Get Annual Immunization Report On Children Enrolled In Child Care Centers - Cdph Ca

Filling out the Annual Immunization Report is essential for ensuring compliance with public health regulations regarding children's immunizations. This guide will provide you with clear and detailed instructions to help you complete the form efficiently and accurately online.

Follow the steps to complete the report effectively.

1. Press the ‘Get Form’ button to access the report and open it in your preferred online editor.
2. Select the type of facility, either public or private, and provide the necessary information in the relevant fields, including the center name, address, city, zip code, and phone number.
3. Obtain immunization records from the California School Immunization Records (PM 286) for all enrolled children. Refer to the specific sections on the report for different age ranges.
4. Fill in the Vaccine Dose Summary for children aged 2 years through 4 years, 11 months by entering the total doses for each vaccine listed, ensuring to follow the worksheet for grand totals.
5. Complete the Exemptions section by indicating the number of children exempt from immunizations for medical reasons and those exempt for personal beliefs.
6. In the Follow-Up section, report the number of children needing follow-up and those who do not need follow-up, ensuring the total matches the enrollment of children ages 2 through 4 years, 11 months.
7. Provide your name and the date when completing the form and review all entries for accuracy before finalizing.
8. Once all fields are completed, save your changes, and download or print the report if needed, ensuring to return the top copy to the Immunization Coordinator at your county health department.

Complete your Annual Immunization Report online today to ensure accurate record-keeping for child care centers.