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October 9, 2002

School and Daycare

Question from Citrus Heights, California, USA:

My three and a half year old son has to take insulin during the day, and his daycare provider has agreed to give him his insulin, but the State of California is saying only a nurse or I can. I work 25 miles away and cannot go and give him a shot if needed. What can we do? I would not leave my son with someone who could not do the job that is needed. I believe in them, and my son is doing great.

Answer:

The California Department of Social Services both licenses and regulates child care providers in your state. Their staff in Sacramento advises me that you can designate another family member to provide care for your child, so long as they receive training in how to recognize your child’s medical needs including measuring of blood glucose as well as how to correctly provide injections of insulin. Such designation must be in writing to the child care provider. If no family member is available to care for the child’s medical needs, a staff member of the child care provider could be trained to respond to your child’s medical needs including measuring of blood glucose as well as how to correctly provide injections of insulin.

However, prior to having the staff member begin providing actual care for the medical needs of the child, the licensed child care provider (not you) would have to make a written request to the California Department of Social Services Childcare licensing office for an “exception to normal regulatory requirements regarding the provision of medical services to a child”. In addition to having a primary staff member trained, it was suggested that an alternate staff member be trained to assume responsibility for your child’s medical needs including measuring of blood glucose as well as how to correctly provide injections of insulin in the event the primary staff member is absent or otherwise unavailable.

The child’s physician must approve of the arrangement. I was not clear as to who should provide the training to the child care staff members for your child’s medical needs including measuring of blood glucose as well as how to correctly provide injections of insulin. I would recommend working through your endocrinologist’s office for training by a Certified Diabetes Educator.

Should your child care provider have any questions they (not you) would call the state licensing office at (916)229-4530. One other alternative that has not been discussed is the possibility of finding suitable child care closer to your work site.

DSH