Daycare Illness and Sick Child Policy Template

A complete illness exclusion policy template for licensed childcare centers. Copy, adapt, and include this in your parent handbook. All 50 states require a written sick child policy as a condition of childcare licensing.

Last updated: April 2026

Compiled by the TotReady Research Team
Key requirement: Most childcare licensing agencies require children to be fever-free for 24 hours without fever-reducing medication before returning to care. Children whose fever has been masked by acetaminophen or ibuprofen may still be contagious and should not be readmitted early.

Illness and Sick Child Policy — Template

Free Template

Policy Purpose

[CENTER NAME] is committed to protecting the health of all children and staff. This policy establishes clear, consistent standards for when a child must be excluded from care, how parents will be notified, and when a child may return. These standards meet or exceed the requirements of [STATE] childcare licensing regulations.

All families are expected to review and follow this policy. A copy of this policy is included in the parent handbook provided at enrollment. Updates will be communicated in writing.

Symptom Exclusion Criteria

A child must be excluded from care — or sent home from the center — if they display any of the following symptoms:

  • Fever of 100.4°F (38°C) or higher, measured by any method
  • Vomiting two or more times in the previous 24 hours (unless caused by a non-infectious condition, as confirmed in writing by a healthcare provider)
  • Diarrhea: three or more loose or watery stools in the previous 24 hours, or stools that cannot be contained in a diaper or underwear
  • Undiagnosed skin rash, blisters, or weeping sores
  • Yellow or green eye discharge, with or without eye redness (pink eye / conjunctivitis)
  • Symptoms of a communicable disease: strep throat, hand-foot-and-mouth disease, impetigo, ringworm, head lice (with live bugs), chicken pox, or any other diagnosed communicable illness
  • Difficulty breathing, persistent cough that disrupts the child's activities, or wheezing that is not controlled by prescribed medication
  • Behavior that is markedly different from the child's typical state — extreme lethargy, unusual irritability — suggesting the child is too ill to participate

Staff are not required to diagnose illness. Any child who appears too ill to participate comfortably in normal daily activities may be excluded at the director's discretion.

Fever Threshold and Policy

[CENTER NAME] defines fever as a body temperature of 100.4°F (38°C) or higher, regardless of measurement method. A child with a fever will be separated from the group in a comfortable, supervised area and parents will be contacted immediately. Pickup is required within one hour of notification.

Staff will not administer fever-reducing medication (such as acetaminophen or ibuprofen) without a current written medication authorization form on file. Administering medication to temporarily lower a fever so a child can remain in care is not permitted.

Return-to-Care Requirements

Children must meet the following criteria before returning to care after an illness exclusion:

  • Fever: Fever-free for a full 24 hours without the use of fever-reducing medication. The 24-hour clock starts when the last elevated temperature is recorded — not when medication was last given.
  • Vomiting / Diarrhea: No vomiting or diarrhea for 24 hours, and the child is eating and drinking normally.
  • Communicable disease: Written clearance from a licensed healthcare provider confirming the child is no longer contagious, OR completion of the full antibiotic course (minimum 24 hours on antibiotics for bacterial infections such as strep throat), OR resolution of symptoms as specified by the [STATE] Department of Health guidelines for that illness.
  • Pink eye (conjunctivitis): Treatment has begun and eye discharge is no longer present, or written clearance from a healthcare provider that the condition is not contagious.
  • Head lice: Treated with an approved pediculicide and free of live bugs. Children may return with nits (eggs) present following treatment.
  • Skin rash: Written clearance from a healthcare provider that the rash is not contagious.

Same-Day Illness Procedure

If a child develops exclusion symptoms during the care day, staff will:

  1. Separate the child from the group immediately and move them to a designated, supervised rest area away from other children.
  2. Contact the parent or guardian by phone. If the primary contact is unavailable, staff will call all emergency contacts on file in order.
  3. Require the child to be picked up within one hour of notification.
  4. Document the symptoms observed, the time of notification, and who was contacted in the child's daily log and, if applicable, on an incident report.
  5. Ensure a staff member remains with the child at all times while they wait for pickup.

If the child's condition deteriorates before pickup — including difficulty breathing, unresponsiveness, seizure, or signs of severe allergic reaction — staff will call 911 immediately and continue attempts to reach the parent.

Communicable Disease Notification

[CENTER NAME] will notify all families with children in the same classroom within 24 hours when a child is diagnosed with a reportable or highly communicable illness. Notifications will be made in writing (email, posted notice, or app notification) without disclosing the name of the affected child.

Reportable communicable diseases — including but not limited to measles, chickenpox, salmonella, E. coli, and meningitis — will be reported to the [STATE] Department of Health in accordance with state law. [CENTER NAME] will cooperate fully with any public health investigation.

COVID-19 and Respiratory Illness Protocols

Children who test positive for COVID-19 must stay home for a minimum of five days from the date of symptom onset or positive test (whichever is earlier). Return to care on day 6 or later is permitted only if the child has been fever-free for 24 hours without medication and symptoms are improving. Children returning between days 6–10 should wear a well-fitted mask if developmentally appropriate.

During periods of elevated community transmission or at the direction of [STATE] or local public health authorities, [CENTER NAME] may implement additional screening, enhanced cleaning protocols, or modified group arrangements. Families will be notified in writing of any temporary policy changes.

[Note: COVID-19 isolation guidance is updated periodically by the CDC and your state health department. Review this section annually and update it to reflect current public health guidance.]

Bringing a Sick Child to the Center

Parents are asked not to bring a child who clearly meets exclusion criteria to the center. Staff may ask parents to take a child home who arrives showing exclusion symptoms. If a parent believes their child's symptoms are non-contagious or due to an existing condition such as allergies, a written note from the child's healthcare provider is required to waive exclusion for specific, documented symptoms.

How to use this template: Replace [CENTER NAME] and [STATE] with your information. Review your state's current childcare licensing regulations and local health department guidance to confirm alignment. Have your director and, if applicable, your licensing consultant review before distributing to families.

Need this policy inside a complete parent handbook?

TotReady generates a state-compliant parent handbook that includes illness policy, discipline, emergency procedures, and more — with your center's name and state requirements already filled in.

One-time · Online access · State-specific

Frequently asked questions about daycare sick policies

How sick is too sick for daycare?
A child is too sick for daycare if they have a fever of 100.4°F or higher, have vomited or had diarrhea within the past 24 hours, have an undiagnosed rash, or show signs of a contagious illness like conjunctivitis or hand-foot-mouth disease. Most states require 24-hour symptom-free periods before return.
Is it 24 or 48 hours after sickness?
Most state licensing agencies require children to be fever-free, vomit-free, and diarrhea-free for 24 hours without medication before returning to childcare. Some illnesses like norovirus and hand-foot-mouth may require 48 hours. Check your state's specific licensing requirements.
How often do kids get sick when starting daycare?
Children new to group care typically get 8–12 illnesses in their first year, mostly upper respiratory infections. This is normal — exposure to other children builds immunity. By the second year, illness frequency typically drops by 30–50%.
When should a child be excluded from daycare due to illness?
Children should be excluded when they have a fever of 100.4°F or higher, have vomited twice or more in the past 24 hours, have had three or more episodes of diarrhea, have an undiagnosed rash, or show signs of a communicable illness such as pink eye or strep throat. Staff may also exclude any child who is too unwell to participate in normal activities.
How long does a child have to be fever-free before returning to daycare?
Most childcare licensing agencies require children to be fever-free for 24 hours without fever-reducing medication before returning to care. A child whose fever was reduced by acetaminophen or ibuprofen may still be contagious. The 24-hour window starts from the last recorded elevated temperature, not when medication was given.
Are daycares required to have a written sick policy?
Yes. All 50 states require licensed childcare centers to have a written illness and exclusion policy. It must be provided to families at enrollment and available for review at the center. Inspectors check illness policies during routine licensing visits.
What should a daycare do if a child gets sick during the day?
Staff should separate the child from the group immediately, keep them supervised in a comfortable rest area, call parents right away and require pickup within one hour, and document symptoms and notification time. If the child shows signs of a medical emergency, call 911 first.