Florida Regulations 65C-25.002: Admission and Assessment
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(1) General Requirements.
(a) A child care facility for mildly ill children shall have at a minimum an ongoing agreement with a Health Provider Consultant, as defined in subsection 65C-25.001(4), F.A.C., for continuing medical or nursing consultation. The health provider consultant shall perform the following services:
1. Oversee the development of written policies and procedures.
2. Review, approve, and update annually, such policies and procedures.
3. Provide at least quarterly on-site monitoring of the implementation of such policies and procedures.
4. Provide ongoing consultation to the facility in its overall operation and management.
(b) A child care facility for mildly ill children shall have at a minimum one licensed health caregiver, as defined in subsection 65C-25.001(7), F.A.C. The licensed health caregiver shall be responsible for performing the written physical assessment and child evaluations, per paragraphs 65C-25.002(2)(b), (c), and (d), F.A.C.; provide ongoing daily oversight; make decisions as to the exclusion of any child; and be present at the facility at all times during the hours of operation.
(2) Admission.
(a) No child shall be accepted to a child care facility for mildly ill children without written parental or guardian permission. However, permission may be obtained by telephone if a child in attendance at a regular child care facility becomes mildly ill and is admitted to that same facility’s program for mildly ill children. Where the child is in care under telephone permission, written parental permission must be obtained prior to the child’s admittance to the program for mildly ill children the following day.
(b) The program director or licensed health caregiver shall have the authority to require a written medical evaluation for a child to include diagnosis, treatment and prognosis, if such evaluation is necessary to determine the appropriateness of a child’s attendance prior to admission and upon worsening of the child’s symptoms.
(c) Prior to admission, the child care facility for mildly ill children shall require a written description, signed by the parent, of the child’s current and recent illnesses; immunization records, habits, special diets, allergies, medication needs; symptoms requiring notification of parent or health care provider, and where and how the parent or health care provider is to be notified.
(d) An initial written physical assessment on each child shall be completed by the licensed health caregiver, as defined in subsection 65C-25.001(7), F.A.C., based on the inclusion and exclusion criteria outlined in subsections 65C-25.002(3) and (4), F.A.C., to determine appropriateness of admission to the facility. A parent must remain on the premises until admission has been determined.
(e) The written physical assessment shall at a minimum include vital signs and observation of the child’s general appearance, head, eyes, nose, mouth, ears, skin, abdomen, arms and legs, and breathing pattern for symptoms of illness.
(f) Once admitted, children shall be periodically monitored by the licensed health caregiver and evaluated according to policies and procedures established and approved by the facility operator and the health provider consultant. Evaluations on each child’s condition shall be documented, and shall include the following, plus additional information that the facility operator and the health provider consultant may add if they deem it is necessary to evaluate the children:
1. Temperature.
2. Respiration.
3. Pulse.
4. Amount of food or fluid intake.
5. Color, consistency and number of stools.
6. Color of urine and frequency of urination.
7. Skin color and alertness.
8. Activities such as amount of sleep, rest, and play.
(g) The condition evaluations must be maintained in each child’s record and retained by the facility for a minimum of 12 months. Copies shall be provided to parents daily.
(h) Children with communicable illnesses (e.g., chicken pox) may be accepted in a child care facility for mildly ill children only if there is an isolation area, as defined in subsection 65C-25.001(6), F.A.C., and provided the isolation area has a separate outside entrance from the rest of the child care facility.
(3) Inclusions. A child care facility for mildly ill children may accept children exhibiting illnesses or symptoms for which they can be excluded from child care provided for well children, but who do not meet exclusion criteria as outlined in subsection 65C-25.002(4), F.A.C. Children exhibiting the following symptoms, illnesses, or disabilities shall be deemed eligible to participate in child care facilities for mildly-ill children:
(a) Not feeling well, unable to participate in regular child care activities, or has other activity restrictions;
(b) Recovering from prior day surgical procedure or hospital admission;
(c) Controlled fever of 102o orally; 101o axillary, or 103o rectally, or below. If the child’s temperature is higher than the temperatures listed above a physician must give written approval for admission; or verbal approval with written follow up for admission;
(d) Respiratory infections, such as cold, flu, or virus;
(e) Vomiting less than three times without dehydration;
(f) Diarrhea (more than one abnormally loose stool within a 24 hour period) without signs of dehydration, and without blood or mucus in the stool;
(g) Gastroenteritis without signs of severe dehydration;
(h) Diagnosed asthma;
(i) Urinary tract infections;
(j) Ear infections;
(k) Orthopedic injuries;
(l) Diagnosed rash;
(m) Tonsillitis, or
(n) Strep throat or conjunctivitis after 24 hours of appropriate medication, if isolation is unavailable. Strep throat or conjunctivitis prior to 24 hours of appropriate medication is included only if isolation area is available.
(4) Exclusions. Any child exhibiting the following symptoms or combination of symptoms shall be excluded from child care facilities for mildly ill children:
(a) Unresponsive temperature of 104° orally;
(b) Undiagnosed or unidentified rash;
(c) Respiratory distress;
(d) Major change in condition requiring further care;
(e) Contagious diseases, if no isolation room is available;
1. Strep throat or conjunctivitis prior to 24 hours of treatment.
2. Diarrhea due to diagnosed shigella, salmonella, rota virus, giardia, or campylobacter.
3. Chicken pox, mumps, measles, rubella, pertussis, diphtheria.
4. Head lice, scabies prior to 24 hours of treatment, or
5. Other conditions as determined by the director or health provider consultant.
Rulemaking Authority 402.305 FS. Law Implemented Florida Statutes § 402.305. History-New 5-21-00, Amended 11-26-19.
Terms Used In Florida Regulations 65C-25.002
- Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
- Oversight: Committee review of the activities of a Federal agency or program.
1. Oversee the development of written policies and procedures.
2. Review, approve, and update annually, such policies and procedures.
3. Provide at least quarterly on-site monitoring of the implementation of such policies and procedures.
4. Provide ongoing consultation to the facility in its overall operation and management.
(b) A child care facility for mildly ill children shall have at a minimum one licensed health caregiver, as defined in subsection 65C-25.001(7), F.A.C. The licensed health caregiver shall be responsible for performing the written physical assessment and child evaluations, per paragraphs 65C-25.002(2)(b), (c), and (d), F.A.C.; provide ongoing daily oversight; make decisions as to the exclusion of any child; and be present at the facility at all times during the hours of operation.
(2) Admission.
(a) No child shall be accepted to a child care facility for mildly ill children without written parental or guardian permission. However, permission may be obtained by telephone if a child in attendance at a regular child care facility becomes mildly ill and is admitted to that same facility’s program for mildly ill children. Where the child is in care under telephone permission, written parental permission must be obtained prior to the child’s admittance to the program for mildly ill children the following day.
(b) The program director or licensed health caregiver shall have the authority to require a written medical evaluation for a child to include diagnosis, treatment and prognosis, if such evaluation is necessary to determine the appropriateness of a child’s attendance prior to admission and upon worsening of the child’s symptoms.
(c) Prior to admission, the child care facility for mildly ill children shall require a written description, signed by the parent, of the child’s current and recent illnesses; immunization records, habits, special diets, allergies, medication needs; symptoms requiring notification of parent or health care provider, and where and how the parent or health care provider is to be notified.
(d) An initial written physical assessment on each child shall be completed by the licensed health caregiver, as defined in subsection 65C-25.001(7), F.A.C., based on the inclusion and exclusion criteria outlined in subsections 65C-25.002(3) and (4), F.A.C., to determine appropriateness of admission to the facility. A parent must remain on the premises until admission has been determined.
(e) The written physical assessment shall at a minimum include vital signs and observation of the child’s general appearance, head, eyes, nose, mouth, ears, skin, abdomen, arms and legs, and breathing pattern for symptoms of illness.
(f) Once admitted, children shall be periodically monitored by the licensed health caregiver and evaluated according to policies and procedures established and approved by the facility operator and the health provider consultant. Evaluations on each child’s condition shall be documented, and shall include the following, plus additional information that the facility operator and the health provider consultant may add if they deem it is necessary to evaluate the children:
1. Temperature.
2. Respiration.
3. Pulse.
4. Amount of food or fluid intake.
5. Color, consistency and number of stools.
6. Color of urine and frequency of urination.
7. Skin color and alertness.
8. Activities such as amount of sleep, rest, and play.
(g) The condition evaluations must be maintained in each child’s record and retained by the facility for a minimum of 12 months. Copies shall be provided to parents daily.
(h) Children with communicable illnesses (e.g., chicken pox) may be accepted in a child care facility for mildly ill children only if there is an isolation area, as defined in subsection 65C-25.001(6), F.A.C., and provided the isolation area has a separate outside entrance from the rest of the child care facility.
(3) Inclusions. A child care facility for mildly ill children may accept children exhibiting illnesses or symptoms for which they can be excluded from child care provided for well children, but who do not meet exclusion criteria as outlined in subsection 65C-25.002(4), F.A.C. Children exhibiting the following symptoms, illnesses, or disabilities shall be deemed eligible to participate in child care facilities for mildly-ill children:
(a) Not feeling well, unable to participate in regular child care activities, or has other activity restrictions;
(b) Recovering from prior day surgical procedure or hospital admission;
(c) Controlled fever of 102o orally; 101o axillary, or 103o rectally, or below. If the child’s temperature is higher than the temperatures listed above a physician must give written approval for admission; or verbal approval with written follow up for admission;
(d) Respiratory infections, such as cold, flu, or virus;
(e) Vomiting less than three times without dehydration;
(f) Diarrhea (more than one abnormally loose stool within a 24 hour period) without signs of dehydration, and without blood or mucus in the stool;
(g) Gastroenteritis without signs of severe dehydration;
(h) Diagnosed asthma;
(i) Urinary tract infections;
(j) Ear infections;
(k) Orthopedic injuries;
(l) Diagnosed rash;
(m) Tonsillitis, or
(n) Strep throat or conjunctivitis after 24 hours of appropriate medication, if isolation is unavailable. Strep throat or conjunctivitis prior to 24 hours of appropriate medication is included only if isolation area is available.
(4) Exclusions. Any child exhibiting the following symptoms or combination of symptoms shall be excluded from child care facilities for mildly ill children:
(a) Unresponsive temperature of 104° orally;
(b) Undiagnosed or unidentified rash;
(c) Respiratory distress;
(d) Major change in condition requiring further care;
(e) Contagious diseases, if no isolation room is available;
1. Strep throat or conjunctivitis prior to 24 hours of treatment.
2. Diarrhea due to diagnosed shigella, salmonella, rota virus, giardia, or campylobacter.
3. Chicken pox, mumps, measles, rubella, pertussis, diphtheria.
4. Head lice, scabies prior to 24 hours of treatment, or
5. Other conditions as determined by the director or health provider consultant.
Rulemaking Authority 402.305 FS. Law Implemented Florida Statutes § 402.305. History-New 5-21-00, Amended 11-26-19.