Published so it is not a negotiation
When we will ring you and ask you to come
This is the conversation that goes worst in childcare, and it goes worst because the thresholds are usually discovered at two in the afternoon. Here they are in advance.
When we will ring you and ask you to come. We will ask you to collect your child at a temperature of 100.4 degrees or above, for vomiting or diarrhoea, for an undiagnosed rash, or when they are simply too unwell to take part in the day. There is no sick room here and we do not have staff to sit with one child away from a group. We publish the thresholds so the decision is not a negotiation at two in the afternoon — and because a nursery willing to bend them for you is a nursery that bent them for the family whose child infected yours.
Every working parent knows this telephone call. It arrives on the worst possible day, it is nobody's fault, and it costs you something real — a shift, a meeting, sometimes a job's goodwill. We are not going to pretend that is a small thing, because it is not.
What we can do is publish the line in advance, so that the call is the enforcement of something you already knew rather than the opening of an argument. A policy you first hear about while being asked to leave work is not a policy, it is an ambush.
The thresholds
A temperature at or above 100.4 degrees. Not a judgement about how the child seems at that temperature — the number is the number, because a threshold that is applied by feel is applied differently to different families.
Vomiting or diarrhoea. An undiagnosed rash. Or, more broadly, a child who is simply too unwell to take part in the day, which is the one that requires judgement and which we will always explain when we use it.
Anything that needs one adult's undivided attention for a sustained period. This is the practical one. A room running to ratio cannot lose an adult to sit with one child in a corner, and a child who needs that is a child who needs to be somewhere they can have it.
Why there is no sick room
Because a sick room requires an adult in it, and that adult is counted in a ratio somewhere else. The moment a centre staffs a sick room properly it has raised everybody's fees; the moment it staffs one improperly it has quietly reduced supervision in a room full of well children.
It also requires a space that is genuinely separate. A corner of the office is not separation, and a child with a stomach bug in a corridor everybody walks through is a plan that only appears to exist.
So we do not have one and we do not describe ourselves as having one. A child waiting to be collected is with an adult, comfortable, away from the group, for as short a time as we can manage.
The uncomfortable argument
A nursery that would bend this threshold for you is a nursery that bent it for the family whose child infected yours. That sentence is the whole of the case and it does not have a comfortable version.
Flexibility here is not kindness distributed evenly. It is a transfer from the families who follow the rule to the families who ask not to, and the cost lands on infants and on children whose own medical situation means they cannot be immunised.
We would rather be the nursery that rang you than the nursery that let somebody else's afternoon become your fortnight.
What we will actually do
Ring you first, and your emergency contacts if we cannot reach you. We ask for contacts who can genuinely be here within the hour, and we ask you to keep that list current, because a list of people who have moved away is the reason these calls go badly.
Tell you what we saw rather than what we concluded. The temperature and when it was taken, how many times, what they have eaten, how they seem. You are the one making the decision about a doctor and you should have the observations rather than our diagnosis.
And tell you plainly when they can come back. Twenty-four hours clear of fever without medication, and twenty-four hours clear of vomiting or diarrhoea, is the ordinary answer. We will not extend it to be safe and we will not shorten it because you asked.
In order
How this works in practice
Keep your contact list current and local
Two or three people who can genuinely arrive within the hour. A list of names in another borough is a list that fails on the day it is needed.
Expect the call to come early
Temperatures rise through the morning. If it were going to be a bad day we would rather tell you at eleven than at four, and we will say when we first noticed.
Take the observations, not our opinion
We will tell you what we saw and when. We are educators rather than clinicians, and the medical judgement is yours and your physician's.
Twenty-four hours clear
Clear of fever without medication, or clear of vomiting or diarrhoea, before returning. It is the ordinary standard and we apply it the same way to everybody.
Tell us about anything diagnosed
A named condition changes what we tell other families and what we watch for. It stays between us and the families who need to know.
Questions we are actually asked
When we will ring you and ask you to come — frequently asked
What temperature means my child gets sent home?
100.4 degrees or above. We use the number rather than an impression, because a threshold applied by feel gets applied differently to different families, and that is neither fair nor safe.
Can my child stay if they have already had medication?
No. Medication that brings a temperature down does not make a child well or non-infectious, and returning requires twenty-four hours clear of fever without it. This is the point families push back on most, and it is the one we will not move on.
Do you have a sick room?
No, and we would be wary of a centre that says it does without explaining who staffs it. An adult sitting with one unwell child is an adult counted in a ratio somewhere else, so a properly staffed sick room is a real cost and an improperly staffed one is reduced supervision for everybody.
What if I genuinely cannot leave work?
We will ring your emergency contacts, which is why we ask you to keep that list current and local. Beyond that, we will keep your child comfortable and away from the group until somebody arrives. What we cannot do is keep them for the rest of the day.
When can my child come back?
Twenty-four hours clear of fever without medication, or twenty-four hours clear of vomiting or diarrhoea. For an undiagnosed rash we will usually ask for a physician to have looked at it. We apply the same standard to every family.
Tuesday and Thursday mornings, while the children are here
Come and see the room
A tour here happens during a session, in the room your child would actually be in, at the time of day they would be in it. You meet the person who leads that room rather than only the director, and you see the noise and the mess that are genuinely there. It takes an hour. If your child is three or four we will ask whether you have applied for free 3-K or Pre-K for All before we quote you a rate, because a good many families should not be paying us at all.