Yes No. If yes, have medication forms been completed? Yes No. Additional information for the caregivers to know about your child's daily requirements or routine ...
Daily Care Form — Pretoddler Date: _____________________________ Child’s Name: ___________________________________
Drop Off Time: _____________________
Parent’s Name: _________________________________
Pick Up Time: ______________________
INFORMATION FROM HOME (to be filled out by parent) What time did your child wake up today? ____________________ Does your child usually nap?
Has your child had breakfast/lunch? Is your child on medication?
If yes, for how long? ____________________________
No If yes, which medications and why? ________________
__________________________________________________________________________________ Will the center administer the medication?
If yes, have medication forms been completed?
Additional information for the caregivers to know about your child’s daily requirements or routine: __________________________________________________________________________________ __________________________________________________________________________________ DAILY HEALTH CONCERNS (to be filled out by parent) Allergies: __________________
Bumps, bruises, or marks: _____________________________________________________________ Additional information for the caregivers: _________________________________________________ __________________________________________________________________________________ INFORMATION ABOUT YOUR CHILD’S DAY (to be filled out by Navy CYP) For breakfast I ate:
For lunch I ate:
During quiet time I:
Didn’t feel like resting
Diaper Changes W = Wet Time
D = Dry Time
B = Bowel Movement Type
Your child enjoyed the following activities: _________________________________________________ __________________________________________________________________________________ Overall, your child’s day was: ___________________________________________________________ For your child’s next visit, be sure to bring: ________________________________________________ Thank you! We look forward to seeing you again soon!