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The Daily
Morning Health Check
Perform a quick health
assessment of each child every day upon arrival and before the parent
leaves. This allows you to make a judgment about what is normal or not for
each child, rather than to diagnose an illness. It also identifies
problems early.
Providers should do their
quick check not in a formal exam routine, but as a casual observation of
the child in their initial contact as they welcome the child. You are
checking easily observable, simple signs of well-being. A health check is
not a medical examination. It is not the way to enforce your policies with
a parent. It is not a way to find reasons to exclude children. Exclusion
of a child may result from a quick check observation and your follow-up,
but your goal is to know your children better and to provide good care.
In a child care setting
where lots of people are coming at the same time, it is hard to take a
moment with each child. However, this welcoming routine can establish many
things and is good child development policy. This contact will help you
better understand each child, help the child feel comfortable and good
about themselves, reduce the spread of illness by excluding children with
obvious signs of illness, and foster better communications with parents.
Signs to observe
When conducting a morning
health check, you should watch for the following:
- General mood (happy,
sad, cranky)
- Activity level
(sluggish, sleepy)
- Skin color and
temperature
- Unusual spots or rashes
- Swelling or bruises
- Sores
- Severe coughing,
sneezing
- Discharge from nose,
ears or eyes
- Breathing difficulties
- Unusual behavior
You should use all your
senses to check for signs of illness:
Listen to what the child
and parents tell you about how the child is feeling. Is the child’s
voice hoarse, is he having trouble breathing, or is he coughing?
Look at the child from down
at their level. Observe for signs of crankiness, pain, discomfort or being
tired. Does the child look pale, have a rash or sores, a runny nose or
eyes?
Feel the child's cheek and
neck for warmth, clamminess or bumps as a casual way of greeting. Smell
the child for unusual odor in their breath, diaper or stool.
Using findings to make
decisions
If you have concerns about
how a particular child looks or feels, discuss them with the parent right
then. Perhaps the parent needs to take the child home. Perhaps you feel
strongly that the child should leave. If you decide that the child will
remain, be sure to discuss how you will care for the child and at what
point you will call the parent. It is your decision, not the parents',
whether the program will accept responsibility for the ill child. If the
child stays all day, make sure you inform the parent about changes in the
child's health status. Simple information about activity level, appetite,
food intake, bowel movements and nap-time can be invaluable to the family.
Contrary to popular belief
and practice, only a few illnesses require exclusion of sick children to
ensure protection of other children and staff.
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