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Illness & Wellness Policy

Illness & Wellness Policy

When to Keep Your Child Home from School 

It's crucial to recognize when your child is too sick for school to ensure their well-being and prevent the spread of illness. 

  • Keep Them Home If They Have: 

  • Fever (100.4 F or above) 

  • Cough 

  • Vomiting 

  • Diarrhea 

  • Contagious disease 

 

Medication Needs: If your child requires medication to manage symptoms, it might be a sign they need to stay home. In some cases, we may advise consulting with your healthcare provider before returning to school. 

Current Outbreaks: We'll communicate any information about illness outbreaks at school and within the community. 

If Your Child Becomes Sick at School 

  • Immediate Care: We'll do our best to care for them and follow our "How Sick is Too Sick" policy. 

  • Pick-Up: For certain illnesses, we'll contact you to pick them up promptly. Please ensure your contact information is up to date with the front desk. 

  • Your Cooperation: We appreciate your timely response in picking up your ill child, so they can rest and recover. 

 

Please consult the resource below for more details, and don't hesitate to contact us with any concerns! 

  • General Exclusion Requirements

    Children and staff must be excluded from schools and childcare facilities when they have certain symptoms of illness, including if they are unable to participate or perform the functions required for their position. 

    A “child” means any child enrolled in the childcare program or a student at a school.

    A “staff member or staff” means any person working or volunteering to perform duties in a childcare facility or school.

    Symptoms that require exclusion are listed in the attached document; How Sick is Too Sick? When Children and Staff Should Stay Home from Child Care (How Sick is Too Sick). The Colorado Department of Public Health and Environment’s Infectious Diseases in Child Care and School Settings (Infectious Disease Guide) will be used to determine exclusion for symptoms of illness not included in How Sick is Too Sick.  There may be additional requirements for specific illnesses like COVID-19 symptoms and illnesses per the federal, county, and town of Telluride guidelines.

    Excluding Children

    Staff is responsible for observing children at drop-off and throughout the day for signs of illness. If a child arrives at the facility or school with signs of illness that require exclusion, they may not be accepted. If a child develops symptoms of illness that require exclusion during the time of care, the parent/guardian will be contacted to pick up the child. The child will be provided with a place to rest which is separate from the other children until the parent/guardian arrives. The child may return to childcare, or school based on the requirements in How Sick is Too Sick, the Infectious Disease Guide, or as directed by their healthcare provider or public health professional.

    Information will be recorded on an illness log when children are sent home due to symptoms of illness that require exclusion. All items used to care for the child (cot, bedding, etc.) will be cleaned and sanitized or cleaned and disinfected if contaminated by body fluids after the child leaves the childcare or school. The date and time when the child returns to the childcare facility or school will be recorded on the illness log. 

    Excluding Staff

    The person in charge of staff is responsible for observing the staff for signs of illness throughout the day. Staff members have the responsibility of reporting, to the person in charge, any signs of infection or illness that may pose a hazard to the health of children and other staff. If a staff member is not well enough to work, they may return based on the requirements in How Sick is Too Sick, the Infectious Disease Guide, or as directed by their health care provider or public health professional.

    Outbreaks

    When a school or childcare facility has a child or staff member with an illness that is required to be reported to the health department, the health department will be contacted immediately. Outbreaks of illness must also be reported to the health department when there is a larger number than normal of children or staff ill with the same symptoms. For example, above normal seasonal absenteeism for a school or childcare facility would be concerning and the health department will be contacted. The health department will also be contacted when there are two or more people who do not live together and are ill with symptoms including vomiting, diarrhea, or jaundice.  

    Food Handling Staff Exclusion Requirements

    Special attention will be given to staff members who handle food because many illnesses can be spread through food from an infected person. Food handling activities include the preparation of any food (i.e. washing, cutting, cooking, and portioning), the mixing and feeding of bottles, and feeding infants and toddlers solid foods.

    Food handling staff must notify the person in charge:  

    1. If they exhibit any of the following symptoms:
      1. Vomiting;
      2. Diarrhea;
      3. Jaundice;
      4. Sore throat with fever; or
      5. Any open or draining wound that is not covered with a waterproof bandage and is:
    1.  On the hands or wrists*;
    2. On any exposed portions of the arms; or
    3. On other parts of the body.   

    *In addition to waterproof bandages covering wounds on hands and wrists, single-service gloves must be always worn when handling food. 

    1. Has an illness diagnosed by a health care provider due to:
      1. Norovirus
      2. Hepatitis A virus
      3. Shigella
      4. Shiga Toxin-Producing Escherichia Coli (e-coli)
      5. Typhoid fever (caused by Salmonella Typhi) or
      6. Salmonella 
    2. Has been exposed to, or is the suspected source of, a confirmed disease outbreak or living in the same household as someone who works or attends a setting where there is a confirmed outbreak. 

    Staff will be allowed to return to work based on requirements in How Sick is Too Sick, the Infectious Disease Guide, as directed by the health department, or as directed by a health care provider, or public health professional.

  • Download the How Sick is Too Sick Guidelines by CDPHE (English/Spanish)

     

    There are four main reasons to keep children and adults at home:

    1. The child or staff is at risk of infecting others with a contagious illness, either because of symptoms, diagnosis, or recent exposure to a contagious illness.
    2. The child or staff member does not feel well enough to take part in usual activities. For example, a child is overly tired, fussy, or will not stop crying.
    3. A child needs more care than teachers and staff can give while still caring for the other children.
    4. The child or staff member who has symptoms or an illness is on this list, and staying home is required.

    When to seek emergency medical attention:

    • Trouble Breathing
    • Persistent pain or pressure in the chest
    • Confusion
    • Inability to wake or stay awake
    • Pale, gray, or blue-colored skin, lips, or nail beds, depending on the skin tone

    These are not all possible indications of a medical emergency, Call 9-1-1 or your health care provider for any any other documents that are severe or concerning to you.

     

    Guidance for Symptoms Not Due to a Specific Disease

    Child or staff must stay home?

    Severe or new cough, including croup

    Yes – Severe cough is often present in people with infectious respiratory illness. A person with severe, uncontrolled coughing, wheezing, or rapid or difficulty breathing (if new or worsening from baseline) should not attend school or childcare and should talk to a healthcare provider.

    If all symptoms are consistent with the usual symptoms of a known chronic condition and the person is otherwise well enough to return to school, no further evaluation is necessary.

    Students and staff may return to school, even if the cough is not fully resolved, as long as exclusion is not required for other symptoms or diagnosis.

    Diarrhea

    Frequent, loose, or watery stools (poop) compared to normal ones that are not caused by food or medicine.

    Yes – Unless the diarrhea is related to an existing chronic condition, is explained by a diagnosed condition not requiring the person to stay home, or is consistent with the person's baseline.

    The child or staff member may return to school or childcare 24 hours after their last episode of diarrhea unless the diarrhea is caused by an illness that requires them to stay home longer. If a specific illness explains the diarrhea, then the child or staff can return to school or childcare following exclusion guidelines for that illness.

    Fever

    Fever is a temperature of 100.4°F or greater. Babies who are 3 months or younger need to see a healthcare provider right away for a fever of 100°F or higher. Call your healthcare provider for any fever in an infant aged 6 months or younger.

    Yes – The child or staff member may return to school or child care if the fever has been resolved for 24 hours without fever-reducing medications unless the fever is caused by an illness that requires them to stay home longer.

    If the fever is consistent with the usual symptoms of a known chronic condition and the person is otherwise well enough to return to school, no further evaluation is necessary.

    A temporary, elevated temperature due to overexertion or overdress, without other symptoms of illness, should not be considered a fever.

    Read Children’s Hospital Colorado’s recommendations on fever care for children for more information about fever.

    Flu-like Symptoms

    Fever with sore throat or cough

    Other flu symptoms can include runny nose, congestion, fatigue, body aches, vomiting, and diarrhea.

    Yes – Children and staff may return to school or childcare as long as they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms are improving, unless the symptoms are caused by an illness that requires them to stay home longer. If a specific illness can explain the symptoms, then follow the exclusion guidelines for that illness.

    In consultation with a healthcare provider, additional evaluation for flu-like illnesses, sore throat, and upper respiratory symptoms may be appropriate, including evaluation for strep throat.

    Vomiting

    Yes – Unless the vomiting is related to an existing chronic condition or is explained by a diagnosed condition not requiring the person to stay home. If the vomiting is unexplained and inconsistent with the person’s baseline state of health, the child or staff member may return 24 hours after the last episode of vomiting. If the vomiting can be explained by a specific illness, then follow the exclusion guidelines for that illness.

    If a child with a recent head injury vomits, seek medical attention.

     

     

    Guidance for Specific Diagnosed Illnesses

    Child or staff must stay home?

     

    Chicken Pox

    Yes – until the blisters have dried and crusted (usually 6 days), or in immunized people without crusting, until no lesions within 24-hour period.

     

    Conjunctivitis (pink eye) Pink color of the eye and thick yellow/green discharge

    No – Children and adults do not need to stay home unless they have a fever or are not able to participate in usual activities. Call your doctor for advice and possible treatment.

     

    Fifth’s Disease (parvovirus)

    No – the illness is no longer contagious once the rash appears.

     

    Hand Foot and Mouth Disease (Coxsackie virus)

    No – unless the child or adult meets other exclusion criteria, is drooling uncontrollably has mouth sores, or is not able to take part in usual activities.

     

    Head Lice or Scabies

    Yes – children may stay at school or childcare until the end of the day but cannot return until after they have had the first treatment.

     

    Hepatitis A, Salmonella, Shigella, or Shiga-toxin Producing E. coli

    Yes – children and staff may return to school or childcare when cleared by the health department.

     

    Herpes

    No – unless there are open sores that cannot be covered or there is uncontrollable drooling.

     

    Impetigo

    Yes – children and adults need to stay home until 24 hours after antibiotic treatment has started.

     

    Norovirus

    Yes – exclude children and staff for at least 48 hours after their last episode of vomiting and/or diarrhea. During the outbreak of confirmed or suspected norovirus, exclusion may be increased to 72 hours after the last episode of vomiting and /or diarrhea.

     

    Ringworm

    Yes - children may stay at school or childcare until the end of the day but cannot return until after they have had the first treatment. Keep the area covered for the first 3 days if participating in activities with person-to-person contact.

    Roseola No - Exclusion is not necessary unless there is a fever or behavior changes.

    Respiratory viruses

    COVID-19, influenza, RSV (Respiratory Syncytial Virus)

    Yes - Children and staff should remain out of school or child care until they are fever-free for 24 hours without the use of fever-reducing medications and other symptoms have been
    improving for 24 hours.

    Additional precautions are recommended for at least five days following the return of anyone recovering from respiratory symptoms, including hand and respiratory hygiene, improved ventilation, masking, physical distancing, and testing.

    Refer to CDC’s Respiratory Virus Guidance for additional information.

    During an outbreak or when case rates are high, exclusion times may be increased to protect hospital capacity.

    Strep Throat Yes - for 12 hours after starting antibiotics.
    Other Vaccine-Preventable Diseases Measles, Mumps, Rubella (German Measles), Pertussis (Whooping Cough) Yes – Children and staff can return to school once they are no longer contagious (see Infectious Disease Guidelines). Public health consultation may be necessary.

    Yeast Infections

    Thrush or Candida diaper rash

    No - Follow good hand washing and hygiene practices.

    Other

    Symptoms or illnesses not listed

    Contact the childcare center director or school health staff to see if the child or staff member needs to stay home (see Infectious Disease Guidelines). Public health consultation may be necessary.
     

     

     

    This document was developed in collaboration with pediatricians, medical epidemiologists, and public health professionals.

    The information presented is intended for educational purposes only. It is not intended to take the place of your personal doctor’s advice and is not intended to diagnose, treat, cure, or prevent any disease. The information should not be used in place of a visit, call consultation, or advice of your doctor or other health care provider.

    References

    American Academy of Pediatrics. Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. Aronson SS, Shope TR, eds. 5th ed. Itasca, IL: American Academy of Pediatrics; 2020.20.

    Colorado Department of Public Health and Environment. Infectious Diseases In Child Care and School Settings: Guidelines for Child Care Providers and Health Consultants, School Nurses, and Other Personnel. 2022.

    Colorado Department of Public Health and Environment. COVID-19 Resources. https://covid19.colorado.gov/. September 2023.

  • Please refer to our How Sick is Too Sick Guidelines (Spanish)

    (From “Infectious Diseases in Child Care and School Settings,” CDPHE, December 8, 2023)

    What is SARS-CoV-2 Disease (COVID-19)?

    COVID-19 is a respiratory disease caused by SARS-CoV-2, a coronavirus discovered in 2019 that caused a worldwide pandemic. Different variants of the virus emerged throughout the pandemic. 

    Signs and symptoms

    The signs and symptoms of COVID-19 can vary based on the variant causing the illness.

    • Fever (100.4°F or higher)
    • Fatigue
    • Headache
    • Myalgia
    • Cough
    • Nasal congestion or rhinorrhea
    • New loss of taste or smell
    • Sore throat
    • Shortness of breath or difficulty breathing
    • Abdominal pain
    • Diarrhea
    • Nausea or vomiting
    • Poor appetite or poor feeding
    • Children infected with SARS-CoV-2 may have many of these nonspecific symptoms, only have a few (such as only upper respiratory symptoms or only gastrointestinal symptoms), or may be asymptomatic. The most common symptoms in children are cough and/or fever.

    Incubation period

    The incubation period for COVID-19 is thought to extend to 14 days, with a median time of onset of four to five days. The incubation period may be shorter or longer depending on the variant that is circulating. 

    Contagious period and spread

    • A person is assumed to be contagious two days before they start having symptoms and for 10 days after symptoms start.
    • In children too young or unable to reliably report their symptoms, parents/guardians, caregivers, and teachers should monitor for symptoms and other age-appropriate signs of disease, including decreased appetite or activity. 
    • Symptomatic individuals should be tested as soon as possible after symptoms develop and seek clinical evaluation if symptoms become severe or concerning (such as trouble breathing).

    Public health reporting requirements

    • Per 6 CCR 1009-1, clinical labs and/or health care providers are required to report positive COVID-19 test results to public health. If school personnel perform and interpret rapid testing on-site, they are functioning as a clinical lab and are required to report positive results. Per 6 CCR 1009-1, schools and childcare facilities are also required to report single COVID-19 cases of which they become aware to public health, even if testing was performed elsewhere. Schools are able to disclose this information to public health without prior written consent under FERPA’s health or safety emergency exception because a person with COVID-19 represents a potential threat to the health and safety of others at the school. This is true even if there is not an outbreak.
    • New variants could emerge and alter the infectivity or severity of the virus. If this does occur, public health may interview the people who have COVID-19 and conduct contact tracing to determine who might be close contacts of the case to make recommendations about mitigation strategies.   
    • Outbreaks of COVID-19 can cause significant increases in absenteeism among staff and students. Outbreak thresholds may be difficult to determine in school or childcare settings. However, significant increases in school or childcare absenteeism resulting from COVID-19-like illness should be reported to local public health agencies within four hours, per 6 CCR 1009-1.
    • Generally speaking, a situation is considered an outbreak if there is an increase in the number of ill children and/or staff members at the school or childcare center. 
    • Schools and childcare providers can report outbreaks by:

    Control of spread

    • The virus spreads mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, or talks. Some people who are infected may not have symptoms. 
    • The state continues to recommend a layered approach of best practices to prevent COVID-19 outbreaks. These best practices to prevent the spread of COVID-19 and other respiratory viruses include vaccination, staying home when sick (isolation and exclusion), increased ventilation, handwashing, cleaning, and disinfection.
    • Additional strategies can be used in response to increases in cases and when outbreaks are detected, including maximization of outdoor activities, mask-wearing, testing, limiting large and crowded gatherings, and mixing between grades, classrooms, and other groups. These strategies continue to be important for preventing the transmission of many infectious diseases in schools.

    Treatment

    Treatment of COVID-19 in hospitalized patients remains largely supportive and includes management of complications. NIH treatment guidelines recommend Paxlovid or remdesivir for children aged 12-17 who are at high risk of progression to severe COVID-19. Remdesivir can also be considered in those <12 (aged ≥28 days and weighing ≥3 kg). 

  • Please refer to our How Sick is Too Sick Guidelines (Spanish)

    Questions or Testing:  Call your provider.  Ensuring people who are ill stay home (and people with COVID-19 follow isolation requirements, regardless of vaccination status) is critical to preventing the spread of COVID-19.

    • People with COVID-19 should isolate themselves for at least five full days to protect others.
    • After staff or students have ended isolation, when they are feeling better (no fever without the use of fever-reducing medications and symptoms improving), they should either:
      • Wear a mask through day 10, or
      • If they have access to antigen tests, use them. With two sequential negative tests 48 hours apart, staff or students may remove their masks sooner than day 10.