Department of Social Services, Building a Stronger Louisiana - Kristy H. Nichols, Secretary

April 30, 2009

Dear Child Care Provider,

As the number of cases of H1N1 (swine flu) virus continues to increase across the country, we wanted to make sure you had important information as a child care provider about steps you might consider taking to help keep the children in your care healthy.

If a child at your facility becomes ill with flu-like symptoms, please send that child home immediately and disinfect your child care environment thoroughly. The child should be tested by their local physician to determine if they have the H1N1 virus. The child should not return to the facility until they are cleared by the doctor. Dismissal of students should be strongly considered in schools with a confirmed or a suspected case linked to a confirmed case by disease investigation (epidemiology). This determination should be made in conjunction with your Regional Office of Pubic Health Medical Director.

If other facilities, such as schools, close because of a confirmed case of H1N1 virus you should resist taking these children into your center temporarily. Accepting these children into your center only negates the reason of why the facility closed in the first place - to keep the virus from spreading to others.

In addition, if parents of children at the facility travel to Mexico, they should isolate themselves upon return and is up to the child care center if they will let the child return.

Below are additional steps provided by the Centers for Disease Control that you should consider taking at your facility to help prevent the spread of disease, as well as share with parents.

Remind children and care providers to wash their hands or use alcohol-based hand cleaners, and make sure that supplies are available to prevent the spread of germs.

  • Encourage care providers and children to use soap and water to wash hands when hands are visibly soiled, or an alcohol-based hand cleaner when soap and water are not available and hands are not visibly soiled.
  • Encourage care providers to wash their hands to the extent possible between contacts with infants and children, such as before meals or feedings, after wiping the child's nose or mouth, after touching objects such as tissues or surfaces soiled with saliva or nose drainage, after diaper changes, and after assisting a child with toileting.
  • Encourage care providers to wash the hands of infants and toddlers when the hands become soiled.
  • Encourage children to wash hands when their hands have become soiled. Teach children to wash hands for 15-20 seconds (long enough for children to sing the "Happy Birthday" song twice).
  • Oversee the use of alcohol-based hand cleaner by children and avoid using these on the sensitive skin of infants and toddlers.
  • Rub hands thoroughly until the alcohol has dried, when using alcohol-based hand cleaner.
  • Keep alcohol-based hand cleaner out of the reach of children to prevent unsupervised use.
  • Ensure that sink locations and restrooms are stocked with soap, paper towels or working hand dryers.
  • Ensure that each child care room and diaper changing area is supplied with alcohol-based hand cleaner when sinks for washing hands are not readily accessible. Alcohol-based hand cleaner is not recommended when hands are visibly soiled.

Keep the child care environment clean and make sure that supplies are available.

  • Clean frequently touched surfaces, toys, and commonly shared items at least daily and when visibly soiled.
  • Use an Environmental Protection Agency (EPA)-registered household disinfectant labeled for activity against bacteria and viruses, an EPA-registered hospital disinfectant, or EPA-registered chlorine bleach/hypochlorite solution. Always follow label instructions when using any EPA-registered disinfectant. If EPA-registered chlorine bleach is not available and a generic (i.e., store brand) chlorine bleach is used, mix ¼ cup chlorine bleach with 1 gallon of cool water.
  • Keep disinfectants out of the reach of children.

Remind children and care providers to cover their noses and mouths when sneezing or coughing.

  • Advise children and care providers to cover their noses and mouths with a tissue when sneezing or coughing, and to put their used tissue in a waste basket.
  • Make sure that tissues are available in all nurseries, child care rooms, and common areas such as reading rooms, classrooms, and rooms where meals are provided.
  • Encourage care providers and children to wash their hands or use an alcohol-based hand rub as soon as possible, if they have sneezed or coughed on their hands.

In addition, CDC recommends that if a child, parent or care provider becomes ill and experiences any of the following warning signs, emergency medical care should be sought.

In children emergency warning signs that need urgent medical attention include:

  • Fast breathing or trouble breathing
  • Bluish skin color
  • Not drinking enough fluids
  • Not waking up or not interacting
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and worse cough
  • Fever with a rash

During this health crisis, please continue to monitor the Department of Health and Hospitals (DHH) website for the most up to date and relevant information related not only to your personal health but also to the operation of your child care facility. The Department of Social Services follows the recommendations of DHH regarding community health issues. A special web site regarding the H1N1 virus has been set up by DHH at

In addition, below are some additional links that provide information that might be useful.

Information for Child Care Providers:
Preventing the Spread of flu
Infection Controls

Thank you for your continued service to Louisiana's children and families.


Sherry Guarisco
Executive Director
Division of Child Care and Early Childhood Education

627 N. Fourth St. | Baton Rouge, LA 70802 | PH: (225) 342-0286 | FX: (225) 342-8636 |

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