Childcare provider, need advice re: illness policy!

[Inci]

I babysit for 6 different families each week, all at different times, in the families' homes.

For the past year, my written illness policy has been that I will care for sick children as long as they're not very contagious and as long as I'm in good health myself. Each time I babysit for sick kids, I notify the other families so they can decide whether it's okay for me to then babysit for their kids or not.

It has worked out alright until now, but I need a more detailed and clear policy, because I have a mom who's quite upset with me right now.
Her child is currently sick with what's likely to be a highly contagious childhood illness - the child has 2 out of the 3 main symptoms, and when I talked to the mom yesterday, she thought it was likely that her child has the illness.

I told the other families about it, describing the child's symptoms, and 3 of the families told me they wouldn't want me babysitting for their children this week if I also babysat for the sick child this week, because they are worried about contagion.
So I told the sick kid's mom I can't babysit for her this week, and now she is mad. She says that because her child hasn't been officially diagnosed with anything, it's wrong for me to independently make the decision that her child is highly contagious. She wants to know how I decide to pass on "vague medical information" to other families, and how I decide whether or not to babysit for sick kids.

She wants to know if there's a way for my policy to be more clear and objective. Any ideas??

It's hard, because I don't want to have to say to all of the families, "I will not babysit for your children if they are sick, ever, end of story." I know one of the reasons families choose to hire babysitters instead of putting their kids in daycare is so that they WILL have childcare coverage when the kids are sick! Daycares have strict policies about kids not attending while sick, of course, and then parents have to miss work. Babysitters generally have more flexibility than this. I do babysit sick kids when they have colds, fevers, diarrhea...and then I let the other families know...occasionally another family will ask me not to come to their house, after I've been with a sick kid, but mostly it hasn't been an issue 'cause the illnesses haven't been too serious or contagious. Although there have been a few times where I've told the parents, sorry, your kid is too sick for me to babysit this time. And sometimes the parents don't even ask me to come in when their kid is sick - they cancel my hours to stay home with the sick kid themselves.

This is the first time I've had a parent get mad at me for not coming in to babysit her sick child, and she wants a more objective policy. And perhaps my policy IS too subjective, and taken on a case-by-case basis. This particular time, I am choosing not to babysit for the sick child because if I did so, I'd be losing 20+ hours of work this week with the other families, who said not to come in if I'm also with the sick child. And I can't afford to lose those 20+ hrs of work.

Suggestions for a better policy?? As it stands now, I say that I won't babysit for "very contagious" children. But, this mom has a point, "very contagious" by whose judgment? The doctor said the child might have X, which is highly contagious, or she might have Y, which is only slightly contagious. If even the doctor can't be sure, then I still have to make a judgment call, don't I? But the mom is mad at me for doing so, wishing that I would go with HER judgment call/opinion, of her child not being very contagious.

Is it wrong for me to factor in the opinions of the other families, when one family's child is sick? That is, if the majority of the other families say "You can't babysit our kids, if you're simultaneously babysitting for the sick kid," is it REASONABLE for me to decide whether or not to babysit for the sick kid based on the collective opinion of the other families?

I want to repair my relationship with the mom who's currently mad at me, and I need to come up with a clear illness policy that's clear and fair to ALL of the families. Currently, I believe she feels that I'm being unfair to her and her family, by canceling my scheduled hours this week. I'd like to point out to her that my illness policy isn't just to penalize her - it's also to protect HER children, when OTHER families' kids are sick. The thing is, this mom is really non-stressed about other kids' illnesses. She has told me that unless some kid has a life-threatening illness, she's not worried about her kids' exposure. So from her perspective, I'm guessing, it seems like my policy unfairly punishes her and doesn't benefit her. But most families are NOT that unconcerned about the spread of illness...

[QueenOfTheMeadow]

Maybe instead of saying that you won't babysit for a highly contagious child, you should change the wording to say that it is up to your discretion to decide whether or not to babysit for a sick child. I would also lay it on the line with her. Tell her that you cannot be expected to lose business with 3 families in order to care for her potentially highly contagious child.

[BinahYeteirah]

I don't know. It seems to me that it is a little strange that you share the health info from one family with another. Even if you do this without naming names, I am not sure I understand it, assuming that you babysit in the families' homes and children from different families have no contact with one another. What if you were out in a public place and were exposed to a contagious disease? Would you tell everyone and ask if you could babysit? It could, however, be useful information for the parents. If I hired a babysitter I wouldn't quiz the babysitter about all her contact with sick people that week. Hmmm, but maybe I'm the weird one!

[My2WildBoys]

I'm a home daycare provider, and I do accept sick children, but only mildly ill. My policy, written into my handbook, is that any vomiting/nausea after the second time in 12hrs means that the child stays with the parents, not me. Temp over 101 goes home. I also have written that if the child is sick enough to be lethargic, whiny, and generally want their mother, then they stay with their mother. Rashes have to be diagnosed by a doc before I'll watch them, and it depends on the rash. In many of the diseases that have a rash, by the time the child is showing the rash, the contagious period is over, so they can come back to my house. Pink eye means they stay at home until on meds/breastmilk in the eye for 24hrs, and must continue the regimen for 24hrs after symptoms are gone. They can come back to me after being on the meds/milk for 24hrs, as long as they continue it.

[Hesperia]

I personally would re word the whole thing, YOU will not care for sick children based on your choice of what is really 'sick' because you cannot afford to become ill, and put out other families.

My guidelines are(but not firm);
If your child has thrown up twice within 12 hours, s/he stays home, (I'm often flexible here, since I babysit a cougher/gager).
If your child has the runs more then twice during the day while they are in my care, I will call you to come pick them up.
If your child has an unknown fever higher then 101.4, without signs of teething, s/he goes home.
If your child is basically ill, unable to PLAY, and not eating, s/he goes home.

I totally base this on a case-per-case, you have to with children. I find I am not firm enough with the above guidelines and strive to be more firm around illness. I have only ever had to use this once but next time I will include it in my contract.

But, like I said before, turn the whole thing around onto YOUR comfort level with ill children, specially if you have your own(I do not). Tap into emotional needs of the child during times of illness. You need to draw your line in the sand somewhere.

[moondiapers]

Illness: I ask that you have back up (someone you can call if I am sick or if your child is sick). If I get sick I will let you know as quickly as possible so that you can make other arrangements for your child. In the case of my illness, I would give you as much notice as possible. I will not accept children for care if any of the following symptoms are present:

In order to control the spread of communicable diseases, any child with one or more of the following symptoms must be kept at home until they are completely well.

1.Oral temperature at or above 100 F.
2.Rectal temperature at or above 101 F.
3.Axillary temperature at or above 99 F.(Axillary: under the arm or on the forehead.)
4.Questionable skin lesions: oozing, purulent, crusty, itching, blistery, bleeding or rashes.
5.Variations in child’s normal behavior: e.g., unusually fussy, irritable, or lethargic.
6.Symptoms of abdominal discomfort: e.g., vomiting, diarrhea, pain, distention, excessive gas (except in the case of colic).
7.Upper respiratory symptoms: e.g., coughing, difficulty breathing, nasal discharge, sore throat. Mild runny nose is ok as long as it is clear and under control with or without medication.
8.The child is suspected or known to have an infectious condition with high communicability potential; staph, ringworm, herpes simplex type 1 (cold sore/ fever blister), chickenpox, conjunctivitis (pink eye), impetigo, scabies, lice, etc.
9.Child is known to have an infectious disease (e.g., AIDS, etc) with low or
questionable communicability in which medical clearance for return to daycare/school has NOT been given. A child with such a disease will not be discriminated against.

When informed that a child may have a communicable disease it is the
parent or guardian’s responsibility to make arrangements to have the child
picked up as soon as possible, and to keep them at home until items 1-8
have been cleared up for AT LEAST 24 HOURS.

This policy has been adopted for the safety and well being of your child, his/her daycare playmates, and my staff and family. If my children or I have any of the above symptoms I am required to close down my facility until they have subsided for at least 24 hours. This is a big inconvenience to all involved and this policy should hopefully help it to happen less often.
If your child shows any of the above symptoms while in my care, I will remove him/her from the group and notify the parent or authorized adult to pick him/her up. Please use your judgment, if a child is ill and would feel better at home and with mommy or daddy, then that is where they should be.