CCMPL 53 (Revised Forms for Licensed Child Care Centers and Type A Family Child Care Homes)
Child Care Manual Procedure Letter No. 53
June 25, 2010
TO: All Child Care Manual Holders
FROM: Douglas E. Lumpkin, Director
SUBJECT: Revised Forms for Licensed Child Care Centers and Type A Family Child Care Homes

The following forms used by licensed child care centers and type A homes have been revised:

JFS 01206, "Rehabilitation Criteria," was a sample form that is now a prescribed form. Owners and administrators must use this form to document that an employee meets the rule requirements for rehabilitation after having a prohibited criminal offense.

JFS 01219, "Child Care Staff Member and Employee Requirements for Child Care Centers and Type A Homes," is a guidance document that has been updated to reflect the revisions made to the rules regarding criminal background checks.

JFS 01303, "Fire Inspection Report," is the form used to document the findings when a fire inspection is completed. It has been revised to incorporate formatting changes and to include the center license expiration date.

JFS 01305, "Child's Medical Statement," is a sample form that may be used to provide the required documentation regarding a child's medical examination. Shading has been added to the Varicella (chicken pox) and the Hepatitis A "Dose 3" boxes, as these immunizations must be given in two doses.

JFS 01307, "Inservice Training," is a prescribed form used to document inservice training completed by child care staff members. This form has been revised to include the training requirements for programs that are participating in the Step Up To Quality program.

JFS 01328, "Statement of Nonconviction," is a prescribed form used to document each child care employee's statement that he or she has not been convicted of any prohibited offenses. This form has been revised to clarify language regarding convictions under Ohio Revised Code 4511.19. In addition, the signature boxes for the administrator have been reorganized, and language has been added to clarify when the form needs to be signed.

In addition, one new form has been created:

JFS 01239, "Field Trip Information Record." This form is designed to assist programs in meeting the requirements of Ohio Administrative Code rules 5101:2-12-18 and 5101:2-13-18 for recording information about children on field trips.

The electronic versions of the Child Care Manuals are located at http://emanuals.odjfs.state.oh.us/emanuals. The manuals contain all rules and transmittal letters that the department has issued to licensed child care centers and Type A homes. All providers in licensed child care centers and Type A homes should use and keep accessible a current version of the appropriate manual.

Please contact the Help Desk for the Office for Children and Families at 1-866-886-3537, option 4, if you have any questions.

INSTRUCTIONS: The following chart identifies the material that needs to be removed from and inserted into the Child Care Manual (CCM).

LOCATIONREMOVE AND FILE AS OBSOLETEINSERT/REPLACEMENT
Child Care Manual AppendixJFS 01206
(Rev. 1/2009)
JFS 01206
(Rev. 7/2010)
 JFS 01219
(Rev. 9/2008)
JFS 01219
(Rev. 7/2010)
JFS 01303
(Rev. 3/2007)
JFS 01303
(Rev. 7/2010)
 JFS 01305
(Rev. 11/2008)
JFS 01305
(Rev. 7/2010)
 JFS 01307
(Rev. 9/2006)
JFS 01307
(Rev. 7/2010)
 JFS 01328
(Rev. 8/2008)
JFS 01328
(Rev. 7/2010)
  JFS 01239
(7/2010)
Procedure Letters CCMPL No.