Health-Related Services


(a) In addition to Section 101226, and notwithstanding Section 101226(a), the following shall apply:

(b) If the child's illness or injury worsens to the point that it exceeds the maximum level of care specified in the admission policies and for which the center is licensed, the licensee shall immediately notify the child's authorized representative and require the child's authorized representative to remove the child from the center.

(1) Notification of the authorized representative shall be recorded in the child's record and shall include the date and time of notification and the name of the qualified staff person making the notification.

(c) A written plan of care shall be developed for each child and shall be updated daily.

(1) This plan shall be completed with the assistance of the child's authorized representative; shall be signed and dated by the authorized representative; and shall be maintained in the child's record.

(2) Each plan of care shall include but not be limited to:

(A) Type and frequency of observations of the child.

(B) Activity level.

(C) Dietary restrictions.

(D) Prescription and nonprescription medications that the child must take while at the center.

(E) Special procedures associated with the child's illness/injury, such as any relating to intake of food and liquid, stool and urine output, or temperature. This requirement may be omitted when the nature of the child's illness/injury warrants doing so.

(F) Developmental activities.

(d) Every center shall have provisions for continuing health consultation from a physician or registered nurse with a current and active license issued by the appropriate State of California licensing board. This health professional shall have pediatric experience/training obtained within the last five years.

(1) Health consultation may be provided by a staff member who is also a health professional as specified in Section 101626(d), as part of his/her staff duties; or by an outside consultant as specified in Section 101626(d).

(2) Health consultation shall include developing written plans and procedures and, if necessary, forms for the following, all of which shall be maintained at the center:

(A) Admissions criteria, center operating policies and procedures, daily inspection procedures, procedures for the surveillance of communicable diseases, and plans for the care of individual children.

(B) Liaison with local health departments.

(C) Recordkeeping and reporting of accidents and illnesses involving staff and children.

(D) Obtaining emergency health care, including provisions for listing emergency telephone numbers.

(E) Administration, handling and storage of medications.

(F) Emergency first-aid procedures and assurance of the availability of staff trained in such procedures.

(G) Establishment of an isolation area and development of related procedures.

(H) Provision of continuing health-care services to children in attendance who do not already have access to such services, which may include making referrals to community resources.

(I) Provision of staff training as specified in Section 101616.2.

(3) If health consultation is provided by an outside consultant, a written contract or letter of agreement between the consultant and the center shall be prepared. This documentation shall be maintained in the center's files.

(4) Each center shall maintain in its files each health consultant's name, address, telephone number, area of specialization and evidence of qualifications.

(A) Evidence of qualifications shall include, but not be limited to, verification of licensure required in Section 101626(d) as demonstrated by the following:

1. A photocopy of the license; and

2. Documentation of written or verbal contact with the appropriate State of California licensing board to verify licensure status.

(5) Health consultation shall occur quarterly or more often, if necessary, and not less than semiannually.

(A) After each consultation, the consultant shall prepare a written report of his/her findings and recommendations. These reports shall be maintained in the center's files.

(B) If consultation is not necessary during a quarter, a notation explaining why shall be made in the center's files.

(e) The licensee shall maintain the most current edition of a manual on the identification and control of communicable diseases.

(1) This manual shall be either the American Academy of Pediatrics' Report of the Committee on Infectious Diseases (Red Book) or another manual approved by the health consultant prior to use.

NOTE: Authority cited: Section 1596.81, Health and Safety Code. Reference: Sections 1596.72, 1596.73 and 1596.81, Health and Safety Code.

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