Foster Care Medical Screening Requirements in California

One of the most common questions from California foster care applicants is whether they need to get a physical exam or TB test before they can be approved. The short answer is: it depends on your county and your health disclosure — and the requirements changed in recent years. Here's what the current RFA standards actually require.

The Health Questionnaire: Form RFA-07

The primary health requirement for all Resource Family Approval applicants is Form RFA-07, the Health Questionnaire. This is a self-disclosure document, not a clinical exam. You complete it yourself and submit it as part of your application packet.

RFA-07 asks about:

• Current physical health conditions that might affect your ability to provide care
• Mental health history, including any diagnoses, hospitalizations, or ongoing treatment
• Use of medications that could impair caregiving
• Any physical or mental health limitations that would prevent you from meeting a child's needs

The form is designed to surface anything that would require follow-up — not to exclude anyone who has ever had a health issue. Many approved resource families manage chronic health conditions without any problem. The question is whether those conditions are stable and managed in a way that doesn't impair caregiving.

When a Physician's Screening Is Required

A formal physician's exam is not automatically required for all applicants. Under the current RFA Written Directives, a physician screening is required when:

• Your answers on RFA-07 indicate a health condition that warrants clinical verification
• The county, in its professional judgment, determines that a medical evaluation is needed to assess your fitness to care for children
• You are seeking approval to care for children with significant medical needs (some counties or FFAs may require this for higher Level of Care placements)

In practice, if your RFA-07 is clean and your interview doesn't raise health concerns, most applicants complete the process without a physician's exam. If a physical is required, the cost is typically borne by the applicant — it can range from $75 to $200 depending on your provider and whether you have insurance.

TB Screening: No Longer Universal

California previously required TB (tuberculosis) screening for all foster care and child care applicants. This requirement was modified under RFA Written Directives updates. As of the current version:

• TB screening is no longer a mandatory pre-approval requirement for all applicants
• It remains at the county's discretion if health concerns are identified through the RFA-07 or other assessment
• Some counties and FFAs may still require it as a standard part of their local intake process

This means you may or may not be asked for a TB test depending on your county. If you want certainty before your appointment, call your county RFA unit or FFA intake coordinator and ask directly. Do not assume that the absence of a universal requirement means your county has removed it from their local process.

If you are required to get TB screening, the most common method is a IGRA blood test (interferon-gamma release assay), which is more reliable than the skin test and takes a few days for results.

Health of Other Household Members

All adults in the household (18+) must also complete background checks, but the formal health screening requirement in RFA-07 applies specifically to the primary applicant(s) — the individuals applying to be resource parents.

However, if a county worker observes during the home assessment that another household member has a health condition that creates a risk to a placed child (for example, an infectious disease that isn't managed, or a condition that creates safety concerns), this can be flagged in the assessment. It's a judgment call by the assessor rather than a fixed rule.

Mental Health and the Screening Process

Mental health history is included in the RFA-07 health questionnaire, and this is an area where many applicants feel anxious about disclosure. A few things to understand:

Having received mental health treatment does not disqualify you. Many excellent resource families have therapy backgrounds or have managed anxiety, depression, or other conditions. The assessment is about current stability and functioning, not past history.

Ongoing treatment is generally viewed positively. Someone who is currently in therapy and managing well demonstrates self-awareness and a commitment to their own wellbeing — qualities that transfer to caregiving.

Undisclosed mental health history can become a problem. If you omit information that later surfaces through references, interview responses, or other household members' disclosures, it raises questions about honesty. The same principle applies here as with criminal records: disclosure with context is almost always better than omission.

If you have a mental health history that concerns you, consider speaking with a social worker or a foster care consultant before submitting your application. Some FFAs have intake staff who can give you a preliminary read on how a particular history is likely to be viewed.

What Happens If the Health Assessment Raises Concerns

If the county or FFA determines, based on your RFA-07 or a physician's exam, that a health condition may affect your ability to care for a child, they have several options:

• Request additional documentation or a specialist's assessment
• Approve you with conditions — for example, specifying that placements should not involve children with high medical needs
• Deny the application, with an explanation and instructions on the 25-day appeal window

Most health-related concerns don't result in denial — they result in a conversation and, potentially, a more specific approval. The system is looking for families who can provide stable, safe care; it's not trying to exclude people on medical technicalities.

Costs to Budget For

While the RFA process is free in terms of government fees, out-of-pocket health-related costs can include:

• TB test or IGRA blood test: $25 to $75
• Physician's exam (if required): $75 to $200
• Any required specialist follow-up from the physician's review

These costs are modest but worth knowing about in advance. Some counties have arrangements with community health clinics for reduced-cost or free TB tests for foster care applicants — worth asking about when you contact your county office.

For a full breakdown of all RFA application requirements — including health screening, background checks, home inspection, and training — the California Foster Care Licensing Guide covers every component of the process with county-specific details.

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