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The
forms listed on this page are examples only!
Content of each form is based on national
recommendations and requirements, as well as sample forms from
other early care and education programs.
You
are welcome to download these forms as examples for
your own program. The individual forms may not
include all the information needed for your specific
program. Please carefully review all related Federal,
state, and local requirements, as well as written policies
for your program; then, you may modify these forms to
meet the needs of your program.
Emergency Preparedness Forms:
Disaster
Preparedness Supply Checklist (English)
Disaster Preparedness Supply Checklist (Spanish)
Most
authorities recommend preparing for three or more days
(72 hours). Begin with a basic list of supplies; then
work with a team to review and complete the list so
that all children’s needs are met.
Basic
First Aid Kit Checklist ( English)
Revised
Basic First Aid Kit Checklist (Spanish)
Sample
Emergency Poster (English)
Revised
Sample Emergency Poster (Spanish)
Modify
to create individualized posters for each classroom or
nursery.
Health Related Forms:
Injury
Reporting
Administration
of Medication
Document
parent
authorization and administration of medication.
Daily
Health Check (English)
Revised
Staff
should complete a visual check of each child upon arrival
and before the parent leaves. A child who appears
to be ill may be sent home or to the doctor/clinic as
appropriate.
Training
Evaluation Forms:
A generic form to be used to evaluate your training sessions,
regardless of topic. Specific pre/post evaluation
forms are also available for each of the available Staff
and Parent Training Programs. (Click here
to see training topics.) Please refer to the specific
training page to download these documents.
Click
here to download this generic form in English,
or
Spanish.
Community Assessment Forms:
This questionnaire
may be modified and used to collect data from the target
population; resulting information may supplement other
community assessment data.
Community
Assessment Questionnaire (English)
Revised
Community Assessment Questionnaire (Spanish)
New
Sample
forms on additional topics may be available.
Click
here for more information.
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