Health Information

Tooth decay is one of the most common preventable diseases seen in children.  Children as young as 12-18 months can get cavities.  Cavities in baby teeth can cause pain and even prevent children from being able to eat, speak, sleep, and learn properly. Children do not lose all their baby teeth until they are about 11 or 12 years old. Dental screenings and applications of fluoride varnish will be offered and administered by a contracted Health Care Provider, at your child’s center.  This voluntary program, which will be offered three times during the school year and is available to all children at no cost.

Fluoride varnish is a protective coating that is painted on teeth to help prevent new cavities and to help stop cavities that have already started to form. Fluoride varnish is a thick consistency and only a couple of drops are necessary to cover the surfaces of primary teeth or baby teeth at high risk for cavities.  The varnish is applied to clean, dry teeth by using a tiny “paint brush.”  NO anesthetic or drilling is done. Children should not brush their teeth until the next morning after the varnish has been applied, allowing the varnish to remain on the teeth for a number of hours, making the teeth more resistant to decay.

This procedure will be completed by a registered dental hygienist at Pickwick Early Childhood Center, and any comments, findings, and/or recommendations will be sent home to you, the parent or guardian.  This DOES NOT replace the need for your young child’s exam at their dentist’s office, and this is not the same type of fluoride treatment used by dentists during a routine check-up and cleaning. 

Lead/Hemoglobin Screening will be offered and administered by a contracted Health Care Provider.  This program is offered one time during the school year at your local Head Start center for all children enrolled at no cost. Lead is a common metal found throughout the environment, lead-based paint, air, soil, household dust, food, certain types of pottery, porcelain, pewter, and water.  Lead can pose a significant risk to your health if too much enters your body.  The greatest risk is to young children.
The procedure will be completed by a Registered Nurse or phlebotomist from a contracted Health Care Provider, and any comments, findings, and/or recommendations will be sent home to you, the parent or guardian. The procedure to determine Lead/Hemoglobin levels requires a drop of blood from a finger stick.  Test results will indicate if your child has been exposed to lead. Contact the School Nurse,  Family Service Worker, Teacher or Building Principal if you have any questions about the above two services.

If a child is injured at school, a trained staff person will treat the injury according to First Aid procedures.  The parents will be notified of the incident and will be given a copy of the Incident/Accident Report according to the nature of the injury. If a child is seriously injured and needs to go to the hospital, the child will be taken to the nearest hospital by ambulance; a Pickwick Early Childhood Center staff member will stay with the child until the parents arrive at the hospital.

Explanation of the Center’s perspective on biting
Biting is a very common behavior among young children.  It is important to think positively of children who bite.  Biting is a form of communication, as biting is almost always a response to the child’s needs not being met or coping with a challenge or stressor.  If we label children as ‘biters,’ we will harm children’s self-perceptions and intensify biting behaviors.

Description of how the Center will respond to individual biting incidents and episodes of ongoing biting

Responsive staff can begin to anticipate when a bite might occur.   When observing signs that a child might be on the verge of biting, the staff may be able to act immediately and prevent the biting behavior (e.g., distraction, redirection, close physical presence of staff). If a biting incident does occur, appropriate staff responses will include the following:

  • Staff will keep their feeling in check and not express frustration or anger to the child.
  • Ensure all children are safe.
  • Staff should (in a firm, calm voice) address the child that bit in a short, simple, and clear way.
  • Staff should shift their attention to the child who was bitten and show concern and support for that child.
  • Go back and talk with the child that did the biting (if child is verbal and able to talk about the experience) about the different strategies he/she can use next time, instead of biting.
  • Help the children move on. Do not make them play with one another, unless they want to.

Description of how the center will respond to the individual child or staff who was bitten.
When a biting incident occurs, the child who was bitten should be immediately cared for and shown concern and support.  First aid should be administered if needed. The School Nurse will be notified of the incident and an evaluation of the child’s health status will be performed (H #39).
Description of how the center will respond to the child that is biting
The child with the challenging behavior should be taught in a caring and firm way that the behavior is not acceptable and be given alternative behaviors to use instead.  The center should also examine the needs of the child, including potential changes to the environment and routines, to prevent future incidents.  If a child is provided developmentally appropriate and individualized care in a purposefully planned environment, discharging a child is needed only in rare, extreme situations.  Consultant and other resources are available to support the center in meeting the needs of the children in our care.

Description of the process of notification to parents of children involved in the incident.
Staff will provide confidential reports to parents of involved children without name of the other child.  If possible, parents will be called. Staff will complete an Incident Report form (H #39).  In addition to notification of specific incidents, parents may benefit from general information about biting. (This information on biting will/shall be provided to parents at their request)   

Description of first aid procedures that the center will use in response to biting incidents.
Because our mouths are full of germs, if a child is bitten by another child and the skin is broken, a wound infection may result.  

When You See:

  • A human bite
  • Open puncture wound
  • Bleeding

Do This First:

  1. Wearing medical exam gloves, clean the wound with soap and water.  Run warm water over wound for 5 minutes (except when bleeding severely).
  2. Control bleeding by applying pressure to affected area
  3. Cover the wound with a sterile dressing and bandage.
  4. The child should be seen by a healthcare provider or go to the emergency department right away for further evaluation.

Additional Care:

  • If any tissue has been bitten off, it should be taken with the child to the emergency department.
  • Check that the child’s tetanus vaccination is up to date. Tetanus vaccine (DTaP) is good for 10 years. 

First Aid for the Child Who Bites:
Did the child who was biting get blood (or body fluids) in their mouth?

  • If yes, have the child rinse mouth out with warm water; then notify the parents of this child about the blood (or body fluid) exposure. They should consult with their family physician for further health evaluation and possible treatment(s). 

Description of how the center will assess the adequacy of staff  supervision and the context and the environment in which the biting occurred.
Children bite to fulfill a need or cope with a challenge.  Rather than focusing on the child as needing “discipline,’ it is staff’s responsibility to observe the child and determine the child’s needs that are not being met.  This can be done through assessing 

Quality of relationships between child and staff.

  • Does the staff have a nurturing relationship with the child?
  • Do the staff know the child’s needs, interests, routines, and preferences?
  • Do the staff need further professional development?

Environmental influences on the child’s behavior

  • Does the environment prevent large groups and reduce disorder?
  • Are there long waits and not enough duplicate toys?
  • Are the centers (dramatic play, quiet space, etc.) organized to minimize confusion and stress?
  • Is there a quiet place where children can go when overwhelmed?

Targeted social-emotional supports

  • Are children provided safe and secure daily routines?
  • Are transitions managed effectively?
  • Do staff routinely assist children with identifying feelings and learning to calm themselves?

The purpose of the assessment is to identify the potential external causes for the challenging behavior, which in this case is biting, so that further incidents can be prevented. When biting occurs, the staff must seek to understand the meaning of the child’s behavior and discover together with the child “more effective means for communicating needs, wishes, and desire” The staff should:

  • Have a signed permission form from each child’s family (as a part of the enrollment policy) for observations.  Observations of all children should complement the child’s portfolio for planning and assessment purposes.  
  • Observe the child and document observations (BIRS), including behaviors and context (where, when, how, who—adults and children) both before and after biting occurs to identify functions of the behavior.  It is also helpful to know when the behavior is absent.
  • Use the data to find patterns and potential solutions
  • Respond immediately to any unsafe behaviors
  • Meet with the family to collect information about the child’s behavior at home, share information, and demonstrate a commitment to working together to address the child’s needs.

Students with signs and symptoms of head lice will be referred to the school nurse for evaluation and recommendations for treatment. If students are referred to the school nurse and live lice are found, a form regarding information about head lice will be sent home with the student whenever the nurse sees fit within the timeline of the day. This form will be returned to the school when the student returns to school and will include the treatment that was given to the student along with a spot for parents and guardians to sign off.

Our goal is to keep all students in the educational environment whenever possible. This district will do everything within their control to closely monitor, assess, and assist with issues that distract from the learning of individual students and the class as a whole. If there is an issue that is disrupting the learning of students within the classroom, the issue needs to be addressed immediately. The nursing department will also use their professional judgment on this matter along with other health related issues.

Head Lice Treatment Information (Iowa Department of Education)
For treatment, it is recommended to have the following supplies on hand: nit comb, medicated shampoo, and your regular shampoo and conditioner. 

For more detailed information, please talk with our building nursing staff or visit .

Steps taken if a child has bed bugs or a classroom has an actual infestation:

  • If bed bugs have been found on a student’s belongings; the items will be placed in a plastic bag/bin to store until the end of the school day. This is to prevent an infestation of the classroom. The student will not be sent home.
  • The guardian of the child will receive a phone call to notify them of our findings. If they are unreachable by phone, a letter will be sent home. 
  • At the student’s parent/guardian request, educational materials will be provided addressing how to reduce the risk of bed bugs in the home, and/or how to manage an actual infestation. Our School Nurse will partner with the family for further assistance
  • If an actual infestation occurs in the classroom; a letter will be sent home with all children in the affected classroom, as well as educational materials for reducing risk or managing an infestation. Further information will be provided regarding treatment of the classroom 

Any prescribed medication for chronic illnesses/conditions must be in its original container with the Health Care Provider’s name, date and the child’s name on it.  The original Medication Permission form must be signed and completed by the Health Care Provider and the child’s parent prior to administration of medication.  The Medication form may be reviewed by parents and staff every 30 days pending new prescriptions or medications.  If a child needs medications such as an antibiotic or nebulizer treatment for an acute illness, the School Nurse will work with the parent to schedule the treatments in a way that is in the best interest of the child.  No over the counter medications such as, Tylenol, cold medicine, cough syrup, etc., will be given at school. Prescription medication for chronic illnesses/conditions is the only type of medication we will administer to our children.


  1. When your child has been running a temperature more than 100 degrees anytime during the 24 hours before class
  2. If your child has been vomiting and/or had diarrhea at anytime during the 24 hours before class
  3. If your child complains of aching and has been tired with little energy or just not feeling up to par (this could be the beginning of flu or other virus).
  4. When your child has a communicable disease such as impetigo, scabies, pink-eye, etc.   Let staff know when doctor will release the child to return to class. Provide a copy of doctor note stating children can safely return to class

All the above symptoms are common indicators of communicable diseases and could indicate the onset of several common childhood diseases.

The rule of thumb that most doctors prescribe is if most of your child’s symptoms are gone within 3 to 5 days you can feel reasonably sure that your child’s illness was the common cold.  If symptoms persist or intensify, you should seek medical attention and treatment. Children in our program need to attend regularly, but when your child is ill, or has symptoms of illness, please keep your child home.  If these recommendations are followed this will help keep the spread of illness down in the centers and keep everyone healthier.


What will you see? What will you do? Return?
Influenza Fever (typically greater than 100 degrees Fahrenheit), headache, extreme tiredness, dry cough, sore throat, runny or stuffed-up nose, muscle aches, and stomach symptoms (such as nausea, vomiting, and/or diarrhea).  If child gets Influenza, they should stay home from school to rest, get plenty of water (stay well-hydrated), take over-the-counter medications (such as Tylenol) to relieve symptoms, and consult with your child’s healthcare provider for lingering symptoms. It is recommended your child receive yearly the Influenza vaccination to help reduce chances of obtaining Influenza during flu season. Vaccination is typically available early in the fall.  Child can return to school 24 hours after fever is gone. Fever should be gone without the use of fever-reducing medications, such as Tylenol.  
Pertussis (Whooping Cough) Head cold, slight fever, cough, characteristic whoop after a week, and/or runny or stuffed-up nose. Coughing can start 1-2 weeks after being exposed to the bacteria.  If you think your child might have Pertussis, see your doctor right away. Help protect your child by making sure he/she is up-to-date on DTap vaccination. Make sure any adults the child is around are current on vaccination as well.  Child may return to school 5 days after the start of antibiotic treatment. 
Crypotsporidiosis (Crypto) Frequent and watery diarrhea accompanied by cramping belly pain.  Other symptoms may include headache, nausea, vomiting and low-grade fever.  Some people experience no symptoms.  Symptoms may briefly improve and then get worse again, but people who are healthy usually get well in 14-30 days.   Contact your healthcare provider.  A medication may be used to treat some people.  Child may return to school when no longer experiencing diarrhea. 
Ringworm Ring shaped, scaly spot on skin or head. May leave a lighter spot on skin or a flaky patch of baldness on head.  May have a raised donut-shaped appearance. Consult with child’s doctor.  Ringworm is spread by direct skin to skin contact.  Cover the area to prevent spread.  Do not let your child share personal items (combs, brushes, clothing, towels, bedding).  Dry skin thoroughly after washing and wash bathroom surfaces and toys daily.  Child does not need to miss school.  Child should not go to the gym, swimming pools or play contact sports.  It is important to know that treatment may take at least 4 weeks. Lesions should be covered if possible. Do not share clothing or other personal items.  
Strep Throat Strep throat is a severe form of a sore throat.  Common symptoms include: sore throat, hard to swallow, fever, enlarged glands and extreme fatigue. Consult with child’s doctor.  Give all medicine for the entire time directed.  Antibiotics are not recommended for treatment without a positive laboratory test. Child can go back to school 24 hours after antibiotics are started.
Scabies Severe itching that can be worse at night.  You may see small red bumps on the skin or burrows between fingers, on wrists or elbows, in armpits or on waistline. Consult with child’s doctor. Child can go back to school 24 hours after first treatment.
MRSA A boil or pimple that can be swollen red and painful and have drainage.  Often mistaken for a spider bite. Consult with child’s doctor. Treat and cover all open wounds.  Reinforce hand washing and environmental cleaning.   Child or staff does not need to stay home if the wound is covered. Child should not share clothing or towels with others, and good hygiene should be adhered to. 
Impetigo Skin sore with a yellow, honey colored scab.  It may ooze and drain.  Most sores are on the face, around the nose and mouth.  Consult with child’s doctor.  Your doctor may give you medicine and will tell you how to take care of the sores.  The child and caregivers should wash hands frequently. Child can go back to school  24 hours after child started medicine from the doctor, and blister are covered.
Hand, Foot and Mouth Child may have a mild fever, rash (palms of hand and soles of the feet) and sores in the mouth.  Consult with child’s doctor.  Child and caregiver should wash their hands frequently. Child can return to school when they have no fever and are feeling better, or if child is experiencing drooling with mouth sores. 
Fifth Disease (Parvo Virus, B19 Infection) Fever, headache and very red cheeks.  Lace-like rash on chest, stomach, arms and legs that lasts 3 day to 3 weeks.  You may see the rash off and on.  Usual for ages 5-14 and is unusual in adults.   Consult with child’s doctor and ask about using over the counter pain/fever medicine.  Give child plenty of fluids.  Prevent scratching by trimming fingernails and putting gloves on the child during the night.  Pregnant women exposed to this disease should consult with their doctor. Keep child home if fever is present.
Diarrhea Child’s bowel movements are more frequent, loose and watery than usual.  Stool may contain blood. Make sure the child gets plenty of rest and give a diet of clear liquids.  If symptoms continue, fever occurs or if blood appears in stool call child’s doctor.  The child and care providers should wash hands frequently. Child can go back to school when diarrhea is gone and the child feels better.  *There are special exclusion rules for E. coli  O157:H7 and Shigella and cryptosporidiosis
Conjunctivitis (Pink Eye) Eyes are red/pink with creamy or yellow discharge and the eyelids may be matted after sleep.  Eyelids and around the eyes may be red, swollen and painful. Consult with child’s doctor.  Child without fever should continue to be watched for other symptoms by parents or child care providers.   Child may return to school when all symptoms are gone or treatment begins.
Chicken Pox Itchy, blistery rash with mild fever.  Blisters usually occur in clumps and are more commonly seen on the stomach, chest and back.  After several days, blister scab over.  Some children have only a few blisters, others have several hundred. Consult with child’s doctor.  Calamine lotion or cool baking soda in water bath can help to reduce itching.  Prevent scratching by trimming fingernails and putting gloves on the child during the night.   Child should stay home, until all the blisters are crusted with no oozing scabs (usually 6 days).

We all want children to grow up healthy and free of diseases.  The easiest and most effective way to achieve this is to ensure all children complete their series of childhood immunizations.  Iowa law requires all children have immunizations before attending preschool.  See the chart below for the immunizations and the ages they should be given

DTaP  Provides protection against diphtheria, pertussis (whooping cough) and tetanus.
OPV/IPV Polio protection either by injection or given orally.  Your physician or clinic will determine which is recommended.
HIB  Provides protection against the HIB (Haemophiles influenzas type b) bacteria, which can lead to several serious infectious diseases.
MMR  An injection to protect against measles, mumps and rubella.
Hepatitis B Helps guard against the Hepatitis B virus.
 Varicella   Provides protection against the chickenpox virus.

The mission of the Positive Behavioral Interventions and Supports Leadership Team is to raise teacher, student, and families’ awareness of the importance of social/emotional development in young children and increase school readiness through the implementation of Positive Behavioral Interventions and Supports framework.

Positive Behavioral Interventions and Supports (PBIS) is a process for supporting young children’s social-emotional development and addressing challenging behavior.  This approach will be used in all of the Pickwick Early Childhood Center classrooms.  The focus is promoting children’s success:  building relationships, creating supportive environments, and teaching social-emotional skills.  This process will assist teachers and families understand and increase positive social-emotional skills while preventing challenging behavior.

PBIS focuses on the use of positive intervention strategies developed for each child based on their need.  Strategies are developed that focus on helping the child be successful in the classroom and at home, building positive social relationships, developing friendships, and learning further communication skills.

PBIS builds these social skills critical to a child’s social-emotional success:

  • Getting along
  • Following directions
  • Identifying and regulating emotions
  • Thinking of solutions
  • Staying on task
  • Communicating and playing with others

These skills will be the foundation to help children be successful learners in school and throughout life.

We strive to ensure all children have a successful preschool experience by promoting Positive Behavioral Interventions and Supports (PBIS). The PBIS Framework or Approach is an evidence-based, universal prevention strategy to reduce disruptive behavior by promoting Social/Emotional competence in young children.  

Disruptive behavior is considered consistent and repeated behavior(s) making the learning environment unsafe and/or interferes with preschool activities. Disruptive behavior includes: aggression towards self or others resulting in physical pain or harm (biting, kicking, hitting, scratching), running out of classroom or away from adults, prolonged tantrums, inappropriate language, breaking or destroying items, spitting, etc. 

Interventions for Disruptive Behaviors include: 

  • Individual reminders to the child of expectations/rules 
  • Redirecting (physical and/or verbal) – helping students find a more appropriate behavior or activity; offering an acceptable alternative
  • Planned ignoring – staff will ignore negative behavior not harmful to the child, other children, or the environment 
  • Calming strategies and problem solving -  staff will teach self-regulation strategies including, learning to recognize when getting upset and using calm-down techniques 
  • Positive reinforcement – providing specific positive feedback when the child engages in appropriate behaviors

Interventions for Behavior Escalation:

  • Calm down area – staff will remove the child from the current situation/activity and provide them with an area in the classroom to take a break and calm down. The area will have breathing techniques, visual supports, and safe items like books, stuffed animals, sensory bottles/objects, etc. Staff will assist the child with the techniques; when calm, expectations and an appropriate alternative of behavior will be discussed upon going back to the activity.
  • Removal from classroom – staff will need to remove a child from the classroom only when behavior escalates into a violent episode and is endangering themselves or others. If a child is removed from the classroom it will only be until the child calms down and is able to continue participation safely. Parents, Principal, and Mental Health Coordinator will be notified every time a child is removed from the classroom due to escalated behavior. Parents will receive a copy of the Incident Report.

If at any time Pickwick Early Childhood Center staff and/or parents feel the need to hold a meeting to discuss possible interventions/strategies best for a child; a meeting will be held with a Child Behavior Plan completed. Staff will partner with parents to determine if there is a need for a Mental Health consultant and/or other community supports. 

Active Parenting– First Five Years - A Video-Based Program for Parents & Other Caregivers of Children from Birth to Age 5.
Provides four sessions that focus on: 

  • What a baby’s cry means
  • Ages and stages of development
  • Building a strong bond 
  • Your child’s growing brain
  • Using mindfulness to keep your cool
  • Effective discipline young children can understand
  • Choices and consequences
  • 6 ways to prepare your child for school success
  • and much more!

Each participant will receive a workbook and Certification of Completion. 

Positive Solutions for Families; Parent Training Modules 
Provides Six Sessions teaching social/emotional skills to young children:

  • Making Connection!
  • Making it Happen!
  • Why do Children Do What They Do? 
  • Teach Me What To Do! 
  • Facing the Challenge (Part 1) 
  • Facing the Challenge (Part 2)

Each participant will receive a Family Workbook and Resources. 

Each child will have speech, hearing, vision, behavior, and developmental screenings completed before classes begin or within 45 calendar days after the child starts attending classes.

Heights and weights of each child will also be recorded two times throughout the school year.

If any concerns are found, assistance is available to make referrals for specific services to meet the needs of your family.  The Family Service Worker, Teacher, or Building Principal will inform you of any necessary further evaluation that may need to be completed.

One of the resources available is the Great Prairie Area Education Agency (GP AEA)  preschool personnel that come into our center’s classrooms.  The purpose is to provide our teaching staff with a variety of learning activities, behavior interventions and general classroom observation.  This will enable the teachers to use some new strategies they may not have been aware of to keep the class day flowing smoothly for all the children.

The AEA staff may be bringing activities and materials which will be shared with the center staff and all the children, or they may just observe the classroom as a total unit to give our Head Start staff suggestions.


If the teaching staff have a concern about something your child may or may not be doing, then they will share that with you.

If teaching staff feel they need further assistance from the AEA staff, then teaching staff will meet together with you to discuss the specific need or concern.

Please talk with your teacher if you have any questions about this resource.