Health Care Policy

The following sections are excerpted from The Chilmark Preschool Health Care Policy.  The complete Health Care Policy is kept on the Preschool premises and is available upon request.

CONTINGENCY PLANS FOR EMERGENCY SITUATIONS

Missing Children:

Should a child be missing from the Preschool the Director will immediately contact 911 and the child’s parents. If the child’s parents cannot be reached, the contacts listed on the child’s First Aid and Emergency Medical Care Consent Forms will be contacted.

Emergency Evacuation Plan:

  • Emergency Evacuation Plans will be posted at all exits.
  • During an emergency evacuation a teacher will be responsible for leading children out of the building. The Director will assist in the evacuation and check for stragglers.
  • The Director will make a visual inspection of the classroom and obtain the Off-Site Emergency Information Notebook, which includes daily attendance records and First Aid and Emergency Medical Care Consent Forms for all children, before exiting the building.
  • The children will be led to The Chilmark Community Center. The Director will take attendance and ensure that all children are accounted for.
  • Reasons for emergency evacuations include, but are not limited to, fire, power outage, loss of heat or water and natural disasters. If loss of power, heat and/or water occurs while children are in care and is unlikely to return within 2 hours, the Preschool will be closed. Parents will be notified and asked to pick up their children immediately.
  • The Director, in conjunction with The Chilmark School Principal, will contact all appropriate Chilmark licensing boards and emergency agencies. The Preschool will remain closed until all involved agencies have approved reopening.
  • The Director will notify the EEC of any evacuations and/or closures within 24 hours.
  • The Director will conduct emergency evacuation drills monthly at different times of the program day, under varied weather conditions and using different evacuation routes.
    • The Director will maintain documentation of the date, time and effectiveness of each drill in the Emergency Evacuation Log. This documentation will be maintained for 5 years.

Plan for Managing Illnesses/Infections/Communicable Diseases: 

  • A child will be excluded from care if he or she displays any of the following symptoms:
    • an illness that prevents the child from participating in program activities or resting comfortable
    • an illness that results in greater care need than the Preschool staff can provide without compromising the health and safety of other children
    • fever of 101 degrees or higher, until child has been without fever for 24 hours
    • unusual lethargy, irritability, persistent crying, difficulty breathing or other signs of serious illness
    • persistent diarrhea
    • vomiting, until maintaining a 24 hour period without vomiting
    • mouth sores, unless the child’s physician states that the child is non-infectious
    • rash with a fever or behavior change, until the child’s physician has determined that the illness in a non-communicable disease
    • purulent conjunctivitis (defined as pink or red conductive with white or yellow discharge, often with matted eyelids), until examined by a physician and approved for readmission with or without treatment
    • tuberculosis, until the child is non-infectious
    • impetigo, until 24 hours after treatment has started
    • pinworm, until 24 hours after treatment has started
    • head lice, until free of all nits or scabies and free of all mites
    • strep infection, until 24 hours after treatment has started and the child has been without fever for 24 hours
    • chicken pox, until the last blister has healed over
  • The Preschool Director may make the final decision concerning the inclusion or exclusion of the child. 
  • In accordance with The Department of Public Health, The Preschool Director will notify the Department of Public Health and all enrolled families immediately, and in writing when any communicable disease or illness has been introduced into the program. Whenever possible, written information will be made available. Children who have not been immunized will be excluded from care for the duration of the incubation period.

Infection Control:

All teachers at The Chilmark Preschool will be trained in infection control procedures.

  • Teachers will educate children about and promote hand washing procedures and health precautions.
  • All teachers and children will wash their hands with liquid soap and running water, using friction, in accordance with DPH guidelines. Hands will be dried with individual or disposable towels or an automatic hand blow dryer. Common towels will not be used. Teachers and children will wash their hands at least at the following times:
    • before and after water play
    • before eating or handling food
    • after toileting or diapering
    • after coming into contact with bodily fluids or discharges (including sneezing or coughing)
  • In addition, all teachers will wash their hands at the following times:
    • before and after the administration of medication
    • after performing cleaning tasks, handling trash or using cleaning products
    • Facilities used for hand washing after toileting or diapering will be separate from facilities and areas used for food preparation and food service.
    • Equipment, materials, items and surfaces (including floors, walls and clothing used for dramatic play) are washed with soap and water and disinfected as needed to maintain a sanitary environment.
    • All floors used by children will be swept and/or vacuumed daily.
    • All eating surfaces will be washed and disinfected before and after each use.
  • Where applicable, the following items, equipment and surfaces will be washed and disinfected after each use:
    • toilet training chairs which have first been emptied into a toilet
    • sinks and faucets used for hand washing after the sink is used for rinsing a toilet training chair
    • diapering surface
    • mops used for cleaning bodily fluids
    • water table and water play equipment
    • Toys mouthed by a child will be set aside and stored after each use and will not be used by another child until they are washed and disinfected.
    • Personal items intended for individual use by children, including but not limited to pacifiers, toothbrushes and sleeping materials, will be labeled with the name of the child for whom they are intended.
  • The following items will be monitored for cleanliness and washed and disinfected at least daily:
    • toilets and toilet training chairs
    • containers, including lids, used to hold soiled diapers
    • sinks and sink faucets
    • drinking fountains
    • play tables
    • washcloths and towels
  • The following will be washed and disinfected at least weekly:
    • cots and other approved sleeping equipment
    • sheets, blankets or other coverings
    • machine washable fabric toys
    • smooth surfaced, non-porous floors
    • mops used for cleaning
    • The disinfectant solution used to disinfect preschool items, equipment and surfaces will be either a bleach solution prepared by EEC guidelines or a commercially prepared disinfectant that has been registered as a sanitizing solution by the EPA.
    • All disinfectant solutions will be stored in accordance with manufacturer’s directions and in a secure place out of the reach of children.
    • Disposable non-latex gloves will be used for the clean up of blood or bodily fluids. The affected area will be disinfected. Used gloves and any other materials containing blood or other bodily fluids must be thrown away in a lined, covered container. Teachers will wash their hands thoroughly with soap and water after cleaning up the contaminated area. Contaminated clothing must be sealed in a plastic container or bag, labeled with the child’s name and returned to the parent at the end of the day.
    • Individual towels or washcloths will be stored open to the air and not touching each other.
    • Children will use individual, labeled toothbrushes, which will be replaced every 90 days. Toothbrushes will be stored in a safe and sanitary manner open to the air without touching each other.

Injury Prevention:

  • Every morning the Director and teacher(s) will assess the safety of the classroom environment and remove any potential hazards. 
    • The Director will monitor the outdoor playground, remove potential hazards and report needed repairs or unsafe conditions to The Town of Chilmark.
  • Liquids, foods and appliances that are or become hot enough to burn a child will be kept out of reach of the children.
  • The use of any substance that may impair a teacher’s alertness, judgment or ability to care for children during preschool hours is prohibited.
  • Drinking alcoholic beverages and smoking on preschool grounds during preschool hours is prohibited.
  • The Director will ensure that the following are easily and readily available at all times and accompany the children anytime they leave the facility in the care of staff.
  • a first aid kit
  • current family contact information
  • information about allergies and known medical conditions
  • emergency or life-saving medications, such as asthma inhalers and epinephrine auto-injectors, for any children for whom they have been prescribed
  • telephone numbers for emergency services
  • authorization for emergency care for each child
  • The Director will maintain adequate first aid supplies, including, but not limited to: adhesive tape, band-aids, gauze pads, gauze roller bandage, disposable non-latex gloves, instant cold-pack, scissors, tweezers, thermometer, and CPR mouth guard.
  • The Director will maintain a record of any unusual or serious incidents, including but not limited to behavioral incidents, injuries, property destruction or emergencies.  These reports will be reviewed on a monthly basis.
  • Teachers will check children’s clothing to ensure that it is free from strings, laces or jewelry that could become entangled or wedged in playground equipment and present a strangulation hazard.
  • Teachers will protect children against cold, heat and sun injury.

Medication:

  • Every teacher who administers prescription or non-prescription medication to a enrolled child during school hours will be trained to verify and to document that the right child receives the proper dosage of the correct medication designated for that particular child and given at the correct time(s) and by the proper method.  Every teacher who administers medication (other than topical medication) will demonstrate competency in the administration of medication before being authorized by the Director to administer any medication.
  • At least one teacher with training in medication administration will be present at any and all times when children are in care.
  • Every teacher who administers any medication, other than oral or topical medications and epinephrine auto-injectors, will be trained by a licensed health care practitioner and will demonstrate annually to the satisfaction of the trainer, competency in the administration of such medications. 
  • Every teacher, including those not authorized to administer medication, will be trained in recognizing common side effects and adverse interactions among various medications and potential side effects of specific medications being administered in the program.

Medication Administration:

  •  All medication administered to a child, including but not limited to oral and topical medications of any kind, either prescription or non-prescription, must be provided by the child’s parent.
  • All prescription medications must be in the containers in which they were originally dispensed and with their original labels affixed. Over the counter medications must be in the original manufacturer’s packaging.
  • Teachers must not administer any medication contrary to the directions on the original container, unless so authorized in writing by the child’s licensed health care practitioner. Any medications without clear instructions on the container must be administered in accordance with a written physician or pharmacist’s descriptive order.
  • Unless otherwise specified in a child’s individual health care plan, teachers will store all medications out of the reach of children and under proper conditions for sanitation, preservation, security and safety during the time the children are in care and during the transportation of children.
  • Those medications found in United States Drug Enforcement Administration (DEA) Schedules II-V will be kept in a secured and locked place at all times when not being accessed by an authorized individual.
  • Prescription medications requiring refrigeration will be stored in a way that is inaccessible to children in a refrigerator maintained at temperatures between 38 and 42 degrees F.
  • Emergency medications such as epinephrine auto-injectors will be stored in a place inaccessible to children, but will be immediately available for use as needed.
  • When possible all unused, discontinued or outdated prescription medications will be returned to the parent by the Director and the return will be documented in the child’s record. When return to the parent is not possible or practical, such prescription medications will be destroyed and the destruction recorded by the Director in accordance with the Department of Public Health, Drug Control Program.
  • Teachers will not administer the first dose of any medication to a child, except under extraordinary circumstances and with parental consent.
  • Each time a medication is administered, the teacher will document in the child’s record the name of the medication, the dosage, the date, the time and the method of administration and who administered the medication.
  • Teachers will administer medications in accordance with the consent and documentation requirements outlined by the EEC 7.11(2)(1)1-5. These guidelines will be posted in a place accessible to all teachers and included in the Parent Handbook.
    • Prescription Medication
      • Parents will fill out the Authorization for Medication form and a copy will be maintained in the child’s record.
      • Health care practitioner authorization is required.
      • Administration must be logged and include name of child, dosage, date, time, method of administration and staff signature.  Missed doses must be noted along with the reason(s) why the dose was missed.
    • Oral Non-Prescription Medication
      • Parents will fill out the Authorization for Medication form and a copy will be maintained in the children's record.
      • Health care practitioner authorization is required.
      • Administration must be logged and include name of child, dosage, date, time, method of administration and staff signature.  Missed doses must be noted along with the reason(s) why the dose was missed.
    • Unanticipated Non-Prescription for mild symptoms (e.g., acetaminophen, ibuprofen, antihistamines)
      • Parents will fill out the Authorization for Medication form and a copy will be maintained in the child’s record. This form will be renewed annually.
      • Health care practitioner authorization is required.
      • Administration must be logged including name of child, dosage, date, time and staff signature.
    • Topical Non-Prescription (when applied to open wounds or broken skin)
      • Parents will fill out the Authorization for Medication form and a copy will be maintained in the child’s record. This form will be renewed annually.
      • Health care practitioner authorization is required.
      • Administration must be logged including name of child, dosage, date, time and staff signature.
    • Topical Non-Prescription (not applied to open wounds or broken skin)
      • Parents will fill out the Authorization for Medication form and a copy will be maintained in the child’s record. This form will be renewed annually.
      • Administration of this category does not require health care practitioner authorization, nor does its administration need to be logged.

Procedures for Illness, Injury or Emergency:

  •  All teachers at The Chilmark Preschool are trained yearly in Infant/Child CPR and Standard First Aid by the American Red Cross.
  • If a child becomes ill while at school (see Plan for Managing illnesses/ infections/Communicable diseases), a parent or guardian will be notified to pick him/her up. If a parent cannot be reached, then the person(s) designated on the child’s First Aid and Emergency Medical Care Consent Form will be contacted.
  •  If a child is injured, the following procedure will be observed:
  • The teacher will assess the child’s injury. 
  • If the injury is not serious/life threatening, the teacher will follow the recommended first aid procedure. The teacher will then monitor and observe the child’s condition throughout the day.
  • The parent or guardian will be provided with timely, full and accurate verbal notification of the injury. 
  • The teacher will complete an Injury Report Form within 24 hours. The report will be given to the parent or guardian for signature. A copy will be returned to the parent or guardian and a copy will be maintained in the child’s file. 
  • The injury will also be documented in the Incident Log.

If the injury is serious/life threatening or a medical emergency occurs, the following procedure will be observed:

  • The Director will immediately administer CPR/First Aid as deemed necessary by the nature of the emergency. 
  • A teacher will immediately contact emergency services (911).
  • The teacher will then notify the child’s parent or guardian of the injury/emergency. If a parent or guardian cannot be reached, then the person(s) designated on the child’s First Aid and Emergency Medical Care Consent Form will be contacted.
  • The other teacher present will care for the non-injured, healthy children.
  • If only the Director and one teacher are present, the following procedure will be followed: The Director will administer First Aid/CPR; the teacher will contact Emergency Services (911) and then contact Designated Adult, Mary Ambulos (ext. 101), to assist in contacting the child’s parent/emergency contact. The teacher will also be responsible for caring for the other non-injured, healthy children.
  • If transport to The Martha’s Vineyard Hospital is necessary, the Director will accompany the child. A copy of the child’s medical information and First Aid and Emergency Medical Care Consent Form will be provided.
  •  The teacher will complete an Injury Report Form within 24 hours. The report will be given to the parent/guardian for signature.  A copy will be returned to the parent or guardian and a copy will be maintained in the child’s file.
  •  The injury/emergency will also be documented in the Incident Log.
  • The Director will provide written notification to the EEC of the injury/emergency within 48 hours of making the original report. Copies of the CPR/First Aid cards of the staff present at the time of the injury/medical emergency will also be provided.

 Emergency Procedures when off site:

  • The First Aid Kit and First Aid and Emergency Medical Care Consent Forms for all children present will be taken on all off site activities.
  • All children will wear a name-tag with the program’s address and phone number.
  • The Director will carry a cellular phone and identify in advance the location of accessible landlines.
  • The procedures for illness, injury or emergency outlined above will be followed.

Abuse and Neglect:

Every teacher is a mandated reporter under M.G.L. c. 119, 51A and must make a report to the Department of Children and Families (DCF) whenever he/she has reasonable cause to believe a child in the program is suffering from serious physical or emotional injury resulting from abuse inflicted upon the child, including but not limited to sexual abuse, or from neglect, including but not limited to malnutrition, no matter where the abuse or neglect may have occurred and by whom it was inflicte

  • The following procedure will be followed:
    • A teacher who suspects abuse or neglect must document her observations including the child’s name, date, time, child’s injuries, child’s behavior and any other pertinent information.  The teacher will discuss this information with the Director.
    • The Director or the teacher with the assistance of the Director will make a verbal report to DCF, to be followed by a required written report 51A within 48 hours.
    • If a teacher feels that an incident should be reported to DCF and the Director disagrees, the teacher may report to DCF directly.
    • All concerns of suspected abuse or neglect that are reported to DCF will be communicated to the parents by the Director unless such a report is contra-indicated.

Any form of abuse or neglect of children while in care is strictly prohibited. The Director and all teachers must operate the program in ways that protect the children from abuse or neglect. Teachers are responsible for abuse or neglect if:

  • The teacher admits to causing the abuse or neglect, or
  • The teacher is convicted of abuse or neglect in a criminal proceeding, or
  • The Department of Early Care and Education determines, based upon its own investigation or an investigation conducted by the Department of Children and Families subsequent to a report filed under M.G.L. c. 119, 51A and 51B, that there is reasonable cause to believe that the teacher or any other person caused the abuse or neglect while the children were in care.
  • The Director will notify the Department of Early Education and Care immediately after filing or learning that a 51A report has been filed alleging abuse or neglect of a child while in the care of the program or during a program-related activity.
  • The Director will notify the Department of Early Education and Care immediately upon learning that a report has been filed naming a teacher or person regularly on the Preschool premises an alleged perpetrator of abuse or neglect of any child.
  • The Director will ensure that any teacher accused of the abuse or neglect of a child in a report to the Department of Children and Families, filed pursuant to M.G.L. c. 119, 51A does not work directly with children until the Department of Children and Families investigation is completed and for such further time as the Department of Early Education and Care requires.

The Director and teacher(s) will cooperate fully with all DCF investigations