South Carolina Department of Social Services Child Care Regulatory Services STAFF HEALTH ASSESSMENT Name: DOB: Type of Activity in Child Care: (Check all applicable) Adult Member of Household Food.
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How to fill out the Dss Form 2926 online
Filling out the Dss Form 2926 is a crucial step for individuals involved in child care activities in South Carolina. This guide provides clear instructions on how to complete the form online, ensuring compliance with health assessment requirements.
Follow the steps to ensure a complete and accurate submission.
- Click the ‘Get Form’ button to obtain the form and open it in the online editor.
- Begin by entering the individual's name and date of birth in the designated fields. Ensure this information is accurate as it is essential for identification purposes.
- Next, check all applicable activities related to the child care role under the Type of Activity in Child Care section. Multiple options can be selected.
- Part I requires completion by a health professional. They will need to indicate 'Yes' or 'No' for various medical history inquiries. Ensure that the health professional fills this section accurately.
- In Part II, the health professional must confirm visual acuity, hearing status, and blood pressure by selecting the appropriate options. Each of these needs to be checked and reported based on a recent physical examination.
- Part III addresses communicable diseases. The health professional must again respond ‘Yes’ or ‘No’ regarding any communicable diseases that may affect their ability to work in child care.
- For the Tuberculosis Certification, fill in the type of test, reading, and date as required, according to local health officer recommendations.
- Verify the immunization status, especially for those working with infants. The health professional should review and comment on the immunization status in this section if necessary.
- Finally, the health care provider must print their name, address, and add their telephone number. They will also need to sign and date the examination section to validate the assessment.
- After completing the form, save your changes. You can then download a copy for your records, print the form, or share it as required.
Start filling out your Dss Form 2926 online today to ensure compliance and facilitate a smooth child care operation.
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