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January 2019

Dear Current and Future Little Lambs’ Families,

It’s that time of year when we need to begin gathering information for the upcoming school year! Enclosed you will find your enrollment packet for next year, 2019-2020. The registration form is the first two page form in this packet. It needs to be completed and sent in with the $100 non- refundable registration fee as soon as possible.

The pages in the packet with the butterfly in the left hand corner are for you to keep at home.

The Standard School/Child Care Center Immunization Record is also included in this packet. Please provide the information requested directly on the form or attach a copy of your child’s immunizations given to you by their doctor. If your child’s physical is scheduled for this summer, you may hold on to the Universal Health Record and Standard School/Child Care Center Immunization Record until your child’s physician has seen him/her. All other forms from the packet must be in by June 7, 2019. Your child’s medical information (Immunization Record and Universal Health Form) must be in no later than August 15, 2019. The Awareness Statement and Emergency Protocol form are ONLY to be completed if your child has allergies that we must be aware of in case treatment (i.e epipen, rescue inhaler, Benadryl, etc.) is necessary during school hours. It is required that a photograph be attached to the Emergency Protocol sheet. Please remember state law requires your child’s physical for the coming fall be done within the period of October 1, 2018 to October 1, 2019, and that it must be in your child’s file by August 15, 2019. If your child has recently had their annual physical or is scheduled at any time between now and the beginning of school do not hesitate to have the Universal Health Record completed and returned to our office. Physician’s offices become backlogged during the summer months as many older children need forms completed to play sports. Don’t get caught with a long wait. Have it completed as soon as your child gets their annual check-up!

Please note that the flu vaccine is mandatory for preschoolers in the State of New Jersey. As you complete this requirement, please update your child’s school file by dropping off a note from the doctor that this has been completed. All proof of flu vaccines must be in the school office no later than December 31, 2019.

You will be receiving (at a later date) your bill for school tuition due for September 2019. This amount is due by May 15th. Current families -- please do not combine this payment with any other payment to the school. Checks should be made payable to Redeemer Lutheran Church. You are more than welcome to pay quarterly, semi-annually, or annually. We also accept credit card payments - please stop by the school office for information.

If you have any questions, please call the school office at 908-232-1592 or stop in to see me. Thank you for your prompt attention to this matter.

Just to clarify upcoming dates: ASAP: The two page registration form, with $100 non -refundable registration fee. May 15th: Payment for September 2019 (you will receive a bill) June 7th: All forms in the enrollment packet need to be complete August 15th: All health forms – Universal Health form and immunization record *If allergies – protocol sheet, awareness statement and picture are due Dec. 31st: Proof of flu vaccine for preschool aged children

Blessings,

Martha L. Gilmore, Director

Office rec’d_______ check #______

LITTLE LAMBS PRESCHOOL AND KINDERGARTENREGISTRATION FORM

2019/2020

Name of Child _______________________________________ Sex: M F DOB_________ Last First Middle

Address_______________________________________________________________________ Street City State/Zip

Father’s Name ________________________ Mother’s Name______________________

Father’s cell # _______________________ Mother’s cell # _____________________

Father’s Email ________________________ Mother’s Email ____________________

PROGRAMS AND FEES

Class Days Gu idelines Tuition

Morning Time: 9:00 – 12 NOON (Tuition is broken down into 10 month installments) .

_____ 2 ½ yrs. Tue. and Thu. 2 yrs. ON or BEFORE April 1, 2019 $290/mo. _____ 3 yrs. Mon., Weds. Fri. 3 yrs. ON or BEFORE October 1, 2019 $403/mo.

_____ 3 yrs. Mon. thru Fri. 3 yrs. ON or BEFORE October 1, 2019 $514/mo.

_____4 yrs. Mon., Weds., Fri. 4 yrs. ON or BEFORE October 1, 2019 $403/mo.

_____4 yrs Mon. thru Fri. 4 yrs. ON or BEFORE October 1, 2019 $514/mo.

Time: 9:00 – 3:00 PM

_____ KINDERGARTEN (M-F) 5 yrs. ON or BEFORE October 1, 2019 $773/mo.

AFTERCARE Please circle day and write approximate times child attending $8.00 per hour for one child

Mon. __________ Tues. ____________Weds. ____________Thurs.____________ Friday____________

REGISTRATION FORM (Pg. 2)

FINANCIAL INFORMATION

1. FEES: A $100 non-refundable registration fee is payable upon registration for preschool and kindergarten.

2. MONTHLY TUITION: The first month’s tuition payment is due May 15, 2019. Failure to make this payment will forfeit enrollment to a first family on the waiting list. Tuition /childcare payments are due the first of every month. All checks are made payable to:

Redeemer Lutheran Church (Please DO NOT write checks to Little Lambs as it is a mission of Redeemer Lutheran Church)

3. LATE FEES: TUITION IS DUE ON THE FIRST OF THE MONTH. Late fees will accrue beginning on the fifth school day of the month at the rate of $5 per day.

4. SERVICE CHARGE: Any returned checks are subject to a $25 service charge.

5. REFUNDS: No refunds will be given for days missed at school due to illness, vacation, or cancellations.

WITHDRAWAL POLICY

Little Lambs reserves the right to remove any child from enrollment at the school for non-payment of tuition fees or other appropriate cause. If for some reason payment of your child’s tuition becomes impossible, it is necessary that you bring this immediately to the attention of the Director so special arrangements can be made. If you remove your child for any reason, moneys will not be refunded.

I have read and understand the above Financial Information and Withdrawal Policy. I will make every effort to provide the information the school requires for enrollment.

Parent’s Signature _________________________________________

LITTLE LAMBS PRESCHOOL AND KINDERGARTEN229 Cowperthwaite Place

Westfield, NJ 07090(908) 232-1592

ENROLLMENT REQUIREMENTS SIGN-OFF SHEET

I have received and understand the following documents/policies. I understand that I am to place my signature next to each document indicating that I have read each document. I will retain the copies with the butterfly symbol in the left hand corner for my files.

Discipline Policy ____________________________________

Information to Parents Statement ____________________________________

Philosophy of School ____________________________________

Policy on Communicable Diseases ____________________________________

Policy on the Release of Children ____________________________________

Expulsion Policy ____________________________________

Preschool Emergency Information ___________________________________

I am returning the following completed forms to the Preschool Office:

Application for Enrollment __________________________________

Emergency Medical Consent Form __________________________________

Chronic Medical Policy, Awareness Statementand Emergency Medical Protocol for Allergies (if applicable) __________________________________

Emergency Form __________________________________

Release Code Form __________________________________

Enrichment Permission Form __________________________________

Photograph Permission Form __________________________________

Expulsion Policy (non-butterfly copy) __________________________________

Family Questionnaire __________________________________

Standard School/Child Care Center Immunization Record __________________________________

Universal Child Health Record/NJ Dept. of Health __________________________________

Preschool Emergency Information __________________________________

I understand that if the above Enrollment forms are not complete my child may not attend school until all of the forms are completed and returned to the Preschool Office.

_________________________________________ __________ ___________________________________

Parent’s Signature Date Please Print Family Name

ALL PAGES WITH THE BUTTERLY IN THE CORNER ARE TO REMAIN IN YOUR FILES.

LITTLE LAMBS PRESCHOOL AND KINDERGARTEN 229 Cowperthwaite Place Westfield, New Jersey 07090 (908) 232-1592

DISCIPLINE POLICY

At Little Lambs Preschool and Kindergarten, setting limits and establishing rules give children a sense of security. In learning rules, children know what is expected of them. When the rules are broken or a child’s behavior is unacceptable, the teacher will gently remind the child of the rules. If the action continues, the teacher will re-direct an uncooperative child to a different activity.

When behavior continues to require too much adult attention, the child will temporarily be removed from the group activity and given a “time out,” which is sitting quietly in a chair for a few minutes. The child may choose to look at books during “time out.” It is a time to calm down and is not used as a punishment. It is used infrequently, and only when all other measures fail.

In any situation in which a child might be endangered, our first concern will be to stop the dangerous activity and provide a safe alternative for the child or children involved.

If a child is disruptive or physically aggressive towards another child or staff member, and “time outs” have been ineffective, the child will be removed from the classroom and taken to the Director’s office for a short “cooling off” period. As a last resort and in the most extreme cases, we will call the parent to take the child home for the day.

In accordance with NJ State requirements, any form of corporal punishment by any adult toward any child will not be allowed while the child is in the care of Little Lambs Preschool and Kindergarten. This includes a parent with his/her own child.

LITTLE LAMBS PRESCHOOL AND KINDERGARTEN 229 Cowperthwaite Place

Westfield, New Jersey 07090 (908) 232-1592

INFORMATION TO PARENTS

Under provisions of the Manual of Requirements for Child Care Centers (N.J.A.C. 10:122), every licensed child care center in New Jersey must provide to parents of enrolled children written information on parent visitation rights, State licensing requirements, child abuse/neglect reporting requirements and other child care matters. The school must comply with this requirement by reproducing and distributing to parents this written statement prepared, by the Office of Licensing, Child Care & Youth Residential Licensing, in the Department of Children and Families (DCF). In keeping with this requirement, the school must secure every parent’s signature attesting to his/her receipt of the information. Our children are our most precious gift and we want you to know that we are committed to their health, happiness, and safety while in our care.

Our school is required by the State Child Care Center Licensing Law to be licensed by the Office of Licensing, Child Care & Youth Residential Licensing, in the Department of Children and Families (DCF). A copy of our current license must be posted in a prominent location at our center. Look for it when you are in the school.

To be licensed, our school must comply with the Manual of Requirements for Child Care Centers (the official licensing regulations). The regulations cover such areas as: physical environment/life-safety; staff qualifications, supervision, and staff/child ratios; program activities and equipment; health, food and nutrition; rest and sleep requirements; parent/community participation; administrative and record keeping requirements; and others.

Our school must have on the premises a copy of the Manual of Requirements for Child Care Centers and make it available to interested parents for review. If you would like to review our copy, just ask any staff member. Parents may secure a copy of the Manual of Requirements for Child Care Centers by sending a check or money order for $5 payable to the Treasurer, State of New Jersey,” and mailing it to: State of New Jersey, Department of Children and Families, Licensing Publication Fees, PO Box 34399, Newark, New Jersey 07189-4399.

We encourage parents to discuss with us any questions or concerns about the policies and program of the school or the meaning, application or alleged violations of the Manual of Requirements for Child Care Centers. We will be happy to arrange a convenient opportunity for you to review and discuss these matters with us. If you suspect our school may be in violation of licensing requirements, you are entitled to report them to the Office of Licensing toll free at 1(877) 667-9845. Of course, we would appreciate your bringing these concerns to our attention, too.

Our school must have a policy concerning the release of children to parents or people authorized by the parent(s) to be responsible for the child. Please discuss with us your plans for your child’s departure from the school.

Our school must have a policy about administering medicine and health care procedures and the management of communicable diseases. Please talk to us about these policies so we can work together to keep our children healthy.

Our school must have a policy concerning the expulsion of children from enrollment at the school. Please review this policy so we can work together to keep your child in our school.

Parents are entitled to review the school’s copy of the Office of Licensing’s Inspection/Violation Reports on the school, which are every State licensing inspection of our school. If there is a licensing complaint investigation, you are also entitled to review the Office’s Complaint Investigation Summary Report, as well as any letters of enforcement or other actions taken against the school during the current licensing period. Let us know if you wish to review them and we will make them available for your review.

Our school must cooperate with all DCF inspections/investigations. DCF staff may interview both staff members and children.

Our school must post its written statement of philosophy on child discipline in a prominent location and make a copy of it available to parents upon request. We encourage you to review it and to discuss with us any questions you may have about it.

Our school must post a listing or diagram of those rooms and areas approved by the Office for the children’s use. Please talk to us if you have any questions about the school’s space.

Our school must offer parents of enrolled children ample opportunity to assist the school in complying with licensing requirements; and to participate in and observe the activities of the school. Parents wishing to participate in the activities or operations of the school should discuss their interest with the school director, who can advise them of what opportunities are available.

Parents of enrolled children may visit our school at any time without having to secure prior approval from the director or any staff member. Please feel free to do so when you can. We welcome visits from our parents.

Our school must inform parents in advance of every field trip, outing, or special event away from the school, and must obtain prior written consent from parents before taking a child on each such trip.

Our school is required to comply with the New Jersey Law Against Discrimination (LAD), P.L. 1945, c. 169 (N.J.S.A. 10:5-1 et seq.), and the Americans with Disabilities Act (ADA), P.L. 101-336 (42 U.S.C. 12101 et seq.). Anyone who believes the center is not in compliance with these laws may contact the Division on Civil Rights in the New Jersey Department of Law and Public Safety for information about filing an LAD claim at (609) 292-4605 (TTY users may dial 711 to reach the New Jersey Relay Operator and ask for (609) 292-7701), or may contact the United States Department of Justice for Information about filing an ADA claim at (800) 514-0301 (voice) or (800) 514-0383 (TTY).

Anyone who has reasonable cause to believe that an enrolled child has been or is being subjected to any form of hitting, corporal punishment, abusive language, ridicule, harsh, humiliating or frightening treatment, or any other kind of child abuse, neglect, or exploitation by any adult, whether working at the school or not, is required by State law to report the concern immediately to the State Child Abuse Hotline, toll free at 1 (877) NJ ABUSE. Such reports may be made anonymously.

Parents may secure information about child abuse and neglect by contacting: Community Education Office, Division of Youth and Family Services, PO Box 717, Trenton, New Jersey 08625-0717.

LITTLE LAMBS PRESCHOOL AND KINDERGARTEN 229 COWPERTHWAITE PLACE WESTFIELD, NEW JERSEY 07090 (908) 232-1592

PHILOSOPHY OF THE SCHOOL

Little Lambs Preschool and Kindergarten is a non-profit organization designed to provide a Christian education for area families with preschool and kindergarten aged children. The School provides an educational environment that maximizes the spiritual, cognitive, personal, social, and physical development of young children. Spiritual development is effected by the Christ-entered beliefs of the parent church, Redeemer Lutheran Church, and the role-modeling of the staff.

Cognitive skills directed toward communication proceed through speaking, reading and writing experiences. Mathematical and thinking skills are important parts of cognitive development as are appreciation of art and music.

Personal development occurs in a spiritual community including prayer and Biblical teachings. Social development is viewed as a co-development in this environment of respect for each other.

Physical development is promoted along with social attributes through acceptance of the body as a creation of God and the care and exercise of the student’s body.

The teacher is a role model of the Christian community and teaches the above attributes by setting a Christian example. A trust relationship is established with the home wherein parenting is continued in the absence of the natural parent(s).

We focus on growing the whole child through developmentally appropriate learning in a caring Christian environment.


Westfield, New Jersey 07090(908) 229-1592

POLICY ON HEALTH REQUIREMENTS OF COMMUNICABLE DISEASES(From Manual of Requirements for Child Care Centers 10:122-7.1)

10:122-7.1 Illnesses/communicable diseases

GEN (a) A center that seeks to serve any children who have any of the illnesses, symptoms of illness or diseases specified in (c) and (d) below shall meet all applicable provisions of this subchapter and all provision of N.J.A.C. 10:122-8.

(b) Under no circumstances shall any center serve or admit any child who has any illness, symptom of illness or disease that a health care provider has determined requires the child to be:

1. Confined to home under a health care provider’s immediate care; or2. Admitted to a hospital of medical care and treatment.

(c) The following provisions relate to illness and/or symptoms of illness:1. A center serving well children shall not permit a child who has any of the

illnesses or symptoms of illness specified in (c)1i through xiii below to be admitted to the center on a given day unless medical diagnosis from a health care provider, which has been communicated to the center in writing, or verbally with a written follow-up, indicates that the child poses no serious health risk to himself or herself or to other children. Such illnesses or symptoms of illness shall include, but not be limited to any of the following:

i. Severe pain or discomfort;ii. Acute diarrhea, characterized as twice the child’s usual

frequency of bowel movements with a change to a looser consistency with a period of 24 hours, or bloody diarrhea;

iii. Two or more episodes of acute vomiting within a period of 24hours;

iv. Elevated oral temperature of 101.5 degrees Fahrenheit or over axillary temperature of 100.5 degrees Fahrenheit or over in conjunction with behavior changes;

v. Lethargy that is more than expected tiredness;vi. Yellow eyes or jaundiced skin;vii. Red eyes with discharge;viii. Infected, untreated skin patches;ix. Difficult rapid breathing or severe coughing;x. Skin rashes in conjunction with fever or behavior changes;xi. Weeping or bleeding skin lesions that have not been treated by a

health care provider;

xii. Mouth sores with drooling; orxiii. Stiff neck.

2.Once the child is symptom-free, or a health care provider indicates that the child poses no serious health risk to himself or herself or to other children, the child may return to the center.

3.If a child who has already been admitted to the center manifests any of the illnesses or symptoms of illness specified in (c)1 above, the center shall remove the child from the group of well children to a separate room or area, as specified in N.J.A.C. 10:122-5.2(p)4 until:

i. He or she can be taken from the center; or ii.The director or his or her designee has communicated verbally with a

health care provider, who indicates that the child poses no serious health risk to himself or herself or to other children, at which time the child may return to the group.

4.The center may exclude a child whose illness prevents the child from participating comfortably in activities, or results in a greater need for care than the staff can provide without compromising the health and safety of other children at the center.

(d) The following provisions relate to excludable communicable diseases:1.The center shall not permit a child or staff member with an excludable

communicable disease, as specified in the table below, to be admitted to or remain at the center, until:

i. A note from the child’s or staff member’s health care provider states that the child or staff member, respectively, has been diagnosed and presents no risk to himself, herself, or to others;

ii.The center has contacted the Communicable Disease Program in the State Department of Health and Senior Services, or the local health department pediatric health consultant, and is told the child or staff member poses no health risk to others; or

iii.If the child or staff member has chicken pox, the center obtains a note from the parent or staff member stating that all sores have dried and crusted.

TABLE OF EXCLUDABLE COMMUNICABLE DISEASES

Respiratory Illnesses Gastro-Intestinal Illnesses Contact Illnesses

Chicken Pox Campylobacter* ImpetigoGerman Measles* Escherichia coli* LiceHemophilus Influenzae Giardia Lamblia* ScabiesMeasles* Hepatitis A* ShinglesMeningococcus* Salmonella*Mumps* Shigella*Strep ThroatTuberculosis*Whooping Cough*

_______________________________

*Reportable diseases, as required by N.J.A.C. 10:122-7.10(a).


Westfield, NJ 07090(908) 232-1592

POLICY ON THE RELEASE OF CHILDREN(From Manual of Requirements for Child Care Centers 10:122-6.5)

GEN (a) The center shall maintain on file and follow a written policy on the release of children, which shall include: 1. The provision that each child may be released only to the child’s parent(s) or person(s) authorized by the parent(s), as specified in N.J.A.C. 10:122-6.8(a)3, to take the child from the center and to assume responsibility for the child in an emergency if the parent(s) cannot be reached;

2. The provision that, if a particular non-custodial parent has been denied access, or granted limited access, to the child by a court order, the center shall secure documentation to this effect, maintain a copy on file, and comply with the terms of the court order;

3. Written procedures to be followed by staff member(s) if the parent(s) or person(s) authorized by the parent(s), as specified in (a) 1 above, fails to pick up a child at the time of the center’s daily closing. The procedures shall require that:

i. The child is supervised at all times;ii. Staff members attempt to contact the parent(s) or person(s)

authorized by the parents; andiii. An hour or more after closing time, and provided that other

arrangements for releasing the child to his or her parent(s) or authorized person(s) have failed and the staff member(s) cannot continue to supervise the child at the center, the staff member shall call the Division’s 24-hour Child Abuse Hotline to seek assistance in caring for the child until the parent(s) or person(s) authorized by the child’s parent(s) is able to pick up the child; and 4. Written procedures to be followed by a staff member(s) if the parent(s) or person(s) authorized by the parent(s), as specified in (a)1 above, appear to be physically and/or emotionally impaired to the extent that, in the judgment of the director and/or staff member, the child would be placed at risk of harm if released to such an individual. The procedures shall require that:The child shall not be released to such an impaired individual;

i. The child shall not be released to such impaired individual;ii. Staff members attempt to contact the child’s other parent or an

alternative person(s) authorized by the parent(s); and

iii. If the center is unable to make alternative arrangements, as noted in (a)3ii above, a staff member shall call the Division’s 24-hour Child Abuse Hotline to seek assistance in caring for the child.


Westfield, New Jersey(908) 232-1592

EXPULSION POLICY

Unfortunately, there are sometimes reasons we have to expel a child from our program either on a short term or permanent basis. We want you to know we will do everything possible to work with the family of the child(ren) in order to prevent this policy from being enforced. The following are reasons we may have to expel or suspend a child from this center:

IMMEDIATE CAUSES FOR EXPULSION

1. The child is at risk of causing serious injury to other children or himself/herself.2. Parent threatens physical or intimidating actions toward staff members.3. Parent exhibits verbal abuse to staff in front of enrolled children.

PARENTAL ACTIONS FOR CHILD’S EXPULSION

1. Failure to pay/habitual lateness in payments.2. Failure to complete required forms including the child’s immunization records.3. Habitual tardiness when picking up your child.4. Physical or verbal abuse to staff.5. Other (explain).

CHILD’S ACTIONS FOR EXPULSION

1. Failure of child to adjust after a reasonable amount of time.2. Uncontrollable tantrums/angry outbursts.3. Ongoing physical or verbal abuse to staff or other children.4. Excessive biting.5. Other (explain).

SCHEDULE OF EXPULSION

1. If after the remedial actions above have not worked, the child’s parent/guardian will be advised verbally and in writing about the child’s or parent’s behavior warranting an expulsion. An expulsion action is meant to be a period of time so that the parent/guardian may work on the child’s behavior or to come to an agreement with the center.

2. The parent/guardian will be informed regarding the length of the expulsion period.3. The parent/guardian will be informed about the expected behavioral changes required in

order for the child or parent to return to the center.4. The parent/guardian will be given a specific expulsion date that allows the parent

sufficient time to seek alternate child care (approximately one to two weeks’ notice depending on risk to other children’s welfare or safety.) Failure of the child/parent to satisfy the terms of the plan may result in permanent expulsion from the center.

A CHILD WILL NOT BE EXPELLED

If a child’s parent(s):

1. Made a complaint to the Office of Licensing regarding a center’s alleged violations of the licensing requirements.

2. Reported abuse or neglect occurring at the center.3. Questioned the center regarding policies and procedures.4. Without giving the parent sufficient time to make other child care arrangements.

PROACTIVE ACTIONS THAT WILL BE TAKEN IN ORDER TO PREVENT EXPULSION

1. Staff will try to redirect child from negative behavior.2. Staff will reassess classroom environment, appropriate of activities,

supervision.3. Staff will always use positive methods and language while disciplining

children.4. Staff will praise appropriate behaviors.5. Staff will consistently apply consequences for rules.6. Child will be given verbal warnings.7. A brief time-out will be given so child can regain control.8. Child may lose certain privileges (explain).

Child’s disruptive behavior will be documented and maintained in confidentiality.

EXPULSION POLICY CONTINUED

9. Parent/guardian will be notified verbally 10. Parent/guardian will be given written copies of the disruptive behaviors

that might lead to expulsion.11. The director, classroom staff and parent/guardian will have a

conference(s) to discuss how to promote positive behaviors.12. The parent will be given literature or other resources regarding methods of

improving behavior.13. Recommendation of evaluation by professional consultation on premises.14. Recommendation of evaluation by local school district child study team.



2019-2020APPLICATION FOR ENROLLMENT

Date____________________________

Name___________________________________Nickname____________________________________

Date of Birth___________________ Sex________ Home Phone_______________________________

Home Address________________________________________________________________________

________________________________________________________________________

Mother’s Name:_______________________________________________________________________

Cell Phone:___________________________________________________________________________

Home Address:_______________________________________________________________________(if different from above)

Occupation: ___________________________________ Business Phone: _____________________

Business Name & Address :_____________________________________________________________

Mother’s Email Address:_______________________________________________________________

Father’s Name:_______________________________________________________________________

Cell Phone:__________________________________________________________________________

Home Address : _____________________________________________________________________(if different from above)

Occupation:_____________________________________ Business Phone:_____________________

Business Name & Address :____________________________________________________________ Father’s Email Address: ______________________________________________________________

2020 APPLICATION FOR ENROLLMENT

CHURCH INFORMATION

Do you have a home church? Yes or No (Please circle)

If yes, Please name the church you attend: ____________________________

Is your child baptized?____________________

Is your child in Sunday School?_______________________

Would you be interested in your child attending our Sunday School? Yes or No

Sunday School meets every Sunday from September to June from 10 AM to 10:45 in between worship services.

Please check any other services of Redeemer Lutheran Church you may be interested in, such as:

Learning about God/Faith_________ Family Activities____________

Small Fellowship Group_________ Desire Pastor to visit_________

Please print family name: __________________________________________________

____________________________________ ________________________Parent’s Signature Date



EMERGENCY MEDICAL CONSENT FORM

I, __________________________________, mother/father of _____________________ do hereby give permission to the personnel of Little Lambs Preschool and Kindergarten to secure and authorize such emergency medical care and/or treatment as my child might require while under the supervision of the said school personnel. I also agree to pay all costs and fees contingent on any emergency medical and/or treatment for my child as secured under this consent.

Every effort will be made to notify parent immediately in case of an emergency.

___________________________________ _____________________________Parent’s Signature Date

___________________________________ _____________________________Home Phone Work Phone

___________________________________ _____________________________Cell Phone Pager

Other Emergency Contact:

________________________________________________________________________Name and Relationship

___________________________________ _____________________________Phone Cell Phone


Westfield, New Jersey 07090(908) 232 -1592

CHRONIC MEDICAL POLICY

Due to the increasing prevalence and severity of childhood allergies and chronic illnesses, Little Lambs Preschool and Kindergarten set forth the following policy. This policy pertains to students that have chronic medical conditions such as, but not limited to, severe allergies, asthma, and diabetes.

1. At enrollment, parents need to provide the school with the completed Universal Child Health Record and Standard School/Child Care Center Immunization Record.

2. If the child has a chronic illness and/or medical condition such as diabetes, asthma, cystic fibrosis and/or severe allergies, the child’s parents and physician must sign and submit the:

a. Awareness Statement in order to proceed with the Registration and Enrollment.

b. Emergency Medical Protocol by August 15th-. This information will be posted in the classroom, office, as well as filed with the child’s medication and school file.

3. By August 15th the parent must provide the necessary medication for the child. They must also provide the necessary training to administer the medication.

4. Parents are required to carry a cell phone at all times while the child is under the supervision of the school.

5. Parents of students with food allergies or dietary restrictions must provide the student with their own snacks. The teacher should be provided with some non-perishable snacks to be used for parties and as substitutes for unexpected treats brought in by other parents.

6. Note that students are NOT under the supervision of the school while at programs provided by outsiders, such as Enrichment Classes. Therefore, it is recommended that students with chronic medical conditions NOT attend these programs unless adequate medical arrangements to safeguard the student are made by the parent with the outside program providers.



AWARENESS STATEMENT

Please be advised of the following:

1. There is no nurse on staff at Little Lambs Preschool and Kindergarten.2. The staff attends CPR, First Aid, and AED training annually but has no medical

training to recognize and treat symptoms of chronic medical illnesses or allergies, such as diabetes, asthma, cystic fibrosis and/or severe allergies.

3. Each chronic medical condition must be presented to and discussed with the Director of Little Lambs prior to enrollment.

4. The school will not be responsible for providing “special snacks” for students with food allergies or diabetes.

5. School snacks are purchased in volume for the school. Parents of children with food allergies are asked to look at what is being provided to the class and if there is a food allergy concern that our snacks have we ask parents to provide a special snack for their child.

6. The school imposes no restriction on food brought into the classroom, building or Lunch Bunch. Although parents are educated about food allergies, it is likely that food containing peanut products, wheat and dairy could be present throughout the school.

7. There are no special seating arrangements at Lunch Bunch.8. The classrooms are multipurpose rooms used by many groups outside and inside the

Church and, therefore, not solely under the control of Little Lambs Preschool.9. We cannot control what children eat at home and what they may bring in on their

hands and clothes.

We have read and understand the Little Lambs Preschool and Kindergarten Awareness Statement for Chronic Medical Conditions and the Chronic Medical Policy. We believe that _____________________________ can attend Little Lambs Preschool and Kindergarten. (Child’s Name)

____________________________ ___________________________Child’s Name Please print Parent’s Name (Please print)

_____________________________ _______________ Parent’s Signature Date



EMERGENCY MEDICAL PROTOCOL

Name___________________________________

Date of Birth_____________________________ Child’s Photo

Medical Condition_______________________________________

Asthmatic____________

SIGNS OF MEDICAL CONDITION/ALLERGY:

Symptoms:

MOUTH __________________________________________________________THROAT __________________________________________________________SKIN __________________________________________________________GUT __________________________________________________________LUNG __________________________________________________________HEART __________________________________________________________

ACTION PLAN/MEDICAL PROTOCOL:

1. __________________________________________________________________2. __________________________________________________________________3. __________________________________________________________________4. Call: 1.________________________________________

2.________________________________________3.________________________________________4.________________________________________5.________________________________________

Any medication left with the school for allergy reaction must be in original package as dispensed from Pharmacy with child’s name and expiration date on it.

_______________________ _______________________ ________________________Parent Signature & Date Parent Signature & Date Physician Signature & Date

EMERGENCY CONTACTS:1.____________________________________ 4._______________________________

2.____________________________________ 5._______________________________

3.____________________________________



EMERGENCY FORMThe information provided below is the information we will use in an emergency. Your child’s health information and this Emergency Form will be duplicated and taken out of the building with us if there were a time that we had to vacate the building due to an emergency. It is IMPERATIVE that when your child is in our care that one or all of the parents’ telephones are reachable. Child’s Full Name:_____________________________________________________

Child’s Date of Birth:___________________________________________________

Name of Both Parents:__________________________________________________

Home Address: _______________________________________________________

Home Phone: _________________________________________________________Mom’s Cell Phone: _____________________________________________________Mom’s Business (if applicable):___________________________________________

Dad’s Cell Phone: ______________________________________________________Dad’s Business (if applicable) _____________________________________________

Telephone numbers in the order we should call if we have not been able to reach you. We would call due to illness, early dismissal/delayed opening, or an emergency at school. You must list at least 3 contacts. These people are authorized by you to pick up your child if either parent cannot be reached.

Name Relationship to Child Phone No.

1.____________________ ___________________ Home:__________________Address:_____________________________________ Cell:____________________

2.____________________ ___________________ Home:__________________Address:______________________________________ Cell:____________________

3.____________________ ___________________ Home:__________________Address:______________________________________ Cell:____________________

Child’s Doctor’s Name and Phone Number:_______________________________________Hospital Preferred:__________________________. Please list any and all allergies should your child need to be transported to a hospital:____________________________________

_____________________________________Parent’s Signature & Date


Westfield, New Jersey 07090(908) 232- 1592

RELEASE CODE FORM

Name of Child__________________________________________________________

My child may be released to the following individuals:

Name Relationship Address Phone

1._____________________ _____________ ____________________ ____________

____________________

2._____________________ _____________ ____________________ ____________

____________________

3._____________________ _____________ ____________________ ____________

____________________

4._____________________ _____________ ____________________ ____________

____________________

5._____________________ _____________ ____________________ ____________

____________________

CODE WORD: ____________________________________

_____________________________________ ______________________________Parent’s Signature Date



PERMISSION FORM FOR ENRICHMENT CLASSES

If my child, _____________________________, attends an Enrichment Class during the 2019-2020 school year, I give a member of the school staff or a staff member from the enrichment class permission to bring or pick my child up to or from his or her classroom. I understand that my child is under the care of the enrichment staff and that it is my responsibility to pick up my child at the appropriate dismissal time.

I also authorize Little Lambs Preschool and Kindergarten to authorize emergency medical treatment for my child while she/she is under the care of the staff during his/her enrichment class.

I can always be reached at (home phone) ________________________________ (cell phone ) _________________________________

I understand that peanut butter/peanut products are not allowed in the programs where lunch/snack is brought from home.

___________________________________ _________________________Parent’s Signature Date


Westfield, New Jersey 07090(908) 232- 1592

PHOTOGRAPH PERMISSION FORM

I, ____________________________, (parent’s name) give Little Lambs Preschool and Kindergarten permission to take pictures of activities of my child’s class. I understand that a picture taken may be used in a school brochure, a DVD of the church and school, or a newspaper article or on the website for the church or school.

Child’s Name: ____________________________

Parent’s Signature: ________________________ Dated: _______________

LITTLE LAMBS PRESCHOOL AND KINDERGARTEN

229 Cowperthwaite PlaceWestfield, New Jersey 07090

(908) 232-1592

Child’s Name: ___________________________ (please print)

*This copy of the Expulsion Policy must be signed by the child’s parent, dated and returned to Little Lambs Preschool and Kindergarten

EXPULSION POLICY

Unfortunately, there are sometimes reasons we have to expel a child from our program either on a short term or permanent basis. We want you to know we will do everything possible to work with the family of the child (ren) in order to prevent this policy from being enforced. The following are reasons we may have to expel or suspend a child from this center:

IMMEDIATE CAUSES FOR EXPULSION

1. The child is at risk of causing serious injury to other children or himself/herself.2. Parent threatens physical or intimidating actions toward staff members.3. Parent exhibits verbal abuse to staff in front of enrolled children.

PARENTAL ACTIONS FOR CHILD’S EXPULSION

1. Failure to pay/habitual lateness in payments.2. Failure to complete required forms including the child’s immunization records.3. Habitual tardiness when picking up your child.4. Physical or verbal abuse to staff.5. Other (explain).

CHILD’S ACTIONS FOR EXPULSION

1. Failure of child to adjust after a reasonable amount of time.2. Uncontrollable tantrums/angry outbursts.3. Ongoing physical or verbal abuse to staff or other children.4. Excessive biting.5. Other (explain).

SCHEDULE OF EXPULSION

1. If after the remedial actions above have not worked, the child’s parent/guardian will be advised verbally and in writing about the child’s or parent’s behavior warranting an expulsion. An expulsion action is meant to be a period of time so that the parent/guardian may work on the child’s behavior or to come to an agreement with the center.

2. The parent/guardian will be informed regarding the length of the expulsion period.3. The parent/guardian will be informed about the expected behavioral changes required in order for

the child or parent to return to the center.4. The parent/guardian will be given a specific expulsion date that allows the parent sufficient time to

seek alternate child care (approximately one to two weeks’ notice depending on risk to other children’s welfare or safety.) Failure of the child/parent to satisfy the terms of the plan may result in permanent expulsion from the center.

A CHILD WILL NOT BE EXPELLED

If a child’s parent(s):

1. Made a complaint to the Office of Licensing regarding a center’s alleged violations of the licensing requirements.

2. Reported abuse or neglect occurring at the center.3. Questioned the center regarding policies and procedures.4. Without giving the parent sufficient time to make other child care arrangements.

PROACTIVE ACTIONS THAT WILL BE TAKEN IN ORDER TO PREVENT EXPULSION

1. Staff will try to redirect child from negative behavior.2. Staff will reassess classroom environment, appropriate of activities, supervision.3. Staff will always use positive methods and language while disciplining children.4. Staff will praise appropriate behaviors.5. Staff will consistently apply consequences for rules.6. Child will be given verbal warnings.7. A brief time-out will be given so child can regain control.8. Child may lose certain privileges (explain).9. Child’s disruptive behavior will be documented and maintained in confidentiality.10. Parent/guardian will be notified verbally.

EXPULSION POLICY CONTINUED

11. Parent/guardian will be given written copies of the disruptive behaviors that might lead to expulsion.

12. The director, classroom staff and parent/guardian will have a conference(s) to discuss how to promote positive behaviors.

13. The parent will be given literature or other resources regarding methods of improving behavior.

14. Recommendation of evaluation by professional consultation on premises.15. Recommendation of evaluation by local school district child study team.

I have received a copy of the center’s policy on the expulsion of children fromenrollment.

________________________ ___________________________ __________________NAME OF CHILD PARENT’S SIGNATURE DATE

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