The Los Angeles Times from Los Angeles, California • 46

VIE San Diego County Tuesday, September 17, 1985Part Cos Angeles (Times Health Child Care Facilities in County Fall Short on Health Provisions By MAGGIE LOCKE SAN DIEGO A San Diego preschooler once managed to infect three day care households and at least a dozen children with impetigo, an acute, contagious skin disease. None of the day care providers recognized the disease or knew what to do about it once they realized it had spread; they simply turned the child away and disinfected their homes. Meanwhile, the mother went on to place her child in a new home. But impetigo's spread can be easily stopped if quickly recog I'd like to see the state set more uniform standards. The way it is now, there's nothing to go by.

Maybe we should set up some sort of rating system Inspector Dana Lovalaca be there, and if you've got a young child, you're going to be out a lot." Walls is leading local pediatricians in the effort to examine day care health as chairman of the infant and preschool child committee of the local chapter of the American Academy of Pediatrics. Infections most commonly upper respiratory and gastrointestinal infections spread rapidly and frequently in day care. Walls committee of local child care experts wants to develop practical ways to reduce the spread of infections and DAY CARE HOMES: A DILEMMA Phoux by BOB GRIESER Lot Angela Timet anyone could do this without a structure," she says about running her own day care home. Some children at play on a climbing dome in Sabrina Woods' backyard. "I don't know how MM Some Youngsters Get Better Care Than Others treat the sick child within the day care setting.

"Colds and diarrheaall kids in day care have them, it's just a question of time," Walls said. "Isolating sick children has been considered, but it is not practical, and it only delays the problem. We feel it is best to leave children in day care and give guidelines to treat them." Walls wants to train day care providers in basic health care and cardiopulmonary resuscitation for infants and chil nized, cleansed, treated with a topical antibiotic and covered with a bandage, doctors say. Treating common ailments like this has captured the attention of pediatricians who face new questions as more of their patients grow up in day care situations. The health of the day care child is becoming so significant a medical issue that the American Academy of Pediatrics gives it top priority.

The issues range from stopping the spread of in Who's watching your children? Most of San Diego County's children who are cared for while their parents work are in day care homes. Many child care experts say such homes can be enriching experiences for children, but there are problems locally. Today, in the second of a four-part series, health problems at some centers are examined and the vast differences in quality among county homes are explored. By MAGGIE LOCKE SAN DIEGO-Dana Lovelace, a San Diego social worker who works in family day care, says the most frustrating part of her job is that she must license homes in which she wouldn't want to leave her own child. Many of her colleagues at the county Department of Social Ser-vices feel the same AS way.

They complain DIEGO that reQuirements to COUNTY Pen a day care DUSi ness at home aren't stiff enough and that the lack of uniform standards creates too broad a variety of licensed care. A licensed home can be a spotless, well-managed household that offers a structured schedule of play and learning activities. It can also be a dirty, chaotic place where children are left to entertain themselves while adults come and go. "I'd like to see the state set more uniform standards," Lovelace said. "The way it is now, there's nothing to go by.

Maybe we should set up some sort of rating system, like restaurants have, to at least give parents an idea of what to expect" Safety Not Guaranteed The license means that the day care operator and other adults in the home were checked for criminal background and tuberculosis, and that the home was checked for basic safety. But because inspections are so and was named parent volunteer of the year by the South Bay Head Start program in 1984. The slim, energetic woman left teaching preschool early this year to open a day care business in her own home, a clean, comfortable tract house in a quiet Chula Vista neighborhood. She lives there with her husband, who works in marine electronics; her two school-age daughters, and her 18-year-old brother, who is a clerk in a store. Woods converted a small dining area of her kitchen into what looks like a mini-preschool for the five boys and one girl in her care this summer.

Brightly colored letters and numbers line the walls, alongside pictures of rainbows and posters proclaiming "Happiness Is Where You Least Expect It" and "Sunny Thoughts Bring Happy Smiles." A pint-size set of table and chairs surplus kindergarten furniture Woods bought at auction sits in the middle of the room. Educational toys sit on another low table along one wall. Beneath the table are colored plastic baskets marked with the children's names and filled with clothing, blankets and special stuffed toys. The boys, ages 2 through 7. had just awakened from naps and were eating a snack of juice and graham crackers with peanut butter all except one chubby, freckled preschooler, who sat draped over his chair, refusing to wake up.

Please see DANA, Page 6 Woods helps some of the children in her day care program. dren during daylong workshops at local hospitals. The California division of the academy has proposed state legislation that would require providers to be certified in such training. Four hours would be devoted to CPR and another four hours to leading child health issues: safety, infectious disease, hygiene, child development, child abuse and nutrition. Participants would then be tested.

Walls also wants to supply child care providers with simple-to-read health manuals and telephone listings of the many San Diego agencies and groups that have information on child care issues. "There is a lack of community support for day care," Walls said. "There are many community resourcesfrom the Beechnut Hotline to Mercy Hospital's outreach Please tee HEALTH, Page 8 fections to recognizing child abuse. But health problems plague the family most because childhood illnesses mean a parent misses work. "It's an extremely emotional issue," said Dr.

Richard Walls, a La Jolla pediatrician who estimates that 75 of his patients are in day care. "When the baby gets sick over and over in day care, the parents start to see the baby as a problem, because one of them has to stay home. It gets into questions as to who is the major provider it just tears at the faroiiy. One of the solutions is quick -and -easy day care. Families need convenient and affordable day care to get by.

"There are many debates in pediatrics on this issue. The physician can't figure out what to do with the sick child in day care. I understand the dilemma of the employer as well. In a small office, you depend on that person to point of telling parents that they cannot recommend any of the day care homes they refer by phone. One home visited with Lovelace and another visited informally illustrate the extreme differences in local licensed homes.

infrequent, even basic safety cannot always be guaranteed in licensed homes. A 15-month-old girl drowned in an uncovered and un-fenced hot tub this summer in a Spring Valley day care home. Pools and the like must be fenced or covered under day care regulations, but that home had not been inspected by the county in five years. People at the state-funded local Childcare Resource Service make a Sabrina Woods, 29, holds a child development degree from Southwestern Community College. She taught preschool for seven years Classes Buoy Handicapped Swimmers Learning Safety, Exercise and Fun Food and Fitness Still a Place for Lean Meat in the Diet By DR.

LAWRENCE POWER To the anguish of the nation's cattlemen, five years ago the surgeon general noted that Americans would be healthier if they ate less meat. Last year the American Cancer Institute and the American Heart Assn. supported the surgeon general by telling us to cut back on fatty foods, mentioning meat. Meat is a major source of fat and cholesterol in our diets, but it's also a major source of blood-building iron. During every minute of life in a normal human adult, about 150 million red blood cells must be manufactured, released and stocked with iron-rich hemoglobin.

That's more than 2 million cells a second and calls for lots of iron, most of it recycled from the 2 million cells that disintegrate each second, so a balance is maintained. But iron losses do occur especial-Please see FITNESS, Page 7 By MIKE EBERTS Two attendants lift Dee Dee Heath out of her wheelchair and onto the lip of the deck at the Sepulveda Pool. Her legs dangle limply in the water. "Go for it!" exclaims her husband, George. She leans forward, her weight slowly shifting until she belly-flops into the water.

She lies face-down for a second, motionless, then twists her face up for air and propels away from the shallow end, using what she calls "a modified crawl." Her arms barely leave the water and her kick is stiff and weak, but it works. Heath, 29, the mother of four, was diagnosed at 11 months old as having cerebral palsy. This summer, she was one of about 4,000 handicapped people who visited 25 Los Angeles city pools that participated in an Adapted Aquatic Swim Program, either for special swim lessons or for recreational swimming. The program continues this fall at eight year-around pools operated by the city and other local facilities. Compassion, Creativity Teaching the physically or mentally handicapped to swim takes compassion, creativity and know-how.

"It's not just like (having) a pool full of kids," said Joe Jondreau, a private adaptive aquatics instructor. "The ultimate goal is water safety," said Tracy Davis-West, coordinator of adapted aquatics for the Pacific Region of the Department of Recreation and Parks, "but we also try to get across that the water can be fun." Certain basics are covered with all disabled people. Breath control is important, although it is not the first skill taught in some cases. According to Vicki Geyer, who teaches adaptive physical education for the Los Nietos School District in Whittier, some physically handicapped people first are taught to float on their backs as a safety precaution. Movements that are taken for granted by those without handicaps must be adapted to the particular limitations of the handicapped swimmer.

Geyer tells her physical education students to gather background information on each prospective swimmer's disability or impairment. Her 24-hour course includes simulations in which the student teachers sample being blind or otherwise physically impaired. She urges her students to put themselves in the place of the handicapped. "They (the teachers) have to accept their swimmers as persons," she said. For a handicapped person, simply getting in and out of the pool can be a problem.

Like Heath, most wheelchair-bound people use a two-person lift. However, some pools are equipped with ramps and hydraulic lifts. Davis-West said adaptive aquatics teachers must be creative, assessing each student's limitations and abilities as well as the swimming environment, to develop a program around them. They often must devise a modified swim stroke for disabled students. Water Temperature Important The water must be just right for some swimmers.

Water temperatures around 90 degrees are desirable for people with such disorders as muscular dystrophy or cerebral palsy, Geyer said. Heath said she feels uncomfortable if the water temperature is lower than 85 degrees. Also, it is easier to get out of the pool if the water level is high. Once in the water, success is measured in the trust that teachers build with their students. "If they don't feel safe, they don't have fun and don't learn," Jondreau said.

With mentally handicapped people, the instructors must simplify processes, provide plenty of repetition and above all-learn patience. "What it takes a regular swimmer one summer to learn, it takes us three (to teach)," said Geyer, who also works with the trainable mentally retarded. Please see SWIMMING, Page 4 III 4" Inside View ASTROLOGY: Carroll Righter's forecast. Page 2. BOM BECK: She loses yards on daughter's run.

Page 8. BRIDGE: Alfred Sheinwold column. Page 8. DEAR ABBY: Her parable prompts a poem. Page 3.

Jack Smith is on vacation. Li ii RICK CORRALES Adaptive-aquatics teachers instruct developmentally disabled children at a Whittier pool. In the foreground, Michele Lakin assists Jaime Espinosa, 5..