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State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602), page 1
Moderate · 61/100Form Complexity Index

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What this form asks for

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DCFS Form CFS 602 is an official medical report completed by a physician for adults associated with DCFS-licensed child care facilities, including employees, volunteers, caregivers in day care/group day care homes, drivers, food handlers, and certain household members. It records required screening information such as TB testing (initial exam), immunization counseling and status (including Tdap/MMR considerations for settings serving children age 6 and under), and any medical or emotional conditions that could affect suitability. The form provides the physician’s determination of whether the individual is free from symptoms of communicable disease and medically/emotionally fit for child care-related duties. It also includes a section to document reexaminations over time.
Fillable fields88
Pages2
Sections22
Tables and lists1
Questions that depend on earlier answers2
Form Complexity IndexModerate, 61/100

The AI checks your answers before you download

18 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Person Examined Name Required and Proper Format

Validates that the 'Name of Person Examined' field is present and contains a plausible full name (e.g., at least first and last name, not only initials or a single character). This is important to uniquely identify the adult being evaluated and to prevent mismatches with licensing or employment records. If validation fails, the submission should be rejected or routed for correction because the report cannot be reliably attributed to an individual.

Birth Date Valid Date and Not in the Future

Checks that the Birth Date is provided, follows an accepted date format (e.g., MM/DD/YYYY), and represents a real calendar date. It also ensures the date is not in the future and implies a reasonable age for an adult (e.g., at least 18 years old). If invalid, the form should be flagged because age/identity verification and compliance determinations may be incorrect.

Position Selection Exactly One (or Valid Multi-Select Rules)

Ensures the 'Position (check one)' section has exactly one option selected, unless the business rules explicitly allow multiple roles. This matters because downstream requirements (e.g., Section B applicability for Food Handler/Driver) depend on the selected role. If multiple or none are selected, the system should block submission or require clarification to avoid applying the wrong medical criteria.

Licensee/Facility Name Required

Validates that the 'Name of Licensee/applicant for License or Licensed Facility' field is completed and not placeholder text. This is necessary to associate the medical report with the correct DCFS-licensed entity and to support audits and compliance tracking. If missing, the submission should be considered incomplete and returned for completion.

Facility Address Completeness and ZIP Code Format

Checks that Street, City, ZIP Code, and County are provided and that the ZIP Code is valid (5 digits or ZIP+4). Address completeness is important for identifying the facility location and jurisdiction, and for ensuring the report is filed under the correct county. If validation fails, the form should be flagged because the facility cannot be reliably located or matched to licensing records.

Tuberculin Test Requirement for Initial Examination

Validates that a Tuberculin test date and result are provided when the report is marked/treated as an initial examination (per the note '* Required in initial examination only'). This is critical for communicable disease screening compliance and to meet DCFS requirements. If missing for an initial exam, the submission should be rejected or marked non-compliant until test information is supplied.

And 12 more checks
  • Test Date and Result Pairing (No Orphan Values)
  • Immunizations Discussion Yes/No Must Be Selected
  • Tdap/MMR Compliance for Facilities Serving Children Age 6 and Under
  • Mutual Exclusivity of 'Received' vs 'Not Medically Indicated' for Same Vaccine
  • Food Handler/Driver Contraindication Section Required When Applicable
  • Contraindication Explanation Required When 'Yes' Selected
  • Fitness Determination Yes/No Must Be Selected
  • Explain 'No' Required When Not Fit
  • Examination Date Valid and Consistent with Test Dates
  • Physician Identification: Name and State License Number Required and Formatted
  • Physician Signature Presence
  • Physician Contact Information Completeness and Phone Format

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How to Fill Out CFS 602 Online for Free in 2026

What the AI walks you through.

  1. Enter the individual’s identifying information (name, birth date) and select the appropriate position/role checkbox (e.g., staff, volunteer, caregiver, household member, driver, food handler).
  2. Provide the child care licensee/applicant or facility name and the facility address (street, city, ZIP code, county).
  3. Complete Section I (Tests) by entering the date and results for the tuberculin (Mantoux) test or chest X-ray if a positive reactor, and list any other required tests with dates/results.
  4. Complete Section II (Immunizations) by indicating that immunization importance was discussed and, if applicable for facilities caring for children age 6 and under, check whether the individual has received or is not medically indicated for Tdap and MMR (or is immune).
  5. Complete Section III-A and III-B by summarizing any medical/emotional findings that may affect the person’s ability to work/volunteer/reside, and indicate whether any conditions contraindicate serving as a food handler or driver (with details if yes).
  6. Complete Section III-C by selecting whether the individual is free from symptoms of communicable disease and medically/emotionally fit; if “No,” provide an explanation, and check the age groups the individual can physically care for.
  7. Have the physician enter the examination date, print name and state license number, sign the form, and provide the physician’s address and telephone number; use the reexaminations area to record future exam dates and physician details as needed.

Common Mistakes in Completing CFS 602

The ones the AI is built to catch.

Leaving the person’s name or birth date blank or inconsistent
People often forget to complete the top identifiers or they enter a nickname, transposed digits, or a birth date that doesn’t match other records. This can cause the report to be rejected or misfiled, delaying hiring/clearance. Use the individual’s legal name exactly as it appears on ID and double-check the birth date format and accuracy before submission.
Not checking exactly one position (or checking the wrong one)
Applicants sometimes check multiple boxes, skip the position section, or select a role that doesn’t match their actual duties (e.g., selecting “Child Care Staff” when they are a household member). This creates confusion about which requirements apply, especially for Food Handlers and Drivers (Section B). Confirm the individual’s primary role and check only the single most accurate category unless the form/instructions explicitly allow multiple selections.
Omitting the licensee/facility name or using an informal facility name
A common error is leaving the “Name of Licensee/applicant for License or Licensed Facility” blank or writing a shortened/DBA name that doesn’t match DCFS records. This can prevent DCFS from linking the medical report to the correct facility and may trigger follow-up requests. Enter the full legal name of the licensee/applicant and the exact licensed facility name as shown on licensing paperwork.
Incomplete facility address (missing county, ZIP, or street details)
People frequently provide only a city, omit the county, or write a P.O. Box without a street address when the form expects a complete location. Incomplete addresses can slow processing and create issues verifying the correct licensed site. Fill in street, city, ZIP code, and county; verify the address matches the facility’s licensing documents.
TB testing section completed without required date, method, or results
The TB section is often filled out with vague notes like “negative” but no date, or the method (Mantoux vs. chest X-ray) is not indicated. Missing details can lead to rejection because DCFS needs a clear test type, date, and result, especially for initial examinations. Record the exact test performed, the date administered/read (as applicable), and the documented result; if a chest X-ray is used due to a positive reactor, note that explicitly.
Misunderstanding the ‘initial examination only’ TB requirement
Some submitters skip TB testing on the initial exam because they assume it’s optional, while others repeat it every time without documenting physician determination. Either mistake can cause compliance questions or unnecessary testing costs. For initial exams, ensure the TB requirement is addressed; for reexams, the physician should document whether a test is needed and complete the section accordingly.
Immunizations section left unmarked or internally inconsistent
A frequent issue is failing to check Yes/No for the immunization discussion, or checking boxes that conflict (e.g., indicating the person has received MMR while also marking “not medically indicated” for MMR). This creates ambiguity and can prompt resubmission requests. Make sure the provider checks the discussion Yes/No and then selects the appropriate Tdap/MMR status without contradictions.
Not completing the special requirement for facilities serving children age 6 and under
When the facility cares for children age 6 and under, the form asks to check two items regarding Tdap and MMR (received vs. not medically indicated). People often miss this conditional instruction or check only one box. This can delay approval because DCFS may treat it as incomplete immunization documentation. Confirm the age group served by the facility and, if applicable, ensure two appropriate boxes are checked and supported by records or medical contraindication.
Findings section too vague or left blank when issues exist
Providers sometimes write “N/A” or leave the findings empty even when there are relevant medical or emotional conditions that could affect work/residency in a child care setting. Overly vague entries can lead to follow-up questions, while omissions can create liability and compliance problems if later discovered. Summarize any relevant conditions clearly (without unnecessary detail), focusing on functional impact and any restrictions or accommodations.
Skipping Section B for Food Handlers/Drivers or failing to specify contraindications
If the person is a Food Handler or Child Care Facility Driver, Section B is critical, yet it’s often left unanswered or marked “Yes” without an explanation. This can result in the form being considered incomplete or can delay placement decisions. Always answer Yes/No, and if “Yes,” specify the condition(s) and any restrictions so the facility can determine suitability and compliance.
Fitness determination marked ‘No’ without explanation or missing age-group strength/mobility checks
People sometimes check “No” for being medically/emotionally fit but forget to complete the “Explain ‘No’” line, or they fail to check any age groups for strength and mobility. Missing these details prevents DCFS and the facility from understanding limitations and may require a new form. If “No,” provide a clear functional explanation and restrictions; always check the applicable age group(s) the individual can safely support.
Provider credentials/signature details missing (license number, signature, date, or contact info)
A very common rejection reason is missing the physician’s printed name, state license number, signature, or date of examination, or leaving the clinic address/phone incomplete. Without these, the report may not be considered valid and DCFS may request re-completion. Ensure the examining physician completes all credential fields, signs and dates the form, and includes full office address and telephone number.

Frequently Asked Questions About CFS 602

 

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How does the AI fill out CFS 602?
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What happens to my information?
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How complex is CFS 602 to fill out?
CFS 602 has a Form Complexity Index of 61 out of 100, in the moderate tier: 88 fillable fields across 2 pages. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is the purpose of the DCFS “Medical Report on an Adult in a Child Care Facility” (CFS 602) form?
This form documents a medical evaluation of an adult who works, volunteers, drives, handles food, or lives in a DCFS-licensed child care setting. It helps confirm the person is free from symptoms of communicable disease and medically/emotionally fit for the role.
Who is required to complete this form?
Adults who are employees or volunteers in DCFS-licensed child care facilities, caregivers/operators of day care or group day care homes, and other adult household members in those homes generally need this form completed. The “Position” section indicates which category applies.
Who fills out and signs the form—me or my doctor?
The medical sections (tests, immunizations discussion, findings, and recommendations) must be completed and signed by a physician, including the physician’s state license number. You or the facility may fill in identifying information (name, birth date, facility name/address) before the exam.
What information do I need to provide before the medical exam?
You should provide your name, birth date, and check your position/role (e.g., staff, volunteer, household member). You also need the name and address of the licensee/applicant or the licensed facility where you work/volunteer.
Is a TB (tuberculin) test required, and what type is acceptable?
Yes—TB testing is required for the initial examination, using a Mantoux tuberculin test or a chest X-ray if the person is a positive reactor. The physician determines whether TB testing is needed for subsequent examinations.
Where do the TB test date and results go on the form?
They are recorded in Section I (“TESTS”) under “Tuberculin test,” with the date and results entered. If another test is performed, it can be listed under “Other (specify).”
Do I have to be fully immunized to complete this form?
The form requires the physician to indicate that they discussed the importance of immunizations and to recommend immunizations as appropriate. It also includes checkboxes for Tdap and MMR status or medical contraindication when the person works with children age 6 and under.
What immunizations are specifically referenced for adults working with children age 6 and under?
The form asks the physician to check two items indicating either the individual has received 1 dose of Tdap and 2 doses of MMR (or is immune), or that those vaccines are not medically indicated. This section applies when the facility cares for children age 6 and under.
What does the “Findings” section mean, and what should be included?
Section III(A) is where the physician summarizes any medical or emotional problems or conditions that may affect the person’s ability to work, volunteer, or reside in a child care setting. If there are no relevant issues, the physician may note none.
I’m a food handler or a child care facility driver—what extra part applies to me?
Section III(B) asks whether there are any conditions that contraindicate serving as a Food Handler or Child Care Facility Driver. If “Yes” is checked, the physician must specify the condition(s).
What does it mean if the physician answers “No” to being fit to work/volunteer/reside?
In Section III(C), if the physician checks “No” to being medically and emotionally fit, they must explain the reason in the “Explain ‘No’” area. This may affect eligibility to work, volunteer, or live in the child care setting.
What are the age-group checkboxes (0–2, 2–6, 7–12, 12–18) used for?
They indicate which child age groups the physician believes the individual can physically manage based on strength and mobility demands. The physician checks one or more age groups as appropriate.
What physician details are required for the form to be complete?
The form requires the date of examination, the physician’s printed name, state license number, signature, office address, and telephone number. Missing physician identification or signature can cause the form to be rejected.
How are reexaminations documented on this form?
The bottom “REEXAMINATIONS” section provides lines to record future exam dates and the physician’s name and state license number. Each reexamination entry should be completed by the physician at the time of the follow-up exam.
Where do I submit the completed CFS 602 form, and how long does processing take?
The form itself does not list a submission address or processing timeline; typically it is provided to the licensee/applicant or the DCFS-licensed facility for their licensing/personnel file. Ask the facility or DCFS licensing representative for the correct submission method and any deadlines.
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Department of State forms: Center for Infertility & Reproductive Surgery – New Patient Questionnaire and Patient/Guarantor Statement (Brigham and Women’s Hospital, Department of Obstetrics and Gynecology), State of Illinois Department of Human Services (IDHS) – Bureau of Child Care and Development Child Care Application (Form IL444-3455), State of Florida Department of Highway Safety and Motor Vehicles (FLHSMV) Form HSMV 82993, Separate Odometer Disclosure Statement and Acknowledgment, DS 1891, Applicant/Vendor Disclosure Statement (State of California Department of Developmental Services), New York State Department of State (Division of Licensing Services) Property Condition Disclosure Statement (DOS-1614-f), State of Hawaii Department of Commerce and Consumer Affairs (DCCA) Contractors License Board – Application for Contractor's License (Sole Proprietor) (CT-36) with supporting forms (Experience Certificate CT-03, Contractors Financial Statement CT-02, and Chronological History of Projects/Project List), Murrieta Police Department Citizen Complaint Form (California Penal Code § 148.6 Advisory Statement), Pennsylvania Department of State — Certificate of Termination (Domestic Limited Liability Company) (15 Pa.C.S. § 8872(f)) (DSCB:15-8872(f)), Colorado Judicial Department Form JDF 1111SC (Form 35.2), Sworn Financial Statement, New York State Department of Labor (NYSDOL) Division of Labor Standards Complaint Form (LS 223), New York State Department of Labor, Division of Labor Standards Complaint Form (LS 223), Dallas Area Rapid Transit Police Department Personal History Statement (Peace Officer / Telecommunicator), California Department of Social Services, Sworn Statement, State of California Department of Transportation California Civil Rights Laws Certification, State of California Department of Transportation Darfur Contracting Act Certification, Form DOT ADM-0077, State of California Department of Transportation, Contract Requirements, State of California Department of Transportation Subcontractor List, State of California Department of Transportation, Certified DVBE Summary, State of Florida Department of Business and Professional Regulation Form DBPR CILB 6-B, Application for Certified Building Contractor Who is Qualifying a Business, New York State Department of Health Certificate of Qualification Questionnaire - Virology

NJ state forms: Form 1095-A, Health Insurance Marketplace Statement, Form W-2, Wage and Tax Statement, Form 593, Real Estate Withholding, Form 8938, Statement of Specified Foreign Financial Assets, Form CMS-2567, Statement of Deficiencies, Form 1098, Mortgage Interest Statement, Form 1098-T, Tuition Statement, Form 1099-S, Proceeds From Real Estate Transactions, Form 1098-E, Student Loan Interest Statement, Form DS-3053, Statement of Consent, Form DS-86, Statement of Non-Receipt of a U.S. Passport, Form DS-86, Statement of Non-Receipt of a U.S. Passport, Form 108, Statement of Intention, Form 107, Statement of Financial Affairs, Form 121, Statement About Your SSNs, Form 122A-1, Chapter 7 Statement of Current Monthly Income, Center for Infertility & Reproductive Surgery – New Patient Questionnaire and Patient/Guarantor Statement (Brigham and Women’s Hospital, Department of Obstetrics and Gynecology), Adult Travel Document Application for Stateless and Protected Persons in Canada (16 years of age or over) (PPTC 190), Form W-8IMY (Rev. October 2021), Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding and Reporting, Form W-2, Wage and Tax Statement (2025)

state ID forms: Application for Renewal or Duplicate of Alabama Driver License or ID card, Form 1095-A, Health Insurance Marketplace Statement, Form W-2, Wage and Tax Statement, Form 593, Real Estate Withholding, Form 8938, Statement of Specified Foreign Financial Assets, Form CMS-2567, Statement of Deficiencies, Form 1098, Mortgage Interest Statement, Form 1098-T, Tuition Statement, Form 1099-S, Proceeds From Real Estate Transactions, Form 1098-E, Student Loan Interest Statement, Form DS-3053, Statement of Consent, Form DS-86, Statement of Non-Receipt of a U.S. Passport, Form 108, Statement of Intention, Form 107, Statement of Financial Affairs, Form 121, Statement About Your SSNs, Form 122A-1, Chapter 7 Statement of Current Monthly Income, Center for Infertility & Reproductive Surgery – New Patient Questionnaire and Patient/Guarantor Statement (Brigham and Women’s Hospital, Department of Obstetrics and Gynecology), Adult Travel Document Application for Stateless and Protected Persons in Canada (16 years of age or over) (PPTC 190), Form W-8IMY (Rev. October 2021), Certificate of Foreign Intermediary, Foreign Flow-Through Entity, or Certain U.S. Branches for United States Tax Withholding and Reporting, Form W-2, Wage and Tax Statement (2025)

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