Individual Interests

Does your child say any words? What do they mean?

What are your child's favorite games, toys, and things to do?

Any information that might be important or helpful to caregivers?

Any pets in your home? If yes, type of pet(s) and name(s)?

Food & Drink Information

What will your child typically use while in our care?

Cup

Bottle

Parent on-site

What does your child eat?

Baby food

Table/Finger foods

Types/Amount

Does your child wear diapers?

Yes

No

Pull-ups

Other

Does your child require any creams/ointments? Please list names and instructions.

What best describes your child's toileting stage?

Does your child let an adult know when they need to use the restroom?

Yes

No

Sometimes

Does your child need assistance with toileting?

Yes

No

Sometimes

Any toileting routines or preferences we should know about?

Will your child bring a comfort item?

No

Yes (please specify)

Will your child bring a pacifier?

No

Yes

I will provide at least one complete change of clothes.

My child will arrive with a labeled backpack containing their daily belongings.