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How Child Care Providers May Prevent the Spread of Disease

Child care providers play an integral role in keeping children healthy. There are important steps you must take to control the spread of germs in your program.

  • Notify parents at the beginning of the school year that they must report absences within 24 hours for any disease or condition that may be a danger to the health of other children.

  • Maintain a daily attendance record for all children.

  • Call parents of child(ren) who are unexpectedly absent for three consecutive days.

  • Conduct a daily health inspection of each child to look for signs and symptoms of illness.

  • Move ill child(ren) into a separate area where they can be supervised until parents pick up the child(ren).

  • Report to the NYC Health Department suspected or confirmed cases of diseases and conditions occurring in children or staff. Specifically, providers must report:
    • One or more cases of a reportable disease or condition; and

    • Three or more cases of any disease/condition

  • Train staff in proper hand washing practices, and ensure children practice good hand washing. Hand washing is the single most effective and important procedure in controlling the spread of disease. All staff and children should practice good hand washing habits:

    • After toileting or diapering
    • Before handling food or dishes
    • Before and after eating
    • After blowing and wiping nose
    • After coming in from outdoors
    • Whenever visibly soiled
    • After handling toys a child had in his/her mouth
    • After handling pets and litter
    • Before staff moves to a new group

  • Prominently display hand washing posters in lavatories and near sinks.

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What Conditions Should Child Care Providers Report to the NYC Health Department and How

For a list of diseases that commonly occur in children, how to recognize the symptoms and the actions the child care provider should take (including notifying DOHMH and whether to restrict the child’s attendance), please see the Disease Chart for Child Care Providers (PDF).
To report the occurrence of a suspected or confirmed case of a reportable disease or condition, and three or more cases of any disease or condition, call the Bureau of Child Care borough office.

Diseases and conditions
that must be reported to DOHMH include:

• Amebiasis
• Campylobacteriosis
• Cryptosporidiosis
• Cyclosporiasis
• Diphtheria
Escherichia coli O157:H7and other Shiga toxin producing bacteria
• Food Poisoning
• Giardiasis
Haemophilus influenza type b
• Hepatitis A
• Measles
• Meningitis (viral or bacterial)

• Meningococcal disease, invasive
• Mumps
• Pertussis (Whooping cough)
• Poliomyelitis (Polio)
• Rubella
• Salmonellosis
• Shigellosis
• Tetanus
• +TB test (+PPD skin test or +blood test)
• Typhoid fever
• Yersiniosis

For a complete list of all reportable diseases and conditions, and phone numbers for reporting after business hours (e.g., overnight, weekends and holidays) please visit Reporting of Communicable Diseases Page.

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Guidance for Child Care Centers on Commonly Occurring Diseases and Conditions

Bed Bugs

There is no need to exclude a child from the program, nor does the child need to see a physician when there are bed bugs in the home. This is NOT a communicable disease. Staff and the parent/guardian should check the child’s clothes upon arrival. A child’s clothes may be kept in a separate plastic bag during the day if a bed bug is discovered.

If the center has bedbugs, an exterminator must be hired and families must be informed. In a private home, exterminating is the responsibility of the home owner, and in public housing, the problem should be reported to 311. In a private apartment building, the tenants must approach the superintendent to hire an accredited exterminator.

Learn more about how bed bugs thrive, how to recognize and inspect for their presence, steps to take to prevent infestation, how to safely eliminate bed bugs if they do occur, and also how to select and work with a pest management professional.

Head Lice

Children who have lice are to be excluded from child care for 24 hours after being treated with the medicated shampoo that is recommended for lice removal and all nits (eggs) are removed from the hair. The removal of the nits is a tedious process, since it has a "gluey hold" to the hair shaft. This process is the responsibility of the parent. When a medical provider sends a student back with a "clearance", the child can still be sent home if the family has not complied with the "nit-free" policy of the Bureau of Child Care. Staff at the child care center should check the child's head to see that the child is "nit-free" before readmission to the program. Physicians sometimes advise parents that the shampoo process is sufficient. A note from a physician is not a requirement for a child who has lice to return to child care. Physicians may not want a child with lice in their office or clinic and do not routinely check heads for a "clearance.”

Note: The Department of Education policy for school-age children, which states a child only needs to be “lice free,” is different from the Health Department’s readmission policy to child care.

Learn more about how to recognize and treat head lice.

Influenza (Seasonal Flu)

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Other Resources

Hand Washing Posters: