77 Ill. Adm. Code 250.2720
Day Care for Mildly Ill Children
Section 250
Section 250.2720Â Day Care
for Mildly Ill Children
a)Â Â Â Â Â Â Â Â General Description
1)Â Â Â Â Â Â Â Â A hospital
may provide a program for the temporary
custodial care of mildly ill children
in accordance with the requirements
of this Section. (Section 6.13 of the Act)
2)Â Â Â Â Â Â Â Â The purpose of a day care program for mildly ill children is
to provide a short-term day care alternative for children who, because of mild
illness, cannot participate in their usual daily routine and whose parent or
guardian cannot stay home with them.
3)Â Â Â Â Â Â Â Â Children who participate in a day care program for mildly ill
children
are not considered hospital patients and are not required to be
under the professional care of a member of the hospital's medical staff except
in those cases where emergency medical treatment is needed during the time the
child is on the program premises.
(Section 6.13(b) of the Act)
b)Â Â Â Â Â Â Â Â For the purposes of this Section, "mildly ill" or
"mild illness" means a temporary medical condition which does not
require in-patient hospital treatment, but which makes a child
unable to
attend school
, renders
participation in normal day care
arrangements
impracticable, or excludes a child from attendance at a day care center or home
licensed by the Department of Children and Family Services [see 89 Ill. Adm.
Code 406.14(d), 407.18(e), 408.60(e), and 408.70(b)]. (Section 6.13 of the
Act)
c)Â Â Â Â Â Â Â Â Policies and Procedures
1)Â Â Â Â Â Â Â Â Each hospital offering a day care program for mildly ill
children shall develop written policies and procedures to govern the operation
of the program. The hospital shall consider the rules of the Department of
Children and Family Services on day care programs (89 Ill. Adm. Code 407) in
the development of the policies and procedures.
2)Â Â Â Â Â Â Â Â Policies and procedures governing the registration of children
into the program, the conditions under which children will be referred for
medical treatment, and the provision of emergency medical treatment shall be reviewed
and approved by the medical director of the program or by another physician
licensed to practice medicine in all its branches.
d)Â Â Â Â Â Â Â Â Program Administration
1)Â Â Â Â Â Â Â Â The program shall designate a physician licensed to practice
medicine in all its branches, experienced in caring for children, who will
serve as the medical director of the program.
2)Â Â Â Â Â Â Â Â The program shall be supervised by a registered nurse or a
physician experienced in caring for children.
e)Â Â Â Â Â Â Â Â Registration and Initial Evaluation
1)Â Â Â Â Â Â Â Â The program shall have a policy for the registration of mildly
ill children into the program. The policy shall include at least the following
requirements:
A)Â Â Â Â Â Â Â The program shall collect background information concerning the
child prior to accepting a sick child into the program, including the
information required under subsections (k)(1) and (2) of this Section.
B)Â Â Â Â Â Â Â The registration procedures shall be designed to provide the
program with sufficient information to enable the parent or guardian and the
program staff to make decisions or act on behalf of the child while at the
program.
2)Â Â Â Â Â Â Â Â A preliminary evaluation of the condition of the mildly ill
child shall be made by a registered nurse or physician affiliated with the
program before the child is brought to the program. The preliminary evaluation
shall consist of the parent's or guardian's reporting the child's symptoms to
the program's designated personnel by telephone. A determination shall be made
at that time as to whether the parent or guardian may bring the child to the
program for on-site evaluation.
3)Â Â Â Â Â Â Â Â An on-site evaluation must be performed by a physician or
registered nurse affiliated with the program. The evaluation which takes place
at the program premises shall include the following;
A)Â Â Â Â Â Â Â An assessment of the child's physical condition, including
current medications.
B)Â Â Â Â Â Â Â An assessment of the probable contagion and risk to the health
of other individuals present.
C)Â Â Â Â Â Â Â An assessment of the ability of the program to provide the
services that the child requires.
4)Â Â Â Â Â Â Â Â The program personnel evaluating the child shall determine
whether a mildly ill child may be registered.
5)Â Â Â Â Â Â Â Â The registration and evaluation process must be followed each
day the parent or guardian wishes to register a child into the program.
6)Â Â Â Â Â Â Â Â Program staff must report cases of suspected child abuse and
communicable disease cases in accordance with current reporting requirements of
the Department of Children and Family Services (89 Ill. Adm. Code 300) and the
Department (77 Ill. Adm. Code 690).
f)Â Â Â Â Â Â Â Â Facility and Equipment Requirements
1)Â Â Â Â Â Â Â Â A day care program for mildly ill children shall be
located
on the hospital's licensed premises.
(Section 6.13 of the Act)
2)Â Â Â Â Â Â Â Â Programs which are located in an area where patients are also
present shall meet the following requirements:
A)
Children in the program shall not simultaneously occupy the
same room as a hospital patient
. (Section 6.13(a)(1) of the Act)
B)Â Â Â Â Â Â Â Policies and procedures shall be developed to assess individual
children's needs and potential infection control implications prior to placing
a program participant in a particular room.
3)Â Â Â Â Â Â Â Â Toilets and handwashing sinks must be within or immediately
adjacent to the room or rooms used for day care for mildly ill children.
g)Â Â Â Â Â Â Â Â Infection Control
1)Â Â Â Â Â Â Â Â The program shall have written infection control and isolation
policies and procedures. The policies and procedures shall specify medical
conditions which will exclude children from participation in the program. The
policies and procedures shall include the use of universal precautions, comply
with the hospital's infection control policies and be reviewed and approved by
the individual responsible for the hospital's infection control program.
2)
Children in the program who are recovering from non-contagious
conditions shall be cared for in a room separate from children registered in
the program who have contagious conditions.
(Section 6.13(a)(2) of the Act)
3)Â Â Â Â Â Â Â Â Programs which accept children with contagious conditions must
separate children with different contagious conditions in accordance with the
hospital's infection control policies.
4)Â Â Â Â Â Â Â Â If a hospital also operates a day care center licensed by the
Department of Children and Family Services, children registered in the day care
program for mildly ill children shall not simultaneously occupy the same rooms
used by well children.
h)Â Â Â Â Â Â Â Â Activities
1)Â Â Â Â Â Â Â Â Each program shall provide activities which are available to
children registered in the program. The activities shall take into account the
educational and developmental needs of program registrants.
2)Â Â Â Â Â Â Â Â Children in the program shall be permitted to participate in
activities which are appropriate to the level of illness and age of each child.
i)         Food Services. Well-balanced meals and snacks must be
offered at appropriate times throughout the day. Menus shall be modified to
meet the individual needs of each child as necessary.
j)Â Â Â Â Â Â Â Â Â Medication Administration
1)Â Â Â Â Â Â Â Â Medication which is brought to the program for a child by the
child's parent or guardian may be administered to the child in the program in
accordance with the following requirements.
A)Â Â Â Â Â Â Â The program shall maintain a record of the dates, hours,
dosages, and the name of the person administering the medication.
B)
Prescription medications shall be labeled with the child's
name, directions for administering the medication, the date, the physician's
name, the prescription number, and the dispensing drug store or pharmacy.
(Section 6.13(c)(1) of the Act)
C)
Only current prescription medications shall be administered
by the program.
(Section 6.13(c)(1) of the Act)
D)Â Â Â Â Â Â Â The medications shall be administered as required by the
child's physician, subject to the receipt of appropriate releases from the
parent or guardian, which shall be on file for each child for the
administration of any and all prescribed medications.
E)
Written parental permission shall be obtained before
non-prescription medication is administered. Such medication shall be administered
in accordance with package instructions.
(Section 6.13(c)(2) of the Act)
F)Â Â Â Â Â Â Â Â Medications shall be kept in locked cabinets or containers
which are in an area well-lighted and out of reach of children even if
medications must be refrigerated.
G)Â Â Â Â Â Â Â Medications shall only be administered by individuals who are
authorized by the hospital's policies to administer medications as required by
Section 250.2140(c)(6).
2)Â Â Â Â Â Â Â Â The requirement that no medication shall be administered
except on the written order of a member of the medical staff (Section
250.330(a)) shall not apply to day care programs for mildly ill children.
Program
staff may administer medication prescribed by any licensed professional who is
permitted by law to do so, whether or not the professional is a member of the
hospital's medical staff
. (Section 6.13(c)(1) of the Act)
k)        Records. A record shall be maintained for each child
registered in the program and shall include each of the following items:
1)Â Â Â Â Â Â Â Â Parent or guardian information:
A)Â Â Â Â Â Â Â Names, home addresses, and home telephone numbers.
B)Â Â Â Â Â Â Â Employers, work addresses, and work telephone numbers.
C)Â Â Â Â Â Â Â Telephone numbers where the parent or guardian can be reached.
D)Â Â Â Â Â Â Â Name, address, and telephone number of a person to be notified
in an emergency, if the parent or guardian cannot be reached.
E)Â Â Â Â Â Â Â Names of persons authorized to remove the child from the
program, if other than the parent or guardian.
2)Â Â Â Â Â Â Â Â Child information:
A)Â Â Â Â Â Â Â Name, address and telephone number.
B)Â Â Â Â Â Â Â Birth date.
C)Â Â Â Â Â Â Â Medical history, including any known allergies, any diet
restrictions or special dietary needs, and proof of immunizations.
D)Â Â Â Â Â Â Â Current health status.
E)Â Â Â Â Â Â Â Any prescription and non-prescription medications taken by the
child during the previous 24 hours.
F)Â Â Â Â Â Â Â Â Any special instructions.
G)Â Â Â Â Â Â Â The name and telephone number of the child's pediatrician or
family practitioner.
3)Â Â Â Â Â Â Â Â Signed consent forms from the parent or guardian, authorizing
the program to take the following actions:
A)Â Â Â Â Â Â Â Care for the child in accordance with the program's policies
and procedures.
B)Â Â Â Â Â Â Â Care for the child in accordance with any special instructions
given by the parent or guardian which do not conflict with the program's
policies and procedures.
C)Â Â Â Â Â Â Â Administer medication, including prescription and
non-prescription drugs.
D)Â Â Â Â Â Â Â Provide emergency medical treatment.
4)Â Â Â Â Â Â Â Â Daily record for each day the child actually spends in the
program, including:
A)Â Â Â Â Â Â Â A description of the evaluation of the child at the time the
child is brought to the program premises.
B)Â Â Â Â Â Â Â A record of the services the child received while at the
program, including any medications administered.
C)Â Â Â Â Â Â Â Periodic assessment of the child's health status while at the
program.
l)Â Â Â Â Â Â Â Â Â Staffing
1)Â Â Â Â Â Â Â Â The program shall develop a staffing plan which assures the
safety, comfort and effective care of children during all times the program is
in operation. Both the numbers and training of staff shall be included in the
staffing plan. In programs located on inpatient pediatric units where staff are
shared, a staffing plan must be developed and implemented that provides a
patient/staff ratio that ensures appropriate staffing levels to meet the needs
of both inpatients and day care participants.
2)Â Â Â Â Â Â Â Â A registered nurse must be available at all times the program
is in operation.
3)Â Â Â Â Â Â Â Â Written job qualifications and descriptions must be prepared
for all personnel involved with the program.
4)Â Â Â Â Â Â Â Â Program staff must have training in the care of ill children
and in normal child development. Such training may be provided by the
hospital.
m)Â Â Â Â Â Â Â Emergency Medical Treatment
1)Â Â Â Â Â Â Â Â The program shall have written policies and procedures
governing the provision of emergency medical treatment to children registered
in the program who become seriously ill.
2)Â Â Â Â Â Â Â Â Emergency medical treatment shall be available at all times
the program is open for operation.