Annual School/Facility Immunization Survey The Role of the School Nurse
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Transcript of Annual School/Facility Immunization Survey The Role of the School Nurse
Annual School/Facility Immunization Survey
The Role of the School Nurse
Brittany Taylor, MPH
Immunization Program
Agenda
Who is being surveyed
The role of the School Nurse
How to complete the survey on paper
How to complete the survey online
Who to contact with questions
Timeline and Deadlines
Helpful hints
Who is being surveyed?
All schools and childcare centers in Kentucky must report for the children in the following grades or groups:
Sixth grade
Kindergarten
Head start
Preschool
Daycare
Role of the School Nurse Receive the survey, worksheets and
instructions from the local health department
Access immunization certificates/information for children in the appropriate grade/group
Complete the worksheet using the instructions provided
Complete the survey using the completed worksheet and instructions provided
Role of the School Nurse cont.
Review the survey to reduce errors before sending
Return the survey to local health department via mail, fax, or online submission by the deadline
Make corrections to the survey if it is necessary and resubmit
Completing the top portionList current and former namesMust list County
Must circle Private or Public
Please include valid number
Indicate ONLY 1.Each grade/group must complete a separate form
A
B
C
E
D
***** Please only use valid numbers: B + C + D + E = A *****
Current, Provisional, & Expired Certificates
Completing the bottom portion
•Indicate the number of children who have had the age appropriate vaccines listed to the left.
•Write NA if the vaccine is not applicable. (ie: Td booster is not appropriate for childcare and Kindergarten.)
•‘Combination’ does not refer to a single shot, but rather a series of immunizations over the course of time.
•Do not leave any of the 9 cells blank.
•Type 1 response in each text box.
•All questions on the survey with an asterisk will require a response
Must click Private OR Public
Indicate date that survey is prepared
•Indicate ONLY 1 grade/group
•Each grade/group must complete a separate survey
# of Children in grade/group with NO Immunization Certificate on file
#
#
#
#
#
Click here to submit the survey when complete
All cells here require an answer.
Indicate the number of children who have had the age appropriate vaccines listed to the left.
Write NA if the vaccine is not applicable. (ie: Td booster is not appropriate for childcare and Kindergarten.)
Completing the Survey• Completing the Survey is required by KY state
regulation 902 KAR 2:055 and CDC.
• All blank fields require an answer/response
• A separate survey is required for each childcare, kindergarten, and/or 6th grade at each school/facility
• Childcares only assess children ages
19 mo -5yrs.
• Children in before/after school programs are assessed only in their school (excluding the childcare)
Who to Contact
For questions regarding the school survey that are not addressed in the
instructions, please contact the School Survey contact person at your local
health department.
Note: some counties have a different people for schools and daycares
Helpful Hints• Utilize the Worksheets and Instructions
that are sent with the survey
• Check over the final form to ensure that it is filled out correctly before returning to the local health department.
• Never leave any response areas blank
• Remember that the purpose of the survey is to assess number of children with age appropriate doses
Thank you!
Brittany Taylor, MPH
502-564-4478 ext. 4038
Re: Kindergarten and
Sixth Grade
Carrie Tuggle
502-564-4478 ext. 3690
Re: Childcare Centers (Daycare, Preschool, Headstart)