Silent Night Signals (Observation)
You are helping unload the bus in the morning and doing health checks. You notice a child has redness in the white part of the eye (sclera). You are unsure if the child has a history of allergies. There is no eye discharge. What do you do as a result of this observation?
Check the child's file for a history of allergies.
If no other symptoms (fever, headache, rash) inform and advise parent/guardian to monitor.
How many days do we have from entry to get a completed dental exam for a child?
90 days.
A child is bleeding heavily from a fall. What is the immediate, first action you must take before calling for help?
What is the minimum amount of time for effective hand
20 seconds.
What is the general minimum amount of time a child must be fever free to return to school?
24 hours
While the Injury/Accident Report is used for acute events, this is the essential daily tool staff must use to document subtle, ongoing health observations, such as changes in appetite or mood.
Daily health check.
How many days do we have to complete a vision and hearing screening for a child?
45 days.
Name 2 red flag symptoms for a child with breathing difficulty and what you would do if a child was experiencing any of these symptoms.
1) Struggling for air/gasping
2) Inability to speak or cry
3) Blue or grey lips, nail beds or skin (cyanosis)
4) Unresponsive or collapsing
5) Wheezing or stridor (high-pitched noise when breathing) that does not stop
Action: Keep the child in the upright position (do not lay down, administer emergency rescue inhaler if one is prescribed), call 911.
Name the mandatory Personal Protective Equipment (PPE) required any time staff is cleaning up body fluids, like blood or vomit.
Disposable gloves.
If a child has ringworm, when can they return to school?
You are in the classroom helping with coverage. You notice a child has a persistent, deep cough. What do you do next?
Check the child for exclusionary symptoms (fever, new or unexplained rash, white patches on the tonsils/throat.
What are two exclusion criteria for head lice?
1) Many nits found (more than 10)
2) Active, mobile lice found (any number)
Name 3 red flag symptoms that you might see in a child with a head injury.
1) Loss of conciousness/unresponsive
2) Active seizure/convulsions
3) Heavy, uncontolled bleeding from the head
4) Clear or bloody fluid leaking from the ears of nose
5) Repeated or projectile vomiting
6) Unequal pupil size or dilated pupils
Head Start requires all non-emergency, prescribed medication to be stored in this specific type of location.
A locked cabinet/container that is inaccessible to children.
What is the return to school requirement following a diagnosis of strep throat?
The child must be fever free for 24 hours without the use of fever-reducing medications and has completed at least 28 hours of prescribed antibiotic treatment.
After observing a child with suspicious symptoms (like repeated vomiting) this is the immediate physical action staff must take to prevent the potential spread of illness to other children.
Isolating child (moving child to separate area)
Today is March 1st, 2025. A child just started at the center. They had a dental exam on January 2, 2024. Is this considered a current dental exam?
No. The exam must have been within the last 12 months.
A child falls on the playground and has a suspected head injury with 30 seconds of loss of consciousness. What are your first 4 steps, in order?
1) Call 911
2) Do not move child. Stabilize head and neck
3) Notify Parent/Guardian of the 911 response
4) Notify Health Coordinator
If a child is suspected of having swallowed a toxic substance (e.g., soap or cleaner), the staff member must immediately perform this critical action before notifying the nurse or parent.
Call poison control.
Name 4 conditions that require a doctor's note to return to school.
1) Pink eye (conjunctivitis)
2) Impetigo
3) Pinworms
4) Rash of unknown origin
5) Ringworm
6) Scabies
7) Strep throat
8) Measles, mumps, hepatitis, scarlet fever
You notice a child has intense itching, burrow tracks between the fingers and on the wrists. What do you suspect?
What are the two required things a child must be up-to-date on in order to start school in the center?
1) A physical within the last 12 months.
2) Up to date immunizations or be on a catch-up schedule.
Children are having lunch at the center. You notice a child starts to break out in minor hives on her face while eating. She does not have any known allergies. What do you do?
Notify parent of situation. Monitor the child for worsening symptoms.
If symptoms worsen (hives spreading, facial swelling, difficulty breathing) call 911.
If symptoms improve/stay the same. Continue to monitor child. Discuss possible triggers with parent and need for additional investigation (see doctor, test similar foods at home, etc).
A child loses consciousness in front of you. You cannot find a pulse. After you call for help, what is an essential action you must take before beginning chest compressions?
Checking the mouth for any object (or tilting the head back to check the airway)
What are the THREE return to school criteria following a diagnosis of HFMD?
1) Fever Status: Child must be fever-free (below 100.4) for 24 hours without the use of fever-reducing medication
2) General well-being: Child must be feeling well and energetic enough to fully participate in all classroom activities
3) Sores: Oral sores must not cause excessive drooling or difficulty swallowing and skin lesions should be drying/fading.