The arrangement
Date and care period:
Caregiver and contact:
Parent or responsible adult and contact:
Agreed pickup or return:
The day
| Care detail | Current arrangement |
|---|---|
| Meals or feeding instructions | |
| Sleep and rest arrangements | |
| Activities or places | |
| Comfort and communication preferences | |
| Toileting or other everyday care |
Essential instructions and contacts
Where the current professional instructions are kept:
Relevant allergy or care information already established:
Health care contact and agreed urgent-help route:
What the caregiver should contact us about:
Share only what is needed for this period of care. If medication is involved, follow the existing professional directions and the rules applying to the caregiver's setting; the worksheet does not supply doses.
Illustrative handoff
“Pickup is at 5:30. The coat is in the blue bag. Before leaving, say, ‘One more turn, then we are going.’ If pickup changes, call me rather than assuming another person is collecting. The current care instructions and contacts are in the agreed folder.”
This is a fictional everyday example. The actual arrangement must fit the child and authorized adults.
Confirm and update
Questions the receiving caregiver has:
Changes to pass on afterward:
Date last checked:
Read about caregiver communication · Prepare to start child care
Edition: October 2026. National Parenting Foundation. Reuse and permissions.