Health Questionnaire Form


    Medical Details



    Immunisations


    If your child has had the following immunisations please give the dates of the vaccinations:


    Medication



    Other Medical Information


    Does your child have any known allergies?
    YesNo

    Does your child have any skin problems?
    YesNo

    Does your child have asthma?
    YesNo

    Has your child had chicken pox?
    YesNo

    Has your child had any other infectious diseases?
    YesNo


    KTB Kids sickness policy


    KTB Kids asks for parents to good practice and if their child is unwell asks for them to be kept at home until a doctor confirms that any risks of infection have disappeared. These include sickness and/or diarrhoea, a fever with a temperature of 101F/38C or above, chickenpox, measles, mumps, meningitis, hepatitis, a virus or any unexplained rash. Should any child develop such symptoms while the child is at the nursery, the named contact person will be contacted so that the child can be taken home. The Department of Public Health guidelines state that 48 hours must have passed since the final episode of diarrhoea or vomiting before children return to a childcare facility and KTB Kids enforce this. Whilst a child is waiting for collection they will be looked after but kept away from the other children where possible. Unfortunately KTB Kids are unable to issue a refund for periods where a child’s nursery place is unfilled due to sickness.

    • KTB Kids do not provide care for children, who are unwell, have a temperature, or sickness and diarrhoea, or who have an infectious disease.
    • Children with head lice are not excluded, but must be treated to remedy the condition.
    • Parents or guardians are notified if there is a case of head lice in the setting.
    • Parents or guardians are notified if there is an infectious disease, such as chicken pox.
    • Good hygiene practice concerning the clearing of any spilled bodily fluids is carried out at all times.
    • Staff suffering from sickness and diarrhoea are excluded from the premises.
    • Ofsted is notified of any infectious diseases which a qualified medical person considers notifiable.


    Administration of medicine policy


    At KTB Kids staff have appropriate first aid training and as a nursery we are willing to administer medicine on site. There is a named co-ordinator at KTB Kids who is responsible for all matters regarding First Aid. KTB Kids works in partnership with parents and information sharing in this area is vital so that staff respect and are aware of cultural, ethical or religious reasons which may relate directly to the administration of medicine.
    The following procedure must be adhered to by parents and staff for the health and well-being of all children in the administration of medicine:

    - KTB Kids requires written consent in advance from parents which clearly shows the date, dosage and expiry date.  The label must have the name of the child on it.  If the medicine has not been prescribed for the child, the nursery will not administer it.
    - KTB Kids requests that all medicines which are non-prescriptive, such as Calpol, are accompanied by a form which is signed by the parent.  The form indicates when the child last had the medicine, and the dosage and frequency required.  As the medicine is non-prescribed, parents will sign a disclaimer to say that they are happy for staff to administer the medicine without having first sought medical consultation.
    - The staff will administer non-prescribed medication for a maximum of 3 days, after which time they will no longer be able to continue giving the medication.  At any time during the 3 days, if the staff deem that the child's health has deteriorated or they have concerns for his/her health, the parent will receive a telephone call to collect the child (or make arrangements for the child to be collected by another named person).
    - Written permission is required for emergency treatment of chronic illnesses, such as asthma where inhalers may need to be given on a long-term basis.
    - Staff will be asked to attend training to meet specific needs concerning administration of medicine, or other health related matters.
    - Staff will sign a consent form to say they are willing to administer medicine. 
    - In an emergency situation, an ambulance will be called for and parents informed immediately.
    The general manager will monitor staff to ensure the procedures are being carried out, and that they are clear to all.  Staff will be asked to feedback at meetings any areas of concern or to identify training needs that they may.

    Process for administering medication

    The authorised member of staff at KTB Kids administering the medication will take the following steps:
    1. Check the consent form has been filled in correctly and the expiry date for the medication has not elapsed.
    2. Talk to the child in appropriate language about why they are on medication and how it will be given.
    3. Ask another member of staff to witness the correct time, dosage and administering of the medication.
    4. Return the medication to the correct storage place.
    5. Fill in the consent form and have it counter signed by the witness.
    6. Ensure the parent/ guardian signs the consent form when they collect their child.

    Storage of medication

    Medication such as antibiotics will be kept in the fridge in the kitchen area. All other medication will be kept in a locked cupboard. All staff, who are authorised to, have access and will know where to the key is stored.


    Emergency treatment consent


    I agree to the nursery at KTB Kids taking the necessary steps to ensure that my child receives the best and most appropriate care, attention and treatment should there be an emergency or accident in the setting or while my child is on an authorised outing. I understand that KTB Kids will make every effort to inform me of any emergency or accidents a soon as possible after the event. I understand that a representative of KTB Kids will accompany my child to hospital in the case of a serious accident in my absence. I give my permission for KTB Kids to authorise hospital staff to administer essential treatment until my arrival.


    Administration of Calpol consent form


    KTB Kids will administer a maximum of 5ml of Calpol i n the situation of your child having a raised temperature and in accordance with our Medication Policy. Calpol will only be given following telephone contact with the parent/ guardian as an interim measure whilst waiting for the child to be collected from the nursery. KTB Kids will not administer Calpol in any other circumstances apart from those set out in the Medication Policy.

    I give permission for KTB Kids Day Nursery to administer a maximum of 5ml of Calpol to my child in line with the administration of medicine policy.


    Administration of plaster consent


    I hereby give my consent for KTB Kids nursery staff to apply a plaster when necessary to my child. My child has not shown an allergy to a plaster from previous applications.


    Sun protection consent


    In order to fulfil our Health and Safety policy it is a requirement that parents must supply sun cream of SPF 25+ and hats for their child during the warm months. All sun cream and hats must be clearly labelled with your child’s name and room. As an emergency measure KTB Kids will use ‘Ambre Solaire’ SPF 50+, this will be used on the rare the occurrence that no sun cream has been provided for a child. It is not intended for daily use.

    I hereby give my consent for KTB Kids nursery staff to apply the sun cream that I supply to my child.
    On the odd occasion I consent for ‘Ambre Solaire’ SPF 50+ to be issued on my child.

    If you agree with the above policies please sign below: