You must not allow an ill child to attend your child-care home if one or more of the following exists:
  (1) The illness prevents the child from participating comfortably in child-care activities, including outdoor play;
  (2) The illness results in a greater need for care than caregivers can provide without compromising the health, safety, and supervision of the other children in care;
  (3) The child has one of the following (unless a medical evaluation by a health-care professional indicates that you can include the child in the child-care activities):
    (A) An oral temperature above 101 degrees that is accompanied by behavior changes or other signs or symptoms of illness;
    (B) A tympanic (ear) temperature above 100 degrees that is accompanied by behavior changes or other signs or symptoms of illness. Tympanic thermometers are not recommended for children under six months old;
    (C) An axillary (armpit) temperature above 100 degrees that is accompanied by behavior changes or other signs or symptoms of illness;
    (D) An infrared temporal (forehead) temperature above 100 degrees that is accompanied by behavior changes or other signs or symptoms of illness; or
    (E) Symptoms and signs of possible severe illness, such as lethargy, abnormal breathing, uncontrolled diarrhea, two or more vomiting episodes in 24 hours, rash with fever, mouth sores with drooling, behavior changes, or other signs that the child may be severely ill; or
  (4) A health-care professional has diagnosed the child with a communicable disease, and the child does not have medical documentation to indicate that the child is no longer contagious.

Source Note: The provisions of this §747.3401 adopted to be effective September 1, 2003, 28 TexReg 1462; amended to be effective December 1, 2010, 35 TexReg 10266; amended to be effective April 15, 2017, 42 TexReg 1906; transferred effective March 9, 2018, as published in the Texas Register February 16, 2018, 43 TexReg 909; amended to be effective March 1, 2023, 48 TexReg 950