Childcare Exclusion List: Information for Parents
The information in this page applies to:
- All children in out-of-home childcare,
- All students in 3, 4, and 5 year old kindergarten, and
- Medically Fragile Students in 1st through 12th grades. Medically Fragile Students are those students with special healthcare needs and/or developmental delays who require close assistance with feeding or personal hygiene activities. You and your child’s school will determine if your child is considered medically fragile.
Refer to the School Exclusion List for students in 1st through 12th grades who are not Medically Fragile.
If you think that your child has an illness that can be spread to others, please keep him or her home from school or out-of-home childcare. Contact your doctor or clinic.
Questions to Ask When Your Child is Sick:
- Does your child’s illness keep him/her from comfortably taking part in activities?
- Does your sick child need more care than the staff can give without affecting the health and safety of other children?
- Could other children get sick from being near your child?
If the answer to any of these questions is “Yes,” please keep your child out of school or childcare.
Frequently asked Questions about when sick children should stay home from school:
When should sick children stay home from school?
If your child feels too sick to go to school, please keep him home. Children should also stay home if they have symptoms of illnesses that they might be able to spread to others.
Does my child need to stay home when he just has a cold?
Most children with mild colds who have no fever and who feel well enough to go to school do not need to stay home. Most colds spread in the 1-3 days before children show symptoms such as a runny nose or slight cough.
How long will my child need to stay home if she is sick?
The inside of this brochure explains how long children should stay home after they become ill with excludable conditions.
Would my child have to stay out of school if he was not sick?
Sometimes children will also have to stay home from school if they are exposed to some diseases, especially diseases preventable by vaccines. Your school or DHEC will discuss this exclusion with you.
What does my child need to come back to school?
The list below shows whether a Medical Note or Parent Note is required to return to school after exclusion for illness.
What about other activities?
Students with illnesses spread by close contact, like lice, scabies, shingles, or staph or strep skin infections, may not be allowed to participate in some sports or physical education activities.
Help your child stay healthy and ready to learn.
We hope that your child never has to miss school because of illness or disease. The best protection from disease is prevention. You can help prevent many illnesses by making sure your child receives immunizations and by making sure your child washes his or her hands often.
If your child has one of the conditions listed below, please keep him or her home from school or out-of-home childcare. Call your child’s school or childcare provider to let them know why your child is absent. Send the appropriate note when your child returns to school or out-of home childcare.
Chicken Pox / Varicella
Children with chicken pox may return with a Parent Note once all of the sores and blisters are dried or scabbed over, or if there are no scabs, until no new sores appear.
For most kinds of diarrhea (defined as 3 or more loose stools in 24 hours), students in 1st through 5th grades should stay home until diarrhea stops, or until a doctor clears the child to return to school. Your child can return with a Parent Note when the diarrhea has stopped. Older children in 6th through 12th grades with diarrhea do not have to stay home, unless they are spreading illness in the school setting, or have diarrhea with blood or mucus.
Students of any age must have a Medical Note to return to school after having diarrhea that contains blood or mucus.
Students who can use the restroom or whose stools are contained in diaper-type underwear do not have to be excluded if the diarrhea is known to be from a non-contagious condition, or if it continues after the child completes antibiotics for a diarrhea-causing illness.
A medically fragile child or child who needs help with toileting may be excluded for fewer than 3 episodes of diarrhea if her condition makes it hard for her caretakers to maintain sanitary conditions in the classroom.
Diarrhea from Campylobacter, E. Coli, Giardia, Norovirus, Rotavirus, Salmonella or Shigella:
Students of any age are excluded for one of these infections. Your child may return to school with a medical note for the following conditions:
Campylobacter, Norovirus, Rotavirus, Shigella and most types of Salmonella
After diarrhea stops.
For the most severe type of E. coli, students of any age must be out of school until the diarrhea stops and 2 lab tests taken 24 hours apart test negative for E. coli O157:H7.
When diarrhea stops or child has taken antibiotics for at least 24 hours.
Salmonella typhi (Typhoid fever)
After 24 hours without diarrhea, and 3 lab tests are negative, if a doctor clears the child to return.
After 5 days of antibiotics or a negative lab test.
Fever by itself
Infants under 4 months old: Keep home for rectal temperature (taken in the bottom) 101 degrees F or higher.
Children over 4 months old: Keep your child home for a fever 101 degrees F or higher by mouth, 100 degrees F or higher if taken under the arm, or 102 degrees F or higher if taken in the bottom.
Children can return with a Parent Note when the fever is gone.
Fever with Rash, Behavior Change or other Symptoms
Take your child to a doctor or clinic for any fever if he or she also has signs of severe illness such as a rash, change in behavior, earache, vomiting confusion, sore throat or irritability. A Medical Note is required to return.
Flu / Influenza or Influenza-Like Illness (ILI)
A student with ILI or the flu will be excluded for a fever of 100 degrees F with cough and/or sore throat until he is fever free for at least 24 hours. without any fever medicines.
German Measles / Rubella / 3 Day Measles
Keep your child home until 7 days after rash starts. He may return with a Medical Note.
Children with crawling lice or with nits (eggs) ¼ inch or closer to the scalp may be sent home at the end of the day if head-to-head contact with other children can be avoided. Otherwise, they may be excluded immediately. Your child may return with a Parent Note after her first treatment with a school-approved lice-removal product, if there are no active lice crawling on your child’s head. The school or center should check your child 7 days after treatment for any newly hatched crawling lice. If any are present, your child will have to be re-treated for lice in order to return to school or childcare.
Hepatitis A / Yellow Jaundice
Children with acute hepatitis A may return with a Medical Note 1 week after the start of the jaundice.
Hib (Haemophilus influenzae Type B)
Students with proven Hib infection need to be out of school until at least 24 hours after they complete their antibiotics. A Medical Note is required to return.
If your child has dry, honey-colored crusty sores that cannot be covered, he will be sent home at the end of the school day until 24 hours after starting antibiotics.
If the sores are weepy, oozing or wet or cannot be covered and kept dry, the child will be sent home immediately. He may return after 24 hours of antibiotics, if the sores have stopped oozing and are starting to get smaller.
A Medical Note is needed to return to school.
Measles / Red Measles / 10 Day Measles
Children with measles can return with a Medical Note 4 days after the rash begins, if they have no fever and feel well enough to participate in regular school activities.
A student with signs of meningitis (high fever, rash, stiff neck) must remain out of school until a healthcare provider says that the student may return.
Your child’s physician will decide when your child is well enough to come back to childcare or school.
Mouth Sores inside the mouth
Children sores inside the mouth, who also drool, should stay home until their health care provider says that the sores are not contagious. A Medical Note is needed to return to school.
Children with mumps can return with a Medical Note 5 days after the beginning of swelling.
Pink-eye / Conjunctivitis
Children whose eyes are red or pink, and who have eye pain and reddened eyelids, with white or yellow eye discharge or eyelids matted after sleep should not be in school until they have been examined and treated. A Medical Note is required to return.
Students who have a rapidly spreading rash or a rash with fever or behavior change are excluded from school immediately. A Medical Note is required to return.
Children with ringworm of the scalp must remain out of school until they have begun treatment with a prescription oral antifungal medication. Your child may return with a Medical Note.
Children with ringworm of the body may return with a Parent Note once they have begun oral or topical antifungal treatment, unless the affected area can be completely covered by clothing the entire time that the child is at school or in childcare.
Children with scabies should be out of school until treatment/medication has been applied. A Medical Note is required to return.
Keep children home who have shingles lesions/sores/blisters that cannot be covered. Your child may return with a Parent Note once the lesions are dried/scabbed.
Staph or Strep Skin Infections (includes MRSA)
A child with a draining sore, boil, or abscess that cannot be covered, or with sores that ooze through and soak dressings, should remain home. She may return once the draining stops, or if the drainage (oozing) can be contained in the dressing, so that no one else comes into contact with the drainage.
“Strep Throat” / Streptococcal Pharyngitis
Your child with “Strep throat” can return to school with a Medical Note 24 hours after starting antibiotics if there is no fever.
Sty (or Stye)
A child with a draining/oozing sty should remain home until the draining stops.
A child with TB should be kept home until the doctor treating the TB writes a Medical Note that says that the child is no longer contagious.
A child who has vomited 2 or more times in 24 hours should stay home until the vomiting stops, unless she is known to not be contagious.
Whooping Cough / Pertussis
Children with whooping cough can return to school with a Medical Note after completing 5 days of prescribed antibiotics, unless directed otherwise by DHEC or your school nurse.
Children with the following conditions do not have to be excluded from school or out-of home childcare, if they feel well enough to participate in regular school activities:
Chronic Hepatitis B
Colds or coughs, without fever or other signs of illness
Illnesses from Tick Bites, like Babesiosis, Ehrlichiosis Lyme Disease, Rocky Mountain Spotted Fever, or Tularemia
MRSA, if child is only a carrier
Rash without fever or behavior change
Red eye without yellow or green discharge, fever, or matting
RSV: Respiratory Syncytial Virus
Warts, including Molluscum contagiosum
Urinary Tract Infection
West Nile Virus
Yeast Diaper Rash
If you have any questions about the Childcare Exclusion List, please contact your child’s school or childcare provider or your local health department
Updated August 1, 2012