(A) The child day-care center shall set its own policy regarding whether the center administers medications, food supplements, modified diets, or fluoride supplements.

(1) "Medication" is defined as any substance or preparation containing active chemical ingredients for the purpose of prevention or treatment of a wound, injury, infection, infirmity, or disease.

(2) "Modified diet" is defined as any diet eliminating the use of any one or more of the four food groups or altering the amount of food required to be served to meet one-third of the recommended daily dietary allowance as required by rule 5101:2-12-61 of the Administrative Code.

(3) "Food supplement" means a vitamin, mineral, or combination of one or more vitamins, minerals and/or energy-producing nutrients (carbohydrate, protein or fat) used in addition to meals or snacks.

(4) "Fluoride supplement" is defined as any fluoride preparation prescribed to be taken internally for the purpose of preventing dental cavities.

(B) When a medication, food supplement, modified diet, or fluoride supplement is administered in the center, it shall be administered in accordance with the requirements of paragraph (C) of this rule.

(C) Except as prescribed in paragraphs (E) to (G) of this rule, prior to the administration of a medication, food supplement, modified diet, or fluoride supplement, the center shall:

(1) Secure the written instructions of a licensed physician or licensed dentist for the administration of the medication, food supplement, modified diet, or fluoride supplement; and

(2) Secure the written, signed, and dated instructions of the parent or guardian on the form provided by the director for the administration of the medication, food supplement, modified diet, or fluoride supplement.

(D) The center shall secure written instructions signed by the licensed physician or licensed dentist in one of the three following ways:

(1) Written instructions signed by the licensed physician or licensed dentist on the form provided by the director for each medication, food supplement, modified diet, or fluoride supplement to be administered.

(a) A medication or food supplement shall not be administered for any period of time beyond the date indicated by the physician or dentist, or six months, whichever comes first. A modified diet or fluoride supplement shall not be administered for any period of time beyond the date indicated by the physician or dentist.

(b) Written instruction forms shall be signed by the physician or dentist and refiled with the center for administration of each medication or food supplement which continues to be administered longer than six consecutive months, or for each modified diet or fluoride supplement which continues to be administered beyond the date indicated by the physician or dentist on the form provided by the director.

(2) A prescription label which contains for each medication or food supplement, at a minimum, the child's name, a current date (within the last six months), an exact dosage to be given, the specific number of dosages to be given daily, and the route of administration.

(a) The prescription label shall be attached to the original container for each medication or food supplement.

(b) Prescription labels which do not contain a specified number of dosages to be given per day but instead contain the instructions "to be given as needed" shall be accompanied by written instructions from the parent or guardian if it is to be administered by the center.

(3) A prescription label for the fluoride supplement which contains the names of all children to whom the fluoride supplement will be administered. A current date, an exact dosage to be given which is the same for all children, the specific number of dosages to be given daily and the method of administration.

(E) In cases of extreme emergency, center personnel may administer syrup of ipecac to a child without written instruction from a physician if following verbal instructions of the poison control center or a licensed physician.

(F) Nonprescription fever-reducing medications that do not contain aspirin, or nonprescription cough or cold medications that do not contain codeine may be administered by the center without written instructions from a licensed physician if administered in accordance with the following:

(1) There shall be written instructions from the parent or guardian on the form provided by the director. The form shall include the name of the medication, name of the child, birthdate of the child, date, and the parent's or guardian's instructions and signature;

(2) The medication shall be in its original container with its original label attached;

(3) The label shall specify appropriate dosages based on the child's age or weight;

(4) The written instructions of the parent or guardian notwithstanding, dosages administered by the center shall not exceed the manufacturer's recommended dosages;

(5) The medication is to be administered by the center for no longer than three days at any one time.

(G) Nonprescription topical ointments, creams, or lotions may be administered by the center without written instructions from a licensed physician if administered in accordance with the following:

(1) There shall be written instructions from the parent or guardian on the form provided by the director. The form shall include the name of the ointment, cream, or lotion, name of the child, birthdate of the child, date, and the parent's or guardian's instructions and signature;

(2) Written instructions shall be valid for no longer than three months;

(3) Authorization for administration of the ointment, cream, or lotion may be cancelled by written request of the parent at any time;

(4) When used for skin irritations or manifestations of skin irritations, the ointment, cream, or lotion shall be administered by the center for no longer than fourteen consecutive days at any one time.

(H) Medications, fluoride supplements, and food supplements shall be kept in a safe location where children cannot reach it. A medication requiring refrigeration shall be refrigerated immediately upon arrival at the center and shall be stored so as not to contaminate foodstuffs.

(I) The child-care staff member responsible for administering medication, food supplements or fluoride supplements shall verify administering the medication, food supplement or fluoride supplement by completing the form provided by the director each time a medication, food supplement or fluoride supplement is administered.

(J) Written instructions of the physician or dentist, written instructions of the parent or guardian, and the form completed by the child-care staff member shall be kept on file at the center for a period of one year following administration of a medication, food supplement, modified diet, or fluoride supplement, and shall be available for review by the director, upon request.