Babysitter Qualifications Checklist Template Page 2
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23. Show your counselor that you know how to diaper
BABYSITTING CHECKLIST
a baby. You might want to bring along a large doll
and use it for your demonstration.
Name of family ______________________________
D
C
:
p
B
:
Name and number where parents can be reached:
ate
ompleteD
asseD
y
B
a
: ________________________
__________________________________________
aDge
pproveD By
__________________________________________
B
C
: _______________________
aDge
ompleteD on
Name and number of doctor ___________________
__________________________________________
Name and number of friend/neighbor ____________
__________________________________________
Phone numbers:
Police ___________________________________
Fire Department ___________________________
Poison Control Center _______________________
Phone number and address of location where you are
baby sitting _________________________________
__________________________________________
YES NO
o I was ready on time.
o
o I asked for the children’s schedule.
o
o I entertained the children (played games,
o
read stories, took them for a walk, taught
them a song, etc.).
o I got the children to bed on time.
o
o The house was neat when the parents re-
o
turned.
Signed ____________________________________
(employer signature/date)
2
EXPLORING: WHERE YOU LIVE: BABYSITTING
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