Form Dcf F Cfs0061 E PDF Details

Dcf F Cfs0061 form is for an election to appoint a guardian for a person with incapacity. A person who has been appointed as a guardian of the person with incapacity must file this form within 30 days after the appointment or before the next annual guardianship hearing, whichever is earlier. The filing of this form does not terminate the prior appointment of the guardian of the person with incapacity. The information includes: name and address of petitioner, name and address of proposed guardian, relationship to proposed ward, statement of allegations, specific authority requested by petitioner, and signatures. Reviewers should always be sure they understand what they are signing before they approve any document - especially one related to guardianship! This guardianship paperwork can be confusing so make sure you get help if you need it! Any questions? Ask away in the comments below!

QuestionAnswer
Form NameForm Dcf F Cfs0061 E
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesdcf_f_cfs0061_e intake for child under 2 years form

Form Preview Example

DEPARTMENT OF CHILDREN AND FAMILIES

Division of Early Care and Education

INTAKE FOR CHILD UNDER 2 YEARS – CHILD CARE CENTERS

Use of form: This form is mandatory for family child care centers to comply with DCF 250.09(1)(c)1. and for certified providers to comply with 202.08(12)(g). Failure to comply may result in issuance of a noncompliance statement. This form is voluntary for group child care centers; however, it meets the requirements of DCF 251.09(1)(am). This form collects information about children under age 2 in order to aid child care workers in individualizing the program of care for the child in a family or group child care center. Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04(1)(m), Wisconsin Statutes].

Instructions: This form is to be completed by a parent and must be on file at the center prior to a child's first day of attendance. Regular updates can be noted. This form should be kept in the room where care is provided. If additional space is needed, attach a separate sheet.

First Day of Attendance (mm/dd/yyyy)

PARENT / CHILD NAME AND ADDRESS

Name – Child (Last, First, MI)

Nickname (If any)

Birthdate (mm/dd/yyyy)

Name – Parent(s) (Last, First, MI)

Telephone Number – Home

Address – Parent(s) (Street, City, State, Zip Code)

HEALTH Note: Health conditions that may affect the care of the child must be recorded on the department’s form, Health History and Emergency Care Plan. The form should be shared with any person who provides care for the child.

Child has frequent colds, ear infections, colic, etc. – Describe.

UPDATES

MEALS

Current feeding schedule

 

 

 

Length of time on current schedule

 

 

 

 

 

 

 

Food type

 

 

 

 

 

 

Formula

 

Strained

Junior

Table

Milk type – Specify:

 

 

 

 

 

New food timetable

 

 

 

 

 

 

 

 

 

When eating, child is –

 

 

 

 

Held in lap

In highchair

Other – Specify:

 

 

 

 

 

 

 

 

 

Feeds self

 

 

 

 

 

 

Yes

No

If "Yes", uses:

Spoon

Fork

Hands

 

 

 

 

 

Special feeding problems

 

 

 

 

Yes

No

If "Yes" – Specify:

 

 

 

 

 

 

 

 

 

Food allergies

 

 

 

 

 

Yes

No

If "Yes" – Specify:

 

 

 

Favorite foods – Specify.

Refused foods – Specify.

UPDATES

DCF-F-CFS0061-E (R. 01/2009)

Page 1 of 4

SLEEP

Current sleep schedule

 

Length of time on current schedule

 

 

 

 

Falls asleep easily

 

Mood upon awakening – Describe.

Yes

No

 

 

 

 

 

 

Takes favorite toy(s) to bed – child over age 1 year

Yes

No

If "Yes" – list toy(s):

Sleep position – child under age 1 year

Note: Children under age 1 year must be placed to sleep on their back unless a written statement from the child's physician is attached.

Back for children under age 1 year

Side or stomach (physician statement attached)

 

 

Sleep position – child over age 1 year

 

Back

Side or stomach

 

 

 

 

UPDATES

 

 

DIAPERING / TOILETING

Diaper – type

 

 

 

Diapers provided by parent

Cloth

 

Disposable

 

Yes

No

 

 

 

 

 

Plastic pants used

 

 

 

 

Always

 

Never

Sometimes

If "Sometimes" – Specify:

 

 

 

 

 

Highly sensitive skin

 

 

Frequent diaper rash

Yes

No

 

 

 

Yes

No

 

 

 

 

Lotions, powders or salves used

 

 

 

Yes

No

If "Yes", product name(s) – Specify:

 

 

 

 

 

 

Toilet training attempted

 

 

 

 

Yes

No

If "Yes", describe routine.

 

 

 

 

 

Type of toilet seat used at home

 

 

 

Potty chair

Special toilet seat

Regular toilet seat

 

 

 

 

 

 

Regular bowel movements

 

 

 

 

Yes

No

How often.

 

Time(s) of day:

 

 

 

 

 

Toileting problems

 

 

 

 

Yes

No

If "Yes" – Describe.

 

 

 

UPDATES

VERBAL COMMUNICATION

Family speaks what language – Specify.

English

Other

If "Other" – Specify:

 

 

 

 

 

Age child began talking

 

Child speaks in

 

 

 

 

Words

Sentences

 

 

 

 

 

Words used to describe special needs – Specify.

UPDATES

Page 2 of 4

COMFORTING

Does child have a fussy time?

Yes No If "Yes" – Specify time.

How is fussy time handled?

Child likes to be:

Held Sung to Rocked Read to Other – Specify:

Special things you say or do to comfort child.

UPDATES

SELF-EXPRESSION

What causes your child to feel angry or frustrated?

What frightens your child and how is it shown?

How does your child express feelings of happiness, enjoyment, etc.?

Additional comments

UPDATES

PHYSICAL AND SOCIAL DEVELOPMENT

Is your child able to – (Check all that apply)

Sit up alone

Pull up

Crawl

Walk holding on

Walk without support

 

 

 

 

 

Yes

No

Is your child used to playmates?

 

 

Comments

UPDATES

Page 3 of 4

MISCELLANEOUS

Child's indoor favorite toys and activities – Specify.

Child's outdoor favorite toys and activities – Specify.

By providing complete information about your child, you will be assisting staff in creating a positive experience for him / her while in care. List any information about your child's habits, abilities or personality that you feel will be helpful to the staff while caring for your child.

UPDATES

SIGNATURE – Parent or Guardian

Date Signed

Page 4 of 4

How to Edit Form Dcf F Cfs0061 E Online for Free

You could fill out Form Dcf F Cfs0061 E instantly using our PDFinity® PDF editor. To make our editor better and simpler to work with, we consistently work on new features, with our users' feedback in mind. For anyone who is seeking to begin, this is what it takes:

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It will be easy to complete the document using this helpful guide! This is what you want to do:

1. The Form Dcf F Cfs0061 E necessitates particular information to be typed in. Make certain the subsequent fields are filled out:

Part # 1 of submitting Form Dcf F Cfs0061 E

2. The third part would be to fill in these blank fields: Length of time on current schedule, MEALS Current feeding schedule, Food type, Formula, Strained, Junior, Table, Milk type Specify, New food timetable When eating, Held in lap, In highchair, Other Specify, Feeds self, Yes, and If Yes uses.

Table, Milk type Specify, and Other Specify of Form Dcf F Cfs0061 E

3. In this particular stage, have a look at SLEEP Current sleep schedule, Falls asleep easily, Mood upon awakening Describe, Yes, Takes favorite toys to bed child, Yes, If Yes list toys, Length of time on current schedule, Sleep position child under age, Back for children under age year, Back, Side or stomach, UPDATES, DIAPERING TOILETING Diaper type, and Cloth. All of these are required to be taken care of with highest focus on detail.

Form Dcf F Cfs0061 E writing process shown (portion 3)

4. To move onward, this fourth part involves completing a couple of form blanks. Included in these are Yes, If Yes product names Specify, Toilet training attempted, Yes, If Yes describe routine, Type of toilet seat used at home, Potty chair, Special toilet seat, Regular toilet seat, Regular bowel movements, Yes, No How often, Toileting problems, Yes, and If Yes Describe, which you'll find key to moving forward with this document.

Form Dcf F Cfs0061 E conclusion process shown (stage 4)

5. Now, the following final part is precisely what you will need to finish before finalizing the PDF. The blanks at issue include the next: COMFORTING Does child have a fussy, Yes, If Yes Specify time, How is fussy time handled, Child likes to be, Held, Sung to, Rocked, Read to, Other Specify, Special things you say or do to, UPDATES, SELFEXPRESSION What causes your, and What frightens your child and how.

The best way to prepare Form Dcf F Cfs0061 E portion 5

A lot of people generally make some mistakes when filling out Held in this section. Be certain to reread what you type in here.

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