Health Care Workers TB Screening

Licensing and Certification (L&C) 

Health Care Workers, Persons who work in a health facility, service or operation, or who have occupational TB exposure in public health services in connection with health care.
California Code of Regulation (CCR) Title 22, Div. 5, Ch.1-12
CDPH Licensing & Certification enforces licensing requirements for hire & annual testing. Notifies health care facilities of policy changes through All Facility Letters


COVID Response

CNA FAQ unable to get tested for tuberculosis

Due to the current state of emergency, a nurse assistant enrolled in an approved certification training program or competency evaluation program may provide patient care prior to having a test for tuberculosis infection. The nurse assistant shall complete the test for tuberculosis infection as soon as practicable but no later than 30 days after the expiration of the state of emergency.  (See AFL 20-35.1)

May 2, 2018 All Facilities Letter


This AFL provides direction to increase uniformity in requests for program flexibility from regulatory requirements.

CalOSHA August 13, 2020 Update

TABLE 1 – Mandated Surveillance Exams and Consideration of Temporary Delay due to COVID-19 Risks

physician or other licensed health care professional (PLHCP)

(2) Aerosol Transmissible Diseases, 
8 CCR 5199

Initial (before placement) Screening for TB
PLHCP should ask about TB symptoms, and should weigh importance of prior negative TB tests, if any, and whether there are new risk factors since most recent prior negative test (per current CDC guidance); offer TST or IGRA, unless ALL of above indicate low risk.

Periodic (annual) Screening for TB

PLHCP should weigh facility prevalence of TB and personal TB risk factors (per current CDC guidance) in deciding to delay offering a periodic TB test. Annual education about TB symptoms and instructions to seek care for symptoms should not be delayed. 

CalOSHA Annual TB testing of Health Care Personnel Code

According to the California Code of Regulations, Title 8, Section 5199(h)(3), “…The employer shall make an assessment for latent tuberculosis infection (LTBI) available to all employees with occupational exposure. Assessment procedures shall be in accordance with applicable public health guidelines.

(A) TB tests and other forms of TB assessment shall be provided at least annually, and more frequently if applicable public health guidelines or the local health officer recommends more frequent testing. Employees with a baseline positive TB test shall have an annual symptom screen.

(B) The employer shall refer employees who experience a TB conversion to a PLHCP knowledgeable about TB for evaluation”.

This section is available at If you need further assistance, please contact the nearest Cal/OSHA Consultation Service office,