Family Child Care Enrollment Packet Face Sheet (Page 5 of 8) in pdf

SLEEPING HABITS

*Does your child sleep in a crib? ________ Bed? ________

Does your child become tired or nap during the day (include when and how long)? _____________________

_______________________________________________________________________________________

Please Note: The American Academy of Pediatrics has determined that placing a baby on his/her back

to sleep reduces the risk of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden and

unexplained death of a baby under one year of age. If your child does not usually sleep on his/her

back, please contact your physician immediately to discuss the best sleeping position for your baby.

Please also take the time to discuss your child’s sleeping position with your educator. Your educator

will place your infant on his/her back unless there is a written physician’s order that specifies

otherwise.

When does your child go to bed at night? ______ and get up in the morning? __________________

Describe any special characteristics or needs (stuffed animal, story, mood on walking etc) ________________

________________________________________________________________________________________

SOCIAL RELATIONSHIPS

How would you describe your child:____________________________________________________________

________________________________________________________________________________________

Previous experience with other children/child care:________________________________________________

Reaction to strangers: _______________________________ Able to play alone: _______________________

Favorite toys and activities: __________________________________________________________________

________________________________________________________________________________________

Fears (the dark, animals, etc.): _______________________________________________________________

________________________________________________________________________________________

How do you comfort your child: _______________________________________________________________

What is the method of behavior management/discipline at home: ____________________________________

________________________________________________________________________________________

What would you like your child to gain from this child care experience?________________________________

________________________________________________________________________________________

DAILY SCHEDULE: Please describe your child’s schedule on a typical day.

*For Infants, please include awakening, eating, time out of crib/bed, napping, toilet habits, fussy time,

night bedtime, etc.

________________________________________________________________________________________

Is there anything else we should know about your child?___________________________________________

________________________________________________________________________________________

Parent/Guardian Signature: __________________________________

Date: _____________________

P a g e

| 5

FCCEnrollmentPacket20110406

Family Child Care Enrollment Packet Face Sheet Page 5