APPLY FOR LITTLE WOODS PROGRAMS

allow 20-30 minutes to complete

see program pages for pricing details

Part-time or Full-time

3 day PT: Monday-Wednesday, 8:30-4:30

4 day FT: Monday-Thursday, 8:30-4:30

How did you learn about Little Woods Preschool?

intake survey required for new families

childcare program

Describe the childcare used up until this point: (provider, setting, amount of time in care, and reason for leaving)

How does your child feel about attending childcare?

Why are you choosing to enroll your child in this program?

What are your hopes for your child while in this program?

personality and behavior

Describe your child’s temperament and personality:

How much time does your child currently spend outside?

What kind of activities does your child enjoy/current interests?

What do you see as your child’s greatest strengths or skills?

Are there any current behavior challenges to be aware of?

social and emotional

What is your child like when playing with other children?

How does your child express their feelings?

How does your child behave when upset? (wants to be alone, wants to be hugged, runs away, acts out, etc)

What comforts or soothes your child?

development

Do you have any comments or concerns about your child’s development? (Hearing, Vision, Speech/Language, Gross Motor, Fine Motor, Social, Emotional, Cognitive, Executive Functioning)

Describe your child's level of independence. (Do they/can they dress/undress themselves, get out/put items away by themselves, wish to walk over being carried or in a stroller... etc)

Does your child have any difficulty with sensory processing? (Sensitive to sound, touch, clothing or grooming, movement, etc)

toileting

When did your child start using the toilet independently?

Does your child wear a diaper or pull-up during nap / nighttime sleep?

Does your child need regular reminders to use the bathroom? Is your child prone to accidents?

sleeping

Does your child nap? If so, what time and how long? how regular?

When is your child’s bedtime and what time do they typically wake up?

Where does your child sleep at home?

food/meals

Does your child have any personal/cultural/religious food restrictions, food allergies or intolerances?

health history

Has your child had any serious injury, illness, surgery, or hospitalization?

Does your child have any ongoing health condition, disability, or disorder (physical, cognitive, developmental, behavioral)?

family

Who is in your child’s family? Parents, siblings (names and ages), pets etc

Describe your family values:

Describe your parenting approach:

Are there any family matters that affect your child’s home life that you would like me to be aware of to be able to better support your child’s emotional needs? (adoption, new sibling, divorce, death, moving, job loss, addiction, physical or mental illness, incarceration)

additional comments or information about your child

Thank you for your submission!

Confirmation that your application has been received will be sent to your email shortly