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									I.       MEDICAL HEALTH

         Health Services Delivery............................................................................................HS-01
         Health Services Review and Completion ..................................................................HS-02
         Growth Charts ............................................................................................................HS-03
         Meal Participation Records ........................................................................................HS-04
         Special Diets ..............................................................................................................HS-05
         Medications/Dispensing Medications ........................................................................HS-06
         Health/Nutrition Referrals .........................................................................................HS-07
         Bloodborne Pathogens Exposure Control Plan ..........................................................HS-08
         First Aid Supplies ......................................................................................................HS-09
         Payment Authorization Voucher ................................................................................HS-10
         Center Health Hygiene-Health Checks, Handwashing and Toothbrushing ...............HS-11
         Emergency Procedures (Includes Medical Emergency Procedures, Transportation
           Of Ill Or Injured Children/Adults, Poisoning, Swallowed Objects, Evacuation
           Methods For Fires, Evacuation Methods For Tornadoes, Evacuation Methods
           For Earthquake, and Chemical & Biohazardous Spills) .........................................HS-12
         Center-Based Health & Dental Screenings ................................................................HS-13
         Staff and Volunteer Health Examination ..................................................................HS-14
         Sick Child Exclusion Policy and Related Illnesses (Includes Febrile Illnesses: Ear
           Infections (Otitis), and Influenza A (Winter Flu). Skin Abnormalities: Herpes,
           Impetigo, Ringworm, and Scabies. Suspected Communicable/ Infectious
           Illness: Common Cold, Diarrhea, Infectious Croup, Infectious Conjunctivitis
           (Pink Eye), Fifth Disease, Lice, Strep-Throat, Roseola, and HIV/Aids) ................HS-15
         Assessment and Management of Trauma and Illness (Includes Trauma, Choking,
           Animal/Human Bites, Bee Stings, Poisonous Bites, Chemical/Electrical &
           Sunburns, Bruises, Cuts/Scrapes, Ear/Eye Injuries, Fainting, Fractures, Heat
           Emergencies, Head Injury, NoseBleeds, Puncture Wounds, Rescue Breathing,
           Seizure, and Shock) .................................................................................................HS-16
         Health Alerts ..............................................................................................................HS-17
         CPR/First Aid Certification .......................................................................................HS-18

II.      FOOD SERVICE/NUTRITION

         Disposal of Excess Food ............................................................................................HS-19
         Problems with Food Service ......................................................................................HS-20
         Food Service Management Certification ...................................................................HS-21
         Proof of Vaccination Against the Hepatitis A Virus..................................................HS-22
         Food for Infants ..........................................................................................................HS-23
         Family-Style Dining ...................................................................................................HS-24
         Family-Style Dining/Dishes .......................................................................................HS-25
         Meal Preparation/Food Safety and Sanitation............................................................HS-26




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         Infant/Toddler Meal Service ......................................................................................HS-27
         Dining Activities (Before, During, After) ..................................................................HS-28
         Meal Service Preparation ...........................................................................................HS-29
         Food Safety ................................................................................................................HS-30
         Nutritional Assessment ..............................................................................................HS-31
         Identification of Nutritional Needs-Early Head Start ................................................HS-32

III.     Early-Infant/Toddler Hygiene

         Diapering and Sanitation............................................................................................HS-33
         Diapering Process ......................................................................................................HS-34
         Infant/Toddler Hygiene and Safety During Sleeping and Napping ...........................HS-35




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                          HS Contents - ii
                                     SIUE HEAD START POLICY/PROCEDURE

Procedure No.          HS 1                                                   Issue Date: 9/98
Unit:         Health Services                                              Effective Date: 9/11/06
                                                                           No. of Pages: 1
Title:     Health Services Delivery
Regulatory Reference:            HSPS 1304.20(a)(1); (c)(5); (e)



PURPOSE:
To ensure that each infant/child receives all required health services.

POLICY:
All Head Start children/infants will receive health services to improve or maintain his/her
optimal level of health. The Family Consultant/Community Worker/Home Visitor and the
assigned Health Associate in coordination with the child’s parent/guardian will determine what
services the infant/child will need, and where the services can be obtained, i.e., medical home,
center clinics and/or community clinics.

PROCEDURE:
During enrollment:
1.     The Family Consultant /Community Worker/ Home Visitor will review all health data in
       infant’s/child’s file to determine whether the required health services have been
       completed and whether any follow-up care is required.

2.       The Family Consultant/Community Worker/Home Visitor in coordination with the
         child’s parent/guardian will determine what services the infant/child will need, and where
         the services can be obtained, i.e., medical home, and/or community clinics.

3.       The Family Consultant/Community Worker/Home Visitor will complete a referral for
         enrollees requiring follow-up care for health-related concerns such as sickle cell, diabetes,
         asthma chronic illnesses, medications, etc. See Referral Process Procedure (SP- 6).

After Enrollment:
1.     The Health Associate/Family Consultant/Community Worker/Home Visitor will run
       Child Plus reports to determine what services are needed by the children within the
       assigned centers.




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2.       The Health Associate will work with the Family Consultant/Community Worker/Home
         Visitor to provide/obtain services.

3.       The Family Consultant/Community Worker/Home Visitor will inform/encourage the
         parents to obtain the needed services. See HS-14. The Health Associate/Family
         Consultant/Community Worker/Home visitor will follow the procedures as outlined in
         the Scheduling Clinics Procedure, HS-13.

4.       The Health Associate will schedule in-center clinics, for those services as needed. (i.e.,
         prior to the end of the 45-day deadline, number of children to be screened.)




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 1 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 2                                                                                        Issue Date: 9/98
Unit:         Health Services                                                                                  Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:       Health Records Review and Completion
Regulatory Reference:          HSPS 1304.20(a)(1) and Department of Children and Family Services Licensing
                               Standards for DayCare Centers



PURPOSE:
To ensure that all infant/children enrolled have all age appropriate required health services.

POLICY:
All infants/children enrolled in the SIUE Head Start program must have all required health services,
as indicated by age before entering or within 45 days after enrollment as indicated by the
Department of Children and Family Services Licensing Standards for Day Care Centers and the
Head Start Performance Standards.

DEFINITIONS:
Required Health Services include a physical exam, dental exam, TB test, immunization records,
blood pressure, hemoglobin and lead assessment. The lead screening is required if the assessment
indicates the child is at risk for high lead levels. Sickle cell is recommended, but is routinely
completed on children born in Illinois.

PROCEDURES:
1.   The Family Consultant/Community Worker/Home Visitor will collect all required health
     data prior to enrollment.

2.         The Family Consultant/Community Worker/Home Visitor will assess each child's record
           for completion, suspected/diagnosed disabilities and needed follow-up services.

3.         The Family Consultant/Community Worker/Home Visitor will a request via Health
           Forms: Health Reminder or Health/Dental Follow-Up Notice to parents, any data missing
           in the record, i.e., results of TB, lab test, etc.

4.         The Family Consultant/Community Worker/Home Visitor will assist parents in obtaining
           results, screenings and/or follow-up services. When a family requires assistance with
           obtaining a screening result, the Family Consultant/Community Worker/Home Visitor
           should obtain a "Consent to Release or Obtain Information" form and forward it to the
           "PHYSICIAN OR LABORATORY".




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                             HS 2 - 1
5.       Children that do not have completed screenings and are not enrolled in any managed care
         program will be scheduled for services during center health screening clinics after parents
         have been notified.

6.       If the children have not received the required screenings, the Family
         Consultant/Community Worker/Home Visitor should seek health care resources for
         children that are not enrolled in the Medicaid program, but are enrolled in a managed-care
         program or private insurance program and cannot afford to pay the fees for the
         screenings. If no health care resources can be obtained and the parent cannot pay for
         services, a Payment Authorization Voucher should be completed. See procedure for
         completing the Payment Authorization Voucher, HS-11.


Form(s):
Health Reminder Notice
Health/Dental Follow-Up Notice
Payment Authorization Voucher
Consent to Release or Obtain Information
Referral
Dispensing Medication Packet




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                              HS 2 - 2
                           SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
    For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                    For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 3                                                                                        Issue Date: 9/98
Unit:      Health Services                                                                                    Effective Date: 9/98
                                                                                                              No. of Pages: 1
Title:         Growth Charts
Regulatory Reference:        HSPS 1304.20(a)(1); 1304.23(a)(1)



PURPOSE:
To assure uniform determination of age for infants and children thereby assuring accurate
plotting of measurement.

POLICY:
The initial height and weight measurement for new enrollees will be taken from the physical
exam. Those measurements will be plotted on a growth chart as indicated by the child’s/infant’s
age. All enrollees will have a height and weight measurement completed within the initial 6
weeks of each yearly session (Sept-Mid Oct). In addition, all enrollees will have height and
weight measurements obtained during the month of April. Both measurements will be plotted on
the growth chart as indicated by the child’s/ infant’s age. All measurements will be entered into
the ChildPlus Data Engine as indicated on the ChildPlus Data Engine Task and Responsibilities
chart.

PROCEDURE:
See attachments.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                            HS 3 - 1
         INTRODUCTION TO ANTHROPOMETRIC MEASUREMENTS

Nutritional anthropometry is the measurement of the variations of the physical dimensions and
the gross composition of the human body at different levels of age and nutrition. Anthropometric
measurements are useful in identifying individuals whose nutritional deficiencies or excesses are
reflected in growth and development. For this reason, physical growth is one of the best
indicators of nutritional status during infancy and childhood.

During growing years, nutrition assessment is greatly simplified by the fact that the level of
nutrition affects growth and the degree of muscularity and fatness. Using anthropometric
measurements, one can quickly and easily assess clients' protein and calorie reserves, identifying
those with depleted protein and fat reserves (less than 5th percentile for WT/HT), those who may
be at risk of depleting their reserves (between the 5th and 15th percentiles), as well as those who
have excess reserves (greater than the 95th percentile for WT/HT). However, chronic
undernutrition or malnutrition will retard growth and development. Retardation of growth and
development may also be caused by other environmental and genetic factors quite independent of
nutrition.

The need for accuracy (closeness to "truth") and precision (reproducibility of two or more
independent measurements) is foremost when obtaining measurements and plotting growth
charts. Measurements are only as useful as they are accurate. Accurate measurements recorded
and plotted correctly are an essential first step in a child's nutrition assessment. In actual practice,
unfortunately, the level of accuracy and precision is often unsatisfactory.

Relatively small errors in measuring, recording or plotting of a child's physical dimensions can
seriously impair results. An error, for instance, of one inch in the length measurement of a y
month old infant can change the infant's percentile ranking from the 5th to the 25th, or vice
versa; similarly, rounding off 4'h months to 5 months could take an infant from the 10th to below
the 5th percentile! For this reason, when gathering and interpreting anthropometric
measurements, standardized equipment and procedures must be used, and appropriate reference
standards for length, weight, circumferences, and skinfold thicknesses must be selected.

The following list of anthropometric measurements are recommended for assessment of infants,
preschoolers, and adults:

Infants (0-12 Months)             Preschoolers (1-5 Years)                   Adults
weight, recumbent                 weight, recumbent or standing              weight, standing stature (standing)
length, recumbent                 length (recumbent) or stature (standing)   arm circumference (optional for WIC)
head circumference                head circumference (optional for WIC       triceps skinfold (optional for WIC)
                                  after 2 years)
chest circumference               chest circumference (optional for WIC)     subscapular skinfold (optional for WIC)
triceps skinfold thickness        arm circumference (optional for WIC)
                                  triceps skinfold-thickness (optional for
                                  WIC)




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                              HS 3 - 2
COMMON ERRORS OF MEASUREMENT
 Inadequate equipment                                               Recording
 Poor or improper techniques                                        Growth chart not plotted properly
 Restless child (procedure should be postponed)                     Measurement not repeated
 Instrument not fixed when value is read                            Age calculated incorrectly
 Reading

PROCEDURES AND STANDARDS FOR GATHERING AND INTERPRETING SELECTED
ANTHROPOMETRIC MEASUREMENTS
A.   Measurement: Recumbent Length
     Age:
     Birth to 24 months and after 24 months if the child is less than 35'/2 inches. If the child is
     longer than infant measuring board, follow the procedure for measuring STATURE.

         Purpose:
         Recumbent length is a linear horizontal measurement from the crown of the head to the
         heels of the feet and is used to determine the stage of skeletal development. Recumbent
         length is used with height/age tables, and National Center for Health Statistics (NCHS)
         growth charts.

         Equipment:
         1.    Infant Measuring Board. A measuring board with a fixed headboard and movable
               footboard, both attached at right angles to the measuring surface.
         2.    Two persons are needed to accurately obtain the recumbent length.
         3.    NCHS Growth Charts:
                Boys: Birth to 36 months
                Girls: Birth to 36 months

         Procedure:
         1.    Completely unclothe infant to diaper and remove headwear and footwear.
         2.    * Lay child on measuring board with head against headboard. The child's line of
               vision should be perpendicular to the measuring board (Frankfort plane).
         3.    One person, the assistant, using both hands, holds the child's head against the
               headboard. The second person, the measurer, extends the child's legs and holds
               securely at the knees.
         4.    The child should be positioned so that head, body, and toes are in a straight line.
         5.    The footboard is positioned against both of the child's heels. Double check that
               the board is secure and properly aligned and that the child's head is in place.
         6.    Read the recumbent length accurately and record exact measurement immediately.
         7.    Repeat procedure to validate accuracy for first measurement. If the measurement
               vary by more than on?fourth inch, do the procedure a third time.
         8.    Plot on the NCHS Growth Chart appropriate for age and sex. Plot the exact
               measurement to the nearest month.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                           HS 3 - 3
         Errors To Avoid:
          Incorrect equipment for age
          Footwear or headgear not removed
          Head not in correct Frankfort plane
          Head not firmly against fixed headboard
          Child's body not straight along measuring board
          Child's body arched
          Knees bent
          Feet not vertical to movable footboard
          Footboard not firmly against heels
          Age calculated incorrectly
          Both legs not extended
          Footboard moved before measurement is read
          Measurement reading not recorded immediately
          Measurement not repeated

         *Measure stature for a child who is longer than the infant measuring board following the
         procedure for measuring STATURE. Plot measurement on NCHS growth chart for age
         2-18 years.

         Standards:
         NCHS Statistics Percentiles

         Interpretation: **
         Suggested criteria for further evaluation of abnormal growth pattern are:
         1.     Recumbent length for age at or below 5th percentile.
         2.     Weight for recumbent length above the 95th percentile.
         3.     Weight for recumbent length below the 5th percentile.
         4.     Growth curve is flat over a period of time.
         5.     Marked deviation from expected growth curve over period of time; i.e., a change
                of more than 25 percentiles in a 6-month period.

B.       Measurement: Stature (Standing Height)
         Age:
         2 years through adulthood

         Purpose:
         Standing height is a linear vertical measurement from the crown of the head to the heels
         of the feet and is used to determine the skeletal development in individuals still growing
         and skeletal size of adults. Standing height is for use with height/age tables,
         weight/height tables, and NCHS charts.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 3 - 4
         Equipment:
         1.    Stature Measuring Board. A measuring board standing perpendicular to a hard
               platform with a moveable headboard attached at right angles to the measuring
               surface. (Instructions for construction of a suitable inexpensive measuring board,
               and information on recommended commercially available standing measuring
               boards can be found in the section on Equipment.) A yardstick or non-stretchable
               tape fixed plumb to a true vertical flat surface is marginally adequate provided
               heels may butt up directly to the vertical surface and a right-angled block is used.
               Do not use a moveable-measuring rod attached to a scale.
         2.    NCHS Growth Charts: (Appendix B)
                Boys: 2 to 18 years
                Girls: 2 to 18 years
                Boys: Prepubescent
                Girls: Prepubescent

         Procedure:
         1.    Remove subject's foot and headgear. Clean, disposable paper should be provided
               for child/adult to stand on.
         2.    2. Subject stands on horizontal bare floor with heels slightly apart, back as
               straight as possible and heels, buttocks, upper part of back, and back of head
               touching wall. The child's line of vision should be perpendicular to the wall
               (Frankfort Plane). It is suggested that an assistant or parent (or guardian) watch
               the child's feet and knees while the measurement is taken to insure their proper
               positioning.
         3.    A block squared at right angles against the wall should be brought to the crown of
               the head.
         4.    Read the stature accurately and record the exact measurement immediately.
         5.    Repeat procedure to validate accuracy of first measurement. If the measurements
               vary by more than one-fourth inch, do procedure a third time.
         6.    Plot on the NCHS Growth Chart appropriate for age and sex. Plot the exact
               measurement to the nearest 6 months.

         Errors To Avoid:
          Incorrect equipment for age
          Footwear or headgear not removed
          Feet not straight and flat on horizontal platform
          Heels, buttocks, upper part of back, or back of head not pressed against vertical
            measuring board
          Knees bent
          Body not straight, shoulders not straight
          Head not in correct plane
          Headboard not firmly pressed onto crown of head




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 3 - 5
             Headboard moved before measurement reading
             Measurement reading not recorded immediately
             Measurement not repeated
             Age calculated incorrectly

         Standards:
         Age 2 to 18 years
         Adults - none

         Interpretation: *
         Suggested criteria for abnormal growth pattern are:
         1.     Stature for age at or below 5th percentile.
         2.     ** Weight for stature above 95th percentile.
         3.     Weight for stature below 5th percentile.
         4.     Growth curve is flat over period of time.
         5.     Marked deviation from expected growth curve over period of time; i.e., a change
                of more than 25 percentiles in a 6-month period.

C.       Measurement: Recumbent Weight
         Age:
         Birth to 24 months, unless child's weight exceeds infant scale capacity (36 lbs.), in which
         case, follow procedure for measuring Standing Weight.

         Purpose:
         Recumbent weight is a measure of total body weight and is used to determine level of
         growth. Recumbent weight is used with weight/age tables, weight/height tables and
         NCHS charts.

         Equipment:
         1.    Infant beam balance scale with non-detachable weights or Digital Pediatric Scale.
               Infant beam balance scale must be checked for accuracy using standard weights at
               least once a year.
         2.    Disposable diapers.
         3.    NCHS growth charts: (Appendix B)
                Boys: Birth to 36 months
                Girls: Birth to 36 months

         Procedure:
         1.    * Zero balance the scale with a clean dry diaper on it.
         2.    Unclothe infant and redress in the same dry diaper used to zero balance the scale.
         3.    Place infant safely on scale. Never leave infant unattended on the scale.
         4.    ** Read the weight and record the exact measurement immediately.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 3 - 6
         5.        Remove infant from the scale and re eat procedure (steps 3 and 4) to validate
                   accuracy of first measurement. If measurements vary by more than 1/4 pound,
                   zero balance the scale using a similar size clean dry diaper and repeat procedure
                   (steps 3 and 4).

Plot on the National Center for Health Statistics Growth Chart appropriate for age and sex. Plot
the exact measurement to the nearest month.




         *To zero balance the beam balance scale, place the main and fractional sliding beam
         weights directly over their respective zeros, and move the adjustable weight until the
         beam is in zero balance. Digital Pediatric Scale has built-in automatic zero adjustment
         and calibration.

         **To read the beam balance: Move the weight on the main beam away from the beam
         position until the indicator shows that too much weight has been added. Then push the
         weight back towards the zero position until too much weight has been removed. Move
         the weights on the fractional beam back and forth until the indicator is centered.

         Errors To Avoid:
          Room cold or drafty, no privacy
          Beam Balance Scale not calibrated to zero
          Infant wearing wet diaper
          Measurement taken while infant moving or anxious
          Measurement taken before Beam Balance indicator has stopped moving
          Measurement reading not recorded immediately
          Measurement not repeated
          Age calculated incorrectly




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 3 - 7
         Standards:
         NCHS Statistics Percentiles

         Interpretation:
         Suggested criteria for abnormal growth pattern are:
         1.     Weight for length above 95th percentile.
         2.     Weight for length below the 5th percentile.
         3.     Growth curve is flat over period of time.
         4.     Weight for age at or above the 95th percentile. This indice is only useful when
                serial measurements are taken over time.
         5.     Weight for age at or below the 5th percentile. This indice is only useful when
                serial measurements are taken over time.
         6.     Marked deviation from expected growth curve over a period of time; i.e., a change
                of more than 25 percentiles in a 6 month period.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                           HS 3 - 8
GROWTH CHARTS
WITH REFERENCE PERCENTILES FOR GIRLS ' BIRTH TO 36 MONTHS OF AGE
     Length for Age
     Weight for Age
     Head Circumference for Age
     Weight for Length

Name                                                                                  Record #
Date of Birth

Date of Measurement             Age in Months           Recumbent Length   Weight Head Circumference

These charts to record the growth of the individual child were constructed by the National Center
for Health Statistics in collaboration with the Center for Disease Control. The charts are based
on data from the Fels Research Institute, Yellow Springs, Ohio. These data are appropriate for
young girls in the general U.S. population. Their use will direct attention to unusual body size
which may be due to disease or poor nutrition.

Measuring: Take all measurements with the child nude or with minimal clothing and without
shoes. Measure length with the child lying on her back fully extended. Two people are needed
to measure recumbent length properly. Use a beam balance to measure weight.

Recording: First take all measurements and record them on this front page. Then graph each
measurement on the appropriate chart. Find the child's age on the horizontal scale; then follow a
vertical line from that point to the horizontal level of the child's measurement (length, weight or
head circumference). Where the two lines intersect, make a cross mark with a pencil. In
graphing weight for length, place the cross mark directly above the child's length at the horizontal
level of her weight. When the chili is measured again, join the new set of cross marks to the
previous set by straight lines.

Interpreting: Many factors influence growth. Therefore, growth data cannot be used alone to
diagnose disease, but they do allow you to identify some unusual children.

Each chart contains a series of curved lines numbered to show selected percentiles. These refer
to the rank of a measure in a group of 100. Thus, when cross mark is on the 95th percentile line
of weight for age it means that only five children among 100 of the corresponding age and sex
have weights greater than that recorded.

Inspect the set of cross marks you have just made. If any are particularly high or low (for
example, above the 95th percentile or below the 5th percentile), you may want to refer the child
to a physician. Compare the most recent set of cross marks with earlier sets for the same child.
If she has changed rapidly in percentile levels, you may want to refer her to a physician. Rapid
changes are less likely to be significant when they occur within the range from the 25th to the
75th percentile.

                   DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, PUBLIC HEALTH SERVICE
    HEALTH RESOURCES ADMINISTRATION, NATIONAL CENTER FOR HEALTH STATISTICS & CENTER FOR DISEASE CONTROL




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                    HS 3 - 9
GROWTH CHARTS
WITH REFERENCE PERCENTILES FOR GIRLS ' 2 TO 18 YEARS OF AGE
Name                                                                             Record #
Date of Birth

                                                                  Age
    Date of Measurement                          Years                  Months       Stature   Weight

These charts to record the growth of the individual chili were constructed by the National Center
for Health Statistics in collaboration with the Center for Disease Control. The charts are based
on data from national probability samples representative of girls in the general U.S. population.
Their use will direct attention to unusual body size which may be due to disease or poor
nutrition.

Measuring: Take all measurements with the chili in minimal indoor clothing and without shoes.
Measure stature with the child standing. Use a beam balance to measure weight.

Recording: First take all measurements and record them on this front page. Then graph each
measurement on the appropriate chart. Find the child's age on the horizontal scale; then follow a
vertical line from that point to the horizontal level of the child's measurement (stature or weight).
Where the two lines intersect, make a cross mark with a pond I. In graphing weight for stature,
place the cross mark directly above the chill's stature at the horizontal level of her weight. When
the child is measured again, join the new set of cross marks to the previous set by straight lines.

Do not the weight for stature chart -for girl: who have begun to develop secondary sex
characteristics.

Interpreting: Many factor: influence growth. Therefore, growth data cannot be used alone to
diagnose disease, but they do allow you to identify some unusual children.

Each chart contains a series of curved lines numbered to show selected percentiles. These refer
to the rank of a measure in a group of 100. Thus, when a cross mark on the 95th percentile line
of weight for age it means that only five children among 100 of the corresponding age and sex
have weights greater than that recorded.

Inspect the set of cross mark: you hew just made. If any are particularly high or low (for
example, above the 95th percentile or below the 5th percentile), you may want to refer the child
to a physician. Compare the most resent set of cross marks with earlier set: for the :ants child. If
she has changed rapidly in percentile levels, you may want to refer her to a physician. Rapid
changes are less likely to be significant when they occur within the range from the 25th to the
75th percentile.

In normal teenagers, the age at onset of puberty varies. Rises occur in percentile levels if puberty
is early, and these levels fall if puberty is late.
                DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, PUBLIC HEALTH SERVICE
  HEALTH RESOURCES ADMINISTRATION, NATIONAL CENTER FOR HEALTH STATISTICS & CENTER FOR DISEASE ONTROL




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 3 - 10
GROWTH CHARTS
WITH REFERENCE PERCENTILES FOR BOYS BIRTH TO 36 MONTHS OF AGE
     Length for Age
     Weight for Age
     Head Circumference for Age
     Weight for Length

Name                                                                                  Record #
Date of Birth

Date of Measurement             Age in Months           Recumbent Length   Weight Head Circumference

These charts to record the growth of the individual child were constructed by the National Center
for Health Statistics in collaboration with the Center for Disease Control. The charts are based
on data from the Fels Research Institute, Yellow Springs, Ohio. These data are appropriate for
young girls in the general U.S. population. Their use will direct attention to unusual body size
which may be due to disease or poor nutrition.

Measuring: Take all measurements with the child nude or with minimal clothing and without
shoes. Measure length with the child lying on her back fully extended. Two people are needed
to measure recumbent length properly. Use a beam balance to measure weight.

Recording: First take all measurements and record them on this front page. Then graph each
measurement on the appropriate chart. Find the child's age on the horizontal scale; then follow a
vertical line from that point to the horizontal level of the child's measurement (length, weight or
head circumference). Where the two lines intersect, make a cross mark with a pencil. In
graphing weight for length, place the cross mark directly above the child's length at the horizontal
level of her weight. When the chili is measured again, join the new set of cross marks to the
previous set by straight lines.

Interpreting: Many factors influence growth. Therefore, growth data cannot be used alone to
diagnose disease, but they do allow you to identify some unusual children.

Each chart contains a series of curved lines numbered to show selected percentiles. These refer
to the rank of a measure in a group of 100. Thus, when cross mark is on the 95th percentile line
of weight for age it means that only five children among 100 of the corresponding age and sex
have weights greater than that recorded.

Inspect the set of cross marks you have just made. If any are particularly high or low (for
example, above the 95th percentile or below the 5th percentile), you may want to refer the child
to a physician. Compare the most recent set of cross marks with earlier sets for the same child.
If she has changed rapidly in percentile levels, you may want to refer her to a physician. Rapid
changes are less likely to be significant when they occur within the range from the 25th to the
75th percentile.

                   DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, PUBLIC HEALTH SERVICE
    HEALTH RESOURCES ADMINISTRATION, NATIONAL CENTER FOR HEALTH STATISTICS & CENTER FOR DISEASE CONTROL




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 3 - 11
GROWTH CHARTS
WITH REFERENCE.PERCENTILES FOR BOYS 2 TO 18 YEARS OF AGE
Name                                                                             Record #
Date of Birth

                                                                  Age
    Date of Measurement                                                              Stature   Weight
                                                 Years                  Months

These charts to record the growth of the individual child were constructed by the National Center
for Health Statistics in collaboration with the Center for Disease Control. The charts are based
on data from national probability samples representative of girls in the general U.S. population.
Their use will direct attention to unusual body size which may be due to disease or poor
nutrition.

Measuring: Take all measurements with the chili in minimal indoor clothing and without shoes.
Measure stature with the child standing. Use a beam balance to measure weight.

Recording: First take all measurements and record them on this front page. Then graph each
measurement on the appropriate chart. Find the child's age on the horizontal scale; then follow a
vertical line from that point to the horizontal level of the child's measurement (stature or weight).
Where the two lines intersect, make a cross mark with a pond I. In graphing weight for stature,
place the cross mark directly above the chill's stature at the horizontal level of her weight. When
the child is measured again, join the new set of cross marks to the previous set by straight lines.

Do not the weight for stature chart -for girl: who have begun to develop secondary sex
characteristics.

Interpreting: Many factor: influence growth. Therefore, growth data cannot be used alone to
diagnose disease, but they do allow you to identify some unusual children.

Each chart contains a series of curved lines numbered to show selected percentiles. These refer
to the rank of a measure in a group of 100. Thus, when a cross mark on the 95th percentile line
of weight for age it means that only five children among 100 of the corresponding age and sex
have weights greater than that recorded.

Inspect the set of cross mark: you hew just made. If any are particularly high or low (for
example, above the 95th percentile or below the 5th percentile), you may want to refer the child
to a physician. Compare the most recent set of cross marks with earlier set: for the :ants child. If
she has changed rapidly in percentile levels, you may want to refer her to a physician. Rapid
changes are less likely to be significant when they occur within the range from the 25th to the
75th percentile.

In normal teenagers, the age at onset of puberty varies. Rises occur in percentile levels if puberty
is early, and these levels fall if puberty is late.
                DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, PUBLIC HEALTH SERVICE
 HEALTH RESOURCES ADMINISTRATION, NATIONAL CENTER FOR HEALTH STATISTICS & CENTER FOR DISEASE CONTROL




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 3 - 12
PRENATAL WEIGHT GAIN GRID INSTRUCTIONS
1.  Complete information in top left hand corner.
     Name:                    Record client's name.
     Pre-pregnancy Weight:    Record client's weight before pregnancy.
     EDC:                     Record client's expected date of confinement.

         First Visit
         Date:                   Record date of first prenatal visit at which weight is taken.
         Height:                 Record height (taken without shoes)
         Weight:                 Record weight in light clothing without shoes.
         Weight Status:          Check appropriate box after calculating whether client is
                                 underweight, normal weight or overweight according to information
                                 below.

2.       Determine pre-pregnancy weight status. Using height and pre-pregnancy weight,
         determine pre-pregnancy weight status by cor:suRing the Height and Weight Table
         below.

3.       Select appropriate weight gain curve.
          Calculate the amount of weight gained or lost since the beginning of this pregnancy.
          Find the vertical line on the grid (for the pre-pregnancy weight status) that
             corresponds with the number of weeks gestation for the visit.
          Place an "x" where the number of weeks gestation intersects the number of pounds of
             weight gained or lost.
          At each prenatal visit, plot the weight gained or lost at the appropriate weeks
             gestation.

4.       Recommend a weight gain range.
         Recommended weight gain range for each weight status is:
          Underweight women                     28-40 pounds
          Normal weight women                   25-35 pounds
          Overweight women                      15-25 pounds

SPECIAL NOTES
 middot; Adolescents and black women should strive for gains at the upper end of the
   recommended range.
 middot; Short women, 62 inches or less, should strive for gains at the lower end of the
   recommended range.
 middot; Obese women should strive for gains of at least 15 pounds.
 middot; Women carrying twins should strive for gains of 35-45 pounds.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 3 - 13
Height and Weight Table
    Height          Normal Weight            Underweight         Overweight          Obese
   (Inches)              (lbs.)                (lbs.) <             (lbs.) >        (lbs.) >
      56                88-115                    87                  116             130
      57                91-119                    90                  120             135
      58                94-123                    93                  124             139
      59                96-126                    95                  127             143
      60                99-130                    98                  131             147
      61               102-133                   101                  134             151
      62               104-137                   103                  138             155
      63               108-142                   107                  143             160
      64               112-147                   111                  148             166
      65               115-151                   114                  152             171
      66               119-156                   118                  157             176
      67               122-161                   121                  162             182
      68               126-166                   125                  167             187
      69               130-171                   129                  172             193
      70               133-175                   132                  176             198
References:
 IDPH, Nutrition Assessment Manual, 1990, Table 4
 Institute of Medicine, Nutrition During Pregnancy: Part 1, Weight Gain, National Academy
   Press, Washington, D.C. 1990




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                        HS 3 - 14
                                     SIUE HEAD START POLICY/PROCEDURE

Procedure No.          HS 4                                                Issue Date: 9/98
Unit:      Health Services                                              Effective Date: 9/06
                                                                        No. of Pages: 1
Title:          Meal Participation Records
Regulatory Reference:            HSPS 1304.23(b)(1)



PURPOSE:
To provide written documentation/accountability of food consumption for USDA reimbursement
and nutritional assessment.

POLICY:
All meals consumed by Head Start children enrolled in all program options will be recorded on
Meal Participation Records. ALL MEAL COUNTS WILL BE DONE DURING THE MEAL
SERVICE.

PROCEDURE:
1.   Blank copies of the ChildPlus Worksheet Report #2315 must be available each Monday
     morning and on the first class day of a new month or on the day of group socialization.
     Teachers/Teacher Assistants/Home Visitor will complete the ChildPlus Worksheet on a
     daily basis to ensure that the meal count information is recorded accurately. The
     worksheet must be completed as indicated in the “Guide to Completing the Meal Count
     Attendance Sheet".

2.       The information collected on the ChildPlus Worksheet must be entered into the ChildPlus
         system before the disk is forwarded to the Central Office for consolidation.

3.       The ChildPlus Worksheet is forwarded to the Health Coordinator by the Monday after the
         week that is reported on the worksheet. A copy of the worksheet is to remain on file at
         the center.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 4 - 1
                           SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
    For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                    For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 5                                                                                      Issue Date: 9/98
Unit:       Health Services                                                                                   Effective Date: 9/98
                                                                                                              No. of Pages: 1
Title:        Special Diets
Regulatory Reference:                      HSPS 1304.23(b)(c); CACFP Reg.



PURPOSE:
To ensure that any special dietary requirements, supplements and/or restrictions are continued
while infants/children are enrolled in the program.

POLICY:
Special diets will be provided for all infant’s/children that require any dietary restrictions or
modifications.

DEFINITIONS:
Special Diet - Any diet prescribed by the infant’s/child’s physician or dietitian. A special diet
may also be requested for religious restrictions.

PROCEDURES:
1.   The Family Consultant/Community Worker/Home Visitor/Health Associate will review
     the health and nutrition history form for special dietary needs or restrictions prior to
     enrollment. The Health Associate will review the forms of children who attend a summer
     screening clinic.
2.   If a special diet is requested, the parent should be informed that a statement signed by a
     physician or religious leader, depending on the reason for the special diet request, must
     support the special diet request.
3.   The Family Consultant/Community Worker/Home Visitor should:
     a)      Notify the Health Coordinator of any dietary restrictions and/or modifications via
             the Referral Form and forward to the Health Coordinator with the required
             documentation. Complete a Special Diet form.
     b)      Place a copy of the Special Diet Form in the kitchen and in the child’s classroom
             in a location that assures confidentiality.
     c)      Inform the parent that requests for special diets:
                  1) Due to religious reason must be supported by a statement signed by a
                      religious leader.
                  2) Due to medical conditions/disabilities must be supported by a statement
                      signed by a medical doctor. The statements must verify that special meals
                      are needed due to a medical condition/disability, identify the medical
                      condition/disability, the alternate food to provide, and the form of food
                      needed to meet the child’s special dietary needs.



D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                            HS 5 - 1
                  This information must be obtained within 2 weeks of ordering a special diet for the
                  infant/child who has restrictions due to medical reasons.

                   1.        The Health Coordinator will:
                             a)    Notify food service of the dietary restriction/modification.
                                   Complete an Individualized Health Plan and forward to the
                                   assigned Family Consultant/Community Worker.
                             b)    Notify the Health Associate assigned to the center of the special
                                   diet request.

Form(s):
Special Diet Form




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                  HS 5 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 6                                                                                        Issue Date: 9/98
Unit:      Health Services                                                                                     Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:       Medications/Dispensing Medications
Regulatory Reference:            HSPS 1304.22(c), DCFS Licensing Standard 407.360



PURPOSE:
To provide an environment that encourages children that require prescription medication to attend
SIUE Head Start.

POLICY:
SIUE Head Start will allow prescription medication that must be administered during the child's
daily attendance to be given. Parents must follow steps outlined in the dispensing medication
policy. The parent is encouraged to consult the child's physician and arrange a medication schedule
that allows for medication to be given at home whenever possible. A Dispensing Medication
Packet must be completed before any medications are administered by any SIUE Head Start staff.

DEFINITIONS:
Prescription medication includes any medication that has been ordered by a physician.

PROCEDURES:
1.   The Family Consultant/Community Worker or designee will review Health Records to
     determine whether a child has been prescribed medication and whether it is to be dispensed
     during the hours that the child is in attendance at Head Start. It is the parent’s responsibility
     to notify staff of their child’s needs to have prescription medication administered during
     Head Start sessions.

2.         The Family Consultant/Community Worker will notify the assigned Health Associate
           through an informational referral of any child that has been prescribed medication that
           needs to be taken during the hours that the child attends at Head Start.

3.         The Health Associate will provide assistance in providing clarification or information on
           medication, as requested by parents or center staff.

4.         Parents must obtain the information requested by SIUE Head Start Program (See
           medication forms). The Center Coordinator or designee will dispense medication




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                             HS 6 - 1
DISPENSING
MEDICATIONS:                 The following procedure is in accordance with DCFS licensing standards
                             section 407.360.

POLICY:
The Center Coordinator or designee is allowed to give prescription medication only at the site. The
SIUE staff will adhere to the DCFS licensing standards section 407.360.

1.       All of the following steps must be completed and appropriate documentation placed in the
         child’s file before giving any medication to any child. The Health Associate will be
         informed of all requests to give medication at sites prior to any medication coming into the
         center.

         a.        The parent must be informed of the SIUE Head Start Medication Policy. The parent
                   will be notified that a non-healthcare professional will be administering medication.
                   The Parent Request Form for Administering Medication sheet (from the Dispensing
                   Medication Packet) must be completed, dated, and signed.

         b.        The Patient Medication Information (PMI) sheet (from the Dispensing Medication
                   Packet) must be completed, dated and signed by the physician. The parent will
                   obtain this information from the physician.

         c.        All of the information on the pharmacy container must agree with the information
                   on the form from the physician.

2.       Medication MUST be in the original pharmacy container and labeled with the:
         a) Name of child
         b) Date of prescription
         c) Name of medication
         d) Dosage
         e) Times to be given
         f) Expiration for the medication

3.       No more than one week's (4-5 days) dosage of medication is to be at the site at any given
         time. The parent is responsible to restock the site supply and instruct center staff in the
         proper method of dispensing medication.

4.       The medication is to be locked at the site, with the Center Coordinator or designee
         responsible to dispense the medication. Medication that requires refrigeration will be
         refrigerated in a locked box separate from food.

5.       The Medication Log sheet (from the Dispensing Medication Packet) must be completed and
         the original kept on file in the child's file. A copy of the medication log should be forwarded
         to the Health Coordinator on the first working day of the month. The Family
         Consultant/Community Worker will review the medication log with the parent monthly.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                  HS 6 - 2
6.       The same person will be responsible for administering all medication on a given shift. The
         person to administer medication will be designated by Center Coordinator. Training will be
         provided to the staff person designated to administer medications in accordance with state
         law. If those instance where state law requires that an individual be licensed to administer
         medication, the services of a nurse or nurse practitioner will be obtained.




Form(s):
Referral
Parent Request Form for Administering Medication
Patient Medication Information
Medication Log
Dispensing Medication Packet




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 6 - 3
                           SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
    For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                    For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 7                                                                                       Issue Date: 9/98
Unit:      Health Services                                                                                    Effective Date: 9/98
                                                                                                              No. of Pages: 1
Title:      Health/Nutrition Referrals
Regulatory Reference:            1304.20(a)(c)



PURPOSE:
To ensure that all children receive all necessary health and nutrition follow-up care and/or
counseling.

POLICY:
Referrals will be completed for all Head Start children with chronic diseases, those requiring
prescription medications or special diets while at Head Start or any other situation that requires
the assistance of the Health Unit.

PROCEDURES:
FAMILY SUPPORT STAFF
1.   The Family Consultant/Community Worker/Home Visitor will review all health records
     and physical exams during the enrollment process as the information is returned to the
     center and entered into Child Plus. The Health Associate will be available for
     clarification and assistance in identifying health issues for enrollees or their families. The
     Family Consultant/Community Worker/Home Visitor (Head Start staff) will interview the
     parent of a child with health and nutrition forms that indicate a chronic disease to
     determine whether the chronic disease has been diagnosed by a physician, if the disease
     has been diagnosed, when was the child last seen by a physician for the diagnosed chronic
     disease? If the parent indicates that the child has not been treated within the previous 12
     months, ask the parent whether the child has been bothered with symptoms of the disease
     within the previous 12 months. If the child has not received treatment AND has been
     bothered with any symptoms, document in the case notes. What specialized care does the
     child require for treatment of the diagnosed chronic disease., i.e. medications, breathing
     treatments, menu modifications, tube feedings? THE PARENT MUST BE INFORMED
     THAT THE CHILD WILL BE REFERRED TO THE HEALTH UNIT FOR FOLLOW-
     UP SERVICES.
2.   Referral forms should not be completed for children with abnormal lab values, dental
     follow-up treatment and/or who are in need of screenings, or for children who have failed
     vision and hearing screenings. The Health Associate will be aware of those children
     before the screening results are forwarded to the centers.
3.   Health referrals should be completed in a clear and concise manner, with a clear copy of
     the physical exam form, growth chart, health and nutrition forms and any supporting
     documentation. The referral and any supporting documentation is to be forwarded to the
     Health Coordinator. The Health Coordinator will forward all health-related referrals to
     the Health Associate.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                            HS 7 - 1
4.       Upon review of the referral by the Health Unit staff, feedback will be provided to the
         center staff as to the plan for completion of the referral. If further information or
         signatures is required the Health Associate will provide the completed forms for the
         Family Consultant/Community Worker/Home Visitor to obtain the required parental
         signatures. The outcome of the Health unit review will lead to one or more of the
         following steps: a) completion of Individualized Health Plan; b) completion of the
         Individualized Education Plan. In all cases, parental involvement is required, i.e., parental
         signature on Consent To Release/Obtain Information, Dispensing Medication Packet,
         Consent for Services.

         The Health Associate will make the necessary contact with parents or caregiver within
         7 days of receiving the referrals. Documentation of disposition of the child’s health issue
         will be provided on case notes. See Special Services procedure #6.

         Any required Individualized Health Plan (IHP)/Individualized Education Plan (IEP)
         meeting will be scheduled within 30 days of receipt of all required documentation. The
         Special Services Coordinator is required to attend the Individualized Educational Plan
         meeting.

OTHERS
1. Complete anecdotal notes to document any observations for a period of two (2) weeks. The
   following information should be included in the anecdotal note: the behavioral the child is
   exhibiting, date and time of the occurrence, activity the child is involved in when the
   behavior occurs, and any other relevant information. No referral of this nature should be
   completed within the first two (2) weeks of enrollment unless the child has a diagnosed
   chronic illness or is receiving medication at the center.

2. Discuss any concerns with the Center Coordinator. Upon approval from the Center
   Coordinator complete a referral. Health referrals should be completed in a clear and concise
   manner, with a clear copy of the physical exam form, growth chart, health and nutrition forms
   and any supporting documentation. The referral and any supporting documentation is to be
   forwarded to the Health Coordinator. The Health Coordinator will forward all health-related
   referrals to the Health Associate.

3. Upon review of the referral by the Health Unit staff, feedback will be provided to the center
   staff as to the plan for completion of the referral. If further information or signatures is
   required the Health Associate will provide the completed forms for the Family
   Consultant/Community Worker/Home Visitor to obtain the required parental signatures. The
   outcome of the Health unit review will lead to one or more of the following steps: a)
   completion of Individualized Health Plan; b) completion of the Individualized Education
   Plan. In all cases, parental involvement is required, i.e., parental signature on Consent To
   Release/Obtain Information, Dispensing Medication Packet, Consent for Services.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 7 - 2
4. The Health Associate will make the necessary contact with parents or caregiver within
   7 days of receiving the referrals. Documentation of disposition of the child’s health issue
   will be provided on case notes. See Special Services procedure #6.

5. Any required Individualized Health Plan (IHP)/Individualized Education Plan (IEP) meeting
   will be scheduled within 30 days of receipt of all required documentation. The Special
   Services Coordinator is required to attend the Individualized Educational Plan meeting.


Form(s):
Referral
Case Notes
Anecdotals




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                            HS 7 - 3
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 8                                                                                       Issue Date: 9/98
Unit:      Health Services                                                                                     Effective Date: 2/04
                                                                                                               No. of Pages: 1
Title:        Bloodborne Pathogen Exposure Control Plan
Regulatory Reference:          HSPS 1304.22(a)(e); OSHA Regulations 29 CFR 1910.1030, DCFS Licensing
                               Standard 407.70



PURPOSE:
This plan was developed to comply with the OSHA (occupational Safety and Health
Administration) Bloodborne Pathogens Standard, 29 CFR Part 1910.1030.

POLICY:
The SIUE Head Start program will educate and train all of its employees on the prevention of
and universal precautions measures required to avoid Bloodborne illnesses.

DEFINITIONS:
Bloodborne Pathogens-Microorganisms found in human blood that may cause disease to an
individual exposed to them. The Bloodborne Pathogen Standard was instituted to minimize the
risk of individual contraction of diseases caused by exposure of the pathogens, such as Hepatitis
B or HIV.

This standard covers all employees who may be "Reasonably Anticipated" to come into contact
with human blood and other potentially infectious materials, which include any body fluid that is
visibly contaminated with blood.

Universal Precautions-An approach to infection control that protects individuals and others
from diseases that are transmitted in blood or other body fluids. According to the concept of
universal precautions, all human body fluids are treated as if known to be infectious for HIV,
HBV and other Bloodborne Pathogens.


I.         PRE - EXPOSURE VACCINATIONS

           A.         POSITIONS COVERED
                      Most SIUE Head Start employees' jobs requiring tasks involving no great
                      exposure to blood, body fluids or tissue than would be encountered by a volunteer
                      or a visitor. The normal work routine involves no exposure to blood, body fluids
                      or tissue. These persons would render first aid only as a collateral duty responding
                      solely to injuries resulting from work place incidents, generally at the location
                      where the incident occurred. However, while this determination of employees
                      was made based on OSHA regulations which allow employers to offer the
                      Hepatitis B vaccinations to certain employees after they have provided first aid

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                             HS 8 - 1
                   rather than offering pre-exposure vaccinations, the Head Start Program, as a
                   precautionary measure, will provide vaccinations to employees who may be
                   subjected to even minimal exposure. It has been determined that vaccinations will
                   be provided for those employees who hold the following positions:
                           -       Teachers
                           -       Teacher Assistants
                           -       Child Care Assistants
                           -       Building Service Workers
                           -       Center Coordinators

         B.        CHARGES FOR VACCINATIONS

                   Vaccinations will be provided through the SIUE Community Nursing Services,
                   located in the East St. Louis Center. The cost for the vaccinations received from
                   SIUE Community Nursing Services will be covered by the Head Start program.
                   For employees electing to get vaccinations through their personal physician or
                   through alternative healthcare providers, Head Start will reimburse the employee
                   up to the cost as charged by SIUE Community Nursing Services. These employees
                   must provide documentation of charges to confirm receipt of the vaccination.

         C.        VACCINATION SERIES

                   The Hepatitis B vaccinations comprise a series of three (3) shots:
                   Initial shot
                   Second shot - one month later
                   Final shot - five months later

         D         VACCINATION PERIOD
                   Hepatitis B vaccinations will be provided annually beginning the first day of each
                   program year through the month of October. Those employees electing not to take
                   vaccinations by October of each year may be required to wait until the next
                   program year for vaccinations to be paid for by the Head Start program. After
                   October 31, of each program year, vaccinations will be provided for new
                   employees only, within the first ten (10) days of employment.

         E.        EMPLOYEE DECLINATION

                   Hepatitis B vaccinations will be recommended and provided for employees
                   holding the positions as indicated in part A above. Though getting vaccinations
                   will be optional, due to possible minimal exposure and the Head Start programs
                   implementation for precautionary measures, those electing not to take
                   vaccinations will be required to sign a declination form. For these employees, in
                   the event of an incident, post-exposure prophylaxis, including Hepatitis B
                   vaccinations within 24 hours of exposure will be implemented.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 8 - 2
II.        IMPLEMENTATION OF UNIVERSAL PRECAUTIONS

         A.        COMPLIANCE MEASURES:

                   Universal Precautions will be practiced at all Head Start facilities. All blood or
                   other potentially infectious material will be considered infectious regardless of the
                   perceived status of the source or individual.

         B.        MINIMUM STANDARDS OF PRACTICE/PERSONAL PROTECTIVE
                   MEASURES:

                   All Head Start employees are required to follow these minimum standards when
                   working in situations which may have been contaminated with infectious
                   materials i.e., Blood and other body fluids.

                   1.        Wash hands immediately after using the restroom, and or after contact
                             with any body fluid. Hand washing facilities are readily accessible at each
                             facility.

                             a.        Wash hands with antibacterial soap and warm running water
                             b.        Rinse hands with running water from the wrist down to the
                                       fingertips.
                             c.        Dry hands well with a paper towel.
                             d.        Use this paper towel to turn off faucet. (All manually controlled
                                       faucets are considered contaminated).
                             e.        Dispose of towel in trash.

                   2.        Wear rubber gloves when anticipating contact with blood, body fluids,
                             tissues, mouths, contaminated surfaces, or if you have breaks in your skin
                             due to injury or rashes. Gloves will be kept in every room of the building.
                             Remove gloves as instructed in training course. After removing gloves,
                             staff must throw them away. Wash hands as indicated above.

                   3.        Wear a mask if blood or other infectious materials may be spread by
                             splatter droplets.

                             CLEANUP PROCEDURES AND WASTE DISPOSAL:
                             OSHA will approve all protective equipment and cleaning materials. All
                             protective equipment and cleaning supplies will be stocked at each facility
                             at no cost to the employee or volunteer.

                             a.        Wear rubber gloves at all times during clean up.

                             b.        Wash hands between going from one area to the other and put on a
                                       new pair of gloves i.e., when cleaning the classrooms, or emptying
                                       the trash etc.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                     HS 8 - 3
                             c.        Clean up all spills of body fluids or other infectious materials
                                       immediately and dispose of it in a biohazard bag if needed.

                             d.        Clean all exposed areas and or soiled surfaces with 10:1 bleach and
                                       water solution, rinse and dry thoroughly. Other OSHA approved
                                       sanitizers and or disinfectants may be used in addition to bleach
                                       and water solutions. Building Service Workers will keep bleach
                                       and water solutions in all areas for emergency disinfecting, in small
                                       spray bottles, and change daily.

                             e.        Cleanup broken glass or other sharp objects with mechanical
                                       equipment, i.e. dust pan and broom. To avoid injury, never pick up
                                       sharp objects with your bare hand.

                             f.        Dispose of sharp objects in a puncture resistant container. Never
                                       dispose of sharp objects in a plastic or paper bag.

                             g.        Contaminated materials or clothing should be disposed of (blood,
                                       vomit, feces or urine) in a red biohazard bag. Gloves should be
                                       worn at all times when handling contaminated materials. If kept,
                                       clothing should be placed in a red biohazard bag and immediately
                                       washed separately with detergent.

           C.     Hepatitis B vaccinations will be provided to Head Start staff upon request.


III.       HEPATITIS B VACCINE-POST EXPOSURE EVALUATION AND FOLLOW-
           UP:

           A.      All employees who have been identified as having exposure to blood or other
                   potentially infectious materials will be offered post-exposure evaluation and
                   follow-up, which is conducted at a Healthcare Provider designated by Head Start.

                   The Hepatitis B Vaccine, at no cost to the employee, will be offered to the
                   employee within 24 hour of possible exposure, and administered at a Healthcare
                   provider designated by Head Start.

           B.      Employees who have medical documentation verifying that they have previously
                   had the vaccine, and or immunity may be exempt, yet post-exposure counseling
                   and follow-up is still recommended.

           C.      Employees who refuse to take the vaccine will sign a declination waiver, which
                   uses the wording in appendix A of the OSHA standard, releasing the program
                   from any present or future responsibility. Post Exposure Counseling is still
                   recommended. Employees who initially decline the vaccine, but whom later


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                       HS 8 - 4
                   decides to have the vaccine may have the vaccine, again at no cost to the
                   employee.

           D.      WHEN AN EMPLOYEE INCURS AN EXPOSURE INCIDENT:

                   1.        Wash the area thoroughly with soap and water and dry well, and if an open
                             area is present cover with a dressing.

                   2.        Report incident to immediate supervisor and complete an incident report.
                             The staff person’s supervisor will contact the Health Coordinator, who
                             will arrange for him/her to go to a healthcare provider designated by Head
                             Start. The Health Coordinator maintains all records of exposure.

                   3.        All employees who incur an exposure incident will be offered post-
                             exposure evaluation and follow-up in accordance with the OSHA standard.
                             This follow-up, conducted by the Healthcare provider designated by Head
                             Start includes the following:

                             a.        Documentation of the route of exposure and the circumstances
                                       related to the incident.

                             b.        If possible, the identification of the source individual and if
                                       possible, the status of the source individual. The blood of the
                                       source individual will be tested (after consent is obtained) for
                                       HIV/HBV infectivity.

                             c.        Results of testing of the source individual will be made available to
                                       the exposed employees through a Healthcare Provider designated
                                       by Head Start. The exposed employee will be informed about the
                                       laws and regulations concerning disclosure of the identity and
                                       infectivity of the source individual, prior to testing and again by
                                       their physician when test results are given.

                             d.        The employee will be offered the option of having their blood
                                       collected for testing of the HIV/HBV Serological Status. The
                                       blood sample can be preserved for up to 90 days, to allow the
                                       employee to choose this option. If the employee chooses against
                                       the test, the specimen will be discarded immediately.

                             e.        The employee will be offered Post Exposure Prophylaxis Hepatitis
                                       Vaccine in accordance with the current recommendations of the
                                       U.S. Public Health Service as determined in consultation with the
                                       Illinois Department of public health and the local health
                                       department.

                             f.        The employee will be given appropriate counseling concerning
                                       precautions to take during the period after the exposure incident.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                       HS 8 - 5
                                       The employee will also be given information on what potential
                                       illnesses to be alert for and to report and related experiences to
                                       appropriate personnel.

                             g.        Post Exposure Documentation will be sent to the Health
                                       Coordinator following evaluation and treatment from the Health
                                       Department. The report will be limited to whether the Hepatitis B
                                       Vaccine was indicated and given, that the employee has been
                                       informed of the results and any pertinent medical conditions
                                       resulting from the exposure.

The following persons have been designated to assure that the policy outlined here is effectively
enforced, as well as, to maintain accurate records related to this policy:

Head Start Project Director                                       Program Operations Coordinators
Head Start Assistant Project Director                             All Supervising Center Coordinators
Health Coordinator                                                Home-Based Supervisor
All Health Associates


IV.      EMPLOYEE TRAINING:

         All Head Start employees are mandated to receive annual education and training on
         preventing the spread of Bloodborne Pathogens. The training will be offered during
         preservice and new staff orientation and will include the following:

         1.        Explanation of the OSHA standards on Bloodborne Pathogens
         2.        The types, signs and symptoms of Bloodborne diseases
         3.        Prevention of transmission
         4.        Review of the Head Start programs action plan
         5.        Safety measures, protective devises and universal precautions
         6.        Post exposure actions, evaluation and follow up assessment
         7.        Explanation of Hepatitis B and Prophylaxis treatment

         All employees are responsible for reviewing the plan and attending the training.
         Exposure certification must be attended by and updated annually by all employees.

V.       PLAN, REVIEW AND UPDATE:

         The Bloodborne Pathogen Exposure Control Action Plan will be reviewed and updated
         annually as required.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                         HS 8 - 6
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 9                                                                                       Issue Date: 9/98
Unit:         Health Services                                                                                  Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:         First-Aid Supplies
Regulatory Reference:             HSPS: 1304.23(f)(1); DCFS Licensing Standard 407.380



PURPOSE:
To ensure all Head Start centers/Home-Based receive required first-aid supplies as set forth by
Illinois Department of Children & Family Services and Illinois Department of Human Services.

POLICY:
The SIUE Head Start Program will provide each Head Start Center and the Home-Based program
with first-aid supplies to assure compliance with Illinois Department of Children & Family
Services and Illinois Department of Human Services. Per licensing standard 407.380, first aid
kits shall be maintained and readily available for use:
    1) Centers with less than 100 children shall maintain at least two first-aid kits, a kit for on-
        site use and a travel kit for use on field trips. Centers with a capacity of 100 or more
        children shall maintain at least three kits.
    2) When a program operates in various parts of a building or on more than one floor, a
        separate first-aid kit shall be maintained in each area or floor.

DEFINITIONS:
Health supplies are any and all materials necessary to provide first-aid treatment and preventive
health care from harmful germs that may cause illness.

PROCEDURES:
1.   The Center Coordinator/Home-Based Supervisor should regularly assess first-aid kits for
     contents and order supplies as needed. The standard consumable inventory form - health
     supplies should be submitted to the Health Coordinator to obtain the supplies. The Health
     Coordinator will process the request for supplies as indicated in PDM-32.

2.         The Health Associates will review first aid kits from assigned sites to determine whether
           the kit has the contents recommended by the Illinois Department of Children & Family
           Services and the Illinois Department of Public Health. The Health Associates will
           complete a physical inventory at least twice per year.

3.         The supplies for each first-aid kit shall be stored in a closed container which is clearly
           labeled as first-aid supplies and stored in a place that is accessible (unlocked) to child
           care staff at all times but out of the reach of children.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                             HS 9 - 1
4.       The on-site first-aid kits shall contain the following supplies, at minimum:

         a)        disposable latex gloves
         b)        scissors
         c)        tweezers
         d)        thermometer
         e)        bandage tape
         f)        sterile gauze pads
         g)        flexible roller gauze
         h)        triangular bandage
         i)        safety pins
         j)        eye dressing
         k)        pen/pencil and note pad
         l)        cold pack
         m)        adhesive bandages
         n)        a current American Academy of Pediatrics or American Red Cross standard first-
                   aid text or an equivalent first-aid guide.

5.       The travel first-aid kits for use on field trips shall contain the above supplies (a first-aid
         chart may replace the required text) plus the following additional items:
         water
         soap
         antiseptic cream or solution
         telephone number of the child care center (preferably on a laminated card) and
         coins for use in a pay phone.


Form(s):
Standard Consumable Inventory Form Health Supplies




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 9 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 10                                                                                        Issue Date: 9/98
Unit:       Health Services                                                                                    Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:     Payment Authorization Voucher
Regulatory Reference:          1304.20(c)(5)



POLICY:
All financial resources for payment of required and recommended health related services must be
exhausted before SIUE Head Start Program provides payment. There is no “blanket” approval
for payments of any children’s medical expenses. Therefore, prior approval on a case by case
basis is always mandatory before committing to payment for services. The SIUE Head Start
program focus will be payment for initial exam and screenings, etc., NOT for follow-up
treatment.

PROCEDURE:

1.         The Family Consultant/Community Worker/Home Visitors are responsible for
           seeking/exhausting all community health resources and alternative payment methods.
           These attempts are to be documented in case notes. In the event of failure to locate
           resources/financial assistance, a Payment Authorization Voucher may be completed.

2.         The Family Consultant/Community Worker/Home Visitor will be responsible for
           completing the voucher and signing in the indicated space for witness signature. The
           services that payment is being requested for should be listed on the bottom of the
           Payment Authorization Voucher.

3.         The completed, signed and dated Payment Authorization Voucher along with a copy of
           the case notes should be forwarded to the Health Associate no later than 3 days prior to
           the screening clinic.

3.         The Health Associate assigned to a center will obtain a cost estimate for services to be
           provided. The cost estimate should be documented on the Payment Authorization
           Voucher prior to the voucher being submitted for authorizing signatures.

4.          The Health Associate will submit the Payment Authorization Voucher along with
           documentation of efforts to obtain services from other sources to the Health Coordinator
           for authorization signature.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 10 - 1
5.       The Program Director and/or Assistant Program Director will authorize the payment of
         services. The Budget Coordinator will initial the voucher. The Health Coordinator will
         keep the pink copy on file and return the original and yellow copy of the voucher to
         Health Associate assigned to the center indicated on the voucher.

6.       The original should be placed in the child’s file. The yellow should be submitted to the
         healthcare provider before services are rendered.

7.       The SIUE Community Nursing Service and the SIUE Dental are the healthcare providers
         designated by SIUE Head Start.

Form(s):
Case Notes
Payment Authorization Voucher




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                             HS 10 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 11                                                     Issue Date: 9/98
Unit:         Health Services                                                Effective Date: 2/04
                                                                              No. of Pages: 1
Title:        Center Health Hygiene- Health Checks, Handwashing, Toothbrushing and Bed Linens
Regulatory Reference:            1304.20(d); 1304.22(e)



DAILY HEALTH CHECKS

PURPOSE:
To identify infectious diseases, prevent the spread of disease and to assess injury.

POLICY:
All infants/children enrolled in the Head Start program will be assessed daily for signs and
symptoms of disease, illness or injury.

PROCEDURE:
1.   The Teacher/Teacher Assistant will assess every infant/child as they enter the classroom
     for any noticeable signs of illness, injury, or disease. Examples of noticeable signs of
     illness are rash, sores, bruises, and burns, scratching or verbal complaints of
     “I am hot” or "I feel sick.” Infants that persistently cry should be assessed for illness,
     rashes, etc. The Home-Based Home Visitor will do the same for field trips and group
     socialization.

2.         If signs of illness or disease are present, the infant/child should be isolated. The Center
           Coordinator/Home-Based Supervisor or designee must notify the parent/guardian or
           emergency contact person.

           The Center Coordinator/Home-Based Supervisor or designee should encourage the
                 parent/guardian or emergency contact person to come pick up the infant/child.

           If the parent is unable, the Center Coordinator/ Home-Based Supervisor or designee
                   should take the infant/child home or to the emergency contact person and send
                   pertinent illness protocols along with infant/child. Car seats should be used, as
                   indicated.

3.         If signs of injury are present, it should be documented on a Child Incident/Accident
           Report.

4.         Complete Child Incident/Accident Report and send a copy to the Risk Management
           Liaison



D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 11 - 1
HANDWASHING PROCEDURE

PURPOSE:
To reduce the spread of germs.

POLICY:
It is the policy of SIUE Head Start program to ensure physical hygiene is practiced daily to
prevent the transmission of harmful germs. The lathering and scrubbing process should last
approximately 15 - 20 seconds.

PROCEDURE:
Children and staff must wash their hands upon entering the center prior to any activities being
initiated.

1.       Children and staff will always wash their hands before and after the following activities:
         a) Before and after eating or drinking
         b) Before and after participating in any cooking activities
         c) After using the toilet
         d) After all activities that soil the hands. This includes classroom activities involving the
            handling of animals, painting or sand/water play

2.       The following handwashing procedure must be followed:
         a)     The teacher or designee should turn the water on to a comfortable temperature and
                make sure that the children wet their hands thoroughly, slightly above the wrist.
         b)     The children should place a reasonable amount of soap in hands and lather well
                including the backs of hands, wrists and under fingernails.
         c)     The children are to rinse hands thoroughly and dry with paper towels or other
                sanitary hand drying device.
         d)     The teacher should turn off the water, or have the children turn the water off using
                a paper towel, to assure hands are not contaminated from the faucet.


TOOTHBRUSHING PROCEDURE

PURPOSE:
To ensure that dental hygiene is practiced to prevent tooth decay.

POLICY:
Toothbrushing will occur following meals to reinforce healthy dental practices. Children
attending full day sessions will brush after lunch; children attending AM sessions will brush after
breakfast; children attending PM sessions will brush after lunch.

PROCEDURE:

1.       The teacher or teacher assistant will carry the toothbrushes to the designated area in the
         provided toothbrush holder.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 11 - 2
2.       The children will be given their toothbrushes when it is their turn to brush their teeth.

3.       The teacher or assistant teacher will place a pea-sized amount of toothpaste in the
         provided 3-oz paper cup.

4.       The child will wet the toothbrush with water and apply the toothpaste to the toothbrush.

5.       The teacher or teacher assistant should guide children through the proper tooth brushing
         technique.

6.       The children should rinse their mouth using the provided 3-oz paper cup.

7.       The toothbrushes should be rinsed thoroughly and returned to the toothbrush holder.

8.       The teacher or the teacher assistant must ensure the toothbrushes never touch each other.

9.       The toothbrush holder should be cleaned with warm soap and water once a week.


CRIBS, BEDS, COTS AND BED LINENS

PURPOSE:
To reduce the spread of germs and to avoid sudden Infant Death Syndrome

POLICY:
Cribs, beds, cots and bed linens will be provided for all children enrolled in the full-day options
(in attendance for five or more consecutive hours). Cribs will be provided for all infants. Either
stacking cots or full-sized cribs will be provided for all children enrolled in full day options

PROCEDURE:
1. Each crib, bed or crib must be labeled with the name of the child.

2. Each crib, bed or cot will be maintained in clean and sanitary conditions.
   a) Cribs, beds and cots will be wiped clean as often as necessary. Cribs shall be cleaned
      twice per week and then sanitized with a germicidal solution. Cots will be cleaned once
      per week with a germicidal solution.

     b) All cribs, beds or cots will be thoroughly cleaned and then sanitized with a germicidal
        solution when a child is no longer enrolled, prior to use by another child.

     c) At no time will two children be allowed to share the same crib, bed or cot unless it is
        thoroughly cleaned and then sanitized with a germicidal solution before each child's use.

3. SIUE Head Start will provide freshly laundered sheets and blankets. No pillows will be
   provided or allowed in any Head Start \Early Head Start center. The blankets and sheets will


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 11 - 3
    be laundered twice per week for infants and toddlers and at least once per week for preschool
    children. The sheets and blankets should be laundered when they become wet or soiled.

4. To avoid sudden infant death syndrome, children who can not turn over alone will be placed
   on their sides or backs when put down to sleep unless contraindicated by a physician. A
   doctor's statement supporting this placement must be in the infant or child's file.



Form(s):
Child Incident/Accident Report




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                           HS 11 - 4
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.           HS 12                                                                                     Issue Date: 9/98
Unit:         Health Services                                                                                  Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:         Emergency Procedures
Regulatory Reference:           HSPS 1304.22(a)



PURPOSE:
To ensure a uniform method of responding to emergencies which may occur in any Head Start
program option.

POLICY:
All Center Coordinators, Teachers, Teacher Assistants and Child Care Assistants will
obtain/maintain certification in CPR/First Aid and Safety as outlined by the American Red Cross.
ALL Head Start staff will be knowledgeable and well trained in the agency emergency procedures
in order to protect the children in their care. All Head Start children will be taught the stop, drop
and roll burn prevention action. A fire drill will be conducted and documented at least monthly.

A.         MEDICAL EMERGENCY PROCEDURES

           1.         If the event of an injury, the center staff must determine the extent of the injury
                      and notify the parents.
                      a)       If an injury is minor:
                              1)       provide First Aid only
                              2)       complete a Child Incident/Accident Report and notify the child's
                                       parent, legal guardian or person designated by the parent.
                              3)       forward the Child Incident/Accident Report to the Special Services
                                       Coordinator within 24 hours

                      b)          If an injury is serious:
                                  An injury should always be considered serious when the following signals
                                  are present:
                                  Significant deformity, bruising or swelling, inability to use the affected
                                  part normally, bone fragments sticking out of a wound, victim feels bones
                                  grating; felt or heard a snap or pop at the time of injury, the injured area is
                                  cold and numb and the cause of the injury may be severe. Source:
                                  American Red Cross.

                                  1.         Call ambulance at 911. If the child's condition changes, call 911
                                             again.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 12 - 1
                             2.        Contact child's parents, legal guardian or person designated by the
                                       parent. Stay with the child and monitor child's condition until
                                       emergency services arrive.

                   c)        If the injury warrants hospital Emergency treatment, the nearest hospital
                             should be used. The possible hospitals are:

                                    Belleville Memorial Hospital      St. Mary's Hospital
                                    4501 North Park Dr.               129 N. 8th St.
                                    Belleville, IL 62223              East St. Louis, IL 62201
                                    Phone: (618) 233-7750             Phone: (618) 274-1900
                                    Touchette Regional                Gateway Regional Medical
                                    5900 Bond Avenue                  Center
                                    Centreville, IL                   2100 Madison Avenue
                                    Phone: (618) 332-3060             Granite City, IL
                                                                      Phone: (618) 798-3000

                   d)        Emergency Card (Regicard.doc revised 12/97) should be taken with the
                             child.

                   e)        A Head Start Incident/Accident Report form should be completed and
                             forwarded to the Risk Management Liaison within 24 hours of the
                             incident.

                   f)        Poisoning
                             For poison emergencies call the Poison Control Center 1-800-222-1222.


B.       TRANSPORTATION OF ILL OR INJURED CHILDREN/ADULTS

         POLICY:
         The policy of the SIUE Head Start program is to assure that sudden illnesses and injuries
         are treated in a manner that prevents transmission of illness to others or further
         discomfort to the infant/child.

         PROCEDURE:
         A)   Minor Injury/Illness
              1)     Contact the parent or emergency contact person to pick up the child and/or
                     arrange for the transportation of the child.

                   2)        The parent is responsible for the transportation of the ill/injured child.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                     HS 12 - 2
         B)        Serious Injury/Illness
                   1)     The Center Coordinator/ Home-Based Supervisor will call the ambulance
                          to transport the infant/child to the hospital specified by the parent. If the
                          injury is too severe, the nearest hospital will be used.

                   2)        Contact the parent or nearest relative and inform them of the hospital to
                             which the infant/child is being transported if the parent was not previously
                             notified of the illness.

                   3)        If the parent requires transportation, Head Start personnel will transport
                             the parent to the hospital.

                   4)        The emergency card is to be taken with the infant/child to the medical
                             facility.

                   5)        All emergencies are to be recorded on an Incident/Accident Report and a
                             copy forwarded to the Risk Management Liaison within 24 hrs.


C.       POISONING

         PURPOSE:
         To provide uniform care and treatment of children following the ingestion or contact with
         poisons.

         POLICY:
         The Head Start center environment will be structured to prevent accidental poisonings.
         The Head Start staff will be knowledgeable of Poison Control Center telephone number
         1-800-222-1222. This number must be posted in the classroom and Center Coordinator's
         office.

         DEFINITIONS:
         Poison is any substance - solid, liquid or gas that tends to impair health or cause death
         when introduced into the body or onto the skin surface.

         PROCEDURES:
         1.   Telephone the Poison Control Center or Emergency Medical System (EMS).

         2.        Follow the instructions provided by the Poison Control Center. If there is no
                   poison control center, call a hospital emergency department or telephone
                   Emergency Medical System (EMS) and follow instructions.

         3.        Do not make the infant/child vomit without medical advice.

         4.        Attempt to identify the poisonous substance.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 12 - 3
                   a)        If the poisonous substance is an inhaled poison (gases):
                             1)      Move to fresh air
                             2)      Loosen tight clothing
                             3)      Check breathing and open airway
                             4)      Administer rescue breathing if necessary.
                             5)      Get medical attention

         5.        Notify parents.

         6.        All emergencies are to be recorded on a Child Incident/Accident Report and a
                   copy forwarded to the Special Services Coordinator.


D.       SWALLOWED OBJECTS

         PURPOSE:
         To provide uniform care and treatment of the infant/child who has ingested an object.

         POLICY:
         Care of swallowed objects will be managed according to the guidelines presented HS-17,
         Procedure for Airway Obstruction (Choking).

         DEFINITIONS:
         A foreign body that has been ingested internally.

         PROCEDURES:                   Follow First Aid procedures.

         All emergencies are to be recorded on a Child Incident/Accident Report and a copy
         forwarded to the Special Services Coordinator.


E.       EVACUATION METHODS FOR FIRES

         PURPOSE:
         To ensure that all Head Start staff and children are knowledgeable of protective steps to
         take in case of fire.

         POLICY:
         The SIUE Head Start program will ensure that all Head Start children, staff, parents, and
         any other persons on premise are protected from fire, and any other hazardous condition
         related to fire.

         DEFINITIONS:
         Fire may be defined as heat and light of combustion that is very hot.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                             HS 12 - 4
         PROCEDURE:
         In the event of a fire:
         1.      The Teacher/Teacher Assistant should guide the children quickly and safely to the
                 outside of the building. Infants and toddlers will be carried, as need.

         2.        The Teacher/Teacher Assistant must take the class roster to the outside of the
                   building during the evacuation. Once the children are outside, the
                   Teacher/Teacher Assistant should check each child’s name to ensure that all
                   children are safely on the outside.

         3.        The staff and children should not re-enter the building unless instructed by the fire
                   department. If the building cannot be occupied, the Center Coordinator or
                   designee must go to the nearest telephone to call transportation services to pick up
                   the children. The Center Coordinator or designee will call central office so those
                   parents can be notified and be prepared to either pick up or receive children.

         Preventive Measures
         1.     Children will be taught the stop, drop, and roll burn prevention action.

         2.        Fire drills will be conducted and documented monthly in all SIUE Head Start
                   centers.


F.       EVACUATION METHODS FOR TORNADOES

         PURPOSE:
         To ensure that all Head Start staff and children are knowledgeable of protective steps to
         take in case of a tornado.

         POLICY:
         All Head Start enrollees, staff, parents, and any other persons on premise will be
         protected from tornadoes or any other hazards that are related to the tornado. Evacuation
         procedures must be posted in all classrooms and offices.

         DEFINITION:
         Tornado is a destructive whirling windstorm with funnel-shaped cloud whirlwind.
         Tornadoes can be hazardous; this situation must be handled with precaution.

         In case of a tornado, take the children to the lower, or center (if there is no basement) part
                 of the building away from windows or objects that can cause serious accidents.
                 Preferable refuge should be taken near a corner with a protective covering, i.e.,
                 mattress or mats for shields.

         2.        If children are on the outside, look for a ditch or make sure children are
                   away from flying objects that could cause physical harm.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 12 - 5
         3.        Call for help as soon as conditions are favorable.


G.       EVACUATION METHODS FOR EARTHQUAKE

         PURPOSE:
         To ensure that all Head Start staff and children are knowledgeable of protective steps to
         take in case of an earthquake.

         POLICY:
         The SIUE Head Start program will ensure that all Head Start children, staff, parents, and
         any other persons on premises are protected from earthquake, and any other hazardous
         conditions related to an earthquake.

         PROCEDURES:
         During an earthquake, remain calm and quickly do the following:
         Indoor Procedures
                 Seek protection in a doorway or under a desk or table.
                 Stay away from glass, windows, shelves and heavy equipment.
                 Be prepared for aftershocks.
                 Call University Police at 911 if emergency help is needed after the initial
                    shock.
                 Report damaged facilities to Facilities Management.
                 If there is a related emergency, such as a fire or gas leak, activate any available
                    building alarm.

         At this point, evacuate the building in the following manner:
                  Assist the disabled in exiting the building in accordance with plans developed
                     within your unit. (See *Emergency Assistance for the Disabled)
                  Walk to the nearest exit and ask others to do the same.
                  Do not use elevators; do not panic.
                  Once outside, move to a clear area at least 500 feet away from the affected
                     building(s).
                  Keep roadways, fire lines, hydrants and walkways clear for emergency
                     vehicles and crews.
                  If requested and if you wish to do so, assist emergency crews.
                  Keep clear of any emergency command posts unless you have official
                     business.
                  Do not return to an evacuated building unless directed to do so by University
                     Police.

         Outdoor Procedures:
               Move away from buildings, trees and utility poles. Remain at least 500 feet away
                   from such structures.
               Avoid power or utility lines.
               Lie or sit down to avoid being thrown about by the quake.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                              HS 12 - 6
                   If you are in an automobile, stop in the safest place available away from power
                       lines and trees. Stay in the vehicle for the shelter it offers.


H.       CHEMICAL & BIOHAZARDOUS SPILLS

         If a chemical or biohazardous material is spilled and unit personnel are not familiar with
         its properties, the unit manager or his/her designee should report the incident immediately
         to University Police, providing as much information as possible; university personnel
         should make no attempt to contain or clean-up the spill unless they are familiar with the
         chemical or biohazardous material and its properties.

         University Police will make arrangements for clean-up of the spill and, depending upon
         the nature of the chemical or biohazardous material involved, may order an evacuation of
         the site. Members of the University community located in the affected area must heed
         such an order, which may be coupled with the sound of the building alarm.



Form(s):
Emergency Card
Child Incident/Accident Report




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 12 - 7
                                     SIUE HEAD START POLICY/PROCEDURE

Procedure No.              HS 13                                                Issue Date: 9/98
Unit:             Health Services                                            Effective Date: 9/11/06
                                                                             No. of Pages: 1
Title:         Center-Based Health Screenings
Regulatory Reference:        HSPS 1304.20(a)(c), DCFS Licensing Standards 407.310, EPSDT Standards



A.       PHYSICAL EXAMINATION

         PURPOSE:
         To ensure Head Start children are in optimal physical condition and to determine if any
         medical follow-up care is needed.

         POLICY:
         All Head Start children of SIUE Head Start programs will have a complete physical
         examination, as appropriate for age, upon enrollment as required by Department of
         Children and Family Services. All physical exams must be dated less than 6 months prior
         to enrollment. The physical exam must be repeated annually. The physical exam will
         include hemoglobin or hematocrit (beginning at 6 months and older), strabismus testing,
         tuberculosis screening (beginning at 1 years old and older), lead assessment (beginning at
         6 months and older) urinalysis, blood pressure, height and weight and immunization
         assessment.

         DEFINITIONS:
         Physical Examination - an examination conducted by a certified medical doctor and/or
         nurse practitioner under the supervision of a physician. The physical examination form
         must be signed by a medical doctor.

         PROCEDURES:
         1.   All Head Start children’s files are reviewed and assessed for completeness by the
              Family Consultant/Community Worker/Home Visitor as indicated in the “Health
              at a Glance” and the Health Services policies and procedures.

         2.        Parents are notified of any required medical screenings or health follow-up
                   treatment as identified on the initial physical examination/dental form via the
                   Health Reminder or the Medical/Dental Follow-up form. The Family
                   Consultant/Community Worker/Home Visitor in coordination with the Health
                   Associate assigned to the center, will assist parents to schedule appointments with
                   the health care provider or medical home to obtain follow up for any
                   abnormalities.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 13 - 1
B.       HEMOGLOBIN/HEMATOCRIT SCREENING

         PURPOSE:
         For early identification, prevention and intervention of nutritional related anemia.

         POLICY:
         All children, age 12 months and older must have a hemoglobin or hematocrit blood test
         result on file within 45 days of the child’s entry date. This is a required screening for
         SIUE Head Start.

         DEFINITIONS:
         Hemoglobin (Hgb)/Hematocrit (Hct)-the measurement of iron in whole blood cells in the
         body.
         Abnormal Hgb-below 11; Hct below 34.
         Anemia- the reduction of red blood cells volume.

         PROCEDURES:
         1.   The Family Consultant/Community Worker/Home Visitor will inform parents of
              the importance of hemoglobin/hematocrit screening and that it is a required lab
              screening for enrollment into SIUE Head Start.                   The Family
              Consultant/Community Worker/Home Visitor will inform parents to bring all
              results to the center.

         2.        If a child does not have record of a hemoglobin/hematoctrit result, the Family
                   Consultant/Community Worker/Home Visitor will send a Health Reminder or
                   Medical/Dental Follow-up Notice and will assist with scheduling the child with a
                   medical provider.

         3.        If the parent cannot obtain the screening results from the medical provider, a
                   signed and dated Consent for Follow-Up Services form and a copy of the medical
                   card, where applicable, or payment authorization voucher must be on file. The
                   child could then be scheduled to receive the test during a center based screening
                   clinic.

         4.        The Health Associates will assist with the development of individual health plans
                   for the child.

         5.        Documentation must be maintained in the files of parent refusal or inability of
                   parent to obtain screening for any child who has not had an initial screening or
                   follow up screenings.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 13 - 2
C.       LEAD POISONING SCREENING

         PURPOSE:
         To detect the presence of lead poisoning in Head Start children and provide for early
         intervention and prevention.

         POLICY:
         Lead Assesment and screening will occur in accordance with Department of Human
         Services and SIUE Head Start Advisory Board rules and regulations for all children, age
         12 m onths and older. Head Start considers levels above 9 as abnormal. The assessment
         is required at SIUE Head Start. The screening must be completed prior to or within 45
         days of the child’s entry date.

         DEFINITIONS:
         Lead Poisoning - a disease caused most often by the ingestion (eating) of lead. Lead can
         be found in paint chips, and can damage a child's brain, kidneys, and stomach. It also can
         slow a child's mental development and cause learning and behavioral problems.

         Lead Assessment- administration of the risk questionnaire to the parent; one "yes"
         response will indicate lead screening is needed.

         Lead Screening - a blood test by venous or capillary methodology.

         PROCEDURES:
         1.   Upon recruitment (at intake), the Family Consultant/Community Worker/Home
              Visitor will inform parents that a lead assessment is required for each child
              entering the program.

         2.        The Family Consultant/Community Worker/Home Visitor will review files for
                   proof of having a completed lead assessment and a record of the results. Parents
                   will be notified to obtain and bring in results when no results are present.

         3.        The Family Consultant/Community Worker/Home Visitor with assistance from
                   the Health Associate will assist parents with scheduling a child for screening with
                   the medical home and will begin to prepare the child.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 13 - 3
D.       IMMUNIZATIONS

         PURPOSE:
         To prevent the spread of infectious diseases by providing children with immunity via
         vaccine administration.

         POLICY:
         All children enrolled in the program will be required to have appropriate immunizations
         based upon age and date of last immunization.

         DEFINITIONS:
         Immunizations protect individuals against certain infectious diseases such as diphtheria,
         pertussis, tetanus, measles, mumps, rubella, hepatitis B, HIB, and chicken pox.


         PROCEDURES:
         1.   Upon recruitment (at intake), Family Consultant/Community Worker/Home
              Visitor will inform parents that immunizations must be up to date prior to
              attending the program. Parents will be assisted with obtaining immunizations
              from their primary health care provider/medical home.
         2.   Immunizations will be assessed by the assigned Health Associate. A review of
              ChildPlus Reports will also be monitored monthly to assess children’s
              immunization status.
         3.   The Family Consultant/Community Worker/Home Visitor will inform parents of
              what immunization requirements their child has not met. The Health Associate
              will provide this information to the Family Consultant/Community Worker/Home
              Visitor and/ or interpret enrollees’ immunization status.
         4.   The Family Consultant/Community Worker/Home Visitor will assist parents as
              needed to obtain immunizations from their primary health care provider/medical
              home.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                             HS 13 - 4
E.       SICKLE CELL SCREENING

         PURPOSE:
         For early identification, prevention and intervention of sickle cell disease or trait.

         POLICY:
         All Head Start children should have a sickle cell test. This is a recommended screening
         and is not required.

         DEFINITIONS:
         Sickle Cell Disease-A hereditary blood disease where red blood cell destruction occurs.
         When situations that lower oxygen, infections, strenuous exercise, anemia or pulmonary
         disease occur the person becomes ill and has a crisis. This test is completed at birth for
         children born in Illinois.

         PROCEDURES:
         1.   The Family Consultant/Community Worker/Home Visitor will inform parents of
              the importance and recommendation of the test. The Family
              Consultant/Community Worker/Home Visitor/Home-Based Home Visitor will
              identify children via file review and communication with parents or caregiver.

         2.        Assist parent with follow-up as requested.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 13 - 5
F.       HEARING SCREENING

         PURPOSE:
         To ensure that children with hearing problems are identified and follow-up care can be
         initiated for early treatment.

         POLICY:
         The SIUE Head Start program will conduct annual hearing screenings on all Head Start
         enrollees and assist parents in making provisions for those requiring follow-up care.

         DEFINITIONS:
         Hearing Screening is a process of identifying individuals who may have a hearing
         impairment.

         PROCEDURES:
         1.   Hearing screening is conducted by a certified hearing technician in a quiet room,
              using a portable audiometer, table and chairs for the screening.

         2.        Two phases are conducted, including play audiometry. These phases are: (1) the
                   preparation phase, during which the child is conditioned to respond; and, (2) the
                   measurement phase, during which the actual screening or threshold test is
                   completed.

         3.        Any child showing a deficit will be rescreened within 2 weeks following the
                   initial screening and referred for hearing follow-up if they fail. Parents will be
                   notified by letter or personal contact of any referrals and community resources.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                              HS 13 - 6
G.       VISION SCREENING

         PURPOSE:
         To ensure that children with vision problems and in need of an examination by an eye
         doctor for possible treatment are identified and treated early.

         POLICY:
         The SIUE Head Start program will conduct vision screening on all enrollees annually to
         identify those children needing professional eye services.

         DEFINITIONS:
         Vision screening is a simple process of identifying children that may have vision
         problems.

         PROCEDURES:
         1.   Vision screening is conducted by a certified vision technician using the screening
              instrument Good-Lite Insta-Line.

         2.        The technician conducts a pre-screening preparation exercise with the child to
                   help him/her understand the rules of the game. Copies of the Vision Screening
                   Readiness Game for HOTV may be obtained from the Illinois Department of
                   Public Health.

         3.        The technician observes the child prior to actual testing for appearance of eyes,
                   child's behavior and for any complaints. Testing is conducted using 20/40
                   symbols for 3 and 4 year olds and 20/30 symbols for 5 year olds and kindergarten.

         4.        All children who fail the rescreening will be referred to the Optometrist for an eye
                   exam. Parents are notified via letter of failed screenings.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 13 - 7
H.       DENTAL EXAMINATION

         PURPOSE:
         To ensure all Head Start enrollees receive proper dental health care that is an essential
         part of growth and development.

         POLICY:
         All children, aged 3 and older, enrolled in the SIUE Head Start program will obtain an
         annual professional dental examination and dental follow up when indicated. The dental
         exam is acceptable for 1 year from the date indicated on the dental exam. Staff’s primary
         responsibility is to assure that the family has a dental home, i.e., a primary dental
         provider.

         DEFINITIONS:
         Dental Examination - An examination by a licensed dentist who reviews dental history,
         charting of teeth, examining hard and soft tissue of the oral cavity, and x-rays, if needed,
         for diagnosis.

         PROCEDURES:
         1.   Each Head Start child will obtain a professional dental examination annually. The
              dental exam form is reviewed and assessed by Center Coordinator/ Home-Based
              Supervisor or their designee to determine whether any follow-up care is needed.
              The Health Associate is available to clarify medical terminology, and assist with
              resource identification.
         2.   The Family Consultant/Community Worker/Home Visitor/Home Visitor and the
              Health Associate will assist parents with resource identification.
         3.   Needed dental services are prioritized and parents are notified initially via the
              Health Reminder or Medical/Dental Follow-Up form or personal contact by
              Family Consultant/Community Worker/Home Visitor.                   The Family
              Consultant/Community Worker/Home Visitor may provide follow-up during
              parent meetings or homes visits and provide assistance as needed.

         Dental treatment includes:
         1)       Extractions
         2)       Pulp therapy as necessary
         3)       Restoration
         4)       Dental prophylaxis and self-care oral hygiene procedures




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                              HS 13 - 8
I.       TUBERCULOSIS (Tb) SCREENING

         PURPOSE:
         To prevent the spread of disease.

         POLICY:
         Unless the examining physician has made a determination that it is unnecessary, a
         tuberculin skin test by the Mantoux method and the results of that test will be included in
         the initial examination for all children who have reached one year of age, or at the age of
         one year for children who are enrolled before their first birthday.

         PROCEDURE:
         1.   The Tuberculosis (Tb) screening result is required before a child may attend any
              Head Start/Early Head Start center. The screening result is required no later than
              30 days following a child's first birthday for infants enrolled in the Early Head
              Start program.

         2.        Children with Tb screening results within normal limits will be allowed to attend
                   Head Start/Early Head Start sessions when slots become available.

         3.        Children with abnormal screening results will not be allowed to attend Head
                   Start/Early Head Start sessions until all required treatment has been completed
                   and a doctor's statement is provided to the Head Start/Early Head Start program
                   staff. The original copy of the doctor's statement is to be maintained in the child's
                   file. Children with abnormal Tb screening results will be required to have a
                   completed Positive Tb Screening Follow-Up Form on file at the Head Start/Early
                   Head Start center. This form is to be completed annually.



Form(s):
Referral
Health Reminder Notice
Medical/Dental Follow-up Notice
Physical & Dental Forms
Payment Authorization Voucher
Consent for Services




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 13 - 9
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.              HS 14                                                                                  Issue Date: 9/98
Unit:                Health Services                                                                           Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:          Staff and Volunteer Health Examination
Regulatory Reference:              HSPS 1304.52(j), DCFS Licensing Standard 407.100



PURPOSE:
To ensure staff and volunteer physical conditions meet local and state regulations to work in
early childhood settings.

POLICY:
The SIUE Head Start program will assure all employees and volunteers that have contact with
children will have physical examinations. The individual must be found free of any
communicable disease. Physical exams will be required every 2 years, according to DCFS
licensing standards. TB skin test is considered part of the exam. TB skin test must be provided
in accordance with the Mantoux method.

DEFINITIONS:
See Physical Examination for children.

PROCEDURES:
1.   The Center Coordinators/Home-Based Supervisors and Unit Mangers will obtain
     completed physical exam forms from staff and volunteers who have contact with children
     on a consistent basis.

2.         The Center Coordinator/Home-Based Supervisor or Unit Mangers will maintain the
           original of the physical in the employee's personnel file. Center staff’s originals will be
           kept at the center. Center Coordinator will forward copies of updated information to
           central office to be placed in the central office personnel file. Home-Based and central
           office originals will be kept in central office personnel files.

3.         Individuals with a positive T.B. test will be required to submit a copy of a chest x-ray
           report for their personnel file and must have repeat chest x-ray annually.

4.         Individuals will be responsible for reporting any illness or condition that they may have
           that is potentially communicable to others.

Form(s):
Physical




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 13 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.                  HS 15                                                                              Issue Date: 9/98
Unit:                Health Services                                                                           Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:          Sick Child Exclusion Policy and Related Illnesses
Regulatory Reference:             1304.20(c)(d); 1304.22(b)



Policies for sick child were developed according to the illness classification as a skin
abnormality, febrile illness, and or communicable/infectious illness. The basic policies for
illnesses/abnormalities are:

A.         Skin abnormality- any abnormal skin lesion should be assessed by a physician. The child
           should be excluded from Head Start sessions and return with a doctor’s statement
           indicating the nature of the skin abnormality.

B.         Febrile illness- A child with fever of 100 or above will be considered contagious and will
           be excluded from Head Start sessions. Parents should not send children to school with a
           fever.

C.         Suspected Communicable/Infectious Illness- Any child suspected of having a
           communicable/ infectious disease should be isolated from other children and excluded
           from Head Start sessions. Child may return with a doctor’s statement indicating the
           nature of the illness. Children that have vomiting and or diarrhea will be excluded from
           sessions and should not return to the sessions until 24 hours after vomiting or diarrhea has
           stopped.

Various skin abnormalities, febrile illnesses, and communicable/infectious illnesses that are
frequently encountered are defined in this section. This section of the Policy and Procedure
manual was organized in this manner to aid the lay person in the assessment and disposition of
children with a suspected abnormality or illness.

Following are description of:
A.     Skin abnormalities- Herpes, Impetigo, Ringworm and Scabies
B.     Febrile Illnesses- Ear Infection and Winter Flu
C.     Suspected Communicable/Infectious Illnesses- Colds, Diarrhea, Infectious Croup,
       Infectious Conjunctivitis (Pink Eye), Fifth Disease, Lice, StrepThroat, Roseola and
       HIV/AIDS




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 15 - 1
A.       FEBRILE ILLNESSES

         1.        EAR INFECTIONS (OTITIS)

                   PURPOSE:
                   Identification and intervention of ear infections.

                   POLICY:
                   Head Start recognizes that chronic ear infection as a child may affect the ability to
                   hear throughout the life cycle. Children/infants who are suspected of having an
                   ear infection 3 or more times will be required to be seen by a physician and return
                   to the center with a doctor’s statement.

                   DEFINITIONS:
                   Ear infections are characterized by earache, pulling at the ear, unusual crankiness,
                   hearing difficulties, or funny sensations in the ear.

                   PROCEDURES:
                   1.   Assess the infant’s/child’s temperature.

                   2.        Contact the parent/nearest relative to pick up the child and/or arrange for
                             transportation of the child.

                   3.        The infant/child can be returned to school when well enough to participate
                             in activity. Children with chronic ear infections must return with a
                             doctor’s statement indicating the nature of the illness and any instructions
                             for follow-up care.


         2.        INFLUENZA A (WINTER FLU)

                   PURPOSE:
                   To identify and prevent the spread of Influenza A.

                   POLICY:
                   An infant/child with fever of 100 or above will be considered contagious and will
                   be excluded from school. The infant/child that is excluded from school may
                   return to school after 24 hours without a fever. Children that have vomiting and
                   or diarrhea will be excluded from sessions and should not be sent to sessions until
                   24 hours after the vomiting or diarrhea has stopped and the infant/child remains
                   without a fever.

                   DEFINITIONS:
                   Characterized by sore throat, fever, chills, headache, muscle aches, loss of
                   appetite, and feeling ill. Spread by direct contact or contact articles recently
                   contaminated by secretions from an infected person's nose or mouth.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 15 - 2
                   PROCEDURE:
                   1.   Assess/observe the infant/child.

                   2.        Isolate infant/child from other children/infants.

                   3.        Contact parent/nearest relative to pickup and/or arrange for transportation
                             of the child.

                   4.        The infant/child can return after 24 hours of no diarrhea, fever.


B.       SKIN ABNORMALITIES

         1.        HERPES

                   PURPOSE:
                   To identify and prevent the spread of herpes.

                   POLICY:
                   Any abnormal skin lesion should be assessed by a physician. Child should be
                   excluded from the session and return with a doctor’s statement indicating the
                   nature of the skin lesion and instructions for and instructions for any follow-up
                   care.

                   DEFINITIONS:
                   Herpes simplex of oral type has symptoms such as, fever, irritability, and
                   inflammation of the mouth and gums with cold sores and fever blisters, and
                   blisters, around the mouth and sometimes on the fingers. Herpes is spread by
                   direct contact with infected mucous or saliva; especially contagious the first day
                   after a blister appears.

                   PROCEDURES:
                   1.   Observe the infant/child for characteristics identified in the definition.

                   2.        Contact the parent/emergency contact to pick-up and/or arrange for
                             transportation of the child.

                   3.        Assess parents’ knowledge of the lesions.

                   4.        Contact proper authorities as indicated.

                   5.        Refer for medical evaluation.

                   6.        Complete Communicable Disease Report. Forward to the Health
                             Coordinator at the end of the month.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 15 - 3
         2.        IMPETIGO

                   PURPOSE:
                   To identify and prevent the spread of impetigo.

                   POLICY:
                   Any abnormal skin lesion should be assessed by a physician. Infant/child should
                   be excluded from sessions and return with a doctor’s statement indicating the
                   nature of the skin lesion and instructions for any required follow-up care.

                   DEFINITIONS:
                   Impetigo signs are red, oozy rash; blisters; or honey colored, crusty scabs. It is
                   spread by contact through cuts and scrapes in the skin that come in direct contact
                   with bacteria in the soil or from another infected person, or by direct contact with
                   objects that have the bacteria on them.

                   PROCEDURES:
                   1.   Assess/observe the infant/child for the characteristics identified in the
                        definition.

                   2.        Contact the parent/emergency contact to pick up and/or arrange for
                             transportation of the child.

                   3.        The infant/child may return 24 hours after treatment has begun.

                   4.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         3.        RINGWORM

                   PURPOSE:
                   To identify and prevent the spread of ringworm.

                   POLICY:
                   Any abnormal skin lesion should be assessed by a physician. The infant/child
                   should be excluded from sessions and return with a doctor’s statement indicating
                   the nature of the illness and instructions for any required follow-up care.


                   DEFINITIONS:
                   Ringworm is generally characterized by a slightly raised, itchy, ring shaped sores
                   anywhere on the body. Ringworm is caused by a fungus. It is spread by direct
                   contact with infected people, animals or surfaces with the ringworm fungus on
                   them.



D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                   HS 15 - 4
                   PROCEDURES:
                   1.   Assess/observe of infant/child for the characteristics identified in the
                        definition of ringworm.

                   2.        Isolate the child from other infant’s/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after treatment starts.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         4.        SCABIES

                   PURPOSE:
                   To identify and prevent the spread of scabies.

                   POLICY:
                   Any abnormal skin lesion should be assessed by a physician. The infant/child
                   should be excluded from sessions and return with a doctor’s statement indicating
                   the nature of the illness and instructions for any required follow-up care.

                   DEFINITIONS:
                   Symptoms of scabies include very itchy red rash that appears between the fingers
                   and around the waist, wrist, elbow, underarm, navel, penis, nipples, abdomen,
                   outer borders of the feet, and lower portion of the buttocks. It is spread by close
                   personal contact or prolonged casual contacts; caused by small insects called
                   mites.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infant/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after treatment starts.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.



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B.       SUSPECTED COMMUNICABLE/INFECTIOUS ILLNESS

                   Staff will routinely inform ALL families whenever any diagnosed highly
                   infectious disease (e.g. measles, chickenpox) occurs in ANY child in the setting
                   via the HEALTH ALERT.

         1.        COMMON COLD

                   PURPOSE:
                   To prevent the spread of germs to other children, infants and staff.

                   POLICY:
                   All precautions will be maintained to prevent the spread of contagious and
                   infectious diseases.

                   DEFINITIONS:
                   Symptoms of colds include sneezing, runny nose, sore throat, cough, watery or
                   irritated eyes, headache, and crankiness-sometimes a fever.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after treatment starts.


         2.        DIARRHEA

                   PURPOSE:
                   To provide adequate response and prevention of spread of diarrhea to others.

                   POLICY:
                   All precautions will be maintained to prevent the spread of contagious and
                   infectious disease.

                   DEFINITIONS:
                   Symptoms of diarrhea may include abdominal cramps, vomiting, fever, and looser
                   and more frequent stools.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.


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                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after diarrhea has stopped.


         3.        INFECTIOUS CROUP

                   PURPOSE:
                   To identify and prevent the spread of infectious croup.

                   POLICY:
                   All precautions will be maintained to prevent the spread of contagious and
                   infectious diseases. The infant/child should be excluded from sessions and return
                   with a doctor’s statement indicating the nature of the illness and instructions for
                   any required follow-up care. Child may return to school 24 hours after treatment
                   starts.

                   DEFINITIONS:
                   Difficult breathing, barky cough, and an especially harsh sound when the
                   infant/child inhales. This is caused by swelling of the airway. Croup is spread
                   through contact with germs from the saliva or nose mucous of an infected person.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after treatment starts.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         4.        INFECTIOUS CONJUNCTIVITIS (PINK EYE)

                   PURPOSE:
                   To identify and prevent the spread of infectious conjunctivitis.

                   POLICY:
                   An infant/child that is suspected of having infectious conjunctivitis will be
                   excluded from school and referred for medical evaluation. The infant/child should

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                   be excluded from sessions and return with a doctor’s statement indicating the
                   nature of the illness and instructions for any required follow-up care. Child may
                   return to school 24 hours after treatment starts.

                   DEFINITIONS:
                   Symptoms of conjunctivitis include red, tearing eyes that may hurt, or feel itchy;
                   swollen lids; and thick, yellow, discharge. Please note that red eyes may also
                   occur with many common respiratory diseases or when a child has eye allergies.
                   The spread of the disease occurs when the infected child rubs his eyes and then
                   touches other objects.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school 24 hours after treatment starts. A doctor’s
                             statement indicating the nature of the illness and any required follow-up
                             care must be provided to Center Coordinator.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         5.        FIFTH DISEASE

                   PURPOSE:
                   To identify and prevent the spread of the fifth disease.

                   POLICY:
                   Children diagnosed as having fifth disease should be excluded from sessions and
                   return with a doctor’s statement indicating the nature of the illness and
                   instructions for any required follow-up care. Child may return to school 24 hours
                   after treatment starts.

                   DEFINITIONS:
                   Fifth disease is a distinctive rash beginning on the face that makes the child
                   appear to have very red slapped cheeks. After one to four days, a lacy-looking
                   rash appears on the arms and moves to the trunk, buttocks, and thighs. The body
                   rash may come and go for one to three weeks, usually appearing when it is hot or
                   the child has been in the sun. Some children have a fever when the illness begins.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

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                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The child may return to school when all signs of infection have subsided
                             and alertness and strength are present.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         6.        LICE

                   PURPOSE:
                   To identify and prevent the spread of lice.

                   POLICY:
                   Lice are classified as a nuisance disease. Infant/child may return to center after
                   one day of treatment. Infants/children with reoccurring cases of lice must be seen
                   by a physician. Those infants/children must return with a doctor’s statement
                   indicating child may return to sessions. Head Start maintains a “no-nit” policy for
                   return to sessions.

                   DEFINITIONS:
                   The signs of lice are itchy bites on the head. The disease is spread by tiny insects
                   that lay eggs (nits) that look like grains of sand on the hair around the neck and
                   ears. The lice crawl from one person or piece of clothing to another, or direct
                   personal contact or contact with infected clothing.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the infant/child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child. Provide parents/emergency contact person with
                             a copy of Parent Handbook for the Treatment of Lice.

                   4.        Center staff should vacuum all carpets, machine launder and dry headgear,
                             articles of clothing, and bed linen at hot temperature, as applicable.

                   5.        The child may return to school/socialization 24 hours after treatment starts
                             and no nits are present. The parents must transport the child to school on
                             the first day following the start of treatment. Upon return to school, the
                             infant/child must be nit-free. The Center Coordinator/Home Based

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                             Supervisor or designee must check the head to ensure that no-nits are
                             present.

                   Head Start will provide a lice treatment shampoo for children with reoccurring
                   cases of head lice. However, a doctor’s statement must be presented prior to the
                   release of the shampoo to the parents. The statement should include the
                   diagnosis of lice infestation and treatment regime, i.e., the doctor’s statement
                   should state that the child has lice and that an anti-lice shampoo is being
                   recommended for treatment.

                   Prior to receiving the anti-lice shampoo from SIUE Head Start, the Center
                   Coordinator/Home-Based Supervisor or designee must ensure that parents view a
                   video that provides information on the proper usage of the shampoo. After
                   viewing the video, the parent will be provided a lice information packet and a
                   bottle of anti-lice shampoo.

                   The Health Associate assigned to the center/program option should be notified of
                   children with lice. The Health Associate will also be available to provide
                   technical assistance.


         7.        STREP-THROAT

                   PURPOSE:
                   Identification of possible symptoms and prevention of the spread of the disease.

                   POLICY:
                   Infants/children suspected of having strep throat must be excluded from school.
                   The infant/child should be excluded from sessions and return with a doctor’s
                   statement indicating the nature of the illness and instructions for any required
                   follow-up care. Child may return to school 24 hours after treatment starts.

                   DEFINITIONS:
                   Strep throat is characterized by a sore throat, fever, infections of ears, lymph
                   nodes, skin, other tissue, and white patches in throat. Spreads by contact with an
                   infected person, or by contaminated food that is improperly refrigerated.

                   PROCEDURE:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.




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                   4.        The infant/child must return with a doctor’s statement indicating child may
                             return to school. The infant/child may return to school 24 hours after
                             treatment starts.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         8.        ROSEOLA

                   PURPOSE:
                   To identify and prevent the spread of /and early detection of roseola.

                   POLICY:
                   Infants/children suspected of having roseola may return to sessions when all
                   signs of infection (rash, fever, weakness) have subsided and alertness and strength
                   are present. The infant/child should be excluded from sessions and return with a
                   doctor’s statement indicating the nature of the illness and instructions for any
                   required follow-up care.

                   DEFINITIONS:
                   Fever for several days that suddenly disappears at the same time a rash appears.
                   Rash lasts one to two days. How it is spread is unknown.

                   PROCEDURES:
                   1.   Assess infant/child for the characteristics identified in the definition.

                   2.        Isolate the child from other infants/children.

                   3.        Contact the parent/emergency contact to pick up and/or arrange for the
                             transportation of the child.

                   4.        The infant/child may return to school 24 hours when the infant/child feels
                             well and the rash has disappeared. Infants/children with diagnosed with
                             roseola may return to Head Start with a doctor’s statement.

                   5.        Complete Communicable Disease Report and forward to the Health
                             Coordinator at the end of the month.


         9.        HIV/AIDS

                   PURPOSE:
                   To incorporate children with HIV/AIDS into the program.




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                   POLICY:
                   SIUE Head Start will follow national guidelines for the inclusion of HIV/AIDS
                   children in the classroom. Staff and personnel will be knowledgeable in aspects
                   of disease including transmission, precautions for infected children, management
                   of significant exposure, need for confidentiality.

                   PROCEDURES:
                   1.   HIV/AIDS children will be included in early childhood programs.

                   2.        Privacy of these children must be maintained.

                   3.        Universal precautions must be followed when blood or body fluids are
                             being handled. See HS-8.

                   4.        When a significant exposure is known or suspected, the exposed child or
                             staff should be seen by their physician for evaluation.


Form(s):
Communicable Disease Report




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                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 16                                                                                        Issue Date: 9/98
Unit:       Health Services                                                                                    Effective Date: 9/98
                                                                                                               No. of Pages: 1
Title:      Assessment and Management of Trauma and Illness
Regulatory Reference:          HSPS 1304.22(a)(d), DCFS Licensing Standard 407.250 and 407.310



A.         TRAUMA

           PURPOSE:
           To ensure appropriate and efficient medical care is provided to individuals who have
           experienced mild or severe injury.

           POLICY:
           The SIUE Head Start program will provide first-aid treatment as recommended by the
           American Red Cross.

           DEFINITIONS:
           Trauma:                      An injury to living tissue caused by sprains, bruises, fractures,
                                        dislocation, concussion, mental or emotional stress.
           Serious Injury:              An injury should always be considered serious when the following
                                        signals are present:
                                        Significant deformity, bruising or swelling, inability to use the affected
                                        part normally, bone fragments sticking out of a wound, victim feels
                                        bones grating; felt or heard a snap or pop at the time of injury, the
                                        injured area is cold and numb and the cause of the injury may be
                                        severe.

           PROCEDURES:
           1.   Observe Universal Precautions. See HS-8.

           2.         Make sure the infant/child is not in any immediate danger of additional trauma.

           3.         Apply check, call, and care as indicated by the type of trauma.

           4.         Keep infant/child flat, unless injury or symptoms specifically indicate otherwise:
                      For head injury, elevate head slightly. If the infant/child is vomiting, carefully
                      turn head to the side.

           5.         If a back or spinal cord injury is suspected, do not move infant/child unless
                      necessary for the infant's/child's safety.



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         6.        Call EMT if the trauma is serious (see HS-12) or if life threatening signs and
                   symptoms appear, i.e., loss of consciousness, difficult breathing and no heart beat.

         7.        Contact the parent/emergency contact regarding the incident.

         8.        Observe infant's/child's behavior until EMT arrives.

         9.        Complete an Incident/Accident Report and forward to the Risk Management
                   Liaison within 24 hours.


B.       AIRWAY OBSTRUCTION (CHOKING)

         PURPOSE:
         Intervention in a life threatening occurrence of choking.

         POLICY:
         SIUE Head Start program will provide staff CPR training in accordance with DCFS
         licensing regulations. Head Start parents and volunteers will have the opportunity to be
         trained in CPR. CPR will be provided utilizing American Red Cross guidelines.

         DEFINITIONS:
         An infant/child is choking when the airway is partially or completely blocked. The
         airway can be blocked by the following: (1) the back of the tongue may drop into the
         throat: (2) tissues in the throat may swell and block the airway; (3) an object such as a
         piece of food or toy may block the airway.

         PROCEDURES:
         OBSERVE WARNING SIGNALS and UNIVERSAL PRECAUTIONS.

         1.        Warning signals: (1) infant/child coughs weakly or makes a high pitched sound
                   while breathing; (2) the child cannot speak, cough, or breath; (3) child is
                   forcefully breathing.

         2.        If the infant/child is conscious or unconscious:

                   a) Call EMS

                   b) Do abdominal thrusts for children. Back blows and chest thrusts are
                      appropriate for infants.

                   c) Stop immediately once the object is cleared from the throat or the infant/child
                      starts to breathe or cough.

                   d) The infant/child should be taken to the hospital to be checked even if he/she
                      seems to be breathing well.


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         3.        Complete and forward the Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


C.       ANIMAL/HUMAN BITES

         PURPOSE:
         To denote proper procedures in the case of animal or human bites.

         POLICY:
         The SIUE Head Start program will provide first-aid treatment as recommended by the
         American Red Cross.

         DEFINITIONS:
         Injuries produced by animal or human teeth that cause punctures, lacerations, or even
         avulsions.

         PROCEDURES:

         1. Call EMS or get medical help immediately if the wound is large or deep. Also, call
            EMS if there is severe bleeding or if the bite comes from an unknown or wild animal.

         2. Contact and notify parent/guardian.

         3. Wash the bite well with soap and water. Rinse well.

         4. Apply pressure with gauze or clean cloth. Elevate the wound unless you suspect the
            child has a broken bone. Maintain pressure and elevation until the bleeding stops.
            Assess immunization record for date of most recent DPT. Child should be referred
            for immunization, if not up to date.

         5. Complete an Incident/Accident Report and forward to the Risk Management Liaison
            within 24 hours.


D.       BEE STINGS

         PURPOSE:
         To identify the care and treatment of bee stings.

         POLICY:
         SIUE Head Start recognizes bee stings as a potential emergency situation. Head Start
         will make every effort to prevent bee stings.




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         PROCEDURES:
         1.   Obtain information from parents in relation to whether child is allergic to bee
              stings. Assess health histories for information related to child’s allergies and
              reaction to bee stings. If allergic reaction is severe the parent should be asked to
              provide medication to counteract allergic reaction. The medication policy (see
              HS-6) and procedure should be followed..

         2.        Telephone EMS or get medical help immediately if the infant/child shows sign of
                   an allergic reaction. Signs include hives, very pale skin, spreading itchy rash,
                   nausea, swelling, or tightness in the nose, throat, or chest or difficulty breathing.
                   Contact parent.

         3.        In cases where there is no evidence of an allergic reaction the following steps
                   should be followed.

                   a)        Remove the stinger by scraping it away with a stiff object, such as credit
                             card, or the dull side of a knife.

                   b)        Wash with soap and water.

                   c)        Apply a cold compress to reduce swelling and pain. Place the injured area
                             below the level of the heart.

                   d)        Be alert for signs of shock.

         4.        Contact the parent/emergency contact person.

         5.        Complete a Incident/Accident Report and forward to the Risk Management
                   Liaison within 24 hours.


E.       BITES: POISONOUS SNAKE AND SPIDER

         PURPOSE:
         To educate for proper action in dealing with poisonous spider and snake bites.

         POLICY:
         Poisonous snake and spider bites will be managed in accordance with the American Red
         Cross recommendation.

         DEFINITIONS:
         A wound that breaks the skin due to a snake and spider bite.

         PROCEDURES:
         1.   Follow Universal Precautions.


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         2.        Rubber gloves must be worn.

         3.        Telephone EMS or Poison Control Center, or get medical help immediately.
                   It is important to give an accurate description of the spider or snake to EMS or to
                   the Poison Control Center. Capture and save the spider or snake, if you can do so
                   safely. If not, then know the color, size, or shape or any distinguishing marks so
                   you can describe it.

         4.        Never apply ice or a cold compress to a snakebite.

         5.        Keep the child quiet and calm.

         6.        Contact the parent/emergency contact person regarding the incident.

         7.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


F.       BURNS (CHEMICAL)

         PURPOSE:
         To identify appropriate care and primary treatment of chemical burns.

         POLICY:
         The SIUE Head Start program will provide immediate care of any person(s) who is
         burned, according to American Red Cross guidelines, and ensure preventive measures are
         maintained.

         DEFINITIONS:
         A burn is an injury that results from heat, chemical agents or radiation. It may vary in
         depth, size and security, causing injury to the cells in the affected area.

         PROCEDURES:
         1.   Telephone EMS or the Poison Center, or get medical help immediately.

         2.        If possible, wear disposable gloves to protect your skin in the case of chemical
                   agents.

         3.        Remove any clothing that has the chemical on it.

         4.        Brush dry chemicals from the skin. Do not brush chemicals onto uninjured skin
                   or toward the eyes.

         5.        Flush areas in contact with chemicals under cool, running water for 20 to 30
                   minutes.

         6.        Apply a clean loose bandage.

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         7.        Contact the parent/emergency contact person regarding the incident.

         8.        Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.

G.       BURNS (ELECTRICAL)

         PURPOSE:
         To identify the treatment and care of electrical burns.

         POLICY:
         The SIUE Head Start program will provide burn care, in accordance with American Red
         Cross guidelines.

         DEFINITIONS:
         A burn is an injury that results from heat, chemical agents or radiation. It may vary in
         depth, size and severity, causing injury to the cells in the affected area.

         PROCEDURES:
         OBSERVE THE SCENE.

         1.        If the infant/child is still touching the power source, turn off the electricity before
                   you touch the child.

         2.        Electricity can cause a child to stop breathing or the child's heart to stop beating.

         3.        Telephone EMS or get medical help immediately. All electrical burns must be
                   evaluated by a physician.

         4.        Apply a clean, loose bandage.

         5.        Prevent or care for shock.

         6.        Contact the parent/emergency contact person regarding the incident.

         7.        Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


H.       BURNS (SUNBURNS)

         PURPOSE:
         To identify treatment and care of sunburn.

         POLICY:
         The care of sunburns will be in accordance with American Red Cross guidelines.

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         DEFINITIONS:
         Primary or Secondary skin burn resulting from prolonged or intense sun exposure.

         PROCEDURES:
         1.   Get infant/child out of the sun.

         2.        Cool the skin with cool cloths or cool water, but cool only a small area of the
                   child's body at a time to prevent chilling.

         3.        Offer fluids to drink.

         4.        Obtain medical help if blisters appear and break or if a child has a fever because
                   of a sunburn.

         6.        Do not apply sprays, creams, or ointments without a doctor's approval.

         7.        Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison Coordinators within 24 hours.


I.       BRUISES

         PURPOSE:
         To identify appropriate care for bruises.

         POLICY:
         The care of bruises will be managed in accordance with American Red Cross guidelines.

         DEFINITIONS:
         An injury transmitted through unbroken skin to underlying tissue causing rupture of small
         blood vessels and escape of blood into the tissue with resulting discoloration.

         PROCEDURES:
         1.   Apply pressure with a cold compress to reduce pain and swelling.

         2.        Elevate the injured area unless you suspect the child has a broken bone.

         3.        Internal damage may occur if the bruise is a result of a crushing injury (from
                   wringers, bicycle spokes, doors, etc.). Phone EMS or get medical help
                   immediately.

         4.        Contact the parent/emergency contact person regarding the incident.

         5.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   with 24 hours


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J.       CUTS AND SCRAPES (BLEEDING)

         PURPOSE:
         To identify treatment for bleeding cuts and scrapes.

         POLICY:
         Cuts and scrapes will be managed in accordance with American Red Cross
         recommendations.

         DEFINITIONS:
         Open wounds in the skin or deep tissue can bleed heavily. Blood vessels, muscles,
         tendons, and nerves may be damaged.

         PROCEDURES:
         1.   Telephone emergency or get medical help immediately if the wound is large,
              deep, or bleeding cannot be controlled, and for deeply embedded materials or if,
              embedded materials remain after cleaning.

         2.        Apply direct pressure with a clean cloth. Elevate the wound unless you suspect
                   the infant/child has a broken bone. Maintain pressure and elevation until the
                   bleeding stops. Apply another cloth on top if needed.

         3.        If bleeding is not severe, check if bleeding has stopped by gently lifting the cloth
                   away from the wound. If the bleeding has stopped, wash the wound with soap and
                   water. Rinse well. If bleeding starts again, repeat pressure and elevation.

         4.        Put a clean, dry bandage on open wound.

         5.        Prevent and/or care for shock.

         6.        Contact the parent/emergency contact regarding the incident.

         7.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


K.       EAR INJURIES

         PURPOSE:
         To identify treatment of ear injuries.

         POLICY:
         Ear injuries will be managed in accordance with the American Red Cross
         recommendations.



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         DEFINITIONS:
         Object in the ear: Insect in the ear or bleeding from the ear.

         PROCEDURES:
         Object in the ear:
         Turn the infant’s/child’s head with the affected ear pointing down. Then the object can
                fall out easily, or you can grasp the object easily.

         Do not try to pull out difficult-to-remove objects. Obtain medical help.

         Contact the parent/emergency contact person regarding the incident.

         Insect in the ear:
         1.      Turn the infant’s/child’s head so that the affected ear points up. Then the insect
                 can fly out.

         2.        If the insect fails to fly out, get medical help.

         3.        Contact the parent/emergency contact person regarding the incident.

         4.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   with in 24 hours.


         Bleeding from the ear:
         1.     Phone EMS or get medical help if there is bleeding or drainage from inside the
                ear.

         2.        Do not stop bleeding from inside the ear. If the child has had a head injury, refer
                   to head injury procedures.

         3.        See cuts and scrapes procedure if the bleeding from a cut or tear on the external
                   part of the ear.

         4.        Contact the parent/emergency contact person regarding the incident.

         5.        Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


L.       EYE INJURIES

         PURPOSE:
         To identify treatment and care of eye injuries.



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         POLICY:
         Eye injuries will be managed in accordance with the American Red Cross
         recommendations.

         DEFINITIONS:
         Eye injuries consist of: small floating object in the eye, piercing object in the eyeball,
         chemicals in the eye and blunt blows to the eye.

         PROCEDURES:
         Small floating object in the eye:

         1.        Hold the upper lid down and slightly away from the eye by the lashes. Have the
                   infant/child keep blinking to flush the eye with tears.

         2.        Try to flush the eye with cool water running from the inside corner of the eye
                   outwards if the object is still there.

         3.        Close the lid over the eye and cover with an eye pad or gauze bandage. Do not
                   press on an injured eye. Do not apply medication.

         4.        Call EMS or get medical help if the object cannot be removed or eye problems
                   persist.

         5.        Contact parent emergency contact regarding the incident.

         6.        Complete and forward an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


         Piercing Object in the Eye:

         1.        Telephone EMS or get medical help.

         2.        Place an upside-down paper cup or similar object over the injured eye.

         3.        Hold the cup in place with a cloth or bandage wrapped loosely around the head. If
                   the infant/child remains calm, cover both eyes.

         4.        Contact parent so they can obtain follow-up treatment.

         5.        Complete and forward a Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                HS 16 - 10
         Chemical in the eye:

         1.        Telephone EMS or get medical help immediately.

         2.        Flush the eye with running water from the inside corner of the eye outwards for 20
                   to 30 seconds.

         3.        Do not use drops or ointments.

         4.        Contact the parent/emergency contact regarding the incident.

         5.        Complete and forward a Incident/Accident Report to the Risk Management
                   Liaiosn within 24 hours.


         Blunt Blows to the eye:

         1.        Telephone EMS or get medical help immediately.

         2.        Keep the child lying down until the ambulance arrives.

         3.        Contact the parent/emergency contact person regarding the incident.

         4.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


M.       FAINTING

         PURPOSE:
         To identify steps in the care of a child who has fainted.

         POLICY:
         Fainting will be managed in accordance with the recommendations of the American Red
         Cross.

         DEFINITIONS:
         A partial or complete loss of consciousness due to a reduced supply of blood to the brain
         for a short time.

         PROCEDURES:
         1.   Lay the child down.

         2.        Loosen any tight clothing and keep the child's airway open.

         3.        Elevate the child's leg 8 to 12 inches above the body until the child fully recovers.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 16 - 11
         4.        Have the child sit up slowly and remain seated for 5 minutes before standing.

         5.        Get medical help if the child does not seem to recover completely.

         6.        Record the time, symptoms, and responses of the child and give these to the
                   medical personnel who cares for the child.

         7.        Parents should seek medical advice if the child has repeated fainting episodes.

         8.        Complete and submit Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


N.       FRACTURES

         PURPOSE:
         To identify the care and primary treatment of possible fractures.

         POLICY:
         Care of fractures will be managed in accordance with American Red Cross Guidelines.

         DEFINITIONS:
         Fractures are a break or crack in a bone. It is often difficult to tell the difference between
         fractures, dislocations, and sprains. Treat them all the same.

         PROCEDURES:
         1.   Telephone EMS or get medical help if:

                   a)        the injury is life threatening

                   b)        you suspect an injury to the head, neck, or spine.

                   c)        the injury involves major bones in the leg.

                   d)        you cannot properly splint the injury to transport the child comfortably.

                   e)        control bleeding by applying light pressure.

                   f)        do not move the child or the injured body part if EMS is on its way. If you
                             must move the child before help arrives, splint the injured part in the
                             position in which you found it and in a position that is comfortable for a
                             child. (Use first aid principle instruction)

         2.        Prevent or care for shock.

         3.        Contact parent/emergency contact regarding the incident.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 16 - 12
         4.        Complete and submit the Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


O.       HEAT EMERGENCIES (CRAMPS, EXHAUSTION, OR STROKE)

         PURPOSE:
         To identify the care and treatment of a child in a heat emergency.

         POLICY:
         Heat emergencies will be managed in accordance with American Red Cross
         recommendations.

         DEFINITION:
         A response of the body's inability to eliminate excess heat which may have internal and
         external reactions.

         PROCEDURES:

         1.        Rest the infant/child in a cool place.

         2.        Give water to drink (½ glass every 15 minutes).

         3.        Contact the parent/emergency contact regarding the incident.

         4.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


P.       HEAD INJURY

         PURPOSE:
         To identify the treatment of an infant/child with a head injury.

         POLICY:
         Head injuries will be managed according to American Red Cross guidelines.

         DEFINITION:
         An unconscious child may have a head injury. A infant/child may have a headache,
         dizziness, sleepiness, bleeding from the mouth, nose or ears, or convulsions.

         PROCEDURES:
         1.   Telephone EMS or get medical help immediately.

         2.        Stop severe bleeding from a wound with pressure and elevation, if you do not
                   suspect a fracture.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                            HS 16 - 13
         3.        Continue to check infant/child for signs of inability to open eyes or move
                   normally.

         4.        Contact parent/emergency contact regarding the incident.

         5.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.


Q.       NOSEBLEEDING (EPISTAXIS)

         PURPOSE:
         To provide early treatment and prevent hemorrhage or shock.

         POLICY:
         Nosebleeds will be managed in accordance with the American Red Cross
         recommendation.

         DEFINITIONS:
         Nosebleeds are common in childhood, usually a result of injury to the nose due to trauma,
         nose picking, allergies, strong sneezing or blowing, infections or drying of hemorrhage-
         severe bleeding. Shock from severe loss of blood is a life threatening condition.

         PROCEDURES:
         1.   Observe Universal Precautions. See HS-8.

         2.        Wear rubber gloves when possible.

         3.        Provide the child with a calm, safe, and supportive environment.

         4.        Assist the child to sit up and lean forward.

         5.        Pinch the base of nose with your thumb and forefinger continuously for 5-10
                   minutes or until bleeding stops.

         6.        Apply an ice pack to nose.

         7.        Clean the nose gently, do not clean the inside of the nostrils.

         8.        Discourage blowing or picking nose and keep child quiet for 1/2 to 1 hour.

         9.        Notify the parent that the child has a nosebleed. If the bleeding cannot be
                   stopped, call the EMS.

         10.       Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                  HS 16 - 14
R.       PUNCTURE WOUNDS

         PURPOSE:
         To identify the care and treatment of a puncture wounds.

         POLICY:
         The care of puncture wounds will be managed according to American Red Cross
         guidelines.

         DEFINITIONS:
         Puncture wound: A break in the skin or the mucous membrane.

         PROCEDURES:
         1.   Observe Universal Precautions. See HS-8.

         2.        Telephone EMS or get medical help immediately if the object is large or is
                   embedded. Bandage large embedded objects in place. Do not remove object.

         3.        Small objects that are easy to remove should be pulled out with a gloved hand.
                   Do not break the skin to remove objects such as splinters. Soak the wound in
                   soapy water, if possible, to make removal easier.

         4.        Contact the infant’s/child’s parent regarding the incident.

         5.        After removal wash or soak the wound well with soap and water for 15 minutes,
                   then rinse. Apply Band-Aid to small puncture wounds.

         6.        Complete and submit an Incident/Accident Report to the Risk Management
                   Liaison within 24 hours.


S.       RESCUE BREATHING

         PURPOSE:
         To provide emergency care for one who has lost the ability to spontaneously breathe on
         his own.

         POLICY:
         SIUE Head Start program will provide staff with Rescue Breathing training in accordance
         with DCFS licensing regulations. Parents and volunteers will have the opportunity to
         attend the training sessions. Rescue Breathing training will be provided utilizing
         American Red Cross guidelines.

         DEFINITIONS:
         A process where breathing is conducted by an individual for one who has stopped
         breathing.

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                             HS 16 - 15
         PROCEDURES:
         1.   Check for unresponsiveness.

         2.        Shout for help if the infant/child is unresponsive.

         3.        Position the infant/child as indicated on the Red Cross posters in your center.

         4.        Follow directions on poster or as learned in CPR/First aid classes.

         5.        Contact parent/emergency contact person regarding the incident.

         6.        Complete and submit a Incident/Accident Report to the risk Management Liaison
                   within 24 hours.


T.       SEIZURES

         PURPOSE:
         To identify the care of a person who is having a seizure.

         POLICY:
         The care of seizures will be managed according to American Red Cross guidelines.

         DEFINITIONS:
         A sudden attack of tremors, jerks, or generalized involuntary body movements. Child or
         infant may be conscious or unconscious.

         PROCEDURES:
         1.   Telephone EMS.

         2.        Lay the infant/child on an area that is clear of any objects. Roll the child onto his
                   or her side to prevent tongue, saliva, or vomit from blocking the airway.

         3.        Do not hold or restrain the infant/child or put anything in the mouth

         4.        Loosen clothing, if possible.

         5.        Stay with infant/child.

         6.        Reassure the infant/child.

         7.        Notify the child's parent/emergency contact of the incident.

         8.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hrs.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 16 - 16
U.       SHOCK

         PURPOSE:
         To identify the care and primary treatment of a person in shock.

         POLICY:
         The care of shock will be managed in accordance with the American Red Cross
         recommendations.

         DEFINITIONS:
         A condition resulting from a depressed state of many vital body functions, a depression
         that could threaten life although the reaction's injury would not otherwise be fatal.

         PROCEDURES:
         1.   Telephone EMS and give first aid for the injury or illness.

         2.        Lay the child down.

         3.        Elevate the child's legs 8 to 12 inches above the body if no bones are broken, there
                   is no head injury, or if the child is not having difficulty breathing. Keep the
                   child's body at a comfortable temperature.

         4.        Reassure a conscious child.

         5.        Cover only enough to keep from losing body heat.

         6.        Contact the child's parent regarding the incident.

         7.        Complete and submit a Incident/Accident Report to the Risk Management Liaison
                   within 24 hours.



Form(s):
Child Incident/Accident Report




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                               HS 16 - 17
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 17                                                                                        Issue Date: 9/00
Unit:       Health Services                                                                                    Effective Date: 9/00
                                                                                                               No. of Pages: 1
Title:      Health Alerts
Regulatory Reference:                            DCFS Licensing Standards 407.310 (b); IDPH 77 ILL Adm Code 690



PURPOSE:
To ensure that parents are informed of infectious, contagious, or communicable diseases, either
suspected or diagnosed, occurring within any SIUE Head Start center.

POLICY:
All Head Start parents will be informed of all suspected or diagnosed infectious, contagious, or
communicable diseases occurring within a Head Start center. Parents will be notified through
Health Alerts.

PROCEDURE:
1.   Upon notification of a suspected or diagnosed infectious, contagious or communicable
     disease, the Center Coordinator will arrange for the immediate distribution of the Health
     Alerts to parents. Infectious, contagious or communicable diseases include viral hepatitis,
     measles, rubella, smallpox, mumps, and chicken pox. (See next page.)

2.         The Center Coordinator will notify the assigned Health Associate of the suspected or
           diagnosed infectious, contagious or communicable disease. The Health Coordinator must
           be notified in the absence of the assigned Health Associate.

3.         The Center Coordinator must record the suspected or diagnosed infectious, contagious or
           communicable disease on the Communicable Disease Report. The report is to be
           forwarded to the Health Coordinator at the end of the month.

4.         The Health Coordinator will determine if the diagnosed disease is reportable to the local
           health department. If it is determined that the illness is reportable, the Health Coordinator
           will:
               a) inform the Center Coordinator to complete an incident report and obtain
                   information as required by IDPH. The incident report is to be routed immediately
                   to the Risk Management Liaison.
               b) Notify the Program Director, Assistant Program Director, Program Operations
                   Coordinator. The Program Director or Assistant Program Director will notify the
                   ESL Center Director or designee.

Form(s):
Communicable Disease Report


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 17 - 1
       REPORTABLE COMMUNICABLE DISEASES AND CONDITIONS IN ILLINOIS

The following are declared to be contagious, infectious, communicable and dangerous to the
public health and each suspected or diagnosed case must be reported to the Illinois Department of
Public Health. Within the SIUE Head Start program, all diseases and conditions listed must be
reported to the Health Coordinator via telephone or Communicable Disease form.

The following diseases and conditions must be reported to the Health Coordinator immediately
upon confirmation of disease or condition by the parent or medical provider.

Section A:
   Anthrax
   Cholera
   Diarrhea of the newborn
   Diptheria
   Foodborne or waterborne illness
   Measles
   Meningitis and other invasive disease due to Neisseria meningitidis or Haemophilus
   influenzae
   Plague
   Poliomyelitis
   Rabies, human
   Smallpox
   Typhoid fever
   Typhus
   Whooping cough (pertussis)

Section B:
   Acquired immunodeficiency
   Amebiasis
   Animal bites
   Blastomycosis
   Brucellosis
   Chlamydia
   Chickenpox
   Cryptosporidosis
   Encephalitis
   Escherichia coli infections due to serotype
   Giardiasis
   Gonorrhea
   HIV infection
   Hepatitis, type A viral
   Hepatitis, type B viral
   Hepatitis, delta
   Hepatitis, viral unspecified
   Hepatitis, non-A/non-B

D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                          HS 17 - 2
    Histoplasmosis
    Intestinal worms
        A.      Tapeworms
        B.      Ascariasis
    Legionnaires' disease
    Leprosy
    Leptospirosis
    Listeriosis
    Lyme disease
    Malaria
    Meningitis and aseptic meningitis
    Mumps
    Opthalmia neonatorum
    Psittacosis
    Rocky Mountain spotted fever
    Rubella, including congenitial rubella syndrome
    Salmonellosis
    Shigellosis
    Staphyloccal infections occuring in infants under 287 days of age
    Streptococcal infections (due to group A streptococci), including pharyngitis, rheumatic
    fever, acute glomerulonephritis, scarlet fever, and invasive disease
    Syphilis
    Tetanus
    Toxic shock syndrome
    Trachoma
    Trichinosis
    Tuberculosis
    Tularemia




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                           HS 17 - 3
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 18                                                                                       Issue Date: 9/00
Unit:      Health Services                                                                                     Effective Date: 2/04
                                                                                                               No. of Pages: 1
Title:         CPR/First Aid Certification
Regulatory Reference:             DCFS Licensing 407.100, HSPS 1304.22(a)



PURPOSE:
To ensure that centers have on duty at all times at least one staff member who has successfully
completed training and is currently certified in first aid, cardiopulmonary resuscitation (CPR) and
the Heimlech maneuver, and for center serving infants, first aid for choking infants in accordance
with the approved method specified in the Department of Public Health’s rules 77 III. Adm.
Code 520, The Treatment of Choking Victims.

POLICY:
All Teachers, Teacher Assistants, Child Care Assistants and Center Coordinators are mandated to
become certified/maintain certification in CPR/First Aid procedures. All other center staff and
central office staff is strongly encouraged to become certified/maintain certification.

PROCEDURE:
1.   The Staff Development and Violence Education Coordinator will track expiration of
     CPR/First Aid certification status and assign mandated staff to CPR/First Aid classes
     based upon the certification expiration date.

2.         The schedule of classes will be available via the Training Calendar.

3.         Non-mandated center staff or central office staff may participate in CPR/First Aid classes
           as space permits.

4.         All center staff is to notify the Staff Development and Violence Education Coordinator of
           any scheduling conflicts.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 18 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 19                                                                                        Issue Date: 9/00
Unit:      Health Services                                                                                     Effective Date: 9/00
                                                                                                               No. of Pages: 1
Title:      Disposal of Excess Food
Regulatory Reference:



PURPOSE:
To provide guidance to center staff as to the disposal of excess food from the service of meals to
children.

POLICY:
Staff will not remove food from any SIUE Head Start center for personal use or consumption. All
excess food will be donated to a pantry or a community non-profit agency.

PROCEDURE:
1.   The Dishporter must notify the Center Coordinator of any excess foods. The dishporter
     should report the amount and type of food that is leftover. This report must be made to
     the Center Coordinator after all children have been fed the required meals.

2.         The Dish Porter must maintain the proper temperature of all leftover food until the food is
           picked up by the community non-profit agency or pantry. The temperature of the food
           must be recorded before the food is released to the community non-profit agency or
           pantry.

3.         The Center Coordinator must track excess food and attendance to determine whether an
           adjustment to the meal count is necessary, or whether any one food item is routinely
           leftover.

4.         The Center Coordinator will arrange for the delivery of any excess foods to a pantry or
           community non-profit agency.

5.         The Center Coordinator must notify the Health Coordinator of any changes in the center
           enrollment that occurs in excess of five (5) consecutive days.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 19 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 20                                                                                      Issue Date: 9/00
Unit:       Health Services                                                                                    Effective Date: 2/04
                                                                                                               No. of Pages: 1
Title:        Problems with Food Service
Regulatory Reference:



PURPOSE:
To ensure the adequate tracking and follow-up of food service problems/issues.

POLICY:
The Health Coordinator will process all food service problems/issues.

PROCEDURE:
1.   The Center Coordinators/Home-Based Supervisor must notify the Health Coordinator of
     all food service related problems/issues.

2.         The Health Coordinator will log the nature of the problem/issue.

3.         The Health Coordinator will notify the Food Service Programs Coordinator of identified
           problem/issue, and will work to resolve the problem/issue.

4.         If food service problems/issues arise in the absence of the Health Coordinator (due to
           absence or no response within ½ hour), the Center Coordinator should:

           SIUE Food Service

           a)         Non-catering problems/issues (NOTE: a food service problem/issue is defined
                      as: not receiving enough food to serve the children, not receiving all foods
                      identified on the menu (not including substitutions), not receiving food that is
                      edible, etc.)
                      1)      Leave a voice mail for the Health Coordinator. The voice mail message
                              should indicate the nature of the problem/issue and that the Food Service
                              Accounting Tech II (Jane) will be contacted.
                      2)      Contact the Accounting Tech II (Jane). The telephone number is 650-
                              2550.
                      3)      In the absence of the Accounting Tech II, notify the Programs Coordinator
                              (Joe Schuette). The telephone number is 650-2550.
                      4)      In the absence of the Account Tech II, notify the Accountant/Bookkeeper
                              (Rosie). The telephone number is 650-3043.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 20 - 1
         b)        Catering issue (NOTE: a food service problem/issue is defined as: not
                   receiving enough food to serve the children, not receiving all foods identified
                   on the menu (not including substitutions), not receiving food that is edible,
                   etc.)

                   1)        Leave a voice mail for the Health Coordinator. The voice mail should
                             indicate the nature of the problem/issue and that the Catering Secretary
                             will be notified.
                   2)        Notify the Catering Secretary (Pat). The telephone number is 650-3041.
                   3)        In the absence of the catering secretary, notify the Catering Manager at
                             650-3044.


         CAHOKIA
         a) Non-Catering issue (NOTE: a food service problem/issue is defined as: not
            receiving enough food to serve the children, not receiving all foods identified on
            the menu (not including substitutions), not receiving food that is edible, etc.)

                   5)        Leave a voice mail for the Health Coordinator. The voice mail message
                             should indicate the nature of the problem/issue and that the Head Cook
                             will be notified.
                   6)        Contact the Head Cook at 332-3720.
                   7)        In the absence of the Head Cook, notify the Food Service Director at
                             332-3700, ext. 234.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                 HS 20 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 21                                                                                        Issue Date: 9/00
Unit:       Health Services                                                                                    Effective Date: 9/00
                                                                                                               No. of Pages: 1
Title:          Food Service Management Certification
Regulatory Reference:             DCFS Licensing 407.330; Food Service Sanitation Code 77 Ill. Adm.Code:
                                  750.540



PURPOSE:
To comply with DCFS licensing regulations and the Illinois Food Service Sanitation Regulations
which state that a person certified in food service sanitation is on site to manage the preparation
and/or service of food, including the service of catered food.

POLICY:
All Health Unit staff, Center Coordinators, Home-Based Supervisors, Dish Porters, Child Care
Assistants will be required to obtain/maintain a Food Service Management Certificate. SIUE
Head Start will provide payment for the training class and the certificate. A minimum of one,
certified food service sanitation manager is required at each center.

PROCEDURE:

1.         A schedule of Food Service Sanitation workshops will be maintained by the Health
           Coordinator.

2.         Centers that are not in compliance because of employee turnover or other loss of certified
           personnel will have 3 months from the date of loss of certified personnel to comply.

3.         All staff shall display the food service sanitation manager certificate in the
           kitchen/offices.

4.         The Health Coordinator will monitor compliance and coordinate training. The Health
           Coordinator will notify affected staff of status of certification and arrange training. Staff
           is to follow current procedures for registering for the training. See PDM-28.

5.         Once staff has passed the examination an invoice will be forwarded to the employee by
           the Illinois Department of Public Health. This invoice is to be turned in to the Health
           Coordinator for payment by SIUE Head Start.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 21 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 22                                                                                       Issue Date: 9/00
Unit:      Health Services                                                                                     Effective Date: 9/00
                                                                                                               No. of Pages: 1
Title:      Proof of Vaccination Against the Hepatitis A Virus
Regulatory Reference:          1304.23 (e)(1); City of East St. Louis Ordinance 00-10002



PURPOSE:
To comply with the East St. Louis ordinance requiring that all food handlers operating within the
city have provided proof of vaccination against the Hepatitis A virus.

POLICY:
All Dishporters, ChildCare Assistants and all Teachers and Teacher Assistants assigned to
centers within the city of East St. Louis must provide proof of vaccination against the Hepatitis A
virus. SIUE Head Start will provide payment for the Hepatitis A vaccination, a series of two
injections given at least (6) months apart and no longer that (12) months apart.

1.         All Dishporters, ChildCare Assistants and Teachers/Teacher Assistants assigned to
           centers within the city of East St. Louis must provide proof of vaccination against the
           Hepatitis A virus within 2 weeks of employment. The employee must provide written
           certification from a health care provider that:
           a)      The person is immune from Hepatitis A,
           b)      The person has been vaccinated against Hepatitis A, including a series of two
                   injections to be given at least (6) months apart; or
           c)      The person has received the initial vaccination against the Hepatitis A virus,
                   however, said person must then provide SIUE Head Start a health care provider's
                   certification of the required subsequent injection received at least (6) months after
                   but not more than (12) months following the initial vaccination.

2.         This requirement does not apply to women while they are pregnant, those persons who
           object to vaccinations because of religious beliefs, or because of medical conditions
           which are verified in writing by a licensed physician.

3.         Copies of the proof of vaccination must be maintained in the employee file. A copy
           should be forwarded to the Health Coordinator.

4.         The Health Coordinator will be notified of all newly hired/to be hired staff via the New
           Employee Checklist. The Health Coordinator will process the required forms for
           payment of the Hepatitis A vaccination.

5.         SIUE Head Start will provide no payment for vaccinations that are not received according
           to the required schedule.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 22 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 23                                                                                      Issue Date: 9/99
Unit:      Health Services                                                                                     Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:      Food For Infants
Regulatory Reference:                         1304.23 (b)(1)(iv), (b)(1)(vii), Licensing Standard 407.210



PURPOSE:
To ensure that each infant and toddler enrolled in the SIUE Early Head Start program receives
food appropriate to his/her nutritional needs, developmental readiness, and feeding skills, as
recommended/required by USDA.

POLICY:
All infants and toddlers enrolled in the SIUE Early Head Start program will receive foods
appropriate to his/her nutritional needs, developmental readiness, and feeding skills, as
recommended or required in the meal pattern by USDA.

PROCEDURE:

1.         SIUE Head Start will provide food for all infants under 12 months of age and for all
           infants/toddlers not consuming table foods as requested by parents in accordance with
           requirements of the CACFP. SIUE Head Start will provide foods for all toddlers and
           children consuming table foods.

2.         All infants will follow a flexible feeding schedule. This schedule will coordinate with the
           parents’ schedule at home.

3.         Infants/toddlers will not be fed foods that pose a risk of choking. These foods include
           berries, candies, raisins, corn kernals, raw carrots, whole grapes, hot dogs, nuts, seeds,
           popcorn, raw peas or peanut butter.

4.         Toddlers/children, according to their developmental ability, will be allowed and
           encouraged to feed themselves. Staff will provide supportive assistance for as long as
           each toddler/child needs the assistance.

5.         Solid foods will be introduced generally between 4 and six months of age. The
           introduction of solids will be indicated by each child’s nutritional and developmental
           needs after consultation with the parent.

6.         Juice will be fed from a cup when the infant is old enough (approximately 6 months).




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 23 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 24                                                                                       Issue Date: 9/99
Unit:       Health Services                                                                                    Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:      Family-Style Dining
Regulatory Reference:           1304.23 ( C )( 4 )



PURPOSE:
To ensure that all Head Start/Home-Based program options, including children, staff and
volunteers, eat together family-style.

POLICY:
Every enrolled child, staff person and classroom volunteer will participate in family-style meal
service.

PROCEDURE:

1.         All foods provided during meal service are to be placed on each table in the proper
           serving dishes and with proper serving utensils.

2.         Children are to serve themselves all foods provided during all meals, for example, hot
           cereals, casseroles, vegetables, snacks, beverages, etc.

3.         Children are to handle all dishes, child-sized pitchers and utensils to pass selected menu
           items.

4.         The proper adult-child ration should be maintained at all times during meal service
           (1 adult: 8 children). An adult is defined as a parent, volunteer or any other Head Start
           staff person.

5.         Children should never be allowed to sit alone nor with another group of students without
           proper adult supervision.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 24 - 1
                           SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
    For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                    For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 25                                                                                       Issue Date: 9/99
Unit:      Health Services                                                                                    Effective Date: 2/04
                                                                                                              No. of Pages: 1
Title:        Family-Style Dining/Dishes
Regulatory Reference:           1304.53 ( b )( 1 ) (iii), (iv)



PURPOSE:
To ensure that all Head Start program options, including children, staff and volunteers are
knowledgeable of the proper serving dishes, child-sized pitchers, and utensils to be used during
family-style meal service.

POLICY:
Every enrolled child, staff person and classroom volunteer will use proper serving dishes, child-
sized pitchers, and utensils during family-style meal service.

PROCEDURE:
1.   Proper serving dishes, child-sized pitchers, and utensils are defined as:
     a) Serving dishes:
        36 oz melamine vegetable server
        5 oz styrofoam bowls
        oval platter
        boullion cups
        3 compartment plates (Early only)

          b) 16 oz child-sized pitcher

          c) child-sized serving utensils:
             soup ladles
             tongs
             serving spoon

          d) miscellaneous supplies:
             18” foodservice film
             food disher (portion scoops)
             napkins
             plastic forks
             plastic spoons
             plastic knives
             portion scale
             utility carts (1 per classroom)



D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                          HS 25 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.              HS 26                                                                                  Issue Date: 9/99
Unit:                Health Services                                                                           Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:      Meal Preparation/Food Safety and Sanitation
Regulatory Reference:           1304.23 (e)(1); Food Service Sanitation Code 77 Ill.
                                Adm. Code 750: 750.520, 750.160, 750.150,

PURPOSE:
To ensure that children enrolled in all Head Start program options receive foods that are in
compliance with local food safety and sanitation laws, including those related to the storage,
preparation and service of food.

POLICY:
All Head Start Dish Porters will comply with the local food safety and sanitation laws.

PROCEDURE:

1.         All Dish Porters will wear the clean clothing, including disposable aprons, gloves and
           hairnets. Aprons should only be worn while preparing the meals. Disposable gloves
           should be thrown away frequently, i.e. after handling chicken salad, before handling
           bread, after using the bathroom. Gloves should be worn anytime the dishporter has to
           handle food with bare hands. The gloves should not be worn to handle utensils/containers
           containing food items.

2.         All menu items need to be received from the food vendor at a temperature, held for
           service and served at the proper temperature that is above 140 degrees Fahrenheit or
           below 41 degrees Fahrenheit. All temperatures must be recorded on the Food
           Temperature Log.

3.         All serving utensils need to be wrapped before being placed on the serving/utility cart.

4.         All menu items need to be covered with food service film except during service at the
           table.

5.         A pail of warm soapy water must be placed on each serving/utility cart to facilitate
           cleaning up of spills etc.

Form(s):
Food Temperature Log




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 26 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 27                                                                                      Issue Date: 9/99
Unit:         Health Services                                                                                  Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:       Infant/Toddler Meal Service
Regulatory Reference:          1304.23 ( c ) (1-7), Licensing Standard 407.210



PURPOSE:
To ensure that nutritional services contribute to the development and socialization of enrolled
children.

POLICY:
Nutritional services provided by SIUE Food Service and SIUE Head Start/Early Head Start staff
will contribute to the development and socialization of all enrolled infants, toddlers and children.

PROCEDURE:
1.   All meal services involving 24-36 month year olds will follow the policy/procedure as
     indicated in HS-24, with the following exceptions. Children in this age range will be
     allowed and encouraged to feed themselves. Staff will provide support as long as each
     child needs the required assistance.

2.         All infants will be held during feeding. Infants that are unable to sit up will always be
           held for bottle feeding.

3.         Infants that are able to hold their own non-glass bottle, will be allowed to feed
           themselves. The bottle must be removed for the infant's mouth once the infant has fallen
           asleep.

4.         Bottle-propping is not allowed. Carrying of bottles by toddlers throughout the day is not
           allowed.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 27 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 28                                                                                        Issue Date: 9/99
Unit:       Health Services                                                                                    Effective Date: 2/04
                                                                                                               No. of Pages: 1
Title:      Dining Activities (Before, During, After)
Regulatory Reference:           1304.23 ( c ) (4), ( 7), ( 2), 1304.23 (B) (3)



PURPOSE:
To ensure that children enrolled in all Head Start options are exposed to a variety of learning
activities that enhance growth and development before, during and after family-style meal
service.

POLICY:
All Head Start enrollees will participate in learning activities that enhance growth and
development before, during and after family-style meal service.

PROCEDURE:
Before the meal:
1.     Identify children to assist with meal preparation activities. These meal preparation
       activities are re-arranging the tables if necessary to assure the opportunity to provide
       adequate supervision during the meal service, washing and sanitizing the table, and
       setting the table. These children will wash hands prior to assisting with these activities.

2.         The remainder of the children will participate in a quiet activity before the meal service
           (i.e., story telling, talking about the menu for that day) with the other staff person.

3.         Once the utility cart has been delivered to the room, all of the children may wash their
           hands in preparation for the meal service and proceed to the table.

During the Meal:
1.    Staff and children should engage in interesting conversations. Open-ended questioning,
      good listening skills and taking turns in conversation should be promoted. Children
      should be encouraged to compare, contrast and classify foods according to color, texture,
      taste, shape and size.

2.         Staff set good examples by demonstrating a positive attitude towards all foods served.
           Food is not used as a punishment or reward. Each child is encouraged but not forced to
           eat or taste his/her food.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 28 - 1
3.       Staff and children will continuously review table manners and safety issues. Children will
         be encouraged to use phrases such as “please, thank-you, pass” when participating in the
         meal service. Children will never be allowed to put knives into their mouth or play with
         the knives (i.e. play swords with the knives).

4.       Children should be encouraged and allowed to wipe up their own spills as they occur.

After The Meal:
1.     Children will be encouraged to remove their plates and clean their area of napkins, cups
       and plastic ware.

2.       After all children have finished eating and removing plates, the serving dishes, pitchers
         and utensils will be returned to the carts.

3.       After the table is cleared, identify children to wipe the tables. An adult must wash and
         sanitize the table immediately after the child has completed wiping the table.

4.       Immediately following, the children will proceed to brush teeth.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                              HS 28 - 2
                           SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
    For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                    For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.         HS 29                                                                                      Issue Date: 9/99
Unit:       Health Services                                                                                   Effective Date: 9/99
                                                                                                              No. of Pages: 1
Title:       Meal Service Preparation
Regulatory Reference:           1304.53                   ( b )( 1 ) (iii), (iv)


PURPOSE:
To ensure that all menu items provided in Head Start program options are served in appropriate
dishes and with child-sized utensils/pitchers to facilitate family-style dining.

POLICY:
Every enrolled Head Start child, staff and classroom volunteers will provide menu items in
serving dishes, child-size pitchers and utensils that are appropriate for the selected menu item.
Every menu item will be placed in the provided melamine serving dishes and covered with
food/service film. Appropriate child-sized serving utensils will be provided for each dish. All
beverages will be served in the appropriate child-sized pitchers to provide the required minimum
serving for each child.

PROCEDURE:
1.   The dishporter will place all menu items in the provided serving dishes according to the
     following chart:

             36 oz vegetable server                                       Child-sized pitchers (provides 2 ½ child sized
             baked potatoes                                               portions)
             boiled eggs                                                  juice
             biscuits                                                     Milk
             casseroles                                                   water
             cereals (hot)
             chips
             fruits, canned and fresh
             jello
             meats
             muffins
             pretzels
             raisins
             sauces and gravies
             vegetables

           Oval Platter                                                   Styrofoam Bowls/Bouillon Cups
           breads                                                         Condiments
           cheeses                                                        jelly
           cookies                                                        peanut butter
           graham crackers
           meats
           Pop tarts


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                          HS 29 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 30                                                                                      Issue Date: 9/99
Unit:         Health Services                                                                                  Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:       Food Safety
Regulatory Reference:                       1304.23 (e) (1), and Licensing Standard 407.10



PURPOSE:
To ensure that all foods provided by the SIUE Early Head Start program meet the food sanitation
guidelines as established by Head Start Performance Standards and Licensing Standards.

POLICY:
All foods provided to enrolled Early Head Start children will be provided according to the Head
Start Performance Standards and Licensing Standards.

PROCEDURE:
1.   All Early Head Start centers will be furnished with refrigerators for the proper storage of
     formula, breast milk and other infant/toddler foods.

2.         Bottles of breast milk and opened containers of unmixed concentrate will be labeled with
           the child’s name and dated, and refrigerated.

3.         All filled bottles of milk, formula or breast milk will be refrigerated until immediately
           before feeding of the infant or toddler. Milk, formula or breast milk remaining in a bottle
           after 2 hours will be discarded.

4.         All prepared formula, milk or breast milk not used within 24 hours will be discarded.

5.         Frozen breast milk will be thawed under running water or in the refrigerator. Bottles of
           formula or breast milk will be warmed by placing them in the crock pots for five minutes
           according to the manufacturer’s directions, followed by shaking the bottle well and
           testing the milk temperature before feeding.

6.         Bottles will never be warmed or defrosted in a microwave oven.

7.         No food other than formula, milk, breast milk, or water will be placed in a bottle for
           infant feeding unless indicated by a physician, in consultation with the parents.

8.         Foods stored or prepared in jars will be served from a separate dish and spooned for each
           child. Any leftovers from the serving dish will be thrown out. Leftovers in the jars will
           be labeled with the infant’s name, dated, refrigerated and served within 24 hours or
           discarded.



D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 30 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.           HS 31                                                                                     Issue Date: 9/00
Unit:      Health Services                                                                                     Effective Date: 2/04
                                                                                                               No. of Pages: 1
Title:       Nutritional Assessment
Regulatory Reference:           1304.23                   (a)


PURPOSE:
To identify each child’s nutritional needs based on nutritional assessment data (height/weight
information as charted on growth charts, hemoglobin/hematocrit) and information received from
the child’s parent/guardian.

POLICY:
The Nutrition Assessment is incorporated into the Health History form. Parents/guardians will
complete a Health History forms, which will be included in the Health Section of the child’s file.
The Form will include information about the child’s eating habits, special dietary needs, likes
and dislikes, etc. This form along with nutritional assessment data received from the child’s
physical exam (height, weight, hemoglobin) will be assessed to determine special needs. The
program will also address major community nutritional issues in an effort to help families
overcome these issues.

PROCEDURE:
1.   The Health Unit will ensure that the Health History is included as part of the enrollment
     packet.

2.         Family Consultants/Community Workers/Home Visitor will assist parents in completing
           the Health History form and will review the information on the form at the time the
           enrollment packet is returned to the Family Consultant/Community Worker/ Home
           Visitor.

3.         The Family Consultants/Community Worker /Home Visitor will clarify any starred
           questions that are answered “yes” with the parent to determine what the child’s nutritional
           needs are while at the center. Comments should be written in the box at the bottom of
           Health History form.

4.         During file reviews, the Health History form will be reviewed and signed by the Health
           Associate.

5.         If needed, within one month of reviewing Health History form, the Health Associate will
           obtain any additional clarification or address concerns with the parent or guardian.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 31 - 1
6.       Teachers/Teacher Assistants/Home Visitor will measure the children for height/weight
         and plot the measurements on the growth charts for each child as indicated in the Growth
         Charts (HS-3).

7.       Upon a receipt of a completed referral, as indicated in the SP- 6 procedure, the Health
         Associate will also review the growth charts. If a child is above the 95% or below the 5%
         for height, weight or height-to-weight, the child will be observed at the center to assess
         eating habits, physical activity, etc.

8.       If further information is needed, the Health Associate will contact the parent.

9.       If necessary, the Health Associate will send a follow-up letter and suggestions for weight
         maintenance or weight gain to the parent.

10.      If a child has a low hemoglobin level, the Health Associate will send the parent a follow-
         up outlining the importance of iron in the diet and recommendations for increasing iron
         the diet. The Health Associate/Family Consultant/Community Worker /Home Visitor
         will encourage the parent to enroll the child in the WIC program.

11.      If a child has a high blood lead level, the Health Associate will send the “Illinois
         Department of Public Health Prevention with Nutrition” handout that contains tips for
         reducing the retention of lead in the body. The parent will also be encouraged to have the
         child’s blood lead level re-tested at the appropriate time.


Form(s):
Health History
Referral
Growth Charts




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                             HS 31 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.       HS 32                                                                                         Issue Date: 9/99
Unit:         Health Services                                                                                  Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:         Identification of Nutritional Needs- Early Head Start
Regulatory Reference:             1304.23 (a)(1), (a)(2), (a)(3), (a)(4), Licensing Standard 407.210



PURPOSE:
To ensure that staff and families work together to identify the nutritional needs of each infant,
toddler and child enrolled in the Head Start and Early Head Start Programs.

POLICY:
All Center Coordinators/Family Consultants/Teachers/Teacher Assistants/Child Care Assistants
will collect information from families regarding the nutritional needs of each infant/toddler
enrolled in the Early Head Start programs. This information will be collected initially during the
enrollment period and collected at least monthly for each infant until 12 months of age. Between
12 and 24 months this information will be collected at least every three months. Staff will discuss
the infant/toddler’s intake and eating patterns daily with parents.

PROCEDURE:
1.   During the enrollment process, parents will complete a nutritional history form. All
     Center Coordinators/Family Consultants/Teachers/Teacher Assistants/Child Care
     Assistants. Staff will discuss and clarify any nutritional concerns of the parent. Any
     concerns should be forwarded to the assigned Health Associate or Early nurse. If the
     infant/toddler is placed on a waiting list, this step should be completed as close to the first
     day of attendance as possible.

2.         Following the enrollment period, Center Coordinators/Family Consultants/Teachers/
           Teacher Assistants/Child Care Assistants will briefly discuss any changes in the
           infant/toddler’s intake and the eating pattern with the parent.

3.         Feeding times and amounts will be documented on the (Daily Information Sheet or the
           Early Head Start "What I Did Today" sheet. One of these sheets should be given to a
           parent daily.


Form(s):
What I Did Today




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 32 - 1
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.          HS 33                                                                                      Issue Date: 9/99
Unit:       Health Services                                                                                    Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:       Diapering and Sanitation
Regulatory Reference:           1304.22 ( e ) (1) & (2) Licensing Standard 407.340



PURPOSE:
To ensure that Early Head Start infants/toddlers/children and traditional Head Start children are
served in a sanitary, hygienic and safe environment.

POLICY:
All Early Head Start staff and Head Start staff with children requiring diapers will adhere to
policies and procedures established to promote a sanitary, hygienic and safe environment for
infants/toddlers/children.

PROCEDURE:
1.   Diaper changing for all Early Head Start infant/toddlers will occur at diapering tables
     only.

2.         Each diapering area serving children wearing diapers will have a designated diapering
           area which includes the following:

           -          a covered, plastic-lined diaper pails located close to the changing table for the
                      disposal of soiled diapers. These diaper pails will be washable, plastic-lined and
                      tightly covered.
           -          a supply of disposable latex gloves.

3.         Diaper changing will occur according to an established procedure

4.         Changing surfaces will be cleaned and sanitized between each diaper change.

5.         The diaper receptacles will be cleaned and sanitized daily.

6.         The contents of potty chairs shall be dumped in the toilet, and the potty chair will be
           cleaned and sanitized between each use.

7.         Children and staff will wash hands thoroughly according to established hand-washing
           procedure after using the toilet or assisting in toileting, and after each diaper change.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 33 - 1
                             SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
      For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                      For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.           HS 34                                                                                      Issue Date: 9/99
Unit:         Health Services                                                                                   Effective Date: 9/99
                                                                                                                No. of Pages: 1
Title:       Diapering Process
Regulatory Reference:                             1304.22 ( e ) (1-7) and Licensing Standard 407.340



PURPOSE:
To ensure a hygienic environment during the diapering process.

POLICY:
All Early Head Start infants/toddlers will be changed according the established procedure. The
procedure must be posted in all diapering areas.

PROCEDURE:
1.   Assemble the following items before bringing the infant/toddler/child to the diapering
     area:
     a)    disposable wipes
     b)    diapers
     c)    disinfecting solution

2.          Lay the infant/toddler/child on the changing surface. Take care to minimize contact with
            the child if his/her outer clothes are soiled.

3.          Put on protective (latex) gloves.

4.          Remove the soiled diaper and any clothes from the infant/toddler/child.

5.          Clean the infant/toddler/child’s bottom from front to back with a fresh disposable wipe.

6.          Dispose of disposable diapers and diaper wipes in covered receptacles. Put any soiled
            clothes and/or cloth diapers into the diaper pail.

7.          Remove disposable gloves. Wash hands or wipe hands with a disposable wipe. See HS-
            11.

8.          Wash the infant's/toddler/child's hands in accordance with established procedures. See
            HS-11.

9.          Put a clean diaper and/or clean clothes on the infant/toddler/child.

10.         Remove the infant/toddler/child from the changing table.


D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                            HS 34 - 1
11.      Wipe up any visible soil from the changing table with disposable wipes.

12.      Clean and disinfect the diapering area.

13.      Adults should wash hands in accordance with the established procedures for
         handwashing. See HS-11.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                       HS 34 - 2
                            SIUE HEAD START/EARLY HEAD START POLICY & PROCEDURE
     For the purposes of this manual, Center Coordinator includes Center Manager, Home-Based Supervisor, and Social Services Coordinator (Early).
                     For the purposes of this manual, Head Start refers to Head Start and Early Head Start unless otherwise specified.

Procedure No.        HS 35                                                                                        Issue Date: 9/99
Unit:       Health Services                                                                                    Effective Date: 9/99
                                                                                                               No. of Pages: 1
Title:        Hygiene and Safety During Sleeping and Napping
Regulatory Reference:          1304.22 ( e ) (1-7) and Licensing Standard 407.340



PURPOSE:
To ensure a hygienic and safe environment during napping and sleeping

POLICY:
All infants/toddlers/children enrolled in the any Head Start program option will be provided a
safe and hygienic environment.

PROCEDURE:
1.   Cribs and cots will wiped after any spills, toileting accidents etc.

2.         Cribs are to be cleaned twice per week and then sanitized with a germicidal solution. Cots
           are to be cleaned once per week with a germicidal solution.

3.         All cribs and cots are to be cleaned and sanitized with a germicidal solution after a child
           leaves the program and before another infant/toddler uses the cribs or cots.

4.         Freshly washed sheets and blankets are to be used and changed twice a week. The sheets
           and blankets are to be changed more frequently if they become wet or soiled.

5.         Infants/toddlers that can not turn over alone are to be placed on their sides or backs when
           put down to sleep unless directed to do otherwise by the infant/toddler’s physician.

6.         Infants/toddlers are not to be put to sleep with a bottle or other small objects.




D:\Docstoc\Working\pdf\bc734f58-c630-4fa6-8fd3-faa854ddbd91.doc                                                                           HS 35 - 1

								
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