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To fill out this form, first, ensure you have read all sections carefully. Then, provide the required details in the specified fields. Finally, ensure you sign and date the form before returning it.

How to fill out the Rilya Wilson Act and Influenza Information for Childcare Providers?
1
Read all sections carefully.
2
Provide child and parent details in the specified fields.
3
Acknowledge receipt of the brochure by signing and dating the form.
4
Return the signed form to the childcare provider.
5
Follow the guidelines provided for reporting absences and preventing flu.
Who needs the Rilya Wilson Act and Influenza Information for Childcare Providers?
1
Childcare providers to comply with the Rilya Wilson Act and DCF requirements.
2
Parents to acknowledge receipt of the influenza information brochure.
3
Case managers to ensure protective services children receive proper care.
4
Healthcare providers to give accurate advice on flu prevention and treatment.
5
Community-based care lead agencies for monitoring and compliance purposes.
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What are the instructions for submitting this form?
To submit this form, provide the required details and acknowledgment, then return the completed form to your childcare provider. For further assistance, contact your community-based care lead agency or the Department of Children and Families. Ensure all sections are filled correctly and follow proper procedures for any reporting requirements.
What is the purpose of this form?
This form serves multiple purposes, including ensuring compliance with the Rilya Wilson Act requirements and providing crucial information on influenza prevention and care. Childcare providers and parents must work together to guarantee protective services children attend childcare programs consistently and follow proper procedures for reporting absences. Furthermore, the document aims to educate parents on recognizing flu symptoms, preventing the spread of germs, and taking appropriate actions if a child gets sick. Cooperation between caregivers, case managers, and healthcare providers is essential to minimize disruptions and maintain stable relationships for children in protective services. This form also emphasizes the importance of seamless transitions in childcare settings and prioritizes the health and well-being of children at risk of abuse, neglect, or abandonment. By adhering to the guidelines and requirements outlined in this document, all parties involved can contribute to a safer and healthier environment for young children.

Tell me about this form and its components and fields line-by-line.

- 1. Child's Name: Enter the full name of the child enrolled in the program.
- 2. Date Received: Provide the date the influenza information brochure was received.
- 3. Signature: Parent or guardian's signature acknowledging receipt of the brochure.
What happens if I fail to submit this form?
Failing to submit the form can result in non-compliance with the Rilya Wilson Act and potential penalties.
- Non-compliance: Not submitting the form means failing to comply with legal requirements for child attendance and reporting.
- Penalties: There may be penalties or consequences for childcare providers not adhering to the law.
How do I know when to use this form?

- 1. Enrolling Child: When enrolling a child from birth to school age in an early education or child care program.
- 2. Acknowledgment: To acknowledge receipt of the influenza information brochure.
- 3. Reporting Absences: For reporting unexcused or consecutive excused absences as required by the act.
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Yes, you can save the edited PDF to your device for future use.
What should I do if my child gets sick with the flu?
Consult your doctor, ensure your child gets plenty of rest and fluids, and avoid giving aspirin. Seek medical attention if severe symptoms occur.
What are the requirements of the Rilya Wilson Act?
Protective services children must attend childcare 5 days a week, cannot be withdrawn without approval, and absences must be reported to the appropriate agency.
How can I prevent the spread of the flu?
Get a flu vaccine annually, wash hands frequently, cover coughs and sneezes, and limit contact with sick individuals.
When should my child stay home from childcare?
Your child should stay home when showing flu symptoms and not return until fever-free and symptom-free for at least 24 hours.
What information is required in the form?
The form requires child and parent details, acknowledgment of influenza brochure receipt, and adherence to reporting guidelines.
How do I contact the community-based care lead agency?
Visit the provided link to get contact information for the community-based care lead agency.
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