Child & Family Profile: Infant, 0-1 year
We take pride in partnering with families to support the wonderful children we share in common. Thank you for taking time to tell us about yours. We value your experience and insights from the start.
Today's Date
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Month
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Day
Year
Date
Your Child's Name
First Name
Last Name
Child's Date of Birth
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Month
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Day
Year
Date
Has your child previously been in a childcare setting?
Yes
No
Parent/Guardian 1
First Name
Last Name
Mobile Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Email
example@example.com
Parent/Guardian 2
First Name
Last Name
Mobile Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Email
example@example.com
Which parent/guardian should we call first in case of illness or an emergency?
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Family Culture & Configuration
Number of children in your family:
Who lives in your household? (Please include all parents, guardians, siblings, live-in caregivers, other relatives, etc.)
If your family has a shared custody arrangement, or your child regularly lives at more than one residence, please describe these arrangements and provide the front office with any legal/court documentation.
Tell us about any extended family members or friends who are an active part of your child's life and/or whom we may see at drop off or pick up (e.g., grandparents, honorary aunt or uncle).
Please describe any family pets and their names.
What languages are spoken in your home?
Do you need help interpreting English?
Yes
No
What words do you use to describe your child’s and family’s cultural identity?
Has your child or family experienced any significant changes, events or life situations in the past year that would be helpful for us to be aware of and understand?
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Family Activities, Celebrations, Traditions
What are some of your favorite family activities?
Describe any special holidays or traditions celebrated in your household.
Any additional information you'd like us to know about your family?
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Child Play, Dispositions, Behavior
What three words or phrases might you use to describe your infant?
What do you really appreciate about your child (and hope that we will too)?
Please describe your infant’s favorite play and current fascinations.
Describe your infant’s emotional temperament. (How does your child respond to new activities or people? Any particular fears? How does he/she handle transitions? How about big feelings?)
How does your infant like to be comforted or responded to when upset?
Tell us about your infant’s social interactions.
Do you have any concerns or questions about any aspects of your child's behavior?
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Medical History / Physical Development
Is there anything we should know about your infant’s medical history? Please describe any current medical issues or challenges.
Does your child have any allergies (food, medicine, environmental, other)?
Yes
No
If yes, describe the allergy, from mild to severe, and submit any relevant documentation to the office. (We work with families to develop individual allergy management plans.)
Do you have any questions or concerns about your infant's development; e.g., gross or fine motor skills, speech, hearing, vision? (As needed, we coordinate with your child's pediatrician and Early Intervention to support your child's development.)
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Food & Feeding
What does your child drink?
Breast milk
Formula
Are you planning to nurse your child at the Treehouse? If so, we provide a private area for nursing mothers.
Yes
No
If your child drinks formula, which is your preference? (Whether provided by home or school, formula must be iron fortified unless accompanied by a doctor's note.)
Provided from home
Similac 360 Total Care provided and mixed by Robin's Nest teachers
What is your infant's typical bottle feeding schedule?
If your child is "eating," along with drinking from a bottle, what form of food is he/she currently eating?
Purees
Solids/chunks (e.g. fruit chunks, cheese, cereal)
Would you like the Treehouse to provide iron-fortified infant cereal for your infant?
Yes, please
No, thank you
I'd like to learn more
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Diapering & Sleep Habits
Does your infant have any diaper allergies?
Yes
No
What type of diapers do you use?
Cloth diapers
Disposable diapers
Does your child use the following when sleeping:
Pacifier
A sleep sack
Does your child sleep in his or her own room?
Yes
No
Does your child sleep in...
A crib
A bed
Please describe your child’s typical nap schedule (how many, how long):
Describe your child's night-time sleep habits. (Typical bed time, wake-up time, sleeping through night, any challenges, etc.)
Please tell us about any special ways you help your child go to sleep.
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Hopes & Dreams
What are your hopes and dreams for your child and family at the Treehouse?
What topics are you, as a parent/caregiver, interested in learning more about?
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Thank you!
We will stay in close communication to ensure your child has a joyous experience at the Treehouse. Loris Malaguzzi, pioneer of the Reggio approach, beautifully described our essential school-home partnership: "A network of communication exists between the children, parents and teachers of Reggio. These three protagonists work together to create a spirit of cooperation and collaboration, interacting toward a common purpose: the building of a culture which respects childhood as a time to explore, create and be joyful... Each family brings a unique perspective to a Reggio-inspired classroom… ”
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