California Code § 101220(a): Child Medical Assessments

Child Medical Assessments are written medical evaluations that must be obtained for every child before enrollment or within 30 days of starting care. This requirement ensures that childcare providers have current health information about each child, including immunization status, existing medical conditions, allergies, and any special health needs. The medical assessment isn't just paperwork - it's a critical tool that helps you understand each child's health requirements and determine whether your center can provide the necessary health-related services to keep that child safe and healthy.

As of November 23, 2025, 23 facilities have been cited for this violation in the past 90 days. This represents about 1 in 328 facilities statewide (0.30% of the 7,551 facilities inspected). The citations have occurred across 10 counties, with Los Angeles County accounting for 6 citations, San Bernardino County with 5 citations, and Alameda, Mendocino, and Sacramento counties each with 2 citations. This relatively low rate suggests that most facilities maintain proper medical documentation, but violations still occur regularly.

Inspectors cite this regulation when they find children enrolled without current medical assessments on file, or when the 30-day grace period has expired without documentation. Common triggers include: accepting enrollment without any medical paperwork started, allowing parents to delay submission beyond the 30-day window, having incomplete or outdated medical forms (missing required sections like immunizations or health conditions), or failing to keep medical assessments in individual child files where inspectors can easily verify them. The violation occurs whether you're missing one child's assessment or multiple children's documents.

Don't accept enrollment without medical paperwork started - give parents the forms during your facility tour and make it clear that incomplete medical information delays their start date. Create a system to track the 30-day deadline for each new enrollment, using calendar reminders or a tracking spreadsheet. Review each medical assessment for completeness before filing it - check that all required sections are filled out, including immunization records, health conditions, allergies, and physician signatures. Keep medical assessments in clearly organized individual child files that are easily accessible for inspections. Follow up promptly with parents who haven't submitted complete documentation, and consider requiring medical assessments before the first day rather than using the full 30-day grace period.

Immediately identify all children with missing or incomplete medical assessments and contact their parents to obtain the required documentation. Set firm deadlines for submission - typically within 5-10 business days depending on your licensing worker's requirements. If parents cannot provide updated medical assessments quickly, you may need to temporarily suspend care for those children until documentation is complete. Review your enrollment procedures to prevent future violations - consider requiring medical assessments before enrollment rather than relying on the 30-day grace period. Document your corrective actions and submit a written plan of correction to your licensing worker showing how you'll maintain compliance going forward.