Early Care & Education Family Toddler Lab Infant/Toddler Needs and Service Plan. Semester/Year: Summer/ Fall/ Spring/

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1 Early Care & Education Family Toddler Lab Infant/Toddler Needs and Service Plan Semester/Year: Summer/ Fall/ Spring/ CHILD S INFORMATION Child s Name: of Birth: Parent s Name: Reviewed: Feeding Plan: Liquids Child is to be fed the following: Breast Milk Formula Brand: Milk Special: Milk Whole Child now uses: Bottle How often & when: Cup How often & when: What age do you plan to introduce your child to: Cup: Solid Foods Child is currently on solid foods? Yes No Child can feed self? Yes No Infant Toddler Needs and Service Plan (revised May 2012) 1

2 Did you plan to introduce your child to solid foods? Yes No Child now uses: Spoon Fork What age do you plan to introduce your child to: Spoon: Fork: Food Groups Age Specific Food Consistency: Bread & Cereals Fruits Vegetables Meats Special instructions from child s pediatrician relating to diet: (It may be necessary for the family to provide the instructions on letterhead from the pediatrician s office with the doctor s signature.) Infant Toddler Needs and Service Plan (revised May 2012) 2

3 Feeding Schedule How many ounces or cups per day? Breast Milk: Formula: Milk: Juices: Approximately what time do you usually offer your child solid foods? Healthy foods child likes: Foods child dislikes: Food Allergies List food allergies: List any other types of allergies: Allergy special instructions: Sleeping Patterns: Sleeping Schedule Does your child take a nap in the morning? Yes No Approximately what time? Usually how long? Does your child take a nap in the afternoon? Yes No Approximately what time? Usually how long? Does your child use any transitional objects (blankets, pacifier, etc.)? Yes No If yes, what objects? Infant Toddler Needs and Service Plan (revised May 2012) 3

4 Special instructions: Some children derive great comfort from personal items such as a photo of the family, a key to the house (not the actual key), or an item belonging to a parent such as a shirt. Please talk with Cindy about transitional objects children can carry with them, both literally and figuratively! We do not wish to have children associate food with behavior and discourage any food items brought into the center for this purpose. Medications: Medication(s) taken (including inhaler): How often: Diapering And Toilet Learning Plan: Infants and toddlers will be checked frequently and will be kept clean and dry. During arrival, the family will complete a diaper check before the family departs. Each family is required to provide the center with diapers and wipes. Child uses: Disposable Diapers Brand: Wipes Brand: Training Pants Brand: Potty Chair Toilet Any other products which family will supply to be used on your child: Special Instructions: Notes: 1) Our children s program does not authorize the use of powder in our centers. 2) A completed Non-Prescription Medical Instruction, Consent and Waiver form on file for the use of all topical ointments (diaper ointments, sunscreen, mosquito repellent etc.) Infant Toddler Needs and Service Plan (revised May 2012) 4

5 At what stage of development does the family anticipate starting the introduction of: Potty Chair: Child-sized toilet: Underwear: Method of toilet learning: Individual Infant And Toddler Activities: What songs do you sing with your child? A plan called Happenings will be posted for each family to review. Families are encouraged to contribute ideas to the plan. Please discuss any special exercises or helpful accommodations for your child: Active play, diapering and toileting and all other interactions will be provided during your child s routine. This form is required to be updated each semester as your child s needs change and reviewed with parent/guardian prior to being signed and approved by persons listed below. The family will receive a copy of the updated plan each semester. Parent/Guardian s Signature Primary Caregiver s at Early Care & Education Lab Signature Lab Instructor s Signature Center Director s Signature Infant Toddler Needs and Service Plan (revised May 2012) 5

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