Health Regulations Affecting Staff. Preemployment Medical Examination. Each staff member shall have a preemployment medical examination including a tuberculin skin test and, if positive or otherwise indicated, a chest x-ray, and furnish certification that he is free of tuberculosis in a communicable stage. The report of the examination shall include the physician's statement that the individual is physically able to perform the duties for which he is employed. Tuberculosis Examination. Each adult in a facility who comes in contact with the children shall furnish certification, annually, unless waived by the Secretary or designee, that he is free of tuberculosis in a communicable stage. This certification shall be based on results of specific tests. The types of tests and the intervals between these tests shall be prescribed by the local Health Officer and shall conform to standards of the Department of Health and Mental Hygiene. The report on each examination shall be submitted promptly to the local health officer and returned to the person in charge of the child care facility. Health Information. Each staff member, volunteer, substitute, participating parent, and member of the household who is in contact with the children enrolled in the facility shall, upon request, furnish such information, permit such examination, or x-rays and submit such laboratory specimens as the Health Officer may require for purpose of determining freedom from disease or condition hazardous to the children when the Health Officer has reason to believe that a communicable disease exists. Communicable Disease. Staff personnel with evidence of communicable disease in a communicable stage or form shall not be permitted to work at the facility during the period of communicability. Hand washing. Staff members shall wash hands thoroughly with soap and running water after handling wet or soiled diapers and clothing, after toileting children, after handling pets, and before handling food. COVID-19 Vaccination. Staff members shall be fully vaccinated for the COVID-19 virus and shall provide proof of such vaccination. Immunizations. Immunizations required for all children prior to admission to a child care facility. Before a child is admitted to a center, evidence shall be furnished of primary immunizations against diphtheria, tetanus, pertussis, poliomyelitis, measles (rubeola), and German Measles (rubella), in a manner approved by the Health Officer and any other immunizations deemed necessary by the Secretary of the Department of Health and Mental Hygiene and in conformance with COMAR 10.06.04 Required Immunizations Prior to Entry Into a Maryland School. The immunization will be in accordance with the current schedule of immunizations recommended by the Maryland Steering Committee on Immunization Practices of the Medical and Chirurgical Faculty of Maryland. Exception may be made for a child whose parent or guardian furnishes proof that his child has had a minimum of one dose of DTP or Td (adult) tetanus, diphtheria, poliomyelitis, measles, and rubella vaccine, and continues to furnish written evidence toward the completion of the primary immunization series according to the current schedule of immunizations. Medical Contraindications. Immunization requirements shall not apply to any child who presents a written statement from a licensed physician or the Health Officer indicating that immunization against any or all of the above mentioned diseases is considered medically contraindicated, detrimental to, or not in the best interest of the child's health. The statement shall indicate whether the contraindication is permanent or temporary. If temporary, the statement shall provide assurance that the child will receive the immunization(s) and furnish evidence of their completion. Religious Conflict. Any parent or guardian who presents a written statement of objection to immunizations upon the grounds that they conflict with the tenets or practices of a recognized church or religious denomination of which he is a member, shall not be required to present a physician's certificate of immunization. This exception will not apply in case of an emergency or epidemic of disease which is declared by the Secretary of Health and Mental Hygiene. Vaccine Provision. If for any reason a parent or guardian is not able to obtain the service of a private physician, he may take his child to the Health Department where such immunizations will be provided.