Health Information and EpiPen Administration Policies and Procedures
Overview:
Crossroads Children’s Ministry is dedicated to bringing church and family together for a child’s spiritual growth. To do this, we strive to provide a safe environment for the children who attend our programming. One way we do this is to be aware of any medical problems a child has, including allergies. We know that allergies can be caused by various sources such as certain foods (peanuts, tree nuts, milk, wheat, etc.), animal allergies, insect stings or bites, medication, environmental agents, latex, etc. and that reactions range from mild to severe. We also understand that some children suffer from other health issues such as asthma or diabetes which may be taken into account in our programming.

To help up care for your child, we need you to complete the attached Detailed Health Form. If your child has severe allergies and you want our staff to administer an EpiPen in the event of an emergency, you must also complete and return Part 2 of the Detailed Health Form as well as the half-sheet EpiPen Administration Permission Form which we require to accompany your child’s EpiPen in a zip lock bag. Allergy policies and forms can be obtained at the Children’s Ministry Welcome Desk, or on the church website at crossroadsefc.com (see link below). If you have any questions or concerns, please contact Kristi Nate at childrensministry@crossroadsefc.com.

Snack Policies:
Outside snacks are sometimes brought in for special occasions. Parents are responsible for watching for any “Special Snack” signs at the Children’s Kiosk and ensuring that their child may safely enjoy the snack or informing their child’s teacher if the snack should not be given. If possible, original snack packaging for special snacks will be available so that parents may read the ingredient list.

Health/Allergy Forms Information:
1. We encourage any parent or guardian whose child has allergy or health concerns to submit a Detailed Health Form. If the child may require the use of an EpiPen, please also complete part two of the Detailed Health Form.

• Forms can be obtained at our Children’s Ministry Welcome Desk or on our church website at crossroadsefc.com (see link below)
• If there is a change in the child’s allergies and/or dosage or conditions under which EpiPens are to be given, please submit a new Detailed Health Form.

2. A half-sheet EpiPen Administration Permission Form should be completed and included in a zip lock bag with
provided Epi-Pens, consistent with the EpiPen policies below. EpiPen Administration Permission Forms may be
used week to week.

EpiPen Policies:
1. Children’s Ministry staff and volunteers are not professional medical personnel. However, basic EpiPen administration training is offered for staff and key volunteer leaders. While we attempt to have trained individuals present at all times, we cannot guarantee that such an individual will always be immediately available in the event of an emergency.
2. We do not provide EpiPens. They must be prescribed by a physician for a specific child and brought to church by a parent each time the child is in attendance.
3. If a child requires the use of an EpiPen, we must have the following:

• A Detailed Health Form with Part 1 and 2 completed and signed by the parent or the legal guardian.
• EpiPens inside a zip lock bag including the completed half sheet EpiPen Administration Permission Form.

EpiPens must be properly and clearly labeled with:

• The child’s first and last name
• The dosage of Epinephrine
• The expiration date (We will not accept expired EpiPens.)

4. Children’s Ministry staff and volunteers will not administer any medication except for an EpiPen in the event of
an emergency.

Procedures
1. If your child requires the use of an EpiPen, place the EpiPen into a zip lock bag with the completed half sheet EpiPen Administration Permission Form which may be reused from week to week.
2. The zip lock bag is to be hand-delivered to the teacher or adult in charge of the classroom or event unless the child is approved to carry his/her own EpiPens.
3. Classroom staff or volunteers will put the EpiPens in the Emergency Containers located inside all classroom doors and large group areas where they can be picked up by the parent at the end of the service/program. A classroom teacher can show you the location of the container for your child’s specific classroom and/or age group.
4. If your child has an anaphylactic reaction and has an EpiPen, the following will occur:

• The EpiPen in its respective zip lock bag will be retrieved from the Emergency Container.
• A Children’s Ministry staff member or volunteer will check the half sheet EpiPen Administration

Permission Form in the zip lock bag to determine parent permission and the EpiPen dosage information.

• An EpiPen will be administered by a Children’s Ministry staff member or volunteer. If no trained individual is available the EpiPen will not be administered until one is present.
• 911 will be called.
• The parents or legal guardian will be called by cell phone.

5. Take your child’s EpiPen with you at the end of the class or event. The Children's Ministry Staff is not responsible for any medication left at Crossroads Church and will not store EpiPens.