1. C ALIFORNIA D EPARTMENT OF P UBLIC H EALTH, I MMUNIZATION B RANCH 07/20161 C ONDITIONAL A DMISSIONS

2. Children must meet one of these conditions for conditional admission: 2 Conditional Admission for Child Care 07/2016 California Code of Regulations A valid Temporary Medical Exemption requires submission of a licensed physician’s written statement which states: the physical condition or medical circumstance of the child is such that the required immunization(s) is not indicated; the vaccine(s) to be exempted; and the date the temporary medical exemption will end.

3. 307/2016 Refer to “Laws” Tab for Details

4. Conditional Entrants For Child Care Self Check Under which three conditions may children be admitted into child care as conditional entrants? 407/2016

5. Implement Immunization Requirements Preparing for a Child’s 1 st Day: Conditional Admission 507/2016 Under 18 months old? Look to Guide for Immunizations Required for Child Care or Preschool to determine if the child may be admitted. Eileen, I added this slide to distinguish between conditional admissions under 18 mos and over 18 mos old.

6. Implement Immunization Requirements Preparing for a Child’s 1 st Day: Conditional Admission 18 months or older and missing doses for age? Look to Table 2 to determine if the child may be admitted. 607/2016

7. Implement Immunization Requirements Preparing for a Child’s 1 st Day: Conditional Admission Use Notice of Immunizations Needed letter to notify parents of vaccines due before admission. 707/2016

8. Conditional Entrants: Under 18 Months Old Throughout the Year Determine timing for the next dose in a series: Children are due for the next dose in a series at the beginning of the age category. 807/2016

9. Conditional Entrants: 18 Months or Older Throughout the Year Determine timing for the next dose in a series: 907/2016

10. Conditional Entrants Throughout the Year Step by Step: 1.Create a reminder entry in your follow-up system to notify parents or guardians when next shots are due. 2.Use the Notice of Immunizations Needed letter and Parents’ Guide to Immunizations Required for Child Care or Preschool to inform parents of the next doses needed. Please make sure you include the deadline. 3.Review records at least every (30) days. If you discover a child has missed the next dose and was not excluded, child-care facilities must notice parents or guardians and may give them up to (10) school days to comply before the child is excluded. 1007/2016

11. Conditional Entrants: Under 18 Months Old For Child Care Self Check Today is November 2, 2015. You are running your monthly follow-up report and are reminded that Jose will turn 15 months and age into new requirements in one month. What will you do? 11 Steps 1.Compare number of doses on his Blue Card to Guide to Immunizations Required for Child Care or Preschool. Jose will need an additional polio shot, additional dose of Hib (on or after 1 st birthday), and (1) MMR (on or after 1 st birthday). 2.Contact and send parents the Notice of Immunizations Needed letter. 3.Create another entry in your follow-up system to ensure that those doses are received when due. 07/2016

12. C ALIFORNIA D EPARTMENT OF P UBLIC H EALTH, I MMUNIZATION B RANCH 07/201612 C ONDITIONAL A DMISSIONS

13. Children must meet one of these conditions for conditional admission: 13 Describe How Children May Be Admitted Conditional Admission for TK/K-12 California Code of Regulations 07/2016 A valid Temporary Medical Exemption requires submission of a licensed physician’s written statement which states: the temporary physical condition or medical circumstance of the child is such that the required immunization(s) is not indicated; the date when the temporary medical exemption will end, and the vaccine(s) to be exempted.

14. 1407/2016 Refer to “Laws” Tab for Details

15. Conditional Entrants For TK/K-12 Self Check Under which two conditions may children be admitted in TK/K-12 as conditional entrants? 1507/2016

16. Conditional Entrants Throughout the Year Determine timing for the next dose in a series: 1607/2016

17. Conditional Entrants Throughout the Year Step by Step: 1.Create a reminder entry in your follow-up system to notify parents or guardians when next shots are due. 2.You may use the Notice of Immunizations Needed letter and Parents’ Guide to Immunizations Required for School Entry to inform parents of the next doses needed. Please make sure you include the deadline. 3.Recommend that the child receive the next dose at the beginning of the vaccine’s time interval from Table 2. 4.Review records every (30) days. If you discover a child has missed the next dose and was not excluded, schools must notice parents or guardians and may give them up to (10) school days to comply before the child is excluded. 1707/2016

18. Conditional Entrants For TK/K-12 Self Check Today is July 25, 2016. Anna is five years old and is starting kindergarten in 1 month. Her last (2 nd ) dose of DTaP was 5 months ago. Can she start classes in a month? 18 Steps 1.No. You will count doses on the Blue Card and compare to the Guide to Immunizations Required for School Entry. She is behind on DTaP. 2.Compare the immunization dates on the Blue Card to Table 2 for interval timing to determine if the next dose must be administered before starting school. The third dose is due “before admission if 8 or more weeks have elapsed since the 2nd dose at the time of admission.” What are your next steps? 07/2016

19. Jane Doe 3 rd DTP James Doe 2 nd MMR Create an Immunization Plan Follow-up for Conditional Entrants Set a schedule and check your follow-up system every 30 days for children with pending vaccinations. 1907/2016

20. Personal Beliefs Exemptions No Longer an Option for New Admissions (Effective 1/1/2016) Summary of Senate Bill 277 (Pan, 2015) Effective January 1, 2016, parents of students in any school or child-care facility are no longer allowed to submit a new personal beliefs exemption (PBE) to a currently required vaccine. A PBE filed before 2016 at: A child-care facility will remain valid until the child first enters the span between TK/K through 6th grade. Entry to any grade from TK/K through 6th grade will remain valid until the child completes 6th grade. Entry to any grade from 7th through 12th will remain valid through 12th grade. Students are no longer required to have immunizations for entry if they attend a home-based private school or an independent study program and do not receive classroom-based instruction. For these students, parents must continue to provide immunization records to their schools and schools must continue to maintain and report records of immunizations. Students who have an individualized education program (IEP) should continue to receive all necessary services identified in their IEP regardless of their vaccination status. 07/201620