According to the California licensing regulations, no child may be accepted until a daily inspection for illness has been completed. Every person bringing a child to the facility must remain until the health check has been completed by the teacher or designee & child is accepted.



Interpreting regulations & putting them into practice can be challenging. Below are strategies to ensure this component is met:


Where should health checks be done

Health checks are usually done in a location between the door & the sign-in sheet.

This allows for the health check & acceptance of the child to happen BEFORE the parent signs-in their child to care.

Occasionally, the health check may occur in a more private location, like in the case of a prolonged nit check.


When is a health check done

The health check is completed EVERYDAY, prior to the parent signing their child in for care.

A more thorough check must be done when:

  • Child returns to care after being absent due to an illness, such as the flu or diarrhea

  • Child has been exposed to a contagious disease either at home or school, such as Hand, Foot & Mouth Disease or Chicken Pox

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How are health checks done

Greet the child & parent/guardian. Ask the parent/guardian of a nonverbal child, “How is Susy doing today?”

“Was there anything different last night?”

“How did he/she sleep last night?”

“Are there any changes at home that may cause him/her to act differently today (death of a pet, illness or death of a relative, change in family structure, etc.)?”

Additionally, if the child is verbal, ask the child, “How are you today?” Listen to the child talk. Is the child complaining of anything? Is the child hoarse, wheezing or making other unusual sounds?

Look for signs of health or illness.

  • Breathing: 1) Is the child coughing? 2) Is the child breathing fast, or having difficulty breathing? 3) Is the child making any unusual sounds?

  • Skin: 1) Does the child look pale or flushed? 2) Do you see a rash, sores, swelling, or bruising? 3) Is the child scratching his/her skin or scalp?

  • Eyes, Nose, Ears, Mouth: 1) Do the child’s eyes look red, crusty, watery, or other than normal? 2) Is there a green runny nose? 3) Is the child pulling at his/her ears?

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When a child is ill, the Keep Me Home If… handout/poster gives parents & teachers/providers the information they need to decide if a child should stay at home instead of attending care.

Note: This is the same poster referred to in the licensing video above.


What if I'm not sure whether to accept a child 

Put yourself in the shoes of the next parent in line.

If you would not want YOUR child to be in the classroom with the child you have concerns about, then the child should NOT be accepted.


When can an excluded child return to care

Children who are excluded for any of these reasons may return when:

  • Symptoms have disappeared, OR

  • Parent brings a doctor’s signed/dated note that the child is not contagious 

  • Child is completely clear of head lice & nits

  • Eye infections have been treated with medication & there is clearance from a doctor


What if a child get's ill while in care

Children who become ill during the day must be isolated from other children & made comfortable.

The child’s parent/caretaker or other authorized adult must be notified to pick the child up immediately.




Record Keeping

Once the daily health check has been completed & the child accepted, a system must be in place to document the daily health check was completed, such as checking the designated box on the sign-in sheet.



Are you ready to check for understanding? No worries, if you do not do well the first time, you can take the Knowledge Check a second time.

Good luck my friend!

Note: You must set-up a free account to run the Group Knowledge Checks


Title 22: Section 101226.1

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