Legal Resources | | T5 5504
Chapter 6. Certified Personnel.Subchapter 1. General Provisions.Article 2. Employment and Dismissal.Medical Certification Procedures.
(a) The governing board of each school district and the county superintendent of schools office shall provide a pre-employment medical examination form and related information as prescribed in this section to persons being employed for the first time in a California school district or county office in a position requiring certification requirements in accordance with section 44839 of the Education Code.
(b) The governing board or office of the county superintendent of schools shall also develop a brief statement of functions involved in the position for which the applicant will be employed and attach it to the medical certification form for the guidance of the physician. Functions should be described in terms of activities which may be performed such as: teaching physical education; being able to readily move about the classroom and playground; climbing flights of stairs or operating mechanical equipment.
(c) The governing board of each school district and the county superintendent of schools office shall use the following medical certificate or a similar certificate developed locally and approved by the California Department of Education:
CERTIFICATE OF MEDICAL EXAMINATION OF APPLICANTS FOR FIRST EMPLOYMENT IN A CALIFORNIA SCHOOL DISTRICT OR COUNTY SUPERINTENDENT OF SCHOOLS OFFICE
_______________________ School District; County Office
Name
 __________________________
Name:
Last
First
Middle
 _________________________
Address:
Street
City
Zip Code
 __________________________
To the Physician:
The medical examination required of a person employed in a certificated position for the first time in a California School District or County Superintendent of Schools Office to determine freedom from any disabling disease unfitting the person to instruct or associate with children should be evaluated on the basis of the function which will be required of the applicant upon employment. A brief description of functions is attached to this form.
Disabling disease should be considered in terms of:
(1) Evidence of lack of ability to demonstrate average physical and emotional capacity for the functions involved.
(2) Evidence of disability which periodically may disable the individual; for example, rheumatoid arthritis, uncontrolled diabetes, asthma.
(3) Evidence of long term disability which may progressively deteriorate; for example, malignancy, Multiple Sclerosis.
Details
Check Every Item YES NO
(Relate to functions to be performed)
________________________________________________________________
________________________________________________________________
1.Is there evidence of disabling disease of
the musculo-skeletal, cardio-vascular,
nervous, gastro-intestinal, genito-urinary,
endocrine systems? _______
________________________________________________________________
2.Is there evidence of disabling disease
affecting vision, hearing or speech? _______
________________________________________________________________
3.Is there evidence of disabling metabolic
disease? _______
________________________________________________________________
4.Is there evidence of infectious disease in
a communicable stage? _______
________________________________________________________________
5.Is there evidence of drug dependency in-
cluding alcoholism? _______
________________________________________________________________
6.Is there evidence of any other disabling
disease? _______
________________________________________________________________
On the basis of my medical examination on (date) ____________ the above named individual is free from disabling disease, except as noted above, which I believe unfits the individual to instruct, in the position for which application is being made, or to associate with children.
______________________________/____________
Signature of Physician Date
______________________________/____________
Name of Physician (print) License #
To be returned by the examining physician directly to the school district or County Office requesting the examination.
(d) The governing board of each district or county superintendent of schools office shall determine, on the basis of information on the medical examination form, whether or not the applicant is free from any disabling disease unfitting the applicant to perform the functions, required in the position for which application is being made, or to associate with children.
(e) The governing board of a school district or the county superintendent of schools office may require certificated employees to undergo a periodic medical examination by a licensed physician and surgeon to determine that the employee is free from any communicable disease unfitting the employee to instruct or associate with children. Such examination shall be at the expense of the school district and may be recorded in a locally developed medical referral form.
Authority cited:
Education Code 44843
Reference:
Education Code 44843
(Amended by Register 2010, No. 52.)