2022 LOOSH ENROLMENT - ADDITIONAL INFORMATION

The following questions are intended to help with the successful inclusion of children at our center.

Child's name*

First NameLast Name

What school does your child attend?*

Leichhardt Public SchoolSt. Fiacres Primary SchoolOther

Does your child have a diagnosed disability or medical condition?*

YesNo

What is your child's disability/medical condition?*

Do you think that your child would be able to participate at our centre with a ratio of one educator per 15 children.*

YesNo

Has your child accessed additional support (such as an additional support worker) in a previous OOSH, daycare or school?*

YesNo

Please provide the name/contact of any previous centres your child has attended. LOOSH may contact them to gather information to assist the inclusion and support of your child at the service. (name/phone number/email)

Please give a brief description of your child's disability/ medical condition

Is your child fully independent in regards to toileting and hygiene?*

YesNo

If no, please describe what assistance your child requires

Is your child fully independent in regards to eating and drinking?*

YesNo

If no, please describe what assistance your child requires

Does your child recognise and know how to deal with common childhood dangers such as road sense, stranger danger, hot or sharp objects etc?*

YesNo

Please describe any supervision/assistance your child may need in the folowing areas:

General play:

Organised activities/games:

Excursions:

What activities / games / toys does your child enjoy?*

Does your child fully understand verbal communication?*

YesNo

If no, please tell us your child's level of understanding?

Does your child communicate verbally?*

YesNoPartially

If no or partially was selected, please describe how your child communicates and if there are any special signs, sounds or gestures your child uses for everyday communication such as toilet/drink/upset etc.

Describe how your child interacts with other children

Describe how your child interacts with adults/Educators

Please describe anything specific that upsets your child

What methods do you use to calm your child if they become upset, angry, overexcited or exhibit inappropriate behaviours?

Is your child aggressive towards others?*

YesNo

If yes, under what circumstances and how do you deal with it?

Does your child wander, abscond or run away?*

YesNo

If yes, please give details to assist educators

Do you have a behaviour management plan for your child?

YesNo

If yes, please provide details to assist educators and provide a consistent approach for the child.

Describe any activities that your child should not do or will be restricted by, due to medical or health reasons.

Does your child take any ongoing prescribed medications? (please include medications even if they will not be administered at the service)*

YesNo

If yes, please list the medication/s and how of often they are administered.

Does your child have any mobility issues?*

YesNo

If yes, please outline any implications this may have on the care for your child.

Please give details of any sensory impairments to assist educators in successful interactions with your child

Does your child experience seizures?*

YesNo

If your child does experience seizures, please answer the folllowing questions

*Please note that you will be required to supply a seizure action plan to the service before the child can start attending.

What type/s of seizures does your child experience?

Are there any warning signs before a seizure?

How often do seizures occur?

Is there any further information you would like to share that educators should be aware of or that may help your child while at LOOSH?

Please attach any diagnosis, medical information/ action plans or additional resources that may assist us in supporting your child at LOOSH

Parent/Guardian name*

First NameLast Name

Signature*

Date*

Date

2023 LOOSH ENROLMENT - ADDITIONAL INFORMATION

Child's interactions at LOOSH

Child's behaviour

Medical information