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Self-Certification of Employee Vaccination Status

September 19, 2022
2080
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Instructions

The definition of a "fully vaccinated" individual was deleted in the May 6, 2022, from the Cal/OSHA ETS revisions as this term is no longer used in the regulations. All protections now apply to all employee’s regardless of vaccination status and the ETS requirements do not vary based on an employee’s vaccination status.

Face coverings are mandatory in the Cal/OSHA ETS when CDPH requires their use, which currently includes dental practice healthcare settings, regardless of the employee’s vaccination status. Employers who have mandatory vaccine policies may use this resource to obtain verification of an employee’s vaccine status.

In lieu of obtaining a copy of the employee’s vaccine card, employees may show official proof of the vaccine or other similar health care provider documentation (see below) confirming the vaccine status to a designated representative of the business. If an employee provides a copy of their vaccine card, or other documentation employers should instruct employees to omit any medical information unrelated to their vaccine status.

Pursuant to the CDPH Guidance for Vaccine Records Guidelines & Standards, only the following modes may be used as proof of vaccination:

  1. COVID-19 Vaccination Record Card (issued by the Department of Health and Human Services Centers for Disease Control & Prevention or WHO Yellow Card) which includes name of person vaccinated, type of vaccine provided and date last dose administered); OR
  2. a photo of a Vaccination Record Card as a separate document; OR
  3. a photo of the client's Vaccination Record Card stored on a phone or electronic device; OR
  4. documentation of COVID-19 vaccination from a health care provider; OR
  5. digital record that includes a QR code that when scanned by a SMART Health Card reader displays to the reader client name, date of birth, vaccine dates and vaccine type. The QR code must also confirm the vaccine record as an official record of the state of California; OR
  6. documentation of vaccination from other contracted employers who follow these vaccination records guidelines and standards.

In the absence of knowledge to the contrary, a facility may accept the documentation presented as valid.

Facilities must have a plan in place for tracking verified worker vaccination status. Records of vaccination verification must be made available, upon request, to the local health jurisdiction for purposes of case investigation.

Workers who are not fully vaccinated, or for whom vaccine status is unknown or documentation is not provided, must be considered unvaccinated.

Employers must meet compliance obligations with respect to medical records and the protection of employees’ private and confidential information.

*Includes associates classified as independent contractors

Self-Certification of Employee Vaccination Status

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