Related pages
You are using an unlicensed and unsupported version of Evoq Content. Please contact for information on how to obtain a valid license.
You are here : Children & Family  >  Child Care Providers

Child Care Providers

The health and well being of children is important for growth and development, which is why the Snohomish Health District works to ensure health and safety at Snohomish County child cares and preschools. Our services are targeted at child care businesses and providers. For more information about our program activities, please see our Child Care Health Outreach Program annual report.

For help finding a child care or day care in your area, Child Care Aware of Washington provides information and referrals. They are available by calling 1.800.446.1114 and online at

To make sure a child care or day care provider is licensed, and review other licensing information including any founded complaints, visit the Department of Early Learning. Here's an overview of the different types of child care options. Some are regulated by the state - requiring licensing - and some are not.

Prevent illness in your child care business

Diseases can spread easily and quickly in child care environments, and children are more susceptible to some illnesses. This is because children have less developed immune systems, may not have received all of their vaccinations, are in close contact with many other children, and are still learning healthy habits.

The Snohomish Health District Child Care Health Outreach program helps child care owners and workers with the challenge of preventing illness and maintaining sanitary child care environments. We offer on-site visits and consultations, distance learning classes, and resources. We publish a bi-annual newsletter. Click on the following links to view our recent newsletters: 

May 2017November 2016October 2015March 2015, December 2014August 2014, September 2013. (PDF).

Our goal is to help child care providers and preschool teachers achieve best practices in out-of-home care for children.

Free consultations for child care providers

A public health nurse and environmental health specialist are available to consult with providers at their child care, by phone, or by email. Here are some of the topics we would be happy to discuss with you. Click on the following items for more information.

Taking Illness Prevention to Preschool

Preschools are a common place for the spread of illnesses. Snohomish Health District is pleased to offer a special illness prevention program designed specifically for preschools exempt from child care licensing. The free outreach program is called "Taking Illness Prevention to Preschool" or "TIPP." We assist license-exempt preschools with the challenge of preventing illness and maintaining sanitary preschool environments.

Our staff will make four monthly visits during which you will receive materials, advice, and resources to help you improve your preschool program. Your preschool will receive a hand washing lesson for the children, use of our lending library of books and games, a curriculum kit to keep, training hours for staff who are interested, and a framed completion certificate that can displayed for parents to see.

There is no cost for participation in the TIPP program. To get more information or to sign up, please send an email to or call 425.339.5278.

Illnesses in child care

When to send a child or worker home: Exclusion guidelines

In group settings, illness can spread rapidly. Child care providers are encouraged to call the Child Care Health Outreach program at Snohomish Health District to discuss guidelines for observing, responding to, and reporting symptoms of illness. Programs staff can:

  • Advise on when a child is too sick to be in care
  • Provide sample notification letters for specific illnesses
  • Answer questions about medications
  • Decide when a child or staff member can return after an illness
  • Support and educate staff and families during a communicable disease outbreak

Telling public health and parents about an illness

Child care providers are required by law to report certain diseases called notifiable conditions to Snohomish Health District.

Although a disease may not require a report, child care providers are welcome to call for advice. Any cluster of cases or an unexpected increase in any illness in a given period may indicate an outbreak. Providers are encouraged to call the Communicable Disease Outreach program for assistance with clusters of chickenpox, MRSA, influenza, norovirus, or other illnesses.

Parents must also be notified when their child has been exposed to a communicable disease. We can provide help with letters home and fact sheets on the various illnesses.

Other disease resources

Other resources for child care providers related to childhood illnesses and exclusion guidelines (all are PDF documents):

Chronic health concerns

The following forms may be helpful when enrolling a child with a chronis health concern or special need. (Call or email for form.)

  • Individual Plan of Care form
  • Asthma Plan
  • Emergency Plan for Severe Alergies

Child care health policies and guidelines

Child care licensing regulations state that every program must have a current, written health policy. Centers and school age programs must have their policies signed by a physician, physician’s assistant, or registered nurse. The Child Care Health Outreach program staff will review and sign your health policy at no cost, provided that you use our most current template (all are Word .doc files):

Your completed policy should specifically reflect the practices that are done in your child care. Leave all text colors, such as red and green, in place until the final review is completed. Once you have finished writing your policy, email the document back to us at After we review it, we will contact you to set up a time to visit your child care and complete the process.

In addition to a health policy, you may need some or all of the following supplemental policies and forms.

Blood and body fluids: Develop a plan

Child care providers, teachers, or managers may come in contact with blood or potentially infectious body fluids as part of their work with young children. Illnesses such as hepatitis B, hepatitis C, or HIV can be transmitted through blood or certain body fluids. Child care providers must use Universal Precautions to protect themselves from becoming infected. The Washington State Department of Labor and Industries requires child care providers to have a Bloodborne Pathogen Exposure Control Plan to help protect staff. A model policy is included here.

Child care medication management

When children need medicine during the day, child care providers are called upon to make sure children receive them in a safe and effective manner. Giving medication requires organization and planning. Mistakes can be avoided with a few simple guidelines. Child care providers should make sure they have a written medication policy in place which addresses:

  • Who will give the medication
  • Staff training
  • Steps involved in giving medication
  • Special equipment
  • Bulk medications
  • Communication with families
  • Medication instructions
  • Documentation
  • Storage

The following documents may be helpful.

Food safety in child care

Children are more susceptible than adults to food poisoning - technically called foodborne illness. Child care providers and preschools are required to follow the food safety guidance provided in the Washington State Food and Beverage Worker’s Manual. For many child cares and preschools, this requirement was first introduced in 2013. Basic food safety rules include:

  • Keep hands and food preparation surfaces clean
  • Eliminate bare hand contact with ready-to-eat foods
  • Keep hot foods hot and cold foods cold
  • Protect foods from contamination during storage
  • Thoroughly cook meat, fish, eggs, and poultry

All child care providers should obtain a Washington State Food Worker Card.

Here are a few guidance documents for child care facilities.

Pets in child care

Pets can have a very positive effect on children. In child care programs, pets can teach even very young children about values such as kindness, responsibility, and caring. Unfortunately, some pets can be a significant source of disease, allergies, and injury in young children. Animal bites can be serious. Petting zoos and animal interactions can be fun experiences for children, but also have many health and safety risks associated with them.

Child care providers with pets on the premises should have a current pet policy and be knowledgeable about the health risks associated with the animal. Parents should be notified whenever pets are present.

The following documents can help you decide if a pet is right for your child care and write your policies. Additional information on health risks from animals or petting zoos can be found on our Animal Bites & Risks page.

Hand washing and sanitation

The best way to reduce the spread of germs in child care settings is by using good hand washing practices and washing hands often. This applies to both child care providers and children. For handwashing information and resources, including a copy of the handwashing poster, go to the Handwashing page of this website.

Cleaning and sanitizing or disinfecting are also very important for preventing the spread of disease in child care environments. When cleaning and sanitizing/disinfecting, use a three step process as follows:

  1. Clean (soap and water) to remove dirt and germs
  2. Rinse (plain water) to remove the soap
  3. Apply sanitizer or disinfectant to kill remaining germs

Child care providers can contact the Child Care Health Outreach program for advice on choosing an appropriate cleaner, sanitizer, or disinfectant, mixing bleach and water solutions, or which surfaces should be sanitized and which should be disinfected. Other helpful information can be found in the following documents:

Wellness and nutrition

Snohomish Health District’s Healthy Communities Program can help you promote healthy eating and physical activity in your child care center or home by providing STARS training and on-site resources. Topics that can be addressed include nutrition, healthy mealtime environments, physical activity, and reducing screen time.

Some resources available to assist you include:

Injury Prevention

The curious and adventurous nature of young children helps them learn about their world, but also makes them prone for injuries. Child care providers can take steps to reduce the chance of injuries in their child care environment. Call the Child Care Health Outreach program if you have questions about preventing injury in your child care or if you wish to schedule a personalized onsite consultation.

Contact us

Child Care Health Outreach

Communicable Disease Reporting: 425.339.5278
Bonnie Decker
Public Health Nurse
Micha Horn
Environmental Health Specialist
Jann Finley
Behavioral Health Specialist
Katy Levenhagen
Nutrition Consultant
Did you know?

The Snohomish Health District's Child Care Health Outreach Program has disease fact sheets on 26 different illnesses commonly found in child group care settings.