JFS 01236 (Rev. 3/2022) Page 2 of 4 Part II: Conditions Requiring Medication or Medical Food Completed by Licensed Physician, Licensed Dentist, Advanced Practice Registered Nurse, or Certified Physician's

We would like to show you a description here but the site won’t allow us.

Welcome to ODJFS Forms Central. At this site you will find the forms currently used in ODJFS programs. The purpose of Forms Central is to provide customers and staff with a dynamic listing of all ODJFS forms along with the capability to order forms online.

Guide to Public Participation in the Rule-Making Process. Child Care Forms. The most recent version of all DCY Forms referenced in Chapters 12 through 18, can be accessed through Forms Central. Information for childcare rules and relevant forms.

Please note that if your child has a current health or medical condition requiring child care staff to perform child specific care, such as: to monitor the condition, provide treatment, care, or to give medication, the JFS 01236 "Child Medical/Physical Care Plan for Child Care" must be completed and be kept on file at the program/home.

JFS 01236 (Rev. 10/2021) Page 4 of 4 The following section must be completed by the child care staff member, family child care provider or in-home aide for the child listed on this form. All medication must be documented when administered. Incomplete information elevates the level of risk to children. Child's Name Name of Medication

(If yes, complete JFS 01217 "Request for Administration of Medication", in addition to this form.) In an emergency does this child require additional assistance (more than other children of the same age or in the same

CHILD MEDICAL/PHYSICAL CARE PLAN FOR CHILD CARE

Please note that if your child has a current health or medical condition requiring child care staff to perform child specific care, such as: provide treatment, care, or to give medication, the JFS 01236 "Medical/Physical Care Plan" or equivalent form and/or the JFS 01217 "Request for Administration of Medication" must be completed and be kept ...