Section 17-897-5 - Provider's health standards(a) Each child care facility shall maintain on file at the child care facility evidence that employees, substitutes, volunteers, and adults in the facility are fi:ee firom health problems which would have a harmful effect on the children or which would interfere with effective functioning, as follows: (1) The results of a physical examination by a health care practitioner of each employee, substitute, volunteer, and adult in the child care facility;(2) Written evidence that each employee, substitute, volunteer, and adult in the facility is fi:ee fi:om communicable TB as a result of a negative TB skin test or a satisfactory chest x-ray taken one year before beginning child care. (A) If the employee, substitute, volunteer, or adult in the child care facility has not completed a TB clearance prior to April 11, 2013, the employee, substitute, volunteer, or adult in the child care facility must complete a consultation visit with a health care practitioner;(B) The health care practitioner conducting the consultation shall assess whether the individual is in a highest risk category. (i) If the individual is assessed by the health care practitioner to be in a highest risk category, the individual shall show written evidence of a negative TB skin test or a satisfactory chest x-ray prior to begiiming child care;(ii) If the individual is assessed by the health care practitioner to not be in a highest risk category, the individual shall have written evidence on file that the individual has been assessed prior to beginning child care and is not in any of the highest risk categories and that the health care practitioner does not recommend the individual complete the chest x-ray evaluation;(iii) For those individuals who have been assessed by a health care practitioner to not be in a highest risk category, and the health care practitioner does not recommend the individual complete the chest x-ray evaluation, the TB clearance requirement shall be deferred until the DOH has reinstated conducting TB skin tests for all persons.(C) Once DOH has reinstated TB skin testing requirements, all employees, substitutes, volxmteers, and adults in the child care facility who were deferred from TB skin test requirements shall provide written evidence of a negative TB skin test within ninety (90) days of the reinstatement of TB skin test requirements.(b) Each child care facility shall require and obtain jQrom each employee, substitute, volimteer, or adult in the child care facility a signed acknowledgement that the employee, substitute, volunteer, or adult in the child care facihty is aware of the temporary suspension of the TB skin testing requirements, and that there may be children, employees, substitutes, volunteers, and adults in the facility who may not have TB clearances.(c) Each child care facility shall post by all entrances used by the public a notice that indicates the temporary suspension of the TB skin testing requirements which may result in the child care facility having children, employees, substitutes, volunteers, or adults who may not have TB clearances.[Eff. MAY 20 2013] (Auth: HRS § 346-162, § 346-172)