This care provider was diligent in researching the online AFH rules, but could not find the answer to this question there. So she called me. Mind you, I'm not actively teaching for the State of Washington ADSA anymore - and I do not know if they have recently updated the TB testing rules. But here's my take on this and any other AFH Licensing rule question.
Understand that if you have read through all the rules, and your question is clearly not addressed, you have several options:
1. You can assume that there is no specific rule regarding this specific issue, and do nothing - just let it go.
2. You can contact your licensor and ask the question - and then expect to see a new rule update regarding your specific question within a year (do you really want more and more detailed regulations?)
3. You can contact local health care authorities or other local businesses for recommendations as to best practice in how to proceed,
and make a pro-active decision. In this case, I might choose to require another TB test, even though the Licensing rules only require testing "upon hire".
Pick number 3. If you've already been through the rules at length, and can find no reference to your specific question, be pro-active as a business owner. Ask yourself, "What is the desired outcome?" The answer will always be - to keep my residents well and happy, to follow the licensing rules, and to do good business.
So - dear care provider - unless you like being tied up very tightly with more and more regulations about every detail on how to run your business - just be pro-active and make the right decision in protecting your residents. YOU ARE THE BUSINESS OWNER. YOU ARE RESPONSIBLE for everything in your business. It's not just about the rules. It's about doing good business.
If you suspect that a caregiver may have come in contact with active TB, and you allow that caregiver to work without a TB test, and your residents' health becomes affected... yes, you would be held accountable for that business decision in one way or another.
So - make "best practice" decisions and thrive in the business!