Staff Records Checklist Form PDF Details

The Staff Records Checklist serves as a comprehensive tool for ensuring that educational and childcare facilities maintain an organized, thorough, and compliant record-keeping system for their staff members. This form encompasses essential information ranging from basic identification data such as staff name and position, to more detailed records including employment application or resume, documentation of interviews and reference checks, date of birth, date of hire, and various certifications such as the EEC (Early Education and Care) Certificate. Additionally, it tracks the status of mandatory and specific training sessions like first aid, CPR, EEC orientation, Medication Training, and several others tailored to the safety and well-being of children, including the Look Before You Lock and SIDS (Sudden Infant Death Syndrome) training for those caring for infants. The list extends to cover areas like professional development hours, program orientation completion, staff observation records, and evaluations, ensuring that each staff member remains current with their professional education and skillset. Moreover, it includes verification processes like Background Record Checks (BRC) with CORI and DCF reviews, the currency of physical examinations, MMR immunizations, and additional qualifications necessary for specific roles within educational and childcare settings. The accurate completion and ongoing maintenance of this checklist not only streamline administrative processes but also significantly contribute to the overarching goal of safeguarding and promoting the health, safety, and educational welfare of children under the care of such institutions.

QuestionAnswer
Form NameStaff Records Checklist Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesStaff Record Checklist for Child Care Center, EEC Staff Record Checklist Form

Form Preview Example

 

 

 

 

Staff Records Checklist

 

 

 

 

Staff Name and Position

 

 

 

 

 

 

 

 

Staff Form

 

 

 

 

 

 

 

 

 

Application/Resume

 

 

 

 

 

 

 

 

Documentation of Interview (date)

 

 

 

 

 

 

 

 

Verification of References

 

 

 

 

 

 

 

 

 

(need two)

 

 

 

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

Date of Hire

 

 

 

 

 

 

 

 

 

EEC Certificate # and

 

 

 

 

 

 

 

 

Qualifications including age groups

 

 

 

 

 

 

 

 

EEC PQ Registry (include date)

 

 

 

 

 

 

 

 

BRC:

CORI

 

 

 

 

 

 

 

 

 

 

DCF

(include dates)

 

 

 

 

 

 

 

 

Physical (include date)

 

 

 

 

 

 

 

 

MMR (needs two)

 

 

 

 

 

 

 

 

First Aid (date of expiration)

 

 

 

 

 

 

 

 

CPR (date of expiration)

 

 

 

 

 

 

 

 

Required Trainings (include dates)

1.

1.

1.

1.

1.

1.

1.

1.

1.EEC Orientation

2.

2.

2.

2.

2.

2.

2.

2.

 

 

 

2. Medication Training

 

 

 

 

 

 

 

 

3. Look Before You Lock

3.

3.

3.

3.

3.

3.

3.

3.

 

 

 

 

 

 

 

 

4. SIDS (If caring for Infants)

4.

4.

4.

4.

4.

4.

4.

4.

5. USDA/ Nutrition

5.

5.

5.

5.

5.

5.

5.

5.

Number of Professional

 

 

 

 

 

 

 

 

Development Hours

 

 

 

 

 

 

 

 

Program Orientation (include date)

 

 

 

 

 

 

 

 

Staff Observations

 

 

 

 

 

 

 

 

Staff Evaluation (include date)

 

 

 

 

 

 

 

 

7-D/School Bus Licenses (Include

 

 

 

 

 

 

 

 

date of expiration)

 

 

 

 

 

 

 

 

EEC Use Only

 

 

 

 

 

 

 

 

 

Program Name__________________________ Completed By________________________ Date_________

EEC Use Only: EEC Staff Initial ________________ Date__________

Page 1 of 3

SG/LG/SAStaffRecordsChecklist&Instructions20130115

STAFF RECORDS CHECKLIST INSTRUCTIONS

These instructions are to assist you in completing the required staff records checklist. A copy of the current checklist must be submitted to the licensor on the day of the licensing study. (Please note: a blank space on the checklist will indicate that the information is not on file. In addition, the column at the bottom marked for EEC Use Only is for BRC verification purposes.

1.Name and Position: List the names of all teaching staff, cooks, transportation staff and administrators.

Indicate the position in which the individual is employed (a staff person’s position may be different from their actual qualifications).

Please note: Sections 2-5 are required for Large Group and School Age Child Care Programs ONLY.

2.Staff Form: Indicate with a √ that a staff information form is on file at the Center. 7.04(18)(c)3

3.Application or Resume: Indicate with a √ that an application or resume is on file. 7.04(18)(c)

4.Documentation of Employment Interview: Indicate the date of the employment interview for all staff hired after 1/21/2010. 7.04(18)(c)2

5.Reference Checks: Indicate with √’s that two verbal reference checks have been documented in the file.

7.04(18)(c)3

6.Date of Birth/Date of Hire: documentation). Indicate date 7.04(18)(c)3

Indicate the date of birth for all staff (this information is significant for MMR of hire (this information is significant to determine training requirements).

7. Qualifications/Certificate or Education/Verification of Experience:

Large Group and School Age qualifications: Indicate staff person’s qualifications level (including

OFC/OCCS/EEC certificate number if on file at the Center). If there is no certificate, indicate with a √ that transcripts and verification of experience forms are on file to support the person’s qualifications for the position.

7.09(10)

Small Group and School Age qualifications: Qualifications determined by capacity of program. Reference form “Qualifications for Small Group and School Age Child Care” to determine what verification must be

maintained in staff file.

8.EEC PQ Registry: Indicate the date the staff person registered with EEC. (Staff must register annually) 7.09(4)

9.BRC CORI/DCF: Indicate with the date(s) of the most recently completed CORI and DCF review. 7.04(18)(c)5

10.Physical Date: Indicate the date of the most recent physical examination that is on file (update is required every two years). 7.09(11)

Page 2 of 3

SG/LG/SAStaffRecordsChecklist&Instructions20130115

11.MMR: Indicate with a √ if required MMR immunizations or evidence of immunity to mumps, measles, and rubella are on file. All educators born in or after 1957, regardless of country of birth must be able to document two doses of MMR or have serologic evidence (blood titer) of immunity to measles, mumps and rubella. Those born before 1957 in the U.S. are considered to be immune. Those born before 1957 in countries other than the U.S. must be able to document one dose of MMR or have serologic evidence (blood titer) of immunity to measles, mumps or rubella. 7.09(11)(b)

12.First Aid Date: Indicate the expiration date noted on the most recent first aid certificate. 7.09(17)(d)

13. CPR Date: Indicate the expiration date of the most recent CPR certificate. (CPR must be renewed annually.) 7.11(1)(a)

14.Required Trainings:

1.An Introduction to Early Care and Education: Indicate the date the training was completed, if applicable. This training is mandatory for educators who are newly employed and working in the field of early education and care for the first time. 7.09(9)

2.Medication Training: Indicate the date Medication Training was completed, if applicable. This training must be done annually. 7.11(1)(b)

3.Look Before You Lock Training: Indicate the date the training was completed. All staff must complete this training. 7.13

4.Reducing the Risk of SIDS in Child Care: Indicate the date the training was completed. All staff caring for infants must complete this training. 7.11(13)(e)

5.USDA/ Nutrition Training: Indicate the date that training in USDA nutrition requirements and food choking hazards was completed.7.12(2)

15.Professional Development Hours: Indicate the number of professional development hours that are documented in the file for the current year. 7.09(19)(b)

16.Program Orientation: Indicate the date the program orientation was completed. 7.09(17)(a)

17.Staff Observations: Indicate with a √ that documentation of observations is on file. Observations of educators should be conducted every two months by a staff with lead teacher, site coordinator or higher qualifications. 7.09(17)(b)

18.Staff Evaluations: Indicate the date of most recent written evaluation. 7.09(17)(c)

19.7-D/School Bus License: Indicate the date of expiration of the license, if applicable. 7.13(4)(b)

Page 3 of 3

SG/LG/SAStaffRecordsChecklist&Instructions20130115

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