Staff And Training Worksheet
Download a blank fillable Staff And Training Worksheet in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Staff And Training Worksheet with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Rev 01/2011
STAFF AND TRAINING WORKSHEET
DCD-0019
Facility Name:
Facility ID#:
Last Name, First Name
(Use one column per person)
Date of Birth
1
Date of Criminal Records
2
Qualifying Letter
Criminal Records Check Date of Expiration
3
Position
4
Total Number of Hours Worked Weekly
5
Group Assignment/Classroom
6
Education
7
Number of Years of Child Care Work
8
Experience
Date of CPR Training
9
CPR Expiration Date
10
Date of First Aid Training
11
Expiration Date of First Aid Training Course
12
Application
13
Date of Employment
14
Date of Medical Statement
15
Date of Initial TB Test
16
Date of Latest Medical or HQ (all staff)
17
Emergency Information (all staff)
18
Orientation Received
19
Date of NCECC, NCECAC
or Equivalent
20
Number of Annual In-service Training Hours
Required
21
Number of Annual In-service Training Hours
Brought Forward from the Previous Year
22
Number of Annual In-service Training Hours
Received
23
Number of In-service Training Hours to Carry
Over to the Next Year
24
Date of Playground Safety Training
25
Date of ITS-SIDS Training
26
ITS-SIDS Training Expiration Date
27
Date of BSAC Training
28
Early Educator Certification/ Scale Level
29
Early Educator Certification Expiration Date
30
*Annual Staff Evaluation
31
*Staff Development Plan
*Job Description, Policy Review, and
32
Enhanced Standards Review
Consultant Comments/Notes:
__________________________________________________________________________________________________________________
* for 2 or more points in Program Standards
I certify that the information contained in this report is accurate to the best of my knowledge.
Provider's Signature: ______________________________________
Title: __________________ Date______________
Child Care Consultant Verifying Information:_______________________________
Date___________________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Miscellaneous