Parkway baptist class room procedures

Parkway Baptist Class Room Procedures
for Allergies and/or Medical Conditions
(to include RAD and Asthma)
1. Parents must complete all necessary release forms (see attached). 2. One copy of the release form is kept by the teacher another is kept in the 3. A sign which list all affected children and their allergies will be posted above sink in class room (see attached) INCLUDE A PICTURE 4. Medication is kept in Director’s office in file cabinet in a container labeled: 5. Two Epipens are needed for your child to attend school. One is kept in the child’s classroom and the other is kept in the Director’s office in the filing cabinet in a container labeled: Individual Children’s Medication. 6. All Teachers in school must watch video and learn how to administer the Epipen 7. NO FOOD, which a child is severely allergic to, is permitted in the classroom. Parents of other children are notified of the food item. Constant reminder notices must be sent home. Any habitual disregard of this request will be handled by the director. 8. All students in the class have a place mat and are instructed to keep their food on their own placemat. Children are instructed to eat only their own food. 9. Parent of child with allergy is asked to send food in a noticeable container so that a teacher may be alerted if the child is eating another child’s food. 10. Teachers are to obtain a list of allergy approved snacks including name brands 11. Teachers are to have a back up snack food on hand. 12. Homemade foods for snacks or birthday parties are not permitted. Parkway Baptist Church Weekday Preschool Ministry Emergency Health Care Plan & Allergy Medication Allergic To: ____________________________________________________________ Student’s Name: _______________________________________________________ Date of Birth: _______________ Teacher’s Name: ______________________________________________________ Class: _______________________________________________________________ Asthmatic: YES ________ (Inhalers are administered by Child Only) NO __________ High Risk of Severe Reaction: YES ___________ NO __________ Signs of Allergic Reaction include: ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ If ingestion/allergic reaction is suspected, give: (medication/dose/rate) __________________________________________________ and__________________________ immediately! Call Rescue Squad (911) (Request Epinephrine) YES ________ NO __________ (If Epinephrine is administered 911 will automatically be contacted) Call MOTHER home _____-______-_____ cell/work ____-_____-______ Call FATHER home _____-_______-_____cell/work ____-_____-______ EMERGENCY CONTACT _________________________________________ (Name) _________________ (Relationship) ______________(Phone) CALL Dr. ________________________________AT _________-_________-________ ________________________ __________ _____________________ ___________ Parkway Baptist Church Weekday Preschool Ministry I hereby give my permission for my child, _____________________ to be given the following dosage ____________________________ of Benadryl if ____________________________________________ (stung by an insect, eats peanut butter etc) The Benadryl has been provided by me and is kept in the Director’s Office. I understand that I will be contacted immediately if Benadryl is
administered and I agree to come to the school immediately to supervise
any additional medical treatment.
Signed: _____________________________________ Date:_________

Source: http://www.parkwaybaptistpreschool.com/pmimages/11-12%20Allergy%20Action%20Plan%204%20pages.pdf