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School & Childcare Health Requirements
Childhood Immunizations & Health Screenings


Children in California are required to receive certain immunizations and health screenings to attend school. Below provides information on the “well-child” health screenings, required immunizations needed to attend school, Tuberculosis risk assessments, oral health screenings, and options for children without health insurance. 

    “Well-child” Health Screening and Evaluation Requirements

    Well-child visits are routine doctor visits for comprehensive preventive health services that occur frequently when a baby is young, then annually until a child reaches age 21. Services include physical exam and measurements, vision and hearing screening, oral health risk assessments, and vaccinations.  Recommended vaccinations are essential, help make sure children stay healthy, and are required for school attendance (CDC).

    All 1st-grade students must have a health evaluation by their physician or other healthcare provider within 18 months of entering first grade. The health exam can be completed as early as six months before entering kindergarten. The Report of Health Examination for School Entry form must be filled out by a health examiner and submitted to the school. 

    The schedule of well-child visits recommended by the American Academy of Pediatrics (AAP) is more frequent during early childhood, then annually from age 3 – 21 years old. 

    In the first year during Infancy:

    As 1-year old:

    As 2-year old:

    3-21 years old:

    • Annual visits are recommended for each year, including for school requirements:
    • 4-year old visit is important for required vaccines and exam before kindergarten
    • 11-year old visit is important for Tdap vaccine required before 7th grade. 

    Benefits of well-child visits to your primary care provider

    Prevention. Your child gets scheduled immunizations to prevent illness. You also can ask your child’s doctor about nutrition and safety in the home and at school.

    Tracking growth & development. See how much your child has grown in the time since your last visit and talk with your child’s doctor about your child’s development. You can discuss your child’s milestones, social behavior, and learning.

    Raising any concerns. Make a list of topics you want to talk about with your child’s doctor, such as development, behavior, sleep, eating or getting along with peers and other family members.

    Team approach. Regular visits create strong, trustworthy relationships between the doctor, the parent, and the child/teen.

    Immunizations Required for Entrance to Pre-Kindergarten & School

    In California, children are required to receive certain immunizations in order to attend pre-kindergarten (child care), elementary and secondary schools. The Immunization Branch website has more information for families, including a Parents’ Guide to Immunizations Required for Pre-Kindergarten (Spanish) and a Parents’ Guide to Immunizations Required for School Entry (Spanish).

    Pre-schools and schools check immunization records before new children/students are enrolled and when students advance from 6th grade to 7th grade.  Helpful tip: Parents should schedule health exams with their child’s doctor or clinic within the year before the immunization records are required (e.g., during 6th grade for the 7th grade entry requirement).  Don’t wait for the summer or the start of school, as few appointments may be available.

    Parents must show their child’s Immunization Record as proof of immunization. This includes:

    • All new children and student admissions to Pre-K and TK/Kindergarten through 12th grade.
    • All students entering to 7th grade need a Tdap and 2 doses of Varicella vaccine before entry.

    Parents of children and teens with health coverage/insurance should contact their child’s doctor or clinic to schedule a health exam or an immunization appointment.  Parents of children without health coverage should read the Health Coverage Options for Children Without Insurance section below for more information.

    TB (Tuberculosis) Risk Assessment for School Entry

    A TB Risk Assessment should be completed by a health examiner before school entry (e.g., all new student admissions at TK/Kindergarten through 12th grade). View and download the form here: Pediatric Tuberculosis Risk Assessment

    Oral Health Screening

    Kindergarten students (or 1st graders if not previously enrolled) in public schools must receive an oral health assessment by a licensed dental health professional. The exam can be completed as early as 12 months before entering kindergarten.

    The form is in the kindergarten registration packet and available to download here.

    For children with Medi-Cal, find a Health Plan of San Mateo Dental Provider here.

    Health Coverage Options for Children Without Insurance

    Medi-Cal offers free or low-cost coverage for children under age 19. Coverage includes primary care, emergency services, dental, vision, and prescriptions. Families can apply online at Covered Califonia, SMC Human Services Agency, or SMC Health Coverage Unit. The SMC Health Coverage Unit can also be contacted via telephone at (650) 616-2002.

    Apply early for Medi-Cal, as the process may take 1-2 months.  If you need a health exam or immunizations sooner, the clinics listed below may be able to provide services to income eligible children and teens who do not have health coverage/health insurance. By appointment only. Please call the clinic for more information: 

    San Mateo Medical Center and Outpatient Clinics 
    Locations: Daly City, South SF, San Mateo, Redwood City, Half Moon Bay

    North East Medical Services  
    (650) 550-3923
    211 Eastmoor Avenue, Daly City, CA 94015 

    Gardner Packard Children’s Health Center 
    (650) 362-2500
    3351 El Camino Real, Suite 100, Atherton, CA 94027

    Ravenswood Family Health Network 
    (650) 330-7400
    1885 Bay Road, East Palo Alto, CA 94303