(a) The licensee and all employees working in the facility shall have a health examination within 6 months prior to employment or within 15 days after employment and at least annually thereafter by a person lawfully authorized to perform such examinations. Each such examination shall include a medical history, physical evaluation and laboratory work as indicated. The health examination report, signed by the examiner, shall indicate that the individual is sufficiently free of disease to perform assigned duties and does not have any health condition that would create a hazard for the employee, fellow employees, visitors or clients.

(b) At the time of employment, testing for tuberculosis shall consist of a test for tuberculosis infection that is recommended by the federal Centers for Disease Control and Prevention (CDC) and licensed by the federal Food and Drug Administration (FDA). If a positive result is obtained from the tuberculosis test, the employee shall be referred to a physician to determine if a chest X-ray is necessary. Annual examinations shall be performed only when medically indicated.

(c) The facility shall maintain a health record of the administrator and each employee which includes reports of all employment-related health examinations.

(d) Employees known to have or exhibiting signs or symptoms of a communicable disease shall not be permitted to work until they submit a physician's certification that they are sufficiently free of the communicable disease to return to their assigned duties.