Parent Package Daycare

Daycare Parent Package
Child Family Profile

The following questions are designed to assist Steps Academy members of staff with information about your child to provide the best, most appropriate care. This information is confidential and will not be shared. These questions are meant to initiate mutual trust and respect with families that will develop into a strong, cooperative partnership between parents and Steps Academy.
Start Date*

MonthDayYear
Child's Name*

First NameLast Name
Gender*

MaleFemaleX
Birth Date*

MonthDayYear
Date
Health
Does your child have any allergies?*
What allergies does your child have?
How should we respond if they have a reaction?
Does your child have any pre-existing health conditions?*
Example: Heart Condition, Asthma
Please Describe
Has your child had any assessments or screenings for any disabilities or disorders?*
Does your child have any disabilities or disorders?*
Example: ADHD, Autism, Cerebral Palsy
Upload your child's IPP here - if applicable

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Please Describe
Has your child had a previous serious illness or injury, or hospitalization during the past 12 months?
Please Describe
Is your child currently taking any medication?*
Will the medication need to be administered while they are in our care?
Please list any side effects we should be alerted to
What medications are they taking? If your child is taking any prescription medication (even if not administered at the centre) it is important to document that here.
If anything changes while your child is registered with us, please update this information via email to registration@firststepsacademy.ca
Parent Name*
Signature*

Clear

Behaviour
Does your child have any fears?*
What are the fears?
Are there any words that your child may use that we may not readily recognize?
Please list any of the words here, with what they mean
How do you tell your child to stop a behaviour that you don't approve of or that might be dangerous?
When your child gets upset, what helps them calm down?
What is a good way to distract your child if they feel frustrated or upset?
Does your child nap?
List any particular routines that are helpful at naptime?
What position is most comfortable for your child when they are napping?

Toileting
While we know occasional accidents happen, regular accidents may jeopardize a child's attendance.Steps Academy considers a child fully potty-trained when he/she can self-discipline going to the bathroom without constant reminders or monitoring.

Your child must have already started potty-training and understand what it means to go to the bathroom before attending at First Steps. Pull-ups are acceptable but diapers are not permitted as FSA does not have diaper-changing stations available. Please ensure you send an ample supply of pull-ups and wipes each day if your child still needs them.

Should bathrooming concerns arise, parents will be contacted to arrange a plan of action, so as not to jepordize their child's attendance.
Is your child fully potty trained*
Does your child need assistance with toileting?
How can we best help?
Parent Name
Signature

Clear

Eating Preferences
Does your child have any food allergies or sensitivities?*
What are allergies or sensitivities to and what is their reaction?
Does your child have any dietary restrictions*
EX: No Beef, No Pork, Vegetarian etc
What are the dietary restrictions?
What are your child's favourite foods?
Does your child use utensils, eat with fingers, feed themselves?
Does your child choke easily while eating or drinking?

Activities
What activities do you like to do with your child?*
What activities does your child like to do with other children?*
What does your child like to play independently?*
Is your child currently enrolled in any extracurricular activities? If so, what are they?*
We have opportunities for families to visit our center to volunteer, discuss their careers, share their cultural experiences, or present interesting items. If such an opportunity arises, would you be interested? Feel free to suggest any ideas you might have about how you'd like to participate*

Family History and Multiculturalism
Steps Academy works with families from many cultures and backgrounds and always tries its best to accommodate the needs, customs and preferences of all families.

An integral element of the multi-cultural events and practices Steps Academy recognizes throughout the year is that input is received from families on anything specifically important to them. The following comment sections are not mandatory but are definitely encouraged.
Tell us about your family*
Are there particular holidays, celebrations or events your family honours each year that differ from what is commonly recognized across Canada? What special significance do these hold for your family?*

Guidelines for Behaviour Management
If a child consistently presents a continued challenging behaviour, the staff are asked to document the occurances and have the parent sign the bottom of the behaviour form. The staff also have a classroom ABC (Antecedent, Behaviour, Consequence) form for tracking behaviours and looking for consistencies in the possible cause which helps give the teacher more insight to be able to work on finding strategies for prevention.

Conversations with yourself as the parent are also very important in finding ways to support through some of these behaviors so we ask you to also be involved in working with teachers and your child to come up with appropriate solutions.

Physically aggressive behaviour, such as biting, kicking, hitting etc. cannot and will not be tolerated. To protect all of the children and encourage acceptable behaviour, instructors will intervene immediately if a child becomes physically aggressive.

Steps Academy staff will make every effort while children are in our care. However, Steps Academy reserves the right to terminate care if after these efforts, it is determined that Steps Academy cannot meet the child's needs.

With respect to a child in the program, Steps Academy will under no circumstances engage in the following:

Inflict or cause to be inflicted any form of physical punishment, verbal or physical degradation or emotional deprivation
Deny or threaten to deny any basic necessity
Use or permit the use of any form of physical restraint, confinement or isolation
Inappropriate Behaviours
Parent/Guardian Name*
Signature*

Clear

Photo and Video Permission
Lillio

Lillio is a software program that allows us to share photos and videos of your child with you. Lillio is used daily for communicating updates and information about your child and the centre which will be sent directly to you using the email you provided us.

If you choose not to receive photos, you will still receive updates and information about your child and the program through Lillio. This is our prime method of communication, and it is your responsibility to make sure you are checking the app frequently to ensure you do not miss any important updates.

**Regardless of your choice, your child's photo may appear in our Centre Newsletters, as well as the TV or Smart Board in the front lobby.

Sometimes other children in the center may be featured in photos, videos or stories of your child. By giving your consent, you agree not to share photos or video of any child, other than your own, outside the program without permission.
I give consent for my child to have their photos shared through HiMama *
1. Parent/Guardian Name*
Email*
example@example.com
2. Parent/Guardian Name
Email
example@example.com
I give permission for my child, to be photographed/appear in video, while attending Steps Academy for:
Steps Academy Website*
Social Media - Facebook, Instagram*
Marketing Materials (Posters, Flyers, Brochures etc.)*
I understand that it is my responsibility to update this form if I no longer wish to authorize one or more of the above uses. If you grant permission for use of photos and if at any time, there is a photo that you wish to have removed please contact the office and we will edit or remove the photo.

**No child names will be displayed by Steps Academy**
Parent/Guardian Name*
Signature*

Clear

Illness Policy
Please note, for the health and security of all families we reserve the right to make assessments regarding children's health. As a preventative measure we may err on the side of caution within our assessment to avoid the spread of illness/disease. Some of the more common symptoms may be:
- Pain - any complaints of unexplained or undiagnosed pain or discomfort
- Fever (100°F/37.5°C or higher) Sore throat or trouble swallowing
- Unexplained diarrhea or loose stool combined with nausea, vomiting or abdominal cramps.
- Nausea or vomiting
- Severe itching of body and scalp
- Frequent coughing
- Pink eye
- Constant nasal drainage (not clear drainage)
Children can return following a 24 hour symptom-free period without the aid of fever reducing medication unless otherwise specified in our Illness Policies.

You are required to keep (or take) your child home when your child:
1. Is suffering from one or more of the above symptoms
2. Is not well enough to participate in the activities at Steps Academy including outdoor time
Please review the Illness Policies in the Parent Handbook for more detailed information.

Parents will inform Steps Academy within 24 hours of a diagnosis of a serious illness or contagious disease of a communicable nature in the family. This is to protect all families who attend Steps Academy. Failure to do so is grounds for immediate termination of care.
Parent/Guardian Name*
Signature*

Clear

Medications
Prescription medications will only be given to a child in care with the following conditions:
- Parent provides written permission to Steps Academy complete with full instructions regarding dosage and times of day to administer prescription medication. (Forms are available online for this purpose for parent(s) to complete.)
- All prescribed medications must have the child's name clearly indicated on the prescription bottle.
- If sending a over-the-counter medication please know we will not administer a medication that reduces fever and ensure you have the correct dosage amount.
When a child becomes ill, they will be able to rest in a designated quiet and comfortable area and will be closely supervised until the parent/guardian arrives.

Parents will be notified immediately and agree to begin making alternate work arrangements or arrangements for alternate care. If your child is seriously ill, you or an alternate must come for the child IMMEDIATELY. If parents cannot be reached, the emergency contact list will be consulted.
Parent/Guardian Name*
Signature*

Clear

Non-Emergency Health Consent

Sunscreen, Lip Balm and Lotion
Please apply sunscreen to your child prior to them attending our centre each sunny day.

Health and Safety guidelines do not allow us to accept aerosol sunscreen into our facility. Please send your child with a cream-based sunscreen. Ensure that the sunscreen you send your child with does not have any nut-based oils or ingredients.

If you do not want your child to wear sunscreen please indicate this on your child's Parent Package. If you choose for your child to not wear sunscreen please keep in mind that there is potential for sunburns when there is no additional sun protection. We have lots of outside time during the summer months and remind all children to take breaks in the shade, drink lots of water and offer water play as mush as possible as well.

In more extreme weather, we also adjust outdoor times to better suit the outdoor needs during that time, such as doing longer walks during the cooler part of the day in the summer and shorter times as the temperature rises in the afternoon.

I give permission for the staff at Steps Academy to apply a sunscreen product, which I have provided, when my child will be playing outside during the months of June to September. I understand sunscreen may be applied to exposed skin, including but not limited to the face, tops of ears, bare shoulders, arms and legs. I will apply sunscreen before my child arrives to Steps Academy in the morning.
Please choose from the following*

I do not know of any allergies my child may have to sunscreen.My child is allergic to some sunscreens. Please only use the brand of sunscreen I have provided from homeI do not want my child to wear any sunscreen
Parent/Guardian Name*
Signature*

Clear

Child Drop-Off and Pick-Up Policy
A parent or guardian must authorize up to 3 individuals to pick up their child from child care Authorized individuals will be required to present valid identification and provide the “ safe word” to pick up any child from our care. This is in addition to the parent/guardian.

I authorize the following individuals to pick up my child from the child care:*

	Name	Phone Number	Phone Number
Person 1
Person 2
Person 3

If an authorized individual without valid identification or an unauthorized individual comes to pick up my child from child care, I can be contacted at this number:*
Please choose a safety word *
This word should be 5 to 14 characters long and one you can remember but not easily guessed.
All alternates without a safety word or ID must report to the office at pick up. To avoid any unnecessary delays or confusion, please ensure you have relayed the safety word and reminded your alternate to bring ID when picking up.
Release of a Child

Children are dismissed and signed out when a parent/legal guardian is present. Students will not be dismissed to anyone other than a parent/legal guardian or previously approved pick-up person, unless prior written permission is granted, and proper identification is provided with your child's safety word. Parents must notify Steps Academy by phone or in writing if there is a change or an addition to who will be picking up their child.

If you are notifying by phone, please have your safety word from the parent package ready for the admin team as you will be asked to provide this at this time as well. Once a person is added to the pick-up list, this change will be documented in the student’s file. Steps Academy must be informed prior to the person arriving for pick up that authorization has been given. Ensure whoever is picking up that they know the safety word and have photo ID available to provide at pick up. This will remain the practice until the staff become familiar with this person. It is the responsibility of the parent to update their approved pick-up list as necessary and a form for this can be found on our website under the forms tab.

Once a parent/guardian or approved pick-up person has picked up their child, the centre is released of liability and the responsibility of the child is returned to the parent.

Unauthorized Pick Up

The parent/guardian is required to notify Steps Academy in writing (personal email) if someone else, other than the authorized persons, will pick up their child. Please provide name, phone number, and description of the person. The person will be asked to show photo identification and will need to have been provided the “safe word.”

Custody and Related Court Orders

Steps Academy staff cannot become involved in the marital or custody issues of enrolled families. If a custody or court order exists, a copy of the order needs to be placed in the child's file. The guardian is responsible for providing up-to-date and accurate information concerning the legal guardianship of the child. Without a custody or court order on file, Steps Academy staff cannot deny access to the non-enrolling parent. If the non-enrolling parent is not listed on the pick up list, the policy on “Unauthorized Pick Up” will be implemented (see above).

Emergency Contact List
Please provide the names and phone numbers of 3 additional persons to contact in case you cannot be reached:

*Please note these contact individuals should have knowledge of the code word you have listed*

Alternate Emergency Contact Information*

	Name	Relationship	Cell Phone	Home Phone
Name 1
Name 2
Name 3

I agree that all the above-mentioned persons have provided their consent to be named on my Emergency Contact List at Steps Academy.
Parent/Guardian Name*
Signature*

Clear

Community Walk Form
Child's Name*

First NameLast Name
I give permission for my child to participate in Community Walks. Information about these walks will be posted on the classroom door. This information will include a map of the route taken, the number of children and staff on the walk as well as the departure and return time.

Safety Measures taken by Steps Academy Staff during this trip:
- First Aid Kit in Transport bag
- Portable records of all children
- Office informed of location, time, route walked and number of children
- Any medication and forms that may be required to be administered during the child’s time with us
- Frequent head counts
- Ratio always maintained
- Rules discussed prior to each trip
- Inform the office of the walking route and location
- Posted walking route and location on classroom door
- Cell Phones for any necessary communication and photos
Parent / Guardian Name*
Date*

MonthDayYear
Date
Signature*

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Community Walk and Supervision Information
FSA to Pond Park
FSA to Log Park
FSA walk around the Plaza

Consent for First Aid / Ambulance / Medical Care / Treatment
I give permission that my child may be given emergency First Aid treatment by a staff member of Steps Academy.
Initial* I give permission for my child to be transported by ambulance or other means available at the time to an emergency centre. I understand that any and all costs incurred due to emergency ambulance transport are solely my/our responsibility.

Initial * In the event that I cannot be contacted immediately, medical care and treatment can be administered to my child by a physician in the case of an accident or emergency.
Parent/Guardian Name*
Signature*

Clear

Liability Release Form
In consideration of allowing the previously declared participant(s) to begin participation in Steps Academy activities, while on the premises and property of said centres, the undersigned, for themselves, and/or being the legal and acting guardian of participant(s), acting for themselves and on behalf of the participant(s), release and hold harmless Steps Academy, its owners, employees, and agents of and from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned while in or upon the premises upon which Steps Academy is conducted, or any premises under the control and/or supervision of Steps Academy, its owners, officers, employees, or agents or in route to or from and of the said premises, or while at any premises or place when activities sponsored by or participated in by Steps Academy, its owners, officers, agents or employees.
Parent/Guardian*
Signature*

Clear

Portable Record Information
Child's Name*

First NameLast Name
Child's Birthdate*

MonthDayYear
Date
Effective Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Parent/Guardian 1 Information
1. Name*

First NameLast Name
1. Cell Phone Number*
Please enter a valid phone number.
1. Work Phone Number*
Please enter a valid phone number.
Is your address same as above?*
1. Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Parent/Guardian 2 Information
2. Name

First NameLast Name
2. Phone Number
Please enter a valid phone number.
2. Work Phone Number
Please enter a valid phone number.
Is your address the same as above?
2. Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Emergency Contact Information

This cannot be a parent's information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Is your child familiar with this person?*
Address*

Street Address

Street Address Line 2

CityProvince

Postal / Zip Code
Allergies, Sensitivities or Dietary Restrictions
If your child has any allergies, sensitivities or dietary restrictions please let us know below:*
Dairy allergy, Epi-Pen Peanut allergy, Vegetarian, No Pork
Is your child up to date with their immunizations?
Does your child have an Epi-Pen *
Does your child have an Inhaler that may be required while in our care? *
Parent/Guardian Name*
Signature*

Clear

Epi-Pen Administration Form
Name*

First NameLast Name
This child has allergies to the following:*
Description of reaction to this allergy*
Please upload a recent headshot of your child*

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Emergency Measures
- Get EpiPen (epinephrine) or other medication and administer immediately.
- HAVE SOMEONE CALL AN AMBULANCE and advise of need for an EpiPen.
- Unless student is resisting, lay student down, tilt head back and elevate legs.
- Cover and reassure student.
- Record the time at which the EpiPen was administered.
- Have someone call a parent.
- If the ambulance has not arrived in 10 – 15 minutes, and breathing difficulties are present, administer a second EpiPen.
- Even if symptoms subside, students require medical attention because there may be a delayed reaction. Take the student to the hospital immediately in the ambulance.
- If possible, have the parent or a school staff member accompany the student to the hospital.
- Provide ambulance and / or hospital personnel with a copy of the Severe Allergy Alert Form for the student, and the time at which the EpiPen or Medication was administered.
I understand I have been asked to disclose the above student’s identifying information and I am aware of the risks or benefits of consenting or refusing to consent to the disclosure. I voluntarily give the school consent to place a copy of this form in the student’s cumulative student record, to post this form including the student’s picture in appropriate locations within the school, to take the Emergency Measures, and to share this information as necessary with the staff of the school and health providers.
Parent/Guardian Name*
Signature*

Clear
Today's Date

MonthDayYear
Date

Medication Authorization Form
Child's Name

First NameLast Name
Medication Name*
Dosage Amount*
Medication Start Date*

MonthDayYear
Medication End Date*

MonthDayYear
If for an Epi-Pen please enter Expiration Date
Medication Expiration

MonthDayYear
Date of expiration on the container
Symptoms to watch for prior to administration*
Symptoms following administration of medication*
Has your child received this medication before (Epi-Pen Excluded)*
Parent/Guardian Name*
Parent/Guardian Signature*

Clear
Should be Empty:

Daycare Parent Package

Health

Behaviour

Toileting

Eating Preferences

Activities

Family History and Multiculturalism

Guidelines for Behaviour Management

Photo and Video Permission

Illness Policy

Medications

Non-Emergency Health Consent

Child Drop-Off and Pick-Up Policy

Emergency Contact List

Community Walk Form

Community Walk and Supervision Information

FSA to Pond Park

FSA to Log Park

FSA walk around the Plaza

Consent for First Aid / Ambulance / Medical Care / Treatment

Liability Release Form

Portable Record Information

Parent/Guardian 1 Information

Parent/Guardian 2 Information

Emergency Contact Information

Allergies, Sensitivities or Dietary Restrictions

Epi-Pen Administration Form

Medication Authorization Form