Lice

POLICY:

NOCAC staff will lower the risk of spreading Pediculosis (head lice) in our classrooms and centers through preventative health practices and appropriate reporting procedures recommended by the Center for Disease Control (CDC), American Academy of Pediatrics (AAP), The National Association of School Nurses and the NOCAC Health Services Advisory Board.

The goals of NOCAC Head Start are to:

1. Decrease school absenteeism due to lice.
2. Support families in their efforts to control and eliminate lice.
3. Maintain confidentiality.

GENERAL GUIDELINES:

• Routine or periodic classroom screening is not recommended. NOCAC will conduct two formal screenings per program year.
• All suspected or identified infestations will be managed discreetly so the child is not ostracized, isolated, humiliated or psychologically traumatized.
• Children should be discouraged from close head-to-head contact with others.
• Education staff and Family Advocates follow-up with family to ensure that the infestation is being addressed appropriately until the infestation has ended.

PROCEDURES:

Prevention

1. Every classroom will screen children two times per year for head lice.
   1. The first screening to be completed by the end of the second week at the start of the program year.
   2. The second screening to be completed by the end of the first week in January.
   3. Refer to How to Screen for Lice and Nits for guidance on checking hair.
2. Each child will have their own personal comb that will remain in their cubby.
3. Children and staff with long hair will be encouraged to keep it pulled back until treatment is complete.

When a child is found to have live lice:

1. NOCAC staff will notify the family and a Head Lice Information Packet will be sent home with the child. Emergency Contacts do not need to be called, this is NOT an emergency.
2. Children with live head lice can remain at the center and go home at the end of the school day and return to school after being treated with an effective pediculicide. The child must be excluded from head-to-head contact with other children or adults until treated.
3. It is NOT mandatory that the child is immediately sent home from the center, however if the parent offers to pick up the child, that is acceptable.
4. Staff will complete a Child Health Observation Form by the end of the class and send home the Communicable Disease/Exposure Notice parent letter with each child present that day.
5. The family is instructed that the child should be treated is included in the Head Lice Information Packet.
   1. Ongoing communication between the staff and family during this process is essential.
   2. Families may be asked to show receipts, doctor notes or other forms of evidence of treatment, when a child returns to the center and it appears that no treatment has taken place.
6. When a child has recurrent or repeated cases of live lice, the education staff, Family Advocates and the Health and Safety Manager will develop a plan with the family meeting the above noted goals, including frequency of Exposure Notice to parents requirements.
7. In some cases (based on the Family Advocate and the Health and Safety Manager judgment), it may be appropriate to have the child’s head checked upon return to school.

When a child is found to have nits present (no live lice detected):

1. The family is notified and a Head Lice Information Packet will be sent home with the child.
2. Immediate or long-term exclusion is not required.
3. The child is NOT required to be sent home from school but is required to be excluded from head-to-head activities and contact with other children while finishing out the day.
4. The family is encouraged to follow indicated treatment plan their healthcare provider has given them and nit-pick (regularly for the next two weeks).
5. If future checks reveal an increased number or nits present or it is obvious to the screener that the child’s hair has not been treated, the parent will be contacted by the teacher or Family Advocate for follow-up and support.

When to check beyond the identified child with live lice or nits:

1. If the infected child has a sibling in the Center, he/she needs to be checked.
2. NOCAC Staff will ask the family to check other siblings and family members and offer support as needed. On occasion NOCAC staff will be asked to provide additional support to families.

Classroom Environment

1. The classroom is only one of many environments where head lice can be transmitted.
2. Classroom tips:
   1. NOCAC Staff will vacuum the affected classroom
   2. Stuffed animals and pillows will be bagged for two weeks
   3. Past practices of separating coats, bleaching toys and furniture, combs, brushes or other personal items have been found not to be as important as research shows that lice cannot survive on inanimate objects. Hence, there is little, if any, reason to focus efforts.
   4. Pesticide sprays are NOT recommended as they have NOT been proven to be effective and they are a health hazard.

Note:

1. The Health and Safety Manager will use professional judgment to determine when unusual measures are necessary to respond extraordinary cases.
2. If the family is not compliant with the treatment options and the child misses several days of class, NOCAC may choose to implement the following measures:
   1. Home visits
   2. Referrals to outside agencies
   3. Report to protective services
3. Collaborative sites or centers located in public schools may have a policy different from NOCAC.

Forms and Additional Guidance:

• How to Screen for Lice and Nits
• Head Lice Information Packet
• Child Health Observation Form
• Communicable Disease/Exposure Notice
• Preferred Drug List for Ohio Medicaid Plans – Head Lice 
• Head Lice Information and Treatment (Spanish)