Dear Parents,Thank you for selecting The Laurel Hill School. We look forward to an outstanding year of excellence for all our children. The roads of our learning community are always open to you. Our Infant Program maintains a commitment to the physical, emotional, social and intellectual growth of each child. Toward this end, learning is seen as a developmental process that occurs naturally and progressively within a stimulating and nurturing environment. Caregivers offer a wide variety of interesting play and learning experiences geared toward each child’s developmental level so that he/she has sufficient opportunity to explore, manipulate and come to a better understanding of the world through his/her own efforts. Welcome, as we travel together through the wonders of the upcoming year.

1

INFANT ORIENTATION

Wednesday, August 28th &

Thursday August 29th

2019 (You will be notified as to what day and time your

individual orientation will take place.)

Regular Schedule Begins

Tuesday, Sept. 3rd 2019

Getting to know your child personally is very important to us. Familiarity with your child’s routines and personality will help us assure a smooth transition. With that goal in mind, we have scheduled an INDIVIDUAL INFANT ORIENTATION for you and your infant. At that time our teachers will meet with you and your child to discuss issues such as eating habits, nap schedule and preferred strategies for soothing and comforting your baby. It is also essential for us to know about your child’s favorite toys, activities, and songs. Through this meeting, we will develop the kind of understanding of your child that will help him or her adjust most easily to this new environment.

ENCLOSED PLEASE FIND IMPORTANT FORMS THAT

MUST BE SUBMITTED TO

SCHOOL

1

DOWNLOAD ALL THE FORMS

ATTACHED

2

SUBMIT FORMS TO

YOUR CHILD’S TEACHER AT

YOUR CHILD’S ORIENTATION

3

INFANT CENTER 6WKS-24MOS.

The Laurel Hill School School Orientation Manual 2019-2020

School Communications

Teacher’s Website Every classroom teacher has their own “class website.” The website will contain information on all activities and events taking place in your child’s class. It will outline the many activities your infant will be introduced to each month. We encourage you to review and utilize the activities at home with your infant when possible.

Weekly E-Mail Pertinent information is sent out every Friday via e-mail. This is the only mode of

communication that will be used during the upcoming school year. It is imperative that we have a current, preferred e-mail address for every student. We urge you to submit your preferred e-mail address immediately if you have not already done so. Be certain to check your e-mail for up-to-date events and happenings each week. It would be most helpful if you would set spam filters, particularly if you’re an AOL user, to allow LHS to get through (info@laurelhillschool.org).

Weather Emergencies

A storm emergency may require the closing of school. The decision to close school (or suspend bus service) due to snow, high winds, or heavy rains is made on the basis of safety to children and commuting staff. Local road conditions are carefully assessed. You will be notified by our automatic telephone system (Parent Reach) regarding school closure if a weather emergency occurs. Announcements will also be made on our website www.laurelhillschool.org

2

2019-2020 INFANT CENTER

Daily Verbal Communication We encourage parents to talk with their child’s teacher at drop-off and/or at pick-up. It is important for the teacher to know information about your child, such as how they slept last night, when they ate last, if they are teething, etc. The sharing of this information is important to best meet your child’s needs. Upon arrival you will need to complete the Daily Log Form along with your child’s teacher, (Please allocate extra time for completion of this form).

3

We Love to Talk To Our Parents…

Communicating with your child’s teacher . . .

•Your child’s well being is our highest priority. The happiness and development of your child areenhanced by the feedback we receive from you. Please call us on any matter concerning your child! Many problems are easily solved if we work together early. Information we receive from you suggests where our program is succeeding, or requires modification for your child. Please do not hesitate to call.

• Calling LHS Call our front desk to leave a message. We will make sure to pass it to your child’steacher. If you desire a call back and it is not an emergency, it shall be made after school, or other timeyour teacher is not in class.

• Texting This is a big “No-no!” We do not support texting. Laurel Hill faculty turn their cell phonesoff while in class. This enables them to keep full attention on their students and lessons. We are sure you agree that receiving and replying to texts may be massive through-the-day distractions.

• Meetings Schedule a meeting and talk in person. You don’t need to wait for progressive reporttime. A meeting may be arranged after the school day or earlier, if possible.

With Laurel Hill administrators . . . • By phone, by casual chat, by scheduled meeting Call and we will be happy to speak with you; and

certainly, if an admin is not available your call will be returned asap. Drop by our offices and we’llchat if we can, or schedule a meeting at your convenience.

• Email- Robert H. Stark, Headmaster: rstark@laurelhillschool.org- Helen Stark, Educational Director: hstark@laurelhillschool.org- Yosefa Klein-Karchmar, PreSchool Director: ykarchmar@laurelhillschool.org

Infant Cubbies and Crib Drawers All infants will have a cubby and a crib drawer assigned to them. Cubbies will hold a child’s outdoor clothing and bags. All other personal items, such as extra clothing, crib sheets, mattress covers, etc. will be stored in crib drawer.

Pacifier If your child uses a pacifier, please provide 3 clearly labeled with your child’s name.

Diapering Your child will be changed at regular intervals throughout the day and as needed. LHS will use only the supply of diapers, ointments, wipes, etc. provided by each parent. In the event an infant develops a diaper rash, caregivers will use only ointments provided by the infant’s parents.

4

Meal Time Young infants will be fed according to their own schedule. As they grow and start eating solid foods, their eating needs will change and the eating times will be adjusted. As they grow and become more adept at eating, they will begin using finger-foods and infant utensils. When infants gradually start to eat cereals, jarred foods, and table foods, parents will inform the teachers in the classroom as to what their child can eat. It is recommended that infants try new foods at home first and then parents can add the new food to the classroom list.

Solid Food Food for your infant must be supplied daily and ready to be served. Any food not used for a meal will be saved and sent home at the end of the day. All food containers (cover and bottom) must be clearly labeled with your child’s full name and dated.

Bottles Parents will need to provide enough bottles, nipples, and lids for each day’s feedings. All bottles (top and bottom) must be clearly labeled with your child’s full name and be dated. If you are breast-feeding your child, all breast milk must be dated and labeled with your child’s name. Bottles will be heated by a bottle warmer. Contents remaining in any bottle will be discarded after feeding. Juice can only be served from a sippy cup. Mothers are welcome to feed their infants at any time.

2019-2020 INFANT CENTER

Safe Sleeping Practices

Infants will be placed on their backs to sleep in a crib. The infants at LHS are provided with a firm, tight-fitting mattress in a crib that meets current safety standards. There will be no pillows, quilts, bumpers, comforters, sheepskins, stuffed toys, or other fluffy products in the crib.

Birthdays

Birthdays are very special events. Please notify the school two weeks in advance of your child's birthday. A time will be planned for you to participate in the celebration.

Sleeping Infants nap according to their own schedules. If an infant should fall asleep while being rocked, or taken for a walk in a stroller, they will be put into their crib to continue their sleep. Parents of infants are to provide 2 crib sheets and 2 mattress covers. Please label each item brought to school.

Healthy Practices

5

Tuition Information

All tuition deposits and outstanding balances must be submitted prior to the beginning of the school year. Please remember that automatic monthly tuition will be electronically deducted from the account families have authorized, on the first of each month beginning Sept. 1st and continue through May 1st. Accounts with insufficient funds will

incur a charge of $30.00 for processing.

           Fresh Air and

Outdoor Play

Classrooms are aired frequently. The children go outdoors daily,

weather permitting.

2019-2020 INFANT CENTER

Hand Washing At LHS we are firm in the belief of

healthy practices. Hand washing is one of the best ways to cut down on the

transmission of germs. Teachers in the classrooms follow proper hand washing

techniques throughout the day, including, but not limited to: before and after eating

or handling food, before and after feeding a child, before and after

diapering, after handling or cleaning body fluids, after wiping noses, mouths, bottoms, sores, after outdoor activities,

and upon entering the classroom. Children, as well, engage in hand

washing throughout the day.

General Disinfecting Classroom toys that have been mouthed are disinfected everyday and throughout the day. Teachers often will place a toy into a container after a child has mouthed it to be cleaned. At the end of the day, other equipment and material will be cleaned as well. The diaper changing area is disinfected after each use. A bleach solution is used for general disinfecting.

Laundering/Sleeping Materials

The bedding on cribs needs to be washed weekly. Teachers will send home all soiled clothes and bedding that need to be laundered on a weekly basis. After every sheet change, crib mattresses are disinfected. All infant soft toys will be washed as much as needed to prevent the spread of germs.

The Laurel Hill School 201 Old Town Road, East Setauket, New York 11733

(631) 751-1154 www.laurelhillschool.org

INFANT PROGRAM SUPPLY LIST

THE FOLLOWING ITEMS WILL BE STORED IN SCHOOL:

θ Disposable diapers (one week’s supply)

θ Wipes and any ointments your child will need for diapering

θ Sunscreen

θ (2) crib sheets (24”x 38”)

θ (3) pacifiers (if needed)

θ Burp cloths

θ (3) changes of seasonal clothing (to be kept in school)

θ A family photo album. It should include parents, siblings, grandparents, pets, etc.

θ Jacket or sweater

DAILY SUPPLY LIST

θ (3) changes of clothing for the dayθ Enough formula or breast milk assembled in bottles clearly labeled with child’s name (with

date) for each day.PLEASE NOTE:Please bring in 1 extra bottle per day. Contents remaining in any bottle after feeding will be discarded. Mothers are welcome to come and feed their infants at any time.

θ Solid Food- Food for your infant must be supplied daily and ready to be served. Any food not used for a meal will be saved and sent home at the end of the day.

θ Bibθ Spoon if needed.

ALL ITEMS BROUGHT TO SCHOOL INCLUDING FOOD MUST BE CLEARLY LABELED WITH YOUR CHILD’S

FULL NAME.

Health Records and Medication

LHS Nurse DIRECT PHONE: 631-771-1299

Documentation of Immunization All children two months and older must show proof of compliance with the immunization requirements in Public Health Law 2164. Immunization forms need to be signed by a New York State certified physician. Immunization records must be on file in the health office PRIOR TO ATTENDANCE.

Medications at School In order for the school nurse to administer medication to your child the enclosed Medications in School form must be completed and signed by both the physician

and the parent, stating the time the medication should be administered and the dosage amount. This includes any over the counter medications. Feel free to call

the Health Office with any questions about this protocol.

Infant Notification of Illness Please call the nurses office in the event your child is ill and will not be attending school 631-771-1299.

IMPORTANT MEDICAL INFORMATION FROM THE HEALTH OFFICE

Dear Parents,

Welcome to The Laurel Hill School. I am looking forward to meeting you, and your little one. I would like to take his opportunity to assure you that the health and safety of your children is my highest priority. Included in this packet you will find required health documents as well as an overview of our health protocols. Please take a moment to familiarize yourself with this important information.

Documentation of Immunization: All children two months and older must show proof of compliance with the immunization requirements in Public Health Law 2164. Immunization forms need to be signed by a New York State certified physician. Immunization records must be on file in the health office PRIOR TO ATTENDANCE.

Medications at School: In order for the school staff to administer medication to your child the enclosed form must be completed and signed by both the physician and the parent. This includes any over the counter medications. Feel free to call the Health Office with any questions about this protocol.

Please be sure to inform us of any health issues and concerns your child might have on an ongoing basis.

Attendance: Many times it is difficult to decide when to keep your child home due to possible illness. Here are some guidelines to follow that are in compliance with The Laurel Hill Infant Center Protocol. In all fairness and consideration to the other children as well as the staff members, we ask that all parents follow these basic infection control guidelines when their child is sick to minimize the sharing of germs. Daily health checks will be administered to children upon arrival which include talking with the parent and observation of the child for:

- Changes in appearance and/or behavior. - Skin rashes. - Elevated temperature. - Other signs of infection such as drainage from nose or eyes, vomiting, diarrhea. - Any illness that results in a greater need for care than the childcare staff can provide without

compromising the health and safety of the other children.

Children should not be brought to school if: - Fever: In general, the child should be fever free (without the use of Tylenol or Ibuprofen) for

24 hours before returning to childcare. - Conjunctivitis: Your child may return 24 hours after medical treatment has begun and the

drainage has stopped. - Diarrhea and vomiting: Children should remain at home until there have been no episodes

for 24 hours.

We thank you for your careful consideration and adherence to these guidelines. For additional information, any question or concerns, please feel free to call the health office (631)771-1299.

Laurel Hill SchoolNEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES

Medical Statement of Child in Childcare To Be Completed By Licensed Physician, Physician’s Assistant or Nurse Practitioner Name of Child: Date of Birth: Date of Examination:

Immunizations required for entry into day care Medical Exemption The physical condition of the named child is such that one or more of the immunizations would endanger life or health. Attach certification specifying the exempt immunization(s).

Yes No

Diphtheria, Tetanus and Pertussis (DPT) Diphtheria and Tetanus and acellular Pertussis (DTaP)

1st Date 2nd Date 3rd Date 4th Date 5th Date

Polio (IPV or OPV) 1st Date 2nd Date 3rd Date 4th Date

Haemophilus influenzae type B (Hib)

1st Date 2nd Date 3rd Date 4th Date OR 1st Date (if given on or after 15 months of age)

Pnuemococcal Conjugate (PCV) for those born on or after 1/1/08)

1st Date 2nd Date 3rd Date 4th Date

Hepatitis B 1st Date 2nd Date 3rd Date

Measles, Mumps and Rubella (MMR)

1st Date 2nd Date

Varicella (also known as Chicken Pox)

1st Date 2nd Date

Other Immunizations may include the recommended vaccines of Rotavirus, Influenza and Hepatitis A Type of Immunization: Date: Type of Immunization: Date:

Type of Immunization: Date: Type of Immunization: Date:

Type of Immunization: Date: Type of Immunization: Date:

Tests Tuberculin Test Date: / / Mantoux Results: Positive Negative mm

TB Tests are at the physician’s discretion.

If positive, or if x-ray ordered, attach physician’s statement documenting treatment and follow-up.

Lead Screening Date: / / Attach lead level statement Lead Screening (Include All Dates and Results)

1 year / / Result: mcg/dL Venous Capillary

2 years / / Result: mcg/dL Venous Capillary Most recent date of lead screening (if different from above):

/ / Result: mcg/dL Venous Capillary Per NYS law, a blood lead test is required at 1 and 2 years of age and whenever risk of lead poisoning is likely. If the child has not been tested for lead, the day care provider may not exclude the child from child day care, but must give the parent information on lead poisoning and prevention, and refer the parent to their health care provider or the county health department for a lead blood screening test.

ADDITIONAL INFORMATION ON REVERSE SIDE !

Laurel Hill School

Medical Statement of Child in Childcare (continued)

Health Specifics Comments

Are there allergies? (Specify) Yes No

Is medication regularly taken? (Specify drug and condition) Yes No

Is a special diet required? (Specify diet and condition) Yes No

Are there any hearing, visual or dental conditions requiring special attention? Yes No

Are there any medical or developmental conditions requiring special attention? Yes No

Summary of Physical Exam Include special recommendations to Day Care Providers

On the basis of my findings as indicated above and on my knowledge of the named child, I find that: he/she is free from contagious and communicable disease and is able to participate in day care. Yes No

Signature of Examiner Address

Please Print Name City, State, Zip

( ) Title Phone Date

Religious Exemptions Public Health law Section 2164 allows a child to be religiously exempted from immunization. A written and signed statement from a parent, parents or guardian of the child stating that they object of the immunization of their child due to their sincere and genuine religious beliefs should be submitted to the day care owner, operator or administrator who shall determine whether the statement of religious belief is acceptable.

OCFS-LDSS-7002 (5/2015) FRONT

NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES

MEDICATION CONSENT FORM CHILD DAY CARE PROGRAMS

• This form may be used to meet the consent requirements for the administration of the following: prescriptionmedications, oral over-the-counter medications, medicated patches, and eye, ear, or nasal drops or sprays.

• Only those staff certified to administer medications to day care children are permitted to do so.• One form must be completed for each medication. Multiple medications cannot be listed on one form.• Consent forms must be reauthorized at least once every six months for children under 5 years of age and at least once

every 12 months for children 5 years of age and older.

LICENSED AUTHORIZED PRESCRIBER COMPLETE THIS SECTION (#1 - #18) AND AS NEEDED (#33 - 35). 1. Child’s First and Last Name: 2. Date of Birth:

/ /3. Child’s Known Allergies:

4. Name of Medication (including strength): 5. Amount/Dosage to be Given: 6. Route of Administration:

7A. Frequency to be administered:

OR 7B. Identify the symptoms that will necessitate administration of medication: (signs and symptoms must be observable and, when possible, measurable parameters):

8A. Possible side effects: See package insert for complete list of possible side effects (parent must supply)

AND/OR8B: Additional side effects:

9. What action should the child care provider take if side effects are noted: Contact parent Contact health care provider at phone number provided below Other (describe):

10A. Special instructions: See package insert for complete list of special instructions (parent must supply)

AND/OR10B. Additional special instructions: (Include any concerns related to possible interactions with other medication the child is receiving or concerns regarding the use of the medication as it relates to the child’s age, allergies or any pre-existing conditions. Also describe situation's when medication should not be administered.)

11. Reason for medication (unless confidential by law):

12. Does the above named child have a chronic physical, developmental, behavioral or emotional condition expected to last 12 monthsor more and requires health and related services of a type or amount beyond that required by children generally?

No Yes If you checked yes, complete (#33 and #35) on the back of this form.

13. Are the instructions on this consent form a change in a previous medication order as it relates to the dose, time or frequency themedication is to be administered?

No Yes If you checked yes, complete (#34 -#35) on the back of this form.

14. Date Health Care Provider Authorized:/ /

15. Date to be Discontinued or Length of Time in Days to be Given:/ /

16. Licensed Authorized Prescriber’s Name (please print): 17. Licensed Authorized Prescriber’s Telephone Number:

18. Licensed Authorized Prescriber’s Signature:X

The Laurel Hill School

OCFS-LDSS-7002 (5/2015) REVERSE

NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES

MEDICATION CONSENT FORM CHILD DAY CARE PROGRAMS

PARENT COMPLETE THIS SECTION (#19 - #23) 19. If Section #7A is completed, do the instructions indicate a specific time to administer the medication? (For example, did the licensedauthorized prescriber write 12pm?) Yes N/A No

Write the specific time(s) the child day care program is to administer the medication (i.e.: 12 pm):

20. I, parent, authorize the day care program to administer the medication, as specified on the front of this form, to (child’s name):

21. Parent’s Name (please print): 22. Date Authorized:/ /

23. Parent’s Signature:X

CHILD DAY CARE PROGRAM COMPLETE THIS SECTION (#24 - #30)24. Program Name: 25. Facility ID Number: 26. Program Telephone Number:

27. I have verified that (#1 - #23) and if applicable,(#33 - #36) are complete. My signature indicates that all information needed to givethis medication has been given to the day care program.28. Staff’s Name (please print): 29. Date Received from Parent:

/ /30. Staff Signature:

X

ONLY COMPLETE THIS SECTION (#31 - #32) IF THE PARENT REQUESTS TO DISCONTINUE THE MEDICATION PRIOR TO THE DATE INDICATED IN (#15) 31. I, parent, request that the medication indicated on this consent form be discontinued on / /

(Date) Once the medication has been discontinued, I understand that if my child requires this medication in the future, a new written medication consent form must be completed. 32. Parent Signature:

X

LICENSED AUTHORIZED PRESCRIBER TO COMPLETE, AS NEEDED (#33 - #35) 33. Describe any additional training, procedures or competencies the day care program staff will need to care for this child.

34. Since there may be instances where the pharmacy will not fill a new prescription for changes in a prescription related to dose, time orfrequency until the medication from the previous prescription is completely used, please indicate the date you are ordering the change inthe administration of the prescription to take place.DATE: / /

By completing this section, the day care program will follow the written instruction on this form and not follow the pharmacy label until the new prescription has been filled. 35. Licensed Authorized Prescriber’s Signature:

X

The Laurel Hill School

OCFS-6010 (5/2015) NEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES NON-MEDICATION CONSENT FORM

Child Day Care Programs

• This form may be used when a parent consents to having over-the-counter products administered to their child in achild day care program. These products include, but are not limited to: topical ointments, lotions and creams, sprays,sunscreen products and topically applied insect repellant.

• This form should NOT be used to meet the consent requirements for the administration of the following: prescriptionmedications, oral over-the-counter medications, medicated patches, and eye, ear, or nasal drops or sprays. OCFSForm 7002 would meet the consent requirements for medications.

• One form must be completed for each over-the-counter product. Multiple products cannot be listed on one form.• This form must be completed in a language in which the staff is literate.• If parent’s instructions differ from the instructions on the product’s packaging, permission must be received from a

health care provider or licensed authorized prescriber.

PARENT TO COMPLETE THIS SECTION (#1 - #14) 1. Child’s first and last name: 2. Date of birth: 3. Child’s known allergies:

4. Name of product (including strength): 5. Amount to be administered: 6. Route of administration:

7A. Frequency to be administered, include times of day if appropriate: OR 7B. Identify the conditions that will necessitate administration of the product (signs and symptoms must be observable prior to administration):

8A. Possible side effects: See product label for complete list of possible side effects (parent must supply) AND/OR

8B: Additional side effects:

9. What action should the child care provider take if side effects are noted:Contact parent

Other (describe):

10A. Special instructions: See package insert for complete list of special instructions (parent must supply) AND/OR

10B. Additional special instructions:

11. Reason(s) for use (unless confidential by law):

12. Parent name (please print): 13. Date authorized:

14. Parent signature:

X

DAY CARE PROGRAM TO COMPLETE THIS SECTION (#15 - #21) 15. Program name: 16. Facility ID number: 17. Program telephone number:

18. I have verified that #1, -#14 are complete. My signature indicates that all information needed to administer this product has been givento the child day care program.19. Staff’s name (please print): 20. Date received from parent:

21. Staff’s signature:

X

The Laurel Hill School

THE LAUREL HILL SCHOOL EMERGENCY CONTACT INFORMATION

Please complete this form and return to LHS immediately. Thank you for your prompt attention to this very important matter.

Child’s Name:_________________________________________________ Gr./Program:______________________

Child’s Home Phone:____________________________________________________________

Parent #1 Name: ____________________________________________________________

Parent #1 Business Phone:________________________________________________________

Parent #1 Cell Phone:____________________________________________________________

Parent #2 Name:______________________________________________________________

Parent #2 Business Phone:________________________________________________________

Parent #3 Cell Phone:____________________________________________________________

Preferred Email Address Email will be the primary form of written communication utilized by Laurel Hill. Please provide us with the email address you would prefer that we use.

Preferred Email Address_________________________________________________________

Emergency Contact Information

Emergency Contact Name: _________________________ Phone #:______________________ Emergency Cell Phone #:_________________________________________________________ Emergency Contact Email:________________________________________________________

It is imperative you fill in & sign the Medical Release form below. MEDICAL EMERGENCY RELEASE FORM

RELEASE In case of emergency, accident, or serious illness to the student named on this form in which medical treatment is required, I (parent/guardian) request the school to contact me. If the school is unable to reach me, my signature below authorizes the school to exercise their own judgment in contacting the physician indicated below and to follow his/her instructions. If this physician is unavailable, the school may make whatever arrangements are necessary or transport the student to a hospital emergency room.

Parent/Guardian Signature__________________________________________________ __________________ DATE SIGNED

Does this student have any major or unusual health conditions? YES NO If yes, please specify.____________________________________________________________________________

Allergies:___________________________________________Other Conditions:___________________________

Local Physician’s Name:_______________________________Phone____________________________________

2019-2020

The Laurel Hill School Infant /Toddler Program

Personal History Form

Child’s Name ____________________________ M / F Nick name ___________ Birth date__________________Parent / Guardian ________________________ Home phone ________________

Cell #:_______________________ Business #: __________________________

Email address _________________________________________________________

The Personal History form will assist us to get to know your child’s needs and will assure a smooth transition to The Laurel Hill School Infant Program. Please complete this form prior to your scheduled personal orientation session. This data is for teacher use and is held in complete confidence. This form must be updated every two months.

PERSONAL HISTORY

Adults in household __________Relationship: Mother Father Grandparent(s) Other

___________________

Marital status : Married Separated Divorced Widowed

If divorced, who has legal custody? _____________________________________________

May the non-custodial parent pick up child? Yes No

(LHS must be provided with court-issued custody papers that clearly describe the custody arrangements. Any person

granted custody in such papers may pick up the child during the times that person has custody, and may designate

other persons who are authorized to pick up the child at such times, unless court papers state otherwise.)

Who is responsible for child if parents work outside the home? _____________________

Relation to child _____________________________________________________________

Language(s) spoken at home ______________________ __________________________

_________________________

List the name(s) and age(s) of brothers /sisters and / or other children in the family.

Name _______________________ Age _______

Name________________________ Age _______

Name _______________________ Age _______

Pet(s) Yes ___ No ___ Name(s) _________________________________________

Type(s) ___________________________

Previous experience away from home : None Babysitter

Other___________________________________________________________________

Has your child attended daycare before? Yes No If yes, how long? ______

Place ____________________________________________________________________

Reason for leaving

___________________________________________________________________________

__________________________________________________________________________________________

____________________________________________________________

SOCIAL INTERACTIONS

Nature of your child: Friendly Shy Aggressive Withdrawn

Other __________________________________________________________________

What is your child’s behavior like within his/her peer group? Outgoing Withdrawn

Typical Other _______________________________________________________

How would you best describe your child’s relationship to adults? Shy Outgoing

Cries easily Eager to please

other _____________________________________________________________________________

What type of activities does your child most enjoy? Quiet Noisy Physical

Artistic Other________________________________________________________

Preference: By himself / herself With other children With adults

Other ___________________________________________________________________

MEAL TIME

Does your child have any food allergies or specific dislikes to food(s)? Yes No

If Yes what? _____________________________________________________________

What are his / her favorite foods?

________________________________________________________________________

How often does child eat? Please state mealtime routine

___________________________________________________________________________

How would you describe your child’s eating habits? Picky eater Non-picky eater

Other _________________________________

Does he / she drink from: bottle sippy cup both

Child uses spoon : Yes No

SLEEP TIMEHow often does your child take a nap?

___________________________________________________________________________

How do you get him/her to nap? Holding / rocking Lay down in crib

Other __________________________________________________________________

How long does he / she nap? _____________Disposition on waking . Please state

___________________________________________________________________________

Does your child use a pacifier or comfy blanket / toy Yes No

If yes , specify ______________________________________________________________

Is there a certain routine we should follow to make naptime as pleasant as it can be?

___________________________________________________________________________

HEALTH : PHYSICAL & EMOTIONAL DEVELOPMENTHistory of health concerns or illness? Yes No

If yes, specify _____________________________________________________________

Does your child have any allergies? Yes No

If yes, explain _____________________________________________________________

Is your child receiving any medication on a regular basis at present? Yes No

If yes, specify _____________________________________________________________

Does your child have any speech, vision (wears glasses), hearing difficulties? Yes No

If yes, specify _____________________________________________________________

Age child began sitting _______________ crawling ______________ walking______ talking

______________

Situations that disturb and/or frighten your child: Noise Darkness Strangers Being left alone Lightning

Animals

Other ___________________________________________________________________________

Do you suspect your child has any learning disabilities? Yes No

If yes, specify _____________________________________________________________

Are you as parents anxious regarding your child’s adjustment to school? Yes No

If yes, please comment______________________________________________________

______________________________________________________________________________________

________________________________________________________________

Instructions for teachers if your child falls ill __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________EXPECTATIONSCan LHS take video’s or pictures on special occasions Yes No

What would you like your child to gain from The Laurel Hill School?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

What areas do you feel are most important in his / her development?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Please note any other information you feel will be helpful in regard to your child’s adjustment:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

This personal history form has been filled to the best of my knowledge.

Parent / Guardian - Print Name: ______________________________________________

Parent / Guardian - Signature ______________________________________________:

Date_____________________________

IMPORTANT NOTE: Please notify school officials immediately concerning changes to any information

GENERAL PICK-UP AUTHORIZATION

DATE ________________________________________________

CHILD’S NAME __________________________________________________________

CAREGIVER _____________________________________________________________

THE PERSON NAMED BELOW WILL BE PICKING UP MY CHILD ON A REGULAR BASIS.

NAME ___________________________________________________________________________________

ADRESS _________________________________________________________________________________

________________________ _______________________ ________________________ Home phone Cell phone Business phone

RELATIONSHIP TO YOU__________________________________________________________________

DRIVER’S LICENSE NUMBER: __________________________ STATE__________________________

DESCRIPTION: ___________________________________________________________________________

__________________________________________________________________________________________

Please note that this form must be completed before child is released. A verbal consent will NOT suffice. LHS holds no responsibility for child after leaving the campus.

___________________________________________________ _______________________ Parent / Guardian Signature Date

AUTHORIZATION FOR CHANGE IN PICK-UP ARRANGEMENTS FOR TODAY

DATE ________________________________________________

CHILD’S NAME __________________________________________________________

CAREGIVER _____________________________________________________________

THE PERSON NAMED BELOW WILL BE PICKING UP MY CHILD.

NAME ______________________________________________________________________

ADRESS ____________________________________________________________________

________________________ _______________________ ________________________ Home phone Cell phone Business phone

RELATIONSHIP TO YOU___________________________________________________________

________________________________________________________________________

DRIVER’S LICENSE NUMBER ____________________ STATE______________

DESCRIPTION: ______________________________________________________________

______________________________________________________________________________

Please note that this form must be completed before child is released. A verbal consent will NOT suffice. LHS holds no responsibility for child after leaving the campus.

___________________________________________________ _______________________ Parent / Guardian Signature Date

THE LAUREL HILL SCHOOL INFANT/TODDLER PROGRAMS

Feeding Schedule and Parent Agreement

• All bottles, cups and utensils must be labeled with the child’s full name. • Powdered formula and sterilized water, ready to feed milk, juice and breast milk must

be pre-measured and labeled with the child’s full name and expiration date. • Children 6 months of age and under must be held during all bottle feedings. • Microwave heating of food and formula is prohibited by regulation. • The provider will make every effort to accommodate the needs of a breast-fed child.

Child’s Name___________________ Date of Birth_______ Parent’s Name____________________________________ Please Initial: ___ I will provide all formula, solid food, water and juice for my child. ___ I give the provider permission to add sterilized water to powdered formula. ___ I give the provider permission to warm milk/formula bottles in a bottle warmer. My child is eating (check all that apply): ! Breast milk ! Formula (Brand)_________________ ! Solid Foods ! Snacks List any food allergies____________________________________ Please feed my child according to the following schedule: Parent’s Signature_______________________Date________ Provider’s Signature______________________Date________

THE LAUREL HILL SCHOOL INFANT/TODDLER PROGRAMS

NAPPING AGREEMENT

I understand and consent to the following sleeping arrangements concerning infants and toddlers enrolled at The Laurel Hill School: Infants 6 months to 18 months will nap in cribs in their own classroom. Toddlers 18 months to 24 months and up will nap on cots in their own classroom. All children will be supervised continuously by the classroom staff by both sight and sound. Sleeping children are checked individually and in close proximity throughout the nap time period.

Child’s Name________________________Age_____years___months Child’s Date of Birth_______________________________________ ______________________________________________________

Name of Parent or Guardian

Signature of Parent or Guardian

__________________________________________________ Date

THE LAUREL HILL SCHOOL INFANT/TODDLER PROGRAMS

PARENT CONSENT CHANGE ORDER ~ DIAPERING/FEEDING

( ) Change In Feeding Instructions___________________________________

( ) Change In Diapering Instructions

_____________________________________________________________

( ) I hereby give permission to The Laurel Hill School to apply sunscreen and baby ointment (provided by parent).

Child’s Name________________________Age_____years___months

Child’s Date of Birth_______________________________________

______________________________________________________ Name of Parent or Guardian

Signature of Parent or Guardian

__________________________________________________ Date