1. (a) No child or staff shall be admitted who has a contagious or infectious disease.

2. (b)

   1. (1) The parent or legal guardian shall be notified as soon as possible when a child has any symptom that requires exclusion from the facility.
   2. (2) The child shall be separated from other children and closely monitored until the parent arrives to pick the child up.

3. (c)

   1. (1) It is recommended that the caregiver determine if the illness:

      1. (A) Prevents the child from participating comfortably in activities;
      2. (B) Results in a greater need for care than the childcare staff can provide without compromising the health and safety of the other children; or
      3. (C) Poses a risk of spread of harmful diseases to others.

   2. (2) Temporarily exclude from child care if child has:

      1. (A) Sudden change in behavior, such as:

4. (i) Lethargy or lack of responsiveness;

   1. (ii) Unexplained irritability or persistent crying;

      1. (iii) Difficult breathing; or

         1. (iv) A quickly spreading rash;

      2. (B)

         1. (i) Fever over one hundred one degrees (101°) oral or one hundred degrees (100°) axillary (or equivalent method) in a child who also has:
5. (a) (a) Pain;

6. (b) (b) Behavior changes; or

   1. (c) (c) Other symptoms of illness.

      1. (ii) An infant younger than two (2) months with any increased temperature shall get urgent medical attention within an hour.

         1. (iii) An infant younger than six (6) months with any increased temperature shall be medically evaluated;

      2. (C)

         1. (i) Diarrhea, defined as watery or runny stools, if frequency:
7. (a) (a) Exceeds two (2) or more stools above normal for that child; and

8. (b) (b) Is not related to a change in diet or medication.

   1. (ii) Exclusion from child care is required if diarrhea cannot be contained in the diaper or if diarrhea is causing soiled clothing in toilet-trained children;

      1. (D) Blood or mucus in stools (unless caused by hard stools);
      2. (E) Vomiting illness (two (2) or more episodes of vomiting in the previous twenty-four (24) hours);
      3. (F) Abdominal pain which lasts more than two (2) hours;
      4. (G) Mouth sores with drooling;
      5. (H) Rash with fever or behavior change;

      6. (I)

         1. (i) Conjunctivitis or pink eye with white, yellow, or green eye discharge, and red (bloodshot) eyes.
         2. (ii) Exclude only if:
9. (a) (a) Child has fever;

10. (b) (b) Child has eye pain;

    1. (c) (c) Child has redness or swelling of the skin around the eyes; or

       1. (d) (d) If more than one child in the program has symptoms;
       2. (J) Pediculosis (head lice), from the end of the day until after the first treatment;

       3. (K) Active tuberculosis, until a healthcare provider or health official states that the child:

          1. (i) Is on appropriate therapy; and
          2. (ii) Can attend child care;
       4. (L) Impetigo, until treatment has been started;
       5. (M) Strep throat, until twenty-four (24) hours after antibiotic treatment has been started;
       6. (N) Chicken pox, until all lesions have crusted (usually six (6) days after the rash appears);
       7. (O) Rubella, until six (6) days after onset of rash;
       8. (P) Pertussis (whooping cough), until five (5) days of antibiotic treatment;
       9. (Q) Mumps, until five (5) days after onset of gland swelling;
       10. (R) Measles, until four (4) days after onset of rash; and

       11. (S) Hepatitis A, until one (1) week after onset of illness or as directed by the Department of Health.

           1. (d) Illness in the registered home shall be handled to protect all children in care.

11. (e)

    1. (1) In case of critical illness or injury, and if the parents cannot be reached, the physician named by the parent shall be called.
    2. (2) If necessary, the child shall be taken to the nearest emergency room.
    3. (3) Injuries that require the attention of medical personnel shall be reported to the parent immediately.
12. (f) In case of critical illness or serious injury that requires the attention of medical personnel, the childcare licensing specialist shall be notified within one (1) business day.

13. (g)

    1. (1) The caregiver shall notify the child’s parent of significant events that affect the children.

    2. (2) This shall include, but not be limited to:

       1. (A) Cases of serious contagious disease shall be reported to the parents of all the children in care; and
       2. (B) Any injury incurred by a child.

14. (h)

    1. (1) The communicable diseases listed in Appendix D, whether suspected in a child or adult, shall be reported within twenty-four (24) hours to either the:

       1. (A) Local county health unit; or
       2. (B) Toll-free reporting system (800-482-8888).

    2. (2) Immediate notification is recommended for the following:

       1. (A) Hepatitis;
       2. (B) Rash illness (including measles and rubella);
       3. (C) Whooping cough (pertussis);
       4. (D) Meningitis;
       5. (E) Mumps;
       6. (F) Tuberculosis;
       7. (G) Salmonellas (including typhoid); and

       8. (H) E.coli.

          1. (i) Reporting data shall include:
    3. (1) The reporter’s name, location, and phone number;
    4. (2) The name of the disease reported and the onset date;

    5. (3)

       1. (A) The patient’s name, address, phone number, age, sex, and the race.
       2. (B) Please spell the patient’s name;
    6. (4) The attending physician’s name, location, and phone number;

    7. (5)

       1. (A) Any pertinent clinical and laboratory information used in the diagnosis.
       2. (B) Please give the laboratory name; and
    8. (6) Any treatment information, if known.

15. (j)

    1. (1) It is recommended that universal precautions be used when handling and disposing of materials containing bodily secretions, such as wet or soiled diapers, fecal matter, etc.
    2. (2) Universal precautions shall be used when handling items contaminated by blood.
    3. (3) These items shall be disposed of separately and by using rubber gloves that shall be properly disposed of after each use.
    4. (4) Note. Hands must be washed even after gloves are used.

16. (k)

    1. (1) Within fifteen (15) days of enrollment of a child, the registered home provider shall verify that the child has been immunized as required by the department or the child cannot remain in care.

    2. (2) A current immunization schedule is provided as an insert in this publication.

       1. (l)
    3. (1) Children shall be protected from overexposure to the sun.
    4. (2) Sunscreen shall be used if needed and as directed by the parent.

    5. (3) Suntan lotions or sunscreens used for infants and toddlers and preschool children shall be:

       1. (A) Kept out of the children’s reach; and
       2. (B) Administered only with written parental permission.
    6. (4) School-age children may apply sunscreen to themselves with supervision.

    7. (5) Blanket permission may be obtained annually.

       1. (m) It is recommended that the facility have an automated external defibrillator on-site.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules contained the following at the end of subdivision (k)(1): “(Arkansas code § 20-78-206 as amended by Act 870 of 1997).”.