Louisiana Administrative Code › Title 51 - PUBLIC HEALTH-SANITARY CODE › Part XXI - Day Care Centers and Residential Facilities › Chapter 3 - Child Day Care Centers › Section XXI-301 - General Standards [formerly paragraph 21:010]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Written policies and procedures regarding
				infection control practices and disease prevention shall be developed by each
				center which include the following.
1.
				[Formerly paragraph 21:010-1] Staff and children shall wash their hands at
				least at the following times: upon entering the center, before preparing or
				serving meals, after toileting or changing diapers, before and after eating
				meals or snacks, and anytime hands become soiled with body fluids (urine,
				stool, saliva, blood, nasal discharge).
2. [Formerly paragraph 21:010-2] Procedures
				shall ensure that staff teach use of running water, soap, and single use of
				disposable towels. Hands shall be washed and scrubbed for at least 10 seconds
				with soap and running water. Warm running water in sinks is required.
3. [Formerly paragraph 21:010-3] Weekly
				monitoring by the center director shall ensure that handwashing and cleaning
				procedures are followed as specified in the center's plan.
4. [Formerly paragraph 21:010-4] Noses shall
				be blown or wiped with disposable, one-use tissues that are discarded in a
				plastic-lined and covered garbage container.
5. [Formerly paragraph 21:010-5] Draining or
				oozing cuts or sores shall be covered.
6. [Formerly paragraph 21:010-6] Child care
				personnel shall adopt routine procedures for handling blood and
				blood-containing fluids and wound exudates of all children in the center.
a. For spills of vomitus, urine, and feces,
				floors, walls, bathrooms, table tops, toys, kitchen counter tops, and
				diaper-changing tables shall be cleaned and disinfected.
b. For spills of blood or blood-containing
				body fluids and injury and tissue discharges, the area shall be cleaned and
				disinfected. Gloves shall be used in these situations unless the amount of
				blood or body fluid is so small that it can easily be contained by the material
				used for cleaning.
c. Persons
				involved in cleaning contaminated surfaces avoid exposure of open skin sores or
				mucous membranes to blood or blood-containing body fluids and injury or tissue
				discharges by using gloves to protect hands when cleaning contaminated
				surfaces.
d. Mops shall be cleaned,
				rinsed in sanitizing solution and then wrung as dry as possible and hung to
				dry.
e. Blood-contaminated material
				and diapers shall be disposed of in a plastic bag with a secure tie.
7. [Formerly paragraph 21:010-7]
				The day care center director shall exclude from care any child with the
				following illnesses or symptoms based on potential contagiousness of the
				disease. Periods may be extended beyond this depending upon individual
				conditions.
Illness/Symptom
Exclude Until
Meningococcal disease (
Neisseria
							 meningitis
)
Well and proof of
							 non-carriage1
Hib disease (
Haemophilus influenza
)
Well and proof of
							 non-carriage1
Diarrhea (two or more loose stool, or over and above
							 what is normal for that child)
Diarrhea resolved or is controlled (contained in
							 diaper or toilet)
Fever of unknown origin (100°F oral or 101 rectal or
							 higher) and some behavioral signs of illness
Fever resolved or cleared by child's
							 physician/health department
Chicken pox
Skin lesions (blisters) all scabbed over
Hepatitis A
One week after illness started and fever resolved
AIDS (or HIV infection)
Until child's health, neurologic development,
							 behavior, and immune status is deemed appropriate (on a case-by-case basis) by
							 qualified persons, including the child's physician2
							 chosen by the child's parent, guardian and the center director
Undiagnosed generalized rash
Well or cleared by child's physician as
							 non-contagious
Any child with a sudden onset of vomiting,
							 irritability or excessive sleepiness
Evaluated and cleared by child's physician
a.
											1Proof of non-carriage: Either by completion of
				appropriate drug regimen of Rifampin (two-day course for Meningococcal disease
				or four-day course for Hib disease) or by a negative throat culture obtained
				after completion of treatment for meningitis.
b.
											2These persons
				should include the child's physician and other qualified individuals such as
				the center director, a representative from the Office of Public Health, and a
				child development specialist, and should be able to evaluate whether the child
				will receive optimal care in the specific program being considered and whether
				an HIV-infected child poses a potential threat to others.
c. With most other illnesses, children have
				either already exposed others before becoming obviously ill (e.g., colds) or
				are not contagious one day after beginning treatment (e.g., strep throat,
				conjunctivitis, impetigo, ringworm, parasites, head lice, and scabies). The
				waiting periods required after the onset of treatment vary with the disease.
				Check with your local health department for information on specific diseases.
				Children who are chronic carriers of viral illnesses such as cytomegalovirus
				(CMV) and Herpes simplex can and should be admitted to day care
				centers.
d. The parent or
				designated person shall be notified as soon as possible if a child develops
				symptoms of illness or suffers an accident while in care.
8. [Formerly paragraph 21:010-8] Guidelines
				shall be developed regarding biting behavior, treatment of bites, and
				notification to parents of the children (if injury requires first aid or
				medical attention).
9. [Formerly
				paragraph 21:010-9] Each child care employee shall receive a total of three
				hours of training per year on infectious diseases, health and safety, and/or
				food service preparation. Whenever possible, this training should be provided
				during regular working hours.