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Additional information that will assist the child care program in providing appropriate child care for the above named child (special health care and developmental considerations) accompanies this form. Optional: Measurements and Recommended Assessments/Screenings
The Ohio Department of Job and Family Services (ODJFS) discovered discrepancies on child care forms that were published to ODJFS Forms Central in October 2021. To better serve child care programs and families of children enrolled, the discrepancies have been corrected and new versions of the forms are being published.
Child Care Forms. The most recent version of all ODJFS Forms referenced in Chapters 12 through 18, can be accessed through Forms Central. Information for childcare rules and relevant forms.
This above named child has been immunized in accordance with the requirements of section 5104.014 of the Ohio Revised Code (please note any exceptions below). Signature of Examining Physician/Physician's Assistant/Advanced Practice Registered Nurse/Certified Nurse
employee medical statement for child care The physical examination and completion of this form must occur no more than 12 months prior to the first day of employment.
Programs funded through the Ohio Department of Education must have written policies and procedures to ensure that children have received comprehensive health screenings and/or that families are informed of the
The Ohio Department of Job and Family Services (ODJFS) discovered discrepancies on child care forms that were published to ODJFS Forms Central in October 2021. To better serve child care programs and families of children enrolled, the discrepancies have been corrected and new versions of the forms are being published. Amended Forms: JFS 01236 ...
Ohio Department of Job and Family Services. EMPLOYEE MEDICAL STATEMENT FOR CHILD CARE. The physical examination and completion of this form must occur no more than 12 months prior to the first day of employment.
participation in group care. This above named child has been immunized in accordance with the requirements of section 5104.014 of the Ohio Revised Code (please note any exceptions below).
CHILD MEDICAL STATEMENT FOR CHILD CARE. Child’s Name (print or type) Date of Birth. This above named child has been examined, the immunization status recorded, and the child is in suitable condition for participation in group care.