PURPOSE
The purpose of this policy is intended to ensure that Denison Child Care has established an anaphylactic reactions protocol in accordance with the CCEYA, 2014, O. Reg. 137/15 s. 39, the York Region District School Board Anaphylactic Reactions policy and Sabrina’s Law, 2005. For the purpose of this document anaphylaxis/anaphylactic means a severe reaction that can be fatal due to exposure to allergens such as insect stings, medicine, latex, exercise and food.
POLICY
All children and staff of Denison Child Care are entitled to a safe and healthy learning environment in our programs. This is especially crucial for students and staff who have life-threatening allergies (anaphylaxis). While Denison Child Care is committed to creating an environment that is safe for all children, these strategies do not guarantee that the premise is void of any of the allergens documented in the Anaphylaxis Emergency Plan.
It is understood that this policy will be implemented for the safe guard of all children and staff/volunteers attending Denison Child Care programs. This policy will ensure that all permanent and temporary staff are made aware of their responsibilities.
Denison Child Care will make every effort to ensure that the premise is allergen safe, acknowledging that we cannot eliminate all allergens. We will work with parents to limit or reduce the risk of exposure to anaphylactic causative agents in the child care program.
This plan will ensure that all children at risk are identified, strategies are put in place to minimize the potential for exposure and all staff/volunteers are appropriately trained.
In order to provide a safe environment for anaphylactic students Denison Child Care will ensure that strategies are developed in conjunction with parents and/or physicians to minimize exposure for children to life threatening allergies. These strategies can include food avoidance, reducing of causative agents, purchasing of foods through an approved source, diligent reading of food labels, and training of staff to educate families, students and volunteers to be aware of allergen triggers.
Denison Child Care will ensure that:
- All Supervisors collect information about the child’s medical condition at the time of registration. Families may meet with Supervisor and the food service staff to discuss all allergies and food restrictions.
- The families and employees are provided with updated information and awareness of the allergies & current policies.
- Ongoing communication with all parents is established to create awareness and support for children at risk. Parents may be reminded through letters, newsletters and signs to be aware of potential allergens and to avoid using them in the program.
- Signs will be posted to indicate what allergens are not to be allowed on the property. These lists will be revised as necessary depending on the life-threatening allergies of the children enrolled.
- Avoidance of the allergen that causes anaphylactic reactions whenever possible.
- An emergency response procedure in case of accidental exposure to allergens.
- Medication for allergic reactions will be kept in safe but accessible location that is known to all staff and volunteers.
- Training for staff and students is held prior to commencing employment, and when a new child is registered and annually each fall.
PROCEDURES
Anaphylaxis Emergency Plan
Denison Child Care will create an Anaphylaxis Emergency Plan which will be available to staff and any volunteers that are in the program. This Plan will include a communication plan and the child’s individual plan for emergency procedures in the event of an anaphylactic reaction.
Communication Plan
Denison Child Care will develop a communication plan to identify the following information and to ensure that the information has been shared with parents, staff, students and volunteers:
- A list of new allergies of the enrolled children will be posted in all activity rooms, eating areas, wherever the children may be present and food preparation areas on or off premises.
- Notices will be sent out to inform families, staff, students, and volunteers of the life-threatening allergies at the center. These notices will also include any foods and/or any causative agents to be avoided.
- An anaphylactic reaction form with a recent picture will be posted in each classroom and in the kitchen to identify children with life threatening allergies that will include general information about the allergens and causative agents as well as the signs and symptoms of the life-threatening allergy. This form will also give consent for the administration of epinephrine (EPI-PEN) to a child exhibiting symptoms of an anaphylactic reaction.
- Parents will provide information about their child’s medical condition including whether children are at risk of anaphylaxis.
- The allergic child and the children that are in the program will be educated on avoidance strategies and sharing of food.
- Denison Child Care provides all snacks and meals through our own kitchens and/or Yummy Catering. A list of foods/causative agents will be provided so that appropriate food substitutes can be made.
- These strategies will be reviewed regularly by the supervisor to ensure that the risk of exposure to life threatening allergies (at least 3 times per year).
Child’s Individual Plan and Emergency Procedure
Denison Child Care will work in conjunction with the parent/guardian and the physician of an enrolled child who have an anaphylactic allergy to create an individual plan for the child. This plan will include the emergency procedure and the following information:
- a description of the child’s allergy;
- monitoring and avoidance strategies;
- signs and symptoms of an anaphylactic allergy;
- action to be taken by the Child Care staff in the event that the child has an anaphylactic reaction;
- emergency contact information for parents/guardians/emergency services; and
- permission to administer medication to stop the anaphylactic reaction.
Parents will provide all details regarding the child’s diagnosis, symptoms and plan of treatment. Parents must provide an up-to-date photo of the child and medication that is in the original bottle with prescription (e.g. an EPI-Pen that is not expired).
It will be the parent’s/guardian’s responsibility to advise the child care operator if their child develops an allergy and requires medication, or if there are any changes to the child’s individual plan or treatment.
Medication
Denison Child Care will store, in an easily accessible location, any asthma medication or emergency allergy medication in accordance with the CCEYA, 2014. All staff, students and volunteers will be aware of the location of the medication. It is the child care staff’s responsibility to ensure that the medication is accessible to staff when children are off site on field trips.
In the event of a child who is older than 6 years old, Denison Child Care will accept parents written authorization to allow the children to carry his/her own medication and self-administer as required. Child Care staff will be required to assist a child who cannot self-administer their medication. A copy of the anaphylactic reaction form will include the parent/guardian’s permission to self-administer the allergy medication. A copy of this form will be kept in the child’s file.
The child care staff will ensure that the child who has been given permission to carry their own medication has the required medication prior to leaving the center at any time including when the child attends field trips or being released to the public school for the day.
Emergency Protocol
Every situation, in which a child has symptoms that are listed in the Anaphylaxis Emergency
Plan, must be treated as an anaphylactic reaction. In the event that a child has a life-threatening reaction to an allergen, staff will follow the following emergency procedure:
- One staff will stay with the child at all times. The staff should be familiar to the child and should be able to remain calm.
- Epinephrine will be administered at the first sign of an allergic reaction. Staff must note the time the EPI-Pen is given.
- A second staff should call for help/call 911. (If a staff is on their own, Epinephrine will be administered prior to leaving the child to call 911.)
- Parents must be called and asked to meet at the hospital the ambulance is scheduled to go to
- The child must be transported to the hospital by ambulance as soon as possible even if the symptoms have stopped.
- The child’s file along with the individual plan must accompany the staff who will travel to the hospital until the parent/guardian has arrived.
Training
Denison Child Care will ask the parent/guardian or the child’s physician to train the supervisor and as many staff members as possible. The Supervisor, with parental consent, will train all other staff members, students and volunteers on recognizing the signs and symptoms of anaphylaxis as well as the procedures to be followed in the event of a child having an anaphylactic reaction. The child’s individual plan will be reviewed with all staff, students and volunteers upon enrollment of the child, change in the child’s individual plan or treatment. The plans will be reviewed with all new staff, volunteer or student prior to their first day of employment.
Denison Child Care staff is also trained in current CPR and First Aid practices, including infant and child CPR. Anaphylactic reaction protocols are reviewed each year with staff by a trained EMS professional, the parent and/or the Supervisor. The training includes signs and symptoms to look for in the event of an anaphylaxis reaction as well has how to administer epinephrine (EPI-PEN).
Prior to employment and annually there after all staff, students and volunteers will review the anaphylaxis reaction policy. This will include the centre’s policy for anaphylaxis reaction, the communication plan and the child’s individual plan.
When new children are enrolled, the child’s individual plan will be reviewed with all staff, students or volunteers prior to the child’s attendance.
Guideline for Bagged Lunches and Food Brought from Home
Parents of school aged children, including those attending kindergarten, will be expected to provide a bagged lunch for PA days, school holidays and summer camp. Lunches should include a nut free nutritious, well balanced meal that meets the requirement set out in Canada’s Food Guide. Parents should pack all lunch bags with an ice pack as they are not stored in the refrigerator. Staff at the centre are able to provide parents with copies of Canada’s Food Guide and suggestions for healthy snacks upon request. The following lays out the responsibility of parents and staff when food is brought from home including bag lunches:
Parent and Guardian’s Responsibilities
- The bagged lunch adheres to Canada’s Food Guide.
- Lunch is provided in a labelled lunch bag with an ice pack.
- Foods that may have come in contact with nuts are not allowed in the child’s lunch.
Staff Responsibilities
- All surfaces will be cleaned with a cleaning solution prior and after the children have their lunch. (The cleaning solution is a germ destroyer approved by Public Health)
- Staff will ensure the children was their hands before assisting children with their lunches.
- Staff will ensure children wash their hands prior to eating lunch.
- Staff will monitor lunches to ensure food arrives at the centre that contains nuts or has the warning sign “may have come into contact with nuts”.
- An alternate lunch will be provided if a child forgets their lunch. A courtesy call to the parent or guardian will be made and the food served will be recorded in the log book.
- Staff will encourage children not to share lunches.
- Staff will supervise closely any child that has a life-threatening allergy by sitting next to them or across from them during lunch time.
- Staff will monitor each child’s lunch and should a child’s lunch consistently not adhere to Canada’s Food Guide then they will work with the parent to provide sample menus.
- Sample lunch ideas/websites will be available at the centre to support families.