1.      Objectives

 The spread of infection is always a problem in childcare.  It carries a financial cost for the Centre when sick staff must be replaced by agency staff and it can result in difficult times for families caring for sick children whilst trying to meet work or study commitments. 

 Annie Dennis Children’s Centre will try to prevent the spread of infectious diseases amongst children and staff by implementing the following strategies:

•  Maintaining hygiene practices including undertaking effective hand washing and other hygienic practices;
• Notify families and staff when an excludable illness or disease is present in the centre.
• Maintain a record of children’s immunisation status
• Comply to relevant health department exclusion guidelines
• Identifying and excluding sick children and staff with symptoms of infection or disease;
• Encouraging and promoting child and adult immunisation; and
• Maintaining clean and hygienic environments

 Anne Dennis Children’s centre has a duty of care to ensure that all children, families and staff are provided with a high level of protection during the hours of the service’s operation. In doing so, the Centre seeks the support and co-operation of parents/guardians and staff.

 2.      Strategies and practices

 2.1 Hygiene

 Staff will ensure that a high level of hygiene is maintained at the Centre and that children are educated in these practices.  Of these practices, hand washing is one of the most effective ways of preventing the spread of infection.  Staff will wash and dry their own hands thoroughly and educate the children to do the same.  Effective hand washing should take place:

• Before handling food, including, babies’ bottles
• Before eating
• After changing a nappy
• After going to the toilet
• After cleaning up blood, faeces or vomit
• After wiping a nose
• Before giving medication
• After handling garbage and in addition, where practical:
• When children and staff arrive at the Centre.  This reduces the introduction of germs
• After coming in from outside play, and
• Before going home. This prevents taking germs home.

 2.2 Immunisation

The most effective method of preventing certain infections is immunisation.  Immunisation protects the person who has been immunised, children who are too young to be vaccinated and other people who have been vaccinated but did not respond to the vaccine.  The principle of immunisation is simple: It gives the body a memory of infection without the risk of natural infection.

If families are receiving Child Care Benefit, it is a requirement that the centre is informed of their children’s immunisation status on enrolment

 Children

 The Centre encourages parents and guardians to ensure that their child has received all the recommended vaccinations for their age group.

•  Parents/Guardians will record their child’s immunisation status on their enrolment form or attach a photocopy of their child’s’ immunisation status. If the immunisation status of a child is not complete or up to date, the office will issue a reminder to families to do so.
• Immunisation information on each child will kept in the office and will be referred to when determining each child’s current immunisation status.
• If a child’s immunisation status is not up to date even after reminder notices have been issued and an infectious disease outbreak occurs the child/ren will be excluded from the centre.
• Families will be reminded to update their child’s immunisation status regularly, this will be done via the centre newsletter and notices posted in the children’s rooms. Immunisation information is available in the parent resource area.

 Children who are not immunised

•  The centre will maintain a record in the office of those children who are not immunised
• For those families who decide not to immunise their children, children will be excluded from the centre until any infectious disease outbreak is under control. This may occur even if the child is well.
• The centre will follow the National Health and Medical Research Council Guidelines (NHMRC)

 Staff

 The Centre encourages appropriate adult immunisation for all staff employed permanently, short term or on a casual basis. 

•  The centre will have a record of each staffs current immunisation status
• Immunisation information will be requested upon employment
• Each staff member will be responsible to inform the centre of any changes to their immunisation status. This information will be recorded on their individual file.
• The centre will provide written information on the recommended adult immunisations for children’s services staff. This information will be displayed in the staff room.
• The centre will support staff immunisation by financing recommended immunisations for adults working in children’s services.

 3.              Exclusion Guidelines

The spread of certain infectious diseases can be reduced by excluding a person who is known to be infectious, from contact with others who are at risk of catching the infection.  The need for exclusion depends on the ease with which the infection can be spread, the ability of the infected person to follow hygiene practices and the severity of the disease. 

•  The centre’s health related exclusion guidelines for infectious diseases will apply to both children and adults.
• Families will be informed of the centres’ exclusion guidelines at the  time of enrolment and orientation
• Families will be provided with clear and reliable information as to when their child can return to the centre.

Exclusion guidelines for infectious illnesses and diseases

If a child or staff member has symptoms or a medical diagnosis of an infectious disease, he or she should not attend the Centre until they are no longer infectious. 

The Centre uses the National Health and Medical Research Council’s (NHMRC) guidelines on minimum exclusion periods for infectious conditions (see Attachment A).  This table sets out minimum periods of exclusion for different infectious conditions.  A child or staff member may need to stay home for longer than the minimum exclusion period to fully recover from the illness. Some of the more common conditions are:

Diarrhoea or Vomiting: A child who has watery stools or vomiting should be kept home and not return to ADCC until he or she has been free of diarrhoea for 24 hours or in some cases 48 hrs (under the advice of the Victorian Health Dept). If, however your child has an allergy or condition that regularly causes diarrhoea, please inform staff at the time enrolment or diagnosis and provide a letter from the Doctor stating this is the case.

Micro-organisms that cause vomiting and diarrhoea are highly contagious and will spread quickly throughout ADCC.

Contagious Conjunctivitis: This is an infection of the eyes, characterised by redness, a yellow discharge and watering. This condition requires specific medical treatment, children should be excluded until the discharge from the eyes has stopped unless a doctor has diagnosed a non infectious conjunctivitis.

Head Lice (Pediculosis): Exclusion is NOT necessary if effective treatment is commenced prior to the day at child care (ie the child doesn’t need to be sent home immediately if head lice is detected).Children must be treated again after 7 days. Other members of the family should be checked.

School Sores (Impetigo): This is a contagious skin infection characterised by crusted sores that usually appear on the face. The condition requires specific medical treatment and the child should be kept at home until the sores have been healed or treatment has started and the sores are completely covered with a water tight dressing.

Cold Sores (Herpes Simplex): These are painful sores usually around the mouth, and possibly accompanied by a fever. The condition requires medical attention if the infection is severe or the area becomes secondarily infected. Exclusion is not necessary if the child is developmentally capable of maintaining hygiene practices to minimise the risk of transmission. If the child is unable to comply with these practices they child should be excluded until sores have healed and are dry.

Hand – Foot – Mouth Infection: This is a highly contagious infection which consists of small lesions which tend to spread quickly on the side of

the tongue or inside the mouth around the cheek region. Lesions may also appear on the hands and feet, and occasionally on the buttocks. Children should be excluded from care until all blisters have healed.

Exclusion guidelines for immunisable diseases

The routine schedule of vaccines provided free under the National Immunisation program is as follows:

                   -   Hepatitis B

-      Measles, Mumps, Rubella

-      Chicken pox

-      Whooping Cough

-      Diphtheria

-      Tetanus

-      Poliomyelitis

-      Pneumococcal

-      Rotavirus

Procedure for reporting a notifiable disease outbreak.

In some cases, infectious disease outbreaks are notifiable to the Communicable Disease Control Unit on. The Centre Director will be responsible to make any notifications and to implement any of the Disease Control Units recommendations and procedures.

All families will be notified and kept informed in the event of a notifiable disease outbreak by the posting of an information sheet in a prominent place in the child’s room and in the main foyer of the centre. The information sheet will detail:

• the date
• the date of the first diagnosed case
• the name of the condition
• symptoms of the condition
• recommended treatment of the condition
• the minimum exclusion period
• and the date and the number of subsequent children diagnosed after the first case.

4.      Exclusion Procedures

It is the responsibility of parents and guardians to ensure that their child is well enough to attend the Centre.  In making this decision parents should be satisfied that children are well enough to participate in normal activities without requiring special attention due to ill health. 

If a child has a fever before attending the Centre, paracetamol should not be used to mask the fever and the child should stay at home.

If a child at the Centre becomes unwell by developing a temperature above the normal 37.4°C, becomes lethargic, displays out of character behaviour, or staff possibly identify and infectious illness or disease the staff will:

• Isolate the child from other children, if possible, and ensure that the child is comfortable and supervised by a staff member

• Continue to observe the child for any sudden changes eg temperature or rash

• Assist to reduce a child’s fever (if applicable)by:

1. encouraging the child to drink plenty of water
2. removing excessive clothing; and
3. sponging lukewarm water on the child’s forehead, back of neck and exposed areas of skin, such as arms or legs

• Ensure all bedding, contact toys and eating utensils are separated and disinfected where appropriate

• In an emergency situation, the staff will call an ambulance.

Notifying families or emergency contacts

When children become unwell at the Centre, the staff/director will:

• Contact the child’s parents or guardians.  If they are unavailable, the staff will contact the other people who are authorised to collect and care for the child as stated on the child’s enrolment form

• Inform the parents or guardians of the child’s condition, or suspected condition, and ask that the child be picked up within 1 hour.  If the child is not collected within 1 hour, the emergency contacts will be contacted to collect the child

• Encourage families to take their child to their medical practitioner to determine if an infectious illness or disease is present and if or when the child is able to return to the centre.

• Ask families to inform the centre when their child has an infectious illness or disease so that other parents in the centre can be notified.

When a child returns to the Centre after having an illness, the Centre staff will make brief enquiries of the parent and child while the parent is present, to ensure that the child is healthy enough to participate in Centre activities.

When a child is well enough to attend the Centre (ie does not fall under the NHMRC guidelines) but requires medication, the Medication Policy applies.

All parents will be informed of any common infectious conditions in the Centre by the posting of an information sheet in a prominent place in the child’s room detailing the symptoms of the condition, recommended treatment, the minimum exclusion period and the number of children affected.

Families will be informed of the centre’s exclusion procedure at enrolment and during the orientation process.

5.      Medication

Where the NHMRC table does not recommend exclusion for a child with a medical condition, but that child has been prescribed antibiotics, he or she should stay home for the first 24 hours after the course of antibiotics has commenced to ensure that they have time to take effect.

Please refer to the centres Medication Policy regarding

fever reducing Medication.

6.       Long Term medical conditions

Where a child has a long term medical condition such as an allergy, anaphylaxis or asthma, parents or guardians must complete a Management Plan upon enrolling the child at the Centre or when the condition becomes known. 

Please refer to the specific policies on these conditions.

7.      Key Responsibilities and Authorities

 The parents/guardians will

• Inform the centre and staff of their child’s illness, and
• Be responsible for their personal adherence to this policy.

The staff will

• Provide parents with information regarding infectious illnesses and exclusion periods
• Provide factsheets for infectious illnesses or diseases and,
• Be responsible for their personal adherence to this

Policy.

The Centre will

• Ensure that all permanent staff are aware and understand all

        procedures regarding the management of infectious illnesses

        and diseases and the administration of medications

• Promote the awareness of excludable infectious illnesses and diseases by regularly discussing  effective hygiene  practice
• Display written and visual information for children, families and staff and,
• Be responsible for implementing, enforcing and evaluating this policy.

1. 8.           Privacy and Confidentiality

The right for children, families, and staff to be afforded a level of privacy and confidentiality in regards to their immunisation status is paramount.

Staff, students and volunteers should be aware of the centre’s commitment to maintaining and respecting privacy and confidentiality

Please refer to the centre’s Privacy Information Policy

1. 9.           Policy review

The centre will review the Immunisation and Exclusion from Childcare policy, every 2 years.

The Committee of management, families and staff will be encouraged to be actively involved.

10.    Breaches of this Policy

Staff who fail to adhere to the procedures set out in this policy may be liable to counseling or disciplinary action.

Date Approved by the COM 20 February 2008

Next review date February 2010

Date 15 July 2009

Next review date July 2011

Key Source Documents

National Health and Medical Research Council (NHMRC), Staying Healthy in Childcare 4^th Edition 2005.

• The two kindergarten rooms side by side and seeing the children mixing in the yard together. I think the decision to have an integrated kindergarten program at ADCC is proving to be a huge success.
• Family grouping, which is always a highlight for me. It’s great to see staff interacting with all aged children from across the centre and seeing the activity that occurs during these sessions.
• The way new staff members have settled in to ADCC. Credit goes to the existing staff and Lara and Anna for all the induction procedures they implemented this year.
• The activity of people on the Committee of Management sub committees who are doing fantastic work from developing and reviewing policies, to organising the working bees, updating the website, thinking about Kinder for 2013 and starting to shape the community sub-committee with input from staff.
• ADCC being approached by other children’s services in Melbourne to bring their staff to ADCC to have a tour and speak with our staff about programming etc. Congratulations to the staff team who have built this reputation for themselves and ADCC.

In the next few months the COM will be focusing on the budget for the next financial year, continuing to focus on the National Quality Standards (NQS) and what we need to look at to improve Annie Dennis, and approving many policies which are being reviewed and developed.

In a new initiative, the COM is joining the staff team on 16^th May to have a Hot Topic conversation on the NQS. This will bring us together to build up our knowledge and give us the opportunity to workshop some ideas. The session is being run by an external facilitator and I’m looking forward to joining the management and staff together to explore what the NQS will mean for Annie Dennis.

The Committee of Management is a dynamic group that continues to work on the management of the centre and it is wonderful that this year we have 17 parents who all bring a depth of skill and experience. If you are interested in being a part of the Committee, for this year or next, you’re very welcome to attend a meeting to see what it’s all about, or feel free to call me or chat with me at the centre.

Lastly, thank you to everyone who attended the Working Bee, the yards look great!

April has been a very interesting time for the implementation of this program.

The Victorian State government finally announced the funding rates for 2013.  Curiously they also declared that “…services unable to implement 15 hours by 2012 will not be penalised…” and that they did not want the introduction of Universal Access to adversely impact the ability to offer pre-kinder.  The guidelines or criteria were due to be released by the State Government by the end of April.  Without all the information, a decision is very difficult to make.  As you can imagine, the inability for services to commit to their offering for 2013 has made it hard for families to indicate their preferred providers on their centralised Kinder Enrolment forms. The City of Darebin is therefore also planning for the submission of many more “change of preferences” than previous years which could have a flow on effect to the timing of offers. 

Despite this fluid situation, the Subcommittee is well positioned to make recommendations to the COM in May (in time for submitting details to the Council by June 15) that will be within government guidelines and also provide the breadth and depth of service that is highly regarded at Annie Dennis.

In the meantime, the ‘new’ 2012 kinder arrangements at ADCC are no longer so new and are working well. Some of the highlights are:

• the 12 hours of kinder is above the statutory requirement of 10.75
• the kinder children sharing the lovely, spacious “kinder” yard and interacting together
• having more kinder teachers than previous years has provided a supportive, internal professional network that didn’t exist before
• the centre offering more kinder places than it otherwise would have been able to
• having the new “mentoring” role that works across both child care and kinder and provides internal and ongoing professional development

Head lice have been around for thousands of years. We are never going to be completely rid of them but, we can make managing them easier. There is no single treatment that kills 100% of head lice or eggs. It takes time and persistence to get rid of them. We have had a number of cases in the Pandas, Grasshoppers and Rainbow rooms and this causes concern and frustration for parents, staff and children. Families have primary responsibility for the detection and treatment of head lice and we will work with families to manage head lice effectively.

Some useful tips:
• Check your child’s hair on a weekly basis, using the conditioner/combing detection method to minimise the problem
• Check any siblings hair too and treat them if necessary
• Notify the centre if your child is found to have head lice and advise when appropriate treatment has commenced
• Tie back long hair

We will contact families if we observe live head lice in your child’s hair. Once your child has been treated (chemical or conditioner method) they can return to the centre.

Conditioner treatment – Comb conditioner on to dry brushed hair. This stuns the lice and makes it difficult for them to grip the hair or crawl around. Conditioner does not kill lice, but it does stun them for about 20 minutes. This allows time to comb through the hair with a lice comb. Do this every week.

Chemical method – There are a number of products on the market. Which ever one you choose, the treatment must be repeated in seven days. You must comb through the hair with a lice comb. By treating again in seven days, you are aiming to kill and comb out lice that have since hatched from eggs, which were missed during the first treatment.

For further information visit www.health.vic.gov.au/headlice

Fees are payable on all public holidays. If your child is enrolled to attend on a day that falls on a public holiday you will be able to pick up an extra day at no charge. Priority will be given to children who have accrued an extra days due to public holidays over parents requesting additional days. In lieu days are only valid for the current year. Please see room staff for picking up extra days.

An allowable absence is one where you can still claim Child Care Benefit and Child Care Rebate for a day when your child is absent. A child is allowed up to 42 absent days per financial year without your Child Care Benefit or the Child Care Rebate being affected. You DO NOT need to provide any documentation eg doctors certificates for the 42 days, however any subsequent absent days taken will need to be supported by documentation.

We are still trying to ‘formalise’ enrolments for a number of new children who have commenced care.

All children and families are required to be registered and assessed in order to claim for Child Care Benefit (CCB) and the Child Care Rebate (CCR). Once you have done this you will then be able to provide us with a Child Reference Number (CRN) and Family Reference Number. These reference numbers link you and your child to our centre through the Family Assistance Office (FAO). So, if you are intending to claim Child Care Benefit (CCB) and Child Care Rebate (CCR) to reduce your daily fee or claim CCB or the CCR as a lump sum you must register now. 

If you have completed all the necessary paperwork with the FAO and your child is still an ‘informal’ enrolment, contact the FAO on 13 61 50 and ask that you and your child are made ‘active’. If you are unsure on what to do, please see Anna in the office.