Lower Columbia College Head Start/EHS/ECEAP Health Table of Contents
1. Communicable Diseases a. Temporary Exclusion Due to Short-Term Illness or Injury Policy and Procedure (Also Includes Reportable Communicable Diseases) (Revised 05/2020) b. Head Lice Information and Policy (English/Spanish) (Revised 08/02) c. Head Lice Parent/Guardian Letter (English/Spanish) (Revised 06/14) d. Daily Health Checks & Observations Policy & Procedure (Revised 07/18) e. Communicable Disease Board List (Revised 04/2020) f. Exposures and Exposure Notices Procedure (Revised 04/2020) g. COVID-19 Operating Plan & Supplemental Health Guidance (Eng./Sp.) (R: 08/2021) h. Parent Statement of Understanding – COVID-19 Operating Plan & Supplemental Health Guidance (English/Spanish) (Revised: 08/2021)
2. Emergency Procedures & Classroom Postings a. Child Health and Safety Policy and Procedure (Revised 05/10) b. Emergency Procedures for Accidents or Critically Ill Children (Revised 08/18) c. Emergency Care in Case of a Seizure (Revised 06/2021) d. Reference & Handout for When a Child has Experienced a Bump to the Head (English/Spanish) (Revised 05/10) e. Health/Nutrition Postings Procedure (Revised 08/18) f. Classroom Emergency Supplies & Postings Proc. (LCC East & West Ctrs.) (R: 08/02) g. Bee Sting & Bee Sting Allergy Procedure (Revised 10/2020) h. Earthquake Preparedness Procedure (Revised 02/2020) i. Fire Drill Preparedness Procedure (Revised 02/2020) j. Fire Safety and Emergency Drills Record (DCYF) (Revised 01/2020)
3. First Aid Kits a. First Aid Kits Policy (Revised 07/18) b. First Aid Supplies List (Revised 08/21) c. Care of a Human Bite Procedure (Revised 06/19) d. Health Supply Request Form (Revised 04/21)
4. Hygiene a. Hygiene Policy (Revised 07/18) b. Handling of Body Fluids Procedure (Revised 08/15) c. Diaper/Pull-Up Changing Procedure (Revised 02/2020) c1. Diaper/Pull-Up Offer Form (Revised 07/20) d. Monthly Bleach Log – Food Prep/Surface Sanitizing (Revised: 08/15) d1. Monthly Bleach Log – Diapering/Bloodborne/Disinfecting (Revised: 08/15) e. Bleach Solution Ratios (Created: 08/15) f. EHS Cleaning and Sanitizing Record – LEHSP (Revised 12/2020) g. EHS Daily Cleaning and Sanitizing of Mouthed Toys – LEHSP (Created 12/2020)
5. Medication Administration a. Medication Policy and Procedure (Revised 07/18) b. Medication Checklist (Revised 06/19) c. Medication Authorization Form (English & Spanish) (Revised 08/15) d. Medication Administration Form (Revised 06/16)
6. Parent/Guardian Assistance for Student Health Services a. Parent/Guardian Assistance for Student Health Services Policy (Revised 07/18)
1 (Revised 08/2021) b. Determination Instructions for Program Pay of Student Physical Exams or Medical Services (Revised 06/14) c. Determination Instructions for Program Pay of Student Dental Exams (Revised 06/14) d. Procedure for FREE Vision Care for Qualifying Children (Revised 02/17)
7. Posted Emergency Evacuation Routes a. Emergency Evacuation and Safety Policy (Revised 07/18) a1. Disaster and Emergency Preparedness Training Acknowledgement (Created 08/16) b. Barnes Center Fire Drill – Evacuation Procedure (Revised 09/19) bb. Emergency Evacuation Procedure – Memorial Park Center (Revised 01/17) c. Barnes Center Diagram for Emergency Evacuation (Revised 07/18) cc. Memorial Park Center Diagram for Emergency Evacuation (Revised 01/17) d. Broadway Center – Room #13 Fire Drill – Evacuation Procedure (Revised 06/16) dd. LVSD/Annex Building Fire Drill – Evacuation Procedure (Revised 04/13) dd1. LVSD/Annex Building Diagram for Emergency Evacuation (Revised 03/19) e. Broadway Center Diagram for Emergency Evacuation Room #13 (Revised 06/16) ee. LCC West Annex Diagram for Emergency Evacuation (Created 07/11) f. Broadway Center – Room #14 Fire Drill – Evacuation Proc. (Eng./Sp.) (R: 06/16) ff. LCC West Annex Fire Drill – Evacuation Procedure (Created 08/11) g. Broadway Center Diagram for Emergency Evacuation Room #14 (Revised 06/16) gg. Catlin Center Diagram for Emergency Evacuation (Created 09/12) h. Broadway Center – Room #15 Fire Drill – Evacuation Procedure (Revised 06/16) hh. Catlin Center Fire Drill – Evacuation Procedure (Created 09/12) i. Broadway Center Diagram for Emergency Evacuation Room #15 (Revised 06/16) j. Castle Rock Center Fire Drill – Evacuation Procedure (Eng./Sp.) (Revised 10/15) k. Castle Rock Center Diagram for Emergency Evacuation (Revised 10/15) l. Broadway Center – Room #16 Fire Drill – Evacuation Procedure (Created 09/09) m. Broadway Center Diagram for Emergency Evacuation Room #16 (Created 09/09) n. LCC East Center Fire Drill – Evacuation Procedure (Revised 08/11) o. LCC East Center Diagram for Emergency Evacuation (Revised 08/11) p. LCC West Center Fire Drill – Evacuation Procedure (Revised 08/11) q. LCC West Center Diagram for Emergency Evacuation (Revised 08/11) r. Wallace Center Fire Drill – Evacuation Procedure (Revised 09/13) s. Wallace Center Diagram for Emergency Evacuation (Revised 09/13) t. Barnes North Center Fire Drill – Evacuation Procedure (Created 09/19) tt. Barnes North Center Diagram for Emergency Evacuation (Created 09/19) v. Broadway Center – Room #7 Fire Drill – Evacuation Procedure (Revised 08/21) w. Broadway Center Diagram for Emergency Evacuation Room #7 (Revised 08/21) x. Broadway Center – Room #19 Fire Drill – Evacuation Procedure (Revised 05/10) y. Broadway Center Diagram for Emergency Evacuation Room #19 (Created 08/09) z. Broadway Center – Room #18 Fire Drill – Evacuation Procedure (Created 04/10) z1. Broadway Center Diagram for Emergency Evacuation Room #18 (Created 04/10)
8. Special Health Care Needs of Students a. Special Health Care Needs of Students Policy (Revised 05/10) b. Acquired Immune Deficiency Syndrome (AIDS) and Hepatitis C Special Procedures (Revised 06/13) c. Individual Care Plan for Child in Child Care (Created 04/2020)
9. Student Accident Prevention and Reporting a. Injury Prevention Policy (Revised 07/18) b. Procedure for Completing an Accident Report (Revised 06/19) c. Child Accident Report Form (Revised 07/19) d. Bicycle Helmets Outdoors Procedure (Revised 07/18)
2 (Revised 08/2021) e. Safe Infant Sleep Procedure (Revised 06/19) e1. Nap and Quiet Rest Period Procedure for Toddlers (not in a crib) and Preschoolers (Revised 08/17)
10. Student Health Examinations a. Child Health and Developmental Services Policy (Revised 07/18) (See Developmental Screening Procedure in FS/PI/ERSEA Handbook) b. Well-Child Exam Letter (English/Spanish) (Created 04/19) c. Physical Exam Form (Revised 06/14) d. Denial of Consent for Medical Services (English/Spanish) (Revised 06/13) e. Dental Exam Form Cover Letter (Revised 06/14) f. Dental Exam Form (Revised 07/13) g. Denial of Consent for Dental Services (English/Spanish) (Revised 06/13) h. Well Child and Dental Exams Process (Revised 07/21) i. Vacant j. End-of-Year Child Health Summary (English/Spanish) (Revised 04/2020) k. Lead Screening Flyer (English/Spanish) (Created 04/19)
11. Student Health History/Nutrition Intake, Health Follow-Up, Referrals and Treatment a. Health Referral for New or Recurring Concerns Policy and Procedure (Revised 07/18) b. Health History/Nutrition Intake (1-5 years of age) (Revised 11/2020) c. Health History/Nutrition Intake (Returning Children) (Revised 11/2020) d. Health /Nutrition Intake (Birth–12months) (Revised 11/2020) e1. Health Record Request Letter (Revised 04/19) e1a. Request for WCE Records (Revised 04/19) e1b. Request for Dental Records (Revised 04/19) e1c. Request for WIC Records (Revised 04/19) e1d. Food Substitution Request (Revised 04/19) e1e. Request for Cow’s Milk Substitution (Revised 06/2020) e1f. Asthma Action Plan Letter (Revised 04/19) e1g. Specialty Clinic Records Request (Revised 04/19) e1k. Anaphylaxis Plan Letter (Revised 04/19) e1l. Seizure Action Plan Letter (Revised 04/19) e2. Prenatal Health Record Request Letter (Revised 10/18) f. Health Follow-Up Memo (Created 02/18)
12. Student Hearing & Vision Screenings a. Hearing Screening Policy and Procedure (Revised 07/18) b. Vision Screening Policy and Procedure (Revised 07/18) c. Hearing and Vision Screening Form (Revised 04/21) d. Hearing Referral Form (English/Spanish) (Revised 02/2020) e. Vision Referral Form (English/Spanish) (Revised 02/2020) f. Record of Vision Exam (Revised 11/13) g. Screening for Vision & Hearing Concerns in Infants & Toddlers Procedure (R: 06/18) g1. EHS Three-Pronged Approach I. Parent Interview Questions (R: 07/18) g2. EHS Three-Pronged Approach II. Developmental Skills Checklist (Revised 07/18) g3. EHS Three-Pronged Approach III. Observations (R: 07/18) h. EHS Screenings Summary Form (Revised 10/17) i. Otoacoustic Emission (OEA) Screening Procedure (Revised 10/2020) j. EHS SPOT Vision and OAE Hearing Screening Form (Revised 02/2020)
13. Student Immunizations a. Immunization Agreement Procedure (Revised 08/18) b. WDOH Required Vaccinations for Preschool Children (Revised 07/21)
3 (Revised 08/2021) c. Immunization Agreement Form (English/Spanish) (Revised 06/14) d. Immunization Records Requirements (Revised 04/21) e. Vaccine Preventable Diseases (English/Spanish) (Created 07/19)
14. Head Start Oral Health Initiative a. Vacant b. Dental Screening Form (English/Spanish) (Revised 04/21) h. Prenatal Oral Health Form (Revised 04/2020)
15. Early Head Start a. Well Child Exam Forms (EPSDT) b. All About My Day – EHS (Created 04/10) c. EHS Home Safety Checklist (English & Spanish) (Eng. R: 05/2020; Sp. C: 11/2020)
16. Emergency Response Notebook
4 (Revised 08/2021) HLTH 1a LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Temporary Exclusion Due to Short-Term Illness or Injury
POLICY: Our program must temporarily exclude a child with a short-term injury or an acute or short- term contagious illness, that cannot be readily accommodated, from program participation in center- based activities or group experiences, but only for that generally short-term period when keeping the child in care poses a significant risk to the health or safety of the child or anyone in contact with the child.
CONTAGIOUS ILLNESS PROCEDURE: 1. Ill children will be separated from others and cared for in a separate area of the classroom.
2. The parent will be notified to pick up the child as soon as possible, and is expected within the hour.
3. Illness incidents will be recorded in ChildPlus/Family Services.
4. The following communicable diseases will be reported to the Health Specialist by the classroom teacher: Head Lice, Chicken Pox, Scarlet Fever/Strep Throat, Impetigo, Pin Worms, Pink Eye, etc. If in doubt, the illness should be reported.
The Health Specialist is responsible for providing an informational sheet on the diagnosed disease to staff, parents and volunteers of the classroom.
5. The Health Specialist or the informational sheet provided will state whether or not a note from the child’s health care provider is needed prior to re-admittance to the classroom.
The following partial list of Reportable Communicable Diseases includes those sometimes found in child care settings.
Diseases Preventable by Vaccination - Call the Health Department whenever the diseases are suspected: *Chicken Pox *Diphtheria *Hemophilus Influenza Type B (HIB) *Measles (Rubeola, 10-day measles, hard measles) *Mumps *Pertussis (Whooping Cough) *Poliomyelitis (Polio) *Rubella (German Measles, 3-day measles) *Tetanus
Uncommon Illnesses Causing Severe Symptoms *Acquired Immune Deficiency Syndrome (AIDS) *E. Coli *Foodborne or Waterborne Illnesses *Gonorrhea (G.C.) *Hepatitis, Viral (Please report all instances of illness in children and their families, and teachers) *Kawasaki Syndrome *Meningococcal Disease 1 (C: 08/02; R: 05/2020) HLTH 1a *Meningitis *Reye Syndrome *Rheumatic Fever *Salmonellosis *Shigellosis *Tuberculosis (T.B.) *Typhoid Fever *Viral Encephalitis
Common Illnesses Causing Severe Symptoms *Campylobacterisis ("Campy") *Giardiasis *Influenza (Call if more than 10% of day care group -- teachers & students -- out ill.)
6. Infections Most fevers are caused by a new infection. If children eat the right foods and get plenty of rest, they are more able to resist infection and/or to recover more quickly when infection occurs.
The following can indicate an infection: 1. Poor appetite - child may pick at solid foods, eat lightly, want only certain foods, and/or prefer liquids. 2. Child may be irritable and have a bad temper; play activities may diminish; child may be hard to please. 3. Fever – Unless covered by an individual care plan, an ill child must stay at home or be sent home if the ill child has: a. A fever of 100.4 degrees Fahrenheit for children over the age of two months (or 100 degrees Fahrenheit for an infant younger than three months) by any method, and behavior change or other signs and symptoms of illness (including sore throat, earache, headache, rash, vomiting, diarrhea).
Call or see a Doctor within 24 hours if your child is: *Under 3 months of age with fever – call or see a provider right away Age 3-6 months with fever Age 6-24 months with fever that lasts more than 24 hours Any age and experiencing a fever that lasts more than 3 days Experiencing a fever that returns after no fever for being gone more than 24 hours Recent travel outside the country to high risk area Seek care from a provider of any fever occurs in children less than 12 weeks old
Taking aspirin should be avoided because of the association of aspirin with Reyes Syndrome. Acetominophine (Tylenol) may be okay to give to children (read warning on label). If you are concerned for your child, do not hesitate to call or visit your provider as soon as possible.
4. Fatigue - children coming down with an illness show greater fatigue and may require more sleep. When this is a change from a child's normal pattern, it may indicate an illness. 5. Sore throat - this can be minor or could possibly be a streptococcal infection. A child may need to see a doctor, as he/she will need medication to clear up a "strep" infection. 6. Earache and/or discharge from the ear - when there is an earache and/or when blood or pus is seen running from the ear, the child needs medical attention. 2 (C: 08/02; R: 05/2020) HLTH 1a 7. Other indicators are skin color, a rash, itching, change in bowel habit, nasal discharge and obstruction, cough, pain (back, limbs, neck, stomach).
7. Keeping Your Ill Child Home Children with symptoms of communicable disease are likely to spread the disease to others. If your child has been diagnosed with an illness by a health care provider, a “cleared to return to school” note that is signed and dated by the health care provider will be required upon the child’s return to school. Keep your child home if any of the following symptoms are present:
Fever - No child with a fever should be sent to school. If a child has been ill he/she should stay home until he/she has been fever free for at least 24 hours.
Cold - If a child has a bad cold, he/she belongs at home in bed. If a child is experiencing chronic greenish nose discharge, it is advisable to have your child evaluated by a health care provider. Runny noses with no fever may be a little uncomfortable but should be okay. Good personal hygiene is important.
Rash - You should find out what it is. If it's localized and he/she has no temperature and no other symptoms, it's most likely an allergic reaction. A generalized rash, particularly with fever, probably indicates a viral or bacterial illness.
Headache - If it is "splitting" enough to hamper functioning or is accompanied by a fever, child should stay home.
Stomach Ache - Stay home if it's severe enough to limit activity. Contact your child’s health care provider for further guidance.
Vomiting - If there's more than one episode with no apparent explanation, check with your child's primary health care provider. Child may return to school after being symptom free for 24 hours.
Sore Throat - Keep an eye on their symptoms for 24 hours. If white spots are seen or they develop a fever, it may indicate a strep infection and should be checked by a health care provider. If strep is diagnosed, the child cannot return for 24 hours after beginning on medication.
Ear Ache - Sharp pain may indicate an infection. Discharge of fluid in the ear definitely means an infection. See a health care provider as hearing loss may result.
Sores – Open or oozing sores that cannot be adequately covered with a bandage and clothing.
Eyes - Thick mucus or pus draining from the eye or pink eye. Child should be seen by a health care provider. The child may not return until the eyes are clear of infection.
Communicable Skin Infections – Impetigo and scabies: The child may return to school 24-hours after starting antibiotic treatment.
Diarrhea - 3 or more watery stools in a 24-hour period, especially if the child acts or looks ill. Child may return to school after being symptom free for 24 hours.
3 (C: 08/02; R: 05/2020) HLTH 1a 8. Scabies Procedure If scabies is suspected, the child must be seen by their Primary Health Care Provider for diagnosis. If scabies is diagnosed, the health care provider may prescribe medication. The child must have a “cleared to return to school” note signed and dated by the health care provider.
If you have any questions regarding the information stated above or whether or not your child needs to stay home, please call your child's health care provider or Head Start/EHS/ECEAP.
9. Short Term Injury A child with a short-term injury, that cannot be readily accommodated, must be temporarily excluded but only for that generally short-term period when keeping the injured child in care poses a significant risk to the health or safety of the child or anyone in contact with the child. If a temporary exclusion is necessary (ex. child with cast or splint), the Direct Service Team/EHS staff along with the Health Specialist will meet to develop an individual action plan with the child’s parent/guardian. The team will take all the necessary steps to follow all guidance provided by the child’s health care provider.
10. Parent/Guardians Being Prepared Parents need to have an alternative plan for the care of their ill child in order to provide the child with the necessary amount of time to recuperate as well as to prevent exposure to other children within the classroom. If a child has been exposed to a communicable disease, or has an illness, the parent/guardian is to inform the child's teacher. For more detailed information on control of communicable disease in children, contact the Head Start Health Specialist at 360-442-2807 or the Cowlitz County Health Department at 360-414-5599.
4 (C: 08/02; R: 05/2020) HLTH 1b
LOWER COLUMBIA COLLEGE HEAD START/ECEAP Head Lice Information and Policy
THE HEAD LOUSE The fertilized female louse lays her eggs at the base of the hair shaft close to the scalp. The egg is attached firmly to the hair shaft with a cement-like substance, and is called a nit. The egg hatches within one week (7 to 10 days), and reaches maturity in ten days. The mature female can lay 50 to 150 eggs during her lifetime of 30 days.
HEAD LOUSE FACTS 1. Head lice do not fly or jump; they fall and crawl. 2. Head lice are a species specific to people. They do not live on dogs, gerbils, other pets or animals. 3. Head lice do not transmit disease. 4. Head lice are NOT dislodged by water or regular shampooing. 5. Head lice do not like heat or direct sunlight. 6. Head lice are sensitive to cold.
TRANSMITTING THE HEAD LOUSE The head louse is spread from person to person by shared combs, hair brushes, barrettes, scarves, hats, helmets, coats and bedding (including sleeping bags and pillows).
TREATMENT Once head lice and/or nits are found, your health care provider may prescribe a LiceMeister comb, medicated lice shampoo or lice cream rinse. When you use a lice shampoo, FOLLOW DIRECTIONS CAREFULLY. Remember these products are chemicals, not just hair care products. Some shampoos may require repeated applications. Examine and treat all household members (including adults) who have lice or nits. Children cannot return to school until lice have been treated and nits have been removed.
Your child must be cleared by a program staff member (teacher, family advocate or assistant teacher) before returning to class.
OTHER WAYS OF KILLING LICE, i.e. on hats, clothing, bedding, combs, hairbrushes, etc. 1. Clean clothes and bedding by machine washing or drying on the hot cycle. 2. Vacuum floors, carpets, furniture (sofas, chairs, mattresses) and the inside of your car. Dispose of vacuum bag after use. 3. Dry clean items that cannot be laundered - inform cleaners so clothing can be handled separately. Take items to cleaners in plastic bags. 4. Soak combs and brushes in very hot water for 10 minutes. Wash in soap and water, rinse and air dry. 5. Bag clothing that cannot be washed in a plastic bag and place in freezer for 48 hours or seal in a bag for 10 days. 6. Clean smooth surfaces with disinfectant solution to wipe away nits or lice. Put cleaning cloths etc. into disinfectant solution until they can be washed.
(C:05/00;R:08/02 Approved by Policy Council 06/19/00) Head Lice Policy & Information HLTH 1b LOWER COLUMBIA COLLEGE HEAD START/ECEAP Información y Política acerca de los Piojos
EL PIOJO El piojo hembra deposita los huevecillos en la raíz del cabello cerca del cuero cabelludo. Los huevecillos están pegados firmemente en la raíz del cabello con una sustancia como-cemento y se llaman liendres. El huevecillo revienta como en una semana (7 a 10 días), y maduran en diez días. La hembra madura puede llegar a poner entre 50 y 150 huevecillos durante su periodo de vida de 30 días.
INFORMACION SOBRE LOS PIOJOS 1. Los piojos no vuelan o brincan; se caen y caminan. 2. Los piojos son especies específicas de las personas. Ellos no viven en los perros, gerbos, en mascotas o cualquier otro animal. 3. Los piojos no transmiten enfermedades. 4. Los piojos NO se pueden caer con el agua o con lavarse el cabello con champú. 5. A los piojos no les gusta el calor o luz directa del sol. 6. Los piojos son sensibles a lo frió.
COMO SE TRANSMITEN LOS PIOJOS Los piojos se transmiten de persona a persona cuando comparten peines, cepillos para el cabello, pasadores, bufandas, sombreros, cascos, abrigos y cosas de la cama (incluyendo sleeping bags y almohadas).
TRATAMIENTO Una vez que se aya encontrado piojos y/o liendres, su doctor le puede recetar un peine, champú o crema de enjuague para los piojos. Cuando usted use champú para los piojos, SIGA CUIDADOSAMENTE LAS INSTRUCCIONES. Recuerde éstos productos son químicos, no son solamente productos para el cabello. Algunos champús pudieran requerir mas de un tratamiento. Examine y trate a todos los miembros de su familia (incluyendo a los adultos) que tengan piojos o liendres. Los niños no podrán regresar a la escuela hasta que no se hayan tratado los piojos y se les haya quitado las liendres.
A su niño lo tendrá que revisar un miembro del personal (maestra, trabajadora social o la asistente de la maestro) antes de regresar a clases.
OTRAS MANERA DE MATAR A LOS PIOJOS, i.e. en los sombreros, ropa, cosas para la cama, peines, cepillos para el cabello, etc. 1. Lave su ropa y las cosas de la cama en lo más caliente de la lavadora y secadora. 2. Aspire los pisos, alfombras, muebles (sofás, sillas, colchones) y adentro de su carro. Deseche la bolsa de la aspiradora después de usarla. 3. Limpie en seco las cosas que no se puedan lavar. Llévese la ropa a la tintorería en una bolsa de plástico e infórmeles a ellos para que se puedan encargar de su ropa por separado. 4. Remoje los peines y cepillos en agua bien caliente por 10 minutos. Lave con agua y jabón, enjuague y seque al aire libre. 5. Ponga en bolsas de plástico ropa y objetos que no se puedan lavar y congélelos por 48 horas o selle bien las bolsas por 10 días. 6. Limpie bien las superficies con desinfectantes para remover los piojos y las liendres. Ponga los trapos de la limpieza en desinfectantes hasta que los pueda lavar. (C:05/00;R:08/02 Approved by Policy Council 06/19/00) HLTH 1c
Date:
Dear Parent/Guardian:
is being sent home today because we found head lice and/or nits. Lower Columbia College Head Start/EHS/ECEAP requires that students found with head lice and/or nits be removed from school until the hair has been treated and ALL NITS have been removed. Once head lice and/or nits are found, your primary health care provider may prescribe a LiceMeister comb, medicated lice shampoo or lice cream rinse. When you use a lice shampoo, FOLLOW DIRECTIONS CAREFULLY. Remember these products are chemicals, not just hair care products. Some shampoos may require repeated applications. Examine and treat all household members (including adults) who have lice or nits. We recommend you contact your own primary health care provider for proper treatment.
Children returning to school after having been sent home with head lice are to be accompanied by a parent/guardian and checked by their school teacher before re-entering the classroom.
Anyone can get lice, no matter the cleanliness of an individual or family. Enclosed is information that may be beneficial in recognition and treatment of head lice.
If you have any further questions, please call me at: .
Sincerely,
Teacher
Cut Here and Return Bottom Portion to Head Start
I certify that my child: (Print Student's Name) has been treated for head lice according to the policy given to me by my child's teacher.
I used: on: for this treatment. (Product Name) (Date)
Signature of Parent/Guardian Telephone Number (C: 11/97; R: 06/14) Head Lice Letter HLTH 1c
Fecha:
Estimado Padre/Guardián:
Ha sido mandado a la casa hoy porque encontramos piojos y/o liendres. College Head Start/EHS/ECEAP sugiere que los niños con poijos y/o liendres sean removidos de la Escuela hasta que su cabello sea tratado y todas LAS LIENDRES hayan sido removidas. Una ves que los poijos y/o liendres han sido encontrados, su proveedor de cuidado de salud quizás recete un peine LiceMeister, shampoo medicado para los piojos o crema de lavado para los poijos. Cuando use el shampoo para los poijos, SIGA LAS INSIDICACIONES CUIDADOSAMENTE. Recuerde estos productos son químicos, no productos para el cuidado del cabello. Algunos shampoos quizás requieran aplicaciones repetidas. Le recomendamos que contacte a su propio proveedor del cuidado de la salud para el tratamiento.
Los niños que regresen a la Escuela después de que hayan sido mandados a la casa con piojos tienen que ser acompañado(a) por el Padre/Guardián y ser resisado por la maestro(o) de la escuela antes de que entre al salon de clases.
Cualquiera puede adquirir los poijos, no importa la limpieza del individuo o familia. En este sobre esta una información que quizás sea beneficial en el reconocimiento y tratamiento de los poijos.
Si usted tiene cualquier pregunta, por favor llámeme al teléfono: .
Sinceramente,
Maestra(o)
Corte aquí y regrese la porción de abajo a el Head Start
Yo certifico que mi niño(a): (Escriba el nombre del estudiante) ha sido tratado con respecto a los piojos de acuerdo a la póliza que me dio la maestro(o) de mi niño(a).
Yo use: el: para est tratamiento. (Nombre del producto) (Fecha)
Firma del Padre Numero Teléfono (C: 07/02; R: 06/14) HLTH 1d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Daily Health Checks & Observations
Policy Direct Service Team/EHS staff members will observe each child daily to identify any new or recurring medical, dental, or developmental concerns so that they may quickly make appropriate referrals.
Procedure Direct Service Team/EHS staff members will conduct daily health checks on the children as they arrive and again prior to leaving the program for the day. (See Keeping Your Ill Child Home and Contagious Illness Procedures HLTH 1a) Children are also observed throughout the day. These checks and observations are a general overview of the child’s appearance and health status and include the following:
HEAD: lice and/or nits; sores/cuts; bumps/bruises;
EYES: dull/circles under; red, runny, itchy, discharge-clear; discharge-pus, lids swollen and/or red;
EARS: ear ache, discharge-pus(clear), pulling at/digging in, discharge-wax;
NOSE: discharge-clear, discharge-yellow-green, swollen-red nostrils, sneezing;
MOUTH: blisters/bumps/sores, white coating, teeth decayed, missing, appear loose, swelling-lips and/or tongue;
BREATHING: noisy/wheezing, fast, cough/hoarseness, labored (difficulty);
SKIN: dry, chapped, swollen, red skin, rash, burns, bruised/discolored, scratches, feels feverish/temperature, bug/insect bites, teeth bite marks;
STOMACH: vomiting or nausea,;
BOWEL MOVEMENTS: diarrhea-watery or soft stools, constipated-firm stools, diaper rash, or body itch;
BEHAVIOR: frequent mood changes, restless/irritable, fearful, angry, seldom smiles or laughs, inactive/sluggish, clumsy/sits poorly, fussy/cries often;
COMPLAINTS: headache, body itch or suspect communicable disease.
(C: 09/06; R: 07/18) HLTH 1e
Lower Columbia College Head Start/EHS/ECEAP Communicable Disease Board List
Your child has been exposed to Su niño ha estado expuesto a
Chickenpox Varicela
Fifth Disease (Parvovirus B19) Infección con el parvovirus B19 (Quinta Enfermedad)
Hand, Foot & Mouth Disease Enfermedad de mano, pié y boca (MPB)
Head Lice (Pediculosis) Infestación por piojos de la cabeza
Impetigo Impétigo
Influenza (Flu) La Gripe (Flu)
Meningitis Menigitis
Pink Eye (Conjunctivitis) Ojo Rosado (Conjuntivitis)
Ringworm Culebrilla
Roseola Infantum Roseola Infantum
Rotavirus El Rotavirus
Scabies Sarna (Scabies)
Pertussis Tos Ferína
Strep Throat Faringitis Estreptococica
Measles Sarampíon
Corona Virus (COVID-19) Coronavirus
When a child in your classroom has been diagnosed with one of the above, state both the English and Spanish sentences underlined above with the name of the disease (in the appropriate language) on your classroom Communicable Disease board. Staff will notify the Health Specialist by phone or email when a contagious illness exposure occurs and will request an informational handout to be provided to parent/guardian in the appropriate languages. (C: 04/06; R: 04/2020) HLTH 1f
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Exposures and Exposure Notices Procedure
EXPOSURE NOTICES When a child has been diagnosed by a medical professional as having an infectious illness and has been at the center during the period in which the illness is considered contagious, an exposure notice will be sent home to all exposed children. The notice will alert parents of the exposure and give them information about signs and symptoms to watch for that may indicate their child has contracted the illness.
Staff will notify the Health Specialist by phone or email when a contagious illness exposure occurs. Staff will also post communicable disease information on the Communicable Disease Board that pertains to the classroom where the exposure occurred. The communicable disease board should be viewable upon entry to each classroom.
Exposure notices have been developed for the most common childhood illnesses. Contact Health Specialist for copies and keep at least one copy of every exposure notice on file in the classroom to facilitate easy access for copying and distributing.
TEMPORARY EXCLUSION DUE TO ILLNESS Children who have an infectious illness are excluded from classroom participation until the contagious phase of the illness has passed. This period of time will vary depending on the illness. Parents/Guardians receive guidance from their primary care provider as to when their child can return to school. For illnesses listed on HLTH 1e as well as other serious diseases that must be reported to the local Health Department, parent/guardian must provide a clearance note upon child’s return to school that is signed and dated by their child’s healthcare provider. Staff consults with the Health Specialist as needed.
REPORTABLE ILLNESSES LCC Head Start/EHS/ECEAP is required to report some illnesses to the Health Department. The Health Department is required to track potential outbreaks in the community. If an enrolled child has a “reportable” illness, the Health Specialist or the child’s health care provider will report the illness to the Health Department according to school/agency procedures. Refer to Temporary Exclusion Due to Short-Term Illness or Injury policy and procedure (HLTH 1a).
(C: 04/10; R: 04/2020) HLTH 1g
Lower Columbia College Head Start/EHS/ECEAP
COVID-19 Operating Plan & Supplemental Health Guidance
TABLE OF CONTENTS
COVID-19 Exposure Notification Chart …………………………………………………………………………………………………………….2 General Guidance ……………………………………………………………………………………………………………………………………………3 COVID-19 Most Commonly Spreads During Close Contact …....…...…………………….…..……………………………………....3 Drop-Off and Pick-Up ………………………………………………………….……..…..………………...……………………………………………3 Entry Into the Building …………………………………………………………………………….………………….………….….……………….....3 Temperature Checks Upon Entry Into the Building ………………………………………………………………………………………….4 COVID-19 EXPOSURES, CLOSE CONTACTS, SCENERIOS, AND FOLLOW-UP Staff Notification Process for COVID Symptoms and Exposures ………………………………………..…..…………………..…….5 If Someone is Fully Vaccinated …………………………………………………………………………………………………………………………5 When You Have Been Fully Vaccinated …………………………………………………………………………………………………….………5 Returning to Program After Suspected Signs or Symptoms of COVID-19 …………………………………..………………………5 Returning if You Were Potentially Exposed to Someone with COVID-19, Tested Positive/Diagnosed with COVID-19, or not Tested after Exposure to Someone with COVID-19 ………….………………………….……..…..5 Close Contact with Person Being Tested …………………………….………..………………………………………………………………....5 What Is Close Contact …………………………………………………………………………….…………..………………………….……………....6 Suspected COVID-19 When On Site ……………………………………………………………………………………………..………………….6 PROGRAM DAY, CLASSROOM ACTIVITIES & ENVIRONMENT Cohorting: Assigning Children and Staff to Groups ……………………………………………………………………………………..…..7 Physical Distancing in the Classroom ……………………………………………………………………………………………………………….7 Meal Service …………………………………………………………………………….……………………..……………………………...... 7 Playground ………….…………………………………………………………………..……………………….……………………………………..…....8 Waterplay Activities …………………………………………………….……………….……………………………………………...…………..…...8 Toothbrushing ……………………………………………………………………………………………………………………………..……...... …8 Sleep and Nap Time …………………………………………….…………………………………………………………………………………………..8 Diapering/Restroom Use ……………………………………………………………………...………………………………………..…………..….8 Transportation ………………………………………………………………………….…………….……………………………………………….….…8 Ventilation …………………………………………………………………………….…….……………………………………………...... ………8 Children’s Belongings ……………………………………………………..………………………………………………...……………………...……8 Staff Belongings ………………………………………………………….……………………………………….…….…………………………...………9 Staff Required Breaks ………………………………………………………………….……………………………………………..…………………..9 Home Visits ……………………………………………………………………………………………………………………………………………….……9 HYGIENE/FACE MASKS Hygiene Policy …………………………………………………………………………………………………………....……………………………..…10 Hand Sanitizer …………………………………….………………………………….…………………….……………….……………………..………11 Gloves ……………………………………………………………………………………….……………………………….….………………..……………11 Face Masks ……………….………………………………………………….…………………………………………………………………………..….11 Face Masks – Adults ………………………………………………………………………………………………………………………………………12 Face Masks – Children ……………………………………………………………………………………………………………………………………12 How to Put On a Face Mask ……………………………………….…………………………………………………………………………….……13 How to Safely Remove a Face Mask …………………………………..…………………………………………………………………………..13 Face Cloth Care ………….……………………………..…………………………………………………………………………………………………..14 Disposable Face Mask Care …………………………………………………………………………………………………………………………..14 CLEANING, SANITIZING, AND DISINFECTING Washing Toys by Hand …………………………………………………………………………………………………………………………………..14 Washing Toys in Dishwasher ………………………………………………………………………………………………………………………….14 Cleaning Toys ………………………………………………………………………………………………………………………………..………………15 Carpets ……………………………………………………………………………………………………………………………………………………..….15 Laundry …………………………………………………………………………………………………………………………………………………………15 In Case of Exposure ……………………………………………………………………………………………………………………………………….15 1 (C: 04/2020; R: 08/2021)
COMPROMISED IMMUNE SYSTEMS/SPECIAL HEALTH NEEDS Children with Chronic Health Conditions ………………….….…………………………...... ………………………15 Staff with Chronic Health Conditions ………………………….………….…….………….……………………………………………..…….15 Women Who Are Pregnant ………………………………………………..……………….…………….……………….………………..……….15 Caring For Someone with COVID-19 ……………………………………..………………………….……………………………………………16
Lower Columbia College Head Start/EHS/ECEAP COVID-19 Exposure Notification
Health Department
Director
Assistant LCC Emergency Human Vice President Director Operations Team Resources of Instruction
Area Food Service Transportation Other Supervisors Managers Supervisor Manager as Needed
Admin. School Health Policy DCYF DCYF Support District/Building Region X Specialist Council ECEAP Licensor Staff Partners Notify Staff Health Specialist completes COVID-19 intakes and forwards to [email protected] DST and Human Resources. Notify Families (phone and Remind App)
(C: 11/2020)
2 (C: 04/2020; R: 08/2021)
Staff, Parents, and Visitors are to follow the Coronavirus (COVID-19) procedure outlined below while at any of our school sites during Coronavirus season until lifted by program management. This Operating Plan is to be used as supplemental guidance to our existing Health & Safety policies and procedures. This Operating Plan is a working document that may be revised and updated throughout the school year per the Centers for Disease Control (CDC) and Washington’s Department of Health guidance.
GENERAL GUIDANCE LCC cannot allow children, staff, parents/guardians, or guests on site if they: • Show symptoms of COVID-19 as outlined below; AND/OR • Have been in close contact (within six feet for 15 cumulative minutes over a 24-hour period) with someone who has a confirmed case of COVID-19 in the last 14 days. • Have tested positive for COVID-19 in the past 10 days or are awaiting results of a COVID-19 test due to possible exposure or symptoms and not from routine asymptomatic COVID-19 screening or surveillance testing. • Have been told by a public health or medical professional to self-monitor, self-isolate or self- quarantine because of concerns about COVID-19 infection in the last 14 days. We ensure staff are trained in health and safety protocols. This includes: • How to screen for symptoms. • How to maintain physical distance. • The use of appropriate personal protective equipment (PPE) • Understanding and practicing frequent cleaning and handwashing.
COVID-19 MOST COMMONLY SPREADS DURING CLOSE CONTACT • People who are within 6 feet of a person with COVID-19, or have direct contact with that person, are at greatest risk of infection. • When people with COVID-19 cough, sneeze, sing, talk, or breathe, they produce respiratory droplets. o Infections occur mainly through exposure to respiratory droplets when a person is in close contact with someone who has COVID-19. o Respiratory droplets cause infection when they are inhaled or deposited on mucous membranes, nose, mouth, eyes). o As the respiratory droplets travel further from the person with COVID-19, the concentration of these droplets decreases. Larger droplets fall out of the air due to gravity. Smaller droplets and particles spread apart in the air. o With passing time, the amount of infectious virus in respiratory droplets also decreases.
DROP-OFF AND PICK-UP • Drop off and pick-up times should be staggered and physical distancing maintained at entry and exit of the building. • Parents and guardians must wash hands and/or use hand sanitizer before signing their child in and out each day. o Hand sanitizer should be at least 60% alcohol, fragrance-free, and kept out of the reach of children. • If parents have a mask, they are encouraged to wear one at pick up and drop off. o Our program may provide masks for parents as they are available.
ENTRY INTO BUILDING All staff, children, parents, guardians, and volunteers must undergo a health screening and temperature check prior to arriving for work or entering any of our program buildings. Staff must ensure that they review the questions outlined below with parents and guardians and perform a temperature check and 3 (C: 04/2020; R: 08/2021) visual check prior to allowing any child into the building while maintaining physical distance recommendations set by the Centers for Disease Control (CDC) and Washington State Department of Health. If at any time there is a parent or guardian that needs to enter the building to accommodate their child into the classroom, staff will review with that parent or guardian the questions outlined below while also performing a temperature check. Staff, parents, and children must ensure they wash hands per program procedure upon entry and exit of classroom and/or building (See Hygiene Policy/Procedure for guidance on hand washing).
1. Have you had any of the following symptoms within the last day that are not caused by another condition? (If it is the first day after a break or for a new student, ask about the past 3 days). • A fever (100.4 or higher) or chills • Headache • Cough • Recent loss of taste or smell • Shortness of breath or difficulty • Sore throat breathing • Congestion • Fatigue • Nausea or vomiting • Muscle or body aches • Diarrhea 2. If you are not fully vaccinated, have you been in close contact with anyone with COVID-19 in the past 14 days? (Close contact is being within 6 feet for 15 minutes or more over a 24-hour period with a person; or having direct contact with fluids from a person with COVID-19 with or without wearing a mask, i.e. being coughed or sneezed on.) 3. Have you had a positive COVID-19 test for active virus in the past 10 days, or are you waiting results of a COVID-19 test? 4. Within the past 14 days, has a public health or medical professional told you to self-monitor, self- isolate, or self-quarantine because of concerns about COVID-19 infection? If anyone answers “YES” to any of the symptoms or questions outlined above, they should be sent home immediately. Refer to “SUSPECTED COVID-19 CASE WHEN ON SITE” at the end of this procedure for guidance. If anyone answers “NO” to all of the symptoms above, and they have passed a visual inspection and temperature is lower than 100.4, they are then clear to enter the building and/or classrooms.
TEMPERATURE CHECKS UPON ENTRY INTO THE BUILDING Staff assisting with temperature and health checks at entry to the building, must wear a disposable face mask. Face shields are optional. Follow face mask guidelines and make sure to wash hands prior to, and upon completion of health checks. 1. All staff, children, parents, and guardians MUST have their temperatures checked prior to entry into the building. a. When using a NO TOUCH DIGITAL SCAN Thermometer: i. Staff and Visitors will use hand sanitizer, if available. ii. Designated staff must wash their hands and use disposable gloves prior to use of the Digital Scan Thermometer. iii. Follow instructions provided with the Digital Scan Thermometer. 1. Temp to be taken approximately 1 inch away from forehead. iv. Staff is to maintain a safe physical distance when taking temperatures. v. Disinfect thermometer with paper towel sprayed with three step solution or bleach wipe after use.
4 (C: 04/2020; R: 08/2021)
COVID-19 EXPOSURE, CLOSE CONTACT, SCENERIOS AND FOLLOW-UP PROCESS
STAFF NOTIFICATION PROCESS FOR COVID SYMPTOMS AND EXPOSURES If you or a staff member have COVID-19 symptoms or have been notified by a “Close Contact” that is being tested or has a confirmed case*: 1. Isolate: Do not come to work OR leave work if already on site. 2. The employee will notify their Supervisor. 3. The Supervisor will notify the Health Specialist, or the Director when the Health Specialist is not available. 4. The Health Specialist or Director will complete an LCC COVID intake form by directly calling the staff member and will forward the intake form to [email protected] and the Human Resources Director. 5. Human Resources will contact the staff member about their leave options and copy the Supervisor and Director.
IF SOMEONE IS FULLY VACCINATED Review LCC’s Return to Campus Guide for Childcare: https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf
WHEN YOU HAVE BEEN FULLY VACCINATED People are considered fully vaccinated: • Two (2) weeks after their second dose in a 2-dose series, like Pfizer or Moderna vaccines, OR • Two (2) weeks after a single-dose vaccine, like the Johnson & Johnson vaccine
IF it has been less than two weeks since your shot, or if you still need to get your second dose, you are NOT fully protected. Keep taking all prevention steps until you are fully vaccinated.
RETURNING TO PROGRAM AFTER SUSPECTED SIGNS OR SYMPTOMS OF COVID 19 Review LCC Return to Campus Guide for Childcare and Flow Chart: https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf People with severe disease or who are immunocompromised may need to isolate for up to 20 days: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
RETURNING IF YOU WERE POTENTIALLY EXPOSED TO SOMEONE WITH COVID-19, TESTED POSITIVE/DIAGNOSED WITH COVID-19, OR NOT TESTED AFTER EXPOSURE TO SOMEONE WITH COVID-19 Review LCC’s Return to Campus Guide for Childcare: https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf
CLOSE CONTACT WITH PERSON BEING TESTED If a staff or child has had close contact with someone who is being tested (due to possible exposure), they must: • Stay home • *Quarantine until the close contact receives test results. It is recommended that you see or speak with your health care provider.
5 (C: 04/2020; R: 08/2021)
WHAT IS CLOSE CONTACT Per the Centers for Disease Control, close contact is someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from two days before illness onset (for asymptomatic patients- 2 days prior to COVID-19 testing) until the time the patient is isolated.
SUSPECTED COVID-19 CASE WHEN ON SITE If a child or staff arrives to school and is a suspected COVID-19 case, they must be sent home immediately. Staff must report the suspected case to their supervisor and the Health Specialist. If a child becomes ill during the school day and is experiencing signs and symptoms of COVID-19 as outlined above: • They must be placed in a separate room away from others, a “low traffic” area within the building, or a separate corner within the classroom where child can wait for parent/guardian if no other spare area within the building has been established. There must be an assigned staff that will wait with child until parent/guardian pick up. • If possible, the designated room or area should be open to the outside to provide for adequate airflow. • Staff is to follow up with the Health Specialist. • It is especially important that anyone experiencing COVID-19 signs or symptoms isolate themselves right away, even before they are confirmed to have COVID-19, because if you have COVID-19, you are already contagious. If a child is instructed by their health care provider to stay home and self-quarantine or if they are informed that they are a probable coronavirus case, it is essential that they report this information to their child’s classroom teacher or family advocate immediately while also following their health care provider’s plan of care. It is critical that staff support families in providing timely follow-up in order to allow staff time to best support children and all other staff who may have come in contact with the ill child. Supervisors are to keep an illness log of any child who becomes ill with symptoms stated previously, and or those who are suspected or confirmed COVID-19 cases. Supervisors are to ensure that all suspected or confirmed cases are reported to the Health Specialist who must then report the case to the local health department. If a staff member becomes ill during their workday with COVID-19 or is notified by a “close contact” of that person’s positive COVID test results: • They must leave the building and ensure that they notify their supervisor immediately before leaving their work site for the day. • Supervisors will then follow up with the Health Specialist. • Staff showing signs of serious illness must contact their health care provider and follow their provider’s plan of care. • It is especially important that anyone experiencing COVID-19 signs or symptoms isolate themselves right away, even before they are confirmed to have COVID-19, because if you have COVID-19, you are already contagious. If a staff member is instructed by their health care provider to stay home and self-quarantine, or if they are informed that they are a probable coronavirus case, they should report this information to their supervisor immediately while following their health care provider’s plan of care. It is critical to provide timely follow-up in order to allow staff to best support children and all other staff who may have come in contact with this individual. Supervisors are to keep an illness log of any staff member that becomes ill with the symptoms that were stated previously, and or those who are suspected or confirmed COVID-19 cases. Supervisors are to ensure that all suspected or confirmed cases are reported to the Health Specialist who then must follow 6 (C: 04/2020; R: 08/2021) up with contact person within the college. The Health Specialist will then follow up with the department as required.
PROGRAM DAY, CLASSROOM ACTIVITIES, & ENVIRONMENT
COHORTING: ASSIGNING CHILDREN AND STAFF TO GROUPS Keeping children and staff in the same small groups or cohorts every day reduces the number of close contacts they have. Assign children to small groups and try to keep them the same every day to the greatest extent possible. Staff should be assigned to individual groups and should not mix with other groups. Do not mix groups during daily activities and limit combining of groups at the beginning and end of the day to the extent possible. If individuals are mixing within groups, track which groups (children and staff) and the timeframe. Keep group sizes to no more than that which is outlined below. Groups should keep the same staff and the staff-to-child ratios must adhere to the licensing guidelines. Maintaining consistency with outside providers is recommended i.e. School Districts, Consultants, Content Area Specialists, Coaches, Interpreters, Health Coordinator. All individuals specified above must follow the health screening, masking and hygiene procedures as outlined throughout this operating plan.
Age Group Max # of Children Staff:Child Ratio Max # Total People in Group in Group Infants aged 0-11 months 8 1:4 10 --or-- Mixed aged children 0-36 months 9 1:3 12 Toddlers aged 12-29 months 14 1:7 16 --or-- Mixed aged children 12-36 months 15 1:5 18 Preschoolers aged 30 months to 6 20 1:10 22 years, not enrolled in school --or-- Mixed aged children 36 months to 6 years, not enrolled in school
PHYSICAL DISTANCING IN THE CLASSROOM Both DOH and CDC recommend that children and youth be physically distanced by at least three feet or more within groups and in rooms as much as possible. Continue to maintain six feet of distance as much as possible when children are eating and sleeping. Your ability to do this will depend on children’s ages and on their developmental and physical abilities.
MEAL SERVICE Children MUST be monitored when washing hands prior to and after mealtime. Hand washing is critical in preventing the spread of disease. Children will be physically spaced as far apart as possible when seated at the table and will be seated on the same side facing the same direction, if spacing permits. Tables will be spaced at least 6 feet apart. Utilize all learning areas or outdoors if weather permits. Children will no longer serve themselves and/or pass food items at the table. The classroom teacher or support staff will serve children during mealtime and will provide additional servings as needed. Children will be excused from the table after they have completed their meal to wash their hands. It is essential that staff monitor hand washing to ensure children are hand washing with a sufficient amount of soap and water.
7 (C: 04/2020; R: 08/2021)
PLAYGROUND Children do not need to wear face masks while on playground but distancing is encouraged while unmasked. Face shields must be removed when on playground and/or when engaging in physical activity due to safety concerns.
WATERPLAY ACTIVITIES All multi-use water play activities are suspended at this time. Individual water play may occur. Cleaning and rinsing will occur each day between groups of children.
TOOTHBRUSHING Toothbrushing is suspended. Staff will be notified when toothbrushing is to resume as part of the daily classroom routine. Promoting tooth brushing at home at this time is critical in order to help support the importance of dental care and cavity prevention.
SLEEP AND NAP TIME Staff are to follow the current sleep procedure (HLTH 9e & HLTH 9e1) while placing cribs and mats as far apart as possible. Sheets are not to be shared among children and should be cleaned on a weekly basis and more often as needed. Any child who shows signs of COVID-19 or any other illness should have their sheets cleaned at the end of the school day. All sleep equipment (ex. cribs and mats) should be wiped down and sanitized after each use.
DIAPERING/RESTROOM USE Staff must wear gloves when diapering and when applying diaper cream. Children and staff must wear face masks while in restroom. If a child needs assistance in the restroom staff is to assist and exit the restroom when child is no longer needing assistance. Monitoring is important to ensure children are washing their hands thoroughly after restroom use.
TRANSPORTATION Transportation (school bus) may only be available to a very limited number of children in order to allow for physical distancing. Children will be asked to wear a face mask while riding the bus. The bus monitor will complete temperature checks and health screenings prior to allowing any child to board the bus. Children are to be separated as far apart as possible. Seat children with children within their classroom or cohort. Maximize outside air flow and keep windows open when possible and/or between bus runs and cleaning of bus. Seats, hand railings, seat belt buckles, and any other frequently touched surface, must be cleaned between bus routes. *See “CLEANING, SANITIZING, & DISINFECTING” for guidance.
VENTILATION Allowing for adequate airflow within the classroom and building supports the slowing down and/or prevention of airborne diseases, such as COVID-19. Opening the doors at the entrance to the building and/or classroom during pick up and drop off, along with opening classroom windows (while monitoring), will support adequate ventilation into the building throughout the day. Monitoring classroom temperatures is necessary.
CHILDREN’S BELONGINGS It is recommended that children bring as few items from home as possible (ex. backpacks). Families should consider bringing needed Items to school at the beginning of each week rather than back and forth to school each day.
8 (C: 04/2020; R: 08/2021)
STAFF BELONGINGS Consider leaving a change of clothes on site or in your vehicle. Try to keep items brought from home and back to home to a minimum, if possible. Keep purses, bags, and backpacks off the floor and in a cupboard. Be mindful of where you place your purse, bags, and backpack when taken home each day. Wear hair up, off the collar, if possible.
STAFF REQUIRED BREAKS If a substitute is needed in the classroom: o The substitute staff must wash their hands immediately upon entering and upon leaving the space. o The substitute must wear a disposable face covering at all times when in the group space.
HOME VISITS LCC HS/EHS/ECEAP is required by its funding sources to resume in-person visits during the 2021-22 program year. August – December 2021 is considered a “ramp-up period” to resuming full pre-COVID comprehensive services. During the ramp-up period LCC has some options for accommodations. This section provides the current requirements for staff and families including accommodations that staff may offer to families. Preparing for the Home Visit To ensure families understand the COVID procedures, LCC is obligated to follow, staff will review the COVID Operating Plan & Supplemental Health Guidance prior to (or during) the first home visit with each enrolled family (include all members who will be present during home visits to the extent possible). Upon completion of reviewing the guidance, have the parent sign and date the Parent Statement of Understanding. Staff will consider the in-person visit options in the section below with each family to establish where the in-person visit(s) will occur during the ramp-up period. Home Visit – Environment In-person visits are required at this time* and may occur indoors or outdoors. Visits ideally occur at the family home, but may also occur at any LCC HS/EHS/ECEAP program center or another community location accessible to and identified in partnership with the family. Outdoor visits are encouraged while weather permits (patio, porch, lawn, playground, etc.) A virtual visit may be offered if any family member participating in the visit does not pass the COVID Screening Questions prior to each visit beginning. The family can also opt for a rescheduled in-person visit in lieu of a virtual visit. A family with a medically fragile child may be accommodated with continued virtual visits during the ramp-up period. Staff will communicate with their supervisor regarding any family unwilling to resume in-person visits. If the Supervisor and Staff are unable to resolve the barrier to completing in-person visits that must be communicated to the Director who is required to communicate accommodations to the Region X Head Start office. When completing home visits outside, staff can place a blanket, sheet or beach canopy on a lawn or porch. When completing visits inside the home, it is best to situate yourself in an area where there is cross ventilation, such as near an open window or door. While inside or outside of home, staff can use a blanket or sheet to cover a chair, sofa or when sitting on the floor. All staff completing home visits will be supplied with a home visitor kit which includes hygiene items for use during home visits (ex. gloves, hand sanitizer, mask, etc.). It is the responsibility of each staff member to request supplies and replenish their kits when supplies are needed. *If federal, state or local health jurisdictions increase restrictions, the program will follow those restrictions by adjusting program COVID Operating Plan and will communicate those changes with staff and families.
9 (C: 04/2020; R: 08/2021)
COVID Screening Questions Prior to Each Home Visit Staff will review the COVID-19 health screening questions prior to the start of their work day for their own health. Staff with symptoms will not report to work and will communicate with their Supervisor. Prior to the start of each home visit, staff will review the COVID-19 health screening questions with the Parent/Guardian for all members who will be present at the visit. If possible, this can be done by phone or text prior to the in-person visit. Providing each enrolled family with a copy of the COVID-19 health screening questions may help support this process. Staff will use the home visit form to document with whom the screening questions were reviewed, who was present at time of meeting, and if anyone in home was displaying signs or symptoms of illness. This information is important in case an exposure to COVID-19 were to occur at time of home visit. If signs/symptoms of illness begin for any participant during the visit, staff will end the visit, refer to pages 5-7 of this document, and take necessary steps. Handwashing, Hygiene, Face Masks Staff are to wash hands and/or use hand sanitizer at beginning and end of each home visit. Staff will be supplies with hand sanitizer and non-latex gloves to use as needed. Handwashing or the use of hand sanitizer must occur regardless of non-latex glove use. All materials (ex. books, pens, markers, scissors, etc.) used during home visit must be wiped down between home visits. Staff will review the “Hand Hygiene” section within this procedure with each enrolled family to help support the importance of hand hygiene. See the “Hand Hygiene” section within this procedure. Face Masks at the Home – Staff are required to wear face masks during the visit when indoors per state regulations for workers who have contact with unvaccinated children. Staff who prefer to not wear a mask when completing visits outdoors are required to provide vaccination verification to LCC HR prior to beginning that practice. If the family request staff to continue wearing a face mask while visiting outdoors, the staff will comply. All other adults and children ages five and up that are present in home, are encouraged to wear a disposable or cloth face mask when interacting with program staff. See “Face Masks-ADULT’S”, “How to Safely Put on a Face Mask or Cloth Face Covering”, and the “Cloth Face Mask Care” sections within this procedure and follow as it applies to you during a home visit. Face Masks at LCC HS/EHS/ECEAP Centers – Refer to Face Mask section (Adult and Children) within this Operating Plan.
HYGIENE/FACE MASKS
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP HYGIENE POLICY
Policy Our program is committed to the effective implementation of hygiene, sanitation, and disinfection procedures that significantly reduce health risks to children and adults by limiting the spread of germs. Hand Washing/Hygiene Procedure The “Be a Germ Buster, Wash Your Hands “ poster or the Washington Department of Health procedure must be posted in all building bathrooms and at each sink in the classroom. Hand washing is the single best way to reduce or stop the spread of germs that cause a child to be ill, e.g. diarrhea. Staff wash hands regularly and teach children to wash their hands, assisting children as needed.
Staff and volunteers wash their hands: a. Upon arrival at the child care center. b. Before putting on food service gloves. c. Before and after handling foods, cooking activities, eating and serving food. d. After touching/handling raw meat, poultry, fish, or eggs. 10 (C: 04/2020; R: 08/2021)
e. After personal toileting. f. After assisting child with toileting. g. Before and after diaper/pull-up changing. h. After handling or coming in contact with body fluids such as mucus, blood, saliva, urine or vomit. i. After touching any unclean item. j. After attending to an ill child. k. Before and after administering first aid. l. Before and after giving medication. m. After handling, feeding or cleaning-up pets or other animals. n. After smoking or vaping o. After being outdoors or involved in outdoor play. Children will be directed or assisted in hand washing: a. Upon arrival at the center. b. Before and after food and meal preparations, eating meals or cooking activities. c. After toileting. d. After outdoor play. e. After coming in contact with body fluids. f. After messy play. g. After handling pets or other animals. How Hand Washing is Done at Our Center: a. Soap, warm running water and individual towels are available for staff and children. b. Turn on water and adjust temperature. c. Wet hands and apply a liberal amount of soap. d. Rub hands in a wringing motion from wrists to fingertips for a period of not less than 20 seconds. (As a general rule, hands should be washed for 30 seconds.) e. Rinse hands thoroughly. f. Dry hands, using an individual towel. g. Use paper towel to turn off water faucet(s) (unless the faucet turns off automatically) and open any door knob/latch before discarding h. Use hand-drying towel to turn off water faucet(s)
HAND SANITIZER Alcohol based hand sanitizers with at least 60% alcohol may be used by adults and children over 24 months of age with proper supervision only when hand washing facilities are not available and hands are not visibly soiled. Hand Sanitizer must be stored where it is not accessible to children. Alcohol based hand sanitizer is not a substitute for hand washing when hands are dirty, after diapering or toileting, or before eating. An alcohol-based hand sanitizer must contain 60% to 90% alcohol to be effective.
GLOVES Gloves are to be worn when handling food, administering first aid, handling dirty laundry, administering topical medication or diaper cream, changing diapers, cleaning, sanitizing, and disinfecting, etc. Hands must be washed with soap and water after removing gloves.
FACE MASKS While vaccinations and ongoing precautions have helped reduce the infection rate, it is important to remember that children under the age of 12 are not yet able to be vaccinated. Face mask requirements that remain in effect for schools and other settings with unvaccinated children are outlined below:
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FACE MASKS – ADULTS Preschool Centers: Indoors – Fully vaccinated staff must wear facial coverings indoors if children under the age of 18 are present or expected to be present, but they do not need to wear facial coverings indoors if no children are present and vaccination status has been verified by LCC HR. All other adults (parent/guardians and visitors) are required to wear face masks indoors regardless of vaccination status. Outdoors – Masks are required outdoors for unvaccinated staff and parents/guardians or visitors. Staff who are vaccinated and who prefer to not wear a mask when outdoors are required to provide vaccination verification to LCC HR prior to beginning that practice. Family member of enrolled children who prefer not to wear a mask when outdoors at a program center may elect to show proof of their vaccination status to the staff member. Staff must verify vaccination status but will not take or keep copies, so family members who prefer this option should plan to keep their proof of vaccination with them during any visits to a program center including pick-up and drop-off and be willing to show their vaccination status to any staff member who asks. People who are unvaccinated are encouraged to wear a mask outdoors where it is hard to maintain physical distance.
Infant & Toddler Center: Follow Preschool Center guidance above (facial coverings are required). Due to longer duration of close contact, staff in infant rooms will need to wear a surgical style face mask along with a face shield and will be provided by the program. *Guidance collected from WA. L&I, CDC, & WA. D.O.H
FACE MASKS – CHILDREN There are specific exceptions based on age, development or disability; outlined below. See the DOH Guidance on Cloth Face Coverings and CDC Recommendation Regarding the Use of Face Coverings for more information. Face masks with ear loops are preferred over ones that tie around the neck or behind the head during physical activity to reduce the risk of injury. Providers must provide face coverings for staff and youth who don’t have them. In some cases, staff may need a higher level of protection under L & I safety and health rules and guidance. Refer to L & I’s Coronavirus Facial Covering and Mask Requirements for additional details. Children age 2 and up are required to wear a face covering at child care, preschool or day camp when indoors. • Face coverings should not be worn by: o Children younger than age 2 years. o Children while they are sleeping. o Those with a disability that prevents them from comfortably wearing or removing a face covering. o Those with certain respiratory conditions or trouble breathing. o Those who are deaf or hard of hearing and use facial and mouth movements as part of communication. o Those advised by a medical, legal or behavioral health professional that wearing a face covering may pose a risk to that person. • In rare circumstances when a cloth face covering cannot be worn, children and staff may sue a clear face covering or a face shield with a drape as an alternative to a cloth face covering. Face shields should extend below the chin, to the ears, and have no gap at the forehead. • Younger children must be supervised when wearing a cloth face covering. These children will need help with their masks getting used to wearing them.
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• Children may remove cloth face coverings to eat and drink and when outside. If children need a “mask break”, take them outside or to a large, well ventilated room where there is sufficient space to ensure more than 6 feet of physical distance between people. • The child care is responsible for providing appropriate PPE for all staff, including those who provide assistance to children and youth who have special needs. *Guidance collected per Washington Department of Health
HOW TO PUT ON A FACE MASK Staff assisting with temperature checks must wear a face mask when completing health checks at entry to the building. Follow facemask guidelines below and make sure to wash hands prior to starting and upon completion of daily health check.
1. Before putting on the mask or cloth face covering, wash your hands for at least 20 seconds with soap and water, or rub your hands together thoroughly with alcohol-based hand sanitizer. 2. Check for defects in the facemask, such as tears or broken loops. 3. Position the colored side of the mask outward. 4. If present, make sure the metallic strip is at the top of the mask and positioned against the bridge of your nose. 5. If the mask has: o Ear loops: Hold the mask by both ear loops and place one loop over each ear. o Ties: Hold the mask by the upper strings. Tie the upper strings in a secure bow near the crown of your head. Tie the bottom strings securely in a bow near the nape of your neck. o Dual elastic bands: Pull the top band over your head and position it against the crown of your head. Pull the bottom band over your head and position it against the nape of your neck. 6. Mold the bendable metallic upper strip to the shape of your nose by pinching and pressing down on it with your fingers so it molds to the bridge of your nose. 7. Pull the bottom of the mask over your mouth and chin. 8. Be sure the mask fits snugly. 9. Don’t touch the mask once in position as you may contaminate the mask. 10. If the mask gets soiled or damp, replace it with a new one.
Do Not: • Don’t touch the mask once it is secured on your face; dangle the mask from one ear; hang the mask around your neck and/or crisscross the ties.
If you have to touch the facemask while you’re wearing it, make sure to wash your hands first as your hands or mask may have pathogens on it after use, and you want to prevent transmitting or contracting these pathogens. Be sure to also wash your hands after touching mask, and/or use hand sanitizer. If you are wearing a cloth mask, make sure to wash frequently in hot water.
HOW TO SAFELY REMOVE A FACE MASK • Try to avoid touching your face, especially your eyes, nose, mouth when removing the mask • If you are able, wash hands prior to removing mask. • Pull elastic bands or ties from back of head or ears and avoid touching your face. • Discard mask (if disposable) and wash hands with soap and warm running water for at least 20 seconds. • If you wear a cloth face covering, make sure to place in a paper or plastic bag after use.
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FACE CLOTH CARE Cloth face coverings should be washed every day with detergent and hot water. Dry face covering completely in the dryer or air-dry the face covering in direct sunlight if possible. If you must reuse your facemask before you wash it, wash your hands after you put it back on and do not touch your face. Throw away cloth face coverings if it: • No longer cover your nose and mouth. • Are stretched out or do not stay on your face. • Have damaged ties or straps. • Have holes or tears in the fabric.
DISPOSABLE FACE MASK CARE Disposable face masks must be discarded when staff leave their program site for any reason, such as lunch breaks and/or at the end of their work day.
A new disposable face cloth is needed when: • Any area of the disposable face mask is damaged, dirty, and/or wet. • Mask is no longer falling on bridge of nose and beneath chin in order to provide full coverage of nose and mouth area.
CLEANING, SANITIZING, AND DISINFECTING Cleaning, Sanitizing, and Disinfecting of all frequently touched objects and surfaces should be completed continuously throughout the day.
WASHING TOYS BY HAND Step 1: Clean • Wash and scrub toys thoroughly with soap or detergent and warm water. It is very important to clean toys thoroughly prior to sanitization, as sanitization is more effective on clean surfaces. Step 2: Rinse • Rinse toys with warm water to remove dirt, germs, and soap residue.
Step 3: Sanitize (3- Step Process) • Dip the toys in bleach/water solution • Allow toys to dry completely either by letting them sit overnight or allow 2 minutes to let them sit out before wiping toys with a paper towel. • Further rinsing is not necessary.
If groups of children are moving from one area to another in shifts, make sure to clean the area before the new group of children enters that area. Clean and disinfect high touch surfaces continuously throughout the day.
WASHING TOYS IN DISHWASHER • Some toys (wood, plastic, and metal) may be washed in the dishwasher. o All removable parts must be removed prior to placing in dishwasher. • Follow dishwasher detergent recommended guidelines. • Run toys through a complete wash and dry cycle • Do not wash toys with dirty dishes, utensils, etc.
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CLEANING TOYS • It is recommended that mouthed toys be provided and stored per individual child • Toys are collected as they become dirty throughout the day o Mouthed Toys- after each use by a child o All other Toys- daily, or as needed • Toys are sorted into separate containers- Cloth & Wood/Plastic toys • Clean, rinse, and sanitize toys daily at the end of day or specified time of day • Staff must wear household rubber gloves when cleaning and disinfecting toys.
CARPETS Carpets should be vacuumed daily at the end of the school day when children are not present. It is recommended that a blanket or towel be placed under infants when on carpeted floors.
LAUNDRY Used cloth face masks are to be washed daily at each center. Used cloth face masks are to be placed in labeled container that is used only for used masks. Staff should wear gloves when handling dirty masks and laundry. Laundry should be washed on warmest possible setting. Mixing of clothing will not cross contaminate articles of clothing. Masks will be placed in dryer and will only be removed when completely dry. Staff must wash hands after handling laundry and removing gloves.
It is recommended that Infants and toddlers keep an extra set or two of clothing in their assigned classroom in case of illness and/or bodily fluid exposure.
IN CASE OF EXPOSURE • If possible, wait up to 24 hours before beginning the cleaning and disinfection of all areas, focusing on frequently touched surfaces. • Open outside doors and windows to increase air circulation in the area. • Follow Cleaning, Sanitizing, and Disinfecting Health procedure and that which is outlined above to prevent further spread of disease and other illnesses. • If it has been more than 7 days since the person with suspected/confirmed COVID-19 visited or used the facility, additional cleaning and disinfection is not required.
COMPROMISED IMMUNE SYSTEMS/SPECIAL HEALTH NEEDS
CHILDREN WITH CHRONIC HEALTH CONDITIONS Staff should be extra vigilant of children with chronic health conditions, such as those with Asthma. During times when COVID-19 cases are on the rise, it is advisable that children with serious chronic conditions (ex. Asthma) be kept at home while following strict hygiene and physical distancing guidelines.
STAFF WITH CHRONIC HEALTH CONDTIONS Staff living with chronic health conditions should contact their health care provider for guidance when considering when to provide or participate in childcare. Staff should work with their supervisor and LCC Human Resources when accommodations are needed.
WOMEN WHO ARE PREGNANT Women who are pregnant should follow staff/volunteer procedures, wash hands often, maintain proper physical distance from others, and wear a face masks at all times. A shield is recommended but not
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CARING FOR SOMEONE WITH COVID-19 Limit Contact • Staying away from others helps stop the spread of COVID-19 • If possible, have the person who is sick use a separate bedroom and bathroom. • If you have to share space, make sure the room has good air flow. o Open the window to increase air circulation. ▪ Increased air circulation helps in removing respiratory droplets in the air.
Caregivers should Quarantine if exposed to someone with COVID-19
Caregivers and anyone who has been in close contact with someone who has COVID-19 should stay home, follow their health care providers plan of care, while also following the guidance provided within this procedure and that which is provided by their Supervisor.
16 (C: 04/2020; R: 08/2021) COVID-19 Operating Plan & Supplemental Health Guidance HLTH 1g
Head Start/EHS/ECEAP de Lower Columbia College
Plan operativo y consejos suplementarios de salud por el COVID-19
ÍNDICE
Notificación de exposición COVID-19 ...... 2 Normas generales ………..………………….……………………………………………………………………………………………………………..3 El COVID-19 se transmite con más frecuencia en situaciones de contacto cercano ………………….……….…………….3 Entrega y recogida del niño ...... 3 Entrar al edificio ...... 4 Toma de temperatura al entrar en el edificio ...... 5 EXPOSICIÓN AL COVID-19, CONTACTO CERCANO, SITUACIONES POSIBLES Y SEGUIMIENTO Procedimiento de notificación del personal en casos de síntomas y exposición al COVID ...... 5 Si una persona está completamente vacunada ...... 5 Cuando usted está completamente vacunado ...... 5 Regresar al programa después de tener señales o síntomas sospechados del COVID 19 ...... 6 Cuando regresar si usted posiblemente fue expuesto al virus COVID-19, si dio positivo en una prueba o fue diagnosticado con COVID-19, o no hizo una prueba después de ser expuesto al COVID-19 ...... 6 Contacto cercano con una persona que se hizo o se va a hacer la prueba ...... 6 ¿Qué es contacto cercano?...... 6 Caso sospechado de covid-19 en uno de nuestros sitios ...... 6 DÍA PROGRAMÁTICO, ACTIVIDADES EN SALONES DE CLASES Y EL AMBIENTE Agrupamiento: asignar a niños y miembros del personal a grupos ...... 7 Distanciamiento físico en el salón de clases ...... 8 Servicio de comidas ...... 8 Patio de juegos...... 8 Actividades con agua ...... 8 Cepillado de dientes ...... 8 Horario de siesta ...... 9 Cambio de pañales/uso del baño ...... 9 Transporte ...... 9 Ventilación ...... 9 Pertenencias de los niños ...... 9 Pertenencias del personal...... 9 Descansos requeridos para miembros del personal ...... 9 Visitas a hogares …………………………………………………………………………………………………………………………………………...10 HYGIENE/CUBREBOCAS Política y procedimientos de higiene ...... 11 Desinfectante de manos ...... 12 Guantes ...... 12 Cubrebocas – adultos/niños ...... 13 Cómo ponerse una mascarilla o un cubrebocas de tela ...... 14 Cómo quitarse una mascarilla o cubrebocas de tela seguramente ………………………………………………………………...15 Cómo cuidar cubrebocas de tela …………………………………………………………………………………………………………………...15 Cuidado de mascarillas desechables ………………………………………………………………..…………………………………………...15 LIMPIAR, HIGIENIZAR Y DESINFECTAR Cómo lavar juguetes a mano ...... 15 Cómo lavar los juguetes en un lavaplatos ...... 16 Limpieza de juguetes ...... 16 Alfombras ...... 16 Lavar ropa ...... 16 En caso de exposición al coronavirus ...... 16
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SISTEMAS INMUNES COMPROMETIDOS/NECESIDADES ESPECIALES DE SALUD Niños con enfermedades crónicas ...... 17 Personal con enfermedades crónicas ...... 17 Mujeres embarazadas...... 17 Cuidar a una persona con COVID-19 ...... 17
Lower Columbia College Head Start/EHS/ECEAP Notificación de Exposición COVID-19
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El personal, los padres y los visitantes deben seguir el procedimiento de Coronavirus (Covid-19) descrito a continuación mientras estén en cualquier de nuestros sitios escolares durante la temporada de coronavirus y hasta que sea levantado por la dirección del programa. Este plan operativo se utilizará como guía suplementaria para nuestras políticas y procedimientos de salud y seguridad existentes. Este plan operativo es un documento de trabajo que puede ser revisado y actualizado durante todo el año escolar por los Centros para el Control y la Seguridad de Enfermedades (CDC) y la guía del Departamento de Salud de Washington.
NORMAS GENERALES El LCC no puede permitir que un niño, miembro de personal, padre/tutor o visitante esté en uno de nuestros sitios si es que: • Tiene síntomas de COVID-19 como están descritos más abajo Y/O • No está completamente vacunado y ha tenido contacto cercano (dentro de seis pies por 15 minutos totales durante un período de 24 horas) en los últimos 14 días con una persona con un caso confirmado de COVID-19. • Dio positivo en una prueba de COVID-19 en los últimos 10 días, o está esperando resultados de una prueba de COVID-19 que se hizo porque es posible que fue expuesto a la enfermedad o porque tiene síntomas, y no fue una prueba rutina de personas sin síntomas o parte de un programa de vigilancia. • Ha tenido contacto cercano con una persona que tiene un caso confirmado o sospechado de COVID-19 en los últimos 14 días.
Aseguramos que miembros del personal estén entrenados en protocolos de salud y seguridad, incluyendo: • Cómo evaluar a personas para síntomas. • Cómo mantener distancia física. • El uso de equipo de protección personal (PPE) adecuado • Comprensión y práctica de limpieza y lavado frecuente de manos.
EL COVID-19 SE TRANSMITE CON MÁS FRECUENCIA EN SITUACIONES DE CONTACTO CERCANO • Las personas que están más a riesgo de infección son las que están dentro de 6 pies de un individuo con COVID-19 o que tienen contacto directo con él. • Cuando personas con COVID-19 producen gotitas respiratorias al toser, estornudar, cantar, hablar o respirar o Una infección ocurre principalmente por medio de exposición a gotitas respiratorias cuando un individuo tiene contacto cercano con una persona que tenga COVID-19. o Gotitas respiratorias infectan a la otra persona cuando esa persona las inhala o cuando caen en las membranas mucosas de la nariz, boca u ojos. o Cuando una persona con COVID-19 está más lejos, la concentración de gotitas respiratorias es menos porque las gotitas más grandes se caen a la tierra debido a la gravedad, mientras las partículas y gotitas más pequeñas se diluyen en el aire. o La cantidad de virus infeccioso también se disminuye al paso del tiempo.
ENTREGA Y RECOGIDA DEL NIÑO • Los horarios de entrega y recogida deben ser alternados y el distanciamiento físico será mantenido a la entrada y salida del edificio. • Los padres y tutores deben lavarse las manos y/o usar desinfectante de manos antes de firmar la entrada y salida de sus hijos todos los días. o El desinfectante de manos debe ser al menos 60% alcohol, sin fragancia, y debe mantenerse fuera del alcance de los niños.
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• Si los padres tienen cubrebocas, se les anima a usarlo cuando entreguen y cuando recojan al niño. o Nuestro programa puede proporcionar cubrebocas a los padres, mientras tengamos disponibilidad.
ENTRAR AL EDIFICIO Todo el personal, los niños, los padres, los tutores y los voluntarios deben someterse a un examen de salud y control de temperatura antes de llegar a trabajar o ingresar a cualquiera de nuestros edificios del Programa. El personal debe asegurarse de revisar las preguntas que se describen a continuación con los padres y tutores, así como tomar la temperatura de un niño y hacer una inspección visual antes de permitir que entre en el edificio, y deben ser mantenidas las recomendaciones de distancia física establecidas por los Centros para el Control de Enfermedades (CDC) y el Departamento de Salud del Estado de Washington. Si en algún momento hay un padre o tutor que necesite ingresar al edificio para acomodar a su hijo en el salón de clases, el personal revisará con ese padre o tutor las preguntas que se describen a continuación y tomar su temperatura. El personal, los padres y los niños deben asegurarse de lavarse las manos de acuerdo con el procedimiento del programa al entrar y salir del salón de clases y/o el edificio. (Consulte las políticas/procedimiento de higiene para obtener información sobre el lavado de manos).
1. ¿Ha tenido usted alguno de los siguientes síntomas en las 24 horas pasadas que no fueron causadas por otro problema de salud? (Si es el primer día después de un descanso o si es un estudiante nuevo, pregunte sobre los 3 días pasados). • Fiebre (100.4 o más) o escalofríos • Dolor de cabeza • Tos • Pérdida reciente de gusto u olfato • Falta de aire o dificultad para • Dolor de garganta respirar • Congestión • Fatiga • Nauseas o vómitos • Dolores de cuerpo o músculos • Diarrea
2. Si usted no está completamente vacunada, ¿ha tenido contacto cercano con una persona con COVID- 19 en los últimos 14 días? El contacto cercano quiere decir estar dentro de 6 pies de una persona por 15 minutos o más durante un período de 24 horas, tener contacto directo con fluidos de una persona con COVID-19 con mascarilla o no (o sea, le tosió o le estornudó).
3. En los 10 días pasados, ¿ha tenido usted un resultado positivo en una prueba de COVID-19 por virus activo, o está esperando los resultados de una prueba del COVID-19?
4. Dentro de los 14 días pasados, ¿Le ha recomendado un profesional médico o de salud pública que usted monitoree su salud, se aísle o haga cuarentena por causa de una posible infección del COVID-19?
Si cualquier persona contesta “SÍ” a cualquier de los síntomas o preguntas que están más arriba, deben regresar a casa de inmediato. Refiérase a “CASO SOSPECHADO DE COVID-19 EN UNO DE NUESTROS SITIOS” del Plan Operativo del COVID; si se trata de una visita a un hogar, no haga la visita ahora, revise el Plan Operativo del COVID y asegúrese de hablar con su supervisora.
Si alguien contesta “NO” a todos los síntomas mencionados y su temperatura es menos de 100.4, tienen permiso para entrar al edificio, salón de clases u hogar.
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TOMA DE TEMPERATURA AL ENTRAR EN EL EDIFICIO El personal que ayude a tomar la temperatura y revisar la salud de personas a la entrada del edificio debe usar una mascarilla desechable. Protectores faciales son opcionales. Sigan las pautas de mascarillas y asegúrense de lavarse las manos antes y después de completar los controles de salud. 1. A todo el personal, los niños, los padres y los tutores se les DEBE tomar su temperatura antes de entrar en el edificio a. Cuando se use un Termómetro DIGITAL INFRARROJO SIN CONTACTO: i. El personal, los niños y los visitantes usarán desinfectante de manos, si está disponible. ii. El personal designado tiene que lavarse las manos y ponerse guantes desechables antes de usar el termómetro digital infrarrojo. iii. Se seguirán las instrucciones incluidas con el termómetro digital infrarrojo. 1. Para tomar la temperatura, el termómetro debe estar a una pulgada de la frente iv. El personal deberá mantener una distancia física segura al tomar la temperatura. v. Se desinfectará el termómetro con una toalla de papel rociada con una solución desinfectante de tres pasos o una toallita desinfectante.
EXPOSICIÓN AL COVID-19, CONTACTO CERCANO, SITUACIONES POSIBLES Y PROCEDIMIENTO DE SEGUIMIENTO
PROCEDIMIENTO DE NOTIFICACIÓN DEL PERSONAL EN CASOS DE SÍNTOMAS Y EXPOSICION AL COVID Si usted o un miembro del personal tiene síntomas de COVID-19 o un “Contacto cercano” le ha notificado que le van a hacer una prueba o tiene un caso confirmado*: 1. Aíslese: Si no está en su trabajo, no vaya. Si ya está presente, salga de su trabajo. 2. El empleado notificará a su supervisora. 3. La supervisora notificará a la especialista en salud o, si ésta no está disponible, a la directora. 4. La especialista en salud o directora llamará al miembro del personal para completar un formulario de ingreso y mandará el formulario completado a [email protected] y la directora de recursos humanos. 5. El departamento de recursos humanos contactará con el miembro de personal para explicar sus opciones de licencia y enviará una copia a su supervisora y la directora.
SI UNA PERSONA ESTÁ COMPLETAMENTE VACUNADA Revise la guía para regresar a un centro de cuidado de niños de LCC (en inglés) https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf
CUANDO USTED ESTÉ COMPLETAMENTE VACUNADO Las personas se consideran completamente vacunadas: • Dos (2) semanas después de su segunda dosis de una serie de dos dosis como las vacunas Pfizer o Moderna o • Dos (2) semanas después de una vacuna de dosis única, como la de Johnson & Johnson
Si es que ha sido menos de dos semanas después de su última vacuna o usted todavía necesita la segunda dosis, usted NO está completamente protegido. Siga tomando todas las medidas preventivas hasta que usted esté vacunado completamente.
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REGRESAR AL PROGRAMA DESPUÉS DE TENER SEÑALES O SÍNTOMAS SOSPECHADOS DEL COVID 19 Guía y diagrama de flujo para regresar al cuidado de niños de LCC (en inglés): https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf Personas que tienen enfermedad grave o son inmunocomprometidos posiblemente necesitarán aislarse hasta 20 días (en inglés): https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
CUANDO REGRESAR SI USTED POSIBLEMENTE FUE EXPUESTO AL VIRUS COVID-19, SI DIO POSITIVO EN UNA PRUEBA O FUE DIAGNOSTICADO CON COVID-19, O NO HIZO UNA PRUEBA DESPUÉS DE SER EXPUESTO AL COVID-19 Revise la guía para regresar al cuidado de niños de LCC: https://lowercolumbia.edu/safety/_assets/documents/return-to-campus-guide-for-childcare-08-09- 2021.pdf
CONTACTO CERCANO CON UNA PERSONA QUE SE HIZO O SE VA A HACER LA PRUEBA Si un miembro del personal o niño ha tenido contacto cercano con una persona que se hizo o se va a hacer la prueba (debido a una exposición posible), tienen que: • Quedarse en casa • *Hacer cuarentena hasta que el contacto cercano reciba los resultados de la prueba. Es recomendado que usted visite o hable con su proveedor de cuidado de salud.
¿QUÉ ES CONTACTO CERCANO? Según los Centros de Control de Enfermedades, contacto cercano quiere decir estar a una distancia menor de dos metros de una persona infectada por un total acumulativo de 15 minutos o más durante un período de 24 horas, desde los dos días previos a la presentación de síntomas (o, si no tiene síntomas, dos días antes de la recolección de la muestra) hasta el momento en el que el paciente es aislado.
CASO SOSPECHADO DE COVID-19 EN UNO DE NUESTROS SITIOS Si se sospecha que un niño o miembro del personal tiene COVID-19 cuando llega a la escuela, es necesario mandarlo a casa de inmediato. El personal tiene que reportar el caso sospechado a su supervisora y la especialista en salud. Si un niño se enferma durante la clase y tiene indicios y síntomas de COVID-19 que están descritos más arriba: • Tiene que estar separado de otras personas, en otro salón, en un área donde no pasan muchas personas o en un rincón de su salón de clases donde pueda esperar a su padre/tutor, si no hay otro lugar adecuado en el edificio. Un miembro del personal tendrá la responsabilidad de esperar con el niño hasta que su padre/tutor lo recoja. • Si es posible, el salón o área designada será abierta al exterior para permitir la circulación adecuada de aire. • Miembros del personal contactarán con la especialista en salud. • Es importantísimo que una persona que tenga síntomas de COVID19 se aísle de inmediato, aun antes de recibir confirmación de tener la enfermedad, porque si la tiene, ya está contagiosa. Si el doctor de un niño dice que tiene que quedarse en casa para hacer cuarentena, o si les informaron que es probable que tenga el coronavirus, es esencial que su familia reporte esta información a la maestra o trabajador social de inmediato, mientras siga el plan de cuidado que su doctor recomendó. 6 (C: 04/2020; R: 08/21)
Es esencial que el personal anime a familias a hacer seguimiento necesario sin tardar, para que miembros del personal tengan tiempo suficiente para ayudar a niños y todos los miembros del personal que podrían haber tenido contacto con el niño enfermo.
Las supervisoras tienen que mantener un registro de enfermedades que incluya los niños que tengan los síntomas descritos más arriba y/o los que tengan un caso sospechado o confirmado de COVID-19. Supervisores asegurarán que reporten todo caso sospechado o confirmado a la especialista en salud, quien tiene el deber de reportar el caso al departamento de salud local.
Si un miembro del personal se enferma durante su día de trabajo y tiene indicios y síntomas de COVID- 19 que están descritos más arriba: • Tienen que salir del edificio y notificar a su supervisora inmediatamente antes de irse. • Las supervisoras se comunicarán con la especialista en salud. • Un miembro del personal que tiene síntomas graves tiene que contactar con su doctor y seguir el plan de cuidado que le recomiende. • Es importantísimo que una persona que tenga señales o síntomas de COVID19 se aísle de inmediato, aun antes de recibir confirmación de tener la enfermedad, porque si la tiene, ya es contagiosa.
Si el doctor de un miembro del personal le instruye que se quede en casa y haga cuarentena, o si le informa que es probable que tenga el coronavirus, debe reportar eso a su supervisora, siempre siguiendo el plan de cuidado que su doctor le haya recomendado. Es esencial dar información sin tardar para que miembros del personal puedan ayudar mejor a niños y todos los demás miembros del personal que hayan tenido contacto con la persona.
Las supervisoras mantendrán un registro de enfermedades que incluya los nombres de todo miembro del personal que tiene los síntomas descritos más arriba y/o tiene un caso sospechado o confirmado de COVID-19. Las supervisoras asegurarán que todo caso sospechado o confirmado será reportado a la especialista de salud, quien tiene que hablar con la persona encargada de contactos de LCC. La especialista en salud se comunicará con el departamento como sea requerido.
DÍA PROGRAMÁTICO, ACTIVIDADES EN SALONES DE CLASES Y EL AMBIENTE
AGRUPAMIENTO: ASIGNAR A NIÑOS Y MIEMBROS DEL PERSONAL A GRUPOS Siempre mantener los niños y empleados en los mismos grupos pequeños disminuye el número de contactos cercanos que ellos tengan. Asignen a niños a grupos pequeños e intenten mantenerlos en los mismos grupos todos los días, al máximo grado posible. Empleados deben de estar asignados a grupos y no deben integrarse a otros grupos. No mezclen los grupos durante actividades diarias y todo que sea posible, limite la combinación de grupos al comienzo y fin del día. Si individuos se ingresan a otros grupos, mantengan un registro de los grupos (niños y miembros del personal) y el día y hora.
Asegúrese que el número de personas en grupos no sobrepase el número de la tabla que está más abajo. Los grupos siempre deben incluir los mismos miembros de personal y la proporción entre éstos y los niños debe cumplir con las normas de licenciamiento. Es recomendado que visitantes a clases sean siempre los mismos, ya sean miembros de personal de distritos escolares, consultores, especialistas de áreas de aprendizaje, entrenadores, intérpretes o la coordinadora de salud. Todas estas personas deben seguir los procedimientos de evaluaciones de salud, mascarillas e higiene de este plan operativo.
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Edad Número máximo Proporción entre Número máximo de niños en un empleados y de personas en grupo niños un grupo Infantes de 0-11 meses 8 1:4 10 --o-- Grupo mezclado de niños de 0-36 meses 9 1:3 12 Niños de 12-29 meses 15 1:7 16 --o-- Grupo mezclado de niños de 12-36 meses 15 1:5 18 Niños de preescolar de 30 meses a 6 años 20 1:10 22 que no estén inscritos en la escuela --o-- Grupo mezclado de niños de 36 meses a 6 años que no estén inscritos en la escuela
DISTANCIAMIENTO FÍSICO EN EL SALÓN DE CLASES Tanto el Departamento de Salud de Washington como los Centros de Control de Enfermedades recomiendan que niños y jóvenes estén separados por 3 pies por lo menos (1 metro) todo lo posible cuando estén en grupos o salones de clase. Sigan manteniendo una separación de 6 pies (2 metros) todo lo posible mientras niños coman o duerman. Su habilidad de mantener esta separación dependerá en las edades de los niños y sus habilidades físicas y de desarrollo.
SERVICIO DE COMIDAS Los niños DEBEN ser supervisados al lavarse las manos antes y después de la hora de comer. El lavado de manos es fundamental para prevenir la propagación de enfermedades. Los niños estarán físicamente separados tan lejos como sea posible cuando estén sentados en la mesa y se sentarán en el mismo lado mirando hacia la misma dirección, si el espacio lo permite. Las mesas estarán separadas por lo menos a 6 pies. Los niños pueden comer en otras áreas de aprendizaje o al aire libre si el clima lo permite. Los niños ya no se servirán a sí mismos ni pasarán alimentos en la mesa. El maestro del salón de clases o el personal de apoyo servirá a los niños durante la hora de comer y proporcionará porciones adicionales según sea necesario. Los niños podrán retirarse de la mesa después de haber terminado su comida y serán enviados directamente a lavarse las manos. Es esencial que el personal supervise el lavado de manos para asegurarse de que los niños se laven las manos con una cantidad suficiente de agua y jabón.
PATIO DE JUEGOS Los niños no necesitan usar cubrebocas faciales de tela mientras están en el patio de juegos, pero se les anima a mantener distanciamiento físico mientras no usen mascarillas. Debido a problemas de seguridad, los protectores faciales deben retirarse cuando están en el patio de recreo y/o cuando realizan actividades físicas.
ACTIVIDADES CON AGUA Por ahora, todas las actividades que incluyan jugar en agua están suspendidas. El juego individual en agua está permitido. Se hará limpieza y enjuague cada día entre horas de juego de diferentes grupos de niños.
CEPILLADO DE DIENTES El cepillado dental está suspendido. El personal será notificado cuando el cepillado dental deba reanudarse como parte de la rutina diaria del salón de clases. Con la finalidad de ayudar a apoyar la 8 (C: 04/2020; R: 08/21) importancia de la atención dental y la prevención de la caries, es fundamental por ahora, promover el cepillado dental en el hogar.
HORARIO DE SIESTA El personal debe seguir el procedimiento actual para la siesta (HLTH 9e & HLTH 9e1) separando las cunas y los tapetes lo más posible. Las sábanas no deben compartirse entre los niños y deben limpiarse semanalmente y con mayor frecuencia según sea necesario. Las sábanas de cualquier niño que muestre signos de COVID-19 o cualquier otra enfermedad deben ser limpiadas al final del día escolar. Todo el equipo para dormir (por ejemplo, cunas y tapetes) deben limpiarse y desinfectarse después de cada uso.
CAMBIO DE PAÑALES/USO DEL BAÑO El personal debe usar guantes cuando cambie los pañales y al aplicar crema para rozaduras. Los niños y el personal deben usar una mascarilla mientras estén en el baño. Si un niño necesita ayuda en el baño, el personal lo ayudara y saldrá del baño cuando el niño ya no necesite ayuda. La supervisión es importante para asegurar que los niños se laven las manos meticulosamente después de usar el baño.
TRANSPORTE El transporte (autobús escolar) podría estar disponible para un número muy limitado de niños para permitir el distanciamiento físico. A los niños se les pedirá que usen una mascarilla mientras estén en el autobús. El monitor de autobús tomará la temperatura de los niños y hará revisiones de salud antes de permitir que cualquier niño suba al autobús. Los niños deben separarse lo más posible, con una fila vacía entre cada niño cuando sea posible. Siente a niños con otros miembros de su clase o grupo. Permita que el aire exterior entre al autobús todo que sea posible, dejando las ventanas abiertas cuando sea posible y/o entre los recorridos o limpieza del autobús. Los asientos, las barandillas de mano, las hebillas del cinturón de seguridad y cualquier otra superficie que se toque con frecuencia deben limpiarse entre cada viaje del autobús. *Consulte "Limpieza y Desinfección " para obtener información.
VENTILACIÓN Para apoyar la disminución y/o prevención de enfermedades transmitidas por el aire, como COVID-19, permita un flujo de aire adecuado dentro del salón y en el edificio. Abrir las puertas en la entrada del edificio y/o salón de clases durante la entrega y recogida de los niños, junto con la apertura de las ventanas del salón, mientras se supervisa, apoyará la ventilación adecuada en el edificio durante todo el día. Es necesario supervisar la temperatura del salón de clases.
PERTENENCIAS DE LOS NIÑOS Se recomienda que niños traigan el menor número posible de artículos de casa (por ej. mochilas). Familias deben considerar llevar lo necesario para su hijo a la escuela al inicio de cada semana en lugar de llevar y traer cosas a la escuela todos los días.
PERTENENCIAS DEL PERSONAL Considere dejar un cambio de ropa en su sitio de trabajo o en su vehículo en caso de que su ropa se contamine durante el día. Trate de mantener un mínimo de artículos traídos y llevados a casa como sea posible. Mantenga las bolsas y mochilas fuera del suelo y en un armario si es posible. Tenga en cuenta dónde coloca las bolsas y mochilas cuando las lleve a casa cada día. Use el pelo recogido, fuera del cuello, si es posible.
DESCANSOS REQUERIDOS PARA MIEMBROS DEL PERSONAL Si se requiere la ayuda de un suplente en el salón de clases: o El suplente tiene que lavarse las manos inmediatamente después de llegar y antes de salir.
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o Mientras esté en el espacio de grupo, el suplente tiene que usar mascarilla desechable a todo tiempo.
VISITAS A HOGARES Los departamentos gubernamentales que proporcionan fondos al programa Head Start/EHS/ECEAP de LCC requieren que el programa comience a hacer visitas a hogares de nuevo durante el año programático de 2021-22. El período de agosto a diciembre del 2021 será un período de transición a la entrega de los servicios completos ofrecidos antes del COVID. Durante el período de transición, el programa de LCC puede hacer unas adecuaciones. Esta sección explica los requerimientos para todos miembros de personal y familias, incluyendo las adecuaciones que el personal puede ofrecer a familias.
Preparación para una visita a un hogar Para asegurar que familias entiendan los procedimientos de COVID que el LCC está obligado a seguir, miembros del personal revisarán el Plan operativo y consejos suplementarios de salud por el COVID-19 con cada familia inscrita en el programa o antes de (o durante) la primera visita (incluyendo todos los miembros de la familia que estarán presentes en la visita, al grado que sea posible). Al terminar la revisión de las normas, pida al padre de familia que firme y ponga la fecha en la Declaración de comprensión de padre de familia. Miembros del personal hablarán con cada familia sobre las opciones de visitas en persona para decidir dónde las llevarán a cabo durante este período de transición.
Visitas a hogares: el ambiente En este tiempo, es requerido hacer visitas en persona*, ya sean adentro o afuera. En una situación ideal, las visitas serán en los hogares de las familias, pero también pueden ser en cualquier de los centros del programa Head Start/EHS/ECEAP de LCC o en otro sitio de la comunidad que sea accesible y tenga una asociación con la familia. Se les anima tener visitas afuera mientras el clima lo permita (en patios, porches, jardines, patios de recreo, etc.).
Si algún miembro de la familia no pasa la revisión de preguntas de detección del COVID antes de una visita, el miembro de personal les puede ofrecer una visita virtual. La familia también puede reprogramar la visita en persona. Una familia que tenga un niño médicamente frágil puede seguir teniendo visitas virtuales durante el período de transición. Si una familia no está dispuesta a tener visitas en persona, miembros del personal lo comunicarán a su supervisora. Si la supervisora y miembro del personal no puede resolver el impedimento a visitas en persona, tienen que comunicarlo a la directora del programa, quien está obligada a reportar adecuaciones a la oficina de la Región 10 de Head Start.
Cuando hacen una visita afuera, miembros del personal pueden poner una cobija, sábana o toldo de playa en el césped o porche. Cuando hagan visitas dentro de una casa, es mejor situarse en un área donde haya ventilación, como cerca de una ventana o puerta abierta. Mientras estén dentro o fuera de una casa, miembros de personal pueden usar cobijas o sábanas para cubrir una silla o sofá o para sentarse en el piso. Todo miembro de personal que haga visitas a hogares recibirá un botequín para visitantes a hogares, que incluirá artículos de higiene (guantes, desinfectante de manos, mascarilla, etc.). Es la responsabilidad de cada miembro del personal pedir suministros y llenar sus botequines cuando sea necesario.
*Si los departamentos de salud del gobierno federal, estatal o local imponen restricciones más estrictas, el programa las seguirá, cambiará el Plan operativo por COVID y comunicará los cambios a miembros del personal y familias.
Preguntas de detección de COVID que serán revisadas antes de cada visita Miembros del personal revisarán las preguntas de detección de COVID19 antes de comenzar su día de trabajo para evaluar so propia salud. Miembros del personal que tengan síntomas no irán al trabajo y se 10 (C: 04/2020; R: 08/21) comunicarán con su supervisora. Antes de comenzar una visita a un hogar, el personal revisará las preguntas de detección de COVID19 con todos los miembros de la familia que estarán presentes. Si es posible, está bien hacerlo por teléfono o texto antes de hacer una visita en persona. Para facilitar este proceso, se les puede dar una copia de las preguntas a las familias. El personal usará el formulario de visitas a hogares para documentar las personas a quienes hicieron las preguntas, quienes estaban presentes en la reunión y si alguien en la casa tenía síntomas de enfermedad. Esa información será importante en el caso de una exposición al COVID19 durante una visita a un hogar. Si un participante en la reunión comienza a tener indicios o síntomas de enfermedad durante la reunión, el miembro de personal terminará la visita, se referirá a páginas 5-7 de este documento y tomará los pasos indicados.
Limpieza de manos, higiene, mascarillas Miembros del personal tienen que lavarse las manos y/o usar desinfectante de manos al comenzar y terminar cada visita a un hogar. El personal recibirá desinfectante de manos y guantes no látex para usar cuando los necesite. Es obligatorio lavarse las manos o usar desinfectante de manos aun cuando use guantes no látex. Todos los materiales (por ejemplo, libros, lapiceros, marcadores, tijeras, etc.) que usen durante una visita tienen que ser limpiados antes de hacer otra visita. El miembro de personal revisará le sección de higiene y limpieza de manos de este procedimiento con cada familia para recordarles de la importancia de higiene de manos. Vea la sección de higiene y limpieza de manos de este procedimiento.
Mascarillas en hogares – Miembros del personal tienen que usar cubrebocas si la visita es adentro, de acuerdo con los reglamentos para trabajadores que tengan contacto con niños no vacunados. Miembros del personal que prefieran no usar mascarilla durante visitas que hagan afuera tienen que proveer un comprobante de su vacunación al departamento de recursos humanos de LCC antes. Si la familia pide que el personal siga usando mascarilla durante visitas que tengan afuera, el personal lo hará. A todos los demás adultos y niños que tengan dos años o más que estén presentes en el hogar se les anima a usar cubrebocas desechables o de tela mientras se interactúen con el personal del programa. Vea las siguientes secciones de este procedimiento y sígalas durante las visitas como le correspondan: Cubrebocas - adultos, Cómo ponerse una mascarilla o un cubrebocas de tela y Cómo cuidar cubrebocas de tela.
El uso de mascarillas en centros del programa Head Start /EHS/ECEAP de LCC – Refiérase a la sección de CUBREBOCAS (Adultos y niños) de este plan operativo.
HIGIENE/CUBREBOCAS POLÍTICA DE HIGIENE DE LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP
Política Nuestro programa está comprometido con la implementación eficaz de procedimientos de higiene, saneamiento y desinfección que limiten considerablemente la propagación de gérmenes y disminuyan riesgos a la salud de niños y adultos.
Procedimiento de higiene y limpieza de manos El póster de “Elimine los gérmenes, lávese las manos” o el procedimiento sobre lavarse las manos recomendado por el departamento de salud de Washington tiene que estar colocado en todos los baños del edificio y arriba de todo lavamanos en el salón de clases. Lavarse las manos es la mejor forma de reducir o parar la propagación de gérmenes que causan enfermedades infantiles como la diarrea. Los maestros lavan sus manos frecuentemente y enseñan a niños a hacerlo, ayudándoles cuando sea necesario. 11 (C: 04/2020; R: 08/21)
Maestros y voluntarios se lavan las manos: a. Cuando llegan al centro de guardería b. Antes de ponerse guantes de servicios alimenticios c. Antes y después de tocar alimentos, cocinar, comer o servir comida d. Después de tocar o preparar carne cruda, pollo crudo, pescado crudo o huevos crudos e. Después de usar el baño f. Después de ayudar a un niño a usar el baño g. Antes y después de cambiar un pañal o pull-up h. Después de manipular o tener contacto con fluidos corporales como moco, sangre, saliva, orina o vómito i. Después de tocar cualquier objeto sucio j. Después de atender a un niño enfermo k. Antes y después de administrar primeros auxilios l. Antes y después de administrar medicina m. Después de tocar, alimentar o limpiar mascotas u otros animales n. Después de fumar o vapear o. Después de estar afuera o participar en juegos exteriores. A Niños se les ordena o se les ayuda a lavar sus manos: a. Cuando llegan al centro b. Antes y después de preparar comida, comer o cocinar c. Después de usar el baño d. Después de jugar afuera e. Después de tener contacto con fluidos corporales f. Después de juegos sucios g. Después de tocar mascotas u otros animales Cómo lavarse las manos en nuestro centro: a. Jabón, agua caliente y toallas individuales están disponibles al personal y niños b. Abrir la llave y acomodar la temperatura c. Mojar las manos y aplicar una cantidad generosa de jabón d. Frotar las manos desde la muñeca hasta los puntos de los dedos por 20 segundos, al mínimo (por lo general, se debe lavar las manos por 30 segundos). e. Enjuagar las manos completamente f. Secar las manos, usando una toalla individual g. Usar una toalla de papel para cerrar la(s) llave(s) (a menos que se cierre automáticamente) y abrir la puerta antes de echarla a la basura h. Usar la toalla de papel para cerrar la(s) llave(s)
DESINFECTANTE DE MANOS Adultos y niños que tengan más de 24 meses pueden usar desinfectantes de manos a base de alcohol que contienen por lo menos 60% alcohol, solamente cuando no haya donde lavarse las manos y sus manos no estén visiblemente sucias. El desinfectante de manos tiene que estar fuera del alcance de niños. Desinfectante de manos a base de alcohol no reemplaza el lavado de manos cuando las manos están sucias, después de cambiar pañales o usar el baño o antes de comer. Para ser eficaz, un desinfectante de manos necesita contener entre 60% y 90% de alcohol.
GUANTES Guantes son obligatorios cuando personas manipulan alimentos, administran primeros auxilios, lavan ropa (o preparan ropa para lavar), administran medicamentos tópicos o crema para bebés, cambian pañales, limpian, higienizan, desinfectan, etc. Después de quitarse los guantes, tienen que lavarse las manos. 12 (C: 04/2020; R: 08/21)
CUBREBOCAS Mientras que vacunaciones y la continuación de medidas preventivas han ayudado a disminuir las infecciones, es importante recordar que niños que tienen menos de 12 años no se pueden vacunar todavía. A continuación, se describen los requerimientos de mascarillas que siguen en vigencia para escuelas y otras situaciones donde hay niños no vacunados.
CUBREBOCAS – ADULTOS Salones de clase de preescolar:
Adentro – Miembros del personal que estén completamente vacunados tienen que usar cubrebocas cuando estén adentro, si es que niños que tengan menos de 18 años están presentes o podrían estar presentes, pero si no hay niños presentes y su estatus de vacunación fue verificado por el departamento de recursos de LCC, no tienen que usar cubrebocas cuando estén adentro. Todos los demás adultos (padres/tutores y visitantes) tienen que usar mascarilla cuando estén adentro de los edificios del programa sin importar su estatus de vacunación.
Afuera – Miembros del personal, padres/tutores y visitantes que no hayan sido vacunadas tienen que usar mascarilla afuera. Miembros del personal que sean vacunadas y prefieran no usar una mascarilla cuando estén afuera tienen que proveer un comprobante de su vacunación al departamento de recursos humanos de LCC antes. Familiares de niños inscritos que prefieran no usar cubrebocas fuera de un centro de este programa pueden elegir mostrar un comprobante de su vacunación al miembro de personal. Puesto que miembros del personal tienen que verificar su estatus de vacunación, pero no van a hacer ni guardar copias, los familiares de niños que prefieran no usar mascarilla fuera de uno de nuestros centros deben tener su comprobante de vacunación cada vez que lo visite, incluyendo cuando deje y recoja a su niño, y debe estar dispuesto a mostrar su comprobante a todo miembro del personal que lo pida. Se les anima a personas no vacunadas que usen mascarilla cuando estén afuera y sea difícil mantener una separación física adecuada.
Salones de clase de bebés y niños muy pequeños: Sigan las normas que se describen más arriba (que cubrebocas son requeridos). Debido a la duración más larga de contacto cercano, miembros de personal que trabajen en salones de clases de bebés necesitan usar mascarilla de tipo quirúrgico junto con un protector facial y éstos les serán proporcionados por el programa.
*Recomendaciones obtenidas de: WA. L&I, CDC, & WA. D.O.H
CUBREBOCAS – NIÑOS A continuación, hay algunas excepciones específicas que se basan en la edad, desarrollo o discapacidad, como está descrito más abajo. Para más información, vea Pautas para los tapabocas de tela durante la COVID19 del DOH y la guía para el uso de mascarillas de los CDC. Para disminuir el riesgo de lesiones, es preferible usar mascarillas con bandas para las orejas en vez de lazos que se atan detrás de la cabeza. Proveedores de cuidado de niños tienen que proporcionar cubrebocas a miembros del personal y niños que no las tengan. En algunos casos, miembros del personal necesitarán un tipo de protección superior para cumplir con las reglas y normas de salud y seguridad del departamento de labor e industrias. Para más detalles, refiérase a los requerimientos del departamento de labor e industrias sobre mascarillas y cubrebocas.
Niños que tengan 2 años o más tienen que usar cubrebocas cuando estén dentro de una guardería, escuela de preescolar o campamento de día. • Personas que no deben usar cubrebocas de tela: o Niños menores de 2 años 13 (C: 04/2020; R: 08/21)
o Niños que estén durmiendo o Personas con una discapacidad que les prevenga usar o quitarse un cubrebocas confortablemente o Personas que tengan ciertos problemas respiratorios o dificultad para respirar o Personas sordas o duras de oído que usen movimientos de su cara y boca como parte de su comunicación. o Personas que han sido aconsejados por un profesional médico, legal o de salud de comportamiento que usar un cubrebocas las podría causar algún riesgo • En ciertas situaciones inusuales, cuando no es posible usar cubrebocas de tela, niños y miembros del personal pueden usar un protector facial transparente o escudo facial con una extensión de tela en vez de usar cubrebocas de tela. Protectores faciales deben extenderse más bajo que su cara y hasta sus orejas y no debería haber un espacio entre el protector y su frente. • Es necesario supervisar a niños menores cuando usen cubrebocas de tela. Estos niños necesitarán ayuda para ponérselos, quitárselos y acostumbrarse a usarlos. • Niños pueden quitarse cubrebocas de tela para comer y beber y cuando estén afuera. Si niños necesitan un descanso de usar mascarilla, llévelos afuera o a un salón grande y bien ventilado donde haya lugar suficiente para asegurar que personas estén separadas por más de 6 pies. • La guardería tiene la responsabilidad de proveer equipamiento de protección personal a todos miembros del personal, incluyendo las personas que ayuden a niños y jóvenes con necesidades especiales *Recomendaciones obtenidas del departamento de salud de Washington
CÓMO PONERSE UNA MASCARILLA O UN CUBREBOCAS DE TELA Miembros del personal que ayuden a hacer chequeos de temperatura tienen que usar cubrebocas y protector facial cuando hagan evaluaciones de salud a la entrada del edificio. Sigan las pautas de cubrebocas que están más abajo y lávese las manos antes y después de hacer los chequeos.
1. Antes de ponerse un cubrebocas, lávese las manos por 20 segundos por lo menos, con jabón y agua, o frote sus manos cuidadosamente con desinfectante de manos a base de alcohol. 2. Inspeccione el cubrebocas para defectos como desgarro o una banda rota. 3. Posicione el cubrebocas para que el lado con color esté hacia afuera. 4. Si el cubrebocas tiene faja metálica, asegúrese de que ésta esté hacia arriba, posicionada en el puente de la nariz. 5. Si el cubrebocas tiene: o Bandas para orejas: Agarre las dos bandas y ponga una sobre cada oreja. o Lazos: Agarre los dos lazos. Amarre los lazos superiores seguramente, cerca de la coronilla. Amarre los dos lazos inferiores cerca de la nuca. o Dos bandas elásticas: Jale la banda superior por encima de su cabeza y póngala alrededor de la coronilla. Jale la banda inferior sobre su cabeza y póngala en la nuca. 6. Ajuste la faja metálica. Pellízquela y apriétela a su nariz para moldearla al puente de la nariz. 7. Jale el borde inferior del cubrebocas hacia abajo para cubrir su boca y barbilla. 8. Asegúrese de que el cubrebocas le quede justamente. 9. Después de posicionar el cubrebocas, no lo toque más, para no contaminarlo. 10. Si el cubrebocas se pone sucio o húmedo, cámbielo por uno limpio.
Lo que no hacer: • No toque el cubrebocas una vez que esté bien posicionado en su cara; no lo deje colgado de una oreja; no lo deje en su cuello; y no cruce los lazos.
Si es necesario tocar el cubrebocas mientras que lo tenga puesto, lávese las manos primero, porque es posible que sus manos o el cubrebocas tengan gérmenes y usted quiere evitar contagiarse o
14 (C: 04/2020; R: 08/21) transmitirlos. También lávese las manos después de tocar el cubrebocas y/o use desinfectante de manos. Si usa un cubrebocas de tela, lávelo frecuentemente con agua caliente.
CÓMO QUITARSE UNA MASCARILLA SEGURAMENTE • Cuando se quita el cubrebocas, evite tocar su cara, especialmente sus ojos, nariz y boca • Lávese las manos antes de quitarse el cubrebocas, si es posible. • Aleje las bandas o hilos de su cabeza y orejas, siempre evitando tocar su cara. • Si es desechable, eche el cubrebocas a la basura y lávese las manos con jabón y agua caliente por 20 segundos, por lo menos. • Si usa cubrebocas de tela, póngalo en una bolsa de papel o plástico después de quitárselo.
CÓMO CUIDAR CUBREBOCAS DE TELA Los cubrebocas de tela deben ser lavados todos los días con detergente y agua caliente. Seque el cubrebocas completamente en una secadora o, si es posible, déjelo secar en la luz del sol. Si tiene que usar el cubrebocas otra vez antes de lavarlo, lávese las manos después de ponérselo y no toque su cara. Eche un cubrebocas de tela a la basura si es que: • No cubre más su boca y nariz • Ha perdido su elasticidad o no se queda en su cara • Sus lazos o bandas están dañadas • La tela tiene desgarros o agujeros
CUIDADO DE MASCARILLAS DESECHABLES Mascarillas desechables tienen que ser desechadas cuando miembros del personal se vayan de su sitio de trabajo por cualquier motivo, como su hora de almuerzo y/o el fin de sus horas de trabajo.
Se requiere un cubrebocas desechable nuevo cuando: • Un área cualquiera de la mascarilla desechable esté dañada, sucia y/o mojada. • La mascarilla ya no se queda en el puente de la nariz o se extiende hasta debajo de su barbilla, con el efecto de no cubrir el área entera de la nariz y boca.
LIMPIAR, HIGIENIZAR Y DESINFECTAR Los maestros y otros miembros del personal deben limpiar, higienizar y desinfectar repetidamente todos los objetos que son tocados frecuentemente.
CÓMO LAVAR JUGUETES A MANO Paso 1: Limpiar • Lavar y fregar los juguetes cuidadosamente con jabón o detergente y agua caliente. Es importante limpiar los juguetes completamente antes de desinfectarlos, porque la desinfección es más eficaz cuando una superficie está limpia. Paso 2: Enjuagar • Enjuague los juguetes con agua caliente para quitar tierra, gérmenes y jabón. Paso 3: Desinfectar (tres pasos) • Sumerja los juguetes en una solución de cloro y agua • Para permitir que los juguetes se sequen completamente, déjelos secarse hasta el próximo día o déjelos dos minutos antes de secarlos con una toalla de papel. • No es necesario enjuagarlos otra vez
15 (C: 04/2020; R: 08/21)
Si grupos de niños se mueven de un área a otra en turnos, limpie cada área antes de que otro grupo de niños la entre. Repetidamente limpie y desinfecte superficies que son tocadas frecuentemente.
CÓMO LAVAR LOS JUGUETES EN UN LAVAPLATOS • Es posible lavar algunos juguetes en un lavaplatos (los de madera, plástico y metal). o Antes de ponerlos en el lavaplatos, tiene que quitarles todas las piezas desmontables. • Siga las instrucciones del detergente de lavaplatos. • Déjelos en el lavaplatos hasta que termine un ciclo entero de lavar y secar. • No ponga platos y cubiertos sucios, etc., en el lavaplatos con los juguetes.
LIMPIEZA DE JUGUETES • Si usan juguetes que son para la boca, es recomendado que provean juguetes individuales a cada niño y que guarden los juguetes de cada niño separadamente. • Coleccionen los juguetes cuando se ensucian o Juguetes para la boca – después de cada uso o Los demás juguetes – cada día, o más si es necesario • Juguetes serán separados y serán guardados separadamente (de tela y de madera/plástico) • Limpien, enjuaguen y desinfecten los juguetes diariamente al fin del día o a una hora específica • Maestros tienen que usar guantes de goma de casa cuando limpian y desinfectan juguetes
ALFOMBRAS Se debe aspirar las alfombras todos los días después de las clases, cuando los niños no están presentes. Se recomienda poner una cobija o toalla debajo de bebés cuando están en alguna alfombra.
LAVAR ROPA Tienen que lavar los cubrebocas usados todos los días en cada centro. Los cubrebocas usados deben serán colocados en un recipiente etiquetado que solamente se usa para cubrebocas. Miembros del personal deben llevar guantes cuando tocan cubrebocas sucios y ropa para lavar. La ropa sucia debe ser lavada a la temperatura máxima. Si mezclan ropa contaminada con otra ropa, no resultará en la contaminación de las demás ropas. Tienen que poner cubrebocas en la secadora y no quitarlos hasta que estén completamente secos. Miembros del personal tienen que lavarse las manos después de que manipulen ropa para lavar y se quiten los guantes.
En caso de enfermedad o exposición a fluidos corporales, se recomienda mantener un cambio de ropa o dos para cada uno de los bebés y niños muy pequeños en el salón.
EN CASO DE EXPOSICIÓN AL CORONAVIRUS • Si es posible, espere hasta 24 horas antes de limpiar y desinfectar todas las áreas, concentrándose en superficies que son tocadas frecuentemente. • Abra las ventanas y puertas exteriores para que el aire circule más. • Siga el procedimiento de “Limpiar, higienizar y desinfectar” y los pasos que están más arriba para prevenir la propagación de enfermedades. • Si han pasado más de 7 días desde que la persona con un caso sospechado/confirmado de COVID-19 visitó o usó el edificio, no es necesario hacer limpieza o desinfección adicional.
16 (C: 04/2020; R: 08/21)
SISTEMAS INMUNES COMPROMETIDOS/NECESIDADES ESPECIALES DE SALUD
NIÑOS CON ENFERMEDADES CRÓNICAS El personal deberá ser cuidadosísimo con los niños con problemas de salud crónica como asma. Durante los periodos cuando los casos de COVID-19 estén aumentando, es aconsejable que los niños con graves problemas crónicos de salud (por ej. asma) se queden en su casa siguiendo estrictas normas de higiene y distanciamiento físico.
PERSONAL CON ENFERMEDADES CRÓNICAS El personal que vive con enfermedades crónicas debe ponerse en contacto con su proveedor de atención médica para obtener orientación al considerar cuándo proporcionar o participar en el cuidado de niños. El personal debe trabajar con su supervisor y recursos humanos de LCC cuando se necesiten adaptaciones.
MUJERES EMBARAZADAS Las mujeres embarazadas deben seguir los procedimientos del personal/voluntarios, lavarse las manos a menudo, mantener la distancia física adecuada de los demás y usar mascarilla en todo momento. Se recomienda un protector facial, pero no es obligatorio. Se recomienda que las mujeres embarazadas eviten las zonas de alto tráfico tan a menudo como sea posible para prevenir la exposición.
CUIDAR A UNA PERSONA CON COVID-19 Limite su contacto • Alejarse de otras personas ayudará a detener la propagación del COVID-19 • Si es posible, instruya a la persona enferma que use dormitorio y baño separado. • Si tiene que estar en el mismo cuarto, asegúrese de que haya buen flujo de aire. o Abra la ventana para permitir más circulación de aire. ▪ Más circulación de aire ayuda a quitar gotitas respiratorias del aire.
Cuidadores deben ponerse bajo cuarentena si están expuestos a una persona con COVID-19.
Cuidadores y toda persona que tenga contacto cercano con una persona con COVID-19 debe de quedarse en casa y seguir las recomendaciones de su cuidador de salud, las pautas descritas en este procedimiento escrito y las instrucciones de su supervisor.
17 (C: 04/2020; R: 08/21) HLTH 1h Lower Columbia College Head Start/EHS/ECEAP PARENT STATEMENT OF UNDERSTANDING COVID-19 Operating Plan & Supplemental Health Policy Guidelines
Lower Columbia College Head Start/EHS/ECEAP COVID-19 Operating Plan & Supplemental Health Policy Guidelines outline our daily operations during the COVID-19 outbreak, our expectations of you as a school community member and reflects our commitment to excellence.
Please understand: • This operating plan is intended as a reference and is to be used as supplemental guidance for parents and staff to our existing Health & Safety policies and procedures; • The school reserves the right to change any or all plans, policies, or procedures, in whole or in part, at any time, with or without notice; • Nothing here creates or constitutes a contract between the school and any school family.
By signing below, you certify the following:
I certify I have read and have had an opportunity to discuss with the administration any questions or concerns about the rules and policies contained in the Lower Columbia College Head Start/EHS/ECEAP COVID-19 Operating Plan & Supplemental Health Policy Guidelines.
I certify that I understand my child will be subject to daily health screenings and that I will be asked a series of health questions related to my child’s current health status prior to the home visit.
I certify that I understand that I will be required to wear a face mask when entering any LCC Head Start/EHS/ECEAP building and if I do not have one at time of entry into the building, one will be provided.
I certify that I understand that masks and/or face shields will be provided to children and staff will teach and encourage their use as they do all other health practices such as hand washing.
I certify that I understand that children and families within the home-base setting are not required to wear a face mask, but those ages 2 and older are encouraged to do so when home visitor is present.
I certify that I understand the exclusionary health policy if my child exhibits symptoms of COVID-19.
I certify that I understand I must notify the school administration immediately if someone in my household has a confirmed case of COVID-19.
I certify that I understand that Lower Columbia College Head Start/EHS/ECEAP may be required to close for a minimum of 2-14 days in the event of a confirmed onsite COVID-19 related exposure.
I certify that I understand Lower Columbia College Head Start/EHS/ECEAP is doing its best to maintain health and safety standards and social distancing directives while providing a much- needed service.
Student Name LOC ID Parent Name (Print) Parent Signature Date
(C: 03/21; R: 08/21) HLTH 1h Head Start/EHS/ECEAP de Lower Columbia College DECLARACÓN DE COMPRENSIÓN DE PADRE DE FAMILIA Normas del plan de operación y política suplemental de salud por el COVID-19
Las normas del plan de operación y la política suplemental de salud por el COVID-19 describen cómo nuestras operaciones diarias serán durante la pandemia COVID-19 y qué esperamos de usted, un miembro de nuestra comunidad escolar, y reflejan nuestro compromiso con la excelencia.
Por favor, comprenda: • El propósito de este plan de operación es servir como referencia para padres de familia y miembros del personal y suplementar nuestras políticas y procedimientos actuales de la salud y seguridad. • La escuela mantiene el derecho de cambiar sus planes, políticas o procedimientos en parte o en todo, en cualquier momento, con notificación o sin notificación. • Ninguna parte de este documento crea o constituye un contrato entre la escuela y las familias que participen en el programa.
Por medio de su firma más abajo, usted certifica lo siguiente:
Yo certifico que leí y tuve la oportunidad de discutir con los directores del programa las preguntas o inquietudes que yo haya tenido acerca de las reglas y políticas incluidas en las Normas del plan de operación y política suplemental de salud por el COVID-19.
Yo certifico que comprendo que van a revisar la salud de mi hijo todos los días de clase y que al entrar al edificio me harán preguntas acerca de la salud actual de mi hijo.
Yo certifico que comprendo que seré obligado a llevar un cubrebocas cuando entre a cualquier edificio del programa LCC Head Start/EHS/ECEAP y si yo no tengo uno conmigo, me proveerán uno.
Yo certifico que comprendo que proveerán cubrebocas o protectores faciales a los niños y que los maestros les enseñarán a usarlas, tal como les enseñan a seguir otras prácticas de salud como lavarse las manos.
Yo certifico que comprendo que no se requiere que niños y familias del programa con base en los hogares usen mascarilla mientras estén en su casa, pero a los que tengan dos años o más se les anima a hacerlo mientras su visitante esté presente.
Yo certifico que comprendo que mi hijo no puede asistir si tiene síntomas del COVID-19.
Yo certifico que comprendo que necesito notificar a los directores de la escuela de inmediato si alguien que vive en mi casa tiene un caso confirmado del COVID-19.
Yo certifico que comprendo que es posible que el programa Head Start/EHS/ECEAP de Lower Columbia College se vea obligado a cerrarse por un mínimo de 2-14 días en el evento de una exposición a un caso confirmado del COVID-19 en un centro del programa.
Yo certifico que comprendo que el programa Head Start/EHS/ECEAP de Lower Columbia College está haciendo lo mejor que pueda para mantener las normas de salud y seguridad y ordenes de distanciamiento al proveer un servicio importantísimo.
Nombre de estudiante: LOC ID: Nombre de padre de familia: Firma de padre de familia: Fecha:
(C: 03/21; R: 08/21) HLTH 2a
Lower Columbia College Head Start/EHS/ECEAP Child Health and Safety
POLICY In order to maintain and promote child health and safety, our program has established and implemented procedures to respond to medical and dental health emergencies with which all staff members are familiar and trained.
Approved by HSAC March 4, 2002
PROCEDURE Procedures include but are not limited to: Posted plans of action for emergencies Posted locations and telephone numbers of emergency response systems Up-to-date family contact information and authorization for emergency care for each child Posted emergency evacuation procedures and routes Methods of notifying parents in the event of an emergency involving their child Emergency Response Procedure notebook which also includes the above stated procedures. Established methods for handling cases of suspected or known child abuse and neglect that are in compliance with applicable Federal and Washington State laws.
The Health Services Advisory Committee (HSAC) will review procedures, which are applicable to this policy, annually.
(C: 03/02; R: 05/10) HLTH 2b LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Emergency Procedures for Accidents or Critically Ill Children
I. SEVERE EMERGENCIES A. Assess the situation for danger and mechanism of injury and then proceed accordingly. In the case of very serious emergencies, such as unconsciousness, severe bleeding, broken bones, severe burns, head injuries or if stops or has difficulty breathing, give IMMEDIATE first aid as spelled out in the first aid guide and call 911 (Castle Rock Center and EHS Teen Center call 9-911) and request an ambulance.
AMBULANCE Barnes, Broadway, Castle Rock & LCC Campus & Memorial Park EHS Teen 911 9-911
B. For emergencies needing police, ambulance, fire department or poison control, call:
Barnes, Broadway, Castle Rock & LCC Campus & Memorial Park EHS Teen
LONGVIEW POLICE 911 9-911 KELSO POLICE 911 9-911 CASTLE ROCK POLICE 911 9-911 FIRE DEPARTMENT 911 9-911 EMERGENCY MENTAL HEALTH SERVICES 8-360-425-6064 9-360-425-6064 POISON CONTROL CENTER 8-1-800-222-1222 9-1-800-222-1222
C. The Lead Teacher/Child & Family Development Specialist staff member will remain with the child before and during transporting child to the hospital emergency department bringing the child's Family Information form with them.
Assistant teacher/remaining EHS staff member is responsible for: - Taking charge of remaining children in class. - Call 360-442-2800 or appoint another adult to contact staff person in main Head Start office of the emergency. (At that time, request a second staff member to come to classroom if needed.)
Office staff will: - Notify the responsible parent/guardian of the emergency situation and plan of action. - Ensure the hospital emergency department has the Family Information Form. - If emergency at LCC East or West Centers, office staff member will also call Campus Services at extension 2911. - Assist, as needed, with placing a second staff member in classroom.
II. SUSPECTED POISONING If a child swallows poison, call the Poison Control Center, 1-800-222-1222. Give the following information immediately: 1. Child’s AGE 2. Child’s SEX 1 (C: 09/99; R: 08/18) HLTH 2b 3. Approximate WEIGHT (usually between 35-40 lbs.) 4. WHAT he/she swallowed and WHEN 5. Have SAMPLE of substance or bottle 6. QUANTITY of substance ingested 7. HISTORY of events and present physical condition THEY WILL TELL YOU WHAT ACTION TO TAKE
III. PROCEDURES FOR MINOR INJURIES A. Staff trained in first aid will take appropriate steps. B. Record incident in ChildPlus/Family Services. C. Report the incident to the parent the day it occurs. D. Complete an Accident Report form.
IV. DENTAL EMERGENCY PROCEDURES In the event of an accident to the tongue, cheeks or teeth: A. Attempt to calm the child: All incidents should be handled calmly and quietly; an upset child is likely to create problems for treatment and may cause further trauma. B. Check for bleeding. C. If child’s tongue, cheeks and/or teeth are bleeding: - Put on gloves. - Apply direct pressure to the area or have child, if able to do so, bite firmly down onto a clean cloth towel too large to swallow. - Have the child stand or sit over a basin to allow blood to fall into it. - Contact parent or Alternate Care Provider to take child to their primary health care provider or the hospital Emergency Department. D. If tooth is fractured or broken: - Staff can do little for a fractured tooth except calm the child - Contact parent or Alternate Care Provider to take child to their primary health care provider or the hospital Emergency Department. Child should be checked for other head, neck and facial trauma. E. If tooth is knocked out: - Place tooth in a clean and moistened cloth/paper towel and then into a new, clean plastic bag. - Contact parent or Alternate Care Provider to take child to dentist for immediate treatment. It is most important that the tooth be replanted immediately. F. If a tooth is knocked into the gums: - Do not attempt to free or pull on the tooth. - Contact parent or Alternate Care Provider to take child to a dentist for treatment. (If the child does not have a dentist, also contact the Health Specialist or Disabilities/Health Coordinator to arrange for the child to see a dentist.)
V. REPORTING AND DOCUMENTING All accidents involving students, parents or staff are to be reported to a Leadership Team member by the end of the same working day.
A. The form titled: Lower Columbia College Head Start/EHS/ECEAP Student Accident Report Form is completed when a preschool student or childcare participant has had an accident.
2 (C: 09/99; R: 08/18) HLTH 2b 1. An Accident Report is to be completed and submitted online at https://cm.maxient.com/reportingform.php?LowerColumbiaCollege&layout_id=1 when an employee, work-study student, volunteer or other adult has had an accident.
B. The staff member administering first aid is to use their best judgement when determining if an Accident Report needs to be completed. If in doubt about completing a form, the staff member needs to contact the Health Specialist or another Leadership Team member. As a guide-line, an Accident Report is to be completed anytime outside medical attention is considered to be warranted. Regardless if an Accident Report is completed or not, the parent/guardian of any child involved in an accident is to be notified of any injuries or potential injuries. (*Reference Instructions for Completing an Accident Form HLTH 9b)
VI. BUS/VAN ACCIDENT PROCEDURES In case of accident, follow the suggestions below: a. Children are your major priority! If needed, evacuate the bus/van. (When evacuating and if possible, take the cell phone, first aid kit and Family Information forms with you.) Take the children to a secure location that is a safe distance from the bus/van. Whether on the bus/van or at a secure location, check for injuries and apply first aid, if indicated. If there are serious injuries, use emergency first aid and try to get help without leaving the children unattended by using the cell phone to call 911, etc. b. Complete a police report. c. If another vehicle is involved, be sure to get appropriate information, such as: license number, make and color of vehicles, name of driver, and name of insurance company. d. As soon as able, call the main Head Start office at 360-442-2800, request any needed assistance and report the accident.
All accidents/vehicle damage are to be reported in WRITING to the Director by the end of the same working day.
3 (C: 09/99; R: 08/18) HLTH 2c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Emergency Care in Case of a Seizure
Should a seizure occur the following protocol should be followed: ➢ If this is a first-time seizure, first call 911. If an Individual Care Plan has been developed with the family of a child, that plan should be followed and a copy should be filed in the classroom’s Emergency Notebook as well as in the student’s file.
1. If you are not sure if a child is having a seizure, give the child a light tough and loudly call the child’s name to get the child’s attention (Absence Seizure). 2. Ease the person to the floor to a safe place in order to provide ample room for convulsive movements (Tonic Clonic Seizure). a. Time the seizure. Remain calm. b. The Lead Teacher/EHS staff member stays with the person having the seizure. c. The Assistant Teacher/other EHS staff member removes other children from the room or vicinity of the child and sends additional staff member to assist, if possible. 3. Loosen tight clothing, especially around the neck and waist. If individual is wearing glasses or a face mask, remove if possible. 4. Turn body to the side (if possible) to allow saliva to drain. 5. Keep the airway clear. Do not put anything between the teeth or give the person anything to drink. 6. In order to prevent injury, move chairs, tables and other unsafe structure or items. 7. Protect the head, arms, and legs, but do not restrain. A coat, sweater, or pillow under the head may be helpful. 8. Maintain a quiet, calm atmosphere. Avoid confusion and crowding. The seizure may last 2-5 minutes. 9. CALL 911 IF ANY OF THE FOLLOWING OCCUR: • A seizure is followed by another major seizure. • A seizure lasts more than 3 minutes. • It is the first time the person has experienced a seizure. • The individual seems to be choking. • The individual sustains an injury to head during seizure. Make sure to note the symptoms and duration of the seizure in order to provide this information to the paramedics and child’s parent/guardian. 10. After the Seizure: a. Tiredness and drowsiness may occur. b. Allow the person the opportunity to rest, preferably on their side. c. Loss of bowel or bladder control may have occurred. 11. Contact the person’s parent/guardian or emergency contact. 12. Complete Student Accident Report form for a child or an LCC Accident Report for staff online on the LCC Website.
What is a Seizure? A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. Most seizures last from 30 seconds to two minutes. A seizure that last longer than five minutes is a medical emergency. Two Main Types of Seizures: ABSENCE SEIZURE (Petit Mal): Often occur in children and are characterized by staring into space or by subtle body movements, such as eye blinking or lip smacking. They usually last for five to 10 seconds. These seizures occur in clusters and cause a brief loss of awareness. TONIC CLONIC SEIZURE (Grand Mal): Are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue. They may last several minutes. MayoClinic (03/31/21) Seizures. Retrieved from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
(C: 03/01; R: 06/21) HLTH 2d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Reference & Handout for When a Child has Experienced a Bump to the Head
Head Injuries: Fall into two categories External (usually scalp) Internal (may involve the skull, the blood vessels within the skull, or the brain.) Fortunately, most childhood falls or blows to the head result in injury to the scalp only, which is usually more frightening than threatening. An internal head injury has more serious possible implications since the skull serves as a protective helmet for the delicate brain.
External (scalp) Injuries of the Head: The scalp is rich with blood vessels, so even a minor cut to the scalp can bleed profusely. The "goose egg" or swelling that may appear on the scalp after a head blow results from the scalp's veins leaking fluid or blood into (and under) the scalp. It may take days or weeks to disappear.
What to do: If the child is unconscious, even briefly, or is an infant call 911. If the child is conscious and not an infant, call the child's parent or alternate care individual (responsible adult). The responsible adult with a staff member's assistance is to determine if their child requires their immediate care. However, a staff member can require that the responsible adult pick-up the child and determine if a medical assessment is needed. If the child has not lost consciousness and is alert and behaving normally after the fall or blow, apply an ice pack or instant cold pack to the injured areas for 20 minutes. (If you use ice, always wrap it in a washcloth or clean cloth; ice applied directly to bare skin can cause frostbite damage.) At School or Home: Observe the child carefully for the next 24 hours. If the child shows any of the signs of internal injury (see below), call 911 immediately. If the incident has occurred close to bedtime or naptime and the child falls asleep soon afterward, check him every two hours for disturbances in color or breathing, or twitching limbs. If color and breathing are normal, and you observe or sense no other abnormalities, let the child sleep (unless the doctor has advised otherwise). If color and/or breathing are abnormal, or if you are not comfortable with the child's appearance (trust your instincts), arouse him partially by sitting him up. The child should fuss a bit and attempt to resettle. If he does not protest, try to awaken him fully. If he cannot be awakened, or shows any signs of internal injury (see below), call 911 immediately.
1 (R: 05/10)
HLTH 2d
Internal Injury to the Head The brain is cushioned by cerebrospinal fluid, but a severe blow to the head may knock the brain into the side of the skull or tear blood vessels. Any internal head injury – fractured skull, torn blood vessels, or damage to the brain itself – can be serious and may even be life-threatening. What to do: Call an ambulance (911) if the child shows any of the following symptoms: Unconsciousness Abnormal breathing Obvious wound or fracture Bleeding from the nose, ear, or mouth or clear drainage from the ear or nose. Disturbance of speech or vision Pupils of unequal size Weakness or paralysis Dizziness Neck pain or stiffness Seizure Vomiting Loss of bladder or bowel control
Until help arrives, do not move the child unless absolutely necessary. If the child is unconscious or dazed, or there is any paralysis, do not move him/her at all – there may be injury to the spine. 1. If child is not breathing, administer mouth-to-mouth resuscitation. 2. If child vomits, roll child to the side keeping his/her head and neck immobile. 3. Place your hands on either side of child’s head and keep child in the position in which you found him/her. If the child is conscious, do your best to keep him/her calm and still. If he/she vomits, sit child up slightly and help child lean forward, unless you suspect a neck injury. In that case, keep head and neck immobile and roll child on to his/her side.
If he has a seizure, keep his airway clear. If there is swelling, apply an ice pack or cold pack. If there is bleeding, apply a sterile dressing (bandage). Do not attempt to cleanse the wound, which may aggravate bleeding and/or cause serious complications if the skull is fractured. Do not apply direct pressure to the wound if you suspect the skull is fractured. Do not remove any objects stuck in the wound.
Adapted from the American Medical Association and the Nemours Foundation "Emergencies and First Aid" Web Page (12/00)
2 (R: 05/10)
When a Child has Experienced a Bump to the Head HLTH 2d
LOWER COLUMBIA COLLEGE HEAD START/ECEAP Forma de Referencias para Cuando un Niño Sufre un Golpe en la Cabeza
Lesiones en la cabeza: Se dividen en dos categorías Externas (comúnmente en el cuero cabelludo) Internas (podría implicar el cráneo, los vasos sanguíneos del cráneo, o el cerebro.) Afortunadamente, la mayoría de los niños que sufren caídas o se dan golpes en la cabeza solamente se lesionan el cuero cabelludo que suele ser más espantoso que serio. Una lesión interna en la cabeza pudiera tener implicaciones posiblemente mas serias ya que el cráneo actúa a modo de casco protector del delicado tejido cerebral.
Lesiones Externas (cuero cabelludo) en la Cabeza: El cuero cabelludo contiene muchos vasos sanguíneos, así que por más pequeña que sea la cortada al cuero cabelludo pudiera sangrar significativamente. El chichón o inflamación que aparezca en el cuero cabelludo después de un golpe en la cabeza es porque las venas están filtrando un líquido o sangre adentro (y por fuera) del cuero cabelludo. Pudiera tomarse días o semanas antes de desaparecer.
Que puede hacer: Si el niño esta inconciente a un que sólo sea brevemente o si es un bebé llame al 911. Si el niño esta conciente y no es un bebé, llame a los padres del niño o tutor (adulto responsable). El adulto responsable con la ayuda de un miembro del personal determinará si el niño requiere cuidados inmediatos. Sin embargo, el miembro del personal pueda pedir que el adulto responsable venga a recoger al niño y determinar si una evaluación medica sea necesaria. Si el niño no a perdido el conocimiento y esta alerta y se esta comportando de manera normal después de la caída o golpe, aplíquele una bolsa con hielo o compresa fría a la herida por 20 minutos. (Si utiliza hielo, siempre envuélvalo en una franela o trapo limpio; si se aplica directamente el hielo a la herida pudiera causar daños de congelación). En la Escuela o en su Casa: Observe al niño cuidadosamente durante las próximas 24 horas. Si el niño muestra cualquiera de los síntomas de lesiones internas (vea más adelante) llame al 911 inmediatamente. Si el incidente ocurre cerca de la hora de irse a la cama o la siesta y el niño se duerme, revíselo cada dos horas por si pudiera tener cambios de color, manera de respirar o que le tiemble alguna parte de su cuerpo. Si su color y respiración son normales, y usted siente que no hay ninguna anormalidad, deje al niño dormir (a menos que el doctor le hay aconsejado diferente). Si su color y/o respiración son anormales, o si no se siente conforme con la apariencia del niño (confié en su instinto), enderécelo poquito para que despierte. Pueda ser que el niño se moleste un poco y se forcejeé. Si no protesta, intente despertarlo completamente. Si no despierta, o muestra señales de lesiones internas (vea mas adelante), llame al 911 inmediatamente.
(C: 09/07; R: 05/10)
When a Child has Experienced a Bump to the Head HLTH 2d
Lesiones internas en la Cabeza El cerebro esta acojinado por un líquido cerebroespinal, pero un severo golpe en la cabeza podría causar que el cerebro choque con el cráneo y rompa vasos sanguíneos. Cualquier lesión interna en la cabeza – podría fracturar el cráneo, romper vasos sanguíneos, o dañar el cerebro – puede ser serio y poner la vida en peligro. Que puede hacer: Llamar a una ambulancia (911) si el niño muestra los siguientes síntomas: Inconciente Respiración anormal Heridas o fracturas evidentes Si esta sangrando de la nariz, oídos o boca o si arroja algo claro de los oídos o nariz. Si tiene dificultad para hablar o de su visión Si sus pupilas son de tamaño diferente Debilidad o parálisis Mareos Dolor o entumecimiento en el cuello Ataques Vomito Perdida del control de la vejiga o del intestino
Mientras la ayuda llega, no mueva al niño a menos que sea absolutamente necesario Si el niño esta inconciente, aturdido o tiene una parálisis, no lo mueva a el/ella para nada – podría tener lesionada la espina dorsal. 1. Si el niño no esta respirando, adminístrele resurrección de boca a boca. 2. Si el niño vomita, voltéelo de lado manteniendo su cabeza y cuello inmóvil. 3. Póngale sus manos a lado de la cabeza para detenérsela y manténgalo en la posición que lo encontró. Si el niño esta conciente, haga lo mejor que pueda para mantenerlo calmado y quieto. Si el/ella vomita, ayúdelo a enderezarse y sentarse despacio, a menos que sospeche de una lesión en el cuello. En ese caso, mantenga la cabeza y el cuello inmóvil y voltéelo de lado.
Si le da un ataque, mantenga el flujo del aire despejado. Si hay inflamación, aplique una compresa fría o una bolsa de hielo. Si esta sangrando, póngale un vendaje esterilizado (venda). No intente limpiar la herida, porque el sangrado podría empeorarse y/o causar complicaciones serias si el cráneo esta fracturado. No le aplique presión a la herida si es que sospecha que el cráneo esta fracturado. No remueva ningún objeto que pueda estar atorado en la herida.
Adaptado de la Asociación Medica Americana y la Fundación Nemours "Emergencias y Primeros Auxilios" Web Page (12/00)
(C: 09/07; R: 05/10)
HLTH 2e LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Health/Nutrition Postings Procedure
LOC ID Number(s) Date
Classroom staff is to complete this check-off list each September and at the time a new classroom is being set-up for operation.
The following documents are to be posted in your classroom prior to the first day of school:
_____ Emergency Medical/Dental Procedures HLTH 2b, Emergency Care for Seizure HLTH 2c & Bump to the Head Handout HLTH 2d –All on a “Ring” together. _____ Classroom Fire Drill/Evacuation Plan for Specific Classroom/Center _____ Exit signs by each Exit Door _____ Fire/Earthquake/Lockdown Drill Record Form HLTH 2j _____ Emergency Phone Numbers for Police, etc. (Post by your telephone.) _____ Phone Location Sign _____ Germ Buster Poster (Handwashing Poster) _____ Justice for All Poster _____ Dental Health Poster(s) _____ First Aid Kit Location Sign _____ Emergency Light Source Location Sign _____ First Aid Poster (Layperson CPR & First Aid for Choking) _____ Food Health & Sanitation Checklist for Staff & Volunteers NUTR 2c _____ Diaper/Pull-Ups Changing Procedure HLTH 4c (Post by changing table or in bathroom.) _____ Toothbrushing Procedure EDUC 7f _____ Bathroom Procedure EDUC 7a (HS/ECEAP only) _____ Toileting Procedure EDUC 7a1 (EHS only) _____ Bleach Solutions & Three-Step Process HLTH 4e _____ Dietary Restrictions List (ChildPlus Health Report)
You will receive a Classroom Allergy/Medical Concerns List (ChildPlus Health Report) to place in your Emergency Response Procedures Notebook.
The following documents are to be posted at your Center prior to the first day of school:
_____ Smoke Free Environment Policy FACI 1g _____ Annual Fire Inspection (If questions, please see Area Manager.) _____ Annual Fire Alarm / Smoke Detector Sensitivity Testing (If questions, please see Area Manager.) _____ Health Department Food Program Permit (Posted in Center Kitchen or Kitchen Area. See Kitchen Manager if Needed or Expired) _____ Building for the Future (USDA) _____ WIC Poster
Turn in completed forms to the Health Coordinator.
(C: 08/00; R: 08/18) HLTH 2f
LOWER COLUMBIA COLLEGE HEAD START/ECEAP Classroom Emergency Supplies and Postings Procedure LCC East and West Centers
Uniform placement, at the LCC East and West Centers, of the following items is in effect:
1. First Aid Kits are to be stored in the cupboard above the sink in each classroom
2. Emergency Procedures Notebook is to be stored in the tall locking cabinet in each classroom.
3. Fire Drill/Evacuation Plans are to be posted on or next to the primary fire exit door.
4. Emergency Medical/Dental Procedures are to be posted above the paper towel dispenser.
5. Emergency telephone numbers are to be posted next to the telephone.
(C:05/97;R:08/02) HLTH 2g
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Bee Sting & Bee Sting Allergy Procedure
This procedure is to be followed by staff when a child has been stung by a Bee or has a known or possible Bee sting allergy.
Plan for Child with a Bee Sting Allergy 1. Work with the parent and team to coordinate an Individual Care Plan (HLTH 8c). 2. Send an Anaphylactic Plan request to Health Coordinator or Health Specialist to fax to child’s health care provider to complete, sign, and date. 3. If child is prescribed an Epi-Pen or other medication by provider, remember to: a. Complete medication forms. b. Assure proper training of staff if Epi-Pen is prescribed. c. Check expiration date on Epi-Pen Jr. and assure proper storage in the center. d. Replace yearly and return to parent when no longer needed. e. Carry Epi-Pen for activities outside of the building, including field trips and playground.
When a Bee Stings a Child Have a staff member contact parent/guardian right away in case of possible unknown Bee sting allergy. Check to see if stinger is present at sting site. If stinger is present, scrape off stinger with an index card or other straight edge object. When removing stinger, do not pinch the stinger as this can inject more venom into the sting site. An infection can occur if stinger is not removed. Clean sting sight with soap and water. Pat dry with paper towel. Apply ice to the area to help prevent irritation and inflammation. Have child sit out and observe child for possible allergic reaction for approximately 15- 20 minutes. o If no allergic reaction is observed, child can resume to normal activities.
Possible Signs and Symptoms of a Bee Sting Allergy Hives, itchy rash, swelling of sting site, face, and/or extremities Severe pain at site of sting Red, itchy, watery eyes Shortness of breath, repetitive coughing, wheezing Itching, tingling or swelling of lips, tongue, mouth (dangerous as can block airway) – call 911
(C: 04/10; R: 10/2020) HLTH 2h LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Earthquake Preparedness Procedure
Teachers instruct children: 1. On what to expect during an earthquake. This will help them to avoid panic and/or injury.
2. Not to run.
3. To remain where they are, indoors or outdoors until the shaking stops. If indoors, the Teacher will inform the class when it is safe to come out from under the tables and chairs. If outdoors, the Teacher will instruct children to move to an open space away from buildings and playground equipment.
4. To keep away from fallen wires, trees, glass, windows, outside doors, and lighting fixtures.
5. That the electricity may go out and the sprinkler system or fire alarm may or may not turn on during an emergency.
Earthquake preparedness drills will be conducted every 3 months and recorded on the Child Care Fire Safety & Emergency Drills Record.
If an earthquake should occur while class is in session, teachers are to instruct children: 1. To crawl under a table or chair. The child should grab the leg of the table or chair they are under and place their other hand over their lowered head. If that is not possible, the child should take a position against a weight bearing wall (usually corridor walls and outside walls), and protect their face, head and neck with their arms. Avoid crouching near windows, heavy pictures, mirrors, under cabinets, all bookcases, and/or other tall movable objects. (Adults will protect infants and toddlers and may adjust positioning, as appropriate, to accommodate.)
2. After the Earthquake and during evacuation of the building, be prepared for aftershocks. Stay away from damaged areas and be prepared for falling objects and cautious of glass and other sharp objects.
(Teachers should also identify and discuss local hazards with their children.)
An easy phrase for your children to remember in the event of an earthquake:
STOP DROP GRAB-ON
*See Emergency Response Procedures Notebook.
RESOURCES FOR TEACHERS:
FEMA Earthquake Safety Activities for Children & Teachers: https://www.fema.gov/media-library- data/20130726-1508-20490-6311/fema-527.pdf
(C: 08/99; R: 02/2020) HLTH 2i
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Fire/Evacuation Drill Procedure
Teacher instructs children:
1. On what to expect during a Fire/Evacuation drill. This will help them to avoid panic and/or injury.
2. Upon hearing the building fire alarm or discovering fire or smoke, to line up calmly to evacuate the building. (EHS staff will utilize evacuation cribs as appropriate.)
3. To walk, not run to the nearest exit
4. To be alert and to follow the Teacher’s instructions.
5. To stay with classroom staff members at all times and to assemble in the designated area. Staff should never leave children unsupervised. If children are left unsupervised due to a staff member emergency, children should be taught to stay in their classroom and wait for an adult to arrive. If a staff member needs to leave their classroom due to an emergency, they must notify their supervisor and/or another staff member as soon as possible in order to establish classroom coverage. WAC 110-300-0470
6. That everyone must follow the orders of the fire and/or police departments when they arrive.
7. To use an alternate exit out of the classroom if the emergency exit is blocked or unsafe.
Staff must store the Emergency Preparedness Supplies container near emergency exit for easy access when evacuating the classroom during a natural disaster.
Additional Staff Responsibilities Direct Service Team/EHS members are to ensure that all children are out of the classroom and accounted for by: Completing a sweep of all areas in the classroom. Having a plan in place for children with physical disabilities, children with emergency medications, and English language learners. Bringing their class roster and classroom Emergency Response Procedures notebook. Assessing children for injuries when all children are out of the classroom and in a “safe space”.
Practice and Record Required Monthly Drills Teachers, with the support of their supervisor, are to ensure that their classroom children participate in an unannounced Fire Drill, at varying times of the day at least once a month. All Fire Drills conducted are to be recorded, by the Lead Teacher or Assistant Teacher/EHS staff, on the Child Care Fire Safety & Emergency Drills Record. (This record can be visibly posted in the classroom.)
*See classroom/center evacuation procedure for further instruction.
(C: 02/04; R: 02/2020) HLTH 2j Child Care Fire Safety & Emergency Drills Record for (year)
Annual Maintenance of Fire Extinguishers Date:
Monthly Inspection of Premises to Identify and Eliminate Possible Fire Hazards JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC Date Staff Initials
Monthly checks to ensure these items are working properly: Alternate alarms Emergency lighting Test smoke detectors Test carbon monoxide detectors Inspect fire extinguishers
Monthly Fire and Evacuation Drills Time of # of # of Length Notes – How did the drill go? How may the drill be improved? Month Date Day/Night Children Staff of Drill (continue notes on back page, if necessary) JAN FEB MAR APR MAY JUNE JULY AUG SEPT OCT NOV DEC
Earthquake, Lockdown or Shelter-in-Place Drill – once every three calendar months Type of Time of # of Length of Notes – How did the drill go? How may the drill be improved? Date # of Staff Drill Day/Night Children Drill (continue notes on back page, if necessary)
CHILD CARE FIRE SAFETY & EMERGENCY DRILLS RECORD DCYF 15-892 (REV. 08/2019) EXT (C: 08/93; 01/2020) HLTH 3a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP First Aid Kits Policy
Policy: Our program maintains readily available, well-supplied and appropriate first aid kits at each of our program centers. First aid supplies are also available on outings away from the center. The First Aid kits are restocked after use, and monthly classroom inventories conducted utilizing the Health Supply Request form.
(C: 08/02; R: 07/18) HLTH 3b
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP First Aid Supplies List
Teacher(s): Center: Rm. #
A first aid supply kit must be stored in a location that is easily accessible to staff, inaccessible to children, separate from food or chemicals, kept clean and sanitary, stored in a manner that prevents contamination, and have sufficient supplies for each classroom or office space (WAC 110-300-0230).
Classroom first aid supplies should be checked monthly by classroom staff and kept fully stocked. An inventory supplies list, which is signed and dated by classroom staff after the first aid kit inventory check each month, should be kept within each first aid kit.
The following items are to be included in your first aid supply kit which is stored in a cupboard within each classroom or office space:
Ice Pack (located in building freezer or an instant ice pack) CPR Barrier or Pocket Mask Digital Thermometer First Aid Tape Disposable Thermometer Covers Non-Latex Gloves (non-sterile OK) Triangular Bandage (sling) First Aid Scissors Gauze Pads Elastic Wrap Bandage Roller Bandage (ECEAP) Tweezers Assorted Bandages (various sizes) Hand Sanitizer (Adult use ONLY) First Aid Manual
The following items must be easily accessible in your classroom and/or on site:
Radio with Batteries (on site) Fire Extinguisher Emergency Response Procedure Notebook Pop-Up Light (windowless restrooms) Soap Carbon Monoxide Detector (any room where children sleep) Flashlight with Extra Set of Batteries CPR/First Aid Posting (posted in classroom) Emergency Blanket (each classroom) Bloodborne Pathogens Kit Supplies (disposable gown, safety glasses, disposable face mask, biohazard bag, gloves) Emergency Supplies Backpack (ALL classrooms) – Must be located by the classroom Emergency Exit to be easily accessible in case an emergency warrants a quick exit from classroom.
The Health Supplies Request form can be found in the Health Handbook (HLTH 3d).
(C: 07/01; R: 08/21) HLTH 3c
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Care of a Human Bite Procedure
Attend to and comfort the bitten child. Apply first aid as needed. Whether the skin is broken or not, use Universal Precautions. Wash with warm water and soap for 10 minutes. Apply ice pack or cool cloth to reduce bruising and swelling
Have the child who bit, rinse his/her mouth with warm water and spit it out in the sink.
If skin is broken, contact the parent/guardian for both children (the child who was bitten and the child who bit).
Call the Health Specialist or Health Coordinator to inform them that a biting incident occurred at your center. Health Specialist or Health Coordinator will review ChildPlus health records for both the biter and bitten child. (If neither the Health Specialist nor Health Coordinator is reached, please leave a message with office staff).
o Review Tetanus Immunization record for bitten child to ensure that it is current. If Tetanus record is not up to date, child will be referred to their healthcare provider to obtain a Tetanus vaccine.
o If either child has not completed the required 3 doses of the Hepatitis B vaccine, child will be referred to their healthcare provider to obtain Hepatitis B vaccine.
o Health records will be reviewed to ensure children are not carriers of HIV, the Hepatitis C Virus, or any other health condition or illness that warrants immediate medical attention. If either child is a carrier of HIV, HBV, or HCV, the child exposed to the disease needs to be evaluated by a Health Care Provider. The Health Specialist will then report the incident to the local health department. Parents/Guardians of both children should always contact their healthcare provider for further guidance.
Staff should continue to observe the child that was bitten for indicators of infection, fever, and swelling or redness of wound. If any of the above occur, contact parent to take the child to be seen by medical provider. (Bite wounds can become infected by bacteria from ordinary mouth germs).
Complete an Accident Report form for the child who was bitten and the child who bit.
A staff person discusses the biting incident separately with the parent/guardian of both children involved encouraging them to contact their child’s medical provider for advice and possible evaluation as their child may have exchanged body fluids with another child in the classroom.
Staff is not to discuss confidential health information regarding other child with parent/guardian if no health risk is identified. If health risk is identified, bitten child’s parent/guardian needs to be informed of exposure without identifying the child who bit.
(C: 04/10; R: 06/19) LOC ID ______HLTH 3d Lower Columbia College Head Start / EHS / ECEAP Health Supply Request Form
Name:______Date Ordered: ______Center: ______Room # ______Date Received: ______Item Quantity Date Back Ordered Completed Ordered Baby Wipes Bandages, Absorbent Gauze Bandages, Assorted (LATEX FREE) Bandages, Assorted Bandages, Butterfly Bandages, Large Bandage, Triangular Bandage Scissors Batteries for Radio or Flashlight: Size ______Biohazard Bag Small Large Blanket (Emergency Supplies Kit) Changing Table Covers CPR Chart CPR Pocket Mask Diapers Size: ______Diapers (pull-ups) Size: ______Disposable Face Masks, Adult Disposable Face Masks, Child Disposable Gown Eye Wash Kit First Aid Tape Flashlight Gauze Pads Gloves (powder) Small Medium Large Gloves (powder-free) Small Medium Large Hand Sanitizer (travel size- First Aid Kits) Hand Soap Pump Hand Soap Refill Ice Pack (freezer or instant) N95 Respirator Mask Pop-Up Light(s) Safety Glasses Thermometer (oral digital) Thermometer Covers (oral) Toothbrushes, Adult Toothbrushes, Children Toothpaste Tweezers
Supervisor’s Approval: (Please initial) ______White: Return White & Yellow Yellow: Returned w/Response Pink: Requestor Copy (C: 10/00; R:04/21) HLTH 4a LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Hygiene Policy
Policy Our program is committed to the effective implementation of hygiene, sanitation, and disinfection procedures that significantly reduce health risks to children and adults by limiting the spread of germs.
Hand Washing/Hygiene Procedure Post Department of Health procedure in all building bathrooms and at each sink in the classrooms. Hand washing is the single best way to reduce or stop the spread of bacteria (germs) that cause a child to be ill, e.g. diarrhea. Our staff washes their hands and teaches or assists children (if help is needed) to wash their hands.
Staff and volunteers wash their hands: a. Upon arrival at the child care center. b. Before putting on food service gloves. c. Before and after handling foods, cooking activities, eating and serving food. d. After touching/handling raw meat, poultry, fish, or eggs. e. After personal toileting. f. After assisting child with toileting. g. Before and after diaper/pull-up changing. h. After handling or coming in contact with body fluids such as mucus, blood, saliva, urine or vomit. i. After touching any unclean item. j. After attending to an ill child. k. Before and after administering first aid. l. Before and after giving medication. m. After handling, feeding or cleaning-up pets or other animals. n. After smoking. o. After being outdoors or involved in outdoor play.
Children will be directed or assisted in hand washing: a. Upon arrival at the center. b. Before food and meal preparations, eating meals or cooking activities. c. After toileting. d. After outdoor play. e. After coming in contact with body fluids. f. After handling pets or other animals.
How Hand Washing is Done at Our Center: a. Soap, warm running water and individual towels are available for staff and children. b. Turn on water and adjust temperature. c. Wet hands and apply a liberal amount of soap. d. Rub hands in a wringing motion from wrists to fingertips for a period of not less than 20 seconds. (As a general rule, hands should be washed for 30 seconds.) e. Rinse hands thoroughly. f. Dry hands, using an individual towel. g. Use hand-drying towel to turn off water faucet(s).
(C: 02/99; R: 07/18) HLTH 4b LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Handling of Body Fluids Procedure
CONTROL METHODS METHODS OF COMPLIANCE There are a number of areas that must be addressed in order to effectively eliminate or minimize exposure to bloodborne pathogens. The five areas of concern are addressed in the plan.
1. The use of Universal Precautions. 2. Establishing appropriate Central Safety Controls. 3. Implementing appropriate Work Practice Controls. 4. Using necessary Personal Protective Equipment. 5. Implementing appropriate Housekeeping Procedures.
Each of these areas are reviewed during the bloodborne pathogens related training. By rigorously following the requirements of OSHA's Bloodborne Pathogens Standard in these five areas, employees' occupational exposure to bloodborne pathogens will be eliminated or minimized as much as possible.
A. UNIVERSAL PRECAUTIONS We will observe the practice of "Universal Precautions" to prevent contact with blood and other potentially infectious materials. As a result, we treat all human blood, blood components and products made from human blood and any body fluid as if they are known to be infectious for HBV, HIV and other bloodborne pathogens.
These universal precautions include staff taking responsibility for preventing transmission from self to others. (i.e. Bandaging own cuts, etc. before and during work.)
B. CENTRAL SAFETY CONTROLS One of the key aspects to our Exposure Control Plan is the use of Central Safety Controls to eliminate or minimize employee exposure to bloodborne pathogens. As a result, our facility employs equipment such as disposal containers where appropriate.
C. WORK PRACTICE CONTROLS In addition to Central Safety controls, our facility used a number of safe work practices, which will be referred to as Work Practice Controls to help eliminate or minimize employee exposure to bloodborne pathogens.
Our facility has adopted the following Work Practice Controls as part of our Bloodborne Pathogens Compliance Program:
1. Employees wash their hands immediately, or as soon as feasible, after removal of gloves or other personal protective equipment. 2. Following any contact of body areas with blood or any other infectious materials, employees wash their hands and any other exposed skin with soap and water as soon as possible. They also flush exposed mucous membranes with water. 3. Eating, drinking, applying cosmetics or lip balm and handling contact lenses is prohibited in work areas where there is potential for exposure to infectious agents. pg. 1 (C: 05/97; R: 08/15) HLTH 4b 4. All procedures involving blood or other infectious materials minimize splashing, spraying or other actions generating droplets of these materials. 5. Blood or other contaminated materials are placed in designated leak-proof containers, appropriately labeled, for handling and storage. 6. If outside contamination of a primary container occurs, that container is placed within a second leak-proof container, appropriately labeled, for handling and storage.
When a new employee comes to our facility, or an employee changes jobs within the facility, the employee receives trainings as arranged by the Heath Specialist in any work practice controls of which the employee is not experienced.
D. PERSONAL PROTECTIVE EQUIPMENT Personal Protective Equipment is our employees' last line of defense against bloodborne pathogens. Because of this, our facility provides (at no cost to our employees) the Personal Protective Equipment that they need to protect themselves against such exposure. Personal protective equipment will be considered to be appropriate only if it does not permit blood or other potentially infectious materials to pass through or to reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used. Appropriate protective equipment or clothing shall be worn while the employee has a potential for occupational exposure. This equipment includes, but is not limited to:
1. Gloves 2. Protective Gowns (disposable) 3. Disposable Mouthpieces or Resuscitation Bags 4. Safety Eyewear
The Health Specialist is responsible for ensuring that all classrooms have appropriate personal protective equipment available to employees.
Our employees are trained regarding the use of the appropriate personal protective equipment for their job classifications and procedures they perform. Initial training or the proper use of personal protective equipment and additional training is provided, when necessary, if an employee takes a new position or if new job functions are added to their current responsibilities.
To ensure that personal protective equipment is not contaminated and is in the appropriate condition to protect employees from potential exposure, our facility adheres to the following practices: 1. All personal protective equipment is replaced as needed. 2. All personal protective equipment is removed prior to leaving a work area. 3. Gloves are worn in the following circumstances: a. Whenever employees anticipate hand contact with potentially infectious materials. b. When handling or touching contaminated items or surfaces. 4. Disposable gloves are replaced as soon as practical after contamination or if they are torn, punctured or otherwise lose their ability to function as an "exposure barrier".
E. HOUSEKEEPING Maintaining the facility in a clean and sanitary condition is an important part of the Bloodborne Pathogens Compliance Program. pg. 2 (C: 05/97; R: 08/15) HLTH 4b 1. All equipment, environmental and work surfaces shall be cleaned and decontaminated after contact with blood or potentially infectious materials. a. Contaminated work surfaces shall be decontaminated with an appropriate disinfectant or an absorbent agent. 1. Whenever surfaces are overtly contaminated or after any spill of blood or other potentially infectious materials. 2. After completion of procedures. 3. At the end of the work shift (if the surface may have become contaminated since the last cleaning). 2. All pails and similar receptacles intended for reuse and for which have a reasonable likelihood of becoming contaminated with blood or other potentially infectious materials shall be inspected on a regular basis and shall be cleaned and decontaminated as soon as feasible upon visible contamination. 3. Broken glassware and other sharp objects shall be picked up using a broom and dustpan. 4. Regulated waste: a. Contaminated sharp items, i.e. broken glass, shall be discarded into containers that are: 1. Closable 2. Puncture resistant 3. Leak-proof on sides and bottom 4. Labeled with biohazard label. Containers shall be easily accessible and located as close as is feasible to the area. The source of waste shall be maintained upright, replaced as needed and not allowed to overfill. 5. Center staff, placing waste in the container, will contact the Health Specialist and Disabilities/Health Coordinator if the container is full/close to full and/or waste smells/has the potential of smelling. The Health Specialist or Disabilities/Health Coordinator (using appropriate procedures) will pick-up this biohazard waste and take it to the lined biohazard waste box in the Annex building. The Health Specialist or Disabilities/Health Coordinator will notify Campus Services when this box needs to be picked up and replaced with a new box. Campus Services will pick-up the filled box, provide a new box with a liner and then contact LCC’s biohazard waste contractor to pick up the filled box for incineration. 6. Approved Disinfectants: a. Routine decontamination of work surfaces may be carried out using an approved intermediate or low-level disinfectant. b. Decontamination of spills or overt contamination of blood or potentially infectious materials shall be disinfected as specified. 7. Chlorine bleach disinfection solution: 1 ¾ teaspoons + 24 ounces of water. 8. Laundry: Contaminated laundry is handled as little as possible: Gloves and other appropriate personal protective equipment are used. The laundry is not sorted or rinsed where it is used. It is placed directly into leak proof bags labeled with biohazard label and disposed of according to site policy.
For additional information, see the Exposure Control Plan. A copy of the plan is located in the Health Specialist's office.
pg. 3 (C: 05/97; R: 08/15) HLTH 4c1
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Diaper/Pull-Up Offer Form
This form is completed during the enrollment process.
LOC ID: Play & Learn Social Group Waitlist Preschool
Child’s Name: Date of Birth:
The center indicated above provides diapers and/or pull-ups for children participating in the Lower Columbia College Head Start/EHS/ECEAP Program while your child is engaged in educational services on-site. The diapers used are unscented for allergy purposes. Parents may choose to supply their own diapers/pull-ups due to allergies, etc. Please mark one of the options listed below:
I accept the diapers provided by LCC Head Start/EHS/ECEAP Size:
I accept “Pull Ups” provided by LCC Head Start/EHS/ECEAP Size:
I decline the offered diapers/pull-ups and will supply my own. Name of Diaper/pull-up I am providing:
My child is no longer in diapers/pull-ups and I will provide his/her underwear and extra clothes.
Signature of Parent/Guardian Date
Signature of Staff Member Date
(C: 04/10; R: 07/2020) HLTH 4c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Diaper/Pull-Up Changing Procedure
Our program has adopted sanitation and hygiene procedures for diapering and the changing of pull-ups that adequately protect the health and safety of our program children. These procedures protect against the spread of bacteria, viruses, parasites, and fungus that are present in the feces and/or urine of sick and healthy people.
Diapering is done on an elevated, nonporous surface used only for diapering. The surface is washable, made of wipeable plastic or equipped with removable paper covers. Pull-ups may be changed in the child bathroom. Designated diapering and pull-ups changing areas are located close to a water source and away from food preparation and service areas.
1. Wash hands with soap and warm running water. (As described in the Hygiene Procedure.)
2. Gather necessary materials.
3. Put disposable gloves on.
4. Change diaper/pull-up – Make certain that the child is safely secured at all times. Do not leave the child unattended. Talk to the child while diapering. a. Take off the child’s dirty diaper/pull-up. b. The child's diaper (peri-anal) area is cleaned from front to back with wet wipes. Use a clean wipe for each stroke. c. At end of this procedure, note anything unusual in the child’s diaper/pull-up.
5. Dispose of diaper/pull-up, gloves and wipes used – Disposables: Place in a covered and hands free container lined with a plastic bag and designated specifically for disposable diapers. At the end of the day, place the closed plastic bag with contents into another plastic bag and then into the classroom garbage can for daily removal from the facility.
6. Clean your hands. Use soap and warm running water only if you can maintain contact with the child. Use disposable wipes otherwise.
7. Slide a clean diaper under the baby. Fasten the diaper securely, making sure it is not too tight. Child is dressed.
8. Wash child’s hands with soap and warm running water. Return child to a safe area.
9. Clean and rinse the diapering area, equipment and supplies touched with soap, warm water and a disposable towel. Also, disinfect with chlorine bleach solution of 1 ¾ teaspoons + 24 ounces of water. Solution must be mixed daily by staff member, labeled with date and stored out of children’s reach.
10. Wash hands with soap and warm running water.
(C: 08/02; R: 02/2020) HLTH 4d1
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Diapering/Bloodborne/Disinfecting for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of 1 ¾ teaspoons to 24 ounces of water. (The above solution meets the ratio necessary for disinfecting surfaces.)
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Diapering/Bloodborne/Disinfecting for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of 1 ¾ teaspoons to 24 ounces of water. (The above solution meets the ratio necessary for disinfecting surfaces.)
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Diapering/Bloodborne/Disinfecting for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of 1 ¾ teaspoons to 24 ounces of water. (The above solution meets the ratio necessary for disinfecting surfaces.)
(C: 08/06; R: 08/15) HLTH 4d
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Food Prep/Surface Sanitizing for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of ½ teaspoon to 24 ounces of water. (The above solution meets the ratio necessary for sanitizing surfaces.)
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Food Prep/Surface Sanitizing for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of ½ teaspoon to 24 ounces of water. (The above solution meets the ratio necessary for sanitizing surfaces.)
Lower Columbia College Head Start/EHS/ECEAP Monthly Bleach Log Food Prep/Surface Sanitizing for Head Start/EHS/ECEAP Centers
Month of:
Week of: Mon Tues Wed Thurs Fri
Solution is changed on a daily basis. Bleach water consists of ½ teaspoon to 24 ounces of water. (The above solution meets the ratio necessary for sanitizing surfaces.)
(C: 08/06; R: 08/15) HLTH 4e
Lower Columbia College Head Start/EHS/ECEAP Bleach Solutions for Cleaning, Rinsing, Disinfecting/Sanitizing
Basic Tips Three-Step Process Bleach solutions must be Solution 1: Disinfecting made fresh daily, kept For use on diaper changing tables, hand washing sinks, for disinfecting and away from heat, and any bathrooms, door and cabinet handles sanitizing non-porous unused solution must be surfaces discarded at the end of Water Bleach – 6% 1. Clean the surface the day. 24 ounces (spray bottle) 1 ¾ teaspoons with soap solution first using 2 drops of Bleach must be added to cool water rather than liquid detergent to 24 ounces of water. adding water to bleach. Soap solutions must Wear gloves and eye Solution 2: Sanitizing be made fresh protection when mixing For use on eating utensils, food use contact surfaces, mixed use tables, weekly. bleach and use a funnel. high chair trays, plastic mouthed toys and pacifiers 2. Rinse with clean Cleaning/disinfecting/ Water Bleach – 6% water and dry with sanitizing products must 24 ounces (spray bottle) ½ teaspoon paper towel. not be used in close proximity to children, and 3. Spray bleach solution adequate ventilation and allow to air dry should be maintained for 2 minutes before during the procedure to wiping dry with a prevent children and Important: If using an EPA-registered product, follow the manufacturer's paper towel. caregivers/teachers from instructions on the label for diluting the product for sanitizing or disinfecting, inhaling potentially toxic as well as for the contact time. Instructions on how to determine this for the fumes. EPA-registered product you are using can be found here: http://cfoc.nrckids.org/Bleach/FindingEPARegInfo.cfm
Post in classroom and child bathroom. (C: 08/15) HLTH 4f
Lower Columbia College Early Head Start – LEHSP Weekly Cleaning and Sanitizing Record
Month: Classroom:
Section 1 Section 2 Section 3 Section 4 Section 5 Bedding
Week 1
Week 2
Week 3
Week 4
Week 5
All section and bedding must be cleaned and sanitized weekly. Date and initial when completed.
(C: 12/2020) HLTH 4g HLTH 4g
Lower Columbia College Early Head Start-LEHSP Lower Columbia College Early Head Start-LEHSP Daily Cleaning and Sanitizing of Mouthed Toys Daily Cleaning and Sanitizing of Mouthed Toys
Month: Month: Date/Time Initial Date/Time Initial
Mouthed toys and soiled laundry must be washed and Mouthed toys and soiled laundry must be washed and sanitized daily. sanitized daily. (C: 12/2020) (C: 12/2020) HLTH 5a LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Medication Policy and Procedure
Policy The Head Start/EHS/ECEA Program’s Medication Policy is not to administer medication to a child. However, medication will be administered to a child in circumstances where the child’s physician/licensed health care provider has advised and authorized such administration of medication by our staff. Approved by HSAC 11/30/00
Procedure A Medication Policy and Procedure training is held annually for staff members. The classroom teacher/Child and Family Development Specialist (CFDS) is designated as the individual responsible for the administration of medications. In the absence of the teacher/CFDS, the assistant teacher/other EHS staff member will take on this responsibility. In the instances where there is more than one assistant teacher per classroom, the teacher will delegate the responsibility of medication administration to one assistant teacher.
1. Medication Authorization The child’s health care provider and the child’s parent/guardian must authorize the administration of all medications: Medication Authorization forms for prescription medications must be completed by the child’s health care provider or by the child’s parent and a Direct Service Team/EHS staff member referencing the original prescription label on the original prescription bottle. Medication Authorization forms or legible instructions on a prescription pad for nonprescription medications must be completed and signed by the child’s health care provider. If the health care provider provides instructions on a prescription pad, the child’s parent and a Direct Service Team/EHS staff member will reference this when completing the Medication Authorization form and when completing a label for the manufacturer’s container. All Medication Authorization forms must be reviewed and signed by the child’s parent/guardian.
The Medication Authorization form must specify the length of time that parental consent is granted: For a specified period of time during a period of illness. For the duration of the prescription Blanket authorization – This is allowed only for certain chronic or life-threatening conditions requiring medication. These authorizations must come with a signed statement from the child’s health provider or a prescription indicating that the treatment is on-going.
2. Medication Containers: All medications must be in child-resistant containers: Prescription medications must be in the original prescription bottle. The label qualifies as a physician’s or health care provider’s authorization to give the medication. Nonprescription medications must be authorized by a physician or health care provider and be in the manufacturer’s container with a label. Parents should provide 1 (C: 08/00; R: 07/18) HLTH 5a instructions and information on the label, including: the child's first and last names; specific, legible instructions for administration and storage authorized by the health care provider; and the name of the health care provider who recommended the medication for the child.
3. Medicines and Home: If the child’s parents do not want to take medicine home every night and bring it back the next morning, they can: Request that the pharmacist prepare two containers when they fill the prescription. Send the container with the pharmacist or manufacturer’s label to the center and keep a supply in a self-labeled container at home.
4. Medication and School Bus Medications will not be transported to or from home on the bus. On field trips, needed Emergency medications will be placed in the fanny pack that the Lead Teacher/CFDS is wearing. The classroom Emergency Response Procedures notebook is taken on field trips and contains completed medication forms for all authorized medications. Health care provider and parent authorized Emergency medications can be appropriately stored on the bus if medication storage/stability requirements are met. (The Health Specialist, Transportation Manager and Area Manager/EHS Supervisor must be contacted prior to Direct Service/EHS staff completing Medication forms and accepting medication from a parent/guardian for placement on a bus.)
5. Medication Storage Area Only staff can put medicines in the storage area or take them out: Medications, (other than emergency medication (i.e., Epi-pen, Jr., etc.) will be kept in locked cabinets. Medication storage cabinets will be labeled, child-resistant, and out of reach of children. However, medications requiring refrigeration will be refrigerated. Again, all medications are to be in child-resistant containers. Emergency medication will be stored in a labeled cabinet out of reach of children. Medications for the skin must be kept separate from medications that children swallow. Medication of any kind needs to be stored away from food and cleaning products or chemical compounds. Unused medication is to be returned to the parents or if expired appropriately disposed of by the Health Specialist. Medication required by staff and volunteers is clearly labeled with their first and last names.
6. Medication Records: A physician or other health care provider legally authorized to prescribe medication provides instructions for the dose, frequency, and method to be used and duration of administration in writing by: 1) completing and signing the Medication Authorization form or 2) by providing signed legible instructions on a prescription pad or 3) by a prescription label. A completed Medication Authorization form will be signed by the child's parent/guardian.
2 (C: 08/00; R: 07/18) HLTH 5a The Medication Authorization form is a triplicate NCR form. The original is to be kept in the child’s classroom Emergency Response Procedures notebook with the Medication Administration form. Upon completion of medication administration, the original is to be given to the EHS Manager/Health Specialist and subsequently filed in the child’s site file. Upon completion and parent/guardian signing, the yellow copy is to be placed in the student’s site file. Upon completion and parent/guardian signing, the pink copy is to be given to the Health Specialist or Disabilities/Health Coordinator. (The Health Specialist or Disabilities/Health Coordinator will provide copies of common side effects (SE) or adverse reactions (AR) for child’s prescription drug(s) to Direct Service Team/EHS staff member and child’s site file. DST/EHS staff member to refer to container on Over The Counter (OTC) medications for SE or AR.)
The Medication Administration form is to be filled out by the staff member administering the medication. Each time medication is administered, the date, time, amount (dose), how administered and staff signature are to be noted. Prior to each administration of medication, the staff member is to compare the medication label with the Medication Authorization form to assure proper medication and dosage. Upon completion of medication administration, the Medication Administration form is to be given to the Health Specialist and subsequently filed in the child’s site file.
Ongoing Communication with Parent/Guardian Medication error, problem and/or reaction are to be recorded on the Medication Administration form. This information is to be shared with the child’s parent/guardian, the Health Specialist, other appropriate staff members and the child’s health care provider. The teacher/CFDS and/or assistant teacher are to record changes in a child’s behavior or physical symptoms, which have implications for drug dosage or type. This information is to be shared with the child’s parent/guardian, the Health Specialist, other appropriate staff members and the child’s health care provider. If changes are noted at any time during medication administration, they are recorded and immediately brought to the attention of the child’s parent. The parent must then contact the child’s health care provider and provide documentation of the contact. Communication, regarding the child’s medication usage and changes in behavior or physical symptoms, is ongoing between the child’s parent/guardian and program staff.
7. Emergency Procedures: A child’s reaction to medication may occasionally be extreme enough to initiate emergency procedures. Refer to emergency procedures.
3 (C: 08/00; R: 07/18) HLTH 5a 8. Medication Return or Disposal Unexpired Medication Return: Upon medication completion, discontinued used and/or when a child will be leaving the program (withdrawn or at the end of the program year), unused medication is to be returned to the child’s parent/guardian. Count amount of medication being returned to parent/guardian and write amount (e.g. number of pills) on Medication Administration form. Expired Medication Disposal: Expired medications are to be given to the Health Specialist for appropriate disposal. The parent/guardian of a currently enrolled child will be notified by the Family Advocate, Lead Teacher or EHS staff member that the medication has expired and been given to the Health Specialist for disposal. Count amount of medication being given to the Health Specialist and write amount (e.g. number of pills) on Medication Administration form. (The Family Advocate, Lead Teacher or CFDS should discuss impending expiration of medication in advance with the parent/guardian to potentially renew the prescription.) Turning-In Medication Forms to the Health Specialist: The Family Advocate, Lead Teacher or EHS staff member is to note the following on the Medication Administration form: Medication status (done, unexpired, expired); If medication remaining -Medication returned to parent/guardian or Health Specialist and amount (e.g. number of pills); Date and sign. The Family Advocate, Lead Teacher or EHS staff member is then to remove the medication forms from the Emergency Procedures Notebook, staple the forms together with the Medication Administration form on top and then forward to the Health Specialist. The Health Specialist or the Disabilities/Health Assistant will then enter medication close out information onto the ChildPlus Student Health Database.
4 (C: 08/00; R: 07/18)
HLTH 5b Child’s Name: LOC ID: Medication Name: Medication Expiration Date:
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Medication Check-List
Instructions: At the time a program parent requests medication be administered to their child at school and a Direct Service Team /EHS staff member accepts this responsibility, the staff member must address and check-off each item on this list.
_____ Discussed alternatives to giving medication at school with child’s parent/guardian.
_____ Obtained written Health Care Provider Authorization with legible medication administration instructions. (Prescription Medication Authorization = Original Prescription Bottle with Original Prescription Label; Non-Prescription Medication Authorization = A Medication Authorization form completed, signed and dated by the Health Care Provider or Legible Instructions on a document (Health Care Provider form, etc.), completed, signed and dated by the Health Care Provider).
_____ Obtained written Parent/Guardian Authorization. (Assisted parent in completing, signing, dating and reviewing a Medication Authorization form).
_____ Reviewed appropriate medication administration, for child’s specific medication, with parent/guardian.
_____ Completed heading on a Medication Administration form.
_____ Completed original Medication Authorization and Medication Administration forms placed together into Section 10 of the Classroom Emergency Response Procedures Notebook. (Place completed Medication Check-List in Notebook, too.) (Medication Authorization form copies: Yellow=Site file; Pink=Health Specialist).
_____ Count and write down the number/volume of medication (tablets, etc.) received here:
_____ Non-emergency medication placed in designated, labeled and locked cabinet out of reach of children. Emergency medication placed in designated and labeled cabinet out of reach of children. (e.g. Oral, topical and refrigerated medications are stored separately and away from food and cleansers).
_____ Outlined ongoing plan of communication, regarding child’s medication usage and changes in behavior or physical symptoms, with parent/guardian. (The teacher, assistant teacher and/or EHS staff member are to record changes in a child’s behavior or physical symptoms, which have implications for drug dosage or type. This information is to be shared with the child’s parent/guardian, the Health Specialist, other appropriate staff members and the child’s physician).
_____ Requested an Accommodation Meeting with Team (Direct Service Staff, Supervisor, Health, & Parent/Guardian) before child’s start in classroom. (If an Accommodation meeting cannot take place before child’s start in class, medication administration was discussed with Teacher AND Supervisor) (e.g. To discuss administration, plan of action in case of an emergency, and any additional health concerns).
______Staff Member Signature Area Manager Date: (C: 03/01; R: 6/19)
HLTH 5c
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Medication Authorization Form
State licensing requirements permit child care facilities to administer medications to children only with a doctor’s written authorization and with written signed direction of a parent/guardian.
Please provide the following information:
CHILD’S NAME
Health Problem
Name of Medication Amount (The container must have a childproof cap)
Frequency Times Given at Home
Method of Administration at (name of facility)
Amount Times to be Given
How Long Medication to be Continued
Medication Expiration Date
Amount Received ______on______(number of pills, etc.) (Date)
Date Parent/Guardian Signature Parent Phone Number
Date Physician’s Signature or Original Prescription Bottle Physician’s Phone #
Distribution: White: Emergency Response Notebook Yellow: Student File Pink: Health Specialist (C: 03/95; R: 08/15) Medication Authorization Form HLTH 5c
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Forma de Autorización de Medicamentos
Los requisitos estatales de las licencias para guarderías permiten administrar medicamentos a niños sólo con una orden escrita del doctor y con las instrucciones escritas y firmadas por un padre/tutor.
Por favor proporcione la siguiente información:
NOMBRE DEL NIÑO
Problema de Salud
Nombre del Medicamento Cantidad (El envase debe tener una tapadera a prueba de niños)
Frecuencia Horario administrado en casa
Método de Administración en (nombre del Centro)
Medicación Fecha de Vencimiento
Cantidad Horario para ser administrado
Cuanto tiempo debe continuarse con el medicamento
Cantidad recibida ______el______(Número de pastillas, etc.) (Fecha)
Fecha Firma del Padre/Tutor # Tel. del Padre
Fecha Firma del Doctor o Envase Original del Medicamento # Tel. del Doctor
Distribution: White: Emergency Response Notebook Yellow: Student File Pink: Health Specialist (C: 03/95; R: 08/15) HLTH 5d LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Medication Administration Form
Child's Name: Teacher/CFDS: Program Year: Name of Medication: Date of Medication Authorization Form: DATE TIME AMOUNT (DOSE) AND STAFF SIGNATURE COMMENTS HOW ADMINISTERED (Mouth, Skin, etc.)
*Comments: Note any side effects that you notice from medication. Print name(s) (teacher/EHS staff member and assistant teacher) assigned to administer medication:
Date/Time Error/problem/reaction Action Taken Name of parent/guardian Teaching Staff Signature to medication notified and time/date
(circle one) Medication Date FA/CFDS or Lead Teacher Signature Done Unexpired RETURNED Amount Returned: to parent/guardian
(circle one) Medication Date FA/CFDS or Lead Teacher Signature Expired Unexpired Turned In Amount Turned In: to Health Specialist
Reminders: 1. Medication must be in original container (with label) from pharmacy. 2. Follow label instructions and refer to the Medication Authorization Form. 3. Keep medication in a locked and labeled cabinet. 4. The teacher/CFDS and/or assistant teacher are to record changes in a child's behavior or physical symptoms that have implications for drug dosage or type. This information is to be shared with the Health Specialist, other appropriate staff members, parents and the child's health care provider. 5. If changes are noted at any time during medication administration, they are recorded and immediately brought to the attention of the child's parent. The parent must then contact the child's health care provider and provide documentation of the contact.
Routing: Form in Use: Emergency Response Notebook Completed: Route to Health Specialist & then place in Child's File HSAC Approved: 11/13/00 (C: 06/00; R: 06/16) HLTH 6a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Parent/Guardian Assistance with Student Health Services Policy
Our program communication systems provide for the ongoing communication between staff members and parent/guardians, of children with identified health needs, to facilitate the implementation of their individual follow-up plans. Our staff members assist parent/guardians with locating transportation and finding financial assistance for their child’s medical services, dental services and prescribed medications, aids and equipment. This assistance is provided as needed to guide parent/guardians in learning how to obtain the needed services. In determining the sources of financial assistance available to the child’s parent/guardian, program staff members utilize the determination instructions for program pay. Incorporated into these instructions are the determination of health insurance status, applying for health insurance coverage and the determination of immediacy of need for medical and/or dental services. As determined in this process, program financial assistance is provided.
(C: 08/02; R: 07/18) HLTH 6b LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Determination Instructions for Program Pay of Student Physical Examinations or Medical Services
Determine Health Insurance Status & Apply for Coverage The DST/EHS Staff reviews child and families health insurance status with the parent. If the child and/or another family member do not have health insurance coverage and are possibly eligible for coverage, the DST/EHS Staff assists the parent/guardian with applying for coverage. Apple Health for Kids applications are available in Center Resource files or via the internet. Applications may be downloaded or coverage applied for at www.wahealthplanfinder.org. Note: A completed and submitted Apple Health for Kids application simultaneously applies for Medicaid (free) and CHIP (low cost) Health Insurance. The Family Health Center (FHC) is a resource for assisting families in applying for Washington State Health Insurance Coverage. The FHC phone number is 636-3892.
Determine Immediacy of Need for Medical Services If the child appears to have a possibly disabling or immediate medical concern, the DST/EHS staff is to communicate this information to the Health Specialist via e-mail. The Health Specialist will respond to the communication. If the child does not appear to have a possibly disabling or immediate medical concern, the DST/EHS Staff will request updates from the child’s parent regarding insurance status.
Non-Qualifying Insurance Status or Immediate Need Determined The DST/EHS Staff reviews and verifies non-qualifying insurance status with parent. The DST/EHS Staff is to ensure a completed Release of Information form for the child’s current Primary Health Care Provider (PCP) is on file. The DST/EHS Staff is to forward a copy of the release to the Health Specialist and inform her of current health insurance status. If the child does not have a current PCP, the Health Specialist will facilitate a referral.
Physical Examination or Medical Service Appointment The Health Specialist contacts the child’s Primary Health Care Provider (PCP) to give notification of program pay for the child’s physical exam or medical service. The Health Specialist responds to the DST/EHS Staff communication e-mail. A copy of the communication is sent to the Fiscal Specialist to establish a field order for future payment. The parent and/or DST/EHS Staff contact the child’s PCP to schedule the child’s appointment.
Head Start Physical Exam Form The parent returns the Physical Exam or medical service record to the DST/EHS Staff or requests that the PCP mail the documentation to our program. The PCP bills the program for the child’s physical examination or medical service. Payment is rendered after the documentation is on file.
(C: 10/99; R: 06/14) HLTH 6c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Determination Instructions for Program Pay of Student Dental Examinations
Determine Health Insurance Status & Apply for Coverage The DST/EHS Staff reviews child and families health insurance status with the parent. If the child and/or another family member do not have health insurance coverage and are possibly eligible for coverage, the DST/EHS Staff assists the parent/guardian with applying for coverage. Apple Health for Kids applications are available in Resource files or via the internet. Applications may be downloaded or coverage applied for at www.wahealthplanfinder.org. Note: A completed and submitted Apple Health for Kids application simultaneously applies for Medicaid (free) and CHIP (low cost) Health Insurance. The Family Health Center (FHC) is a resource for assisting families in applying for Washington State Health Insurance Coverage. The FHC phone number is 636-3892.
Determine Immediacy of Need for Dental Services If the child appears to have a possibly disabling or immediate dental concern, the DST/EHS Staff is to communicate this information to the Health Specialist and to the Oral Health/ABCD Coordinator via e-mail or health memo. The Health Specialist will respond to the communication. If the child does not appear to have a possibly disabling or immediate dental concern, the DST/EHS Staff will request updates from the child’s parent regarding insurance status.
Non-Qualifying Insurance Status or Immediate Need Determined The DST/EHS Staff reviews and verifies non-qualifying insurance status with parent. The DST/EHS Staff is to have the parent complete a Release of Information form for the appropriate dental provider. The DST/EHS Staff is to forward a copy of the release to the Health Specialist and provide current health insurance status information.
Dental Examination Appointment The Health Specialist responds to the DST/EHS Staff communication. As appropriate, a copy or e-mail of the communication is sent to the Fiscal Manager to establish a field order for future payment. The Health Specialist contacts the dental care provider to arrange for a free or program paid dental exam for the child. The parent and DST/EHS Staff contacts the dental care provider to schedule the child’s appointment. The parent takes a Dental Exam form to the appointment.
Head Start Dental Exam Form The parent returns the completed Dental Exam Form or dental services record to the DST/EHS Staff or requests that the dental care provider mail the documentation to our program. As appropriate, the Dental Care Provider bills the program for the child’s dental examination. Payment is rendered after the Dental Exam documentation is on file.
(C: 08/02; R: 06/14) HLTH 6d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Procedure for FREE Vision Care for Qualifying Children
The Lions Club will provide free vision care to qualifying children.
Process Head Start conducts vision screening and/or staff or parent request a vision referral. The Disabilities/Health Coordinator sends a Vision Referral letter to the child’s parent/guardian via the Direct Service Team/EHS staff member notifying them of the need for a vision exam by a health care professional. Parent notifies DST/EHS Staff that financial assistance is needed. DST/EHS Staff assists the parent with applying for insurance coverage. DST/EHS Staff, with parent, determines that free services are needed. DST/EHS Staff can obtain KEX KIDS FUND Application for Vision Exam and Eyeglasses from the Health Specialist. Direct Service Team and parent complete forms: 1. Parent and DST/EHS Staff complete KEX KIDS FUND Application for Vision Exam and Eyeglasses (Parent and Direct Service Team signatures required). 2. Parent completes Release of Information forms for the Lions Sight and Hearing Committee of Cowlitz County (see information at bottom of procedure). DST/EHS Staff gives the Health Specialist: Completed application and a copy of release. Health Specialist mails original application and copy of release to the Lions Sight and Hearing Committee of Cowlitz County. Lion’s Club Representative contacts parent to schedule an appointment. Child attends appointment, with program Vision Referral letter, and orders free glasses if needed. Program Vision Referral Letter is given to parent to return to Head Start or is mailed to Head Start.
*Siblings and other community children may also request these free services. However, referrals are to be made in conjunction with an educational or social service agency.
Mail Application To: Lions Sight and Hearing Committee of Cowlitz County Attention: Hope Ramsdale PO Box 265 Longview, WA 98632 (360) 431-9969
(C: 10/99; R: 02/17) HLTH 7a1
Lower Columbia College Head Start/EHS/ECEAP Disaster & Emergency Preparedness Form
I acknowledge that I have received training on Disaster & Emergency Preparedness which includes review of Emergency Notebooks.
______Name (Please Print) Date
______Signature
(C: 08/16)
HLTH 7a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Emergency Evacuation and Safety Policy
Emergency Evacuation procedures are posted in each building classroom and main hallway. A program Emergency Response Procedure notebook is provided to and used by each classroom team, Assigned Office Staff Member and assigned Leadership Team member. This confidential notebook is updated annually and as needed and includes the following information and procedures: School Building Data, Preparedness Outline, Emergency Evacuation Parent Information; Classroom Evacuation Plan and Map; Emergency Phone Numbers; Emergency Procedures for Accidents or Critically Ill Children; School Calendar; Staff and/or Volunteer Emergency Information; Class Roster; Student Emergency Contact Information & Parent Agreement Contracts; Medical Concerns/Allergies List; Medication Policy, Procedure and Forms; Accident Forms & Procedure; Emergency Medical Assistance/Student Release Forms; Bomb Threats; Bus/Chemical Accidents; Earthquakes; Missing Child or Kidnapping; Classroom and Building Lockdown Procedures; Fire, Floods, Gas Leaks; Emergency Preparedness Supplies List; Lightening, Nuclear Accidents; Response for Death of Student/Staff; Riots; Volcanic Eruptions, Windstorms. Fire drills, earthquake drills and the classroom lockdown procedures are practiced regularly. Staff members are trained in the use of the Emergency Response Procedures notebook at regularly conducted New Staff Orientations and annually.
(C: 08/02; R: 07/18) HLTH 8a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Special Health Care Needs of Children Policy
Provided our program can reasonably accommodate them, all eligible children are afforded an equal opportunity to be included in Head Start/EHS/ECEAP, regardless of special health needs or medication requirements, so that they and their families may benefit fully from the experience.
Policy and procedures, for children with special health care needs or medication requirements (i.e. HIV, Diabetes, etc.), are developed as needed with the assistance of the Health Consultant and/or Health Services Advisory Committee. Developed policies and procedures are to include:
Making reasonable accommodations for the child. The Health Consultant, Health Services Advisory Committee and local agencies or organizations, such as hospitals, school, and local health departments, are utilized as resource for suggesting ways to accommodate the child in the program;
Ensuring that parents and health care providers supply clear, thorough instructions on how best to care for the child, in order to protect his or her health, as well as the health of other children and staff;
Ensuring that our program has adequate health policies and protocols, staff training and monitoring, and supplies and equipment to perform necessary health procedures;
Reassuring parents of other children that their children are at no health risk;
Promoting understanding of the child's special needs, without embarrassing or drawing attention to the child; and
Protecting the privacy of the affected children and her or his family.
(C: 08/02; R: 05/10) HLTH 8b LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Acquired Immune Deficiency Syndrome (AIDS) and Hepatitis C Special Procedures
Upon identification of a student by a competent authority as having Hepatitis C or Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Condition (ARC), or antibodies to the AIDS virus, the following procedure will be followed:
The people who shall know the identity of a student who is infected with Hepatitis C or HIV are those who will, with the infected student's parent or guardian, determine whether the student who is infected with Hepatitis C or HIV has a secondary infection that constitutes a medically recognized risk of transmission in the school setting. They are as follows:
1. The Director, or a person designated by the director, to be responsible for the decision; 2. Supervisor; 3. Health Specialist; 4. The classroom teacher/CFDS and Family Advocate to whom the child is assigned; 5. The personal physician of the infected student; 6. A medical consultant from the Cowlitz County Health Department; 7. Interpreter and/or Assistant Teacher as determined by the Director, Supervisor and Health Specialist.
Notification of Additional Persons The decision makers listed above and a child's parent or guardian will determine whether additional persons need to know that an infected student attends or works at a specific school. The additional persons will not know the name of the infected student without the consent of the infected child's parent or guardian. Depending on the circumstances of the case, the following persons may know about the student who is infected with Hepatitis C or HIV, but do not know his or her identity:
1. Health Consultant
Additional persons may be notified if the decision makers feel that this is essential to protect the health of the infected student, or if additional persons are needed to periodically evaluate or monitor the situation. Consent for notifying these additional persons must be given by the infected child's parent or guardian.
Confidentiality All persons shall treat all information as highly confidential. No information shall be divulged, directly or indirectly, to any other individuals or groups. All medical information and written documentation of discussion, telephone conversations, proceedings, and meetings shall be kept in a confidential notebook by the DST in a locked file. Access to this file will be granted only to those persons who have the written consent of the infected student's parent or guardian. To further protect confidentiality, names will not be used in documents except when essential. Any document containing the name, or any other information that would reveal the identity of the infected student, will not be shared with any person, not even for the purposes of word processing or reproduction.
(C: 05/97; R: 06/13) HLTH 8c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Individual Care Plan for Child in Child Care Plan must be updated annually or when there is a change in the child’s special need.
Child’s Full Name Today’s Date
CONTACT INFORMATION Parent’s/Guardian’s Name Telephone
Parent’s/Guardian’s Name Telephone
Primary Health Care Provider Telephone
Specialist (if applicable) Telephone
Specialist (if applicable) Telephone
CHILD’S SPECIAL NEEDS Diagnosis, if known:
Known symptoms and triggers:
Describe activity, behavioral, or environmental modifications that are needed for the child:
Allergies (other than food allergy):
For food allergies or special dietary needs due to a health condition - must obtain written instructions from child’s health care provider (use page 3 of this form or health care provider’s form) MEDICATIONS (Medication Authorization Form must be completed for each medication.) List medication to be given at scheduled times, and how medication is to be given.
List medication to be given during an emergency, and how medication is to be given.
Describe symptoms that would trigger emergency medication.
INDIVIDUAL CARE PLAN FOR CHILD IN CHILD CARE DCYF 15-970 (REV. 08/2019) EXT Page 1 of 3 Original: Site File Copy: Emergency Notebook Copy: Health Specialist (C: 04/2020) HLTH 8c EMERGENCY RESPONSE PLAN List the steps and procedures the early learning provider should perform during an emergency related to your child’s special need.
SUGGESTED TRAINING FOR STAFF List suggested special skills training/education for the early learning program staff.
SUPPORTING DOCUMENTATION Please attach supporting documentation to this Individual Care Plan, including any existing individual educational plan (IEP), individual health plan (IHP), 504 plan, or individualized family service plan (IFSP). WAC 110-300-0300 requires an early learning provider to have supporting documentation of the child’s special needs provided by the child’s licensed or certified: (i) Physician or physician’s assistant (ii) Mental health professional (iii) Educational professional (iv) Social worker with a bachelor’s degree or higher with a specialization in the individual child’s needs; or (v) Registered nurse or advanced registered nurse practitioner. SIGNATURES
______Parent or Guardian Signature Date
______Early Learning Provider Signature Date
______Health Care Provider Signature Date (recommended)
This section to be completed by child’s parent or guardian, if applicable: I hereby give permission for to provide (name of visiting health professional or specialist) services to my child at this early learning program.
______Parent or Guardian Signature Date
INDIVIDUAL CARE PLAN FOR CHILD IN CHILD CARE DCYF 15-970 (REV. 08/2019) EXT Page 2 of 3 Original: Site File Copy: Emergency Notebook Copy: Health Specialist (C: 04/2020) HLTH 8c FOOD ALLERGY AND/OR SPECIAL DIETARY REQUIREMENTS This page must be completed and signed by the child’s health care provider and parent or guardian.
Child’s Full Name: Today’s Date:
Food the child must not consume Appropriate substitute food(s) (list each food separately)
Describe allergic reactions and symptoms associated with this child’s particular allergies.
Describe the treatment plan for the early learning provider to follow in response to child’s allergic reaction (include names of medication, dosage amount, and directions for how to administer medication).
Other special dietary requirements due to a health condition.
Health Care Provider Signature Date
Parent or Guardian Signature Date
INDIVIDUAL CARE PLAN FOR CHILD IN CHILD CARE DCYF 15-970 (REV. 08/2019) EXT Page 3 of 3 Original: Site File Copy: Emergency Notebook Copy: Health Specialist (C: 04/2020) HLTH 9a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Injury Prevention Policy
Our program establishes and implements procedures to ensure that staff members and volunteers can demonstrate safety practices, violence prevention practices and foster safety awareness among children and parent/guardians. Procedures incorporate maintaining safe and hazard free facilities and physical environments by providing effective supervision, taking action to eliminate or reduce hazards, appropriately responding to an emergency, and teaching children, parent/guardians and staff members about safety through activities and trainings which focus on safety practices in both the home and program.
(C: 08/02; R: 07/18) HLTH 9b LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Procedure for Completing an Accident Report
REPORTS Lower Columbia College Head Start/EHS/ECEAP utilizes three Accident Reporting forms. 1. The form titled: Lower Columbia College Head Start/EHS/ECEAP Child Accident Report Form is completed when a child has had an accident. 2. The form titled: Child Care Injury / Incident Report Form is completed when a child, in a Childcare Licensed Center, has had an accident and professional medical and/or dental treatment is sought. The Area Manager of child’s center, is to notify the Assistant Director of the accident and facilitate the Childcare Licensor being notified via phone or email. The completed form will then be faxed to the Childcare Licensor. 3. An Accident Report is to be completed and submitted online at https://cm.maxient.com/reportingform.php?LowerColumbiaCollege&layout_id=1 when an employee, work-study student, volunteer or other adult has had an accident.
WHEN AN ACCIDENT REPORT FORM NEEDS TO BE COMPLETED/SUBMITTED The staff member administering first aid or that has had an accident is to use their best judgment when determining if an Accident Report needs to be completed/submitted. If in doubt about completing/submitting a report, the staff member needs to contact their Supervisor or another Leadership Team member. As a guideline, an Accident Report is to be completed/submitted anytime outside medical attention is considered to be warranted. If child was involved in a biting incident, refer to Care of Human Bite Procedure (HLTH 3c). If there is a biting incident which caused a break in skin/exposure to blood, an accident report form needs to be completed for both the parent/guardian of the child who bit and the bitten child. The staff member completing the Accident Report form should refrain from identifying the other child when completing an Accident Report form.
NOTIFICATION OF CHILD’S PARENT/GUARDIAN If a Child Accident Report form is to be completed, the child’s parent/guardian or other responsible adult, noted on the child’s Family Information form, is to be contacted by phone or in person as soon as possible. All attempts to make this contact are to be noted in case management. If child was involved in a biting incident, refer to Care of Human Bite Procedure (HLTH 3c). Health Specialist or Health Coordinator will provide further direction after child’s health information is reviewed. When completing the Accident Report form or when discussing incident with parent/guardian, the staff member will refrain from identifying the other child involved in incident.
Regardless if a Child Accident Report form is completed or not, the parent/guardian of any child involved in an accident is to be notified of any injuries or potential injuries (i.e. A bump to the head that shows no visible injuries). This information is to be noted in the child’s site file.
The parent/guardian needs to sign and date the Accident Report form before distribution of copies. The parent/guardian is then given the pink copy of the form.
NOTIFICATION OF LEADERSHIP TEAM MEMBER OF A CHILD ACCIDENT If a child has a serious injury and/or an emergency medical condition, the Staff Member who witnessed the accident is to complete a Child Accident Report form and give or fax it to the Health Specialist or another Leadership Team member immediately. If child was involved in a biting incident which caused a break in skin/exposure to blood, refer to Care of Human Bite Procedure (HLTH 3c). The Health Specialist or Health Coordinator will review ChildPlus health records and provide further direction, as needed. All other completed Accident Report forms must be given to the Supervisor, Health Specialist or another Leadership Team member before the end of the same working day the accident occurred. A Leadership Team member or if unavailable, a main office staff member must be notified on the date the accident took place.
Approved by HSAC 11/13/00 (C: 11/00; R: 06/19) Approved by Policy Council 11/27/00 HLTH 9b MEDICAL SERVICES FOR CHILD If outside medical treatment is sought, the parent or health care provider is to complete the treatment section on their pink copy. (Health Care Provider Signature is requested.) The parent/guardian is then to return the pink copy, with the Medical Services section completed, to a Direct Service Team/EHS staff member. The DST/EHS staff member is to make a two copies, file one and give one to the Health Specialist. The pink copy is then returned to the parent.
LOWER COLUMBIA COLLEGE ONLINE ACCIDENT REPORT Make a report online at https://cm.maxient.com/reportingform.php?LowerColumbiaCollege&layout_id=1 All areas of the online form are to be complete. When completing the report click on: Email a copy of this report. When you receive the email with your completed report, forward the email to your Supervisor and the Health Specialist. For assistance on completing a report online, contact your Supervisor or the Lower Columbia College Human Resources Department located in the LCC Administration building or call 360-442-2120.
A Report of Industrial Injury or Occupational Disease (L&I form) will need to be completed if an employee seeks medical consultation for an accident that has occurred at work. Health Care Providers have L&I forms.
Approved by HSAC 11/13/00 (C: 11/00; R: 06/19) Approved by Policy Council 11/27/00 HLTH 9c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Child Accident Report Form
Name of Injured Child: Date of Birth: Date & Time of Incident: Reported to Parent/Guardian: Reported to Manager/Office Staff: ______Date: ______Date & Time reported: ______Time: ______Staff Completing Report: ______CHECK ALL THAT APPLY Type of Injury / Incident Body Parts Affected _____ Bite (Call Health Specialist & follow Bite Procedure) _____ Head/Face _____ Abdomen _____ Open Wound/Cut _____ Ears _____ Hands/Wrists _____ Sprain/Strain/Twist/Dislocation _____ Eyes _____ Fingers _____ Broken Bone/Fracture _____ Nose _____ Other: _____ Respiratory Condition _____ Mouth/Teeth _____ Pain/Inflammation/Bump _____ Feet/ Ankles _____ Allergy/Sensitivity Reaction _____ Legs/Knees _____ Loss of Consciousness _____ Arms/Elbows _____ Other: Where Injury/ Incident Occurred First Aid Given by: ______Classroom _____ Washed with Soap & Water _____ Ice Pack _____ Bathroom _____ Applied Pressure _____ TLC _____ Hallway _____ Applied Bandage (after cleaning with soap and water) _____ Bus _____ Immobilized Area _____ Playground _____ Antiseptic Towelette (Bus & Field Trip Only) _____ Other: _____ Bump to the Head handout given to parent/guardian _____ Other:
Describe incident: (Please describe with as much detail as possible; list names of staff present and/or witnesses): Staff Present: ______
Parent/Guardian Signature: Date: Parent/Guardian Plans to Seek Medical Care:
Yes: ______No :______Health Specialist Information Date Health Specialist Received Yellow Copy: ______Date Health Specialist Notified to Review Health Record (for bite Incident):______Health Specialist Notes: ______Copy to Area Manager:______Medical Services Information Health Care Facility: ______Date: ______Health Care Provider Comments: ______Provider Name: Signature:
Licensor Contacted By Area Manager: Yes: _____ No: _____ ( If yes, by phone _____ or Email _____ )
Distribution: White- Student File Yellow: Health Specialist Pink: Parent/Guardian/Health Care Provider (C: 11/00; R: 07/19) HLTH 9c LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Reporte de Accidente del Niño
Nombre del niño herido: Fecha de nacimiento: Fecha y hora del incidente: Reportado al padre de familia/tutor: Reportado a la supervisora/oficina: ______Fecha: ______Fecha y hora del reporte: ______Hora: ______Miembro del personal que lo reportó: ______MARQUE TODOS QUE CORRESPONDAN Tipo de lesión o accidente Partes del cuerpo afectados
_____ Mordida (llamar a la especialista en salud y seguir el _____ Cabeza/cara _____ Abdomen procedimiento de mordidas) _____ Orejas _____ Manos/muñecas _____ Corte/herida abierta _____ Ojos _____ Dedos _____ Torcedura/distensión/torsión/dislocación _____ Nariz _____ Otros: _____ Hueso quebrado/fracturado _____ Boca/dientes _____ Condición respiratoria _____ Pies/tobillos _____ Dolor/inflamación/bulto _____ Piernas/rodillas _____ Reacción por alergias/sensibilidad _____ Brazos/codos _____ Pérdida del conocimiento _____ Otros: Donde la lesión/incidente ocurrió Atención de primeros auxilios Proporcionada por: ______Salón de Clases _____ Lavado con jabón y agua _____ de hielo _____ Baño _____ Aplicación de presión _____ TLC _____ Pasillo _____ Aplicación de vendaje (después de lavar con jabón y agua) _____ Autobús _____ Inmovilización del área _____ Área de juego _____ Toalla antiséptica (autobus y excursion solamente) _____ Otros: _____ Se entrego a los padres folleto con información de golpes en la cabeza _____ Otros:
Describa el incidente: (Escriba todos los detalles posibles, incluyendo nombres de miembros de personal presentes y/o testigos) Miembros del personal presentes: ______
Firma de padre de familia/tutor: Fecha: El padre/tutor planea buscar atención médica:
Sí: ______No :______Información de la especialista en la salud Fecha cuando recibió la copia amarilla: ______Fecha cuando recibió notificación para revisar la información de salud (para mordidas):______Notas de la especialista en salud: ______Copia entregada a la supervisora de área:______Información de los Servicios Medicos Lugar del cuidado de salud: ______Fecha: ______Comentarios de los proveedores del cuidado de la salud: ______Nombre de proveedor de cuidado de salud: Firma:
La supervisora contactó con el licenciador: Sí: _____ No: _____ ( Por teléfono_____ o email _____ )
Distribution: White- Student File Yellow: Health Specialist Pink: Parent/Guardian/Health Care Provider (C: 11/00; R: 06/19) HLTH 9d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Bicycle Helmets Outdoors Procedure
Overview: In order to prevent head injuries, bicycle helmets are to be worn by each child during the time he or she is riding a tricycle, scooter or wagon. When a child gets off the tricycle, scooter or wagon, he or she is to take the bicycle helmet off.
1. The staff member will assist each child with properly wearing a bicycle helmet at the time the child is to ride a tricycle, scooter or wagon. A properly fitting bicycle helmet means: the side buckles are at the child's ears; the helmet is not more than one finger- width from the child's eyebrows; and the helmet is securely tightened by the child buckle so that when the child "yawns" the helmet is pulled down by the action. The helmet should not significantly move when the child shakes his or her head "yes" and "no".
Helmet Measurement Ranges in Inches Small Helmet: 19” to 20.25” Medium Helmet: 20.25” to 21.5” Large Helmet: 21.5” to 22.75”
The Health Specialist has a sizing tape that the Direct Service Team can checkout to measure a child’s head to assist with making an appropriate helmet fit.
2. When a child gets off the tricycle, scooter or wagon, a staff member is to ensure that the child takes the helmet off. (There is a "hidden hazard" of strangulation if a child wears a helmet while playing on playground equipment, climbing trees, etc.)
3. Staff members perform daily head checks OR prior to the use of the helmet by another child and placement back into the storage shed, a wet-wipe will be used to clean the inside of a worn bicycle helmet. A staff member will perform this task or ensure that the child who originally wore the helmet has appropriately done so.
4. Once every two weeks, the teaching staff will check helmets for any worn sizing pads needing replacement and for cracks. (Any helmet with significant cracks should no longer be used.)
(C: 10/02; R: 07/18) HLTH 9d
Do you know the correct way to wear a helmet?
Make sure the helmet fits snugly and does not obstruct your field of vision. Make sure the chin strap fits securely and that the buckle stays fastened.
(C: 10/02; R: 07/18) HLTH 9e1 Lower Columbia College Head Start/EHS/ECEAP Nap and Quiet Rest Period Procedure for Toddlers (not in a crib) and Preschoolers
LCC Head Start/EHS/ECEAP will provide rest time each day to children in care for four (4) or more hours in a day. This rest time will be flexible and meet the individual developmental needs of the children. Quiet learning activities will be accessible for non-napping children and those that rise early. Safe sleep practices will be followed as outline below.
Nap & Quiet Rest Period: 1. Sleeping and nap equipment is available for each toddler and preschool-age child not using a crib and remaining in care for at least four hours and any other child requiring a nap or rest period. 2. Toddlers, twenty-nine months of age or younger, are allowed to follow an individual sleep schedule. 3. During naptime, staff to child ratios must be met and maximum group size maintained. When only one staff person is required to meet the staff to child ratio, a second staff person (who at least meets classroom staff qualifications) must be readily available in case of emergency. Staff members will remain alert and actively supervise sleeping children in an ongoing manner by visibly checking often and being within sight and hearing range when a child is going to sleep, is sleeping or waking up. 4. Mats are not placed directly on any floor that is cooler than 65 degrees F when children are resting. 5. To reduce the spread of communicable illnesses, mats or cots are placed three feet apart or if not enough space allows for this, children are spaced as far apart as possible and children alternated head to feet. 6. Children sleep in the same spot each day. In order to assure this, the Lead Teacher creates a map of where each child sleeps and has it posted or otherwise easily accessible in the classroom.
Requirements Specific to Toddlers: 1. Toddlers will be allowed to follow their own sleep patterns. 2. Rooms will have sufficient lighting in the room in which a toddler is sleeping in order to observe skin color. 3. A blanket, bedding, or clothing will not be allowed to cover any portion of a toddler’s head or face while sleeping, and staff members will adjust these items when necessary. 4. Staff members will supervise toddlers actively, in part, to prevent the child from getting too warm while sleeping, which may be exhibited by indicators that include, but not limited to, seating, flushed, pale, or hot and dry skin, warm to the touch; a sudden rise in temperature; vomiting; refusing to drink, a sunken fontanelle (soft spot); or irritability. 5. A sleep positioning devised will not be used unless directed to do so by a toddler’s health care provider. The directive must be in writing, signed and dated by the health care provider. This signed directive will be kept in the child’s site file and all applicable staff will be notified. A copy of the signed directive will be given to the Health Specialist and the Area Manager.
Mats and Cots: 1. Only mats and cots made with a waterproof material that can be easily washed and disinfected, will be used. 2. Each child is provided a separate, firm and waterproof mat or cot long enough so a child’s head or feet do not rest off of it. (Canvas cots will not be used by toddlers.)
(C: 07/17; R: 08/18) HLTH 9e1 3. Mats and cots are kept clean and in good repair. Once a mat is torn it is not cleanable and will be discarded. Duct tape or fabric to repair sleeping mats or cots is never done. 4. The sleeping surfaces of one child’s rest equipment is not to come in contact with the sleeping surfaces of another child’s rest equipment during storage.
Bedding: 1. Bedding for each child consists of a clean tight fitting sheet for the sleeping surface and a clean blanket or suitable cover for the child. 2. Bedding is laundered weekly or more often if necessary and between uses by different children. 3. Each child's bedding is stored separately from bedding used by other children. Once the bedding has been used, it is considered dirty. One child's bedding is not allowed to touch another child's bedding during storage.
(C: 07/17; R: 08/18) HLTH 9e LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Safe Infant Sleep Procedure
This Safe Infant Sleep Procedure will be reviewed annually with all staff to familiarize them with the program’s sleep procedures for infants and to provide them with current recommendations. Safe sleep practices reduce the risk of Sudden Unexplained Infant Deaths (SUIDs) including, Sudden Infant Death Syndrome (SIDS), suffocation and other deaths that may occur when an infant is in a crib or asleep. Note: Most sleep-related deaths in child care facilities occur in the first day or first week that an infant starts attending a child care program. Many of these deaths appear to be associated with prone positioning (on their stomach), especially when the infant is unaccustomed to being placed in that position
In order to maintain safe sleep practices and to advocate to parent/guardians their use in the home and in all infant care settings, the below procedures will be followed:
1. Back to sleep for every sleep. Infants up to 12 months of age are placed in a supine position (wholly on their back) for every nap or sleep time unless an infant’s primary health care provider has completed a signed waiver indicating that the child requires an alternate sleep position. This signed waiver will be kept in the child’s site file and all staff will be notified of the infant’s prescribed sleep position. A copy of the signed waiver will be given to the Health Specialist and one to the Area Manager. If an infant turns over while sleeping, the staff member must return the infant to his or her back until the infant is able to independently roll from back to front and front to back. If a child is able to independently roll from back to front and front to back, a sign stating, “I CAN ROLL OVER” will be placed above the child’s crib.
A sleep positioning device will not be used unless directed to do so by an infant’s health care provider. The directive must be in writing, signed and dated by the health care provider. This signed directive will be kept in the child’s site file and all staff will be notified. A copy of the signed directive will be given to the Health Specialist and one to the Area Manager.
2. Sleep patterns. Staff will allow infants to follow their own sleep pattern.
3. Use a safety-approved crib with a firm sleep surface. Infants will be placed for sleep in safe sleep environments; which include a firm crib mattress covered by a tight-fitting sheet in a safety-approved crib (the crib must meet the standards and guidelines reviewed/approved by the U.S. Consumer Product Safety Commission (CPSC) and ASTM International (ASTM)). No monitors or positioning devices will be used unless required by the child’s primary health care provider and a signed waiver is on file. No other items will be in a crib except for a pacifier.
4. If not already in their crib, a sleeping infant will immediately be placed in their crib. Infants will not nap or sleep in a car safety seat or any type of furniture/equipment that is not a safety- approved crib (that is in compliance with the CPSC and ASTM safety standards). If an infant arrives at the facility asleep in a car safety seat, the parent/guardian or staff member will immediately remove the sleeping infant from this seat and place them in the supine position in the infant’s assigned crib. If an infant falls asleep in any place that is not a safe sleep environment, staff will immediately move the infant and place them in the supine position in their crib.
5. No soft objects and loose bedding in, on or around crib. Soft or loose bedding will be kept away from sleeping infants and out of cribs. These include, but are not limited to: bumper pads, pillows, quilts, comforters, sleep positioning devices, sheepskins, blankets, flat sheets, cloth diapers, bibs, etc. Also, blankets/items will not be hung on the sides of crib or cover or drape over a crib. Note: Loose or ill-fitting sheets have caused infants to be strangled or suffocated.
6. No toys, stuffed animals and mobiles. Toys, including mobiles and other types of play equipment that are designed to be attached to any part of the crib will be kept away from sleeping infants and off of/out of cribs.
(C: 03/12: R: 06/19) HLTH 9e 7. Each infant will be assigned their own crib, will not share cribs and spacing between cribs will be appropriate. Each infant will have their own crib that is labeled with their name. Space cribs a minimum of 30 inches apart. Cribs can be placed end-to-end if a barrier, to prevent communicable disease, is in place. If barriers are used, staff must be able to observe and have immediate access to each infant. Barriers must be solid, moisture resistant and easily cleanable and placed on the side or end adjacent to another crib.
8. Avoid overheating and bundling. When caregivers/staff members place infants in their crib for sleep, they should check to ensure that the temperature in the room is comfortable for a lightly clothed adult, check the infants to ensure that they are comfortably clothed (not overheated or sweaty), and that bibs, necklaces and garments with ties or hoods are removed. The infant’s face will remain uncovered. The infant’s head will remain uncovered when sleeping. There is currently insufficient evidence to recommend the use of a fan as a SIDS risk-reduction strategy. Possible indicators of overheating may include, but are not limited to: sweating; flushed, pale, or hot and dry skin, warm to the touch; a sudden rise in temperature; vomiting; refusing to drink, a depressed or sunken fontanelle (soft spot); or irritability.
9. Use sleep sack and do not use swaddling. If an infant requires additional warmth, a sleep sack will be used. There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.
10. Infants will be observed and actively supervised when napping or sleeping. A staff member must be present in the room with infants at all times. The lighting in the room must allow the staff see each infant’s face, to view the color of the infant’s skin, and to check on / monitor the infant’s breathing and placement of the pacifier (if used). A staff member trained in safe sleep practices and approved to care for infants will be present in each room at all times where there is an infant. This staff member will remain alert and actively supervise sleeping infants in an ongoing manner by visibly checking every fifteen minutes and being within sight and hearing range, including when an infant goes to sleep, is sleeping, or is waking up. Also, the staff member will check to ensure that the infant’s head remains uncovered and re-adjust clothing and items (sleep sack and sheet) as needed.
11. Provide consistent tummy time. Supervised, awake tummy time will be provided to facilitate development and to minimize development of flat areas on the head.
12. Encourage breastfeeding. Breastfeeding is associated with a reduced risk of SIDS. Unless contraindicated, mothers will be encouraged to breastfeed exclusively or feed with expressed milk (i.e. not offer any formula or other nonhuman milk-based supplements) for 6 months, in alignment with recommendations of the AAP.
13. Recommend crib in parent’s room. It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants, ideally for the first year of life, but at least for the first 6 months.
14. Recommend consideration of offering a pacifier at nap time and bedtime. The pacifier should be used when placing the infant for sleep. It does not need to be reinserted once the infant falls asleep. If the infant refused the pacifier, he or she should not be forced to take it. In those cases, parents can try to offer the pacifier again when the infant is a little older. Because of the risk of strangulation, pacifiers will not be hung around the infant’s neck nor attached to infant clothing.
(C: 03/12: R: 06/19) HLTH 9e
Objects, such as stuffed toys and other items that may present a suffocation or choking risk, will not be attached to pacifiers. For breastfed infants, pacifier introduction should be delayed until breastfeeding is firmly established. Infants who are not being directly breastfed can begin pacifier use as soon as desired.
15. Recommend avoiding smoke exposure during pregnancy and after birth.
16. Recommend avoiding alcohol and illicit drug use during pregnancy and after birth.
17. Recommend pregnant women obtain regular prenatal care.
18. Endorse and model. Staff members will endorse and model the SUIDs risk-reduction recommendations from birth.
(C: 03/12: R: 06/19) HLTH 10a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Child Health and Developmental Services Policy
Our program staff members work together with families and health care professionals to ensure that all child health and developmental concerns are identified, and children and families are linked to an ongoing source of continuous, accessible care to meet their basic health needs. Program procedures are developed and implemented to: determine the health status of each child; screen for developmental, sensory and behavioral concerns; facilitate extended follow-up and treatment services; identify any new or recurring medical, dental, or developmental concerns for making timely and appropriate referrals; involve and assist parent/guardians with enrolling and participating in a system of ongoing family health care; respond to each child's individual characteristics, strengths and needs.
(C: 08/02; R: 07/18) HLTH 10b
Lower Columbia College Head Start/EHS/ECEAP
Dear Health Care Provider:
In order to meet Performance Standards for the Health Component of the Head Start/EHS/ECEAP Program, it is required that we have record of a completed Well-Child exam on file.
Our program requires the following: Hematocrit/Hemoglobin results Lead Growth assessment Vision examination Hearing examination Urinalysis Blood Pressure Physical examinations Developmental assessment Immunizations – DTaP-4, IPV-3, MMR-1, Varicella-1, HIB-4, PCV-4
Thank you for your assistance in helping us meet our federal and state requirements.
Sincerely,
Health Specialist
(C: 04/19) Well-Child Exam Letter HLTH 10b
Lower Columbia College Head Start/EHS/ECEAP
Estimado proveedor de atención médica:
Las normas de desempeño del componente de salud del programa Head Start/EHS/ECEAP requieren que mantengamos documentación de un examen físico de cada niño.
El programa requiere lo siguiente: Niveles de hematocrito y hemoglobina Nivel de plomo Evaluación de crecimiento Examen de visión Examen de audición Análisis de orina Presión arterial Examinaciones manuales Evaluación de desarrollo Vacunas (Estados Unidos/México): 4 DTaP/DPaT, 3 IPV/VPI, 4 Hib/Hib (estas tres son incluidas en la vacuna Pentavalente acelular) 1 MMR/SRP, 1 Varicella/Varicela, 4 PCV/Neumocóccica conjugada
Gracias por ayudarnos a cumplir con nuestros requisitos federales y estatales.
Atentamente,
Especialista en Salud
(C: 04/19) HLTH 10c CHILD HEALTH RECORD: Physical Examination/Assessment Record CHILD NAME Sex Birthdate Immunization and Test Record 1 2 3 4 5 Significant Child/Family History DTaP IPV MMR Hepatitis B Hepatitis A HIB Prevnar Varicella TB Test as Indicated
EXAMINATION RESULTS: Please fill in each area. Hematocrit or Hemoglobin Urinalysis (If Hct is <34 or HgB is <11, Head Start is to refer to WIC) Vision Acuity R-20/ L/20/ Both-20/ Blood Lead Level (ug/dl) (Test done between 12 and 72 months of age.) Strabismus BIN ET XT Blood Pressure: Pass Fail (Circle One) Eyes Height/Inches Ears/Nose/Throat Weight/Pounds Posture Skin Gait Heart Lungs Lungs Neurological Muscular Coordination Hearing R 1000 2000 4000 L 1000 2000 4000 Speech Teeth Abdomen Hernia Gentitalia Social
Findings/Recommendations:
Follow-up Treatment:
SIGNATURE EXAM DATE Physician/Health Provider Name (Please Print) ____ Phone # Fax # Source of Payment:
HEALTH ORGANIZATION: Please return to: Name: LCC HEAD START/EHS/ECEAP Address: P.O. Box 3010 Longview, WA 98632-0310 City, State: Phone (360) 442-2800 FAX (360) 442-2819 Benefits of LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP are available to all children without regard to race, color, national origin, or handicapping/disabling condition. Print on Blue (C: 06/00; R: 06/14) HLTH 10d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Denial of Consent for Medical Services
As parent or legal guardian of (Name of Child)
It is my desire that no medical services be provided to my child by Head Start/EHS/ECEAP. I understand that services have been recommended for my child. I accept the consequences of this action and in no way hold Lower Columbia College Head Start/EHS/ECEAP responsible for any future medical problems resulting from the lack of medical services.
Signature of Parent/Guardian Date
Signature of Witness Date
Supervisor, Health Specialist, and DST/EHS staff will determine if and when a Denial of Consent for Medical Services form is completed.
Distribution: White: Site File Yellow: Parent Copy (C: 01/02; R: 06/13) Denial of Consent for Medical Services HLTH 10d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Negativa de Consentimiento de Servicios Médicos
Como padre o tutor legal de (Nombre del Niño)
Es mi deseo que ningún servicio médico sea proporcionado a mi niño por el Head Start/EHS/ECEAP. Entiendo que se han recomendado servicios médicos a mi niño. Acepto las consecuencias de esta acción y de ninguna hare responsable al Lower Columbia College Head Start/EHS/ECEAP por cualquier problema médico futuro que resulte por de la falta de servicios médicos.
Firma del Padre/Tutor Fecha
Firma de Testigos Fecha
Supervisor, Health Specialist, and DST/EHS staff will determine if and when a Denial of Consent for Medical Services form is completed.
Distribution: White: Site File Yellow: Parent Copy (C: 01/02; R: 06/13) HLTH 10e
RE: DENTAL EXAM
Dear Dentist:
In order to meet Federal Performance Standards for the Health Component of the LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP, each enrolled child one year of age or older, must have a dental examination which includes:
a) An oral exam;
b) Diagnostic radiographs;
c) Prophylaxis;
d) Instruction in self-care and oral hygiene;
e) Topical fluoride application (at the discretion of the dentist);
f) Any necessary treatment for pulp therapy to be determined and immediate follow-up arranged.
After completing the child's initial examination, please complete and return a Dental Health form to Head Start/EHS/ECEAP. Indicate specific services provided, the service date(s), and costs. Please also note all additional treatment and preventative care needed.
Following each dental treatment appointment, another Dental Health form needs to be completed and faxed or mailed to Head Start/EHS/ECEAP.
It is a federal "mandate" to have the results of this examination on file at Head Start/EHS/ECEAP.
Sincerely,
Health Specialist
(C: 03/96; R: 06/14) HLTH 10f LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Dental Form
Child's Name Birthdate Is the child now receiving: Topical Fluoride Application? Yes No Fluoridated Water? Yes No Fluoride Supplement Diet? Yes No
EXAMINATION AND TREATMENT RECORD: (List services provided in order.) Description of Work Completed Date Service Performed Actual Charges
PREVENTATIVE DENTAL CARE TO BE COMPLETED INCLUDES: Sealants Cleaning Fluoride Approximate number of visits needed Appointment Date
CHILD ORAL HEALTH SUMMARY: All planned treatment is is not complete. Description of Work Needed and NOT Completed Date Scheduled Estimated Charges
Approximate number of visits needed Approximate Cost DENTAL HEATLH RECOMMENDATIONS AND/OR CONCERNS: Routine recall visits Special home emphasis on oral hygiene Dietary Problem(s) Developmental problem(s) Harmful oral habits Needs fluoride supplement "Baby bottle" tooth decay Other concerns:
Source of payment
Dentist or Dental Office Name (Please Print) PLEASE RETURN TO: LCC HEAD START/EHS/ECEAP Signature of Dentist or Office Staff P.O. Box 3010 Longview, WA 98632-0310 Date (360) 442-2800 FAX: (360) 442-2819
Benefits of LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP are available to all children without regard to race, color, national origin, or handicapping condition.
Print on Blue (C: 07/93; R: 07/13) HLTH 10g
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Denial of Consent for Dental Services
As parent or legal guardian of (Name of Child)
It is my desire that no dental services be provided to my child by Head Start/EHS/ECEAP. I understand that services have been recommended for my child. I accept the consequences of this action and in no way hold Lower Columbia College Head Start/EHS/ECEAP responsible for any future dental problems resulting from the lack of dental services.
Signature of Parent/Guardian Date
Signature of Witness Date
Supervisor, Health Specialist, and DST/EHS staff will determine if and when a Denial of Consent for Dental Services form is completed.
Distribution: White: Site File Yellow: Parent Copy (C: 01/02; R: 06/13) Denial of Consent for Dental Services HLTH 10g
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Negativa de Consentimiento de Servicios Dentales
Como padre o tutor legal de (Nombre del Niño)
Es mi deseo que ningún servicio dental sea proporcionado a mi niño por el Head Start/EHS/ECEAP. Entiendo que se han recomendado servicios dentales a mi niño. Acepto las consecuencias de esta acción y de ninguna hare responsable al Lower Columbia College Head Start/EHS/ECEAP por cualquier problema dental futuro que resulte por de la falta de servicios dentales.
Firma del Padre/Tutor Fecha
Firma de Testigos Fecha
Supervisor, Health Specialist, and DST/EHS staff will determine if and when a Denial of Consent for Dental Services form is completed.
Distribution: White: Site File Yellow: Parent Copy (C: 01/02; R: 06/13) HLTH 10h LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Well Child and Dental Exams Process
Assuring children have access to and receive preventative medical and dental care are LCC Head Start/EHS/ECEAP requirements. Regular well-child care and dental care greatly aid in the early detection of potential health concerns, which can affect a child’s growth, development, and learning. Records of these exams provide documentation that care has been provided and gives staff important information about a child’s individual health status. Information about the importance of Well Child and Dental exams is to be reviewed with parents at enrollment and ongoing according to the age appropriate schedule of Well Child Care below.
Age-appropriate Schedule of Well Child Exam • 1st Visit: Birth – 6 Weeks • 2nd Visit: 2-3 Months • 3rd Visit: 4-5 Months • 4th Visit: 6-7 Months • 5th Visit: 9-11 Months • Three screening examinations are recommended for child 1 through 2 years of age. (12 month, 18 month and 2 years). • One screening examination is recommended per 12-month period for children 3 through 6 years of age.
Dental Exams • First Dental Exam: Due at 12 Months of Age. o A dental risk assessment should be preformed by child’s health care provider prior to 12 months of age if a current dental home has not been established. It is highly recommended that a child be seen by a dental provider before 1 year of age if a child is experiencing discomfort, improper tooth growth, decay, etc. • Dental Exams should occur every 6 months.
Direct Service Team and EHS staff members support families and pregnant women in locating a dental home (i.e. Refer to Youth & Family Link-Access to Baby and Childhood Dentistry Program (ABCD) and Youth & Family Link-Oral Health Connections (Pregnant Mother), etc.)
Procedure: 1. Prior to requesting records for a Well Child Exam, clarify with child’s parent/guardian to ensure child was seen for a Well-Child exam and not an office visit for illness. 2. Review the Well-Child Exam record on file and cross check with the Schedule of Well- Child Care (listed above) to determine if the child is current or behind on their Well- Child Care. 3. If a child has not had an exam or if a child is due for an exam, provide the parent with the appropriate Well-Child Exam form (HLTH 10c) and/or Dental Exam form (HLTH 10f) and facilitate the scheduling of the appointment. Discuss upcoming exam appointments with parents. Support family by answering any questions or discussing any concerns they may have related to well-child care or child’s dental health care needs. 4. If health records are needed, complete a Request for WCE Records (HLTH 11e1a) or Request for Dental Records (HLTH 11e1b). Attach a copy of the appropriate provider release (ROI), and turn in to the Program Coordinator to fax to the child’s health care or dental care provider.
(C: 06/10; R: 07/21) HLTH 10j Lower Columbia College Head Start/ECEAP End-of-Year Child Health Summary
Child’s Name: LOC ID: Date Reviewed/Given to Parent/Guardian:
Immunizations: ___ Current and Complete for Kindergarten Entry ___ Exempt ___ Immunizations Needed and Due Dates:
Annual Well Child Exam: ___ Current and Due: ___ Past Due as of:
Lead Screening Record on File: ___ Yes ___ No If no, plan to obtain:
Medical Follow-up or Treatment Currently Needed? ___ Yes ___ No If yes, determine next steps and state here:
*If Spring Growth Assessment BMI is below 5% or above 95%, it is recommended that the child be seen by their healthcare provider within 6 months.
6-Month Dental: ___ Current and Due: ___ Past Due as of: Dental Follow-up or Treatment Currently Needed? ___ Yes ___ No If yes, determine next steps and state here:
Additional Health Documentation Provided for Next Education Setting: ex. copy of existing Emergency Action Plan (Anaphylaxis, Seizure or Asthma), Dietary Restriction Form (CACFP Fluid Milk Substitution Form, CACFP Medical Disability Statement for Food Substitutions and/or CACFP Medical Non-Disabling Statement for Food Substitutions) and/or Individual Care Plan.
Distribution: Original: Site File Copy: Parent/Guardian (C: 04/10; R: 04/2020) End-of-Year Child Health Summary HLTH 10j
Lower Columbia College Head Start/ECEAP Resumen de Fin de Año de la Salud del Niño
Nombre del Niño: LOC ID: Fecha de Revisión/Entregado a los Padres/Tutor:
Vacunas: ___ Actualizadas y completas para entrar al Kínder ___ Exentas ___ Vacunas Necesarias y Fechas Límites:
Examen Físico del Niño: ___ Actual y Próximo: ___ Vencido:
Reporte del Plomo en el expediente: ___ Sí ___ No Sí no, cual es el plan para obtenerlo:
¿Seguimiento Médico o Tratamiento Actualmente Necesario? ___ Sí ___ No Si contestó sí, determine el próximo paso y anótelo aquí:
*Si el índice de masa corporal de su evaluación de crecimiento en primavera es menos de 5% o más de 95%, es recomendado que el niño sea atendido por su doctor dentro de seis meses.
Examen Dental de cada 6-Meses: ___ Actual y Próximo: ___ Vencido: ¿Seguimiento Dental o Tratamiento Actualmente Necesario? ___ Sí ___ No Si contestó sí, determine el próximo paso y anótelo aquí:
Documentación adicional sobre la salud para la próxima escuela del niño: p. ej. una copia de un plan de acción en situación de emergencia (para anafilaxis, convulsiones o asma), forma de restricción de dieta (Requisición del padre/tutor para substitución de leche líquida, declaración de discapacidad medical para substituciones de alimentos, y/o declaración para substituciones de alimentos sin discapacidad medical) y/o plan de cuidado individual.
Distribution: Original: Site File Copy: Parent/Guardian (C: 04/10; R: 04/2020) HLTH 10k LCC Head Start Head Start/EHS/ECEAP LEAD SCREENING Required for Head Start Children
Every Child Needs a Lead Screening: Head Start requires that every student have a blood lead level screening record on file. All children should have a lead screening tests completed at age 12 months and 24 months. Children between 24 and 72 months of age with no record of a previous blood lead screening test, should also complete a lead screening test. Completion of a risk assessment questionnaire does not meet this requirement.
Lead is most dangerous to children under six years of age. At this age children’s brains and nervous systems are more sensitive to the damaging effects of lead. Children’s growing bodies absorb more lead than adults and is therefore more harmful to them.
Exposure to lead can cause: Damage to the brain and nervous system Slowed growth and development Learning and behavior problems Hearing and Speech problems.
Please provide this informational sheet to your healthcare provider.
(C: 04/19)
HLTH 10k LCC Head Start Head Start/EHS/ECEAP LEAD SCREENING Required for Head Start Children
Every Child Needs a Lead Screening: Head Start requires that every student have a blood lead level screening record on file. All children should have a lead screening tests completed at age 12 months and 24 months. Children between 24 and 72 months of age with no record of a previous blood lead screening test, should also complete a lead screening test. Completion of a risk assessment questionnaire does not meet this requirement.
Lead is most dangerous to children under six years of age. At this age children’s brains and nervous systems are more sensitive to the damaging effects of lead. Children’s growing bodies absorb more lead than adults and is therefore more harmful to them.
Exposure to lead can cause: Damage to the brain and nervous system Slowed growth and development Learning and behavior problems Hearing and Speech problems.
Please provide this informational sheet to your healthcare provider. (C: 04/19) Lead Screening HLTH 10k LCC Head Start Head Start/EHS/ECEAP ANÁLISIS DE PLOMO Requerido Para Niños de Head Start
Todo niño necesita una prueba de plomo: El programa Head Start requiere que mantengamos documentación de un análisis de plomo de todo estudiante. Todos los niños deben recibir un análisis de plomo entre los 12 y 24 meses de edad. Niños que tengan 24 a 72 meses también deben recibir un análisis de plomo, si no lo recibieron anteriormente. No es suficiente completar un cuestionario para determinar el riesgo por exposición a plomo.
El plomo es más perjudicial antes de los seis años de edad, porque los cerebros y sistemas nerviosos son más sensibles a los efectos dañinos del plomo y sus cuerpos crecientes también absorban más plomo que los de adultos, causándoles todavía más daño.
Exposición al plomo puede causar: Daño al cerebro y el sistema nervioso Crecimiento y desarrollo atrasado Problemas de aprendizaje y comportamiento Problemas de audición y lenguaje
Por favor, entregue esta hoja informacional a su proveedor de atención médica.
(C: 04/19)
Lead Screening HLTH 10k LCC Head Start Head Start/EHS/ECEAP ANÁLISIS DE PLOMO Requerido Para Niños de Head Start
Todo niño necesita una prueba de plomo: El programa Head Start requiere que mantengamos documentación de un análisis de plomo de todo estudiante. Todos los niños deben recibir un análisis de plomo entre los 12 y 24 meses de edad. Niños que tengan 24 a 72 meses también deben recibir un análisis de plomo, si no lo recibieron anteriormente. No es suficiente completar un cuestionario para determinar el riesgo por exposición a plomo.
El plomo es más perjudicial antes de los seis años de edad, porque los cerebros y sistemas nerviosos son más sensibles a los efectos dañinos del plomo y sus cuerpos crecientes también absorban más plomo que los de adultos, causándoles todavía más daño.
Exposición al plomo puede causar: Daño al cerebro y el sistema nervioso Crecimiento y desarrollo atrasado Problemas de aprendizaje y comportamiento Problemas de audición y lenguaje
Por favor, entregue esta hoja informacional a su proveedor de atención médica. (C: 04/19)
HLTH 11a
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Health Referral for New or Recurring Concerns
Policy Our program utilizes procedures to ensure the ongoing identification of any new or recurring medical, dental, or developmental concerns of our children. These procedures include: periodic observations (from parents and staff) and recordings, as appropriate, of individual children’s developmental progress, changes in physical appearance (e.g., signs of injury or illness) and emotional and behavioral patterns.
Procedure 1. Center-based children are observed throughout the day, as they participate in indoor and outdoor activities, routines, transitions, arrivals, and departures. Pertinent observations are recorded in case management and if appropriate in the child’s developmental tracking tool. Whereas, home-based children are observed at weekly home visits and socializations. 2. Parents are regularly provided with information on developmental milestones, and are asked for their observations concerning their child’s development. 3. When parents or staff members observe medical, dental or developmental changes, which are of possible concern, those observations are to be shared with a health professional. The DST/EHS Staff member will ask the parent if the child has been seen, by a health professional, for these concerns. If the child has, the DST/EHS staff and parent will discuss the follow-up plan(s) and complete a request letter (HLTH 11e1) for forwarding to the Program Coordinator. All sources of information are to be used in evaluating each child. 4. When a child has been identified as possibly benefiting from diagnostic evaluation, the DST/EHS Staff member is to contact their supervisor and the Health Specialist. As determined, the DST/EHS Staff or Health Specialist will contact the Health Consultant. 5. As warranted, a letter stating concerns, observations, and request for further diagnostic evaluation will be sent to the child’s Primary Health Care Provider. 6. A Health Accommodation Plan meeting can be arranged and/or the child/family can be staffed at a Content Area Support Team (CAST) meeting. 7. The DST/EHS Staff member is to note all pertinent information in case management.
(C: 08/02; R: 07/18) HLTH 11b Loc ID #
Lower Columbia College Head Start/EHS/ECEAP Health History/Nutrition Intake (1 to 5 years of age) Date Child's Name Birthdate HEALTH INSURANCE STATUS: 1. Head Start/EHS/ECEAP Child? Yes No Type 2. Parent/Guardian? Yes No Type 3. Siblings? Yes No Type
Child’s Primary Health Insurance Coverage (PIR): Please check only one box: Medicaid and/or CHIP (CHPW, Molina, ProviderOne)(Open Medical Coupon, Healthy Options & BHP-PLUS) Private Health Insurance Other Health Insurance (Military Health, Tri-Care, CHAMPUS, etc.) No Health Insurance
Child’s Continuous and Accessible Medical and Dental Care (PIR): Please check each applicable box: Child has an ongoing source of continuous, accessible health care. Child received medical services through the Indian Health Service. Child received medical services through a migrant community health center. Child has an ongoing source of continuous, accessible dental care provided by a dentist.
PREGNANCY: 1. Were you told that your child was born early or premature? How early? 2. Were there significant complications during pregnancy? 3. Is there any additional information that you would like to share regarding your pregnancy?
PHYSICAL, PSYCHOLOGICAL & SOCIAL DEVELOPMENT 1. Please explain any problems, worries or fears your child may have such as Separation Anxiety Difficulty transitioning from one activity to the next Nightmares/Sleepwalking Aggression Unsafe Behaviors______ Other
2. Do you have any concerns regarding your child's interactions with other adults and children? Yes No If yes, please explain:
3. My child naps during the day: Sometimes Always Never 4. In a 24-hour period, how many hours does your child sleep? ______5. Has your child received counseling? Yes No Currently Counselor’s Name 6. Does anyone smoke/vape in a car with your child? Yes _____ No _____ 7. Does anyone in your household smoke/vape inside the home? Yes _____ No _____
Office Use Only: Scanned (date and initials): (C: 06/99; R: 11/2020) HLTH 11b Loc ID #
HEALTH HISTORY - Page 2 of 6
DISEASES OR CONDITIONS IN FAMILY 1. Please explain any current major health concerns for family living at home and any diseases or conditions that run in your immediate/extended family (e.g. Seizures, Diabetes, Heart Cond., Dyslexia, ADHD, Anxiety, Depression,):
HOSPITALIZATIONS AND ILLNESSES: 1. Since birth, has your child been hospitalized, seriously ill, required surgery, been in a serious accident, or been chronically ill (e.g. Asthma, Diabetes, Eczema, Food Allergy)
VISION AND HEARING: 1. My child . . . (indicate those which apply) has trouble hearing has or has had ear tubes _____ history of ear infections has trouble seeing wears or is supposed to wear glasses
HEALTH PROBLEMS Explain All Current Conditions (including Past Current medications) & State Follow-Up Plans: 1. Chicken Pox 2. Strep Throat/Tonsillitis 3. Bronchitis 4. Pneumonia 5. Fevers 6. Headaches 7. Tiredness 8. Joint Pain 9. Dizziness 10. Bruising 11. Vomiting 12. Diarrhea 13. Constipation 14. Stomach Aches 15. Hepatitis 16. Eczema 17. Urination/Bedwetting Discussed with PCP? Yes No FA Recommended Informing PCP 18. Child Wears: Diapers Pull-ups Underwear
CONDITIONS REQUIRING A SPECIFIC PLAN OF ACTION AT THIS TIME: 1. Please check all applicable diagnosed conditions and complete a specific plan for each: Asthma Seizure/Convulsions Cerebral Palsy Diabetes Anemia Bee Stings Cystic Fibrosis Heart Problems Immuno Compromised None Allergies (i.e., food, medication, latex) explain: Other Condition(s)
(C: 06/99; R: 11/2020) HLTH 11b Loc ID #
HEALTH HISTORY - Page 3 of 6 2. My child has a life threatening illness (e.g. Seizures, Asthma, Heart Condition) No Yes If yes, please explain: ______ Name of Condition: Past Current* (*Please answer the following if this is a current condition and/or concern.) a. Known Causes: b. Signs & Symptoms: c. Date of Last Occurrence: d. Current Action Plan (Plan of Care): e. Emergency Action Plan: (A copy of a written plan of action, from the child's Primary Health Care Provider is required. Fax for plan.) f. Medication: Name: Dosage: Frequency: Additional Information: g. Specialist Name (complete a release): h. Child Last Seen for Condition: Date: Provider Name:
Name of Condition: Past Current* (*Please answer the following if this is a current condition and/or concern.) a. Known Causes: b. Signs & Symptoms: c. Date of Last Occurrence: d. Current Action Plan (Plan of Care): e. Emergency Action Plan: (A copy of a written plan of action, from the child's Primary Health Care Provider is required. Fax for plan.) f. Medication: Name: Dosage: Frequency: Additional Information: g. Specialist Name (complete a release): h. Child Last Seen for Condition: Date: Provider Name:
DENTAL: 1. Has child complained of pain in teeth or gums? Past ____ Present _____ No 2. Have you noticed cavities in your child's teeth? Past ____ Present _____ No 3. Does your child suck his/her thumb? Use a pacifier? Yes _____ No _____ 4. Is there fluoride in the water at home? Yes _____ No _____ If no, receiving fluoride supplement? Yes _____ No _____
TUBERCULOSIS SURVEY: 1. Has your child ever received a PPD (TB Skin Test)? Yes _____ No _____ If yes, has your child ever had a positive result? Yes _____ No _____ 2. Has your child lived with someone known or suspected to have active TB? Yes _____ No _____ Comments:
If answer to question 2 is yes, staff recommend further follow-up with child's Primary Health Care Provider:
(staff initials & date)
(C: 06/99; R: 11/2020) HLTH 11b Loc ID #
HEALTH HISTORY - Page 4 of 6
OTHER: PLEASE LIST ANY SPECIALIST THAT MAY HAVE SEEN YOUR CHILD DURING THE PAST TWO YEARS AND THE REASON THEY WERE EXAMINED, ASSESSED OR EVALUATED:
Name: Reason: Name: Reason: (Please complete release forms for specialists listed above) SCREEN TIME: 1. Does your child use electronics (TV, tablets, phones, computer) in the home? ___ Yes ___ No 2. If yes to using electronics, does your child spend more than 2 hours per day using them? ___Yes ___No If yes, how many hours per day? (2-5 years old: If more than 2 hours per day, give limit screen time handout.) (staff initials) (If any screen time under the age of 2, give limit screen time handout. (Staff initials)
NUTRITION INTAKE FOR 12 TO 36 MONTHS (EHS): Estimate how many servings your child eats of these food groups EACH DAY: Milk, Yogurt & Cheese Group GOAL: 4 - 6 servings / day Milk or breast milk: ½ cup or 120 mL Cheese: ¾ oz or 20g Cottage cheese: ¾ cup or 180 mL Yogurt, pudding, custard made with milk: ½ cup or 120 mL 2 3* 4 5 more Fruit Group GOAL: 2 - 4 servings / day Fresh: ¼ - ½ small Canned or frozen: 2-3 tbsp. Juice: 1/8 cup or 30 mL 1* 2 3 4 more Bread, Cereal, Rice & Pasta Group GOAL: 6 - 11 servings / day ¼ - ½ slice of bread, tortilla, roll, muffin, pancake or waffle Dry cereal: ¼ cup to ½ cup Noodles, rice, cooked cereal: 1/8 cup to ¼ cup Crackers: 1-2 small 1 2 4* 6 8 more Meat, Poultry, Fish, Dry Beans, Eggs & Nut Group GOAL: 2 - 3 servings / day Animal Protein: Meat, chicken turkey, fish: 1 tbsp. or 15 mL Eggs: ½ egg Vegetable protein: Cooked dry beans, lentils: ¼ cup or 60 mL Peanut Butter: 1 tbsp. or 15 mL Tofu: ¼ cup or 60 mL 1* 2 3 4 more Vegetable Group GOAL: 3 - 5 servings / day Cooked/Raw: 2-3 tbsp. 1 2* 3 4 more
(C: 06/99; R: 11/2020) HLTH 11b Loc ID #
HEALTH HISTORY - Page 5 of 6
NUTRITION INTAKE FOR 3 TO 5 YEARS OLD: Estimate how many servings your child eats of these food groups EACH DAY: Milk, Yogurt & Cheese Group GOAL: 4 - 6 servings / day ½ cup or 1 oz. servings: 2 3* 4 5 more Fruit Group GOAL: 2 - 4 servings / day ½ piece or 2 oz. juice servings 1* 2 3 4 more Bread, Cereal, Rice & Pasta Group GOAL: 6 - 11 servings / day ½ slice or ¼ cup servings 2 4* 6 8 more Meat, Poultry, Fish, Dry Beans, Eggs & Nut Group GOAL: 2 - 3 servings / day 2 slices lunch meat or 2 tablespoons peanut butter or 2 fish sticks or 2 ounces (1/2 deck of cards) meat/poultry 1* 2 3 4 more Vegetable Group GOAL: 3 - 5 servings / day ¼ cup cooked or ½ cup raw servings 1 2* 3 4 more SNACKS What does your child eat for snacks? (*snacks are sugar and fat) What does your child drink for snacks?
FOOD ALLERGY: 1. Does your child have food allergies or food intolerances? Yes No
2. If yes, what food(s) (e.g. Dairy (milk, cheese, yogurt (type), fruit, nuts, etc.)? ______
3. What is reaction (e.g. Trouble breathing, Hives)? ______
4. What does parent/guardian substitute (Be Specific: Type & Amount) ______ If reaction is life threatening, faxed Anaphylaxis Emergency Plan form to Primary Health Care Provider.
DIETARY ACCOMMODATIONS REQUESTS Cow’s Milk Substitution: If parent/guardian wants our program to provide child Soy Milk, Lactose Reduced or Lactose Free Milk or if parent/guardian wants to provide Organic Milk, then have the parent/guardian complete a Request for Fluid Milk Substitution form. Completed Request for Fluid Milk Substitution Form Parent Requests Substitute Soy Milk Lactose Free Milk Lactose Reduced Milk
If a parent/guardian wants our program to provide their child water, Almond Milk, Rice Milk or another Fluid Food as a substitute for cow’s milk: 1. Assist the child’s parent/guardian with completing the first section of the Request for Special Dietary Accommodation Form which includes the parent/guardian signing and dating this section; (C: 06/99; R: 11/2020) HLTH 11b Loc ID #
HEALTH HISTORY - Page 6 of 6
2. Place a copy of the form, with the first section completed, into the Red Folder in the Health Coordinator’s mailbox. (The Health Coordinator will then Fax it to the child’s Primary Health Care Provider or Specialist for the completion of the Diet Order section of this form.) Parent requests other substitute (Almond, Rice, etc.) Place copy of Request for Special Dietary Accommodation Form, with first section completed, into the Red Folder in the Health Coordinator’s mailbox.
Food Substitution Food Other Than Milk: If a parent/guardian does not want a food offered to their child (for other than religious reasons): 1. Assist the child’s parent/guardian with completing the first section of the Request for Special Dietary Accommodation Form which includes the parent/guardian signing and dating this section; 2. Place a copy of the form, with the first section completed, into the Red Folder in the Health Coordinator’s mailbox. (The Health Coordinator will then Fax it to the child’s Primary Health Care Provider or Specialist for the completion of the Diet Order section of the form.) Place copy of Request for Special Dietary Accommodation Form, with first section completed, into the Red Folder in the Health Coordinator’s mailbox.
VITAMINS Does your child take vitamins? Yes No What kind? Do they contain iron? Yes No Were they prescribed? Yes No
Is the enrolled child receiving WIC services? Yes No ______Not Interested
What concerns do you have about your family's nutritional health?
Weight Issues Child Adult Appetite Child Adult Meal Planning Budgeting Shopping Tips Healthy Eating Child Adult Cultural/Religious Preferences? (Please list) Special Diet? (Please list) ______ Other ______ Having enough food for each month. Staff Provided Resource Information: ______(Staff initials & date) I would like to discuss my concerns with the nutritionist.
I would like to participate in the Nutrition Committee. I would like to participate in the Health Services Advisory Committee.
Parent/Guardian Signature Staff Member Signature
______Date Date
(C: 06/99; R: 11/2020) HLTH 11c Loc ID # Lower Columbia College Head Start/EHS/ECEAP *RETURNING CHILDREN ONLY* Health History/Nutrition Intake (1 to 5 years of age) Date Child's Name Birthdate HEALTH INSURANCE STATUS: 1. Head Start/EHS/ECEAP Child? Yes No Type 2. Parent/Guardian? Yes No Type 3. Siblings? Yes No Type
Child’s Primary Health Insurance Coverage (PIR) Please check only one box: Medicaid and/or CHIP (CHPW, Molina, ProviderOne (Open Medical Coupon, Healthy Options & BHP-Plus) Private Health Insurance Other Health Insurance (Military Health, Tri Care, CHAMPUS, etc.) No Health Insurance
Child’s Continuous and Accessible Medical and Dental Care (PIR) Please check each applicable box: Child has an ongoing source of continuous, accessible health care. Child received medical services through the Indian Health Service. Child received medical services through a migrant community health center. Child has an ongoing source of continuous, accessible dental care provided by a dentist.
PHYSICAL, PSYCHOLOGICAL & SOCIAL DEVELOPMENT 1. Please explain any current problems, worries or fears your child may have such as: Separation Anxiety, Difficulty transitioning, Nightmares, Sleepwalking, Aggression, Unsafe Behaviors etc.
2. Do you have any concerns regarding your child's interactions with other adults and children? Yes No If yes, please explain:
3. Any Concerns regarding child’s sleep? Yes_____ No_____ If yes, please explain: ______5. Has your child received counseling? Yes No Currently Counselor’s Name HOSPITALIZATIONS AND ILLNESSES: 1. Please explain if since the last program school year, your child has been hospitalized, seriously ill, required surgery, has had a serious accident, or been chronically ill (e.g. asthma, diabetes, eczema, food allergy).
MAJOR HEALTH CONCERNS IN FAMILY 1. Please explain any current major health concerns for any member of your family:
Office Use Only: Scanned (date and initials): *COPY ON YELLOW PAPER
DST/CFDS to Turn-in Copy to Health Coordinator (C: 03/18; R: 11/2020) HLTH 11c Loc ID # HEALTH HISTORY - Page 2 of 5 Child's Name
HEARING AND VISION: 1. My child . . . (indicate those which apply) current trouble hearing recent ear infections has ear tubes trouble seeing wears or is supposed to wear glasses
HEALTH PROBLEMS 1. Explain All Current Conditions (including medication) and State Follow-up Plans for: Fevers, Headaches, Tiredness, Joint Pain, Dizziness, Bruising, Vomiting, Diarrhea, Constipation, Stomach Aches, Hepatitis, etc. (Circle those that apply and explain)
2. Urination/Bedwetting: Yes No Discussed with PCP? Yes No FA Recommended Informing PCP 3. Child Wears: Diapers Pull-ups Underwear
CONDITIONS REQUIRING A SPECIFIC PLAN OF ACTION AT THIS TIME: 1. My child has a life threatening illness (e.g. seizures, asthma, heart condition): No Yes If yes, please explain:
2. Please check all applicable diagnosed conditions and complete a specific plan for each: Asthma Seizure/Convulsions Cerebral Palsy Diabetes Anemia Bee Stings Cystic Fibrosis Heart Problems Immunocompromised None Allergies (i.e., food, medication, latex) explain: Other Condition(s) Name of Condition: Past Current* (*Please answer the following if this is a current condition and/or concern.) a. Known Causes: b. Signs & Symptoms: c. Date of Last Occurrence: d. Current Action Plan (Plan of Care): e. Emergency Action Plan: (A copy of a written plan of action, from the child's Primary Health Care Provider is required. Fax for plan.) f. Medication: Name: Dosage: Frequency: Additional Information: g. Specialist Name (complete a release): h. Child Last Seen for Condition: Date: Provider Name:
Name of Condition: Past Current* (*Please answer the following if this is a current condition and/or concern.) a. Known Causes: b. Signs & Symptoms: c. Date of Last Occurrence: d. Current Action Plan (Plan of Care): e. Emergency Action Plan: (A copy of a written plan of action, from the child's Primary Health Care Provider is required. Fax for plan.) f. Medication: Name: Dosage: Frequency: Additional Information: g. Specialist Name (complete a release): h. Child Last Seen for Condition: Date: Provider Name:
DST/CFDS to Turn-in Copy to Health Coordinator (C: 03/18; R: 11/2020) HLTH 11c Loc ID # HEALTH HISTORY - Page 3 of 5 Child's Name
DENTAL: 1. Has child recently complained of pain in teeth or gums? Yes _____ No _____ 2. Have you noticed untreated cavities in your child's teeth? Yes _____ No _____ 3. Does your child suck his/her thumb? Use a pacifier? Yes _____ No _____ 4. Is there fluoride in the water at home? Yes _____ No _____ If no, receiving fluoride supplement? Yes _____ No _____
TUBERCULOSIS SURVEY: 1. Has your child ever received a PPD (TB Skin Test)? Yes _____ No _____ If yes, has your child ever had a positive result? Yes _____ No _____ 2. Has your child lived with someone known or suspected to have active TB? Yes _____ No _____ Comments: If answer to question 2 is yes, staff recommend further follow-up with child's Primary Health Care Provider:
(staff initials & date) OTHER: PLEASE LIST ANY SPECIALIST THAT MAY HAVE SEEN YOUR CHILD DURING THE PAST YEAR AND THE REASON THEY WERE EXAMINED, ASSESSED OR EVALUATED: Name: Reason: Name: Reason: (Please complete release forms for specialists listed above)
NUTRITION INTAKE FOR 12 TO 36 MONTHS (EHS): Estimate how many servings your child eats of these food groups EACH DAY: Milk, Yogurt & Cheese Group GOAL: 4 - 6 servings / day Milk or breast milk: ½ cup or 120 mL Cheese: ¾ oz or 20g Cottage cheese: ¾ cup or 180 mL Yogurt, pudding, custard made with milk: ½ cup or 120 mL 2 3* 4 5 more Fruit Group GOAL: 2 - 4 servings / day Fresh: ¼ - ½ small Canned or frozen: 2-3 tbsp Juice: 1/8 cup or 30 mL 1* 2 3 4 more Bread, Cereal, Rice & Pasta Group GOAL: 6 - 11 servings / day ¼ - ½ slice of bread, tortilla, roll, muffin, pancake or waffle Dry cereal: ¼ cup to ½ cup Noodles, rice, cooked cereal: 1/8 cup to ¼ cup Crackers: 1-2 small 1 2 4* 6 8 more Meat, Poultry, Fish, Dry Beans, Eggs & Nut Group GOAL: 2 - 3 servings / day Animal Protein: Meat, chicken turkey, fish: 1 tbsp or 15 mL Eggs: ½ egg Vegetable protein: Cooked dry beans, lentils: ¼ cup or 60 mL Peanut Butter: 1 tbsp or 15 mL Tofu: ¼ cup or 60 mL 1* 2 3 4 more Vegetable Group GOAL: 3 - 5 servings / day Cooked/Raw: 2-3 tbsp 1 2* 3 4 more DST/CFDS to Turn-in Copy to Health Coordinator (C: 03/18; R: 11/2020) HLTH 11c Loc ID # HEALTH HISTORY - Page 4 of 5 Child's Name
NUTRITION INTAKE FOR 3 TO 5 YEARS OLD: Estimate how many servings your child eats of these food groups EACH DAY: Milk, Yogurt & Cheese Group GOAL: 4 - 6 servings / day ½ cup or 1 oz. servings: 2 3* 4 5 more Fruit Group GOAL: 2 - 4 servings / day ½ piece or 2 oz. juice servings 1* 2 3 4 more Bread, Cereal, Rice & Pasta Group GOAL: 6 - 11 servings / day ½ slice or ¼ cup servings 2 4* 6 8 more Meat, Poultry, Fish, Dry Beans, Eggs & Nut Group GOAL: 2 - 3 servings / day 2 slices lunch meat or 2 tablespoons peanut butter or 2 fish sticks or 2 ounces (1/2 deck of cards) meat/poultry 1* 2 3 4 more Vegetable Group GOAL: 3 - 5 servings / day ¼ cup cooked or ½ cup raw servings 1 2* 3 4 more
FOOD ALLERGY: Does your child have food allergies or food intolerances? Yes No If yes, What food(s) (e.g. dairy-milk, cheese, yogurt(type), nuts, fruit, etc.)?
What is reaction (e.g. trouble breathing, hives)?
If reaction is life threatening, faxed Anaphylaxis Emergency Plan form to Primary Health Care Provider. What does parent/guardian substitute (be specific: type and amount)?
DIETARY ACCOMMODATIONS REQUESTS Cow’s Milk Substitution: If parent/guardian wants our program to provide child Soy Milk, Lactose Reduced or Lactose Free Milk or if parent/guardian wants to provide Organic Milk, then have the parent/guardian complete a Request for Fluid Milk Substitution form. Completed Request for Fluid Milk Substitution Form Parent Requests Substitute Soy Milk Lactose Free Milk Lactose Reduced Milk
If a parent/guardian wants our program to provide their child water, Almond Milk, Rice Milk or another Fluid Food as a substitute for cow’s milk: 1. Assist the child’s parent/guardian with completing the first section of the Request for Special Dietary Accommodation Form which includes the parent/guardian signing and dating this section; 2. Place a copy of the form, with the first section completed, into the Red Folder in the Health Coordinator’s mailbox. (The Health Coordinator will then Fax it to the child’s Primary Health Care Provider or Specialist for the completion of the Diet Order section of this form.) Parent requests other substitute (Almond, Rice, etc.) Place copy of Request for Special Dietary Accommodation Form, with first section completed, into the Red Folder in the Health Coordinator’s mailbox.
DST/CFDS to Turn-in Copy to Health Coordinator (C: 03/18; R: 11/2020) HLTH 11c Loc ID # HEALTH HISTORY - Page 5 of 5 Child's Name
Food Substitution Food Other Than Milk: If a parent/guardian does not want a food offered to their child (for other than religious reasons): 1. Assist the child’s parent/guardian with completing the first section of the Request for Special Dietary Accommodation Form which includes the parent/guardian signing and dating this section; 2. Place a copy of the form, with the first section completed, into the Red Folder in the Health Coordinator’s mailbox. (The Health Coordinator will then Fax it to the child’s Primary Health Care Provider or Specialist for the completion of the Diet Order section of the form.) Place copy of Request for Special Dietary Accommodation Form, with first section completed, into the Red Folder in the Health Coordinator’s mailbox.
SNACKS: What does your child eat for snacks? (*snacks are sugar and fat) What does your child drink for snacks? (*sugared beverages) *Note on database
VITAMINS: Does your child take vitamins? Yes No What kind? Do they contain iron? Yes No Were they prescribed? Yes No
Is the enrolled child receiving WIC services? Yes No
What concerns do you have about your family's nutritional health? Weight Issues Child Adult Appetite Child Adult Having enough food for each month. Staff Provided Resource Information: Budgeting (Staff initials & date) Meal Planning Shopping Tips Healthy Eating Child Adult Cultural/Religious Preferences? (Please list) Special Diet? (Please list) Other I would like to discuss my concerns with the nutritionist.
I would like to participate in the Nutrition Committee. I would like to participate in the Health Services Advisory Committee.
Parent/Guardian Signature Staff Member Signature
DST/CFDS to Turn-in Copy to Health Coordinator (C: 03/18; R: 11/2020) HLTH 11d Loc ID # ______
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Health/Nutrition Intake (Birth – 12 months)
Date Child's Name Birth Date / / Male Female
HEALTH COVERAGE: 1. Date of last Well Child Exam Date of next Well Child Exam 2. Does your child have medical coverage? Yes _____ No _____ 3. Please check type of medical coverage: Medicaid/DSHS (Healthy Options) CHIP Private Insurance 4. Does parent have medical coverage? Yes _____ No _____ Type
RETURNING CHILDREN ONLY: Child’s Primary Health Insurance Coverage (PIR) Please check only one box: Medicaid/Apple Health and/or CHIP (CHPW, Molina, Kaiser, ProviderOne) (Open Medical Coupon, Healthy Options) Private Health Insurance Other Health Insurance: (Military Health, Tri Care, CHAMPUS, etc.) No Health Insurance Child’s Continuous and Accessible Medical and Dental Care (PIR) Please check each applicable box: Child has an ongoing source of continuous, accessible health care. Child received medical services through the Indian Health Service. Child received medical services through a migrant community health center. Child has an ongoing source of continuous, accessible dental care provided by a dentist.
BIRTH INFORMATION: 1. Type of Delivery: Vaginal C-Section 2. Birth Weight: _____lbs. _____oz. Birth Length: _____inches Head Circumference: ______3. Gestational Age weeks 4. Did mother receive prenatal care? Yes No If yes, when did care begin? 5. What type of facility was your baby born at? Hospital Home Other 6. Name of facility: Length of stay: 7. Did the mother have any health problems during this pregnancy/delivery?
8. Did the baby have any problems at birth? 9. Was caffeine used during your pregnancy? 10. Were drugs/alcohol or cigarettes part of family life during pregnancy? Yes No
Office Use Only: scanned/date & initial
(C: 04/10; R: 11/2020) HLTH 11d Loc ID # ______HEALTH/NUTRITION INTAKE - Page 2 of 4 Child's Name CHILD’S HEALTH INFORMATION: Explain All Current Conditions (including Past Current medications) & State Follow-Up Plans: Allergy Anemia Bruising Colic Constipation Diabetes Diarrhea Ear Problems/Infections Eczema Heart Problems Low Birth Weight Respiratory Problems Seizures Sickle Cell Yellow Jaundice Other Explain All Current Conditions (including Yes No medications) & State Follow-Up Plans: Cerebral Palsy Downs Syndrome Exposure to Lead Exposure to TB Fetal Alcohol Surgery
MEDICATION: 1. Does your child take medication on a regular basis? Yes No If yes, what? 2. Will your child need this medication while in care? Yes No 3. Does your child have medication for emergency use? Yes No If yes, what?
DEVELOPMENTAL HISTORY: 1. Does your child sleep on his/her? _____ stomach _____ back _____ side 2. How do you put your child to sleep? 3. How many hours does your child sleep in a 24-hour period? Most of Some Rarely Never Time Times Does your child arch/stiffen when picked up? Does your child make eye contact when being fed or held? Do you have concerns about your child’s sleep pattern? Does your child look at objects and follow them with his/her eyes? Does your child make sounds like ah, eh, uh? Does your child respond to your voice by looking at you? Does your child have different cries when he/she is upset, uncomfortable, happy? Does your child suck her/his hand or thumb? Does your baby hold her/his head steady when being held? Do you need assistance getting a car seat for your baby? Do you have any concerns about your child’s development?
(C: 04/10; R: 11/2020) HLTH 11d Loc ID # ______HEALTH HISTORY - Page 3 of 4 Child's Name
ENVIRONMENTAL INFORMATION: 1. Does anyone in your household smoke inside the home? Yes No If yes, handout: _____ 2. Does anyone smoke when in a car with your child? Yes No If yes, handout: _____
DENTAL INFORMATION: 3. Does your child have dental coverage? Yes No 4. Do you clean your child’s gums and/or teeth? Yes No 5. Do you have any family dental concerns? Yes No 6. Is there fluoride in your water? Yes No Unknown 7. Do you have a dentist for your child? Yes No 8. Does your child take a fluoride supplement? (6 mos./over) Yes No
FEEDING/NUTRITION: 1. Do you breast feed your child? Yes No How often? times/24 hrs 2. Does your child drink from a bottle? Yes No How often? times/24 hrs 3. Do you feed your child formula? Yes No How much per feeding? ______oz/bottle If yes, what brand? 4. What kind of bottle do you use? Nipple type? 5. What do you put in the bottle? 6. Does your baby drink a bottle in bed? Yes No 7. Does your child take a vitamin supplement? Yes No 8. Does your child take a prescribed iron supplement? Yes No 9. Do you give your child milk? Yes No If yes, what kind? 10. Which of these foods do you offer your child? (circle) Eggs Poultry Vegetables Bread Fruit Fish Meat Cereal Rice Juice 11. Any known food allergies (e.g. milk, yogurt, fruit)? 12. Do you have any questions/concerns about feeding your baby? Yes No If yes, what? 13. Do you have any concerns about your child’s growth? Yes No If yes, what? 14. Is your child on WIC? Yes No 15. What concerns do you have about your family’s nutritional health? Weight Issues Child Adult Appetite Child Adult Having enough food for each month. ESH staff provided resource info: Budgeting (EHS staff initials & date) Meal Planning Shopping Tips Healthy Eating Child Adult Cultural/Religious Preferences? (Please list) Special Diet? (Please list) Other I would like to discuss my concerns with the nutritionist.
(C: 04/10; R: 11/2020) HLTH 11d Loc ID # ______HEALTH HISTORY - Page 3 of 4 Child's Name
List Health And Nutrition Education Resources Shared With Parents:
Lead and Your Kids Nutritional Information Oral Health Information Fluoride Information Other (please list)
I would like to receive information regarding the Nutrition/Food Service Committee. I would like to receive information regarding the Health Services Advisory Committee.
Parent/Guardian Signature Date
Staff Signature Date
Health Specialist Date
(C: 04/10; R: 11/2020) HLTH 11e1a
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following as required by our program:
MOST RECENT WELL CHILD EXAM ( ) HEIGHT/WEIGHT IMMUNIZATIONS HCT/HGB (If on file) URINALYSIS (If on file) LEAD SCREENINGS (Lead Screening is a Head Start requirement. If a lead screening is not on file, at your clinic, please contact child’s parent/guardian to have this screening completed.) OTHER:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Date of Last WCE on file at Head Start & Staff Initials: ______
Fax Date & Staff Member Initials: ______C: 01/07; R: 04/19) HLTH 11e1b
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. As indicated, program staff and I are requesting the following as required by our program:
Most recent dental exam records ( ), any recommendations or follow-up needed, future appointment dates Most recent dental treatment records ( ), future appointment dates Other:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Date of Last Dental on file at Head Start & Staff Initials: ______
Fax Date & Staff Member Initials: ______C: 01/07; R: 04/19) HLTH 11e1c
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear FAMILY HEALTH CENTER -WIC: (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following as required by our program:
MOST RECENT OFFICE VISIT / WIC RECORDS HEIGHT/WEIGHT HCT & HGB LEVELS ANY RECOMMENDATIONS (State documents and/or information being requested and include date(s) if known.)
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date, DB Date & Staff Member Initials: (C: 01/07; R: 04/19)
HLTH 11e1d
LOC ID#
Head Start /EHS ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following medical documentation as required by USDA in order to provide food substitutions.
Parent states child has the following food allergies:
Please review and sign the Request for Special Dietary Accommodations form. (The USDA requires a recognized medical authority: licensed health care professional authorized to write medical prescription under Washington State Law complete the forms.)
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 01/07; R: 4/19)
HLTH 11e1e
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following medical documentation as required by USDA in order to provide food substitutions.
Parent requests no cow milk, request substitution:______ Parent states child has allergy to cow’s milk
Parent has been counseled on the nutritional value of cow’s milk. Please complete the Request for Special Dietary Accommodations form OR respond to this request and state why a Special Dietary Accommodation Statement will not be completed by you. (The USDA requires a recognized medical authority: licensed health care professional authorized to write medical prescription under Washington State Law complete the forms)
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 01/07; R: 06/2020)
HLTH 11e1f
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. As indicated, program staff and I are requesting the following as required by our program:
Verification of asthma, to include: medication list and asthma action plan for school entry. (See sample action plan) Other:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 01/07; R: 04/19) HLTH 11e1g
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Organization, i.e Legacy Health)
AT: : (Clinic Name i.e Family Medicine, Neurology Clinic)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following medical, dental, or growth and developmental documentation as required by our program:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 01/07; R: 04/19)
HLTH 11e1
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. At this time, program staff and I are requesting the following medical, dental, or growth and developmental documentation as required by our program:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 01/07; R: 04/19)
HLTH 11e1k
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. As indicated, program staff and I are requesting the following:
Anaphylaxis Emergency Plan- Due to allergies/reaction to : (See sample action plan) Verification of allergies other than food allergies: Medication list. Other:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 03/16, R: 04/19)
HLTH 11e1l
LOC ID#
Head Start/EHS/ECEAP
Date: Date of Birth:
Child’s Name:
Parent/Guardian Name:
Dear : (Health Care Provider Name or Clinic Name)
Your patient is currently enrolled in the Lower Columbia College Head Start/EHS/ECEAP Program. As indicated, program staff and I are requesting the following as required by our program:
Seizure Action Plan: (See sample action plan) Other:
Included with this letter is a completed Release of Information form signed and dated by the child’s parent/guardian. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 02/16. R: 04/19) HLTH 11e2
LOC ID# ______
Head Start /EHS ECEAP
Date:
Expectant Mother’s Name:
Date of Birth:
Dear: ______: (Health Care Provider Name or Clinic Name)
Your patient is currently a participant of the Lower Columbia College Early Head Start program. At this time, program staff and I are requesting the following medical or dental documentation.
(State documents and/or information being requested and include date(s) if known.)
Included with this letter is a completed Release of Information form signed and dated by the program participant. Please send the requested information to my attention at:
LCC Head Start/EHS/ECEAP OR Fax to (360) 442-2819 P.O. Box 3010 email: [email protected] Longview, WA. 98632
Your time and assistance regarding this matter are greatly appreciated. I look forward to your reply.
Sincerely,
Lily Terry Health Specialist
Fax Date & Staff Member Initials: ______(C: 10/12; R: 10/18)
HLTH 11f Lower Columbia College Head Start/EHS/ECEAP HEALTH FOLLOW-UP NEEDED/REQUIRED BY FAMILY ADVOCATE/CHILD DEVELOPMENT SPECIALIST
DATE: LOC ID: STUDENT NAME: The attached health document requires medical and/or dental follow-up by you. Please: 1. Review highlighted comments / notations on the document regarding a screening and/or follow-up/ referral/treatment for: Allergy Growth Orthopedic Anemia Hearing Urinalysis Asthma Heart/Lungs/Pulmonary Vision Communicable Disease Lead Other______ Development MH Referral to Specialist(s) Additional Info 2. Follow-up with the parent/guardian, assist with scheduling appointment(s) etc., obtain release(s) and request records as appropriate; 3. Document actions/follow-up/ongoing status, etc. in ChildPlus/Family Services & 4. E-mail health status updates (applicable ChildPlus/Family Services entries such as scheduled appointments dates, parent statements of when they plan to address, etc.) to the Health Specialist, Health Coordinator & Area Manager; 5. File in Health section of child’s Site file. (C: 02/18)
HLTH 11f Lower Columbia College Head Start/EHS/ECEAP HEALTH FOLLOW-UP NEEDED/REQUIRED BY FAMILY ADVOCATE/CHILD DEVELOPMENT SPECIALIST
DATE: LOC ID: STUDENT NAME: The attached health document requires medical and/or dental follow-up by you. Please: 1. Review highlighted comments / notations on the document regarding a screening and/or follow-up/ referral/treatment for: Allergy Growth Orthopedic Anemia Hearing Urinalysis Asthma Heart/Lungs/Pulmonary Vision Communicable Disease Lead Other______ Development MH Referral to Specialist(s) Additional Info 2. Follow-up with the parent/guardian, assist with scheduling appointment(s) etc., obtain release(s) and request records as appropriate; 3. Document actions/follow-up/ongoing status, etc. in ChildPlus/Family Services & 4. E-mail health status updates (applicable ChildPlus/Family Services entries such as scheduled appointments dates, parent statements of when they plan to address, etc.) to the Health Specialist, Health Coordinator & Area Manager; 5. File in Health section of child’s Site file.
(C: 02/18) HLTH 12a LOWER COLUMBIA COLLEGE HEAD START/ECEAP Hearing Screening Policy and Procedure
Policy Each child's hearing must be screened within 45 calendar days of his or her entrance into the program. These screenings are authorized and done in collaboration with each child's parent/guardian. The screenings are used for identification purposes only and are not intended or used for diagnostic purposes.
Hearing Screening Procedure 1. Each child's hearing is screened yearly and as needed or requested by the child's parent/guardian and/or Direct Service Team. The child's parent/guardian is informed of the screening results by receiving a copy of their child's completed Vision, Hearing & Strabismus Screening form.
A hearing screening using evidenced-based screening equipment (audiometer, etc.) completed by a Health Care Provider, three (3) months or less prior to a child’s enrollment date for the current program year, can be used to meet the child’s 45-count hearing screening deadline if the record is received prior to the child’s 45-count deadline.
2. If a child fails their program hearing screening, the screener (Health Coordinator or Office Assistant) will determine whether or not the program will screen the child's hearing a second time or make a referral to the child's health care provider. A hearing referral can also be made based upon a parent/guardian and/or Direct Service team request.
3. When a child's hearing is unscreenable: a. The Health Coordinator and/or Office Assistant will make at least two (2) additional attempts to screen the hearing of child who is not in process of or receiving Special Needs Services. b. If a child is in process of or receiving Special Needs Services, the Health Coordinator and/or Office Assistant will make a hearing referral to the child's health care provider. The Health Coordinator will also work with the child's Family Advocate/CFDS and school district to arrange for an ESD 112 (van) hearing screening as appropriate.
4. When a hearing referral is made: a. The child's Hearing, Vision & Strabismus Screening form provides the initial notification of the referral to both the parent/guardian and the Direct Service Team. b. The Family Advocate/CFDS notes the screening results (pass, unscreenable or failed/referral) in ChildPlus/Family Services. The original of the screening form is then placed into the Health section of the child's Site file. c. The Health Coordinator and/or Office Assistant completes and mails a Hearing Referral letter to the child's parent/guardian. At this time, the referral is entered into ChildPlus/Health. d. The Health Coordinator and/or Office Assistant will fax a copy of child’s Hearing, Vision and Strabismus form, with the appropriate release, to child’s primary health care provider. e. The Family Advocate/CFDS appropriately documents in ChildPlus/Family Services and works with the child's parent/guardian and their other DST members to ensure that needed follow-up (appointments, etc.) and treatment services, for each child, are arranged and provided in a timely manner.
(C: 08/02; R: 07/18) HLTH 12b LOWER COLUMBIA COLLEGE HEAD START/ECEAP Vision Screening Procedure
Policy Each child's vision must be screened within 45 calendar days of his or her entrance into the program. These screenings are authorized and done in collaboration with each child's parent/guardian. The screenings are used for identification purposes only and are not intended or used for diagnostic purposes.
Vision/Strabismus Screening Procedure 1. Each child's vision is screened yearly and as needed or requested by the child's parent/guardian and/or Direct Service Team. The child's parent/guardian is informed of the screening results by receiving a copy of their child's completed Vision, Hearing & Strabismus Screening form.
A vision screening using evidenced-based screening equipment (SPOT Vision Screener, etc.) completed by a Health Care Provider, three (3) months or less prior to a child’s enrollment date for the current program year, can be used to meet the child’s 45-count vision screening deadline if the record is received prior to the child’s 45-count deadline.
2. If a child fails their program vision screening, the screener (Health Coordinator and/or Office Assistant) will refer the child or meet with the Health Specialist to determine whether or not the program will screen the child a second time or make the referral. A referral can also be made based upon a parent/guardian and/or Direct Service Team request.
3. When a child's vision is unscreenable: a. The Health Coordinator and/or Office Assistant will make at least two (2) additional attempts to screen the vision of child who is not in process of or receiving Special Needs Services. b. If a child is in process of or receiving Special Needs Services, the Health Coordinator and/or Office Assistant will make a vision referral to the child's health care provider.
4. When a vision referral is made: a. The child's Hearing, Vision & Strabismus Screening form provides the initial notification of the referral to both the parent/guardian and the Direct Service Team. b. The Family Advocate/CFDS notes the screening results (pass, unscreenable or failed/referral) in ChildPlus/Family Services. The original of the screening form is then placed into the Health section of the child's Site file. c. The Health Coordinator and/or Office Assistant completes and mails a Vision Referral letter to the child's parent/guardian. At this time, the referral is entered into ChildPlus/Health. d. The Health Coordinator and/or Office Assistant will fax a copy of child’s Hearing, Vision and Strabismus form, with the appropriate release, to child’s primary health care provider. e. The Family Advocate/CFDS appropriately documents in ChildPlus/Family Services and works with the child's parent/guardian and their other DST members to ensure that needed follow-up (appointments, etc.) and treatment services, for each child, are arranged and provided in a timely manner.
(C: 08/02; R: 07/18) HLTH 12c
LOWER COLUMBIA COLLEGE HEAD START/ECEAP Hearing and Vision Screening Form
Student Name: Teacher: LOC ID #
HEARING SCREENING Screening Date: Signature of Screener:
Left: Pass Unscreenable/Rescreen Refer Left: Pass Unscreenable/Rescreen Refer Referral Letter to Parent:
Comments:
VISION SCREENING Screening Date: Signature of Screener:
Pass Unscreenable/Rescreen Refer Referral Letter to Parent:
Comments:
Distribution: White: Site File Yellow: Parent/Guardian Pink: Health Coordinator Copy to PCP if child is referred. (C: 09/00; R: 04/21) HLTH 12d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Hearing Referral
Date: LOC ID #
Dear Parent/Guardian of:
Recently, your child's hearing was screened. The hearing screening is performed in order to identify children with possible hearing loss and/or middle ear conditions. This does not mean your child has hearing loss, but they should be evaluated by an audiologist or medical professional.
Please take this hearing referral notice to your child's Primary Care Physician and/or a local health care provider. Please have the doctor complete and sign the lower portion of this form then return the form to your child's classroom teacher or have your doctor mail or fax it to my attention at the address stated below.
If you have any questions or concerns, please call me at (360) 442-2807.
Sincerely,
Health Specialist
HEARING EXAMINATION--To be completed by health care provider.
Patient Name: Hearing Exam Date:
Hearing Results: R - L -
Recommendations to support learning in school environment and/or home:
Physician/Health Care Provider's Name Hospital/Office/Clinic Name
Signature Date
Please mail or fax the completed form to: Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA 98632-0310 (360) 442-2800 Fax: (360) 442-2819
(C: 04/95; R: 02/2020) Hearing Referral HLTH 12d
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Reexaminación del Oído
Fecha: LOC ID#:
Querido Padre Guardián de:
El oído de su hijo fue examinado recientemente. Esta prueba de la audición se realiza para identificar a niños que podrían tener una pérdida auditiva o condición del oído medio. Esto no quiere decir que su hijo tiene una pérdida auditiva, sino que un otólogo o profesional médico debería evaluarlo.
Por favor tome esta nota de reexaminación al doctor familiar de su niño y/o a un proveedor de servicios de salud local. Por favor haga que el doctor llene y firme la parte de abajo de esta forma. Después, regrese la forma a la maestra del salón de clases de su hijo o haga que su doctor la mande por correo o por fax para mi atención, al domicilio señalado abajo.
Si usted tiene alguna duda o pregunta, por favor llámeme al (360) 442-2807.
Atentamente,
Directora de Salud
HEARING EXAMINATION – To be completed by health care provider.
Patient Name: Hearing Exam Date: Hearing Results: R: L: Recommendations to support learning in school environment and/or home:
Physician/Health Care Provider's Name Hospital/Office/Clinic Name
Signature Date
Please mail or fax the completed form to: Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA, 98632-0310 (360) 442-2800 Fax: (360) 442-2819
(C: 04/95; R: 02/2020) HLTH 12e
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Vision Referral
Date: LOC ID #
Dear Parent/Guardian of:
Your child's vision was recently screened. The vision screening is performed in order to identify children with possible vision conditions. We found that your child needs to have his/her vision checked by an Eye Care Professional. This does not mean your child has vision loss, but they should be evaluated by an ophthalmologist or medical professional.
Please take this vision referral notice to your Primary Health Care Provider, a local ophthalmologist or optometrist and have your child's vision screened. Please have the Health Care Provider complete and sign the lower portion of this form and return it to your classroom teacher or have your Health Care Provider Fax or mail this form, to my attention, at the Fax number or address stated below.
If you have any questions or concerns, please call me at (360) 442-2807.
Sincerely,
Health Specialist
------VISION EXAMINATION -- To be completed by health care provider
Patient Name: Vision Exam Date:
Glasses needed: At school At home N/A
Recommendations to support learning in school environment and or home:
Physician/Health Care Provider's Name Hospital/Office/Clinic Name
Signature Date
Please mail or fax the completed form to: Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA 98632-0310 (360) 442-2800 Fax: (360) 442-2819
(C: 07/98; R: 02/2020) Vision Referral HLTH 12e
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Remisión para Examen de la Vista
Fecha: LOC ID #
Querido Padre/Tutor de:
La visión de su niño fue recientemente examinada. Esta prueba de la visión se realiza para identificar a niños que podrían tener problemas de visión. Nosotros encontramos que su niño necesita que su vista sea evaluada por un Profesional en el Cuidado de la Vista. Esto no quiere decir que su niño tiene una deficiencia visual, sino que un oftalmólogo o profesional médico debería evaluarlo.
Por favor tome esta notificación de remisión para la visión a su Doctor, a un Oftalmólogo u Optometrista y haga que la vista de su hijo sea examinada. Por favor pídale al doctor que llene y firme la parte de inferior de esta forma y regrésela a la maestra del salón de clases o pida al doctor que envíe esta forma por fax o por correo, para mi atención, al número o dirección indicada en abajo.
Si tiene alguna pregunta o duda, por favor comuníquese conmigo al teléfono (360) 442-2807.
Atentamente, Especialista de Salud
VISION EXAMINATION – To be completed by health care provider.
Patient Name: Vision Exam Date:
Glasses needed: At school At home N/A
Recommendations to support learning in school environment and or home:
Physician/Health Care Provider's Name Hospital/Office/Clinic Name
Signature Date
Please mail or Fax the completed form to: Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA 98632-0310 (360) 442-2800 Fax: (360) 442-2819
(C: 08/02; R: 02/2020) HLTH 12f
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Record of Vision Exam
PATIENT NAME: BIRTH DATE: DATE:
VISION REFERRAL RESULTS AND RECOMMENDATIONS:
______Normal eye exam for age. No need for glasses at this time. Re-evaluate in ______months/years.
______Glasses to be worn at school only. Re-evaluate in ______months/years.
______Glasses to be worn continuously. Re-evaluate in ______months/years.
______Glasses to be worn for reading/distance only. Re-evaluate in ______months/years.
______Patching of LEFT/RIGHT eye. Hr/day Re-evaluate in ______months/years.
______Other vision recommendations:
Date of exam: ______
Doctor/Clinic Name: ______
Signature of Doctor or Staff Member Completing Form: ______
Please mail or fax the completed form to: Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA. 98632-0310 (360) 442-2800 Fax: (360) 442-2819
(C: 01/06; R: 11/13) HLTH 12g1 LOWER COLUMBIA COLLEGE EARLY HEAD START Three-Pronged Approach I. Parent Interview Questions
RELATED TO VISION AND HEARING CONCERNS
Child’s Name: LOC ID #
These topics are meant to be introduced within the first home visits to alert staff to the need to look more carefully at a child’s vision and hearing. This piece of the summary is to be done by a EHS staff or health professional.
1. When was your baby’s last “well baby” check up?
2. How would you describe (child’s name) birth?
3. Did your baby have newborn hearing screening done in the hospital or at the doctor’s office? Did he/she pass? (If not, what happened next?)
4. Has (child’s name) has any ear infections that you’re aware of?
5. Has (child’s name) hearing or vision ever been tested by a doctor? If yes, when and who did the evaluation?
6. Do you have any concerns about the way (child’s name) looks at you (or at books, or watches TV)?
7. Do you have any concerns about the way (child’s name) is learning to talk?
8. Do any of your family members or close friends have concerns regarding your child’s vision or hearing?
9. Does anyone in your family (immediate family, uncles, grandparents, etc.) have a hearing loss or vision problem? If yes, what are the reasons for the hearing or vision loss?
(C: 05/10; R: 07/18) HLTH 12g1
Medical/Family History Review Supplement for Vision and Hearing Concerns
Check off any of the following factors noted during the parent interview and/or in reading the child’s medical records.
Family History:
_____ Family history of vision impairment or hereditary childhood hearing loss.
Prenatal History:
_____ Mother has history of infection during pregnancy. (e.g., toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis).
_____ Child was exposed to alcohol or drugs (e.g., cocaine, medications) prenatally.
Perinatal History:
_____ Child’s birth weight was less that 1500 grams (3.3 pounds). _____ Child had Apgar score of 0-4 at 1 minute or 0-6 at 5 minutes, (i.e. blue, needed oxygen, not crying). _____ Child was premature (less than 37 weeks gestation) and exposed to oxygen in hospital. _____ Child had elevated bilirubin (hyperbilirubinemia) requiring transfusion. _____ Child required mechanical ventilation lasting 5 days or longer.
Postnatal History:
_____ Child had bacterial meningitis or encephalitis. _____ Child sustained head trauma associated with loss of consciousness or skull fracture. _____ Child has neurological disorders such as seizures. _____ Child has syndrome known to include hearing loss and/or visual impairment (e.g., Down Syndrome, Fetal Alcohol Syndrome, CHARGE, Coldenhar, Hurler, Norrie, Refsum, Trisomy 13, Waardenburg). _____ Child has cerebral palsy. _____ Child has hydrocephaly. _____ Child had excessive fever for a prolonged period of time. _____ Child was given “mycin” drugs or other known ototoxic medications (e.g., chemotherapeutic agents or aminoglycosides).
Original Screening: Update: Update: Update: Update: Update:
(C: 05/10; R: 07/18) HLTH 12g2 LOWER COLUMBIA COLLEGE EARLY HEAD START Three-Pronged Approach II. Developmental Skills Checklist
RELATED TO SEEING AND HEARING IN YOUNG CHILDREN
Child’s Name: LOC ID #
Y N Y N SEEING: Does the Child… HEARING: Does the Child… BIRTH TO 3 MONTHS OLD: BIRTH TO 3 MONTHS OLD: Look at your face? (briefly looking by Startle or jump when there is a sudden 1 month old) loud sound? Imitate your smile? (2 mo.) Stir or awaken from sleep, or cry, when someone talks or makes a loud noise? BY 3 TO 6 MONTHS OLD: Recognize and get comforted by a Smile at others? familiar voice? Look at own hands? Watch you as you enter or cross the room? (from 6 feet away) BY 3 TO 6 MONTHS OLD: Reach out and bat at objects? Turn his or her eyes to look for an interesting sound? Respond to mother’s or other BY 6 TO 12 MONTHS OLD: caregiver’s voice? Try to reach out and grasp at toys or Turn eyes forward when his or her other objects? (6 mos.) name is called? Notice something small (ex: raisin) when 12 inches from him? (6 mos.) BY 6 TO 12 MONTHS OLD: Try to move toward an object that is at least 5 feet away? (7 mos.) Turn toward an interesting sound or toward caregiver when his or her Pick up or attempt to pick up a name is called from behind? Cheerio, raisin, or lint? (8 mos.) Search or look around when new Imitate movements or actions of sounds are present? another person or a toy? (9 mos.) Understand “no” “mommy” “bye bye” Stare at or try to grab your jewelry or and similar common words? glasses? (9 mos.) Participate in vocal play with parents; Look for dropped toy? (9 mos.) experiment with different speech and React to facial expressions of others non-speech sounds? (9 mos.) (ex: frowns, smiles, funny faces)? Babble in speech-like strings of single (10-12 mos.) syllables? (ex: “dad a da” “ga ga”) (10
mos.)
BY 12 TO 24 MONTHS OLD: BY 12 TO 24 MONTHS OLD: Show an interest in picture books? Say one or more real, recognizable (12 mos.) words? (12 mos.) Imitate scribbling? (8-15 mos.) Put words together? (ex: mommy Reach into a container and pull out shoe, big boat) (18 mos.) objects out easily? (12-18 mos.) Use at least 50 words? (24 mos.)
(C: 05/10; R: 07/18) HLTH 12g2
Y N Y N SEEING: Does the Child… HEARING: Does the Child… BY 24 TO 36 MONTHS OLD: BY 24 TO 30 MONTHS OLD: Imitate crayon stroke? (24-30 mos.) Follow two requests combined? (ex. Copy circle make by another person? “Get the ball and put it on the table”) Color Identification: (24 mos.) Understand conversation easily? Match two items that are the same Hear when you call from another color? (24-32 mos.) room? Sort items by color? (36 mos.) Point to objects in a book when they Point to a color when asked? (36-42 are named? mos.) Say the following sounds clearly: Object to Picture Matching and Picture P, B, M, K, G, W, H, N, T, D? Identification: Use three-word sentences? Identify one picture of a familiar item? Use past tense verbs? (ex: walked, (18-24 mos.) batted, fished, ran) Identify two or more pictures? (24-32 Name five pictures? mos.) Answer questions? Match objects with pictures of Use 1-2 prepositions (in, on, under)? objects? (24-36 mos.) Use sentences with real words instead Does your child say. . .? of using nonsense-sounding “word” strings? “My eyes are itchy.” “My eyes hurt.” “Things look blurry.” BY 30 TO 36 MONTHS OLD: Hear TV or radio at same loudness level as other family members? The “seeing” developmental skills on this page Notice sounds – dogs barking, phones are from Dr. Tanni Anthony’s doctoral work ringing? (2005) on visual skills for Transdisciplinary Play-Based Assessment. Can make most sounds correctly at start of words? (ex: says the “th” sound in “think,” but says “baff” instead of “bath.”) The “hearing” developmental skills are adapted Use 1-2 prepositions (in, on, under)? from the Hawaii Early Learning Profile Use plurals? (ex: dogs, cookies) Language Scale. Refer to self using a pronoun (I, me)?
Use 200+ words? (300+ by age 3)?
Give full name when asked? Help tell stories? Initial Screening Date Ask questions beginning with “what” “where” or “when”? 6 Month/Annual (1) Use speech that can be understood by Screening Dates (2) others most of the time? (3) (4) (5)
(C: 05/10; R: 07/16) HLTH 12g2
(C: 05/10; R: 07/16) HLTH 12g3
LOWER COLUMBIA COLLEGE EARLY HEAD START Three-Pronged Approach III. Observations
Child’s Name: LOC ID #
Associated with Visual Impairment Associated with Hearing Loss
Differences in How Eyes Look: Differences in How Face or Ears Look: Drooping eyelid Cleft lip and palate One eye slightly higher or lower than the Head or neck have malformations other eye Ears are malformed, or there may be no Obvious differences in the shape or opening at ear canal structure of the eyes Frequent earaches or ear infections Pupil of the eye is not round, clear, black Discharge from the ears White of the eye is red and sore looking Eyes are watery even when baby is not Unusual Listening Behaviors: crying Few or inconsistent responses to sounds Baby is very sensitive to bright light and Does not seem to listen squints, closes eyes, or turns away from it Does not turn when name is called Notices certain types of sounds more than Unusual Eye Movements: others Eyes move in jerky way back and forth or up and down Unusual Vocal Development Eyes do not move together Does not make a lot of different sounds Eye turns inward or outward after 4 to 6 Voice sounds different; can’t make certain months of age speech sounds Is behind in talking (no spoken words at 15 Unusual Gaze or Head Positions months; fewer than 50 words at 24 months) Tilts or turns head in certain ways when looking at an object Other Behaviors Holds object close to eyes Pulls on ears or puts hands over ears Seems to be looking beside, under, or Breathes through mouth above the person or object Cocks head to one side
Absence of Visual Behaviors No eye contact by 3 months Does not look at objects, or follow moving (Sources: Calvello, 1990; Chen, 1998, 1990; Fewell, objects, by 3 months 1983; Gatty, 1996; Joint Committee on Infant Hearing, 2007; Teplin, 1995)
(C: 05/10; R: 07/18) HLTH 12g LOWER COLUMBIA COLLEGE EARLY HEAD START Screening for Vision and Hearing Concerns in Infants and Toddlers Procedure
At the beginning of each EHS program year or at the time of enrollment, each child will have their vision and hearing screened using the Three-Pronged Approach as well as the Infant Vision Development Checklist (Infants Only) or SPOT Vision Screener (Toddlers Only) and OAE Screener within 45 days.
I. A Three-Pronged Approach: Early Head Start uses a three-pronged approach designed by Washington Sensory Disabilities Services. Parents, EHS staff and other service providers can document parent concerns, observable infant behaviors, and signs that may indicate high risk for vision impairment or hearing loss. The purpose of gathering this information is to determine the need for further diagnostic evaluation of a child’s vision and hearing status, and to provide evidence that these areas have been addressed.
II. General Instructions: Within 45 days of enrollment, the Child & Family Development Specialist will screen each child’s vision and hearing using the following:
1. Parent Interview (I) – Contains questions that can be included in first conversations with families. i. Medical/Family History Review Supplement for vision and hearing concerns. 2. Developmental Skills Checklist (II) – A form to identify a child’s abilities based on chronological age. Child & Family Development Specialist completes with parent. 3. Observations: What to Look For (III) – A resource tool with pictures and descriptive of signs that may be observable or reported by parents. Not to be used as a checklist. 4. Infant Vision Development Checklist (Infants Only) or SPOT Vision Screening (Toddlers Only) and Otoacoustic Emissions (OAE) Hearing Screening – As required by Head Start/EHS Performance Standards, within 45 calendars after the child first attends the program or, for the home-based program option, receives a home visit, a program must either obtain or perform evidence-based vision and hearing screenings. 5. Guidance on Using a Vision and/or Hearing Screening from a Previous Program Year for a Returning EHS Child – If a returning EHS child’s vision and/or hearing screening(s), for the prior program year were completed 45 days or less before their enrollment date for the new program year, the screening(s) can be used to meet the 45-day count for the new program year. 6. Guidance on Using Newborn Hearing Screening to Meet 45-Day Count for an Infant’s Required OAE Hearing Screening – A new born hearing screening Otoacoustic Emissions (OAE) or Auditory Brainstem Response (ABR) can be used to meet an infant’s OAE hearing screening requirement if the newborn hearing screening was administered 45 days or less prior to infant’s EHS enrollment date and the record is received prior to the child’s 45-day count deadline.
Relevant information and results from each of the sources listed above, as well as other sources (i.e. Well Child Exam, Health History forms, etc.) is to be transferred to the corresponding section on:
7. Developmental & Sensory Screening Summary form. Parents may take a copy of this form to their child’s Primary Care Provider to support the request for further evaluation of the child’s vision or hearing.
(C: 06/10; R: 06/18) HLTH 12g III. Review Of Instructions For Infants & Toddlers Up To Two Years Of Age: Every six months, from the date of initial 45-day screening, the staff and parents will review and update the Postnatal History section of the Medical/Family History Review Supplement for Vision and Hearing Concerns and the Developmental Skills Checklist II. If a child’s original vision screening was done using the Infant Vision Development Checklist and the child is now 12 months old or older, staff will arrange for the child to have a SPOT Vision Screening. Results from these instruments along with parent/staff observations and other pertinent prenatal, health, developmental, and/or nutrition information is to be recorded on a new Screenings Summary form and the appropriate copies given to the Health Specialist.
(C: 06/10; R: 06/18) HLTH 12h LOWER COLUMBIA COLLEGE EARLY HEAD START Screenings Summary Form
Child’s Name: Birthdate: Child & Family Development Specialist: LOC ID# Primary Health Care Provider: Screening Start Date:
I. Parent/Guardian Interview (Three-Pronged Approach) The parent/guardian has concerns about the child’s vision and/or hearing at this time: No Yes If yes, the concern is related to the child’s: Vision Hearing Speech/Language (rule out hearing loss) Describe the concerns regarding the child’s hearing or vision skills development:
II. Health History & Screening Results III. Observations & Developmental Skills (Three-Pronged Approach) Related to Seeing & Hearing note any high-risk factors (Three-Pronged Approach) a. Prenatal History note any high-risk signs observed
b. Birth, Health/Nutrition History
c. ASQ (when age eligible) Results of newborn hearing screening or OAE or ASQ SE BAER screening through Primary Health Care Provider, if applicable: Date: ______d. Other screening results (e.g. well child visit) Pass Rescreen Refer
IV. EHS Spot Vision Screening (Toddler) or Vision Milestones Tool (Infant) & OAE Screening Results Date: ______SPOT or Milestones Tool Results: Pass Rescreen Refer ______ Pass Rescreen Refer Comments:
Date: ______OAE Screening Results: Pass Rescreen Refer ______ Pass Rescreen Refer ______ Pass Rescreen Refer Comments:
Summary We have no concerns regarding the child’s vision or hearing at this time. We have identified high risk factors/signs/observations, as noted above for: Vision Hearing Note: These concerns and a follow-up plan, will be addressed in Family Partnership Plan. Referral to child’s Primary Health Care Provider Referral back to specialist
Parent/Guardian Date EHS Staff Member Date Original: Site File Yellow: Parent Pink: Primary Care Provider Goldenrod: Health Specialist (C: 06/10; R: 10/17) HLTH 12i
Lower Columbia College Early Head Start Otoacoustic Emission (OAE) Screening Procedure
Objective Screening Method: Otoacoustic emissions (OAE) screening is an objective screening method that screens hearing in a range of sound frequencies critical for normal speech and language development. The procedure is performed with a portable handheld screening unit. A small probe is placed in the child's ear canal. This probe delivers a low-volume sound stimulus into the ear. The cochlea responds by producing an otoacoustic emission, sometimes described as an “echo,” that travels back through the middle ear to the ear canal and is analyzed by the screening unit. In approximately 30 seconds, the result is displayed on the screening unit as a "pass" or a "refer." Otoacoustic emissions (OAE) screening can help to detect sensorineural hearing loss occurring in the cochlea. It can also call attention to hearing disorders affecting the pathway to the inner ear. Please Note: OAEs are a direct measure of outer hair cell and cochlear function in response to acoustic stimulation and yield an indirect estimate of peripheral hearing sensitivity. OAEs do not technically test an individual's hearing, but rather OAE results reflect the performance of the inner ear mechanics. OAEs are not sensitive to disorders central to the outer hair cells, such as auditory neuropathy spectrum disorder (ANSD), which is a neural hearing loss that leaves cochlear (outer hair cell) function intact.
Mechanics of an OAE Screening: Before beginning a screening session, the staff member will check the OAE equipment by conducting a self-screening. The staff member will also have the required forms and procedure as well as the following materials: appropriate sized foam/rubber tips for OAE probe, gloves, tissues and alcohol wipes. Tones are presented to each ear by placing a tiny sound transmitter/microphone (probe) into the childʼs ear canal. The child does not need to make a behavioral response to the sound. Child cannot have anything (including a bottle or pacifier) in their mouth during the screening. Screening can be done when the child is sleeping. A quiet environment is helpful as the OAE may not read well in a noisy environment. Having another adult (parent/guardian or staff member) hold the child on their lap or distracting child with quiet toys, can be helpful to the screener; occupying or re- directing the child’s hands away from the probe in the ear canal can be especially helpful. Be prepared to soothe children who may become distressed during the screening. It usually takes about 3-5 minutes to conduct each child’s screening.
Visual Inspection: 1. Prior to placing the OAE probe into a child’s ear, the staff member will look at child’s outer and inner ear, to insure there is no foreign object inside of the ear. 2. If there is some type of visible drainage, foreign bodies, impacted cerumen, infection, or a significant malformation which affects the ear canal, the staff member will not place the OAE probe into child’s ear canal. Instead, the staff member will inform the child’s (C: 06/17; R: 10/2020) HLTH 12i
parent/guardian (or Child & Family Development if parent/guardian is not present) of the issue/concern and refer child to their Primary Health Care Provider for an ear exam and possible hearing screening. 3. If child has Pressure Equalizer Tube(s) or buttons, the staff member will not proceed with the OAE Screening. Instead, the staff member will check the Program Database and child’s Site file (if appropriate) to determine if ENT records are on file have been requested and/or need to be requested. The staff member will follow-up with the child’s parent/guardian and/or Child & Family Development Specialist and request records as appropriate
Conducting Screening: A screening shall consist of either a passing test or 3 “refers” per ear that are deemed reliable by the tester on the same day. Testing is discontinued on an ear once a passing result is obtained and that ear is recorded as a pass. Testing is repeated on an ear if a “refer” is obtained until either 3 reliable “refer” tests are obtained or the screening is discontinued for another reason (e.g. poor child cooperation). Ears producing 3 “refer” results in the same day that are deemed reliable shall be recorded as a “refer”. A test may be deemed unreliable due to extraneous noise, probe placement issues, an uncooperative child, equipment malfunction, etc. Tests deemed unreliable may be repeated and not count toward the screening session results at the discretion of the tester. 1. Conduct an initial screening of both ears on every child (birth to three years of age). Each ear is screened independently; whenever one does not pass, proceed to the next step for that ear. 2. Any ear not passing the initial (1st OAE) screening is screened again (2nd OAE) within approximately 2 weeks of the first screen. 3. If the ear does not pass the 2nd OAE screen, the child will be referred to their Primary Health Care Provider to be evaluated and determine whether there is an outer or middle ear condition (blockage, fluid, structural anomaly, etc.) interfering with accurate completion of the OAE screening. Treatment or monitoring may be needed. 4. Once the child’s Primary Health Care Provider gives medical clearance, indicating that there are no conditions present that would impede an accurate screening, an OAE rescreen (3rd OAE screen) is conducted. (Results of OAE screening or other appropriate audiological evaluation performed by the child’s Primary Health Care Provider or other healthcare provider may be substituted for a 3rd OAE screen.) If the ear does not pass the OAE rescreen, the child will be referred back to their Primary Health Care Provider with a request for consideration of a referral for comprehensive audiological evaluation.
(C: 06/17; R: 10/2020) HLTH 12j Lower Columbia College Early Head Start SPOT Vision and OAE Hearing Screening Form LOC ID:
Child’s Name: Birthdate:
HEARING SCREENING Had Newborn Hearing Screening? ___Unknown ___Not Screened ___Passed ___Referred
Right Ear Screener for Initial Screening:
1st OAE Date (___/___/___) 2nd OAE Date (___/___/___) 3rd OAE Date (___/___/___) Can’t test (need 2nd OAE) Can’t test Can’t test Refer (need 2nd OAE) Refer Refer
Pass _____ Initials Pass _____ Initials Pass ______Initials
Notes:
Left Ear Screener for Initial Screening:
1st OAE Date (___/___/___) 2nd OAE Date (___/___/___) 3rd OAE Date (___/___/___) Can’t test (need 2nd OAE) Can’t test Can’t test Refer (need 2nd OAE) Refer Refer
Pass _____ Initials Pass _____ Initials Pass ______Initials
Notes:
VISION SCREENING: Date Screener
Pass Unscreenable Referral Referral letter to Parent: OR Infant, CFDS to use paper tool Date of First Birthday:
Notes:
Copy – After Each Screening Attempt/Completion to: Health Coordinator Copy – After Each Screening Attempt/Completed to: Area Manager Original Site File – After Completion of All Screening Attempts and/or Screenings (C: 07/17; R: 02/2020) HLTH 13a LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Immunization Agreement Procedure
I. Intake Staff Member Activities: 1. The Intake Staff member reviews each child's Washington State Certificate of Immunization (CIS) form to determine the child's immunization status and whether or not the child needs a completed Immunization Agreement (and possibly a COE) on file. 2. The parent/guardian and Intake Staff member complete an Immunization Agreement. Immunizations needed (out of compliance and conditional) are noted directly from the Immunization form. However, numbers needed are not noted on this form. (Example: 3 DTP's and 2 OPV's are needed; the Immunization Agreement will simply state DTP and OPV.) 3. The Intake Staff member distributes the copies of the Immunization Agreement: Original: Site File, Copy: Health Specialist, Copy: Parent/Guardian. The Health Coordinator or Health Specialist will enter the Immunization Agreement date and other applicable information in the immunization notes on the database. 4. The Intake Staff member gives the parent/guardian a Washington State Certificate of Exemption (COE) to take to their child’s Primary Health Care Provider to begin the discussion of whether the child will receive the needed immunization(s) and/or if the COE will be completed. 5. The Intake Staff member asks the parent/guardian to bring in a record of the needed immunizations (at least the first or next ones needed in a series) or a COE completed by their child’s Primary Health Care Provider or both if applicable.
II. Health Coordinator Activities: 1. The Health Coordinator and/or Health Specialist reviews the copies of the Washington State Certificate of Immunization (CIS) form and the Immunization Agreement. 2. The child's immunization status, as determined by the Intake Staff member, is verified or revised and this information is entered on the Student Health Database. (Revisions will be noted on the Immunization Agreement.) Due dates for children with Conditional Immunization Status are also entered on the database and noted on the Health Specialist's Immunization Agreement copy. As with all data based health documentation, the copies are returned to the child's Site File.
III. DST/EHS Staff Follow-Up: 1. If a child has Out of Compliance Immunization Status, documentation to gain Current Status, Conditional Status or a Certificate of Exemption must be on file prior to the finalization of enrollment or approval by the Health Specialist given and databased. 2. If a child has Conditional Immunization Status, the Intake Staff member will have established a due date for receiving the needed immunization(s). If a child misses this due date, the child will have one month (30 calendar days) from the due date to turn-in the necessary documentation. 3. If it is determined that a child is not to receive an immunization noted on their Immunization Agreement, for medical reasons, the parent/guardian must complete, with their child’s Primary Health Care Provider, a Washington State Certificate of Exemption form. 4. If the above guidelines are not followed, the DST/EHS Staff is to contact their supervisor to discuss and problem-solve a resolution. Based upon the decision made, with the supervisor, the parent/guardian can be given a new deadline (7 days or less).
(C: 06/99; R: 08/18) HLTH 13b Vaccines Required for Child Care and Preschool
Hepatitis B DTaP Hib Polio PCV MMR Varicella (Diphtheria, Tetanus, (Haemophilus (Pneumococcal (Measles, mumps (Chickenpox) Pertussis) influenzae type B) Conjugate) rubella)
By 3 Months 2 doses 1 dose 1 dose 1 dose 1 dose
By 5 Months Not routinely Not routinely 2 doses 2 doses 2 doses 2 doses 2 doses given before 12 given before 12 months of age months of age By 7 Months 2 doses 3 doses 3 doses 2 doses 3 doses
By 16 Months 2 doses 3 doses 4 doses 2 doses 4 doses 1 dose 1 dose
By 19 Months 3 doses 4 doses 4 doses 3 doses 4 doses 1 dose 1 dose
By 7 years or Not routinely given Not routinely given Kindergarten 3 doses 5 doses to children age 5 4 doses to children age 5 2 doses 2 doses entry years and older years and older
School aged children (K-12) in before and after-school programs must meet the immunization requirements for their grade in school. Find information on other vaccines that are recommended, but not required, for child care/preschool attendance at: www.immunize.org/cdc/schedules. Review the Individual Vaccine Requirements Summary for more detailed information, located on our web page: https://www.doh.wa.gov/scci. To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [email protected]. DOH 348-053 Nov 2020 Vaccine Dose # Minimum Minimum Interval* Between Notes Age* Doses
Hepatitis B (HepB) Dose 1 Birth 4 weeks between dose 1 & 2 The final dose in the series should be given at least 24 weeks of age. Dose 2 4 weeks 8 weeks between dose 2 & 3 Dose 3 24 weeks 16 weeks between dose 1 & 3 Diphtheria, Tetanus, and Dose 1 6 weeks 4 weeks between dose 1 & 2 Typical vaccine schedule: 2, 4, 6 and 15-18 months of age. Pertussis (DTaP) Dose 2 10 weeks 4 weeks between dose 2 & 3 Recommended: 6 months between dose 3 and 4, but at least 4 months minimum interval acceptable. Dose 3 14 weeks 6 months between dose 3 & 4 Dose 4 12 months 6 months between dose 4 & 5 Dose 5 4 years — Haemophilus influenzae Dose 1 6 weeks 4 weeks between dose 1 & 2 If all 3 doses of PedvaxHIB given, only need 3 doses total. Dose 3 must be >12 months of age. type B (Hib) Dose 2 10 weeks 4 weeks between dose 2 & 3 Only one dose required if the dose is given on or after 15 months of age. Review the Dose 3 14 weeks 8 weeks between dose 3 & 4 Individual Vaccine Requirements Summary for minimum doses required: https:// Dose 4 12 months — www.doh.wa.gov/SCCI
Pneumococcal Conjugate Dose 1 6 weeks 4 weeks between dose 1 & 2 Only one dose is required if the dose is given on or after 24 months of age. Review the Individual Vaccine Requirements Summary for minimum doses required: https:// (PCV13) Dose 2 10 weeks 4 weeks between dose 2 & 3 www.doh.wa.gov/SCCI Dose 3 14 weeks 8 weeks between dose 3 & 4 Dose 4 12 months — Polio (IPV or OPV) Dose 1 6 weeks 4 weeks between dose 1 & 2 Three doses are acceptable if the child received dose 3 on or after their 4th birthday. Dose 2 10 weeks 4 weeks between dose 2 & 3 Dose 3 14 weeks 6 months between dose 3 & 4 Dose 4 4 years — Measles, Mumps, and Dose 1 12 months 4 weeks between dose 1 & 2 MMRV (MMR + Varicella) may be used in place of separate MMR and varicella vaccines. Must be given the same day as varicella OR at least 28 days apart, also see* footnote. Rubella (MMR or MMRV) Dose 2 13 months — Varicella (Chickenpox) Dose 1 12 months 3 months between dose 1 & 2 (12 months Recommended: 3 months between varicella doses, but at least 28 days minimum interval is (VAR) through 12 years). 4 weeks between dose 1 acceptable. & 2 (13 years and older) Must be given the same day as MMR OR at least 28 days apart, also see* footnote. Dose 2 15 months — *The 4 day grace period can be applied to all doses except between two doses of different live vaccines (such as MMR, MMRV, varicella, and Flumist). To request this document in another format, call 1-800-525-0127. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [email protected]. DOH 348-053 Nov 2020
HLTH 13c
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Immunization Agreement
Date:
Child's Name: Date of Birth:
Parent/Guardian Name:
I am aware of the state regulation that my child be fully immunized. I am also aware that a Washington State Certificate of Immunization must be on file before my child may attend this program.
In order for my child to continue attending this program, the following immunizations need to be administered or Washington State Certificate of Exemption must be completed and turned in:
(* I acknowledge that the Health Specialist may determine that additional immunizations are needed.)
If a child has Conditional Immunization Status, the Health Specialist will establish a due date for receiving the needed immunization(s). If a child misses this due date, the child will have one month from the due date to turn-in the necessary documentation.
Immunization documentation must state the immunization(s) given, the date of administration and be signed or initialed by a Health Care Provider. (*If it is determined that your child is not to receive an immunization, for medical reasons, the parent/guardian must complete, with their child’s Primary Health Care Provider, a Washington State Certificate of Exemption form.)
Signature Relationship Date
Original – Site File Copy to Parent Copy to Health Specialist (C: 06/99; R: 06/14) Immunization Agreement HLTH 13c
LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Acuerdo de Inmunizaciones
Fecha:
Nombre del niño: Fecha de Nacimiento:
Nombre del Padre/Tutor:
Estoy consciente del Reglamento del Estado acerca de que mi niño debe contar con todas las vacunas. También estoy consciente de que un Certificado de Vacunación del Estado de Washington deberá estar archivado en el expediente de mi niño antes de que él pueda asistir al programa.
Para que mi niño pueda continuar asistiendo al programa, necesita recibir las siguientes vacunas o deberé completar y entregar un Certificado de Exención del Estado de Washington para las siguientes:
(Estoy de acuerdo en que la Especialista de Salud podría determinar que son necesarias otras vacunas adicionales).
Si un niño tiene Situación de Inmunización Condicional, la Especialista de Salud establecerá una fecha límite para recibir las vacunas necesarias. Si el niño no recibe las vacunas en la fecha acordada, el niño contará con un mes a partir de la fecha límite para entregar la documentación necesaria.
La documentación de las vacunas tiene que indicar cuales fueron administradas, la fecha de administración y debe estar firmada o con las iniciales doctor. (*Si se determina que su niño por razones medicas no puede recibir una vacuna, el padre/tutor deberá llenar con el Proveedor de Cuidados de la Salud del niño, un Certificado de Exención del Estado de Washington)
Firma Relación con el niño Fecha
Original – Site File Copy to Parent Copy to Health Specialist (C: 06/99; R: 06/14)
HLTH 13d Lower Columbia College Head Start/EHS/ECEAP Immunization Records Requirements
Per the Washington State Administration Code (WAC) 246-105-050: The required documentation of immunization status, to be on file, before a child attends LCC Head Start/EHS/ECEAP is a Washington Certificate of Immunization Status (CIS) and/or a Washington State Certificate of Exemption (COE).
A CIS form must include: ➢ Name of child; ➢ Birth date; ➢ Type of vaccine(s) administered; ➢ Month, day, and year of each dose of vaccine received; ➢ The CIS is to have least one immunization date on the form. ➢ A check mark in the appropriate section indicating whether or not a COE form accompanies the CIS form; ➢ As appropriate, completion of the section to document serologic proof of immunity signed by a health care provider and including a copy of a lab report (i.e. Varicella, etc.); ➢ Parent/guardian signature and date.
A COE form must include: ➢ Name of child; ➢ Birth date; ➢ Indication by parent/guardian of the type of exemption being claimed: a medical, religious, religious membership, or personal/philosophical exemption. This must include: ➢ The COE must be signed and dated by a health care practitioner stating that he or she has provided the parent information about the benefits and risks of immunization to the child as a condition of obtaining a medical, religious, personal, or philosophical exemption. A healthcare practitioner is defined as a physician (M.D.), physician assistant (P.A.), osteopath (D.O.), naturopath (N.D.), or advanced registered nurse practitioner (A.R.N.P.) licensed in Washington state. ➢ Indicate if any permanent or temporary medical exemption for one or more vaccines which must be signed and dated by a health care practitioner; ➢ Indicate if any personal or philosophical exemption for one or more vaccines; ➢ Indicate if any religious exemption for one or more vaccines; and ➢ If religious membership exemption, indicate religious membership. Parent will complete this section only if the religious beliefs or teachings of the church or religious body preclude a health care practitioner from providing medical treatment to the child; ➢ Staff must review the notice on the COE with parent/guardian that if an outbreak of vaccine- preventable disease for which the child is exempted occurs, the child may be excluded from program for the duration of the outbreak; and ➢ Parent/guardian signature and date.
Type of Exemption: ➢ Medical Exemption: A health care practitioner may grant a medical exemption to a vaccine required by rule of the State Board of Health only if in his or her judgement, the vaccine is not advisable for the child. When it is determined that this particular vaccine is no longer contraindicated, the child will be required to have the vaccine. ▪ Indicate if any permanent, temporary, or not exempt; ▪ If a temporary medical exemption, the health care practitioners must put the date that the temporary exemption ends on the Certificate of Exemption. When the
(C: 08/18; R: 04/21) HLTH 13d temporary exemption ends the child can be in conditional status for up to 30 days in order to get the missing immunization or another exemption. ➢ Philosophical/Personal Exemption: To be used when the parent/guardian has a personal or philosophical objection to the immunization of the child. A philosophical/personal exemption may not be used to exempt a child from the measles, mumps or rubella vaccine requirements (effective July 28, 2019). ➢ Religious Exemption: To be used when the parent/guardian has a religious belief that is contrary to the required immunization. ➢ Religious Membership Exemption: To be used when the parent/guardian affirms membership in a church or religious body that does not allow medical treatment of the child. Therefore, it is against their religious beliefs to get information about the benefits and risks of immunizations from a health care practitioner. This exemption does not require a health care practitioner signature; RCW 28A.210.090
If the child receives medical treatment for things other than immunizations, the religious membership exemption is not appropriate type of exemption. Ask the parent if the child sees a health care provider for well-child or injury, illness care. If the parent or guardian says yes, then the Religious Exemption or Philosophical/Personal Exemption, which requires a health care practitioner signature, must be used instead. Note: A child cannot be exempt from the Measles, Mumps or Rubella vaccine under personal/philosophical reasons per Washington State Law.
The COE does not need to be renewed annually. Once a COE is filled out, it can be used for the length of the student’s Washington state school career, including school transfers. If parent request changes to the COE, a new form must be completed.
(C: 08/18; R: 04/21) HLTH 13e LCC HEAD START/EHS/ECEAP Vaccine Preventable Diseases
Diphtheria – A contagious and potentially life-threatening bacterial infection that affects the nose, throat and skin. The bacteria produce a toxin that can cause life-threatening swelling of the neck and can also affect the heart and nervous system. Diphtheria is spread by coughing or sneezing.
Tetanus – Also known as lockjaw. It is a serious disease that affects the body’s muscles and nerves. Lives in dirt and the intestines and feces of animals. Enters the body through cuts, punctures, or other wounds.
Pertussis – Also known as “whooping cough”. It is extremely contagious and spreads easily through coughing and sneezing. A serious disease, especially for babies. Most babies who get pertussis have to be hospitalized.
Polio – A highly contagious viral disease that can invade the nervous system. Lives in the throat and intestines of an infected person and usually spreads to other people through contact with feces. Can cause severe illness, paralysis, and death.
Measles – Measles spreads when a person infected with the measles virus breathes, coughs, or sneezes. It is very contagious and spreads quickly and easily between people. Can cause serious illness and/or death for those with compromised immune systems.
Mumps – A serious and contagious disease caused by a virus that spreads through coughing, sneezing, or casual contact with an infected person. Will cause swelling in the cheeks or jaw and neck areas. Serious complications include deafness, meningitis (infection of the brain and spinal cord covering) and a painful swelling of the testicles or ovaries.
Rubella – Also known as German measles or three-day measles. Serious disease that can strike children, adults, including pregnant women and their unborn babies. Spreads through coughing, sneezing, and respiratory droplets.
Hib (Haemophilus influenzae type b) – Very dangerous to infants and children under five years of age. Caused by contact with infected person. Germs enter body through the nose and throat.
Hepatitis A – Liver disease caused by a virus. Transmitted by swallowing the virus (fecal-oral route). Hepatitis A can spread by eating contaminated foods that are not properly washed or cooked, or from inadequate hand washing after using the toilet or changing a diaper.
Hepatitis B – Serious liver disease caused by a virus that spreads through contact with infected blood or body fluids. Babies can be infected during childbirth if the mother is infected.
Varicella (chickenpox) – Common childhood disease. Spreads through coughing, sneezing, and contact with an infected person’s chickenpox sores. Can be especially serious in teenagers and adults who have never had the disease.
Pneumococcal (PCV) – Pneumococcal bacteria. Spread from person-to-person by direct contact with respiratory secretions, such as saliva or mucus. Can cause bacterial infection of blood and the tissue of the brain and spinal cord, causing meningitis. Children under 2 years of age and/or those with compromised immune systems are at increased risk of acquiring disease.
Source: Centers for Disease Control, 11/2016. (C: 07/19)
HLTH 13e LCC HEAD START/EHS/ECEAP Enfermedades prevenibles por vacunas
Difteria – Una infección contagiosa que puede amenazar la vida y afecta la nariz, garganta y piel. Las bacterias producen una toxina que puede resultar en hinchazón del cuello que amenace la vida y también puede afectar el corazón y sistema cardíaco. La difteria se propaga por la tos y los estornudos.
Tétanos – También es conocido como trismo. Es una enfermedad grave que afecta los músculos y nervios. Se encuentra en la tierra y en los intestinos y heces de animales. Entra al cuerpo por medio de lesiones como cortes, heridas por punción u otras heridas.
Pertussis – También es conocido como tos ferina. Es extremadamente contagiosa y se propaga fácilmente por la tos y los estornudos. Es una enfermedad grave, especialmente en infantes. La mayoría de infantes que se contagian de pertussis tienen que ser hospitalizados.
Poliomielitis – Un virus muy contagioso que puede invadir el sistema nervioso. Se encuentra en la garganta e intestinos de una persona infeccionada y típicamente se propaga por medio de heces. Puede causar enfermedad grave, parálisis y muerte.
Sarampión – El sarampión se propaga cuando una persona infeccionada respira, tose o estornuda. Es muy contagioso, propagándose rápida y fácilmente. Puede causar enfermedad grave y/o muerte en personas cuyos sistemas inmunológicos son deficientes.
Paperas – Una enfermedad grave y contagiosa causada por un virus que se propaga por la tos, estornudos o contacto con una persona infectada. Puede causar hinchazón en las mejillas, mandíbulas o cuello. Complicaciones graves incluyen sordera, meningitis (infección de las membranas que cubren el cerebro y médula espinal) e hinchazón doloroso de los testículos u ovarios.
Rubéola – Es una enfermedad grave que afecta a niños y adultos, incluyendo mujeres embarazadas y sus niños no nacidos. Se propaga por la tos, estornudos y gotitas respiratorias.
Hib (Haemophilus influenzae tipo B) – Es muy peligroso en infantes y niños menores de cinco años de edad. Se propaga por medio de contacto con una persona infectada. Las bacterias entran al cuerpo por la nariz y garganta.
Hepatitis A – Enfermedad de hígado que se contrae por tragarse el virus (ruta fecal-oral, de ano a mano a boca). El Hepatitis A se contrae por comer alimentos que no son bien lavados o cocidos o por no lavarse bien las manos después de usar el baño o cambiar un pañal.
Hepatitis B – Enfermedad de hígado grave que se propaga por contacto con la sangre u otros fluidos corporales de una persona infectada. Si una mujer embarazada es infectada, su bebé puede contagiarse durante el parto.
Varicela – Enfermedad común en la niñez. Se contagia por medio de la tos, estornudos o contacto con las lesiones de una persona infectada. Es grave en adolescentes o adultos que no la han tenido antes.
Pneumococcal (PCV) – Las bacterias neumococo se transmiten de una persona a otra por medio de contacto directo con la saliva o mucosidad. Pueden causar una infección de la sangre y cerebro, resultando en meningitis. Niños que son menores de dos años de edad y/o personas cuyos sistemas inmunólogos son deficientes son las personas que tienen mayor riesgo de contagiarse de esta enfermedad.
Referenced: Centers for Disease Control, 11/2016. (C: 07/19)
HLTH 14b Lower Columbia College Head Start/EHS/ECEAP Dental Screening / Evaluación Dental
Date/Fecha:
Name/Nombre: Loc ID: First/Nombre Last/Apellido MI
Findings today indicate that your child/Los resultados de hoy indicant que su niño: _____ Needs immediate care by a dentist within 24 hours. Necesita cuidado dental urgent en 24 horas. _____ Needs care by a dentist as soon as possible, if an appointment is not already scheduled. Necesita cuidado dental lo más pronto posible, si no tiene una cita programada. _____ Needs routine dental care, at the next regularly scheduled appointment. Necesita cuidado dental de rutina, en su próxima visita.
Provider Signature: Date/Fecha: Firma del Proveedor: Dental Hygienist
You may contact your Family Advocate if you need assistance with getting a dental appointment or have questions. Thank you. Si necesita ayuda para obtener una cita dental o si tiene preguntas hable con su Trabajadora Social. Gracias.
For Examiner Use/Para Uso de la Examinador 5. Treatment Referral: 1. White Spots: Y or N 0 = no obvious problem Pre-decay 1 = decay noted 2 = urgent: get care as soon as possible 2. Untreated Decay: Y or N 3 = emergent; get care within 24 hours
3. Treated Decay History: Y or N 6. Plaque Assessment: DMF (decayed, missing, filled) 0 = none to minimal 2 = severe amount 1 = moderate amount 4. Rampant Decay History: Y or N Rampant >7 teeth 7. _____Child would not allow visual exam.
Comments/Comentarios:
Original: Parent Yellow: Site File Pink: Health Specialist (C: 02/06; R: 04/21) HLTH 14h
Head Start Oral Health Form—Pregnant Women Patient Information n n n n Patient’s name Date of birth Phone number n n n n n n Address City State Zip code This practice is the patient’s dental home: Yes No
Current Oral Health Status
Does the patient have any teeth with untreated decay? Yes (decay) No (decay free) Does the patient have any teeth that have previously been treated for decay, including fillings, crowns, or extractions? Yes No Does the patient have gum disease? Yes No Are there treatment needs? Yes, urgent Yes, not urgent No treatment needs
Oral Health Care Services Delivered During Visit Diagnostic/Preventive Services Counseling/Anticipatory Guidance Restorative/Emergency Care Examination: Yes No Yes No Fillings: Yes No X-rays: Yes No Crowns: Yes No Risk assessment: Yes No Referral to Specialty Care Extractions: Yes No Cleaning: Yes No Yes No Emergency care: Yes No Fluoride varnish: Yes No Other: Dental sealants: Yes No (Please specify specialist) (Please specify)
Future Oral Health Care Services
All treatment completed: Yes No Next recall date: / (month/year) More appointments needed for treatment? Yes No If yes: Approximate number of appointments needed: Next appointment: Date: Time:
Additional Information for Patient, Head Start Staff, and Medical Providers
Oral Health Provider’s Contact Information and Signature n n n n Provider name (please print) Phone number Fax number n n Practice name Address n n Provider signature Date of service
This document was prepared under grant #9OHC0005 for the U.S. Department of Health and Human Services, Administration for Children and Families, Office of Head Start, by the National Center on Early Childhood Health and Wellness. This publication is in the public domain, and no copyright can be claimed by persons or organizations. C: 04/06; R: 04/2020 HLTH 15b HLTH 15b
All About My Day All About My Day
Name: Name: Date: Date: I napped at I napped at I last ate at I last ate at At school we At school we
I really enjoyed playing with I really enjoyed playing with
My mood today My mood today
I ate: at I ate: at at at at at at at at at at at
My Diaper was: My Diaper was: at at at at at at at at at at at at at at at at
Nap: to Nap: to to to to to to to
Gums/Teeth Cleaned/Brushed at: Gums/Teeth Cleaned/Brushed at:
Please bring me: Diapers Please bring me: Diapers Formula Change of Clothes Formula Change of Clothes
Distribution: White – Site File Yellow - Parent Distribution: White – Site File Yellow - Parent (C: 04/10) (C: 04/10) HLTH 15c LOWER COLUMBIA COLLEGE EARLY HEAD START Home Safety Checklist
Name Date Loc ID
Home Safety Checklist ______Spring-loaded lid-support devices ______Write clear instructions for other Yes No are on toy chest lids. These caregivers about what medicine to give children, ______I keep cleaning products, prevent a lid from falling on a when to give it and how much to give. Printable pesticides, medicine, liquor, child’s neck or from closing and example here: Medication log cigarettes, matches, and lighters trapping a child inside. out of the reach of children. ______Climbing equipment is placed Sleep Safety ______I keep all prescribed medication outside on mats, mulch, or sand to Yes No out of the reach of children as well prevent dangerous falls. ______Infants and toddlers sleep alone in as over-the-counter medications ______Dangerously placed lamps and a crib or bassinet. (Tylenol, cold medications, etc.). electrical cords are removed. ______Infants do not sleep in the crib This includes marijuana, edibles, with toys, stuffed animals or topicals and street drugs. Visit ______Outlets are covered with sliding pillows. www.poison.org or call 800-222- safety plates, plastic plugs or heavy 1222 if accidental ingestion occurs. furniture. ______Infants are always placed on their backs to sleep. ______I have a list of emergency phone Bathroom numbers near my phone. ______The crib does not have a drop side. Yes No ______I know the temperature of my hot ______The crib is not near a window or ______Non-slip mat or strips are in tub or water where I live. curtain/blinds. shower. ______My babysitter is older than 13 and ______Items like razors and shampoo are mature enough to handle common Stairs, Windows and Doors stored out of reach of young emergencies. children. Yes No ______Electrical cords are out of reach or ______Loops are cut on window blind ______Give young children all of your in cord keepers. cords or blind cord safety kits attention when they are in and installed. ______Safety latches and locks are on around water. cabinets and drawers in kitchens, ______Windows are securely closed and ______Check the water temperature with bathrooms, and elsewhere. screens in good shape. your wrist or elbow before giving ______Fans and air conditioners are out your child a bath. ______I have safety measures so my child of reach. cannot fall out if windows are opened. ______Store separately guns and Medication Safety ammunition. Free gun locks are ______Stairs are kept clear of tripping Yes No available at local police hazards. ______Keep all medicine and vitamins out departments, no questions asked. of children’s reach and sight, even ______Furniture and large toys are placed www.projectchildsafe.org medicine you take every day. away from walkways.
(C: 06/12; R: 05/2020) HLTH 15c Fire and Carbon Monoxide Safety ______Avoid holding a child while cooking ______Sign up for product recalls at on the stove. It is better to put http://www.safekids.org/product- Yes No your child in a high chair where recalls or locate a specific item’s ______Does anyone in your home ever you can still see them. Tip: Ensure safety history. smoke? there is a “kid-free” zone of three ______Make sure there are working feet around the stove when adults Preventing Choking and Strangulation smoke alarms and carbon are cooking. Yes No monoxide alarms on every level of ______I know how to prevent my child your home. Test the batteries Poison Prevention from choking. every month. (Know how to Yes No replace it?) ______My child does not wear a pacifier ______Store all household cleaning or jewelry around his or her neck. ______Know two ways out of every room products and chemicals in their in case of a fire. Tip: Refer to Fire original containers, out of ______Rooms are checked for potential Escape Plan reviewed at home children’s reach and sight. choking hazards like toys, visit. decorations, and foods. ______Use a labeling system for ______Irons, toasters, hairdryers, curling poisonous or dangerous chemicals ______My child does not play with objects irons or similar appliances are such as the Mr. Yuk sticker system. that are small enough to fit unplugged when they are not in through a paper towel roll. ______Save the toll-free Poison Help use. number into your phone in case of ______Plastic wrappers, plastic bags and ______Fire extinguishers are in the master emergency 1-800-22-1222. balloons are kept away from your bedroom and kitchen and are children. labeled for use in all types of fires. Preventing TV and Furniture Tip-Overs ______Keep small objects out of They are located in a quick and children’s reach and sight. Look easy to use location. Yes No for and remove small items that ______Mount flat-panel TV’s to the wall are at your child’s eye level. Preventing Burns/Kitchen Safety and place large box-style TV’s on a low, stable piece of furniture. ______Keep cords and strings out of Yes No ______Use brackets, braces or wall straps children’s reach, including those ______I do not ever drink or carry hot to secure unstable or top-heavy attached to window blinds. liquids when holding my baby. furniture to the wall. ______Have a choking plan, make sure to ______Cook on the back burners of the cut up children’s food and have stove when possible and keep pot Toy Safety them sitting while eating their handles turned away from the food. edge. Keep hot foods and liquids Yes No away from the edge of the ______I check my child’s toys for safety ______Know infant, child and adult CPR, counters and tables. hazards. sign up for a class today!
______When choosing a toy, read the ______Ensure an adult is always present in the kitchen when food is cooking instructions and warning labels. on the stove. Make sure the toy is appropriate for your child’s age and ______Ensure kitchen knives are stored in development. childproof drawers or cabinets. (C: 06/12; R: 05/2020) HLTH 15c Car Safety My family’s home safety action plan is: Yes No ______Ensure everyone wears seatbelts (for rides in an age-appropriate, properly installed child safety seat) while riding in motor vehicles.
______Children are not left unattended in
a motor vehicle (illegal, unsafe,
dangerous).
______Focus is kept while driving and cell
phones are not used while driving to text or make phone calls.
Yard and Neighborhood Safety Yes No ______Yard tools and other power tools are put away after use. ______Garage door openers are kept out of reach. ______Oily rags and other flammable trash are discarded. ______Paint is not chipping or peeling off the walls or woodwork.
What are your safety concerns?
(C: 06/12; R: 05/2020) HLTH 15c LOWER COLUMBIA COLLEGE EARLY HEAD START Lista de verificación de seguridad en el hogar
Nombre Fecha Loc ID
Lista de verificación de seguridad en el ______Armas de fuego y municiones son Seguridad de medicina hogar guardadas en lugares separados. Se puede obtener dispositivos de bloque Sí No Sí No del gatillo gratis en departamentos de ______Mantiene toda medicina y vitaminas ______Mantengo productos de limpieza, policías locales, sin preguntas. fuera del alcance y vista de niños, aun pesticidas, medicina, cigarrillos, www.projectchildsafe.org si es medicina que usted toma todos fósforos y encendedores fuera del ______Las tapas de baúles de juguetes tienen los días. alance de niños. dispositivos de soporte con resorte. ______Escribe instrucciones claras para otras ______Mantengo fuera del alcance de niños Éstos previenen que una tapa caiga en personas que cuiden a su niño para toda medicina de receta y también el cuello de un niño o que se cierre y explicar qué medicina darle, cuándo toda medicina de venta libre (Tylenol, atrape al niño dentro de la caja. dársela y cuánta le tiene que dar. Usted medicina para el resfriado, etc.), ______Juguetes para trepar son colocados puede obtener un ejemplo para incluyendo marihuana, comestibles afuera, en esteras de goma, mantillo o imprimir aquí: Registro de (edibles), tópicos (topicals) y drogas. arena, para prevenir caídas peligrosas. medicamentos Visite www.poison.org o llame al 800- Seguridad al dormir 222-1222 si ocurre una ingestión por ______Se han quitado lámparas y cables accidente. eléctricos de ubicaciones peligrosas. Sí No ______Tengo una lista de números de ______Enchufes son cubiertos con placas ______Bebés y niños pequeños duermen en emergencia cerca de mi teléfono. deslizantes de seguridad, tapones de su propia cuna o moisés. plástico o muebles pesados. ______Yo sé cuál es la temperatura del agua ______Bebés no duermen en cunas con caliente en mi domicilio. Baño juguetes, peluches o almohadas. ______La persona que cuida a mis niños tiene Sí No ______Los bebés siempre están acostados más de 13 años y es suficientemente ______En la tina o ducha, hay un tapete o boca arriba para dormir. madura para responder a situaciones tiras antideslizantes. ______La cuna no tiene baranda móvil. comunes de emergencia. ______Cosas como navajas y champú son ______La cuna no está cerca de una ventana ______Cables eléctricos están fuera del guardadas fuera del alcance de niños o cortina/persianas. alcance de niños o son restringidos por jóvenes. bridas, velcros, etc. Escaleras, Ventanas y Puertas ______Usted presta toda su atención a niños ______Los gabinetes y cajones de la cocina, jóvenes cuando están cerca de o en el Sí No baños y otros cuartos tienen cierres y agua. ______Los cordones de persianas son seguros. ______Usted prueba la temperatura de agua cortados o tienen dispositivos de ______Ventiladores y aparatos de aire con su muñeco o codo antes de bañar a seguridad. acondicionado son fuera del alcance de su hijo. ______Las ventanas están cerradas niños. seguramente y los mosquiteros están en buenas condiciones.
(C: 11/2020) HLTH 15c ______Tengo medidas de seguridad que de la orilla. Mantiene alimentos y ______Usa soportes y/o correas para fijar a la impiden la caída de mi hijo por la líquidos calientes fuera de la orilla de pared los muebles inestables o pesados ventana cuando está abierta. encimeras y mesas. en la parte superior. ______Las escaleras están siempre libres de ______Se asegura de que un adulto esté Seguridad de juguetes cosas que puedan causar tropiezos. siempre presente en la cocina cuando algo está cociéndose. Sí No ______Muebles y juguetes grandes están fuera de las áreas por donde caminan. ______Se asegura de que cuchillos de cocina ______Reviso los juguetes de mi niño para estén guardados en gabinetes o riesgos a su seguridad. Seguridad contra incendios y carbono cajones que son a prueba de niños. ______Al escoger un juguete, lee las monóxido ______Evita tener su niño en sus brazos instrucciones y etiquetas de aviso. Se Sí No mientras cocine. Es mejor ponerlo en asegura de que el juguete sea una silla alta donde usted lo pueda ver. adecuado a la edad y desarrollo de su ______¿Hay alguien que vive en su casa que niño. fuma? Consejo: Mientras adultos cocinan, asegúrese de que haya una zona “libre ______Regístrese para recibir avisos de ______Se asegura de que en cada piso de su de niños” de un metro alrededor de la retiros de productos en el sitio casa hay alarmas contra incendios y estufa. http://www.safekids.org/product- carbono monóxido. Prueba las pilas recalls o encuentre el historial de cada mes. (¿Sabe reemplazarlas?) seguridad de un producto específico. ______Sabe dos maneras de salir de todo Prevención de envenenamiento Prevención de atragantamiento o cuarto en caso de incendio. Consejo: Sí No refiérase al Plan de evacuación por estrangulamiento incendio que fue revisado en la visita a ______Almacena todos los productos de Sí No su hogar. limpieza y químicas en sus recipientes originales, fuera del alcance y vista de ______Yo sé prevenir que mi niño se ______Planchas, tostadores, secadoras de niños. atragante. pelo, planchas para cabello y otros aparatos parecidos están enchufados ______Usa un sistema de etiquetas (como las ______Mi niño no tiene chupete o joyería en cuando no los estén usando. de Mr. Yuk) para químicas tóxicas o su cuello. peligrosas. ______Extinguidores de incendios están en la ______Los cuartos son revisados para riesgos recámara principal y cocina y son ______Guarda el número gratis de la línea potenciales de atragantamiento, como etiquetados para el uso contra todo de ayuda para envenenamiento en su juguetes, decoraciones y alimentos. tipo de incendios. Están colocados para teléfono en caso de emergencia. 1-800- ______Mi niño no juega con objetos que que sea fácil encontrarlos y usarlos. 222-1222. puedan caber en un el tubo de un rollo de toallas de papel. Prevención de quemaduras/seguridad en Prevención de caídas de televisores y la cocina muebles ______Envolturas de plástico, bolsas de plástico y globos son mantenidos fuera Sí No Sí No del alcance de niños. ______Nunca bebo o llevo líquidos calientes ______Fija televisores planos a la pared y ______Mantiene objetos pequeños fuera del pone televisores grandes en forma de cuando tengo mi bebé en los brazos. alcance y vista de niños. Busca y quita caja en muebles bajos y estables. ______Cocina en las parillas o quemadores objetos pequeños que estén al nivel de de atrás cuando sea posible y mantiene ojos de su niño. los mangos de sartenes volteados fuera (C: 11/2020) HLTH 15c ______Mantiene cordones fuera del alcance ¿Qué inquietudes tiene usted sobre la de niños, incluyendo las que se usan seguridad? para persianas.
______Tiene un plan en caso de atragantamiento, se asegura de cortar la comida de los niños y que ellos estén sentados mientras coman.
______Sabe RCP (CPR) para bebés, niños y adultos. (¡Regístrese en una clase hoy!)
Seguridad en el carro
Sí No
______Cuando andan en vehículos, se asegura de que todos usen cinturones de seguridad (o usa asiento de El plan de acción de seguridad del hogar de seguridad para niños que es adecuado para su edad y está instalado mi familia es: correctamente). ______Niños nunca están sin supervisión en un vehículo (es ilegal, inseguro, peligroso).
______Siempre mantiene la concentración al manejar y no usa celulares para hacer llamadas o mandar mensajes de texto cuando está manejando. Seguridad fuera de la casa
Sí No ______Herramientas de jardinería y otras herramientas eléctricas son guardadas después de su uso. ______Controles remotos de puerta de garaje están siempre fuera del alcance de niños. ______Trapos aceitosos y otra basura inflamable son desechados. ______La pintura no está descascarándose de paredes o carpintería.
(C: 11/2020)
Lower Lower Lower
Columbia Columbia Columbia
College College College
Head Start/ Head Start/ Head Start/
EHS/ECEAP EHS/ECEAP EHS/ECEAP
E E E
M M M
E R E R E R
R E R E R E
G S P G S P G S P
E P R E P R E P R
N O O N O O N O O
C N C C N C C N C
Y S E Y S E Y S E
E D E D E D
U U U
R R R
E E E
S S S
Table of Contents
1. School Building Data/Preparedness Outline/ Emergency Evacuation Parent Information 2. Classroom Evacuation Plan & Map 3. Emergency Phone Numbers 4. Emergency Procedures for Accidents or Critically Ill Children 5. School Calendar 6. Staff and/or Volunteer Emergency Information 7. Class Roster 8. Student Emergency Contact Info. & Parent Agreement Contracts 9. Medical Concerns/Allergies 10. Medication Forms & Policy 11. Accident Forms & Procedure 12. Emergency Medical Assist./Student Release 13. Bomb Threats 14. Bus/Chemical Accidents 15. Earthquakes 16. Missing Child or Kidnapping 17. Classroom and Building Lockdown Procedures 18. Fire/Floods/Gas Leaks 19. Emergency Preparedness Supplies 20. Lightning/Nuclear Accident 21. Response for Death of Student/Staff 22. Riots 23. Volcanic Eruption/Windstorms 24. Corona Virus/COVID-19
*Emergency Care & Basic Life Support Student Manual to be kept with this notebook.
Emergency
Response
Procedures
Approved by Health Advisory Committee 05/96 Revised 08/2020
Lower Columbia College Head Start/EHS/ECEAP P.O. Box 3010 Longview, WA 98632 (360) 442-2800
School Building Data Date Completed ______
Site Name Telephone
Address Hours
Total enrollment Total number of mobility impaired
Total # of staff # of classrooms # of portable classrooms
Key Staff Name Work/Home Telephone
Principal or Director /
Area Manager/Supervisor /
/
Admin. Services Mgr. /
Day Custodian /
/
Location of: First Aid supplies Fire extinguishers
Water shut-off: Be aware of location Gas shut-off: Be aware of location
Electric shut-off: Be aware of location Chemical storage: Be aware of location
Evacuation assembly area outside of school building (i.e. playground, sports field)
Neighboring identifiable hazards within one-half mile radius (i.e. gas pipelines, railroad tracks, high voltage lines, chemical storage or manufacturer)
Getting Prepared
With effective pre-planning, you will better survive even the most devastating crisis. With a plan, you can act and communicate in a proactive fashion rather than in a reactive mode. This manual provides what you need to plan before a crisis and to guide actions during and after the crisis. It can help clearly identify responsibilities and give direction to staff while under difficult conditions.
How you respond, manage, and communicate during that crisis, is of critical importance to ensuring the safety of students and staff, protecting the program's property, restoring normal educational process as quickly as possible, ease parents' minds about the safety of their children, and maintain good media relations.
Leadership Team Preparedness Checklist
Make sure that all staff members, especially office staff, are aware of the manual contents, location, and its use during a crisis (New Staff Orientation). Conduct annual training and review of emergency procedures each year. Provide copies of earthquake procedures to staff members who supervise children (Section 16). Insert calendar and/or schedules into the manual. Insert current staff roster. Insert the school building floor plans and utility locator shutoff maps. Insert the fire evacuation plan and map after (Section 2). Have first-aid equipment and instructions in designated areas.
Area Manager / Supervisor Preparedness Checklist
Distribute and review the disaster preparedness outline (Section 1) with all staff. Send copies of the school data sheets, disaster preparedness, and classroom lockdown procedure outline to the Health Specialist. Distribute completed Emergency Evacuation Information sheets to Parent/Guardians.
DST & EHS Staff Member Preparedness Checklist
Insert the ChildPlus Report which includes the information regarding the child's guardian and to whom the student may be released and Medical Concerns and Allergy List. Update when appropriate. Insert completed Medication Authorization Forms and Medication Administration Forms. Complete a school building data sheet (Section 1). Complete the disaster preparedness outline (Section 1). Complete classroom lockdown procedure (Section 17). Insert the fire evacuation plan and map after (Section 2). Have first-aid equipment and instructions in designated areas.
Disaster Preparedness Outline (school-wide incidents) Coordinators wear Identification Badges that state Head Start/ECEAP
School Principal Area Mgr./Supervisor Evacuation Site Alternate Center Coordinator Alternate
Center team duties: Communicates evacuation notice, if necessary. Accounts for the presence of al students and staff (take roll). Coordinates various team responses-demobilizes/redirects teams as necessary. Completes Crisis Assessment and Information Sheet within 30 minutes. Communicates with the Director, Area Manager/Supervisor, Building Principal, staff, children and parents. If evacuating, checks each room. Locks rooms without persons. Tapes an X over doors of rooms without persons. Takes victims to first aid location using approved first aid techniques. Locks external doors after evacuation. Posts signs directing parents to pick-up areas. Administer First Aid Documents injuries and first aid administered (Section 13). Takes charge of existing authorized student medication (Refer to Medication Authorization Forms). Supervises area. Reunites children and guardians. Documents student release to guardian (Section 13). Alternate Plan:
Required Supplies: Emergency Response Procedures notebook (class rosters, Family Information forms, Child Medical Concerns & Allergy List, map and building information).
Recommended Supplies: First Aid Supplies Designated Communication Runner Flashlight Battery Operated AM Radio Classroom Keys Masking Tape Stretchers Blankets Forms for releasing students
*Recommend that team members have First Aid, CPR, or other emergency medical training.
LCC Head Start/ECEAP Date of Form Completion: ______Emergency Evacuation Information
Emergency Evacuation Information For Program Parent/Guardians
Center Name Principal Area Mgr./Supervisor
Teacher Name Main LCC Head Start/EHS/ECEAP Phone Number: 360-442-2800
On Site Evacuation Area: ______(Children are taken to this outdoor area when the building needs to be evacuated.)
Off Site Evacuation Area: ______(Children will be transported to this off-site location only if the school building and outdoor area become unsafe due to a natural disaster, etc. Off-site location could change depending upon the type and location of the disaster.)
Off Site Evacuation Information:
1. During evacuation, staff members will check each room. Prior to transporting students to the off site, attendance will be taken by the Lead Teacher, EHS Staff member or Assistant Teacher.
2. If possible, signs will be posted directing parent/guardians to the off site. It is also recommended that parent/guardians listen to a local radio station for disaster and program updates. (Parent/Guardian: Please keep this copy of your Center’s Emergency Evacuation Information.)
3. Upon arrival at the off site, the Lead Teacher, EHS Staff member or Assistant Teacher will again take attendance.
4. Any first aid administered to a child will be documented and shared with his or her parent/guardian upon their arrival to the off site.
5. Staff members will supervise children at all times.
6. Staff members will supervise the reuniting of each child with his or her parent/guardian at the off site.
7. Staff members, to document the release of each child to their parent/guardian, will use an Emergency Child Release Roster. The staff member will note the following information for each child: Child Name, the Date & Time the Child was released, the Signature of the Staff Member releasing the child, the Destination of the Child. The staff member will also obtain the Signature of the Parent/Guardian that the child is being released to.
Emergency Evacuation Information Fecha en que se lleno la forma: ______for Program Parents/Guardians
Información De Evacuación De Emergencia Para Padres/Tutores Del Programa
Nombre del Centro Directora Supervisora Nombre de la Maestra No. Teléfono de LCC Head Start/EHS/ECEAP: 360-442-2800
Área de Evacuación en el sitio: ______(Los niños son llevados a esta área exterior cuando el edificio necesita ser evacuado)
Área de Evacuación fuera del sitio: ______(Los niños serán transportados a este lugar fuera de la escuela sólo si el edificio y el área exterior se tornan inseguros debido a un desastre natural, etc. El lugar fuera del área podría cambiar dependiendo del tipo y lugar del desastre).
Información de Evacuación fuera de la Escuela:
1. Durante la evacuación, los miembros del personal revisarán cada salón. Antes de transportar a los estudiantes fuera de la escuela, la Maestra a cargo/Miembro del Personal de EHS/o la Asistente de la Maestra pasarán lista de asistencia.
2. Si es posible, se colocarán señales para dirigir a los padres/tutores al lugar fuera de la escuela. También se recomienda que los padres/tutores escuchen la estación local de radio para enterarse del desastre y del programa. (Padres/Tutores: Por favor, conserven esta copia de su Información de Evacuación de Emergencia de sus Centros).
3. Al llegar al lugar fuera de la escuela, la Maestra a cargo/Miembro del Personal de EHS/o la Asistente de la Maestra pasarán lista de asistencia de nuevo.
4. Cualquiera de los primeros auxilios administrados a un niño serán documentados y compartidos con sus padres/tutores al momento de su llegada al sitio fuera de la escuela.
5. Los miembros del personal supervisarán a los niños todo el tiempo.
6. Los miembros del personal supervisarán la reunión de cada uno de los niños con sus padres/tutores en el lugar fuera de la escuela.
7. Los miembros del personal, para documentar la entrega de cada uno de los niños a sus padres/tutores, usarán una Lista de Entrega del Niño en Emergencias. Los miembros del personal anotarán la siguiente información para cada niño: Nombre del Niño, Fecha y Lugar donde el Niño fue entregado, la Firma del Miembro del Personal que entregó al niño, y el Destino del Niño. Los miembros del personal también obtendrán la Firma del Padre/Tutor al cual se entregó el niño. (R: 08/17)
Emergency: 911 Barnes, Barnes North, Broadway, LCC Campus and Memorial Park Centers
Phone Numbers Lower Columbia College Security...... 8-360-442-2911 2911 from LCC Campus phone Campus Services ……………………………………...... 8-360-442-2911 2260 from LCC Campus phone Longview Police ………………………………………… 8-360 -442-5800 Kelso Police …………………………………………….. 8-360-423-1270 Castle Rock Police ……………………………………… 8-360-274-4711 Kalama Police …………………………………………... 8-360-673-2165 Cowlitz County Health Department ……………………. 8-360-414-5599 Cowlitz County Sheriff …………………………………. 8-360-577-3092 Longview Fire Department ……………………………... 8-360-442-5503 Fire District #2 / Kelso / Cowlitz County ………………. 8-360-578-5217 Castle Rock Fire Department …………………………… 8-360-274-4413 Toutle Fire Department …………………………………. 8-360-274-8940 Department of Emergency Management ……………….. 8-360-577-3130 St. John Medical Center/PeaceHealth …………………... 8-360-414-2000 Red Cross ……………………………………………….. 8-360-693-5821 Poison Control Center …………………………………... 8-1-800-222-1222 Emergency Mental Health ……………………………… 8-360-425-6064 *Also see the Community Resource Directory
News Media/Local Radio Stations *Refer media questions to College President, College Public Relations Office or Authority on duty. The Daily News …………………………………………. 8-360-577-2516 KBAM–1270AM; KRQT–107.1FM; KPPK–98.3FM ….. 8-360-423-1210 KLOG–1490 AM; KUKN–105.5FM; WAVE–101.5FM.. 8-360-636-0110 KEDO–1400 AM; KLYK–94.5FM …………………….. 8-360-425-1500
Emergency: 9-911 Castle Rock and LEHSP
Phone Numbers Lower Columbia College Security...... 9-360-442-2911 2911 from LCC Campus phone Campus Services ……………………………………...... 9-360-442-2911 2260 from LCC Campus phone Longview Police ………………………………………… 9-360 -442-5800 Kelso Police …………………………………………….. 9-360-423-1270 Castle Rock Police ……………………………………… 9-360-274-4711 Kalama Police …………………………………………... 9-360-673-2165 Cowlitz County Health Department ……………………. 9-360-414-5599 Cowlitz County Sheriff …………………………………. 9-360-577-3092 Longview Fire Department ……………………………... 9-360-442-5503 Fire District #2 / Kelso / Cowlitz County ………………. 9-360-578-5217 Castle Rock Fire Department …………………………… 9-360-274-4413 Toutle Fire Department …………………………………. 9-360-274-8940 Department of Emergency Management ……………….. 9-360-577-3130 St. John Medical Center/PeaceHealth …………………... 9-360-414-2000 Red Cross ……………………………………………….. 9-360-693-5821 Poison Control Center …………………………………... 9-1-800-222-1222 Emergency Mental Health ……………………………… 9-360-425-6064 *Also see the Community Resource Directory
News Media/Local Radio Stations *Refer media questions to College President, College Public Relations Office or Authority on duty. The Daily News …………………………………………. 9-360-577-2516 KBAM–1270AM; KRQT–107.1FM; KPPK–98.3FM ….. 9-360-423-1210 KLOG–1490 AM; KUKN–105.5FM; WAVE–101.5FM.. 9-360-636-0110 KEDO–1400 AM; KLYK–94.5FM …………………….. 9-360-425-1500
Emergency Medical Assistance
Child’s Name Date
Allergies (if known) and/or other considerations
Apparent injury #1 First Aid First Aid administered by Time
Apparent injury #2
First Aid First Aid administered by Time
(Attach one copy to the injured person; retain one copy of this form for school records)
Emergency Medical Assistance
Child’s Name Date
Allergies (if known) and/or other considerations
Apparent injury #1 First Aid First Aid administered by Time
Apparent injury #2 First Aid First Aid administered by Time
(Attach one copy to the injured person; retain one copy of this form for school records)
(Reproduction on NCR recommended)
Emergency Child Release Roster
Date Time Child Name Signature of Person Destination Signature of Person Released To of Child Released By
(Retain this form for school records)
Emergency Response
Checklists
(Alphabetical Listing)
Bomb Threats Keep the caller on the line as long as possible. Fill out the bomb threat form on this page. Use a silent non-verbal communication (written note, etc.) to notify another employee who will contact the Director or Area Manager / Supervisor. Notify the appropriate administrator (i.e., Campus Services, Superintendent . . . ) who makes the decision whether to call in public safety officials. If the threat appears to be real, of if the authorities advise it, direct students and staff to safe areas. If the threat appears to be real and public safety personnel are dispatched, arrange a meeting place to meet safety personnel. Re-admit students to the building when it is deemed safe.
Bomb Threat Report Form Date Time Number the call came in to Person answering the call
Ask these questions: Exact wording of response When is the bomb going to explode?
Where is it right now?
What does it look like?
What will cause it to explode?
What kind of bomb is it?
Did you place the bomb?
Why did you put it here?
What is your address?
What is your name?
Caller's Voice: male female Young Middle Age Old _____ Describe accents or other voice characteristics
Is the voice familiar? Background noise? The First 24 Hours: Crisis Assessment and Information Sheet Make copies of this completed form for the security and police departments and the main office.
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? No Yes How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the completed information to the main office as soon as possible. *Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800
Bus accidents involving child injuries
Children are your major priority! Check for injuries and apply first aid, if indicated. If there are serious injuries, use emergency first aid in the bus/van and try to get help without leaving children unattended.
If there are no serious injuries, check damage to vehicle(s) and contact appropriate police department.
Contact the Head Start/ECEAP Director at 360-442-2800.
If another vehicle is involved, be sure to get appropriate information, such as: license number; make and color of vehicle; name of driver; and name of insurance company.
Chemical accident in the neighborhood
If spill occurs inside building: Evacuate children and staff. Call 911 or 9-911. Isolate, deny entry, and if possible safely identify hazardous materials. Notify maintenance and main office.
If spill occurs outside building: Notify Police and Fire Department (911 or 9-911) Make sure students are indoors-preferably in rooms without windows or exterior entrances. Notify the main office and building office; Ask staff and volunteers: Close all windows and doors Close as many internal doors as possible Seal gaps under doorways and windows with dry towels and duct tape or a similar thick tape Turn off all ventilation systems
If the building is evacuated: Move crosswind -- never up or downwind -- to avoid fumes Cover nose and mouth with a dry cloth Re-enter the school only when public safety officials declares the area safe
Monitor Emergency Broadcast System for instructions.
Reminders for Handling the Media Working with members of print and broadcast media can be tricky at the best of times, a crisis in the worst of times. Lower Columbia College’s administrative procedures designate specific spokespersons to represent the institution during these situations. If you are involved in or witness a crisis situation, the best thing to do is refer all questions by media personnel to the College president, the College Relations office or another authority on duty (i.e., the police or fire department). That way you are protected from being misrepresented through giving incomplete information or speculation.
The second thing to do is to inform the president's office or College Relations office of the situation, if they have not been contacted already. They will then be able to compile data as complete as possible and be prepared for queries from the press or others.
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible. *Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800 Earthquakes
Before the earthquake--
Review the "During the earthquake" and "After the earthquake" information (below) with staff, and be certain individuals who supervise children have copies of these guidelines handy. Review utility turn-off points, and assign the head custodian or designated staff to be responsible for utility shut-off, i.e. include gas, oil, water, and electricity. Brief your staff on how to secure all records and office valuables in a safe place. Be sure the Family Information forms are accessible.
During the earthquake--
If you are inside during the earthquake: Stay inside. Move students away from windows, shelves, heavy objects, and furniture that may fall. Instruct children to kneel under desks, tables, or chairs with their arms and hands protecting their heads. In halls, stairways, or other areas where no cover is available, tell students to-- move to an interior wall. kneel with your back to wall, place your head close to knees, cover the sides of your head with your elbows, and clasp your hands firmly behind your neck
If you're outdoors during the earthquake: Move children to an open space away from buildings and overhead power lines. Have children lie down or crouch low to the ground. Be aware of dangers that may demand children to move away from the area.
After the earthquake--
Teachers / EHS Staff should immediately take a roll count of children. Class rosters should be kept with teachers at all times. Account for all students. Teachers / EHS Staff directed to evacuate should keep the class together on the way out of the building. A responsible adult should lead while the teacher / EHS staff member brings up the rear. Call 911 or 9-911 if needed for fire, etc. Give first aid to injured individuals. Shut off the main power, gas, oil, and water if necessary. Seal off and indicate areas where hazardous materials have spilled. Calm and reassure frightened students and staff. Keep records of children who are released to parents or other authorized people (Form in Section 13). Establish communication with building administrator and main office. Monitor Emergency Broadcast System for instructions.
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible. *Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800
Missing Child or Kidnapping
Follow Emergency Lockdown Procedure in Section 17 of this notebook.
When calling emergency personnel, provide the following information: Child’s name and age Address Physical and clothing description of the child, including distinguishing marks such as visible scar or birthmarks Medial status, if appropriate Time and location child was last seen Person with whom the child was last seen Vehicle information and direction of travel
Have child’s information including picture, if possible, available for the police upon their arrival. Area Manager will notify parents of missing child and attempt confirmation that child is with family; if not – inform parents of situation and steps taken. Area Manager, with assistance from Director or Assistant Director, will report incident to Childcare Licensor and Child Protective Services. Area Manager will complete a Crisis Assessment and Information Sheet.
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible. *Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800
FACI 1p LOWER COLUMBIA COLLEGE HEAD START/EHS/ECEAP Classroom Lockdown Procedure
Designated Classroom Responder (DCR): Designated Classroom Security (DCS):
Teacher / EHS Staff If an intruder or someone with a gun or weapon is observed heading into or toward the entrance of school; or if someone is observed with a gun in hand in the halls or a classroom; or if notified by announcement or phone call of such an occurrence:
INDOORS
DCR initiates building security for intruder, DCS Secures Room: gun or weapon threat: Lock exterior and interior doors and windows.
Call: Turn off lights. 911 Your Building's Campus Services 8-911 Main Office 360-442-2260 Find safe spot where students will not be 360-442-2911 visible to the intruder. (Insert Phone Number) (Emergency) Designated Safe Spots:
DCR If there are medical emergencies, notify building office and perform first aid. (Insert Location) (Insert Location)
DCR Maintain Classroom: DCS Takes attendance in classroom. Only use intercoms, cell phones, telephones or radios for vital information during a lockdown DCS Maintain Classroom: (for example, reporting the location of the intruder). Only use intercoms, cell phones, telephones or radios for vital information during a lockdown Maintain a calm atmosphere in the classroom, (for example, reporting the location of the intruder). keeping alert to emotional needs of students. Being quiet is necessary to be able to hear Maintain a calm atmosphere in the classroom, announcements, not attracting unwanted keeping alert to emotional needs of students. attention to oneself, etc. Being quiet is necessary to be able to hear announcements, not attracting unwanted DCR Call Main Head Start Office at attention to oneself, etc. 360-442-2800 or by two-way radio. DCS Wait for notification from principal's DCR Wait for notification from principal's office or Main Head Start Office for further office or Main Head Start Office for further instructions. instructions. OUTDOORS
If outside, take students to a designated safe If outside, take students to a designated safe location on or away from campus ; location on or away from campus ; Account for students; report via telephone to Account for students; report via telephone to the staff in Head Start Office at 360-442-2800 the Main Head Start Office at 360-442-2800 or by two-way radio; stay with students until or by two-way radio; stay with students until instructed to do otherwise. instructed to do otherwise. (C: 06/11; R: 06/18) CONFIDENTIAL FACI 1q
Lower Columbia College Head Start/EHS/ECEAP LCC Centers, Barnes Center and Barnes North Center Building Lockdown Procedure
Leadership or Office Staff member, if you observe a person brandishing a gun or weapon on campus OR police have reported a criminal on the perimeter of the campus OR someone is evading law enforcement OR a shooting or hostage situation is taking place OR if notified of such an occurrence:
Contact: Call 8-911 Call 911 Campus Services: 360-442-2260 or 360-442-2911 (Emergency) Your Building’s Main Office ______Area Manager ______(Insert Phone Number) Head Start Main Office @ 360-442-2800 or by Elementary School Principal ______Two-Way Radio as appropriate. (Insert Phone Number) Call Buses ______, ______, ______(Insert Phone Numbers)
The Area Manager or designee will notify each classroom that there is a need for a Lockdown. If the situation dictates, this message may be delivered verbally person to person. Staff on the playground and in each building classroom, office and meeting/break room will be notified.
Students, staff and identified volunteers on playgrounds or in hallways will go into the nearest supervised classroom and stay there.
Staff members in classrooms will follow the Classroom Lockdown procedure.
Exterior Doors will be locked by: PRIMARY: Staff Member at Front Desk Area Manager
ALTERNATE: Direct Service Team Member
Staff members in offices and meeting/break rooms will lock their interior doors and windows. Turn off lights and find a safe spot where children and adults are not visible to the intruder.
Maintain a calm atmosphere and keep alert to the emotional needs of others. Being quiet is necessary to be able to hear announcements, not attracting unwanted attention to oneself, etc.
When police have deemed the situation to be safe or the emergency situation as over, the Area Manager or designee will announce that all is clear. The Area Manager or designee will then call and notify other appropriate parties. If the situation dictates, this message may be delivered person to person. (Staff in each building classroom office and meeting/break room will be notified.)
The Area Manager or designee will complete a Crisis Assessment and Information Sheet. A copy of the completed sheet will be given to the Health Specialist and the Assistant Director for follow-up with the Director.
Reminders for Handling the Media: If you are involved in or witness a crisis situation, the best thing to do is refer all questions by media to the College Relations office or another authority on duty (i.e., the police or fire department). That way you are protected from being misrepresented through giving incomplete information or speculation.
(C: 06/11; R: 08/2020) Fire Staff is to do the following if fire and/or smoke is discovered in the building: Evacuate the involved room or area and activate the building fire alarm. When a fire alarm sounds, complete evacuation is required. Make sure all children are out of the classroom. Bring the attendance records, Emergency Procedures Notebook and supplies. Check to see that everyone is accounted for. WALK, DO NOT RUN to the nearest exit. After evacuating the building and sounding the alarm, the Designee is to call 911 or 9-911 for the Fire Department. Designee: Area Manager / Supervisor Alternate #1: Lead Teacher / EHS staff member Alternate #2: Lead Teacher / EHS staff member Attempt to confine a small fire by closing the door(s) and/or window(s) on the fire. Staff may also attempt to contain a small fire by utilizing available fire extinguishers if trained to do so. If fire is beyond control or involves potentially explosive materials, do not attempt to control – leave the area immediately. Children and staff are to assemble in the designated outdoor area. Children with their teacher and teacher assistant / EHS staff are to remain in a group. Do not return to the building until directed to do so by the person directing the fire drill, the police or a fire officer. Designee needs to meet the fire department and provide pertinent information to them. Everyone must follow the orders of the fire and/or police departments when they arrive. Designee or other staff member is to notify firefighters on the scene if it is suspected that someone may be trapped inside the building.
Floods
Monitor the potential dangers and maintain contact with the main office. Don't touch any electrical equipment if the floor is wet or under water. Have the head custodian and/or responsible staff turns off all utilities, if deemed safe. If evacuation is necessary, inform the main office. Account for all children. Monitor Emergency Broadcast System for instructions.
Gas Leaks If the odor of natural gas is detected in or near the building: Evacuate the building immediately. Follow the fire evacuation plan unless routes pose hazards to students. Move children a safe distance away from the building, up wind if possible. Call 911 or 9-911 from a nearby building to summon the fire department. Turn off the main gas valve. Location Notify the main office at 360-442-2800.
Reminders for Handling the Media Working with members of print and broadcast media can be tricky at the best of times, a crisis in the worst of times. Lower Columbia College’s administrative procedures designate specific spokespersons to represent the institution during these situations. If you are involved in or witness a crisis situation, the best thing to do is refer all questions by media personnel to the College president, the College Relations office or another authority on duty (i.e., the police or fire department). That way you are protected from being misrepresented through giving incomplete information or speculation.
The second thing to do is to inform the president's office or College Relations office of the situation, if they have not been contacted already. They will then be able to compile data as complete as possible and be prepared for queries from the press or others. The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible.
*Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800 Emergency Preparedness Supplies
Emergency Classroom Pack on Wheels: Emergency Response Procedures Notebook First Aid Kit 20 Disposable Emergency Blankets 20 32-Gallon Garbage Bags Snacks Water Pouches 20 Moist Towelettes 20 First Aid Antiseptic Towelettes 3 Packages of Travel-Size Tissues Hand Sanitizer – To be used by staff only Helping Children Cope with Disaster Brochure
Optional Classroom Pack Items to be Provided by Parent/Guardian: Family Photo Comforting Note to Child
On Hand in Classroom: Three (3) Gallons of Water Acceptable Foods: Dry Cereal, Saltine Crackers, Non Fat Dry Milk, Vacuum Packed Tuna or Chicken, Dried Mix Fruit, Canned Fruit (any choice) and Canned Vegetables (only if desired) *All Foods Must be Non-Peanut
Shelter in Place Kit: Towels Map Flashlight Batteries Radio Large pieces of heavy plastic Duct tape Bucket with Toilet Seat Lid Feminine Products Set of Two-way Communication Radios
Lightning
Make sure all children are inside the school's main structure (not in metal portables) Avoid using the telephone except in emergencies Turn off and unplug computers
Nuclear Accident
Move children to the center of the building's lowest level, away from outside walls or openings Close all window and doors Close as many internal doors as possible Seal gaps under doorways and windows with wet towels, plastic sheeting and duct tape or a similar thick tape Turn off all ventilation systems Monitor Emergency Broadcast System for instructions
Reminders for Handling the Media Working with members of print and broadcast media can be tricky at the best of times, a crisis in the worst of times. Lower Columbia College’s administrative procedures designate specific spokespersons to represent the institution during these situations. If you are involved in or witness a crisis situation, the best thing to do is refer all questions by media personnel to the College president, the College Relations office or another authority on duty (i.e., the police or fire department). That way you are protected from being misrepresented through giving incomplete information or speculation.
The second thing to do is to inform the president's office or College Relations office of the situation, if they have not been contacted already. They will then be able to compile data a complete as possible and be prepared for queries from the press or others.
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible. *Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800
Response for Death of Child/Staff
1. Initiate Emergency Procedures
2. If a death has been declared, on school property, by the appropriate authorities: . Do not move the body -- isolate and secure the area. . If not already present at the scene, immediately contact Area Manager / Supervisor and building Principal. . Identify witness(s) or person who discovered the body.
3. If word is received of the death of a child or staff member: . Immediately contact building Principal and Area Manager/Supervisor.
4. In either case, the building Principal and Area Manager/Supervisor: . Notify the Superintendent and Director. . Alert building crisis response team and/or Leadership Team. . Notify parents, spouse and family, law enforcement. . Obtain law enforcement approval prior to removing personal items. . Debrief Staff. . Provide statement for staff to read to classes / parents. . Provide substitutes for staff unable to return to job site. . Provide counseling necessary for emotional needs of children, parents and staff.
Riots
Call 911 or 9-911. Lock exterior and interior doors Alert the principal's office or campus services and the main office Keep children inside and curtail student movement in the building Alert all staff Direct a staff member to handle incoming telephone calls Direct a staff member to maintain the log included below Do not authorize the release of any staff member or child until it is safe to do so
Riot Report Form
Complete for each incident
Incident #1 Date Time Location
Briefly describe
Names of those involved
Reliable witnesses
Action taken
Incident #2 Date Time Location Briefly describe
Names of those involved
Reliable witnesses
Action taken
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible.
*Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800 Volcanic Eruption
If ash is falling, make sure all students are indoors Close all windows and doors Turn off all ventilation systems Monitor Emergency Broadcast System for instructions Listen to the radio for announcements of resulting mudflows or floods If students must be moved out of the building, have them place a damp cloth or damp paper towels over their nose and mouth
Windstorms
Close windows and blinds on windward side and open slightly windows on leeward side of building Keep children in their classrooms near an inside wall away from windows Monitor Emergency Broadcast System for instructions
Reminders for Handling the Media Working with members of print and broadcast media can be tricky at the best of times, a crisis in the worst of times. Lower Columbia College’s administrative procedures designate specific spokespersons to represent the institution during these situations. If you are involved in or witness a crisis situation, the best thing to do is refer all questions by media personnel to the College president, the College Relations office or another authority on duty (i.e., the police or fire department). That way you are protected from being misrepresented through giving incomplete information or speculation.
The second thing to do is to inform the president's office or College Relations office of the situation, if they have not been contacted already. They will then be able to compile data a complete as possible and be prepared for queries from the press or others.
The First 24 Hours: Crisis Assessment and Information Sheet
Brief description of crisis
Actions completed
Who knows of crisis
Number of people involved How many unaccounted for Injuries (Briefly describe seriousness.)
Evacuation needed? NO YES
Briefly describe damage to buildings
Further damage potential/facilities at risk
What do you project will happen in the next two hours?
Are the media on site? NO YES How many? Who?
Check the support needed Transportation First Aid/Nurse Legal/Insurance Food Service Clerical Maintenance Counseling
Your name Time Phone Number
FAX or phone the complete information to the main office as soon as possible.
*Main Office FAX Number: 360-442-2819 *Main Office Phone Number: 360-442-2800