Community Care Facilities (that are licensed to provide care to children are required to have a copy of the immunization Status on file for each child in care, in the event that an outbreak of a communicable disease should occur. This information will assist in identifying those that may require exclusion because they are not immunized. This for has been provided to: • Assist in identifying those children who are not fully immunized and • Assist licensees in meeting Section 57(2) (a) of the Child Care Licensing Regulation.
Child’s name
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Complete Immunization:(Required)

Received immunization in:

Incomplete Immunization:(Required)
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