Daycare sick policy: exclusion rules and a sample policy

A sick policy earns its keep at two moments: morning arrival, when a teacher has to decide whether a child who showed up symptomatic can stay, and again mid-morning, when a child develops symptoms in the room and someone has to make the same call with the day in progress.

Exclusion criteria are the rules for both moments.

Written well, they let any staff member reach the same decision without waiting for the director.

Texas shows how a licensing rule frames the decision. Unless the center is licensed to provide get-well care, it may not admit an ill child whose illness prevents comfortable participation, needs more care than staff can give without compromising the other children, or involves listed symptoms — an oral temperature above 101 degrees with behavior change is the rule's example (26 TAC 746.3601).

Read as a policy draft, that is three tests your staff can apply at the door:

• Participation. Can this child take part in the day — meals, play, outdoor time — or is the illness keeping them on a cot away from the room?
• Care capacity. Would caring for this child pull staff from everyone else? The Texas test makes that an exclusion ground on its own: an illness that needs more care than staff can give without compromising the other children.
• Named symptoms. The symptoms the rule lists — the temperature-and-behavior-change example above is one of them.

Separately from the symptom tests, Texas centers must follow the communicable-disease exclusions the Department of State Health Services requires for schools (25 TAC 97.7, applied through 26 TAC 746.3603) — so the specific-disease list in a Texas policy is the state's, not the center's own.

Your state's list is the one that goes in your policy. The Texas rule above is a worked example, not a national standard: your state's rule may set the same three tests, its own symptom list, or a different source for communicable-disease exclusions entirely.

That is why the criteria in your policy must come from your state child care licensing agency and the health department your rule names — quote the rule's words rather than another center's paraphrase.

Which written policies your state requires in the first place is a state-by-state question the national research behind this page did not compile; your licensing agency can name your list.

The exclusion test reads in both directions.

Texas's rule bars admission — at a center not licensed for get-well care — while an illness prevents comfortable participation, needs more care than staff can give without compromising other children, or involves the named symptoms (26 TAC 746.3601); a child who no longer meets any of those tests is no longer the child that rule excludes.

That symmetry is the cleanest way to write your own return clause: the child comes back when they pass the same test they were sent home on.

What the return clause needs to settle. Who clears a returning child — the director, or a staff member you name — and what they check at drop-off.

What you ask the family to report overnight.

How a teacher flags a child who is back but not back to full activity, so the room runs one plan rather than two.

And who re-runs the participation test when a child returns still slightly symptomatic, rather than leaving the call to whoever is at the front desk.

Diseases on a state exclusion list are different. Return after a condition on a communicable-disease list should not be a judgment call your staff improvise: take the return conditions from the same state source the list comes from, and quote them in your policy.

If the document your state's rule names does not address return, ask your licensing agency what applies before you write a timeframe into the policy.

Write no number you cannot source. A fever-free window copied from another center's handbook is the fastest way to write a rule your own state's standard contradicts.

The same sources that give you the exclusion criteria — your state child care licensing agency, and the health department your rule names — are the ones to confirm return conditions with.

Hand the rules to families before anyone needs them.

The return criteria belong in the parent handbook next to the exclusion criteria, and families should acknowledge them at enrollment: in Texas, parents sign a child-care enrollment agreement on or before admission that includes at least the required operational policies — illness and exclusion criteria among them — and the center keeps the signed document in the child's record (26 TAC 746.503).

The daycare parent handbook page shows where the illness section sits in that document.

A sick policy that only covers children stops halfway.

The same document — or its staff-side twin — has to answer the question that breaks the schedule: what happens when the teacher is the one with the symptoms.

Leave it unwritten and every sick day is improvised — the call comes before opening, and the person answering is inventing the coverage procedure while the room fills.

The mirror standard. A workable design holds staff to the same logic your policy applies to children: if a symptom would keep a child out of the room, it keeps the adult responsible for that room home too.

Whatever standard you set, apply it to every role that works a classroom — teachers, assistants, floaters, substitutes — and put the re-entry expectation in writing next to it.

Write the sick day as a procedure, not a value statement. Who the staff member contacts, and by when.

Who arranges coverage, and from where — floaters, substitutes, or a director step.

When a same-day call-out is treated differently from a scheduled absence.

What happens to pay and leave, which is a benefits and employment-law question rather than a licensing one — your state labor agency or employment counsel answers it, and the terms belong in your staff handbook, not in the parent-facing policy.

The scheduling half — who covers which room when someone is out — is its own staff scheduling problem.

Ask before you write this section. What your state expects of staff health — if anything — is a licensing-agency question: confirm it with your state child care licensing agency before you finalize wording either way.

The staff handbook and the sick policy should then say the same thing, so a teacher never hears two versions of the rule.

The skeleton below is a daycare sick policy sample to adapt, not to adopt.

Every bracket is a decision your state's rule or your own operations has to fill in — and the criteria in clause 2 must be the ones your state child care licensing agency and health department give you, not the ones another center's handbook uses.

1. Purpose and scope. This policy states when a child may not attend [Center Name] because of illness, when the child may return, and what staff do when a child becomes ill during the day. It applies to every enrolled child and every employee.
2. Exclusion criteria. [Center Name] will not admit — and will send home — a child whose illness: prevents comfortable participation in the program's normal activities; requires more care than staff can provide without compromising the care of other children; involves [the symptoms your state's rule lists, including any fever threshold it sets]; or falls under the communicable-disease exclusions [the state document your licensing rule names] sets.
3. Illness during the day. Staff notify [director or designee], who moves the child to [location] under supervision and contacts the parent or authorized pickup. The child is cared for away from the group until pickup, by [time window].
4. Return to care. A child returns when the illness no longer meets any criterion in clause 2 and the child can take part in the routine, including outdoor time, unless [director or designee] approves a modified day. For a condition on the communicable-disease list in clause 2, return follows [the return conditions that state document sets — ask your licensing agency if it does not address return].
5. Documentation. Staff record each exclusion on [form or system]: the symptoms observed, the time the family was contacted, who picked the child up, and the time of pickup. Injuries and more serious illness events are documented on [your state's incident and illness report form].
6. Medication. [Center Name] [dispenses medication only with written parent authorization, following the medication procedure in the parent handbook / does not dispense medication].
7. Staff illness. An employee who is ill notifies [director] by [time] and does not report to work while experiencing symptoms this policy excludes for children. [Director] arranges coverage under the staffing plan. Leave and pay while out sick follow the staff handbook.
8. Communication and review. Families receive this policy at enrollment and acknowledge it in writing. [Center Name] reviews the policy [annually] and whenever your state's licensing or health guidance changes, and gives families notice before a change takes effect.

Two documents make the sample real.

The first is your state's own topic list: several of the clauses above mirror what Texas expects its licensed centers to keep in writing — illness and exclusion criteria, medication procedures or a statement that medication is not dispensed, medical emergency procedures and parent notifications (26 TAC 746.501) — so treat your licensing agency's list as the clause checklist for your state.

The second is your records: an exclusion that involves an injury, a hospitalizing illness or a reportable disease can also trigger your state's incident-reporting process, which the daycare incident report page covers separately.

If you are drafting this as part of opening a center, the sick policy belongs in the same writing project as your licensing application, plan of operation and parent handbook: draft them together, keep the exclusion criteria identical across all three, and confirm the required topics with your licensing consultant before you print.

This page is employer information, not licensing or legal advice. The exclusion criteria, symptom list, any temperature threshold and the communicable-disease exclusions your policy must reflect come from your state child care licensing agency and the health department your rule names — confirm them before you finalize the policy.