Authorization to Dispense External Preparations

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Authorization to Dispense External Preparations

590-1-1-.20(1)

Parental Authorization

Except for first aid, personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child’s physician or parent. Such authorization will include, when applicable, date, full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent.

, permission to apply one or more of the following topical ointments/preparations to
, in accordance with the directions on the label of the container.
Please Select One
*This form should remain in students file*
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Sleep Safe Practices Policy

Date of Birth:(Required)

Safe Sleep Practices/Policy:

  1. Infants will be placed on their backs in a crib to sleep unless a physician’s written statement authoring another sleep position for that infant is provided. The written statement must include how the infant shall be placed to sleep and a time frame that the instructions are to be followed.
  2. Cribs shall be in compliance with CPCS and ASTM safety standards. They will be maintained in good repair and free from hazards.
  3. No objects will be placed in or on the crib with an infant. This includes, but is not limited to, covers, blankets, toys, pillows, quilts, comforters, bumper pads, sheepskins, stuffed toys, or other soft items.
  4. No objects will be attached to a crib with a sleeping infant, such as, but limited to, crib gym, toys, mirrors, and mobiles.
  5. Only sleepers, sleep acks and wearable blankets provided by the parent/guardian and that fit according to the commercial manufacturer’s guidelines and will not slip up around the infant’s face may be worn for the comfort of the sleeping infant.
  6. Individual crib bedding will be changed daily, or more often as needed, according to the rules. Bedding for cots/mats will be laundered daily or marked for individual use. If marked for individual use, the sheets/covers must be laundered weekly or more frequently if needed.
  7. Infants who arrive at the center asleep or fall asleep in other equipment, on the floor or elsewhere, will be moved to a safety-approved crib for sleep.
  8. Swaddling will not be permitted, unless a physician’s written statement authorizing it for a particular infant is provided. The written statement must include instructions and a time frame for swaddling the infant.
  9. Wedges, other infant positioning devices and monitors will not be permitted unless a physician’s written statement authorizing it for a particular infant is provided. The written statement must include instructions on how to use the device and a time frame for using it.

I acknowledge that the director or designee has advised me of the safe sleep practices followed by the facility.

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Behavior

Carol’s Daughter Learning Center

Carol’s Daughter Learning Center is designed to prepare your child for primary school in every way possible. We are committed to protecting the health and safety of each child entrusted in our care. Therefore, continued behavioral issues will not be tolerated. Suspension or termination if childcare services may occur if a child has a developmental or serious behavioral issues that cannot be adequately met by our staff (example: children who continually put themselves, other children, or staff at risk of physical harm). During the day your child will be given four chances (depending on severity of the situation).

  • The first time, the director(s) are notified of a child’s repeated disruptive behavior, he/she will be given a verbal warning.
  • The second time, the child will be given a second verbal warning and quiet time in class.
  • The third time, the child will be given a quiet time in the office. Parents will be notified via phone.
  • The fourth time, a parent/teacher conference will be scheduled. (Please note that depending on the severity of the incident, parents may be required to pick up the child, immediately)
  • Consequences may include but are not limited to suspension. Length of suspension will be based on severity of the incident, with one week being max.
  • If disruptive behavior continues, the child will be expelled from Carol’s Daughter Learning Center.

This is to certify that I have read and agree to these terms and conditions.

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Media/Internet Release

Carol’s Daughter Learning Center

I/we understand that as part of our child’s enrollment at Carol’s Daughter Learning Center, photos, videos, and quotations may be taken for use in publications and reports about the center. We further understand that members of the news media may be invited to cover the program, may take photos, videos, and quotations.

Photo Permission:

Consent
, photograph on the website, fliers, brochures, or any other publication relative to the center. We realize that our child’s first or last name will not be used in such publications.
Consent
, photograph on the website, fliers, brochures, or any other publication relative to the center. We realize that our child’s first or last name will not be used in such publications.

Internet Permission

As part of your child’s curriculum and as a development of their technological skills, Carol’s Daughter Learning Center provides supervised internet access. We believe that computer training and internet proficiency are vital to your child’s success as a student and later in life.
Internet Permission(Required)
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