Yes! You can use AI to fill out State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602)
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 physicianâs 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.
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Form specifications
| Form name: | State of Illinois Department of Children and Family Services Medical Report on an Adult in a Child Care Facility (CFS 602) |
| Number of pages: | 2 |
| Filled form examples: | Form CFS 602 Examples |
| Language: | English |
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How to Fill Out CFS 602 Online for Free in 2026
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Follow these steps to fill out your CFS 602 form online using Instafill.ai:
- 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.
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Frequently Asked Questions About Form CFS 602
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.
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 âPositionâ section indicates which category applies.
The medical sections (tests, immunizations discussion, findings, and recommendations) must be completed and signed by a physician, including the physicianâs state license number. You or the facility may fill in identifying information (name, birth date, facility name/address) before the 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.
YesâTB 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.
They are recorded in Section I (âTESTSâ) under âTuberculin test,â with the date and results entered. If another test is performed, it can be listed under âOther (specify).â
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.
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.
Section III(A) is where the physician summarizes any medical or emotional problems or conditions that may affect the personâs ability to work, volunteer, or reside in a child care setting. If there are no relevant issues, the physician may note none.
Section III(B) asks whether there are any conditions that contraindicate serving as a Food Handler or Child Care Facility Driver. If âYesâ is checked, the physician must specify the condition(s).
In Section III(C), if the physician checks âNoâ to being medically and emotionally fit, they must explain the reason in the âExplain âNoââ area. This may affect eligibility to work, volunteer, or live in the child care setting.
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.
The form requires the date of examination, the physicianâs printed name, state license number, signature, office address, and telephone number. Missing physician identification or signature can cause the form to be rejected.
The bottom âREEXAMINATIONSâ section provides lines to record future exam dates and the physicianâs name and state license number. Each reexamination entry should be completed by the physician at the time of the follow-up exam.
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.
Compliance CFS 602
Validation Checks by Instafill.ai
1
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.
2
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.
3
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.
4
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.
5
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.
6
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.
7
Test Date and Result Pairing (No Orphan Values)
Ensures that for each test line (Tuberculin and 'Other'), a date is not provided without a corresponding result, and a result is not provided without a date. This prevents ambiguous medical records and supports accurate interpretation of screening status. If pairing fails, the system should require correction because incomplete test entries can be misread as completed screening.
8
Immunizations Discussion Yes/No Must Be Selected
Checks that the immunizations discussion question has exactly one selection (Yes or No). This is important because the form explicitly requires documenting whether the provider discussed immunization importance and made recommendations. If neither or both are selected, the submission should be flagged as internally inconsistent and incomplete.
9
Tdap/MMR Compliance for Facilities Serving Children Age 6 and Under
If the form indicates the individual is employed in a facility caring for children age 6 and under (or if that facility type is known from context), validates that exactly two items are checked across the Tdap/MMR section as instructed (either 'has received' items, or 'not medically indicated' items, or a consistent combination per policy). This ensures compliance with immunization requirements and clear documentation of vaccination status or medical exemption. If the rule is not met, the form should be rejected or routed for follow-up because immunization compliance cannot be determined.
10
Mutual Exclusivity of 'Received' vs 'Not Medically Indicated' for Same Vaccine
Validates that the same vaccine is not simultaneously marked as both 'received' and 'not medically indicated' (e.g., Tdap received AND Tdap not medically indicated). This logical consistency check prevents contradictory medical statements that could invalidate the report. If a conflict is detected, the submission should be blocked and returned for physician clarification.
11
Food Handler/Driver Contraindication Section Required When Applicable
If the Position selected is 'Food Handler' or 'Child Care Facility Driver', validates that Section III.B (contraindications Yes/No) is completed. This is important because these roles have specific safety-related medical considerations and the form explicitly calls out Section B for them. If missing, the submission should be considered incomplete for those roles and require completion before acceptance.
12
Contraindication Explanation Required When 'Yes' Selected
Checks that when Section III.B is marked 'Yes' (conditions contraindicate serving as Food Handler/Driver), the 'If yes, please specify' text field is populated with a meaningful explanation. This is necessary to document the nature of the limitation and support employment/assignment decisions. If absent, the form should be rejected because a 'Yes' without details is not actionable and may create liability.
13
Fitness Determination Yes/No Must Be Selected
Validates that the physicianâs statement about being free from symptoms of communicable disease and medically/emotionally fit is answered with exactly one of Yes or No. This is a core outcome of the medical report and is required for clearance decisions. If not selected or both selected, the submission should be blocked because the clearance status is undefined.
14
Explain 'No' Required When Not Fit
Ensures that if the fitness determination is 'No', the 'Explain âNoâ' field is completed with sufficient detail (not blank or trivial text). This is important for documenting the reason for non-clearance and for enabling appropriate follow-up or accommodations. If missing, the form should be rejected or flagged because a denial without rationale is incomplete and may be challenged.
15
Examination Date Valid and Consistent with Test Dates
Checks that the Date of Examination is present, is a valid date, and is not in the future. It also validates that any listed test dates are not after the examination date (or, if allowed, are clearly documented as ordered/performed after with appropriate context), to avoid temporal inconsistencies. If validation fails, the submission should be flagged because the medical timeline may be unreliable.
16
Physician Identification: Name and State License Number Required and Formatted
Validates that the physicianâs printed name and state license number are provided and that the license number matches expected formatting rules (e.g., alphanumeric length constraints as configured for the state). This is essential to confirm the report is completed by an authorized medical professional and to support verification/audit. If missing or malformed, the form should be rejected or routed for verification because the report may not be legally acceptable.
17
Physician Signature Presence
Ensures the Physicianâs Signature field is present (captured as a wet signature scan, e-signature, or attestation per system rules). The signature is critical for legal attestation that the findings and recommendations are accurate. If absent, the submission should be considered invalid and not accepted as an official medical report.
18
Physician Contact Information Completeness and Phone Format
Validates that the physicianâs address (Street, City, State, ZIP) is complete and that the Telephone Number is present and matches a valid phone format (e.g., 10 digits with optional separators). This information is important for follow-up questions, verification, and compliance audits. If invalid or missing, the form should be flagged because the physician cannot be reliably contacted to confirm or clarify medical information.
Common Mistakes in Completing CFS 602
People often forget to complete the top identifiers or they enter a nickname, transposed digits, or a birth date that doesnât match other records. This can cause the report to be rejected or misfiled, delaying hiring/clearance. Use the individualâs legal name exactly as it appears on ID and double-check the birth date format and accuracy before submission.
Applicants sometimes check multiple boxes, skip the position section, or select a role that doesnât match their actual duties (e.g., selecting âChild Care Staffâ when they are a household member). This creates confusion about which requirements apply, especially for Food Handlers and Drivers (Section B). Confirm the individualâs primary role and check only the single most accurate category unless the form/instructions explicitly allow multiple selections.
A common error is leaving the âName of Licensee/applicant for License or Licensed Facilityâ blank or writing a shortened/DBA name that doesnât 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.
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 facilityâs licensing documents.
The TB section is often filled out with vague notes like ânegativeâ 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.
Some submitters skip TB testing on the initial exam because they assume itâs 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.
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 ânot medically indicatedâ 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.
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.
Providers sometimes write âN/Aâ 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.
If the person is a Food Handler or Child Care Facility Driver, Section B is critical, yet itâs often left unanswered or marked âYesâ without an explanation. This can result in the form being considered incomplete or can delay placement decisions. Always answer Yes/No, and if âYes,â specify the condition(s) and any restrictions so the facility can determine suitability and compliance.
People sometimes check âNoâ for being medically/emotionally fit but forget to complete the âExplain âNoââ 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 âNo,â provide a clear functional explanation and restrictions; always check the applicable age group(s) the individual can safely support.
A very common rejection reason is missing the physicianâs 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.
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