Get California Hearing Conservation Program Forms - Dhcs

This guide provides step-by-step instructions for completing the California Hearing Conservation Program Forms - DHCS online. It is designed to assist individuals in navigating the form efficiently and accurately.

Follow the steps to complete the form with ease.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Identify and fill out the required identifying information, including the reporting school year and County District School (CDS) code number. This code can be sourced from the California Public School Directory.
3. Complete column (1) by listing all grades within the district that require screening. Pay attention to which grades have an asterisk, as students in those grades must be screened annually.
4. Fill in column (2) with the total number of students enrolled in each grade as recorded in the October CALPADS report.
5. In column (3), document the number of students who underwent initial screening per the specified section of the California Code of Regulations (CCR), Title 17.
6. For column (4), enter the number of students who failed both threshold tests as required by the CCR.
7. In column (5), indicate the number of students referred for medical and/or audiological evaluation based on the previous column.
8. Complete column (6) by noting how many students were examined by a doctor or audiologist or who are currently receiving treatment.
9. Provide information about special education services, detailing the audiometric and medical services used for students in need of special education.
10. Check the appropriate boxes to identify the personnel conducting the testing. Include the name of any authorized agency or individual involved.
11. Once all fields are completed, save your changes. You can then download, print, or share the form using the available functions.

Start filling out your documents online to ensure timely submission.