Student Health Services

Credentialed School Nurses

Nurse Coordinator: Oversees the District Nurses and helps to coordinate services and care for all students in CUSD.

• Megan Bustle, MPH, RN, PHN 

District Nurses: District Nurses are specialized in ensuring students with health conditions have their health needs met, while also promoting equitable access to learning. District Nurses collaborate with healthcare providers to create Individualized Health Plans, 504s, and IEPs for students with health needs. District Nurses also provide information and training to unlicensed school staff members as appropriate to ensure the health and safety of students.

• Yaya Alimi, BSN, RN: Hyde, DeVargas, Dilworth, Eisenhower
• Sarah Brown, RN, CSN: CMS, Lincoln, Montclaire, West Valley
• Catherine MacDougall, RN: Kennedy, Stevens Creek, Eaton, Faria
• Thanh "Katie" Tran, RN, PHN: Lawson, Collins, Nimitz, Stocklmeir
• TBD: Miller, Blue Hills, McAuliffe, Muir
• Thelma Floresca: Murdock-Portal, Sedgwick, Garden Gate, Preschool/LEAP, NPS/Private

Site Nurses

Site Nurses: School site nurses implement the plan that is created by the District Nurse. School site nurses also manage medications and provide daily care/first aid in health offices.

• Sunshine Adona, LVN: Hyde Sedgwick
• Cheryl Apodaca, LVN: Lincoln, Montclaire, Kennedy
• TBD, LVN: Faria, Muir
• Shyno George, LVN: Eisenhower, Stocklmeir
• Julie Low, RN: McAuliffe
• Margaret Torcuato, LVN: Cupertino, Garden Gate, Stevens Creek
• Suja Varughese, LVN: Miller, Eaton
• Alejandra Canton, LVN: Nimitz, West Valley
• Khay Escote, LVN: Blue Hills, Murdock-Portal
• Itzel Mendoza, LVN: Lawson, Collins
• Vanessa Laconico, LVN: De Vargas, Dilworth

Health Clerks

Health Clerks: Health Clerks are our organizational superstars, gathering and organizing data regarding immunizations, health screenings, and student health conditions that require the attention of the Nurses. Health Clerks can be contacted at healthclerks@cusdk8.org

• Samantha Garza: Collins, De Vargas, Dilworth, Eaton, Eisenhower, Faria, Garden Gate, Lincoln, Montclaire, Sedgwick, Montclaire, YCC
• Guadalupe De Almanza: Cupertino, Kennedy, Lawson, Nimitz, Stevens Creek, Stocklmeir, West Valley
• Lydia Burnham: Hyde, Miller, McAuliffe, Blue Hills, Murdock-Portal, Lincoln, John Muir

CDPH Illness Guidelines for School

https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Schools/SymptomGuidance.aspx 

Please note: This document does not apply to students who have tested positive for COVID-19. If your child has tested positive, please go to this link for instructions.

The decision to keep your child home is not an easy one to make. Keeping ill children home from school is intended to protect not only the ill child, but also classmates and instructional staff. This note outlines the criteria for keeping students home when they are ill and for sending children home when they appear to be suffering from a contagious or infectious disease (Ed.Code section 48211, 48212).

Use the sign/symptom guidance table ONLY if:

1. The child can participate meaningfully in child care or school activities; AND
2. The staff can provide appropriate care without compromising the health and safety of other children.

If these criteria are not met, the child should be sent home.

A child’s parent/guardian should be notified if their child has any of the signs or symptoms in the table below. 

Special attention to handwashing is recommended.
Warrants immediate medical attention.
Consider masking for respiratory illness.

Sign/Symptom	Symptom definition and additional criteria for when the child should stay home
Abdominal pain/stomachache	Definition: Pain experienced anywhere between the chest and groin, pain may be continuous or may come and go. May attend school or child care unless the child has one of the following:  Pain is severe enough that child has difficulty participating in routine activities Pain starts after an injury Bloody or black stools Diarrhea (see Diarrhea) Vomiting (see Vomiting) No urine for 8 hours (dry diaper, or ask older children if they have urinated since they woke up) Fever (see “Fever" for return guidance)
Cough and cold symptoms	Definition:  May include runny/stuffy nose, sore throat, sneezing, congestion, body aches, and/or cough, typically lasting up to 7-10 days. May attend school or child care unless the child has one of the following: Fever (see “Fever" for return guidance) Difficulty with or rapid rate of breathing (see “Difficult or noisy breathing") Cough is severe or child cannot catch breath after coughing For a cough suspected to be associated with asthma: coughing that cannot be controlled by the medications that the child care or school has been instructed to use
Diarrhea	Definition:  Stools that are more frequent (typically at least two more than normal) or less formed than usual for that child AND not associated with a change in diet.  Note that young infants may normally have frequent, somewhat watery stools, particularly if breastfed. May attend* school or child care unless the child has one of the following: Stool not contained in the diaper or toilet (when toilet-trained) Stool looks like it contains blood or mucus, or appears like sticky black tar Yellow skin/eyes (jaundice) Diarrhea that occurs during an outbreak, and exclusion is recommended by the local health department  (continued on next page) *Note: If the child has been diagnosed with a specific infection (such as Shigella, Salmonella/typhoid, Shiga toxin-producing E. Coli, norovirus, etc.), follow the advice of the local health department if they are involved, or the guidance of the child's health care professional.    If there is concern for an outbreak (more persons with diarrhea than would be expected in the setting for that time of year), contact the local health department for guidance.
Vomiting	Definition: Expulsion of stomach contents  May attend school or child care unless the child has one of the following: Vomiting has occurred 2 or more times in 24 hours Note: Student may return when vomiting has ended overnight, and child is able to hold down liquids and food.
Earache	Definition:  Pain (dull, sharp, or burning sensation) experienced inside the ear. May attend school or child care unless the child has one of the following: Fever (see “Fever" for return guidance) Behavior changes Pain pr​​events participation in routine activities
​Eye irritation, pink eye, or drainage	Definition: Red or pink appearance to the white part of the eyeball.  Child's eye may also be itchy, have crusted/matted eyelashes, more watering than normal, or yellow/white drainage. May attend school or child care unless the child has one of the following: Problems seeing (vision changes) An injury to the eye involving forceful impact to or penetration of the eye Pain or discomfort the child cannot tolerate Note:  Pink eye (i.e., conjunctivitis) is inflammation of a layer that covers much of the eyeball. It is most often caused by a virus, and children with viral pink eye typically get better after 5-6 days without antibiotics. Staying home from school or child care is not necessary.  Frequent hand washing should be encouraged.  Eye irritation can also result from allergies or ch​​emical exposures (e.g., air pollution, smoke, or swimming in chlorinated pool water).
Fever	​Definition:  An oral (under the tongue), temporal (forehead), rectal, or axillary (underarm) temperature above 100.4°F (38°C). Axillary (underarm) measurements should be used only if other options are not available. Follow instructions for the specific thermometer, including directions for use, cleaning and covers (if applicable). If a temperature is close to 100.4°F, repeat to confirm the result.  It is ONLY recommended to take a child's temperature if the child seems ill, feels hot, or has other symptoms or signs of illness. Checking the temperature of a child or group of children to allow entry (also known as screening) is NOT recommended in school or child care settings. Unless otherwise directed by a healthcare provider, a child with another symptom or sign of illness who also has a fever should NOT attend school or child care.  Return when: Fever went away in the night – without using fever reducing medications, e.g., Tylenol®, Advil®, Motrin® (acetaminophen or ibuprofen) - and is still gone in the morning; AND Other symptoms are improving and the child can participate comfortably in routine activities.

If you do not have health insurance, the Children’s Health Initiative of Santa Clara County will help your family obtain free and low-cost health, dental and vision insurance. There are three insurance programs: Medi-Cal, Healthy Families and Healthy Kids. Please call 1-888-244-5222 to speak to an intake worker (many languages are spoken) who will help you find a program for your child.

District School Nurses

If your student needs medication while at school, please note the following:

• Instructions for Medications in School
• Schools do not supply any medication to students, including over-the-counter (OTC) medications such as Benadryl, Tylenol, etc. Medications must be supplied by the student's parent or legal guardian.
• Each medication, whether prescription or OTC, should be accompanied by a signed doctor's order (see student medication authorization form)
• Each prescription medication should have a pharmacy label and all medications should be in the original box/container. The label should match the doctor's order.
• The Student Medication Authorization Form must be completed, front and back, and signed by both the physician and the student's parent or legal guardian. EACH prescribed and/or OTC medication must be listed on the Authorization Form.
• For anaphylactic allergy medications, including EpiPens, the Food Allergy and Anaphylaxis Action Plan protocol must be completed.
• All forms and medication need to be placed in a gallon-size Ziplock bag and labeled with the student's name and grade on the outside.
• Please remember to check the medication periodically to make sure that it does not expire during the school year. Expired medications will be discarded.
• Students may self-carry and self-administer their own emergency medications, which includes Epi-Pen, Rescue Inhaler, and Insulin only. For students who will self-carry these medications, their medical provider must deem them competent to do so, and the Self-Administration Form must be completed and signed by both the student's healthcare provider and a parent or legal guardian. The School Nurse reserves the right to contact the prescribing healthcare provider if a student's competency regarding self-administration of their medications is questionable.
• All medication orders for the following school year must be dated after the end of the current school year.

See Asthma Action Plan.

Rules for Assisted Devices at School

1. Specific orders are needed from your healthcare provider to use assistive devices, and they must be provided by the student’s family. The school district does not provide assistive devices.

2. Students may attend school using assistive devices, but must have been taught proper use of the device(s) before returning to school. This information may be included in the doctor’s note.

3. School Nurses do not teach students how to use assistive devices, but may observe the student to determine that they can safely navigate the school grounds.

4. It is unsafe to use assistive devices on stairways. Please discuss with administration if this is an issue at your student’s school site.

5. Students who cannot do all of the above, will be sent home until such time as they are properly trained to perform these skills.

6. Students must be able to be responsible for not participating in restricted activities during recess and throughout the school day. Optional activities include bringing a book to read during recess. If a student cannot be responsible for not participating while out on the playground, other arrangements must be discussed with the site administrator.

7. For the safety of all of the students, the above practices will be followed by all CUSD schools regardless of grade level.

8. A note from a medical provider must be submitted to the school to clear the student for participation in physical activities once the assistive device(s) are no longer needed.

9. Should the student require activity restrictions after they are no longer in need of assistive devices, parents must submit a Physical Activity Recommendation form from their child’s healthcare provider. Alternatively, a comparable doctor’s note will suffice.

Cast/Ankle Brace/Special Boot Please provide a doctor’s note that specifies the device that the student needs to wear and for how long. Please have the doctor’s note specify any limitations, restrictions, or accommodations for the student while at school, including for PE.	Crutches Specific orders are needed from your healthcare provider regarding the use of crutches. Students may attend school using crutches but must have been taught proper crutch walking before returning to school. This information may be included in the doctor’s note.
Wheelchair Please provide the school office with a doctor’s note specifying the need for a wheelchair and for how long. The wheelchair must have brakes & a seatbelt. Please give us advance notice if possible regarding the use of a wheelchair at school.	Scooter Please provide the school office with a doctor’s note specifying the need for a scooter and for how long.  Students may attend school using a scooter, but must have been taught proper use of the scooter before returning to school. This information may be included in the doctor’s note.