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Lexington Public Schools, School Health Services March 19, 2015 Diane Celi M.Ed, BSN, RN, NCSN

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Requirements for entry into Kindergarten Immunization Compliance per Massachusetts State law All immunizations series must be completed or recently started. Physical Exam A physical completed within the past 12 months must be submitted and include documentation of the following: Lead Blood Test Complete Vision Screen with Stereopsis TB Risk Assessment

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Tuberculosis Risk Assessment TB Cases by County, Massachusetts, 2013 (N=201) *No TB cases were reported in Nantucket or Dukes, Counties World Health Organization, Estimated TB Incidence Rates Worldwide, 2013 Iyer, Patricia (2014). Tuberculosis Basics in the School Setting [PowerPoint Slides]. Retrieved from :

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Immunization Requirements for kindergarten entry 2015 DTaP /DTP(Diphtheria, Tetanus, Pertussis)- A series of 5 doses, unless 4th dose given after age 4. POLIO(IPV or OPV)- A series of 4 doses, unless 3rd dose given after age 4. MMR (Measles, mumps, rubella)- 2 doses required. 1st dose must be after age 1 HEPATITIS B- A series of 3 doses required to enter Grades K-12. VARIVAX (Chicken Pox)- 2 doses required to enter kindergarten or Chickenpox Disease must be documented by your doctor or nurse practitioner in writing.

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Immunization Exemptions Medical- MD written documentation required Religious- Parental written documentation required (LPS form)(LPS form) Exemptions must be updated yearly Exclusion policies per Massachusetts Department of Public Health regulations will be applied for students with immunization exemptions should a contagious disease outbreak occur.

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Life-Threatening Allergies An Anaphylaxis Emergency Action Plan should be completed annually by students allergist or primary care physician. EpiPens will be stored in the health office in an unlocked cabinet. LPS provides LTA awareness and EpiPen training to all employees based on Massachusetts DPH recommendations. All parties and celebrations during the school day are food- free. Approval is required from the Principal & RN for the use of food in curriculum instruction. A No food or utensil sharing practice is implemented at the elementary school level.

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No bake sales are allowed at the elementary or middle school level during the school day. LTA policy and related protocols and procedures are not in effect during events which occur on school property after school hours. School nurses are not available after school hours. LTA policy Peanut free/tree-nut free tables are available in the cafeteria at the elementary level. Please indicate if your child will sit at this table on page 2 of the Anaphylaxis Emergency Action Plan. Because of the confidentiality of medical records, a students parent/guardian has the responsibility for notifying school bus drivers directly of any life threatening allergies of which the bus driver should be aware.

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Medication at School ALL medication (prescription and over-the-counter) must have an MD order and parent permission prior to administrationMD order and parent permission

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Injury or Illness during the school day Safety is a priority at school. Parents are contacted in the event of acute injury or sudden illness at school. Please be sure to complete emergency contact form and update when changes occur. An MD order is required if student is temporarily excused from participating in gym or recess while recovering from a medical condition. Please present this order to the school nurse. Our guidelines are that if a student is well enough to attend school they are well enough to go outdoors for recess with their peers.

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When to keep your child home A temperature of 100 degrees or greater within the past 24 hours Vomiting or diarrhea within the past 24 hours An undiagnosed rash Untreated pediculosis (lice) infestation Suspected conjunctivitis (pink eye)-please stay home until you have had 24 hours of antibiotic Strep throat- please stay home until you have had 24 hours of antibiotic treatment Please note that when a student has been absent for five (5) or more consecutive days, parents must obtain a doctors note and submit it to school. See page 14 of LPS Elementary HandbookLPS Elementary Handbook

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Healthy Tips Sleep- Please ensure that your child gets enough sleep to participate fully in the school day. Kindergarten students have a rest time after lunch. Nutrition- Be certain that your child eats breakfast and brings a healthy snack/ lunch to school. Healthy favorites include fruit, veggies, yogurt, crackers, 100% fruit juice, and water.healthy snack Hydration- Water bottles are encouraged. The use of lotion for dry skin and lip balm is encouraged. Sunscreen- Please apply at home if desired. Staff are not permitted to apply sunscreen.

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Dressing for the weather Children go out to recess twice daily unless the temperature is below 18 degrees. All students must wear boots and snow pants to play in the snow at recess during winter. Students are not allowed in the snow without these. Please send extra socks, underwear, and pants to be stored in students locker if clothing becomes wet. Parents will be called to bring clothing if it is needed and not available. LPS Wellness Policy and Implementation Guidelines provide further information. LPS Wellness Policy Implementation Guidelines

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For more information: LPS Nurses Website