INFANT CARE INSTRUCTION SHEET

INFANT CARE INSTRUCTION SHEET
To be filled out monthly by parents of infants
Which location is your child enrolled at?*
Child's Name*
Date of Birth*

MonthDayYear
Date
Specific type of formula*
Warmed?*

YesNo
How many ounces and how often?*
Infant cereal or cheerios?*
Meats what kind of meats from our published menu (i.e. hotdogs, corndogs, chicken, hamburger meat.) *
Vegetables what kind of vegetables? Baby food vegetables? What kind? Vegetables from our published menu?*
Fruits what kind of fruits? Baby food fruits? What kind? Fruits from our published menu?*
Infant snacks Mum-Mums, LIL' Crunchies? Snacks from our published menu (i.e. cheez Its, animal crackers, saltine crackers, pretzels, graham crackers.)
Food Allergies
Skin Allergies
Allergy symptoms produced
Ointment or powders you will provide; how often do you want these applied?
Soap
If your child cannot turn over on their own and you want your child to sleep on his/her stomach, we must have a statement signed by your physician giving us permission to do so. This is a licensing regulation and requires a specific form. Please speak with your center Director to request this form.
Sleeping Position*

on back
Does your baby use a pacifier?*

YesNo
Other helpful information: (Please include a schedule for sleeping, the more information you provide the better we can meet the needs of your infant.)
THANK YOU FOR ALLOWING US TO CARE FOR YOUR CHILD. THIS INFORMATION WILL BE UPDATED FROM MONTH TO MONTH OR MORE OFTEN IF NEEDED
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: