> For the complete documentation index, see [llms.txt](https://docs.caqualityearlylearning.org/printable-inspection-list-tool/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.caqualityearlylearning.org/printable-inspection-list-tool/basic-checklist/medical-forms.md).

# Medical Forms

This resource is only for CQEL members and is not to be redistributed. Please have interested programs contact CQEL at hello\@caqualityearlylearning.org

**Site Director:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Center Name:**  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Student forms**

* [ ] All students have up-to-date immunizations. 
* [ ] All students have a current physical, dental, and vision exam on file. 
* [ ] All students have filled out and returned Children's records, including emergency contact information. 
  * [ ] All students have filled out and returned the Prescription Medication Permission Form, and the Medication Logs are up to date.
* [ ] All students have filled out and returned Medical Information and Consent forms.
  * [ ] All students have filled out and returned Medical Liability forms
* [ ] All students have filled out and returned the Food Allergy form, Asthma Action Plan, and/or Anaphylaxis Emergency Care Plan.  
* [ ] All students have filled out and returned Emergency Treatment and Transportation forms

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_      **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Employee forms**

* [ ] All staff filled out and returned the Employee Emergency Contact Information
* [ ] All staff filled out and returned Employee Medical Records.
  * [ ] All staff returned up-to-date vaccine shot documentation
* [ ] All staff have [Mandated Reporter Certificates](https://mandatedreporterca.com/training/child-care-providers)
* [ ] All staff have CPR and First Aid Certificates

**Date:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_        **Signature:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**Inspection Findings:** \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_


---

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