CitiTots Daily Healthcheck

CitiTots Daily Healthcheck

Please fill out every morning prior to coming in to CitiTots
Child's First Name and Last Name Initial
Your Email
example@example.com
Check body temperature. Is temperature ABOVE than 100.40° F (38.0 ° C)?

Yes, child has a fever No, child's temperature is normal
Does the child display any signs or symptoms of respiratory infection, such as runny nose, cough, shortness of breath, or sore throat?

Yes, child has one or more symptoms No, child has no symptoms
Has the child have had ANY contact with someone exposed to, or someone infected with Covid-19?

Yes No
Has the child travelled outside the country for the past 14 days?

Yes No
The child went to bed last night at what time?
This morning, the child woke up at what time?
The child last ate at what time?
The child's last diaper change was at what time?
Is there anything else you would like us to know as we spend time with your child today?
Please Remember:

• Place morning snack in disposable bag.
• Child must have facial covering
• Please provide indoor shoes
• Please provide an extra set of clothes

THANK YOU!
Should be Empty: