Want
to know more?
• Why
the health and well being of your caregiver is important:
- Children model what they see - Healthy caregivers
doing healthy things will help your children learn good attitudes
and behaviors.
- Caregivers' work is demanding both emotionally and physically. They have
to enjoy being around children, have lots of energy, form attachments, put children's
needs before their own, be creative, be flexible, move quickly, sit
on the floor, lift children and equipment, transfer children to car
seats, position children
with special needs, hear and see while supervising. They can't do
all this and more if they are not physically healthy and mentally
prepared.
- Caregivers with health insurance are more apt to get preventative health
care services and treatment for injuries and illnesses, reducing
the need to miss work. The fewer times your caregiver misses work, the better
for
your
child. Source: The Milbank Quarterly (2003) (http://www.milbank.org/quarterly/8101feat.html)
• Have caregivers received training on ways to promote health and prevent injuries for both children and themselves? Do they practice what they have learned?
Topics that should be covered in training:
- Good handwashing and diapering procedures.
- Appropriate handling of blood and body fluids (known as "Standard precautions").
- First aid and emergency preparedness procedures.
- Proper methods for lifting and bending to reduce back injuries.
- Good nutrition practices.
- Good dental health practices.
Note: Bacteria that contribute to dental decay can be transmitted from
caregivers to infants (For example: coughing and kissing). Caregivers with active tooth decay are more likely to
transmit these bacteria to children.
- Up-to-date immunizations.
- Health risks in child care settings.
• Have caregivers received training on social and emotional issues? Do they practice what they have learned?
Examples:
- Methods of handling aggressive behaviors and other
emotional issues.
- Awareness of and willingness to integrate diverse cultural traditions
of the children and their families.
- Promoting positive emotional health of children.
- Program planning, including how to move from one activity to another.
- Techniques for managing groups of children.
- What children like and need at each stage of development (known as "developmentally
appropriate practice").
- Caring for and appreciating the contributions children with special needs
bring to a program.
• Does
the child care program promote a healthy work environment?
Examples:
- Work stations and equipment that reduce back injuries
and falls. Diapering changing stations are at appropriate
heights and small, stable step-stools are available
for children to use for climbing on to a changing table instead
of being lifted.
- Using adult sized furniture like chairs and desks for caregivers.
- Using non-toxic substances (such as non-toxic art supplies).
- Eliminating the exposure to toxic substances such as making sure that
pesticides are applied when caregivers and children are not in
the facility.
- Testing for lead, radon, carbon monoxide and asbestos.
- Fresh air is circulated (to minimize indoor pollution from cleaning products,
diaper odor, etc.).
- Noise levels are reduced by using carpeting, curtains and/or sound absorbing
building materials.
- Temperature and lighting are adjusted to promote comfort.
- Soaps, gloves, and non-scented lotions and creams are available and within easy access to the caregiver (not children)
that protect caregivers' hands from the chapping caused by frequent
handwashing.
- Buildings are secure from outside visitors. A system is in place to allow
parents and authorized individuals to visit.
- Facilities are clean and maintained.
- Smoking is not allowed inside or outside of the program or wherever children are present.
• How
is caregiver stress reduced and dealt with in the child care setting?
- Ongoing training is provided on new skills and knowledge
needed to work with children (Example: training on asthma
control when a child with asthma joins the program).
- Breaks are taken from caregiving and other duties during the
day.
- A staff lounge, separate from the child care area, is available.
- Communication is encouraged and supported among the caregivers, administration,
and the parents. The workplace culture promotes positive solutions and
discourages criticism and blame.
- Training is provided on stress management techniques.
- Dependable substitutes are available so that caregivers can stay home
when sick or take needed vacation without "feeling guilty" or being afraid
that they will receive negative feedback from their supervisor.
- A fair salary and basic benefits help to
reduce caregiver stress. All caregivers should receive:
- Wages that fairly pay for skills, knowledge
and responsibilities and that are competitive with similar
requirements in
other jobs.
- Affordable health insurance.
- Sick leave.
- Vacation leave.
- Social security or other retirement plan.
- Worker's compensation.
- Holidays.
- Personal leave.
- Educational benefits.
- Family, parental and medical leave.
- Access to a child care health consultant and other experts
for help with:
- Stress management techniques.
- Concerns about the health, development, well-being and behavior of children.
- Employee conflicts with other staff or parent consumers.
- How to locate a source of health care for themselves and their family. See Sources
of Health and Dental Care Section.
- Help in specific health concerns and referrals to community resources.
See Child Care
Health Consultants Section for more information.
• When
should a caregiver be excluded due to illness?
A caregiver should NOT come to work if they have the following:
- Chickenpox (Varicella-Zoster), until all sores have
dried and crusted (usually 6 days).
- Diarrhea-- three or more episodes of diarrhea during
the past 24 hours or blood in stools, until diarrhea stops.
- Adults with diarrhea caused by Shigella or E.
coli must stay home until
2 stool cultures test negative.
- Head lice (Pediculosis), from the end of the work day
until after the first treatment.
- Hepatitis A virus, until 1 week after onset of illness,
jaundice, or as directed by the health department when passive
immunoprophylaxis (currently, immune serum globulin) has been administered to
appropriate
children and staff members.
- Impetigo, until 24 hours after treatment has been initiated.
- Measles, until 4 days after onset of rash.
- Meningococcal infection, until all caregivers, for whom
antibiotic prophylaxis has been recommended, have been treated.
- Pertussis, until 5 days of appropriate antibiotic treatment
have been completed.
- Pink eye - Purulent conjunctivitis (defined as pink or red conjunctiva
with white or yellow eye discharge), until 24 hours after treatment
has been initiated. In epidemics of pink eye without pus, exclusion shall
be required
only if the health authority recommends it.
- Rash with fever or joint pain, until diagnosed not to
be measles or rubella.
- Respiratory illness, if the illness limits the caregiver's
ability to provide an acceptable level of care and compromises
the health and safety of the children.
- Rubella, until 6 days after onset of rash.
- Scabies, until after treatment has been completed.
- Shingles (herpes zoster), only if lesions can not be
covered by clothing or a dressing (until the lesions have crusted).
- Strep throat or other streptococcal infection, until
24 hours after initial antibiotic treatment and end of fever.
- Tuberculosis, until a health care provider or health
official states that the caregiver is on appropriate therapy
and can return.
- Vomiting - two or more episodes of vomiting in the previous
24 hours - until vomiting stops or it is determined that the
cause of the vomiting is not contagious such as pregnancy or a stomach disorder.