414-305-1010 Illness (1) A certified child care center must observe and monitor each child upon their arrival at the center and throughout the hours of care for symptoms of an illness and obvious signs of infestation or physical injuries. (a) A child's temperature is taken when there is a concern. (b) A child's temperature is not taken rectally at any age. (c) Mercury and glass thermometers are not used. (2) A certified child care center must not accept a child into care who: (a) Is diagnosed as having or being a carrier of a child care restrictable disease, as defined in Oregon Health Authority administrative rules, except with the written approval of the public health administrator or licensed health care provider; or (b) Has one or more of the following symptoms of illness, except with the written approval of the public health administrator or licensed health care provider: (A) Fever over 100.4°F. A child with a fever over 100.4°F may return if fever free for 24 hours without the aid of medication. (B) “Diarrhea”, which means three or more watery, bloody, or loose stools in 24 hours, the sudden onset of loose stools, or a child is unable to control bowel function when previously able. A child with diarrhea may return 48 hours after diarrhea resolves or with written clearance from a licensed healthcare provider. (C) Vomiting at least one time, where there is no explanation for the vomiting. A child who vomits without explanation may return 48 hours after the last episode of vomiting or with written clearance from a licensed healthcare provider. (D) Severe or persistent coughing. A child with severe or persistent coughing may return after symptoms are improving for 24 hours or with written clearance from a licensed healthcare provider. (E) Unusual yellow color to skin or eyes. A child with unusual yellow color to skin or eyes may return to care with written clearance from a licensed healthcare provider. (F) Open sores or wounds discharging bodily fluids. A child with open sores or wounds discharging bodily fluids may return to care after rash is resolved, when sores and wounds are dry or can be completely covered with a bandage, or with written clearance from a licensed health care provider. (G) Stiff neck and headache with one or more of the symptoms listed above; (H) Uncharacteristic lethargy, decreased alertness, increased irritability, increased confusion, or a behavior change that prevents active participation in usual school activities. A child with any of the above symptoms may return to care when symptoms resolve, return to normal behavior, or with written clearance from a licensed health care provider. (I) Difficulty breathing or abnormal wheezing. A child with difficulty breathing or abnormal wheezing may return to care after symptoms are improving for 24 hours. (J) Complaints of severe pain. A child with complaints of severe pain may return to care after symptoms are improving. (K) Eye lesions that are severe, weeping, or pus filled. A child with eye lesions that are severe, weeping, or pus filled may return to care after symptoms resolve or with written clearance from a licensed healthcare provider. (3) If a child who has been admitted into care shows signs of illness, as described in this rule, a certified child care center must: (a) Separate the child from the other children in a location where the child can be seen and heard by staff and carefully observed at all times. (b) Notify the parent to remove the child from the center as soon as possible. (c) Until the parent arrives, provide the child with an individual cot, mat, or bed that can be easily cleaned and disinfected after use. (d) Give extra attention to handwashing and sanitation including cleaning and disinfecting toys, equipment, and surfaces used by the ill child immediately after the child leaves. (e) Keep disposable items and used linens in a closed container in the isolation area until cleaned or thrown away. (4) If any child, staff member or volunteer has a restrictable disease, as defined in Oregon Health Authority, Public Health Division Chapter 333, Division 19 Investigation and Control of Diseases: General Powers And Responsibilities, a certified child care center must: (a) Immediately report the incident or illness to the local health department; (b) Follow the health department’s recommendations on exclusion and readmission of children and staff; and (c) Post a notice for the parents of all children who attend the center. (5) A certified child care center must develop a written care plan at the time of enrollment, or when an allergy is identified, for each enrolled child who has an allergy that poses a threat to the child’s health, safety and wellbeing. The plan must include instructions regarding the allergen and steps to be taken to avoid the allergen; signs and symptoms of an allergic reaction; and a detailed treatment plan including the names, doses, and methods of prompt administration of any medication in response to allergic reactions. In addition: (a) The parent must be notified immediately of any suspected allergic reactions or if the child consumed or came in contact with the allergen, even if a reaction did not occur; (b) If epinephrine is administered, emergency medical services must be contacted immediately, and, Office of Child Care must be notified within 24 hours; (c) All staff involved in care of the child must be trained on the written care plan; (d) Specific food allergies must be shared with all staff that prepare and serve food; and (e) A list of each child’s allergies should be easily accessible for staff but not visible to those who are not parents or guardians of the enrolled child. Statutory/Other Authority: ORS 329A.260 Statutes/Other Implemented: ORS 329A.260 History: ELD 10-2023, adopt filed 06/28/2023, effective 01/01/2024