State funded ECEAP programs require that all staff working with children receive an initial health examination, requires that all staff working with children complete a two-step Mantoux tuberculosis (TB) skin test or proof of Negative Mantoux TB test in the 12 months prior to hire, medical therapy to treat TB, or a recent negative chest x-ray and a statement from a health care provider, regular and ongoing medical care, and do not pose a risk to the young children (ages 0-5) or pregnant mothers that our program serves. Exposure to dust, fumes, bleach and disinfectants, traffic, infectious diseases/sickness, human waste, occasional extreme noise levels and occasionally high risk, emotionally disturbed or dangerous individuals when making home visits.