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(c) Applicants must be able to communicate with the licensing agency and health care and other service providers. (d) Applicants must have verifiable income or resources to make timely payments for shelter, food, utility costs, clothing, and other household expenses prior to the addition of a child in the home. Income may be verified through income tax records, pay stubs, bank account statements or other verifiable means. Promised gifts or donations do not constitute income or financial resources. (3) The agency must not deny to any individual the opportunity to become a foster parent or adoptive parent on the basis of the race, color, or national origin of the individual, or of the child, as required by the federal Multiethnic Placement Act (MEPA), 42 U.S.C.A. sec. 1996b, and Title IV–E of the Social Security Act, 42 U.S.C.A. sec. 671(18). MEPA also provides that this law must not be construed to affect the application of the Indian Child Welfare Act, which contains preferences for the placement of eligible American Indian and Alaska Native children in foster care, guardianship, or adoptive homes. Furthermore, the agency must not discriminate with regard to the application or licensure of a foster family or approval of an adoptive family on the basis of age, disability, gender, religion, sexual orientation, gender identity or marital status. H. Physical and Mental Health Standards. (1) All applicants and household members must have physical exams completed by a licensed health care professional. The exam results must be current and within one year of application and must state that the applicant can care for additional children. In its discretion, the agency may require further documentation and evaluation to make such a determination. (2) All children who are household members must be current on immunizations as recommended by the child’s pediatrician or as required for compulsory school attendance jointly recommended by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians, unless the immunization is contrary to the child’s health as documented by a licensed health care professional or the department determines that other extenuating circumstances exist. (a) All household members who will be caregivers of infants must have an up-to-date pertussis (whooping cough) vaccine consistent with the recommendations of the ACIP, unless the immuniza- tion is contrary to the individual’s health as documented by a licensed health care professional or the department determines that other extenuating circumstances exist. (b) All household members who will be caregivers of infants and children with special medical needs must have an up-to-date annual influenza vaccine consistent with the recommendations of the ACIP, unless the immunization is contrary to the individual’s health as documented by a licensed health care professional or the department determines that other extenuating circum- stances exist. (3) Applicants and all household members must disclose any past or current mental health or substance abuse issues. The agency may require further documentation and evaluation to determine the suitability of the home. I. Home Study Standards. (1) The agency must conduct a written comprehensive family assessment and home study in collaboration with the applicants upon initial application and renewal to include the following: (a) An initial application shall require a minimum of two (2) on-site visits to the home, unless the SCDSS Director or director’s designee allows for a deviation due to a public health crisis or natural disaster. The visits will assess the safety of the home using the SCDSS licensing and adoption standards. An individual interview of each applicant must be conducted to observe family functioning and assess the family’s capacity to meet the needs of a child in foster care. It is preferred that all additional household members be interviewed in the home; however, a virtual interview may be conducted if additional household members are unable to be interviewed in person at an alternative time. The agency will determine whether to interview or just observe each household member based on his or her age and development. (b) For a renewal application, a minimum of one (1) on-site visit to the home, unless the SCDSS Director or director’s designee allows for a deviation due to a public health crisis or natural disaster, shall be required. The visit will assess the safety of the home using the SCDSS licensing