ARTICLE 4. Physical Examinations [49450. - 49458.]

Cal. Education Code - EDC 4.

in effect

Cal. Education Code - EDC § 49450. Section 49450.

The governing board of any school district shall make such rules for the examination of the pupils in the public schools under its jurisdiction as will insure proper care of the pupils and proper secrecy in connection with any defect noted by the supervisor of health or his assistant and may tend to the correction of the physical defect.

Cal. Education Code - EDC § 49451. Section 49451.

A parent or guardian having control or charge of any child enrolled in the public schools may file annually with the principal of the school in which he is enrolled a statement in writing, signed by the parent or guardian, stating that he will not consent to a physical examination of his child. Thereupon the child shall be exempt from any physical examination, but whenever there is a good reason to believe that the child is suffering from a recognized contagious or infectious disease, he shall be sent home and shall not be permitted to return until the school authorities are satisfied that any contagious or infectious disease does not exist.

Cal. Education Code - EDC § 49452. Section 49452.

(a) The governing board of a school district shall, subject to Section 49451, provide for the testing of the sight and hearing of each pupil enrolled in the schools of the school district. (b) The test shall be adequate in nature and shall be given only by any of the following: (1) By duly qualified supervisors of health employed by the school district. (2) By certificated employees, registered nurses, or licensed vocational nurses, under the supervision of a credentialed school nurse, of the school district, charter school, or the county superintendent of schools who possess the qualifications prescribed by the Commission on Teacher Credentialing. (3) By contract with an agency duly authorized to perform those services by the county superintendent of schools of the county in which the school district is located, under guidelines established by the state board. (4) By accredited schools or colleges of optometry, osteopathic medicine, or medicine. (c) The records of the tests shall serve as evidence of the need of the pupils for the educational facilities provided physically handicapped individuals. The equipment necessary to conduct the tests may be purchased or rented by governing boards of school districts. The state, any agency, or political subdivision thereof may sell or rent such equipment owned by it to the governing board of a school district upon terms as may be mutually agreeable. (d) As used in this section, the following definitions apply: (1) “Credentialed school nurse” means only qualified persons who possess an appropriate credential issued pursuant to Section 44267.5. (2) “Licensed vocational nurse” means a person licensed pursuant to the provisions of Chapter 6.5 (commencing with Section 2840) of Division 2 of the Business and Professions Code.

Cal. Education Code - EDC § 49452.5. Section 49452.5.

The governing board of any school district shall, subject to Section 49451 and in addition to the physical examinations required pursuant to Sections 100275, 124035, and 124090 of the Health and Safety Code, provide for the screening of every female pupil in grade 7 and every male pupil in grade 8 for the condition known as scoliosis. The screening shall be in accord with standards established by the State Department of Education. The screening shall be supervised only by qualified supervisors of health as specified in Sections 44871 to 44878, inclusive, and Section 49422, or by school nurses employed by the district or the county superintendent of schools, or pursuant to contract with an agency authorized to perform these services by the county superintendent of schools of the county in which the district is located pursuant to Sections 1750 to 1754, inclusive, and Section 49402 of this code, Section 101425 of the Health and Safety Code, and guidelines established by the State Board of Education. The screening shall be given only by individuals who supervise, or who are eligible to supervise, the screening, or licensed chiropractors, or by certificated employees of the district or of the county superintendent of schools who have received in-service training, pursuant to rules and regulations adopted by the State Board of Education, to qualify them to perform these screenings. It is the intent of the Legislature that these screenings be performed, at no additional cost to the state, the school district, or the parent or guardian, during the regular schoolday and that any staff time devoted to these activities be redirected from other ongoing activities not related to the pupil’s health care. In-service training may be conducted by orthopedic surgeons, physicians, registered nurses, physical therapists, and chiropractors, who have received specialized training in scoliosis detection. Pupils suspected of having scoliosis during the initial screening shall be rescreened by an orthopedic surgeon when there will be no cost to the state, the school district, or the parent or guardian. No person screening pupils for scoliosis pursuant to this section shall solicit, encourage, or advise treatment or consultation by that person, or any entity in which that person has a financial interest, for scoliosis or any other condition discovered in the course of the screening. The governing board of any school district shall provide for the notification of the parent or guardian of any pupil suspected of having scoliosis. The notification shall include an explanation of scoliosis, the significance of treating it at an early age, and the public services available, after diagnosis, for treatment. Referral of the pupil and the pupil’s parent or guardian to appropriate community resources shall be made pursuant to Sections 49426 and 49456. No action of any kind in any court of competent jurisdiction shall lie against any individual, authorized by this section to supervise or give a screening, by virtue of this section. In enacting amendments to this section, it is the intent of the Legislature that no participating healing arts licentiate use the screening program for the generation of referrals or for his or her financial benefit. The Legislature does not intend to deny or limit the freedom of choice in the selection of an appropriate health care provider for treatment or consultation.

Cal. Education Code - EDC § 49452.6. Section 49452.6.

(a) The department, in coordination with any other entity the department deems appropriate, shall develop type 1 diabetes informational materials for the parents and guardians of pupils. The informational materials shall be made available to each school district, county office of education, and charter school through the department’s internet website. (b) On and after January 1, 2023, the governing board of a school district, county board of education, and governing body of a charter school shall make the type 1 diabetes informational materials accessible to the parent or guardian of a pupil when the pupil is first enrolled in elementary school, or with the information provided pursuant to Section 48980. (c) Information provided to parents and guardians pursuant to this section may include, but shall not be limited to, all of the following: (1) A description of type 1 diabetes. (2) A description of the risk factors and warning signs associated with type 1 diabetes. (3) A recommendation regarding those pupils displaying warning signs associated with type 1 diabetes that the parents or guardians of those pupils should immediately consult with the pupil’s primary care provider to determine if immediate screening for type 1 diabetes is appropriate. (4) A description of the screening process for type 1 diabetes and the implications of test results. (5) A recommendation that, following a type 1 diagnosis, parents or guardians should consult with the pupil’s primary care provider to develop an appropriate treatment plan, which may include consultation with and examination by a specialty care provider, including, but not limited to, a properly qualified endocrinologist.

Cal. Education Code - EDC § 49452.7. Section 49452.7.

(a) On and after July 1, 2010, the school district shall provide an information sheet regarding type 2 diabetes to the parent or guardian of incoming 7th grade pupils. The information sheet may be provided to the parent or guardian of incoming 7th graders with the information provided pursuant to Section 48980. The information sheet shall include, but shall not be limited to, all of the following: (1) A description of type 2 diabetes. (2) A description of the risk factors and warning signs associated with type 2 diabetes. (3) A recommendation that pupils displaying or possibly suffering from risk factors or warning signs associated with type 2 diabetes should be screened for type 2 diabetes. (4) A description of treatments and prevention methods of type 2 diabetes. (5) A description of the different types of diabetes screening tests available. (b) The information sheet shall be developed by the State Department of Education in coordination with any other entity the department deems appropriate. The information sheet shall be made available to each school district through the State Department of Education’s Web site and any other Web site the department deems appropriate, as well as by providing written copies of the information sheet to the school district upon written request to the department. (c) It is the intent of the Legislature that school districts, to the extent that resources or funds, or both, are available, provide information to parents regarding locations at which parents may receive diabetes screening and education services at free or reduced costs from public or private sources.

Cal. Education Code - EDC § 49452.8. Section 49452.8.

(a) (1) A pupil, while enrolled in kindergarten in a public school, or while enrolled in first grade in a public school if the pupil was not previously enrolled in kindergarten in a public school, no later than May 31 of the school year, shall present proof of having received an oral health assessment by a licensed dentist, or other licensed or registered dental health professional operating within the professional’s scope of practice, that was performed no earlier than 12 months before the date of the initial enrollment of the pupil. (2) For purposes of this section, “kindergarten” includes both transitional kindergarten and kindergarten. The proof described in subdivision (a) shall be required only once during a two-year kindergarten program. (b) The parent or legal guardian of a pupil may be excused from complying with subdivision (a) by indicating on the form described in subdivision (d) that the oral health assessment could not be completed because of one or more of the reasons provided in subparagraphs (A) to (C), inclusive, of paragraph (2) of subdivision (d). (c) A public school shall notify the parent or legal guardian of a pupil described in subdivision (a) concerning the assessment requirement. The notification, at a minimum, shall consist of a letter that includes all of the following: (1) An explanation of the administrative requirements of this section. (2) Information on the importance of primary teeth. (3) Information on the importance of oral health to overall health and to learning. (4) A toll-free telephone number to request an application for Medi-Cal or other government-subsidized health insurance programs. (5) Contact information for county public health departments. (6) A statement of privacy applicable under state and federal laws and regulations. (d) In order to ensure uniform data collection, the department, in consultation with the state dental director and interested persons, shall develop, revise as necessary, and make available on the internet website of the department, a standardized notification form as specified in subdivision (c) that shall be used by each school district. The standardized form shall include all of the following: (1) A section to be used by the licensed dentist or other licensed or registered dental health professional performing the assessment to record information that is consistent with the information collected on the oral health assessment form developed by the Association of State and Territorial Dental Directors. (2) A section in which the parent or legal guardian of a pupil can indicate the reason why an assessment could not be completed by marking the box next to the appropriate reason. The reasons for not completing an assessment shall include all of the following: (A) Completion of an assessment poses an undue financial burden on the parent or legal guardian. (B) Lack of access by the parent or legal guardian to a licensed dentist or other licensed or registered dental health professional. (C) The parent or legal guardian does not consent to an assessment. (3) (A) A section stating that, if a school or school district hosts a free oral health assessment event at which licensed dentists or other licensed or registered dental health professionals perform schoolsite assessments of pupils enrolled in the school, a pupil shall be given an oral health assessment unless the parent or legal guardian of the pupil has opted out of the schoolsite assessment pursuant to subparagraph (B). (B) A section in which the parent or legal guardian of a pupil can indicate that the parent or legal guardian does not consent to the pupil receiving the oral health assessment described in subparagraph (A). A failure to opt out of the pupil oral health assessment pursuant to this subparagraph shall not be deemed to be consent for dental treatment of any kind. (C) A section informing the parent or legal guardian that a pupil shall not receive dental treatment of any kind as part of the schoolsite assessment described in subparagraph (A) unless the pupil’s parent or legal guardian has provided informed consent for the treatment. (e) Upon receiving completed assessments, all school districts, by July 1 of each year, shall submit a report to a system designated by the state dental director for the collection of those reports or the county office of education of the county in which the school district is located, or both. The report shall include all of the following: (1) The total number of pupils in the school district, by school, who are subject to the requirement to present proof of having received an oral health assessment pursuant to subdivision (a). (2) The total number of pupils described in paragraph (1) who present proof of an assessment. (3) The total number of pupils described in paragraph (1) who could not complete an assessment due to financial burden. (4) The total number of pupils described in paragraph (1) who could not complete an assessment due to lack of access to a licensed dentist or other licensed or registered dental health professional. (5) The total number of pupils described in paragraph (1) who could not complete an assessment because their parents or legal guardians did not consent to their child receiving the assessment. (6) The total number of pupils described in paragraph (1) who are assessed and found to have had caries experience. (7) The total number of pupils described in paragraph (1) who are assessed and found to have untreated decay. (8) The total number of pupils described in paragraph (1) who did not return either the assessment form or the waiver request to the school. (f) All school districts that have fulfilled the report requirement described in subdivision (e) by submitting a report to the county office of education and all county offices of education are encouraged to submit the report described in subdivision (e) to a system designated by the state dental director for the collection of those reports. (g) Each county office of education shall maintain the data described in subdivision (e) in a manner that allows the county office of education to release it upon request. (h) This section does not prohibit any of the following: (1) County offices of education from sharing aggregate data collected pursuant to this section with other governmental agencies, philanthropic organizations, or other nonprofit organizations for the purpose of data analysis. (2) Use of assessment data that is compliant with the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191) for purposes of conducting research and analysis on the oral health status of public school pupils in California. (i) (1) This section does not preclude a school district or county office of education from developing a schoolsite-based oral health assessment program to meet the requirements of this section. (2) If a school district or county office of education hosts an oral health assessment program, reports made to a parent, legal guardian, or caregiver of a pupil experiencing homelessness about a pupil defect identified from this oral health assessment should be made by alternative communication channels rather than mail, when possible. (j) The Office of Oral Health of the Chronic Disease Control Branch of the State Department of Public Health shall conduct or provide for the conducting of periodic evaluations of the requirements imposed by this section. The Office of Oral Health may receive private funds and contract with the University of California to fulfill the duties described in this subdivision. (k) Funds appropriated in the annual Budget Act for the activities required by this section shall first be used to offset reimbursement provided to local educational agencies pursuant to Part 7 (commencing with Section 17500) of Division 4 of Title 2 of the Government Code for state-mandated costs imposed by this section.

Cal. Education Code - EDC § 49454. Section 49454.

A person employed by a school district in a position requiring certification qualifications who holds a valid special credential authorizing the teaching of lipreading or the teaching of the deaf and hard of hearing or a standard teaching credential with specialized preparation in the area of the deaf and hard of hearing or in the area of the speech and hearing handicapped or who holds a certificate of registration to serve as a school audiometrist issued by the State Department of Health Services may, subject to Section 49451, test the hearing of pupils of the district through the use of an audiometer for the purpose of detecting pupils with impaired hearing.

Cal. Education Code - EDC § 49455. Section 49455.

(a) (1) During the kindergarten year or upon first enrollment or entry in a California school district of a pupil at an elementary school, and in grades 2, 5, and 8, the pupil’s vision shall be appraised by the school nurse or other authorized person under Section 49452. (2) A pupil whose first enrollment or entry occurs in grade 4 or 7 shall not be required to be appraised in the year immediately following the pupil’s first enrollment or entry. (b) The vision appraisal shall include tests for near vision, far vision, and color vision; however, color vision shall be appraised once and only on male pupils, and the results of the appraisal shall be entered in the health record of the pupil. Color vision appraisal need not begin until the male pupil has reached the first grade. (c) The appraisal may be waived, if the pupil’s parents so desire, by their presenting of a certificate from a physician and surgeon, a physician assistant practicing in compliance with Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business and Professions Code, or an optometrist setting out the results of a determination of the pupil’s vision, including visual acuity and color vision. (d) A pupil’s vision may be appraised by using an eye chart or any other scientifically validated photoscreening test. Photoscreening tests shall be performed, under an agreement with, or the supervision of, an optometrist or ophthalmologist, by the school nurse or a trained individual who meets requirements established by the department. (e) Continual and regular observation of the pupil’s eyes, appearance, behavior, visual performance, and perception that may indicate vision difficulties shall be done by the school nurse and the classroom teacher. (f) This section shall not apply to a pupil whose parents or guardian file with the principal of the school in which the pupil is enrolling, a statement in writing that they adhere to the faith or teachings of any well-recognized religious sect, denomination, or organization and in accordance with its creed, tenets, or principles depend for healing upon prayer in the practice of their religion. (g) The department shall adopt guidelines to implement this section, including training requirements and a method of testing for near vision.

Cal. Education Code - EDC § 49455.5. Section 49455.5.

(a) A local educational agency maintaining kindergarten or any of grades 1 to 12, inclusive, may enter into a memorandum of understanding with a nonprofit eye examination provider to provide eye examinations to pupils at any schoolsite within the local educational agency. Eye examinations provided under this section shall be supplemental to, and shall not replace, the vision screenings provided pursuant to Section 49455, and shall be noninvasive and provided exclusively for the purpose of providing eyeglasses. Examination providers providing eye examinations pursuant to this section shall provide reports to parents and guardians consistent with Section 49456. (b) (1) Before an eye examination is provided at a schoolsite pursuant to subdivision (a), the local educational agency shall have a memorandum of understanding in place with a nonprofit eye examination provider, including, but not limited to, a nonprofit mobile eye examination provider, and the school shall notify parents and guardians of the upcoming provision of eye examinations at the schoolsite. Notification shall include a form on which a parent or guardian may indicate that they do not consent to an eye examination being provided, pursuant to subdivision (a), to their child. The parent or guardian may opt out of their child receiving an eye examination, pursuant to subdivision (a), by submitting the completed form to the school before an eye examination is provided at the schoolsite. Except as provided in clause (ii) of subparagraph (D) of paragraph (3) of subdivision (d), a parent or guardian who submits a written statement in accordance with Section 49451 is deemed to have opted out of their child receiving an eye examination pursuant to subdivision (a). (2) No later than March 1, 2023, the department shall develop and post on appropriate department internet websites a model opt-out form for purposes of paragraph (1). (c) (1) Notwithstanding any other law and subject to paragraph (3), participating licensed health care professionals, including independent contractors of those professionals, shall have immunity from civil and criminal liability, and shall not be subject to disciplinary action by a licensing board, for providing services that are authorized by this section without parent or guardian consent pursuant to this section or Section 49091.12. (2) Notwithstanding any other law and subject to paragraph (3), participating local educational agencies shall have immunity from civil and criminal liability for providing services that are authorized by this section without parent or guardian consent pursuant to this section or Section 49091.12. (3) This subdivision does not affect any of the following: (A) A person’s liability for damages caused by an act or omission that constitutes gross negligence or willful or wanton misconduct. (B) A person’s culpability for an act that constitutes a crime and is not specifically authorized by this section. (C) The ability of a licensing board to take disciplinary action against a licensed health care professional for an act not specifically authorized by this section. (D) (i) The ability of a parent or guardian, having control or charge of a pupil enrolled in the school, to file an annual written statement pursuant to Section 49451, stating that they do not consent to a physical examination of their child, thereby exempting the pupil from any physical examination, including, but not limited to, the eye examination authorized in this section. (ii) Notwithstanding the filing of a written statement exempting a child from any physical examination in accordance with Section 49451, a parent or guardian having control or charge of any child enrolled in the school may consent to an eye examination authorized in this section by means of executing a written consent to the examination, a copy of which shall be provided to the parent or guardian and the school. (d) Eye examination providers providing eye examinations to pupils at a school pursuant to this section are subject to, and shall comply with, Section 51520. (e) Any nonprofit eye examination provider, participating licensed health care professional, including independent contractors of these professionals, or other entity providing services under this section shall comply with the requirements of Section 45125.1 before interacting with any pupils. (f) Reports made to a parent, legal guardian, or caregiver of a pupil experiencing homelessness about a pupil defect identified from an eye examination facilitated by a nonprofit eye examination provider pursuant to this section should be made by alternative communication channels rather than mail, when possible. (g) For purposes of this section, the following definitions apply: (1) “Local educational agency” means a school district, county office of education, or charter school. (2) “Nonprofit mobile eye examination provider” means a nonprofit owner and operator of a “mobile optometric office,” as defined in subdivision (a) of Section 3070.2 of the Business and Professions Code.

Cal. Education Code - EDC § 49456. Section 49456.

(a) When a defect other than a visual defect has been noted by the supervisor of health or his assistant, a report shall be made to the parent or guardian of the child, asking the parent or guardian to take such action as will cure or correct the defect. Such report, if made in writing, shall not include any recommendation suggesting or directing the pupil to a designated individual for the purpose of curing or correcting any defect referred to in the report. (b) When a visual defect has been noted by the supervisor of health or his assistant, a report shall be made to the parent or guardian of the child, asking the parent or guardian to take such action as will correct the defect. Such report, if made in writing, must be made on a form prescribed or approved by the Superintendent of Public Instruction and shall not include therein any recommendation suggesting or directing the pupil to a designated individual or class of practitioner for the purpose of correcting any defect referred to in the report. (c) The provisions of this section do not prevent a supervisor of health from recommending in a written report that the child be taken to a public clinic or diagnostic and treatment center operated by a public hospital or by the state, county, or city department of public health.

Cal. Education Code - EDC § 49457. Section 49457.

The supervisor of health shall make such reports from time to time as he deems best to the governing board of the school district, or as the board may call for, showing the number of defective children in the schools of the district and the effort made to correct the defects.

Cal. Education Code - EDC § 49458. Section 49458.

When a school district or a county superintendent of schools requires a physical examination as a condition of participation in an interscholastic athletic program, the physical examination may be performed by a physician and surgeon or physician assistant practicing in compliance with Chapter 7.7 (commencing with Section 3500) of Division 2 of the Business and Professions Code.

Source: CA Legislative Counsel Bulk DataURL: https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zipFetched: 6/27/2026