Child's Information

I authorized the following person(s) to pick up my child/children:

Emergency information: ALL INFO IS REQUIRED

In the event of an emergency and I am unable to be reached, I authorized the following person to pick

up my child/children: (2 contacts are required)

Phycisian and Hospital Information

Consent for medical treatment:

I give permission for the child care facility to obtain emergency medical treatment, including emergency transportation, for my child if I cannot be reached immediately. I agree to be responsible for any emergency medical expenses incurred. (If parent/guardian refuses to sign, instructions must be attached stating what procedure the facility is to follow in an emergency)

Transportation, Field Trip, Water Activities

I hereby GIVE consent for my child (ren) to be transported and supervised by the operation’s employees.

I hereby GIVE consent for my child to participate in Field trips.

My child attends the following public school and his/her immunization record is on file at the school and all immunization, vision/hearing screen, tuberculosis test are current as required by family protective services.

My child attends the following public school and his/her immunization record is on file at the school and all immunization, vision/hearing screen, tuberculosis test are current as required by family protective services.

His / Her immunization record is on file at the school and all required immunizations and/or tuberculosis test are current.

 

Immunization & Health Statement:

If your child does not attend a Pre-Kindergarten or school away from the child-care operation, one of the following must be presented when your child is admitted to the child-care operation or within one week of admission.

 

1, A signed and dated copy of a health care professional’s statement is attached.

2. Medical diagnosis and treatment conflict with the tenets and practices of a recognized religious organization, I adhere to or am a member of; I have attached a signed and dated affidavit stating this.

3. My child has been examined within the past year by a health care professional and is able to participate in the day care program. Within 12 months of admission, I will obtain a health care professional’s signed statement and will submit it to the child-care operation. Provide Name & Address of Health Care Professional:

(Please initial by each policy signifying you have read and understand each policy)

Monday-Thursday 6am – 8pm Friday 6am – 10pm Saturday 9am – 8pm Sunday - CLOSED Please be sure to arrive to pick up your child before closing time.

THERE WILL BE A FEE OF $1.00 PER MINUTE PER CHILD AFTER CLOSING TIME.

We are closed on the following holidays:

New Years Day Memorial Day July 4th Labor Day Thanksgiving Day Christmas Eve

Christmas Day Holiday hours will be posted in advance in the front office.

ADMITTING & RELEASING CHILDREN:

We must have the following before enrollment: 1. Completed Registration Form and Operational Policies

2. Updated Immunization Records & Physician’s Health Statement*(any child not enrolled in public school)

3. Non-Refundable Initial & Renewal Registration Fee- which is due on the First Visit. Any person dropping off a child MUST sign them in via “Sign In Sheet” / Computer Sign In Any person picking up must have a valid photo ID and be authorized to pick up. Children will ONLY be released to the Parent/Guardian or person(s) on the Authorized pick up list or Emergency Pick up list.

ALL OTHERS WILL NOT BE PERMITTED TO PICK UP.

Reservations are REQUIRED for infants (6 weeks – 17 months Please call if you are unable to make your reservation. Failing to arrive at scheduled time could lead the reservation being cancelled. Any reservation that is not canceled, there will be a $10.00 No Call- No Show fee. Initial

We cannot accept children who are ill into our care. Children must be fever free without medication for at least 24 hours before coming into our care. We cannot accept children sent home from school due to being ill. If your child becomes ill while at the center you will be contacted immediately to pick up your child. Once you have been called, your child must be picked up with 35min to avoid incurring late pick up charges ($1 per min

Some common illnesses and return policy are:

Fever of 100.4 or greater ~ Must be 100% fever free WITHOUT the use of fever reducing medicine Vomiting ~ Must not have vomited for 24hrs Diarrhea ~ must be48hrs diarrhea free Conjunctivitis (Pink Eye) ~ must have a note of clearance from a medical Physician Fifth Disease ~fever free for 24hrs Strep Throat ~24hrs after beginning antibiotic AND fever free 24 hrs Coxsackie (Hand, foot, mouth) ~ fever free for 24 hrs * Chickenpox ~ 7 days after onset of rash and fever free 24 hrs * Measles ~ 4 days after onset of rash

* These are immunized illness and we are required by law to report any confirmed and suspected cases to the CDC. We may also exclude any NON immunized children from care if we have a confirmed case until we are cleared from the incubation period.* Although Head lice are not an illness, children cannot be in the center with lice ~ they may return after medicated shampoo treatment. (Note: we do have a NO NIT policy) Initial

We will only dispense medicine if a Medication Authorization form is completely filled out upon drop off. The medicine must not be expired or mixed in a cup/bottle i.e. (drink / food) without a written and signed Physician’s note, and in its original container. Initial

We provide transportation to and from school and field trips. Parents MUST sign the release on the registration form before the child can be transported. Initial

We will provide a chair for nursing mothers to nurse their baby in the infant room.

Any movie or video brought into the center must be rated “E” or “G”. We strongly recommend that children leave all toys and personal items at home as they can become a distraction as well as lost or damaged. WE ARE NOT

RESPONSIBLE IF ANY PERSONAL ITEM BECOMES LOST, STOLEN, OR DAMAGED IN ANY WAY.

All parental notifications and policy changes will be posted in the front office. Please remember to keep all emergency contact info updated. In the event of an emergency, we will contact parents/guardians immediately and call 911. ALL OF OUR STAFF IS CPR & FIRST AID CERTIFIED. Please see a member of management if you would like to review: Minimum Standards, Most recent inspection report, our policy and procedures, and/or contact info for the local licensing office CRS child abuse hotline and or CRS website. Initial

We follow the State’s Discipline and Guidance policy. A copy is included in this registration. Caregivers use positive redirection and discussion with the children. We praise and encourage good behavior instead of focusing only on unacceptable behavior. We do use brief supervised separation of the group as a last resort method of discipline. The separation is a min per the child’s age. No corporal punishment or verbal abuse of any nature is ever allowed. For the safety of all children and staff, those who show repeated unacceptable behavior in the form of hurting others will be asked to take a week break from the center. Initial

All meals are covered under the Flat Rates. Hourly Care students can purchase meals at a rate of: $3.00 for Breakfast $3.75 for Lunch, and $3.75 for Dinner. Snacks are complimentary. Children are always welcomed to bring their own food. We are a PEANUT FREE facility. If a child is late being picked up, and is present during meal time, a meal will be provided to them. Additional fees may apply. Meal and snack times are as followed: Actual time depends on class Breakfast ~ 6:30am-8:30am AM Snack ~ 8:00am-9:30am Lunch 10:45am-12:15pm Pm Snack 2:30pm-3:45pm Dinner 5:00pm – 6:30pm Evening Snack 8:00pm-8:30pm Initial

Parents are welcome to visit the center at any time. We maintain an open door policy. The office staff is always available to answer any questions or concerns you may have. For the safety of the children in care and staff, parents/guardians are not allowed to walk through the center unaccompanied. They must be escorted by a member of management. Initial

Children are asked to dress comfortable and weather appropriate, ready to participate in indoor and outdoor activities. Children must wear closed toe, closed heel shoes (or bring a backup pair) at all times for safety. Children are asked to bring extra clothes and a blanket for nap time. We ask that all personal belongings be labeled with the child’s first and last name or initial. Initial

Tuition is due on Mondays by the end of the day; closing time (at the beginning of each week If tuition is NOT paid by Wednesday morning, a $25.00 late fee will be applied. If you are paying an hourly rate, payment is due when your child / children are picked up on the same day. If your child is school aged and rides the TKA van, there will be a $7.00 fee if you do NOT call when your child / children will NOT ride the van. We DO NOT accept cash; we accept all credit cards, money orders and checks. Initial

ACKNOWLEDGEMENTS OF POLICIES AND PROCUEDURES

I understand that my child(ren) must have on file current state and city immunizations required by the first visit. I understand my child(ren) will be refused admittance into the center without them. Hearing and vision screening is required for children starting at age 4.

This Center is regulated by the Family and Protected Services. The minimum standards policies for child care centers and our inspection reports are available for review. We maintain an open door policy and parents may visit and observe the center at any time. Management is always available to discuss any questions or concerns. Family and Protective services Local Office: 1501 Circle Dr. Ste 310, Fort Worth, TX 76119 Phone: 817-321-8604

I certify that my child is in excellent health and physical condition and has no medical, physical, or mental condition, which has not been disclosed on this registration form. I have provided or will provide (within a year) a signed document from my child’s physician verifying my child’s good health.

Consumer Safety Information~ Recall information for unsafe children’s products can be found at: WWW.CPSC.GOV ~under the link for recalls and product safety news.

This notification is to inform parents our facility is in a Gang Free Zone. Any criminal offenses related to organized criminal activity within 1,000ft of the facility is subject to harsher penalties. Parent notifications can be found in the Front Office.

DISCIPLINE AND GUIDANCE POLICY

• Discipline Must Be: (1) Individualized and consistent for each child (2) Appropriate to the child’s level of understanding; and (3) Directed toward teaching the child acceptable behavior and self control
• A caregiver may only use positive method of discipline and guidance that encourage self-esteem, self-control, and self-direction which include at least the following: (1) Using praise and encouragement of good behavior instead of focusing only upon the unacceptable behaviors. (2) Reminding a child of behavior expectations daily using clear positive statements; (3) Redirecting behavior using positive statements; and (4) Using brief supervised separation or time out from the group, when appropriate for the child’s age and development, which is limited to no more than 1min per year child’s age
• There must be no harsh, cruel, or unusual treatment of any child. The following types of Discipline and Guidance are Prohibited: (1) Corporal punishment or threats of corporal punishment (2) Punishment associated with food, naps, or toilet training (3) Pinching, shaking, or biting a child; (4) Hitting a child with hand or instrument; (5) Putting anything in or on a child’s mouth (6) Humiliating, ridiculing, rejecting, or yelling at a child; (7) Subjecting a child to harsh, abusive, or profane language; (8) Placing a child in a locked or dark room, bathroom, or closet with the door closed; and (9) Requiring a child to remain silent or inactive for inappropriately long periods of time required for the child’s age.

My signature verifies I have read and received a copy of this Discipline and Guidance policy.

Use the following number to report: Abuse, neglect, or exploitation or the elderly, and Violations of minimum

standards in a child care operation: 1-800-252-5400 or http://www.txabusehotline.org. This number is available 24 hours a day, seven days a week.

Our Center requires 24 hours of annual training for everyone employed including Reporting Suspected Abuse and Neglect of a Child: A Guideline for Education Professionals Training through the Texas Department of Family and Protective Services. We with City House to help at-risk children and young adults, who have been abused, neglected or are homeless. They serve youth ages newborn to 21-years-old through three primary programs — our Emergency Shelter for children in Plano, Outpatient Counseling Services for individuals and families, and our Transitional

Living Program in both Plano and Frisco. See more at: http://www.cityhouse.org. You may also contact them at 972- 424-4626.

1. Evacuation (A) In case of an emergency, the first responsibility of staff is to move the children to Fellowship at the Parks at 9900 N. Beach St Keller, Texas 76244. This designation is known to all employees. (B) The children will be transported by the center’s van. (C) The evacuation and relocation diagram is posted at all times. (D) Management will designate each employee responsible for securing children’s attendance sheet during the emergency. The person in charge will ensure all children in attendance at the time of emergency are accounted for at the designated safe area. The children’s files and an emergency phone will be located in the office in the emergency black box. This black box is to be taken to the designated safe place. In case of an emergency, you can contact us at (817) 726-9463. (E) Children that are non mobile due to their age or a disability will be carried to the van and properly fastened for transport.

2. Communication (A) Management will use their cell phone to communicate to the parents and licensing. (B) The Director will designate the Office Assistant to call the fire department in case of fire or danger of fire, explosion, toxic fumes, or other chemical release. This phone call will be made from Fellowship at the Parks.

3. The staff will evacuate with the following essential documentation: Parent Sign In Sheet, Computer Sign In Sheet, Parent and Emergency Contact Info and Authorization for Medical Care

4. Intruder In The Building (A) If there is an intruder in the building, a called out employee is to use the emergency phone in the alternate location of the facility to phone the Emergency numbers. Caregivers are to have each class go to their designated locked areas in the facility. (B) Infants and toddlers will go to the girl’s bathroom and the pres/prek and schoolers will go to the boy’s bathroom.