Special Care Plan For A Child With Allergy printable pdf download

INSTRUCTIONS for the DHS 908

PURPOSE

The DHS 908 Early Childhood Pre-K Health Record Supplement (EC Pre-K HRS) form

was created with the assistance of the Healthy Child Care Hawaii, a collaborative project

of the University of Hawaii/School of Medicine - Department of Pediatrics, American

Academy of Pediatrics - Hawaii Chapter, Department of Health/Children with Special

Health Needs Branch. The purpose of the DHS 908 is to provide developmentally

appropriate information on the child’s health, growth and developmental status for

entrance into a Pre-Kindergarten (Pre-K) program which includes an Infant and Toddler

Child Care Center (IT), Group Child Care Center (GCC), and Group Child Care Home

(GCH). The child’s physician is requested to complete the DHS 908 in conjunction with

the Department of Education (DOE) Form 14.

INSTRUCTIONS FOR THE CHILD CARE FACILITY:

A health record shall be required and obtained from the parent or guardian of

each child entering a licensed child care facility such as a Family Child Care

Home (FCC), GCC, GCH, or an IT and be kept on file at the facility in

accordance with the applicable Hawaii Administrative Rules (HAR) §§17-

891.1-20, 17-892.1-20, and 17-895-20.

The Department of Education (DOE) Student Health Record “Form 14” (F14)

shall be used to comply with this requirement listed in #1, or a comparable

writing (documentation) of a child’s current immunizations, evidence of

child’s good health/physical examination results, and TB test/clearance results.

The F14 (rev. 2010) is available and may be downloaded from the DOE

website,

In addition, the records of each child in a GCC, GCH, and IT shall include

pertinent information about the health status, developmental progress, and any

special needs and efforts necessary to meet these needs in accordance with

HAR §§17-892.1-20(c) and 17-895-20(c).

The DHS 908 or comparable

writing (document) shall be used to comply with the requirement listed in #2.

The DHS 908 may be downloaded from the DHS Child Care Connection

Hawaii website,

At the time of a facility’s initial licensing visit, each child shall have a F14 and

a DHS 908 on file.

At the time of a facility’s annual licensing visit, new students enrolled for the

school year who do not have a F14 on file shall, also, be required to have a

DHS 908 on file.

The facility’s director shall document at least 2 attempts to obtain the DHS

908 from the parent. If after 2 attempts the DHS 908 is not returned, the

child’s health requirement shall be met as long as the F14 is on file.

DHS 908A (09/11)

Special Care Plan For A Child With Allergy