SLEEPING HABITS. Each student has the right to sleep in a safe, quiet environment from undue inference, such as guests, noise, etc., in one’s space What time do we like to go to bed during the weekdays? What time do we like to go to bed during the weekends? What time do we like to get up during the weekdays? What time do we like to get up during the weekends? How quiet do we want it to be when we are sleeping? Are we comfortable sleeping with the windows open? How much light in the room do we want when we are sleeping? If one of us returns to the room while one of us is sleeping, what should they do? If one person is sleeping, what activities are acceptable in the room? How many times can we snooze the alarm? How will we be working things out if we have different sleeping patterns? PHONE USAGE Each student has the right to converse with their family and friends. Students must be mindful of their conversations and make sure they are not interrupting the study/sleep schedule of their roommates. What times work best for us to be on the phone? Where can we talk on the phone? Alerts on or off? What is an appropriate ringer volume/tone? Can we talk on speaker mode? Can we talk using FaceTime? Do we use headphones when talking via FaceTime/phone audio?
SLEEPING HABITS. Does your child typically nap? Please describe your child’s routine for going to sleep (include security item, etc:) EATING HABITS: Please describe your child’s eating habits including likes/dislikes/ and list all food allergies: ELIMINATION HABITS: Is your child toilet trained? if not, has your child begun toilet training? How may we work together in this area? Are there any special words your child uses to let you know he or she needs to use the restroom? ACTIVITIES and INTERESTS: What are your child’s favorite activities and toys? What does your child do to entertain him/herself at home? Does your child have any special friends he/ she li kes to play with? If so, what are their names? REACTION TO NEW ENVIRONMENTS: Has your child ever been in a child care setting before? How does he/she respond to new people or places? How do you help him/her to become comfortable in new situations? How does your child currently handle separation from you and what works best to comfort him/her? BEHAVIORS and TEMPERAMENT: Please describe your child’ general personality. Please describe any behaviors that concern you and list what discipline approach you use with your child. Please use this space for any additional information you would like to share: Parent’s Signature Date HOME TIES CHILD CARE PROGRAM CHILD PORTRAIT FOR SCHOOL AGE CHILDREN Please complete and return to the center by your child’s first day of attendance. This will assist staff in getting acquainted with your child and in helping him/her adjust. Date: Person completing form: Child’s Name: Age: Sex: School: Grade: FAMILY RELATIONSHIPS: Please share with us who lives in your home (Parents, Siblings, Grandparents, Pets, etc.) EATING HABITS: Please describe your child’s eating habits including likes/dislikes/ and list all food allergies: ACTIVITIES and INTERESTS: What are your child’s favorite activities, hobbies, sports, etc.? What does your child do to entertain him/herself at home? REACTION TO NEW ENVIRONMENTS: Has your child ever been in a child care setting before? How does he/she respond to meeting new people and making friends? How do you help him/her to become comfortable in new situations? BEHAVIORS and TEMPERAMENT: Please describe your child’ general personality. What techniques best manage your child’s behavior? Please use this space for any additional information you would like to share:
SLEEPING HABITS. What time does your child go to bed? Awaken? Does your child have his/her own room? Yes No Is your child accustomed to napping? Yes No What is your child’s nap schedule? What is your child’s mood on awakening? Does your child sleep with a special toy or blanket?
SLEEPING HABITS. On school nights I go to bed BEFORE midnight On school nights I go to bed AFTER midnight Cleanliness: Messy Average Neat and clean Study Habits: I can study with noise nearby I like quiet for studying Will you have overnight guests? Yes No Do you mind if your roommate has overnight guests? Yes No Are you interested in student leadership? Yes No Would you like to live with a student leader? Yes No Do you smoke? Yes No Do you mind if your roommate smokes? Yes No *Note: Smoking is only permitted in designated smoking areas*
SLEEPING HABITS. Each student has the right to sleep in a safe, quiet environment from undue inference such as guests, noise, etc., in one’s space. o What time do we like to go to bed during the weekdays? o What time do we like to go to bed during the weekends? o What time do we like to get up during the weekdays? o What time do we like to get up during the weekends? o How quiet do we want it to be when we are sleeping? o Are we comfortable sleeping with the windows open? o How much light in the room do we want when we are sleeping? o If one of us returns to the room while one of us is sleeping, what shouldthey do? o If one personis sleeping, what activities are acceptable in the room? o How many times can we snooze the alarm? o How will we be working things out if we have different sleeping patterns?
