10A NCAC 09 .2404 inclusion and exclusion REQUIREMENTS

(a) Centers may provide care for mildly sick children over three months of age who meet the following inclusion criteria and staff qualifications described in Rule .2408 of this Section:

(1) Centers may provide care for children with Level One symptoms as follows:

(A) children who meet the guidelines for attendance in 10A NCAC 09 .0804, except that they are unable to participate in group activities and are in need of increased rest time or less vigorous activities; or

(B) children with fever controlled with medication of 101 or less axillary or 102 or less orally;

(2) Centers may provide care for children with Level Two symptoms as follows:

(A) inability to participate in group activity while requiring extra sleep, clear liquids, light meals, and passive activities such as stories, videos or music, as determined by a health care professional;

(B) fever controlled with medication of 103 maximum orally, or 102 maximum axillary, with a health care professional's written screening;

(C) vomiting fewer than three times in any eight hour period, without signs of dehydration;

(D) diarrhea without signs of dehydration and without blood or mucus in the stool, fewer than five times in any eight hour period; or

(E) with written approval from a child's physician and preadmission screening by an on-site health care professional prior to the current day's attendance unless excluded by Subparagraphs (b)(1), (2), (3), (4), (6), or (7) of this Rule.

(b) Any child exhibiting the following symptoms shall be excluded from any care by the on-site administrator or the on-site health care professional:

(1) temperature unresponsive to control measures;

(2) undiagnosed or unidentified rash;

(3) respiratory distress as evidenced by an increased respiratory rate and unresponsiveness to treatment, flaring nostrils, labored breathing, or intercostal retractions;

(4) major change in condition requiring further care or evaluation;

(5) contagious diseases required to be reported to the health department, except as provided in Part (a)(2)(E) of this Rule;

(6) other conditions as determined by a health care professional or on-site administrator; or

(7) mental status such as decreased awareness or change in mood.

(c) Once admitted, children shall be assessed and evaluated every four hours, or more frequently if warranted based on medication administration or medical treatment, to determine if symptoms continue to meet inclusion criteria as set forth in this Rule.


History Note: Authority G.S. 110-88(11); 143B-168.3;

Eff. April 1, 2003;

Amended Eff. December 1, 2014;

Readopted Eff. October 1, 2017.