School Nursing

In May 2024, public health guidance around COVID-19 was dissolved into general guidance for preventing the spread of infections and respiratory viruses.

Included below are the current guidelines being followed in schools and by employers in California. 

The only requirements still in place is the Cal/OSHA reporting and recordkeeping requirements, which remain in effect until Feb. 3, 2026. It requires that the employer keep a record of and track all COVID-19 cases with the employee's name, contact information, occupation, location where the employee worked, the date of the last day at the workplace, and the date of the positive COVID-19 test and/or COVID-19 diagnosis. These records must be retained for two years. It also requires that information on COVID-19 cases be provided to the local health department with jurisdiction over the workplace, CDPH, the Division, and NIOSH immediately upon request, and when required by law.

Guidance for preventing the spread of infections in schools (CDC)

On May 17, 2024 the U.S. Centers for Disease Control and Prevention (CDC) released consolidated, evidence-based guidance for preventing the spread of infections in K-12 schools. The guidance includes everyday actions that schools can take to prevent and control the spread of respiratory and stomach viruses, such as influenza and norovirus, and bacterial illness, such as strep throat. This guidance is designed to maximize school attendance and its benefits for all students, while also preventing the spread of infectious diseases. Being in school provides many benefits, including ongoing learning and social and emotional development. 

Guidance for preventing the spread of respiratory viruses when your sick (CDC)

On May 17, 2024, CDC also released guidance for preventing the spread of respiratory viruses when you're sick. The guide includes core prevention strategies to protect yourselves and others from respiratory viruses when experiencing symptoms.  CDPH recommends following the CDC guidance on Preventing the Spread of Respiratory Viruses When You're Sick for confirmed or suspected cases of COVID-19 infection. 

Considerations when a child has symptoms of illness in child care or school (CDPH)

On Oct. 2, 2023, California Department of Public Health (CDPH) in consultation with the California Department of Social Services (CDSS) and the California Department of Education (CDE), released considerations when a child has symptoms of illness in child care or school.  This guidance is intended to support decision-making for situations when an individual child has symptoms of illness in child care or school settings. General recommendations and symptom-based considerations are provided.

Cal/OSHA COVID-19 Guidance: Cal/OSHA COVID-19 Resources

As of Feb. 3, 2025, there is no longer a specific set of regulatory requirements relating to COVID-19 prevention in the workplace. Employers will still be required to maintain a safe and healthful place of employment as required by Labor Code section 6400, and must establish, implement, and maintain an effective Injury and Illness Prevention Program (IIPP) as required by Title 8, California Code of Regulations, section 3203. If an employer identifies COVID-19 as a workplace hazard at their place of employment, then the employer must identify, evaluate, and correct any unsafe or unhealthy conditions, work practices, or work procedures that are associated with COVID-19.

County Resources for Diseases and Conditions

San Diego County Health and Human Services Agency compiles the latest resources on diseases, conditions, and vaccines, on its website. You can find materials for each disease, including fact sheets, infographics, brochures, and more.  

Measles is a highly contagious virus that infects the respiratory tract and then spreads throughout the body. It begins with a fever that lasts for a few days followed by a cough, runny nose, conjunctivitis, and a rash that typically appears first on the face then the rest of the body. Measles can cause serious health complications, especially in children younger than 5 years old. The best way to prevent measles is with the measles, mumps, and rubella (MMR) vaccine.

Templates

• Parent letter about monitoring measles outbreaks

Resources

• Measles information webpage - San Diego County Health and Human Services
• Measles FAQs in multiple languages for parents and schools - Los Angeles County Public Health
• Measles outbreaks and activity webpage - California Department of Public Health
• Measles cases and outbreaks - U.S. Centers for Disease Control and Prevention

Resources

• Parent letter about triple threat of RSV, flu, and COVID-19
• Parent letter about flu season
• CDPH communications toolkit
• San Diego County influenza webpage
• Flu shot locations in San Diego County and across the state

Tips To Help You Stay Safe This Flu Season

• Get a flu vaccine
• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it and wash your hands.
• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth with unwashed hands. Germs spread this way.
• Clean and disinfect surfaces and objects that may be contaminated with germs that can cause respiratory illnesses like the flu.
• Avoid close contact with people who are sick.
• If you are sick, limit your contact with others as much as possible so you don’t spread your infection to them.

Pursuant to California Education Code Section 49452.6, this type 1 diabetes information provided by the California Department of Public Health is for local educational agencies to provide to parents and guardians of incoming elementary school students beginning Jan. 1, 2023. The fact sheet includes information about risk factors, warning signs, screening tests, and treatments.

The County of San Diego is monitoring the Tijuana River Valley and beach water sewage crisis in South San Diego County and the potential impacts on health and quality of life. 

To support the community, the county’s website provides information and resources on the health concerns and impacts from sewage and pollution on the surrounding communities. 

They have a dedicated page of resources for schools, including guidance around reducing exposure to harmful gases and poor air quality associated with this crisis.

Individuals are encouraged to report air quality concerns to the County of San Diego through the San Diego County Air Pollution Control District, which is actively investigating numerous odor complaints from communities surrounding the Tijuana River Valley.

Report odor complaints to the San Diego County Air Pollution Control District:

• Mobile app (available on Google Play and the App Store)
• Phone at 858-586-2650
• Email to apcdcomp@sdapcd.org, or
• Visit online

The Tijuana River Research Project at SDSU is also asking individuals who show negative health symptoms associated with pollution in the region to share details by taking their Community Health Survey. Adults should submit information on behalf of their child. 

• California School Nurses Association
• National Association of School Nurses

School Nurses Resource Meeting (Virtual)

Please visit the Health and Well-Being page for a complete list of professional development opportunities and events offered by SDCOE.

The disease / disorder-based Individual Student Healthcare Plan (ISHP) templates are provided by credentialed school nurses from all over San Diego County. Many thanks to all those who have contributed and will contribute as we add to the list.

There are many approaches to developing ISHPs for our students. These Word templates are downloadable and editable and merely provide a starting point for individualizing the care and approach our students need and deserve. Some students with multiple concerns may require sections from several of the templates to be incorporated into their ISHP. 

A   B   C   D   E   F   G   H   I   J   K   L   M   N   O   P   Q   R   S   T   U   V   W   XYZ

 

A

• Attention Deficit Hyperactivity Disorder
• Adrenal Insufficiency
• Allergy and Anaphylaxis Emergency Plan
• Anaphylaxis
• Anemia
• Angioedema
• Anomalous Aortic Origin of a Coronary Artery
• Anxiety
• Aplastic Anemia
• Asthma Symptom Action Plan (ASAP)
• Autism
• Autoimmune Hepatitis

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B

• Bipolar Disorder

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C

• C4-Quadriplegia
• Central Line
• Cerebral Palsy
• Chiari's Malformation
• Chronic Kidney Stones
• Chronic Renal Failure
• Complex Regional Pain Syndrome
• Conversion Disorder
• Costochondritis
• Cystic Fibrosis

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D

• Depression
• Diabetes Type I
• Diabetes Type I Independent
• Diabetes Type II
• Diapering/Toileting Procedure
• Diapering/Toileting Procedure Slides
• Down Syndrome
• Duchenne Muscular Dystrophy
• Dysmenorrhea
• Dysthymia

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E

• Encephalitis - Status Post
• Encopresis
• Eosinophilic Esophagitis
• Epidermolysis Bullosa
• Ewing's Sarcoma

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F

• Fibromyalgia
• Fragile X

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G

• Gastritis
• Gastrostomy
• Gluten Related Disorders

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H

• Hearing Loss
• Heart Transplant
• Hemophilia
• Henoch-Schonlein Purpura (HSP)
• Hydrocephalus
• Hypertension

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I

• IgA Nephropathy
• Inflammatory Bowel - Crohn's Disease
• ISHP Blank Template

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J

• Juvenile Degenerative Disc Disease
• Juvenile Macular Degeneration
• Juvenile Rheumatoid Arthritis

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K

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L

• Latex Allergy
• Leukemia
• Liver Injuries
• Lowe Syndrome

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M

• Marfan Syndrome
• McArdle Disease
• Migraines
• Multiple Sclerosis
• Myelomeningocele

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N

• Narcolepsy
• Nephrotic Syndrome
• Neurofibromatosis
• Noonan Syndrome

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O

• Oral Aversion
• Osteogenesis Imperfecta
• Ostomy

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P

• Phenylketonuria
• Pituitary Adenoma-Hormonal Imbalance
• Post Concussion Syndrome
• Post Rattlesnake Bite
• Postural Orthostatic Tachycardia Syndrome
• Prader Willi Syndrome
• Pseudotumor Cerebri
• Psoriatic Arthritis
• Pulmonary Atresia

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Q

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R

• Rectal Prolapse

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S

• Schizophrenia
• Severe Allergic Reaction-Anaphylaxis
• Sickle Cell Anemia
• Spondyloarthritis
• Status Post Care Gastrointestinal Bleed
• Steroid Hyperglycemia
• Student with 1-1 LVN at school
• Suicidal Ideation
• Syncope

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T

• Toileting/Diapering Procedure
• Toileting/Diapering Procedure Slides
• Traumatic Brain Injury
• Trisomy 21
• Tubular Sclerosis

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U

• Urinary Catheters
• Urinary Frequency

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V

• VP Shunt

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W

• Waardenburg Syndrome

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XYZ

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As you may be aware, there is an opioid epidemic impacting people of all ages in this country. Thankfully, the documented impact on teens in San Diego County remains extremely low. But even one child using drugs and putting their life in jeopardy is one too many. To promote awareness and aid districts in obtaining naloxone, a life-saving drug that reverses an opioid overdose, SDCOE has gathered a variety of resources to provide instruction and guidance in this process. 

The California Department of Health Care Services' (DHCS) Naloxone Distribution Project (NDP) is funded by Substance Abuse and Mental Health Services Administration and administered by DHCS to combat opioid overdose-related deaths throughout California. The NDP aims to address the opioid crisis by reducing opioid overdose deaths through the provision of free naloxone, in its nasal spray formulation. Since October 2018, qualified organizations and entities have been able to request free naloxone from DHCS. SDCOE recommends all county districts partner with DHCS.

Supporting Documents and Information

• California Department of Health Care Services (DHCS) — Naloxone Distribution Project (NDP) Website 
• California DHCS - Statewide Standing Order and Training Video for Naloxone
• California DHCS — Naloxone Distribution (NDP) Flier
• California DHCS — Naloxone Distribution (NDP) Overview
• SAMHSA Overdose, Prevention and Response Toolkit
• Template — Standing Physician Orders (.docx)
• Sample — Naloxone Policy and Procedure (.docx)
• Sample — Opioid Antagonist Board Policy (.doc)
• Overview — Assembly Bill #1748, Chapter 557 (PDF)
• Overview — CA Education Code Section 49414.3 (PDF)
• California School Nurse Organization- Guideline for Specialized Health-Care Services in Educational Settings: Opioid Antagonist (includes all documents to meet CA Ed Code 49414.3; training guidelines, checklists, request for volunteers, etc)

Other sources for free Narcan for schools

• SAY San Diego

SAY San Diego can provide free training regarding fentanyl and opioid risks, how to recognize opioid overdose symptoms, and how to use Naloxone to try and reverse the overdose. We can distribute Narcan nasal spray and Fentanyl test strips to those who attend the training and request it.  Our services, the Narcan nasal spray, and Fentanyl test strips are provided at no cost. SAY is funded by the County of San Diego to do alcohol and other drug prevention in the community and in collaboration with the Harm Reduction Coalition of San Diego.  SAY can provide this training anywhere in San Diego County. 

SAY can provide training to:

• Parents, community members, community groups, civic organizations
• School staff and students (middle and high school)
• Law enforcement and first responder 
• Military personnel
• Transitional age youth (ages 12 -25)
• College students and staff
• Trade schools
• Justice involved youth and adults

To request free presentations, receive Narcan Nasal Spray and/or Fentanyl Test Strips please contact:
William Perno, wperno@saysandiego.org or Claudia Ciarmoli, cciarmoli@saysandiego.org
 

• ADAPT Pharma Application for Free Narcan Nasal Spray High School Program Order (PDF)

 

This toolkit aims to share sample protocols/policies, templates, and resources that align with best practices when identifying and supporting students who are possibly under the influence of drugs.

These materials were created by the SDCOE’s Student Wellness and School Culture Department with input from more than 200 California credentialed school nurses and San Diego physicians. 

 

Return to the Health and Well-Being Webpage

• CDPH health guidance for schools on sports and strenuous outdoor activities during extreme heat (rev. May 22, 2024)
• SDCOE tips and resources for staying safe during extreme heat

 

AB 367 Menstrual Equity

Assembly Bill 367 requires California public schools to provide free pads and tampons in campus bathrooms.

What’s the Requirement for Schools?

On or before the start of the 2022-23 school year, Assembly Bill 367 requires a public school, including a school operated by a school district, county office of education, or charter school, maintaining any combination of classes from grades 6 to 12, inclusive, to stock at all times an adequate supply of menstrual products, available and accessible, free of cost, in all women’s restrooms and all-gender restrooms, and in at least one men’s restroom.

There also needs to be a notice posted about the requirements of the bill section related to grade 6-12 schools in a prominent and conspicuous location in every restroom required to stock menstrual products. 

• Resource guide with requirements for schools and template notices

The California Department of Public Health (CDPH), in partnership with the California Department of Education (CDE), issued in April 2024 a statewide standing order to help reduce morbidity and mortality associated with anaphylaxis by facilitating the distribution and administration of epinephrine in California schools. This standing order authorizes a California school (public, charter or private), school district or county office of education to obtain epinephrine auto-injectors for elementary schools, junior high schools, middle schools, and high schools.

You can find additional information on the CDPH and CDE websites. 
CDPH Standing Order Site - Home (ca.gov)
Administration of Epinephrine Auto-Injectors - Health Services & School Nursing (CDE)

In partnership with the California Department of Education (CDE) and the California Department of Health Care Access and Information, and to support local medical emergency planning associated with California Education Code (EC) Section 49414.7, the California Department of Public Health (CDPH) has issued a statewide standing order for albuterol to provide emergency medical aid to persons suffering, or reasonably believed to be suffering, from respiratory distress in California schools.

• Apply Now
• Albuterol Standing Order Frequently Asked Questions 
• Administration of Albuterol Inhalers - Health Services and School Nursing (CDE)

You can find additional information on the CDPH and CDE websites.

The California Department of Education confirmed that the sunset of the CHDP program has cancelled the requirement where students were required to get CHDP physicals for Kindergarten/First grade entry. It is no longer a mandate after July 1, 2024.