Teacher Questionnaire Kindergarten
Please read each item below and check the column on the right that best applies to this child.
Child's Name
First Name
Last Name
Names ten colors when requested?
Always
Often
Rarely
Answers “where” and “when” questions?
Always
Often
Rarely
Follows two-step directions in the sequence given?
Always
Often
Rarely
Speaks clearly in complete sentences of at least five words?
Always
Often
Rarely
Tells others his/her first and last name?
Always
Often
Rarely
Tells others his/her age?
Always
Often
Rarely
Tells others his/her birthday when asked (month and day)?
Always
Often
Rarely
Retells a story with a beginning, middle, and end?
Always
Often
Rarely
Names most (20 or more) uppercase letters?
Always
Often
Rarely
Counts by rote to 30?
Always
Often
Rarely
Walks up and down stairs using alternating feet?
Always
Often
Rarely
Uses the same hand as the preferred hand?
Always
Often
Rarely
Follows the pattern of working left to right and top to bottom?
Always
Often
Rarely
Prints his/her first name?
Always
Often
Rarely
Draws pictures that are recognizable?
Always
Often
Rarely
Manages personal items (coat, backpack, etc.)?
Always
Often
Rarely
Cares for toileting needs independently?
Always
Often
Rarely
Knows which shoe goes on which foot?
Always
Often
Rarely
Ties his/her shoes?
Always
Often
Rarely
Reacts to disappointment and failure in a reasonable manner?
Always
Often
Rarely
Shares and takes turns willingly?
Always
Often
Rarely
Plays cooperatively in a large-group activity or game?
Always
Often
Rarely
Shows concern for using materials safely and appropriately?
Always
Often
Rarely
Able to sit for a 15 minute lesson?
Always
Often
Rarely
Makes an effort to solve problems before seeking help?
Always
Often
Rarely
Follows classroom routines?
Always
Often
Rarely
Continues a task until completed or until it is time to stop?
Always
Often
Rarely
Transitions appropriately from one activity to another?
Always
Often
Rarely
Asks before using another child’s toy or things?
Always
Often
Rarely
What are this child's favorite classroom activities?
What are this child's strengths?
In what areas does this child need to continue to develop?
Describe this child’s behavior during the transition from parents/caregivers to school.
Has this child ever been suspended from school or had limited participation in your classroom or programs?
May we contact you if we have additional questions?
Yes
No
Your Name
First Name
Last Name
Email
example@example.com
Best Contact Number
Please enter a valid phone number.
Signature
Clear
Submit
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