We report a nearly ideal quantum anomalous Hall effect in a three-dimensional topological insulator thin film with ferromagnetic doping. Near zero applied magnetic field we measure exact quantization in the Hall resistance to within a part per 10 000 and a longitudinal resistivity under 1 Ω per square, with chiral edge transport explicitly confirmed by nonlocal measurements. Deviations from this behavior are found to be caused by thermally activated carriers, as indicated by an Arrhenius law temperature dependence. Using the deviations as a thermometer, we demonstrate an unexpected magnetocaloric effect and use it to reach near-perfect quantization by cooling the sample below the dilution refrigerator base temperature in a process approximating adiabatic demagnetization refrigeration.