S/R will be applied in accordance with the package directions for use. If the parent’s instructions do not match the package directions, the program will obtain health care provider or authorized prescriber instructions before applying the TO/S/R.

 

All over the counter TO/S/R will be kept in its original container. All child specific TO/S/R will be labeled with the child’s first and last names.

 

TO/S/R will be kept in a clean area that is inaccessible to children.

Explain where these will be stored:   In a bin on a high shelf in the pantry next to the bathroom.    

All leftover or expired TO/S/R will be given back to the child’s parent for disposal. TO/S/R not picked up by the parent may be disposed of in a garbage container that is not accessible to children.

All over the counter TO/S/R applied to a child during program hours will be documented and maintained in the following way (check all that apply; at least one MUST be selected):

✔OCFS form Log of Medication Administration, OCFS-LDSS-7004

On a child-specific log (please attach form developed by the program)

Other:      

Explain here:      

All observable side effects will be documented. Parents will be notified immediately of any observed side effects. If necessary, emergency medical services will be called.

The program will (check all that apply):

✔Apply over the counter TO/S/R, which parents supply for their child.

✔Keep a supply of stock over the counter TO/S/R to be available for use on children whose parents have given consent. These include the following:

Explain here:  Parents can give consent to use stock sunscreen and insect repellent in the Little Wings Application Form. We will use Babyganics Mineral Sunscreen and Babyganics Insect Repellent.     

Parent permission will be obtained before any non-child specific over the counter TO/S/R will be applied. Parents will be made aware that the TO/S/R being applied is not child-specific and may be used by multiple children.

 

The program will adhere to the following infection control guidelines whenever using non childspecific TO/S/R:

Hands will be washed before and after applying the TO/S/R.

Care will be taken to remove the TO/S/R from the bottle or tube without touching the dispenser.

An adequate amount of TO/S/R will be obtained so it is not necessary to get more once the staff has started to apply the TO/S/R (if additional TO/S/R must be dispensed after applying it to a child’s skin, hands will be washed before touching the dispenser).

Gloves will be worn when needed.

TO/S/R that may be contaminated will be discarded in a safe manner.

 

It is the program’s obligation to protect the children in care from injury. Part of this obligation includes the application of TO/S/R according to parent permission.

 

Describe the program’s procedure for protecting children in the absence of parental permission to apply TO/S/R, such as sunscreen or insect repellant:

Explain here:  If a parents has forgotten their supply of sunscreen or insect repellent or a child has run out, we will make a call to any parent who has not signed the consent form at the beginning of enrollment to apply the school stock brands.     

 

Patient-Specific Epinephrine Auto-Injectors, Diphenhydramine in Combination with the Epinephrine AutoInjector, Asthma Inhalers and Nebulizers.

Staff NOT authorized to administer medications may administer emergency care through the use of patient-specific epinephrine auto-injector devices, diphenhydramine when prescribed for use in combination with the epinephrine auto-injector, asthma inhalers or nebulizers, when necessary to prevent or treat anaphylaxis or breathing difficulty for an individual child, when the parent and the child’s health care provider have indicated such treatment is appropriate.

In addition, the program will obtain the following:

A written Individual Health Care Plan for a Child with Special Health Care Needs, OCFS-LDSS-7006 must be submitted to meet this requirement.

(See Section 2: Children with Special Health Care Needs.)

Form OCFS-6029, Individual Allergy and Anaphylaxis Emergency Plan for children with a known allergy, and the information on the child's OCFS-LDSS-0792, Day Care Enrollment (Blue Card).

An order from the child’s health care provider to administer the emergency medication including a prescription for the medication. The OCFS Medication Consent Form (Child Day Care Program), OCFSLDSS7002 may be used to meet this requirement.

Written permission from the parent to administer the emergency medication as prescribed by the child’s health care provider. The OCFS Medication Consent Form (Child Day Care Program), OCFSLDSS7002 may be used to meet the requirement.

Instruction on the use and administration of the emergency medication that has been provided by the child’s parent, child’s health care professional or a healthcare consultant.

Additionally:

Staff who have been instructed on the use of the epinephrine auto-injector, diphenhydramine, asthma medication or nebulizer must be present during all hours the child with the potential emergency condition is in care and must be listed on the child’s Individual Health Care Plan.

The staff administering the epinephrine auto-injector, diphenhydramine, asthma medication or nebulizer must be at least 18-years old, unless the administrant is the parent of the child.

Staff must immediately contact 911 after administering epinephrine.

If an inhaler or nebulizer for asthma is administered, staff must call 911 if the child’s breathing does not return to normal after its use.

Storage, documentation of administration of medication and labeling of the epinephrine auto-injector, asthma inhaler and asthma nebulizer must be in compliance with all appropriate regulations.

Explain where these will be stored: In a bin sealed and labeled “Medications” in the pantry near the bathroom on a high shelf with each child’s medications in a ziplock baggie with their first and last names on them. When travelling outdoors we will take these in the Emergency Backpack. 

School-Age Children Exemptions for Carrying and Administering Medication

When a program has agreed to administer an inhaler to a child with asthma or other diagnosed respiratory condition, or a patient-specific epinephrine auto-injector for anaphylaxis, a school-age child may carry and use these devices during daycare hours if the program secures written permission of such use of a duly authorized health care provider or licensed prescriber, and written parental consent, and completes an Individual Health Care Plan for the child.

The Individual Health Care Plan, parental consent and health care provider or licensed prescriber consent documenting permission for a school-age child to carry an inhaler or patient-specific epinephrine autoinjector must be maintained on file by the program.

Sections 10-12 must be completed ONLY if the program plans to administer over the counter topical ointments, lotions and creams, and sprays, including sunscreen products and topically applied insect repellant and/or patient specific epinephrine auto injector, diphenhydramine in combination with the patient specific epinephrine auto injector, asthma inhalers and nebulizers, and NOT administer any other medication.

Section 10:  Confidentiality Statement

Information about any child in the program is confidential and will not be given to anyone except OCFS, its designees or other persons authorized by law.

Health information about any child in the program can be given to the social services district upon request if the child receives a day care subsidy or if the child has been named in a report of suspected child abuse or maltreatment or as otherwise allowed by law.

Section 11:  Americans with Disabilities Act (ADA) Statement

The program will comply with the provisions of the Americans with Disabilities Act.  If any child enrolled in the program now or in the future is identified as having a disability covered under the Americans with Disabilities Act, the program will assess the ability of the program to meet the needs of the child.  If the program can meet the needs of the child without making a fundamental alteration to the program and the child will need regular or emergency medication, the program will follow the steps required to have the program approved to administer medication.

Section 12:  Licensee Statement

It is the program's responsibility to follow the health care plan and all day care regulations.

OCFS must review and approve the health care plan as part of the licensing process.  OCFS must review and approve any changes or revisions to the health care plan before the program can implement the changes.

The program's health care plan will be given to parents at admission and whenever changes are made, and the health care plan will be made available to the parents upon request.

The program's anaphylaxis policy will be reviewed annually, and parents will be notified of the policy at admission and annually after that.

 

Section 22: Training

All child day care personnel must be trained in the program’s Health Care Plan and policies

including a training program for child day care personnel in screening and identification of children with allergies, how to prevent, recognize and respond to food and other allergic reactions and anaphylaxis, strategies to reduce risk of exposure to allergic triggers, how the program will handle anaphylaxis episodes.

Staff/volunteers will be trained in the following method(s) (check all that apply; at least one MUST be selected):

 ✔Orientation upon hire

 Staff meetings

 Scheduled professional development.

Communication plan for intake and dissemination of information among staff and volunteers regarding children with food or other allergies (including risk reduction) will include

(check all that apply; at least one MUST be selected):

✔Posting in program

✔Staff meetings

Other

Explain here:      

 

The program will routinely monitor to ensure new staff/volunteers are receiving the training outlined above in the following manner (check all that apply; at least one MUST be selected):

✔File review

✔Staff meetings

Other

Explain here:     

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