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• Children with Allergies and Asthma


• Does the program have a "no smoking" policy both inside and outside where children are present?



• Are air quality reports checked every morning to determine if air quality conditions pose a significant risk for outdoor play? If air quality is poor, how do children get exercise indoors?



• Is the building air conditioned?



• Are filters, vacuum bags and other air protection devices replaced frequently?



• Are all areas well aired, and is there a source of fresh air?



• Does the program prohibit chemical air fresheners and other strong chemicals?



• Are caregivers discouraged from using perfume and other strong scents?



• Are scented cleaning products prohibited?



• Are water leaks fixed quickly to prevent mold and insect breeding?



• Are carpet and furniture vacuumed and cleaned frequently (when children are not present)?



• How does the program get rid of dust mites?



• Are the least dangerous techniques for getting rid of pests used?



• On field trips or during transporting children, is the written care plan for a child with special needs (and emergency medicine) always brought along?



• Before any pet or animal is allowed into the program, are children's health records checked for allergies to animals?



• Are outside areas free of weeds, standing water and high grass?



• Does vigorous exercise trigger your child's asthma attacks?



• If yes, how can the caregiver make sure that your child gets the right amount of exercise?

• Children with Food Allergies
• Are all parents in the program asked to avoid bringing in foods (especially nuts) or other items that trigger an allergic reaction?



• Are parents informed of this policy at orientation?



• If there are families in the program that don't speak English well, are the health risks explained in their native language?


• Are menus changed for children with food allergies with input from the child's health care provider or a nutrition specialist/consultant?



• When introducing solid food, caregivers and parents should always exchange information on what new foods have been introduced.





Nuts, particularly peanuts and peanut butter, can cause bad allergic reactions in some children. Children, who have such allergies, could have their airways swell shut quickly. If your child only eats peanut butter and jelly sandwiches, and you have been asked to never pack a peanut butter and jelly sandwich for your child to take to child care, please understand: There probably is a child at the child care program who can have a life threatening reaction if they have contact with peanuts or even smell peanuts or peanut butter. This is a great time for you to teach your child about being a good citizen - sometimes we have to put another's needs before our own desires. Try to take this opportunity to get your child to try new foods.


• Children with Diabetes
• Who will monitor the child's blood sugar?



• Who will plan meals that are on the child's diet?



• How will insulin be given?



• How will caregivers (and substitutes) be trained to monitor, record and respond if blood sugar is low?

• Children with Fragile Immune Systems (cancer, heart problems, etc.)
• How will the child who needs extra rest be supervised when other children are not resting?



• Where will medical equipment be stored and how will other children be prevented from playing with the equipment?



• How would medical equipment be operated in the event of a power failure?



• How will other children be supervised while medical treatments are given?

• Child's Health Plan and Caregiver Training
• Has the child's health care provider developed a plan to be shared with the caregiver(s) so that your child can safely participate in the child care program?



• In the health plan, are there training requirements that need to be conducted prior to your child entering the child care program? Who will conduct these trainings? If the caregiver needs a substitute, how is that person trained?



Note: Caregivers must have training that is individualized for each child. No two children react the same way. Caregiver training should be given by a health professional (either the child's health provider or a child care health consultant/ nurse in consultation with the child's health care provider). Caregivers should demonstrate their knowledge back to the trainer. Even though the caregiver may have another child with asthma, for example, they need to be given a specific health care plan for your child that includes:


• List of conditions to avoid that trigger symptoms. Examples: No pet hair; no peanuts.



• List of symptoms that indicate the need for medicine or treatment.



• Names and doses and method of giving medications. Example: Inhalers.



• List of symptoms that indicate an allergic reaction (in case a child has a reaction to a new substance or medicine while they are in child care).


• If there is no way to train a substitute caregiver, and your child needs skilled care:



• Are you contacted (at home, the day before or early in the morning) so that you can make other arrangements for your child when your regular caregiver is going to be absent?


• Do health care plans and practice sessions include ways to keep other children safe while the caregiver is responding to an emergency?



• Are plans for immediate response to a problem kept in an easy to get to place (that still provides confidentiality to a family)?



• Have the caregivers been trained to meet a child's needs in a variety of settings? (during meals, on a field trip, etc.)



• Have caregivers demonstrated that they know how to use equipment and give medicine?


Please see the following sections in Healthy Kids, Healthy Care for information that is particularly important if you have a child with a chronic illness:


Children with Special Needs - more general questions about caring for a child with special needs.
Medicine - questions regarding how medicines are given, stored and labeled in the program.
Cleaning and Sanitizing - questions on cleaning practices to insure a healthy environment.
Selecting Child Care - resources for finding child care for children with chronic illnesses.
Sources of Health and Dental Care - resources for finding health professionals.