Health Manager Orientation Guide

Exclusion for Illness

Sick little girl being attended to by a woman.A clear written policy for when children should stay home or go home due to illness helps families understand when they should keep their child home. The illness policy should be up to date and include guidelines for when the child can return. Telling families in their preferred languages about the program’s written illness policy, and making sure staff understand the policy and how to apply it, are effective ways to keep programs safe.

Consistently enforcing the illness policy will help reduce conflicts. According to CFOC, most illnesses are mild and do not require exclusion. Health managers can consider how children may miss out on the benefits of Head Start programming and how their families might miss work or school if they stay home unnecessarily.

If any of these occur, the child should stay home, regardless of the type of illness. Head Start programs must also follow any local public health orders and licensing laws about exclusion for illness, including during epidemics and pandemics.

A child should stay home if:

  • They don’t feel well enough to take part comfortably in routine activities.
  • They need more care than staff members can give without compromising the health and safety of other children.
  • They risk spreading a harmful disease.

Fever by itself is not an illness, but it may be a symptom of an illness. Fevers are most often in response to an infection or illness. But overheating or a vaccination also can cause fevers. So, fever alone is usually not enough reason to exclude a child. If a child has a fever, programs can look for other symptoms of infection or illness such as behavior changes, rash, or cough, before excluding them. But in epidemic or pandemic health emergencies, a fever alone may be a reason to exclude someone.

Giving fever-reducing medication to an ill child will bring a fever down temporarily. It does not make the cause of the fever go away. Encourage families to talk with their child’s health care provider before using a fever-reducing medication.

If a child becomes ill during the day, programs should ask their family to pick them up as soon as possible. While waiting, staff should care for and supervise the child away from other children. They should also make the child as comfortable as possible and continue to watch for symptoms. After the child leaves, staff can then clean and disinfect toys and equipment the child has used and wash hands properly.

Children who have been excluded because of illness may need an in-person visit with a health care provider or a note to return to the program. The local health department can give information on whether clearance from a health care provider is needed.

Classroom staff should stay home if:

  • Their illness limits their ability to teach and care for children.
  • Their illness poses a risk of spreading a harmful disease. See CFOC for a list of staff conditions that could compromise the health and safety of children.

Tips and Strategies Related to Exclusion for Illness

  • Make your illness policy part of your orientation for staff and families. Make sure this policy is in handbooks for staff and parents.
  • Reinforce your illness policy by using social media, email, newsletters, bulletin boards, websites, and other communications channels.
  • Train staff on your illness policy and how to talk to families about the policy.
  • Tell families when their child may have been exposed to an infectious disease so they can watch for symptoms.
  • Ask families to report illnesses even if they keep their child at home.
  • Encourage families to have a backup plan for when their child can’t attend your Head Start program because of illness.
  • Keep family emergency contact information up to date.
  • Plan for substitutes for staff who cannot work because of illness. Staff may experience more illnesses during the first year in the classroom. The frequency of illness usually decreases as adults develop immunity to the illnesses.
  • Encourage general health promotion and wellness for families and staff in their preferred languages to reduce the number and severity of illnesses (e.g., get enough sleep, exercise, eat nutritious food, and manage stress).