Adapted with permission from the Crawford County Health Department

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Provider’s Name
Does the provider have a current Kansas License or Registration? (Ask to see it at the visit.)

Is the group size and range acceptable?

Note to parents:

Licensing information available from The Kansas Department of Health and Environment as well as in our downloadable Parent Newsletter.

How do the provider (and the children) spend their day?

Request names and numbers of two parent references.

Request a copy of the provider's contract.

What is the fee and what does it include?

Do you pay fees when the children are gone due to illness, vacation, or holidays?

Do the hours fit your needs?

What arrangements are made if the provider is illness?

Does the provider transport or watch children walk to and from school?

Yes No
_____ _____ Is the home bright, cheerful, clean, and orderly?

_____ _____ Are the indoor and outdoor play areas safe?

_____ _____ Are poisons, medications, and guns locked up?

_____ _____ Are bathrooms adequate, clean, and acceptable?

_____ _____ Are health assessments, immunizations, emergency information, and medical treatment releases kept for all children in care?

_____ _____ Are children with contagious diseases excluded from care?

_____ _____ Is there a safety plan to follow in emergencies?

_____ _____ How will I be notified if my child will be someplace other than the home?

_____ _____ Are precautions taken to assure children are released only by authorized adults?

_____ _____ Do children brush their teeth and wash their hands regularly?

_____ _____ Does provider wash hands regularly?

_____ _____ If the provider transports children, are there individual sear belts for each child and car seats or boosters for children under four years?



Yes No
_____ _____ Is the day structured to include varied activities which challenge thinking, stimulate creativity, and develop physical and social skills?

_____ _____ Are there adequate space and materials for both active and quiet play?

_____ _____ Does provider talk to children, read aloud to them and answer their questions?

_____ _____ Is the amount and content of television watching limited?



Yes No
_____ _____ Are parents encouraged to visit anytime?

_____ _____ Does the provider take time to talk to parents and make them feel welcome?

_____ _____ Can parents get regular feedback on children’s behavior? How?

_____ _____ Does provider seem supportive of mothers who work outside the home?

_____ _____ Are there opportunities for parents to participate?



Yes No
_____ _____ Is mental and physical stimulation provided by offering things to look at, touch, and listen to?

_____ _____ Is time spent holding, playing with, and talking to babies?

_____ _____ Are diapering and feeding sanitary?

_____ _____ Does provider cooperate with parent’s efforts to toilet train toddlers?



Yes No
_____ _____ Is the provider warm, calm, and friendly in dealing with children and adults?

_____ _____ Are positive discipline methods used?

_____ _____ Are simple, consistent limits of behavior set and maintained?

_____ _____ Does the provider bend to the child’s level when talking to them?

_____ _____ Are children comforted when needed?

_____ _____ Are different cultural values accepted and respected?

_____ _____ Is provider’s family supportive supportive of her work?

_____ _____ Does the provider attend child care training?



Take some time to think about the type of care, cost, and location that will meet your family’s needs.
Call homes which appear to meet your needs and use this form to gather information.

Make appointments to visit several locations by phone. It is best to visit at a time when the children are active so you can observe the adult/child interaction.

Parents interested in receiving information about a provider's regulation status or compliance history should send a written request to the state KDHE office at KDHE, 1000 SW Jackson, Topeka, KS 66612 or send an e-mail to cclr@kdhe.state.ks.us. Please include specific information about what you want to know, such as complaints within the past six months and past annual surveys. Information will be returned to you within five business days.

Additionally, concerns about illegal care (not registered or licensed), poor quality care or other concerns should be reported to the Health Department. (You can call the Child Care Resource and Referral Office at 1.866.732.9700 for the number of your local Health Department.)