CCMPL 134 (Changes to the Child Care Prescription Medication Sample Forms)
Child Care Manual Procedure Letter No. 134
February 13, 2020
TO: All Child Care Manual Holders
FROM: Kimberly Hall, Director
SUBJECT: Changes to the Child Care Prescription Medication Sample Forms

Background:

The Ohio Department of Job and Family Services (ODJFS) has revised the prescription pad sample forms to update the documents to align with rule 5101:2-12-25 of the OAC.

The following forms have been revised:

  • JFS 01580 “Your Prescription For Safely Administering Prescription Medication” has been revised to add a Certified Physician’s Assistant as a party that can complete Box 2 of the JFS 01217.
  • JFS 01581 “Your Prescription For Safely Administering Non-Prescription Medication” has been revised to add a Certified Physician’s Assistant as a party that can complete Box 2 of the JFS 01217.
  • JFS 01582 “Your Prescription For Safely Caring For Children With Special Health Conditions” has been revised with minor grammar changes and to clarify that the administrator must also sign the form.
  • JFS 01583 “Your Prescription For Safely Caring For Children With Medication And Health Care Needs On Field Trips” has been revised with minor grammar changes.

Child care programs are not required to use these forms but may use them as a checklist to ensure all medication administration requirements are met.

Please contact the Child Care Policy Helpdesk at 1-877-302-2347, option 4, if you have any questions.