Missouri Code of State Regulations › Title 19 - DEPARTMENT OF HEALTH AND SENIOR SERVICES › Division 30 - Division of Regulation and Licensure › Chapter 62 - Licensing Rules for Group Child Care Homes and Child Care Centers › Section 19 CSR 30-62.192 - Health Care

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This rule sets forth the requirements for
				  reporting communicable diseases, caring for a child when ill, medication,
				  emergency care and handwashing.
(1) General Requirements. The provider shall
				report to the local health department if any child in the facility is suspected
				of having a reportable disease as defined by section
				210.003,
				RSMo. In the event of an outbreak of communicable disease in the facility,
				care-givers shall implement control measures recommended by a local state
				health authority as required by the department.
(2) The Ill Child.
(A) Each child shall be observed for
				contagious diseases and for other signs of illness on arrival and throughout
				the day.
(B) Each child's parent(s)
				shall be notified immediately when any contagious disease occurs in the
				facility.
(C) Unusual behavior
				shall be monitored closely and parent(s) shall be contacted if the behavior
				continues or if other symptoms develop. These behaviors include, but shall not
				be limited to:
1. Is cranky or less active
				than usual;
2. Cries more than
				usual;
3. Feels general discomfort
				or seems unwell; or
4. Has loss of
				appetite.
(D) The
				parent(s) or his/her designee shall be contacted when signs of illness are
				observed. Unless determined otherwise by the parent(s) or provider, a child
				with no more than one (1) of the following symptoms may remain in care:
1. A child with a temperature of up to one
				hundred degrees Fahrenheit (100oF) by mouth or
				ninety-nine degrees Fahrenheit (99oF) under the
				arm;
2. After an illness has been
				evaluated by a physician, medication has been prescribed and any period of
				contagion has passed as determined by a licensed physician;
3. When it has been determined that a child
				has a common cold unless the director and the parent(s) agree that isolation
				precautions should be taken;
4.
				When a child has vomited once with no further vomiting episodes, other
				symptoms, or both; or
5. When a
				child has experienced loose stools only one (1) time with no further problems
				or symptoms.
(E) If
				children exhibit any of the following symptoms, they must be sent home:
1. Diarrhea-more than one (1) abnormally
				loose stool. If a child has one (1) loose stool, s/he shall be observed for
				additional loose stools or other symptoms;
2. Severe coughing-if the child gets red or
				blue in the face or makes high-pitched croupy or whooping sounds after
				coughing;
3. Difficult or rapid
				breathing (especially important in infants under six (6) months);
4. Yellowish skin or eyes;
5. Pinkeye-tears, redness of eyelid lining,
				irritation, followed by swelling or discharge of pus;
6. Unusual spots or rashes;
7. Sore throat or trouble
				swallowing;
8. An infected skin
				patch(es)-crusty, bright yellow, dry or gummy areas of the skin;
9. Unusually dark, tea-colored
				urine;
10. Grey or white
				stool;
11. Fever over one hundred
				degrees Fahrenheit (100oF) by mouth or ninety-nine
				degrees Fahrenheit (99oF) under the arm;
12. Headache and stiff neck;
13. Vomiting more than once; and
14. Severe itching of the body or scalp, or
				scratching of the scalp. These may be symptoms of lice or scabies.
(F) Parental contact and the
				decision made shall be recorded and filed in the child's record.
(G) The ill child shall be kept isolated from
				the other children until the parent(s) arrives.
(H) The caregiver shall be in close proximity
				to the child until the parent(s) arrives. Close proximity means that a
				caregiver is close enough to hear any sounds a child might make that would
				indicate a need for assistance.