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Step
1
of 4
Checklist Date
*
Checklist Location
*
Worker's Name
*
Child's Name
*
I. Residence Information
House Size
*
Number of Floor
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Child's Bedroom Location
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Child's Bathroom Location
Nannies Bedroom Location
Clothesline Location
Number of Family Members
Number of another Domestic Workers
Number of Pets
Next
II. Child's Equipments
Brand and type of milk bottle
Brand and type of sterilizer
Brand of breast milk warmer
Stroller's Brand
Brand and type of carrier
Bathtub type
Brand & type of shower
Brand and type of thermometer
Brand and type of scales
Next
III. Milks and Foods
Are you using a breast pump?
Do Nanny have to do breast milk care?
What is the child's pattern of breastfeeding?
Do you use formula milk?
Is there a special method applied in the process of making milk?
Has the baby been given solids?
Will the Nanny be involved in determining the menu for the baby?
Will the Nanny cook for the baby?
Do you have a standard or special method for creating menus?
How is the baby's eating patterns?
Does the baby have a history of illnesses that cause nausea, vomiting or anorexia?
Next
IV. Personal Hygiene
How is the baby bath pattern?
What is the excretion pattern of the baby?
Do you have a special tool for cleaning baby's ears?
Do you have a special tool to clean baby's gums?
V. Baby Habits
Are babies still being sunbathed often?
Do babies often have reflux (spit up)?
Does the baby often wake up for a long time at night?
VI. Baby Behavior
Baby's Ages
Baby's Character
Physical development (Weight and height)
Baby's motor development
VII. Policy for Babysitter / Nanny
Does the Nanny sleep with the baby?
Is the Nanny responsible for the cleanliness of the baby's room and play area?
Is the Nanny responsible for cooking personal meals and for other workers?
Is the Nanny responsible for caring for the baby's linen?
Is there a special task / responsibility that must be carried out by the nurse?
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