Visit Category

1 - What type of visit is this?

2 - Number of children in care at the time of visit?

3 - Others present at time of visit:

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Educational Program & Practice

4 - Select all that are applicable:

5 - Comments:

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Children Health & Safety

6 - Select all that are applicable:

7 - Comments:

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Physical Environment

8 - Select all that are applicable:

9 - Comments:

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Relationship with Children

10 - Select all that are applicable:

11 - Comments:

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Collaborative Partnerships

12 - Select all that are applicable:

13 - Comments:

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14 - Vacancies

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

15 - Educator Comments / Feedback

16 - Sign Off & Review

Signed by Educator

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Signed by Coordinator:

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Select date
Review By:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.