Quick answer: A daycare sick policy is a written set of rules that tells families when children must stay home from child care and when they can return. Most policies set the fever threshold at 100.4°F (38°C) and require a child to be fever-free for 24 hours without fever-reducing medication before returning.
A daycare sick policy is essential to running a successful childcare business. Not only does it protect children’s health by preventing the spread of illness, but it also helps maintain a safe and healthy environment for your staff, who work closely with young children all day. A daycare sick policy is a set of established guidelines and procedures that providers and families follow if the children under their care start showing signs of illness in the classroom or at home.
A well-thought-out policy will help you effectively communicate your expectations to families and keep everyone healthy. Also, by having a policy in place, you’ll be able to take swift and appropriate action if a child does become sick while in your care.
However, many childcare programs don’t have a well-documented sick policy—or any sick policy at all. This can leave families and staff frustrated and unsure of what to do when a child becomes ill.
In this article, we’ll cover the basics of a daycare sick policy and the different procedures for different ailments. We’ll also include key points to consider and adjust to fit the specific needs of your center as you create or update your own sick policy.
In this article:
- What is a daycare sick policy?
- When to keep children home from daycare
- Daycare sick policy at a glance
- Daycare fever policy
- Daycare vomiting policy
- Daycare diarrhea policy
- Daycare COVID-19 policy
- Administration of medication policy
- Sample daycare sick policy language
- How brightwheel helps you enforce your sick policy
- Daycare sick policy examples
- FAQ
Family Handbook Templates for Childcare Centers and Preschools
Free templates to create a comprehensive and well-organized handbook for the families you serve.
What is a daycare sick policy?
A daycare sick policy is sometimes referred to as an “exclusion for sickness policy,” since children experiencing certain symptoms of illness are often required to stay at home. Children in group childcare settings are exposed to a lot of germs and may experience up to 12 respiratory illnesses in their first year. Daycare sick policies help childcare providers avoid the spread of these infectious diseases, maintaining a healthy environment for staff, children, and their families. In addition, some families have vulnerable individuals like infants and the elderly whose immune systems are fragile. A daycare sick policy allows sick children to receive appropriate care and rest without compromising the health of others.
It’s important for childcare programs to include a detailed sick policy in their family handbooks so families understand when to keep their child at home and what criteria they must meet to return back to your center. Update your policy on a regular basis to ensure that it is compliant with state regulations and to accommodate any occurrences of new infectious diseases like COVID-19.
When creating a daycare sick policy, it’s also necessary to include separate procedures for different ailments like vomiting, fever, diarrhea, medication administration, and COVID-19 since they are contracted differently, and some are more infectious than others. Childcare health requirements vary from state to state, so it’s essential to check the rules for your state to ensure compliance.
Your sick policy may include a daily health check for children and staff before entering your center in the morning. With brightwheel’s daily health check feature, you can customize health screen statements to accommodate your unique program requirements. Record the health of each child upon arrival, manage immunizations records, and quickly share any relevant health updates with families in the app.
When to keep children home from daycare
To keep all children and staff safe and healthy, it’s important to keep your child home from daycare if they’re experiencing any of the following:
- Fever: A temperature of 100.4°F (38°C) or higher. Children should stay home until they are fever-free for at least 24 hours without the use of fever-reducing medication.
- Vomiting: Two or more episodes of vomiting in the past 24 hours, or any vomiting with fever, stomach pain, or signs of dehydration, unless a non-contagious cause has been identified.
- Diarrhea: Stool that cannot be contained in a diaper, accidents by a toilet-trained child, more than two extra stools in 24 hours, or stool with blood or mucus. Children should remain home until symptoms resolve for at least 24 hours.
- Severe or persistent cough: A cough that is constant, worsening, or causes breathing difficulty, which can be disruptive or signal an infection.
- Runny nose with other symptoms: A runny nose on its own, including green or yellow mucus, does not usually require staying home. Keep a child home if the runny nose comes with a fever, cough, fatigue, or behavior changes that suggest an infection rather than allergies.
- Unexplained rash: Any new rash with fever or behavioral changes should be evaluated by a healthcare provider before returning to daycare.
- Eye discharge (pink eye) with other symptoms: Red, irritated eyes with discharge may indicate conjunctivitis, which is contagious. A child with pink eye and no fever can usually attend, but should stay home with fever, behavior changes, or if your program or healthcare provider requires treatment first.
- Lethargy or unusual fatigue: Excessive tiredness or inability to participate comfortably in activities may mean a child is too ill to attend daycare.
- Contagious illnesses: Diagnosed infections like flu, strep throat, COVID-19, RSV, or chickenpox should keep children home until cleared by a doctor or until they’re no longer contagious.
- Difficulty breathing or wheezing: Any breathing issues should be evaluated by a healthcare provider before the child returns to daycare.
Tip for families: If you’re unsure whether your child should attend daycare, consult your pediatrician or check your daycare’s sick policy for specific guidelines.
Daycare sick policy at a glance: When to stay home and when to return
This table summarizes common exclusion and return guidance from the American Academy of Pediatrics (AAP) for childcare programs. Your state licensing rules may be stricter, so check them before finalizing your policy.
| Symptom or illness | Stay home? | Typical return guidance |
|---|---|---|
| Fever of 100.4°F (38°C) or higher | Yes, in most programs | Fever-free for 24 hours without fever-reducing medication |
| Vomiting | Yes, after two or more episodes in 24 hours | Vomiting has stopped and the child can take part comfortably |
| Diarrhea | Yes, if stool leaks from the diaper, a toilet-trained child has accidents, there are more than two extra stools in 24 hours, or stool has blood or mucus | Symptoms have resolved |
| Runny nose or cold without fever | Usually no, regardless of mucus color | Not applicable |
| Pink eye without fever | Usually no | Follow your program’s policy and state rules |
| Rash with fever or behavior changes | Yes | A healthcare provider confirms the rash is not contagious |
| Strep throat | Yes | At least 12 hours after antibiotics start |
| Head lice, scabies, or ringworm | Until treated | After the first treatment |
| Chickenpox | Yes | All lesions have dried or crusted (usually about 6 days after the rash starts) and no new lesions have appeared for 24 hours |
Source: American Academy of Pediatrics, When to Keep Your Child Home From Child Care (HealthyChildren.org).
Daycare fever policy
Fever is one of the most prevalent causes of keeping a child home from daycare. While a low-grade fever might not be a big deal for an adult, it can be more serious for a young child.
For this reason, your policy must detail what to do when a child has a fever. Here are five things to consider:
- Temperature thresholds: What is the temperature at which a child needs to stay home? A temperature of 100.4°F (38°C) or higher is a common threshold, but you can set it greater or lower based on the requirements of your center and your state.
- Exclusion period: How long should a child with a fever stay at home? Fever policies typically indicate that a child can return to child care after they are fever-free for 24 hours without the use of fever-reducing medicine.
- Recurrence policy: What do you do if a child has a fever more than once in a short time, like within a week? Consider excluding the child for a longer time or requiring a doctor’s note before the child can return.
- Exception for other symptoms: What if a child has a fever but no other symptoms? You may want to consider letting the child stay if they’re otherwise feeling well, or you may choose to send every child with a fever home.
- Medication: What if the child’s temperature drops only after taking fever-reducing medicine? Because the fever has not resolved on its own, most policies still require the child to go home and meet the 24-hour fever-free requirement.
Daycare vomiting policy
Vomiting is another common reason to keep a child home from daycare. It may indicate a more serious illness, such as the stomach flu or food poisoning.
If a child vomits while at daycare:
- Keep the child away from other children and adults
- Clean up any vomit immediately with a bleach solution
- Have the child drink clear fluids, such as water or ginger ale, to prevent dehydration
- Monitor the child closely for any other symptoms
Children are often sent home from daycare for vomiting, but it’s important to have a policy in place for this. Here are some other things to consider:
- The number of episodes: How many times must a child vomit before they’re sent home? AAP guidance recommends keeping a child home after two or more episodes in 24 hours, though one episode may be enough if the child also has a fever or other symptoms.
- Exception for other symptoms: If a child is vomiting but has no other symptoms, you might allow them to stay. However, if the child also has a fever or diarrhea, then going home might be the best option.
- Medication: What if a child takes medication to stop vomiting? If the child can stop vomiting and they have no other symptoms, you might allow them to stay. However, if the child is still vomiting or not feeling well, you’ll probably require them to go home. You may also require a doctor’s note before the child can return.
Daycare diarrhea policy
If a child is experiencing diarrhea, that may be a sign of a more serious illness and another reason to stay home from daycare.
Here are factors to consider when developing your daycare diarrhea policy:
- Frequency: Your policy can detail how many loose stools a child can have in one day before they are sent home. AAP guidance uses more than two extra stools in 24 hours, or stool that cannot be contained in a diaper or toilet, as the point to send a child home.
- Other symptoms: If a child is experiencing other symptoms along with diarrhea, such as a fever or other behavior changes, or there is blood or mucus in the stool, your policy might require them to stay at home until symptoms are gone.
Daycare COVID-19 policy
The coronavirus (COVID-19) pandemic has changed how we live and work. As a result, any childcare facility should have a plan in place to protect the health and safety of staff and children.
Your daycare COVID-19 policy may choose to exclude children experiencing COVID-19 symptoms and ask families to follow current CDC and local health department guidance on when a child can return. You may also encourage families, staff, and children to stay up to date on vaccinations, including COVID-19 and the flu.
Your policy can also include preventative measures for staff and families to take to stop the spread of COVID-19:
- Staff training: Provide health and safety training for all staff members on the proper way to prevent the spread of illnesses, including hand-washing protocols, the use of personal protective equipment (PPE), and cleaning and disinfecting procedures. If there is a known or suspected case of COVID-19, staff may be responsible for alerting the families at your center, isolating the sick individual, and disinfecting the facility.
- Health screenings: All staff members and children can be screened for symptoms of COVID-19 before entering the facility each day. This can be done with a daily health screening procedure that includes a temperature check and a symptom checklist.
- Hand washing and spacing guidelines: Encourage frequent hand washing throughout the day at your center and keep alcohol-based hand sanitizer on hand. You can also limit the number of adults that enter your facility and modify your drop-off and pick-up procedures to limit unnecessary contact. If possible, consider keeping children and adults in small groups, ensure classrooms are well-ventilated, and hold activities outside whenever possible.
- Cleaning and disinfecting protocols: Establish a cleaning routine so all common surfaces in the facility are cleaned and disinfected regularly, paying special attention to high-touch locations, including chairs, tables, and door handles.
Administration of medication policy
While your policy may encourage families to administer medication at home whenever possible, there might be times when children may need to take medication at your childcare facility. Most childcare programs have a clear policy outlining general medication policies as well as policies related to prescription and over-the-counter medications. Check your state’s licensing agency for any regulations regarding childcare providers and medication administration.
General medication policies can include:
- Written authorization: Before administering medication, your program can require written authorization from the child’s parent or legal guardian and written instructions and authorization from the child’s physician or other health professional.
- Medication storage: Your policy can include proper medication storage requirements such as storing medication separately for each child and storing in the original, tamper-resistant container.
- Staff administration and documentation: The staff member administering the medication needs to be trained in the proper procedures and must also document each dosage on a specific medication form, listing the time and amount given.
Sample daycare sick policy language
Use the sample below as a starting point for your family handbook. Replace the bracketed items and adjust every threshold to match your state licensing rules.
Illness policy. For the health of all children and staff, children must stay home or will be sent home if they have a temperature of 100.4°F (38°C) or higher, two or more episodes of vomiting in 24 hours, diarrhea that cannot be contained, a rash with fever or behavior changes, or any illness that prevents them from taking part comfortably in activities or requires more care than staff can provide.
Pickup. Families will be contacted when a child becomes ill and must arrange pickup within [time frame]. Sick children will rest in [location] under staff supervision until pickup.
Return to care. Children may return after they have been fever-free for 24 hours without fever-reducing medication, symptoms are improving, and any required treatment period is complete (for example, at least 12 hours of antibiotics for strep throat). A note from a healthcare provider may be required for [conditions].
Reporting. Families must notify the program within [time frame] if a child is diagnosed with a contagious illness so we can inform other families and follow state reporting requirements.
How brightwheel helps you enforce your sick policy
A written policy only works if families see it and staff apply it the same way every day. Brightwheel’s daily health checks let you record each child’s health on arrival, and the app lets you send health updates and policy reminders straight to families. In fact, 95% of admins and staff report that brightwheel improves communication with families.
Daycare sick policy examples
The health of the children and staff at your childcare program is always a top priority. To help prevent the spread of illness and keep everyone healthy, a few examples of sick policies will help you get started and ensure everyone knows what to do if someone gets sick.
- Caring for Our Children (CFOC) Standard 3.6.1.1 outlines when caregivers should send a child home, such as a fever of 100.4°F or above with behavior change.
- The Centers for Disease Control and Prevention (CDC) provides information on preventing infectious diseases in early care and education programs.
- The American Academy of Pediatrics (AAP) offers comprehensive guidance on preventing and managing infectious diseases in schools and childcare settings to keep children healthy and safe.
- The California Childcare Health Program health and safety notes outline four steps to a healthier program and the symptoms or conditions for which exclusion is recommended.
Daycare sick policy FAQ
Below are answers to common questions families and childcare providers have about daycare sick policies.
What is a daycare sick policy?
A daycare sick policy is a set of guidelines that explains when children should stay home from child care to prevent the spread of illnesses and protect the health of other children and staff.
Why is a daycare sick policy important?
A clear sick policy helps limit the spread of contagious diseases, keeps everyone healthier, and ensures families and staff know exactly when it’s safe for children to attend daycare.
What symptoms mean my child should stay home from daycare?
Children should usually stay home if they have a fever of 100.4°F or higher, two or more episodes of vomiting in 24 hours, diarrhea, a persistent cough, unexplained rashes, severe fatigue, or any contagious illness like flu, RSV, or COVID-19.
What temperature is too high for daycare?
Most daycares require children to stay home with a temperature of 100.4°F (38°C) or higher. Children can usually return after they have been fever-free for 24 hours without fever-reducing medication.
Can a child go to daycare with a runny nose?
Yes, in most cases. AAP guidance says a runny nose alone, regardless of mucus color, does not require staying home. A child should stay home if the runny nose comes with a fever, behavior changes, or if the child cannot take part comfortably in activities.
How many times can a child vomit before staying home from daycare?
AAP guidance recommends keeping a child home after two or more episodes of vomiting in 24 hours, unless a non-contagious cause has been found and the child is not at risk of dehydration.
How can daycares communicate their sick policy to parents?
Daycares can provide a written sick policy at enrollment, post it on their website, discuss it during family meetings, and send reminders during peak illness seasons like winter and early spring.
When can my child return to daycare after being sick?
Return-to-care timing varies by illness, but generally, children can return once they are fever-free for 24 hours without medication, symptoms are improving, and a doctor has cleared them if required for certain infections.
Bottom line
Your daycare sick policy is the first step in providing a safe and healthy learning environment for children, families, and staff. Your policy will help ensure families and staff know what to do when a child is sick and offer guidelines for everyone to follow to limit the spread of illness. Creating a comprehensive policy—and consistently enforcing it—will keep everyone at your childcare center healthy and happy.
