Child Information

* Confidential *

We would greatly appreciate you filling out the information below to help us know you and your child a little better. All information contained on this sheet will be confidential. Please complete a information sheet for each child you are enrolling. This is very helpful for us to care for your child.

Child's Name:(Required)

How well do I:

Do in the morning?(Required)
Do in the afternoon?(Required)
Do in the evening?(Required)
Sleep at night?(Required)
Take naps?(Required)
Eat lunch?(Required)
Eat dinner?(Required)
Play with adults?(Required)
Play by myself?(Required)
Play with other children?(Required)
Play in a small group?(Required)
Play in a large group?(Required)
Play inside?(Required)
Play outside?(Required)
Play with younger children?(Required)
Play with older children?(Required)
Do when children sit near me?(Required)
Do when children sit further away?(Required)
I want my child to take naps?(Required)
Has my child been in a child care setting before?(Required)

How do I let others know when:

What helps me when I am:

What makes me:

Fully Potty-Trained Definition

We consider children fully potty trained when they can do the following things independently:

• Be able to TELL the teacher that they need to go the bathroom BEFORE they have to go. They must be able to say the words, "I have to go to the potty or bathroom" BEFORE they have to go.
• Be able to pull down and up their underwear and pants without assistance.
• Be able to wipe themselves after they have used the bathroom.
• Be able to wash and dry their hands independently.
• Be able to go to the bathroom and directly back to the classroom without directions.
• Be able to postpone going to the bathroom if they must wait for someone who is in the bathroom or if they are outside or on a field trip.

Rates will not be adjusted until all of these things can be done independently. See the section on Potty trained in the billing section for more details. We do understand that children have accidents occasionally and need additional assistance when they are struggling. We will assist children when they are struggling if they have already met the requirements of being fully potty trained.

Due to the nature of potty training and the additional assistance it requires, children are not allowed to attend field trips until they are fully potty trained.
How well does my child go to the bathroom independently?(Required)