All About Me - Sunflower Child Development Center

Child Information

Name

Date of Birth

Siblings

Name

Age

Pets

I have a:

It's name is:

Play

Previous group experience:

Daycare
Playgroup
Other

Please describe

Playmates are usually:

Girls
Boys
Older
Younger

How does your child get along with other children:

EMOTIONAL AND PERSONALITY DEVELOPMENT

Is your child affectionate?

Yes
No

Does your child accept new people easily?

Yes
No

Typical reaction to new people:

Does your child have specific fears:

Does your child separate easily from you?

Yes
No

Ways we can help with this:

How does your child react to change?

INFANT

(Duckling Room Only)

Does your infant:

Use a pacifier
Suck thumb/finger

Is your infant:

Breast Fed
Bottle Fed w/ Breast Milk
Bottle Fed w/ Formula

How often and how many ounces at each feeding?

Has your infant had any feeding issues?

Yes
No

If yes, explain:

Solid Foods

Has your infant started solid food?

Yes
No

Have you noticed any allergies or sensitivities to particular foods?

Yes
No

If yes, explain:

What solids has your infant tried?

Sleep

Does your infant:

Sleep in a crib/bassinet
Co-Sleep

What techniques do you use to get your infant asleep?

INFANT AND TODDLER

(Duckling & Chipmunk Rooms Only)

Does your child have a fussy time?

Yes
No

When & the best way to handle fussy time:

Sleep

Sleeping habits during the day:

How often does your infant/toddler nap and for how long?

TODDLER

Toilet Training

Has toilet training been attempted?

Yes
No

If yes, is child dry:

Occasionally
All day
While sleeping
Fully trained Day/Night

What strategies are used at home while training?

Does your child wear:

Diaper
Pull ups
Underwear

Does your child struggle going to the bathroom away from home?

Yes
No

If yes, explain:

OTHER INFORMATION

Please list some of your child's favorites!

Food:

Game:

Song:

Activity:

Color:

Animal:

Toy:

Book:

Please use this space to share anything you would like us to know about your child: