22VAC40-185-40. Operational responsibilities.

M. The center shall maintain, in a way that is accessible to all staff who work with children, a current written list of all children's allergies, sensitivities, and dietary restrictions. This list shall be dated and kept confidential in each room or area where children are present.  

Due to the large amount of children we serve we would like to add an exception allowing a photo with allergy information to be posted in a visible area in each classroom with parent’s signed consent.

Rational: Visible posting will allow for more ease of accessibility and better allergy management. Things that are hidden away are not readily utilized and this could be very concerning if allergy information is not readily accessible.  Furthermore, we recommend adding children with special care needs that staff should be aware of to be posted on the list as well with parent’s written consent (example: asthmatic)  

22VAC40-185-245. Ongoing training.

4. Any child for whom emergency medications (such as albuterol, glucagon, and epipen) have been prescribed shall always be in the care of a staff member or independent contractor who meets the requirements in subdivision 1 of this subsection.

Modify statement to allow for a trained or licensed staff member able to give these medications to be on site, instead of “in the care of” trained staff member, unless off-site for a field trip.

22VAC40-185-240. Staff training and development orientation

D. Orientation training for staff shall be completed on the following facility specific topics prior to the staff member working alone with children and within seven days of the date of employment:

Add: or within 14 days for part-time employees (rationale: they may not be available 5 days a week for training).

E. Prior to working alone with children and within seven days of the first day of employment, staff shall be provided in writing with the center's information listed in 22VAC40-185-420 A and the following: :

Add: or within 14 days for part-time employees (rationale: they may not be available 5 days a week for training).

22VAC40-185-60. Children's records.

8. A written care plan for each child with a diagnosed food allergy, to include instructions from a physician regarding the food to which the child is allergic to and the steps to be taken in the event of a suspected or confirmed allergic reaction.

Add to clarify: “diagnosed severe food allergy.”

Rationale: Many parents disclose their child’s mild food allergies and food intolerances to us, which we treat as food allergies and post on our allergy lists. We currently have 50 students enrolled with food allergies; 21 of which have epinephrine prescribed. The students with epinephrine prescribed have a care plan written by our RN on file as well as an Allergy Action Plan completed by their MD, with a medication consent form from their parent(s). We feel that requiring all students who have any allergy to have a written plan would be difficult to manage and would be unnecessary, even potentially causing more harm  than good with too many documents to manage the significate ones are lost in the masses.

If this standard proceeds as written, it presents a challenge as to handle parent-diagnosed food intolerances or allergies that the physician did not write on the health examination form. Would we then have to require that the child re-visit the MD for the assessment of the parent-diagnosed food intolerance/allergy?