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INDIVIDUAL CARE PLAN   

Child:

Child’s Date of Birth:

Teacher:

Family Member(s):

Date:


FAMILY INFORMATION FORM
                                                                                                                              

Arrival

What time will you usually arrive at the center?

What will help you and your child say good-bye to each other in the morning?

Diapering and Toileting

What type of diapers do you use?

How often do you change your child’s diaper?  When does your child usually need a diaper change?

Are there any special instructions for diaper changes?

Is your child beginning to use the toilet?  If so, are there any special instructions for toileting?

Sleeping

How will we know that your child is tired and needs to sleep?

When does your child usually sleep?  For how long does he or she usually sleep?

What helps your child to fall asleep?

Yes

No

 We put babies to sleep on their backs.  Is your baby used to sleeping on his or her back? 

How does your child wake up?  Does he or she wake up quickly or slowly?  Does your child like to be taken out of the crib immediately or to lie alone in the crib for a few minutes before being held?



INDIVIDUAL CARE PLAN       

FAMILY INFORMATION FORM, continued

Eating

Babies:

Are you breast-feeding or bottle-feeding your baby?

Yes

No

If breast-feeding, will you come to the center to breast-feed? 

            If so, at what time:

Yes

No

            If not, will you send expressed breast milk? 

If bottle-feeding,

            What kind of formula do you use?

            How do you prepare the bottles?

            How much do you prepare at one time?

            How much does our baby drink at one time?

Yes

No

Does your baby drink bottles of water during the day?

            If so when and how much?

Yes

No

Is your baby eating solid foods?

            If so, which ones?

            When?

            How do you prepare your baby’s solid foods?

            How much does your baby eat at one time?

How is your baby used to being fed (in what position)?

Does our baby eat any finger foods?  If so, which ones?

ALL CHILDREN:

What are some of your child’s favorite foods?

What foods does your child dislike?

Is your child sensitive or allergic to any foods?  If so, please list them.

Are there any foods that you don’t want your child to eat?

INDIVIDUAL CARE PLAN       

FAMILY INFORMATION FORM, continued

Dressing      

Is there anything special that we should know about dressing and undressing your child?

Awake Time

How does our baby like to be held?  What position does your baby prefer when awake?

What language does your child use when talking and singing with family members?

                       

What does your child like to do when awake?

How do you play with your child?

Departure

What time will you usually come to pick up your child?

What will help you and your child say hello to each other at the end of the day?

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Permission is granted to duplicate the material on this page for use in programs implementing The Creative Curriculum for Infant, Toddlers & T