You are here : Children & Family  >  Child Care Providers  >  Health & Illness

Health and Illness

Prevent illness in your child care business

Diseases can spread easily and quickly in child care environments, and children are more susceptible to some illnesses. This is because children have less developed immune systems, may not have received all of their vaccinations, are in close contact with many other children, and are still learning healthy habits.

The Snohomish Health District Child Care Health Outreach program helps child care owners and workers with the challenge of preventing illness and maintaining sanitary child care environments. We offer on-site visits and consultations, distance learning classes, and resources.

Illnesses in child care

When to send a child or worker home: Exclusion guidelines

In group settings, illness can spread rapidly. Child care providers are encouraged to call the Child Care Health Outreach program at Snohomish Health District to discuss guidelines for observing, responding to, and reporting symptoms of illness. Our qualified staff can:

  • Advise on when a child is too sick to be in care
  • Provide sample notification letters for specific illnesses
  • Help set up a safe medication management system
  • Advise on when a child or staff member can return after an illness
  • Support and educate staff and families during a communicable disease outbreak

Telling public health and parents about an illness

Child care providers are required by law to report certain diseases called notifiable conditions to Snohomish Health District. If the disease is on the list of notifiable conditions, or if there is a cluster of any illness suggesting a possible outbreak, it should be formally reported to the Communicable Disease program at 425-339-5278. 

Although some diseases may not require reporting, child care providers are welcome to call for advice. If the disease is NOT on the list of reportable conditions, or if you are unsure, call our program line at 425.252.5415.

Parents must also be notified when their child has been exposed to a communicable disease. We can provide help with letters home and fact sheets on the various illnesses.

Other disease resources

Other resources for child care providers related to childhood illnesses and exclusion guidelines (all are PDF documents):

Chronic health concerns

The following forms may be helpful when enrolling a child with a chronic health concern or special need. (Call or email for form.)

  • Individual Plan of Care form
  • Asthma Plan
  • Emergency Plan for Severe Allergies

Child care health policies and guidelines

Child care licensing regulations state that every program must have a current, written health policy. Centers and school age programs must have their policies signed by a physician, physician’s assistant, or registered nurse. The Child Care Health Outreach program staff will review and sign your health policy at no cost, provided that you use our most current template.

If you are interested, please email and we can provide you with the correct policy. Once you have finished filling in your policy, email the document back to us at After we review it, we will contact you to set up a time to visit your child care and complete the process.

In addition to a health policy, you may need some or all of the following supplemental policies and forms.

Blood and body fluids: Develop a plan

Child care providers, teachers, or managers may come in contact with blood or potentially infectious body fluids as part of their work with young children. Illnesses such as hepatitis B, hepatitis C, or HIV can be transmitted through blood or certain body fluids. Child care providers must use Universal Precautions to protect themselves from becoming infected. The Washington State Department of Labor and Industries requires child care providers to have a Bloodborne Pathogen Exposure Control Plan to help protect staff. A model policy is included here.

Child care medication management

When children need medicine during the day, child care providers are called upon to make sure children receive them in a safe and effective manner. Giving medication requires organization and planning. Mistakes can be avoided with a few simple guidelines. Child care providers should make sure they have a written medication policy in place which addresses:

  • Who will give the medication
  • Staff training
  • Steps involved in giving medication
  • Special equipment
  • Bulk medications
  • Communication with families
  • Medication instructions
  • Documentation
  • Storage

The following documents may be helpful.

Contact us

Child Care Health Outreach

General Questions: 425.252.5415

Communicable Disease Reporting: 425.339.5278

For general questions or information:

To submit class materials or register for a class:


Bonnie Decker

Public Health Nurse

Phone: 425.339.5228


Micha Horn
Environmental Health Specialist

Phone: 425.339.8712


Alexandria Deas
Behavioral Health Specialist

Phone: 425.339.3535 


Katy Levenhagen
Nutrition Consultant

Phone: 425.252.5407