Childcare Licensing Glossary

Illness Exclusion

The symptoms or conditions that require a child to be kept out of (or sent home from) childcare until they are no longer contagious.

Last updated: June 2026

Compiled by the TotReady Research Team

Definition

All 50 states require licensed childcare programs to have a written illness exclusion policy. The policy must identify symptoms that prevent a child from attending — typically fever of 100.4°F or higher, two or more vomiting episodes in 24 hours, three or more diarrhea episodes in 24 hours, undiagnosed rash, and signs of specific communicable illnesses like pink eye, strep throat, or hand-foot-mouth disease. Most states require the child to be symptom-free for 24 hours (without medication) before returning. For some illnesses, a healthcare provider's clearance note is required. The policy must be provided to families at enrollment and kept on file for inspection. See the guide at /guides/illness-policy for a full template.

Frequently asked questions

What is Illness Exclusion in childcare licensing?
The symptoms or conditions that require a child to be kept out of (or sent home from) childcare until they are no longer contagious.
Does Illness Exclusion vary by state?
The general definition is consistent, but the specific requirements attached to Illness Exclusion can differ by state. Always confirm current rules with your state's childcare licensing office.
Where can I find the Illness Exclusion rules for my state?
Your state's childcare licensing agency publishes the current rules in its administrative code or licensing regulations. TotReady's state pages at /states cover key licensing topics by state, and the /data section has cited 50-state tables for ratios, training hours, capacity limits, fees, and exemption thresholds.