The "Medical Report on an Adult in a Child Care Facility (CFS 602)" form is used in Illinois to ensure children's safety and well-being in childcare facilities. The form collects medical information about adults who work in such facilities to determine their suitability for working with children. Its purpose is to ensure the safety and well-being of children in these facilities. It must be completed by all adults who have contact with children in a childcare setting.
The form is required by the Illinois Department of Children and Family Services (DCFS) and must be completed by all adults who work in childcare facilities, including employees, volunteers, and contractors. The information provided on the form is confidential and is only be shared with authorized individuals who have a need to know.
To complete the CFS 602 form, the adult must provide their personal information, including their name, address, and date of birth. They must also provide details about their medical history, including any medical conditions, allergies, or medications they are taking. Additionally, the form requires the adult to disclose if they have ever been convicted of a crime or if they have ever been subject to a child abuse or neglect investigation.
Once the form is completed, it must be signed and dated by the adult and a licensed healthcare professional, such as a physician, nurse practitioner, or physician assistant. The healthcare professional must attest that they have reviewed the adult's medical history and that, to their knowledge, the adult is physically and mentally able to care for children in a childcare facility.
The completed form must be submitted to the child care facility where the adult works, or volunteers, and a copy must be kept on file at the facility. The childcare facility must also provide a copy of the form to the DCFS upon request.