Excluding children with mild illnesses is unlikely to reduce the spread of most germs. Most germs are spread by children who do not have symptoms. Children frequently carry contagious germs that do not limit their activity nor pose a threat to others. Three key measures to prevent the spread of germs are handwashing, surface/sneeze/cough hygiene and keeping immunizations up to date.
State regulations may differ from national recommendations. Updating the regulations can take a long time. The regulations are legal requirements. Staff must follow them.
Usually, a health care provider’s note is not necessary to readmit a child. A note is only necessary if the program needs more information about the child’s condition or need for special care. Current Pennsylvania regulations require a note for return to care if the child was excluded for a condition that is a threat to the health of others as specified in 28 Pa Code Chapter 27. If uncertain about whether the condition that required the child’s exclusion poses a threat to others, ask the local or state health department whether a note should be required from the child’s health care provider.
For more information regarding inclusion/exclusion see
• Caring for Our Children, (CFOC) Standard 188.8.131.52 - Inclusion/Exclusion/Dismissal of Children adapted from Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide
• Chapter 5: Signs and Symptoms Chart in Managing Infectious Diseases in Child Care and Schools: A Quick Reference Guide. This publication is available from the American Academy of Pediatrics Updated 4-2019