** Archive **
CCMTL 52 (Child Care Centers and Type A Forms - ARCHIVE)
Child Care Manual Transmittal Letter No. 52
April 25, 2003
TO: All Child Care Manual Users
FROM: Thomas J. Hayes, Director
SUBJECT: Forms for Child Care Centers and Type A Homes

This letter transmits forms to be used by Child Care Centers and Type A Homes. As a result of the completion of a five year review by the Bureau of Child Care and Development, the rules governing Child Care Centers and Type A Homes have been revised. The rule changes are in separate Child Care Manual Transmittal Letters. This review also resulted in form changes. One form was obsoleted and not replaced, nine were revised and eight were developed. Several of the forms are optional use and are designated with an asterisk (*) after the form number.

Child care centers need to begin utilizing the Incident/Injury Report, Employee Record Chart, Sleep Position Waiver, First Aid Supplies, and Center Plan of Operation (as applicable), as soon as they receive form copies. The remaining forms, in order to provide for a transition period, should begin to be implemented as soon as possible upon receipt, with full implementation expected no later than December 31, 2003.

Type A homes revised forms will need to begin being utilized by July 1, 2003.

The revised forms that are included in this transmittal are:

Revised Forms
JFS 01217 Request for Administration of Medication
For use by Centers and Type A homes.
JFS 01240 Food Service Exemption
For use by Centers
JFS 01247 Child Care Center Compliance Report
For use by Centers - Optional Resource
JFS 01250 Child Care Center Plan of Operation
For use by Centers - Initial Licensure
JFS 01296* Employee Medical
For use by Centers and Type A homes.
JFS 01299 Incident /Injury Report
For use by Centers and Type A homes.
JFS 01303 Fire Inspection Report
For use by Centers and Type A homes.
JFS 01305* Child Medical
For use by Centers and Type A homes
JFS 01306 Employee Record Chart
For use by Centers and Type A homes.
JFS 01307 Documentation of In service Training
For use by Centers and Type A homes.
JFS 01313 Non Conviction Statement
For use by Centers and Type A homes.

 

The new forms that are included in this transmittal are:

 

New Forms
JFS 01234 Child Enrollment/Health Information (Enrollment, Health, ETA, Roster Permission)
For use by Centers and Type A homes.
JFS 01235 Sleep Position Waiver
For use by Centers and Type A homes.
JFS 01236* Child Medical/Physical Care Plan
For use by Centers and Type A homes.
JFS 01237 Center Parent Information Sheet
For use by Centers
JFS 01238 Second Adult Statement
For use by Centers
JFS 01242* Medical/Dental and General Emergency Plan
For use by Centers and Type A homes.
JFS 01244 First Aid Supplies List
For use by Centers and Type A homes.
JFS 01335 Type A Home Initial Questionnaire
For use by Type A homes
JFS 01336 Type A Home Building Inspection
For use by Type A homes
JFS 01337 Type A Home Parent /Employee Information
For use by Type A homes

 

The forms that have been obsoleted are:

JFS 01294 - Emergency Transportation Authorization Form

JFS 01299 - JFS 01299 Incident/Injury Report (Rev. 11/2002). Please remove from Chapter 7 Forms and Pamphlets.

Instructions:

Place the enclosed forms in numerical order in Chapter 7 Forms and Pamphlets. File the transmittal letter in Chapter 8.

Please contact the Child Care Licensing Section at (614) 466-3822, should you have any questions.