Forms, Policies, and Checklists

Safe Sleep Policy for Infants in Child Care

All child care providers at [program name] will follow safe sleep recommendations for infants to reduce the risk of Sudden Infant Death Syndrome (SIDS), other sleep-related infant death, and the spread of contagious diseases:

Preschool (3-5 years) Development and Routine

As a basis for meeting a child's health, behavioral and social needs in the child care setting, the file for each child in care should include a history form completed by the parents/guardian upon admission, preferably with staff involvement. This form addresses issues relevant to preschoolers only.

Infant/Toddler (birth to 36 months) Development and Routine

As a basis for meeting a child's health, behavioral and social needs in the child care setting, the file for each child should include a history form that is completed by the parent/guardian upon admission, preferably with assistance from the staff. This form addresses issues relevant to infants and toddlers only.

Injury Report Form

It is important that all child care programs record any injury that requires first aid, such as a bandage or a cold compress. Planning for injuries, reporting injuries and eliminating hazards or conditions that cause injuries should be part of the overall plan to keep children safe while they are in child care. And by tracking injuries that happen, programs can look for patterns caused by hazardous conditions and identify problem areas before they cause serious injury.

Notice of Exposure to Communicable Disease

This form will help you prepare a written notice to parents about their children's exposure to communicable disease. The notice will alert them to watch for signs and symptoms of the illness while maintaining confidentiality of the child or staff member who has the disease.

Exclusion Form for Suspected Illness or Communicable Disease

Communicating with parents about health concerns at child care is an important step in caring for an ill child. This form will help you report your observations to parents. It includes a list of signs and symptoms that indicate a need for medical attention.

Liability Exposure and Child Care Health Consultation

Child care health consultation is a new profession emerging out of an identified need to link the public health and child care fields together. As of yet, there exists no definitive consensus on the scope of this work or the standards of care that are expected of those who engage in the work. This document describes the most significant methods available for minimizing liability exposure in California

The Daily Encounter Form (DEF)

Child Care Health Consultants (CCHCs) fill out the Daily Encounter Form (DEF) every day they work as a Linkages CCHC. The research team collects these DEFs to learn about the activities of CCHCs. Tracking the activities of the CCHCs will allow the researchers to understand changes that occur as a result of the CCHCs' work.

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