When to keep your child home from daycare
Daycares send children home for a fever, vomiting, diarrhea or a contagious illness, and in Texas most can come back after 24 hours without symptoms. But the rules differ by state: Texas writes them into law, with its own fever line and a list of contagious illnesses, while California leaves most of the details to each center. Here is what Texas and California require, what the national standard says illness by illness, and what to ask your center.
Updated Oct 12, 2026. Inspection numbers come from state records and update daily.
Quick answer
Keep your child home if they:
- have a fever: 100°F or higher under Texas’s rules, or above 101°F with a change in behavior or other symptoms under the American Academy of Pediatrics’ child care guidance;
- vomited two or more times in the past 24 hours, or have diarrhea that can’t be contained;
- are too sick to take part in the day, including outdoor play, or need more care than the staff can give without compromising the care of other children;
- have signs of a more serious illness: unusual sleepiness, trouble breathing, a rash with a fever, or mouth sores with drooling;
- have a contagious illness that requires staying home, such as flu, chickenpox, measles, or strep throat until 12 to 24 hours after starting antibiotics (see the table below).
Usually fine to go: a cold or cough without a fever, and, under the national standard, pink eye without a fever (Texas keeps children with pink eye home). Your center’s own policy can be stricter, and it is the rule that applies to you.
Going back: in Texas, after 24 hours free of fever (without fever-reducing medicine) and other symptoms, or with a note from a health-care professional. A child a doctor has diagnosed with a contagious illness needs a note saying they’re no longer contagious. California’s rules for regular centers set no return date; ask your center, and see the CDC’s 24-hour guidance for respiratory illnesses below.
This guide explains state rules and national guidance; it isn’t medical advice. If you’re not sure, call your child’s doctor. Call 911 if your child is struggling to breathe, turns blue, is hard to wake, or has fast-spreading bruising or small purple-red spots. Call the doctor for signs of dehydration (no urine for 8 hours), a stiff neck, or blood or mucus in the stool.
What Texas and California require
Texas writes its sick-child rules into state law and borrows the health department’s school list of contagious illnesses. California’s rules say less, and leave the details to each center’s written policy.
| Texas | California | |
|---|---|---|
| Who sets the rules | The state. Centers must follow the licensing rules (§746.3601) and the health department’s school exclusion list (§746.3603; 25 TAC §97.7). | Mostly the center. State rules for regular centers require a daily health check and an isolation area but don’t list illnesses (§101226.1, §101226.2); each center sets its own sick policy. |
| Fever | A fever of 100°F or higher keeps a child out until 24 hours fever-free without fever-reducing medicine (25 TAC §97.1, §97.7, applied to centers by §746.3603). The licensing rule also requires sending home a child above 101°F by mouth, or above 100°F by ear, armpit or forehead, with behavior changes or other signs of illness (§746.3601). | No number in the rules for regular centers: a center may not accept a child with “obvious symptoms of illness including, but not limited to, fever or vomiting.” |
| Vomiting, diarrhea, other signs | Send home for signs of possible severe illness: unusual sleepiness, abnormal breathing, uncontrolled diarrhea, vomiting two or more times in 24 hours, a rash with fever, mouth sores with drooling, or behavior changes. | Not accepted with obvious symptoms; a child who gets sick during the day goes to the isolation area until picked up. |
| Contagious diseases | The school list applies: for example flu, strep throat, pink eye, chickenpox, scabies and measles (table below). A child a health-care professional has diagnosed with a contagious disease needs a note saying they’re no longer contagious (§746.3601(4)). | No state list. Outbreaks are reported to licensing and the local health officer, who can tell a center whom to exclude. |
| Going back | After 24 hours symptom-free, or with a health-care professional’s statement that the child no longer has an excludable illness (§746.3606). | Set by the center’s policy. |
| If your child gets sick there | Staff call you to pick up, care for your child apart from the others and watch them, and step up hand washing for vomiting or diarrhea; in an emergency they call 911 or take your child to the ER (§746.3605). | The center must notify you immediately and ask you to pick up as soon as possible; your child waits in an isolation area, on a mat, cot or bed, where staff can easily supervise (§101226.2). |
| Telling other families | Written notice to every family within 48 hours of learning that a child or employee has a disease the health department lists as notifiable, such as measles, whooping cough, chickenpox or salmonella; a single case of a cold, flu, strep or hand, foot and mouth isn’t on that list, but the list also covers outbreaks; notice to the group’s families within 48 hours of an outbreak of lice or another infestation, by note or a posted notice (§746.307). | Outbreaks go to licensing by the next working day (in writing within 7 days), to parents, and to the local health officer, including outbreaks of head lice involving two or more children (§101212; 17 CCR §2508). |
| Care for mildly ill children | Centers licensed for get-well care may keep mildly ill children. | Centers licensed as mildly ill child care centers may care for mildly ill children. |
Illness by illness
The Texas column is the state’s school and child-care exclusion list (25 TAC §97.7), which Texas centers must follow, as the health department’s chart sets it out. California has no list for regular centers, so the second column is the national standard: the American Academy of Pediatrics’ guidance for child care, from HealthyChildren.org and its book Managing Infectious Diseases in Child Care and Schools (7th edition). In Texas the state column is the minimum: a center can be stricter, not looser. In California, the center’s policy decides.
| Illness | Texas: stay home? Back when? | National standard |
|---|---|---|
| Fever | Home at 100°F or higher. Back after 24 hours fever-free without fever-reducing medicine. | Home with a fever above 101°F (by any method) and a change in behavior or other symptoms, or any fever with a cough, runny nose or sore throat. A baby under 2 months with a fever above 100.4°F needs a doctor right away. |
| Cold, cough, runny nose | Only with a fever. | No need to stay home, whatever the color of the mucus, unless the child can’t take part or has a fever. |
| Flu | Home. Back after 24 hours fever-free without medicine. | Follows the fever and “can’t take part” rules. |
| COVID-19 | Home. Back after 24 hours fever-free without medicine. | CDC: back when symptoms are improving and 24 hours fever-free without medicine, with extra precautions for 5 days. |
| RSV | Only with a fever. | Follows the fever and “can’t take part” rules. |
| Strep throat | Home. Back after 24 hours of antibiotics and 24 hours fever-free. | Home until 12 hours after starting antibiotics. |
| Pink eye | Home. Back with a doctor’s or health authority’s permission, or 24 hours after symptoms are gone. | No need to stay home without a fever or behavior change. |
| Hand, foot and mouth | Only with a fever, or mouth sores with drooling. | No need to stay home, unless the child has mouth sores with drooling they can’t control, or a fever with behavior change. |
| Vomiting | Two or more times in 24 hours is a sign of possible serious illness: home (licensing rule). | Home after vomiting two or more times in 24 hours. |
| Diarrhea | Home with three or more loose stools in 24 hours. Back after 24 hours without diarrhea or anti-diarrhea medicine. | Home if stool can’t be contained in a diaper, if a toilet-trained child has accidents, or with more than 2 stools a day above normal. |
| Head lice | No need to stay home. The center must tell the group’s parents within 48 hours (licensing rule). | No need to stay home if treated before returning. |
| Impetigo | Only if the sores can’t be kept covered with a clean, dry bandage. | Treatment started before returning. |
| Ringworm | Only if the area can’t be covered by clothing or a bandage. | No need to stay home if treated before returning. |
| Scabies | Home until treatment has begun. | Treatment started before returning. |
| Chickenpox | Home until the blisters are dry (or, without blisters, 24 hours with no new spots). | Home until all spots have dried or crusted and no new ones for 24 hours. |
| Fifth disease | Only with a fever. | No need to stay home. It can be serious for children with sickle cell disease or a weak immune system, so centers should alert those families. |
| Measles | Home until 4 days after the rash starts. During an outbreak, unvaccinated children stay home at least 21 days after their last exposure. | Home until 4 days after the rash starts. |
| Whooping cough | Home until 5 days of antibiotics, or 21 days after the cough started, whichever comes first. | Home until 5 days of antibiotics, or 21 days after the cough started if untreated. |
Illness by illness, in more detail:
Texas: Communicable Disease Chart for Schools and Child-Care Centers (Texas Department of State Health Services, rev. March 2024), from 25 TAC §97.7; vomiting and lice rows from §746.3601 and §746.307. National: American Academy of Pediatrics (HealthyChildren.org, 2024) and its Managing Infectious Diseases in Child Care and Schools (7th ed.) sheets for measles, whooping cough, chickenpox, fifth disease, scabies, impetigo; COVID-19 from the CDC. In Texas, a child a doctor has diagnosed with any contagious illness also needs a note saying they’re no longer contagious, and some illnesses need the local health department’s permission to return. Don’t give aspirin for a viral illness unless your doctor says to. If you’re pregnant and your child’s group has chickenpox, fifth disease, CMV, measles or rubella, call your own doctor (DSHS chart).
If your child gets sick at daycare
Expect a call asking you to pick up. Until you arrive, your child is kept apart from the other children and watched by staff. Ask how quickly your center expects you to arrive, since many policies set a time limit, and line up a backup person who can collect your child.
Before sending your child back, the 24 hours must pass with no fever and no fever-reducing medicine: start counting from the last fever or the last dose, whichever is later. A dose of a fever reducer in the morning can hide a fever for a few hours.
What the inspection records show
Texas
Since October 2021, Texas inspectors have cited 83 currently licensed centers 90 times under the sick-child rules. 85 of the 90 citations (94%) came from investigations, which follow a report to licensing (from a parent, a staff member or the center itself), and 5 from routine inspections: an inspector rarely sees how a center handles a sick child on a routine visit.
| What the center did | Citations | Centers |
|---|---|---|
| Accepting or keeping a child who should have been sent home | 9 | 9 |
| Not calling the parent or keeping a sick child apart | 12 | 11 |
| Not handling a medical emergency as required (911, first aid, calling the parent) | 18 | 17 |
| Letting a child back before 24 hours symptom-free or a health-care professional’s note | 7 | 6 |
| Not telling parents in writing within 48 hours about a notifiable disease | 38 | 38 |
| Not telling parents within 48 hours about lice or another infestation | 6 | 6 |
California
Since February 2021, California has cited 173 currently licensed centers 201 times under these rules. The most common: not reporting an outbreak or contagious illness (160 citations at 140 centers); the illnesses named most often were hand, foot and mouth disease (50), COVID-19 (33, 29 of them in 2021–22) and head lice (11). 196 of the 201 citations came from complaint investigations and other visits, and 5 from routine inspections.
| What the center did | Citations | Centers |
|---|---|---|
| Accepting a child with obvious signs of illness (the daily health check) | 25 | 25 |
| Not isolating a child who became ill, or not calling the parent | 16 | 16 |
| Not reporting an outbreak or a contagious illness | 160 | 140 |
Counts are citations at centers licensed today, under the rules listed in the table above (Texas §746.3601, 746.3603, 746.3605, 746.3606 and 746.307(d)–(e); California §101226.1, 101226.2, and §101212 citations about outbreaks or contagious illness), and update daily. A citation records what the state found, not how many children were affected. If you think a center is ignoring its sick policy, you can report it: see how to report a daycare.
Backup care for sick days
Most daycares can’t take a sick child, so plan for sick days before the first one: a relative or friend on call, a sitter, or a backup-care benefit from your employer.
Texas: centers licensed for get-well care may care for mildly ill children, but not a child with a fever or an illness on the state exclusion list, and you’ll need to give them your child’s diagnosis from a health-care professional (§746.3103, §746.3109). 24 licensed centers list get-well care among their programs in state licensing data; call to confirm what they accept.
Texas centers listing get-well care (24)
California: the state licenses mildly ill child care centers separately, under their own rules on fevers and illnesses they can’t take; 4 are licensed today. Some take only children already enrolled at the center, so call first.
Time off: California employers must give at least 40 hours or 5 days of paid sick leave a year, usable from your 90th day on the job, including to care for a sick child (Labor Code §246, §246.5). Texas has no state paid sick leave law, so check your employer’s policy.
Questions to ask about a center’s sick policy
What temperature sends a child home, and how do you take it?
When you call, how soon must I pick up, and what happens if I can’t?
When can my child come back: 24 hours without fever, without medicine? Do you need a doctor’s note?
Which illnesses keep a child home even without a fever (pink eye, rashes, vomiting)?
How do you tell families about illness in my child’s room, such as lice, flu or hand, foot and mouth?
Do you give fever reducers or other medicine during the day, and what forms do you need?
What happens with staff who are sick?
Do I still pay tuition for sick days?
Do you offer, or know of, backup or get-well care?
Ask for the written policy at enrollment; it usually covers these. Then read the center’s inspection record on Daycare Record. More questions to ask on a tour →
Common questions
How long does my child have to be fever-free before going back to daycare?
In Texas, 24 hours without a fever and without fever-reducing medicine, or sooner with a health-care professional’s statement that your child no longer has an illness that requires staying home. California’s rules for regular centers leave it to each center; the CDC’s guidance for respiratory illnesses uses the same 24 hours, along with symptoms getting better.
What temperature is a fever for daycare?
In Texas, 100°F or higher: the state’s school and child-care exclusion rules keep a child with a fever that high out until 24 hours fever-free without medicine. Texas licensing rules also require sending a child home above 101°F by mouth, or above 100°F by ear, armpit or forehead, when the fever comes with behavior changes or other signs of illness. The American Academy of Pediatrics’ child care guidance uses above 101°F, with a change in behavior or other symptoms. California’s rules for regular centers give no number.
Can daycare send my child home for a runny nose or cough?
A cold without a fever doesn’t require staying home under Texas rules or the national standard. But in Texas a center must send home a child who can’t take part comfortably or needs more care than staff can give, and a center’s own policy can be stricter than the state’s.
Can my child go to daycare with pink eye?
Not in Texas: the state’s chart and licensing rules keep a child with pink eye home until a doctor or the health authority gives permission or the symptoms have been gone for 24 hours. The national standard doesn’t require staying home without a fever or behavior change, so in California it depends on the center’s policy.
Can my child go to daycare with hand, foot and mouth disease?
In Texas, yes, unless your child has a fever or mouth sores with drooling. But if a doctor diagnosed it, the center needs a note saying your child is no longer contagious. The national standard doesn’t require staying home either, unless your child has a fever with behavior change or mouth sores with drooling they can’t control.
Does my child need a doctor’s note to go back?
In Texas, a note is one of two ways back: either 24 hours symptom-free, or a health-care professional’s statement that your child no longer has an illness that requires staying home. A child a doctor diagnosed with a contagious illness needs a note saying they’re no longer contagious, and pink eye needs a doctor’s permission or 24 hours without symptoms. Any center may also ask for a note after an absence. In California, it depends on the center.
Can I give my child Tylenol or ibuprofen before daycare?
A fever reducer can hide a fever for a few hours, and Texas counts only fever-free time without it. If your child needed medicine for a fever, keep them home: the 24 hours start from the last fever or the last dose, whichever is later. Don’t give aspirin for a viral illness unless your doctor says to.
Will the daycare tell me if other children are sick?
Texas centers must give every family written notice within 48 hours of learning that a child or employee has a disease the health department lists as notifiable, such as measles, whooping cough or chickenpox (a single case of a cold, flu, strep or hand, foot and mouth isn’t on that list, but an outbreak is), and tell the families in a group within 48 hours about an outbreak of lice or another infestation. California centers must report outbreaks to licensing, to parents and to the local health officer.
Do I have to pay daycare when my child is home sick?
Check your contract: many centers charge for the enrolled spot whether or not your child attends, and some give sick-day credits.
Sources: Texas: 26 Texas Administrative Code §746.307, 746.3103, 746.3109, 746.3601, 746.3603, 746.3605 and 746.3606 (Cornell LII); 25 TAC §97.1 and §97.7, Diseases Requiring Exclusion from Schools; Texas Department of State Health Services, Communicable Disease Chart for Schools and Child-Care Centers (rev. March 2024); California: Title 22, California Code of Regulations §101212, 101226, 101226.1 and 101226.2 (Cornell LII); Title 17 §2508; Labor Code §246; American Academy of Pediatrics, When to Keep Your Child Home from Child Care (HealthyChildren.org, Aug 2024); AAP, Managing Infectious Diseases in Child Care and Schools, 7th ed.; CDC, Preventing spread of respiratory viruses when you’re sick (Aug 2025); California Childcare Health Program (UCSF), Excluding Children Due to Illness; Texas Health and Human Services and California Department of Social Services inspection records.