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Children’s Land at Wheeling Learning Center Registration File 850 McHenry Rd. Wheeling, IL 60090 phone: 847 537-3340 fax: 847 537-3341 e-mail: www.childrensland.us [email protected]

Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: [email protected] - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

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Page 1: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

Children’s Land at Wheeling Learning Center Registration File

850 McHenry Rd.

Wheeling, IL 60090

phone: 847 537-3340 fax: 847 537-3341

e-mail: www.childrensland.us [email protected]

Page 2: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 2 -

CHILDREN’S LAND L e a r n i n g C e n t e r

MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-------SINGLE PARENT

35BSCHEDULE TO ENABLE US TO PREPARE STAFF AND PLAN ACCORDINGLY, PLEASE PLACE A CHECK IN FRONT OF THE APPROPRIATE SCHEDULE AND THE

APPROPRIATE DAYS.

1. ____FULL TIME _______MONDAY 2. ____PART TIME _______TUESDAY

_______WEDNESDAY _______THURSDAY _______FRIDAY

CHILD’S PHYSICIAN INFORMATION:

NAME: _______________________________________________

ADDRESS: _______________________________________________ PHONE#: _______________________________________________

38B

PARENT(S)/GUARDIAN(S) SIGNATURE: _______________________________ 39BDATE: ________________________

0BREGISTRATION FORM 5BChild Information

Child’s Name _______________________________________________ Birth Date _____________________ Gender _____________________ Address ___________________________________________________ City __________________________ Zip Code ____________________ Starting Date ___________________ Ending Date _________________

42BParents / Legal Guardians Information Father’s Name Mother's Name Home Phone # Home Phone # SSN# SSN# Home Address Home Address

Occupation Occupation Employer Employer Work Address: Work Address: Working Hours Working Hours Business Phone # Business Phone # Cell Phone # Cell Phone # E-Mail E-Mail

Page 3: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 3 -

CHILDREN’S LAND L e a r n i n g C e n t e r

Emergency Card 6BChild’s Name _____________________________

7BGroup Age _______________________________

8BBirth date________________________________

9BAddress__________________________________

10BCity _______________Zip___________________

11BParent(s)/Guardian(s):

12BName___________________________________ 13BName___________________________________

14BWork# __________________________________ 15BWork# __________________________________

16BHome# __________________________________ 17BHome# __________________________________

18BMobile/Beeper# __________________________ 19BMobile/Beeper# __________________________

Relative or Friend Alternate: ____________________________ 1.________________________ Phone________________ 2.________________________ Phone________________

Pediatrician______________ Phone________________ Allergies---------------- Last DPT-------------

Medications______________ Hospital______________ Other Significant Medical Info________________________________________ ___________________________________________________________________ I hereby give permission to the medical personnel selected by Children’s Land, Inc to order x-ray, routine tests and treatment for my child, and in the event I cannot be reached in an emergency, I hereby give permission to the physician selected by Children’s Land, Inc to hospitalize, secure proper treatment for, and to order injections and/or anesthesia and/or surgery for my child. I hereby give my permission for the Children’s Land, Inc to contact my pediatrician for any information needed about my child, and to authorize my pediatrician to release such information to Children’s Land, Inc.

Signature Parent/Guardian:________________________________

Date:_____________________________________________________

37BMEDICAL CONSENT

I, ______________________________, as parent/guardian of ______________________________________, hereby authorize The Children’s Land, Inc by and through its officers, agents, or employees to remove the above minor child from its premises for the purpose of obtaining emergency medical treatment if the need so arises. I further agree that The Children’s Land, Inc is hereby authorized to procure whatever emergency medical treatment that may be necessary, either through a duly licensed physician, dentist and/or a duly accredited hospital or clinic. It is also understood that I will hold The Children’s Land, Inc harmless for the nature, performance, and outcome of any such emergency medical treatment and that the determination of whether and emergency has arisen within the terms of this agreement shall be left to the sole discretion of The Children’s Land, Inc.

Parent/Guardian_________________________________ Date ________________________________________

Page 4: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 4 -

CHILDREN’S LAND L e a r n i n g C e n t e r

Emergency Contacts:

I, ______________________________, as parent/guardian of_______________________________________________________, hereby authorize Children’s Land, Inc staff in case of emergency, to contact people listed below if I cannot be reached:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Signature Parent/Guardian:________________________________ Date ______________________________

Page 5: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 5 -

CHILDREN’S LAND L e a r n i n g C e n t e r

Family Profile Form Have there been any recent family changes (if yes, please check and list date):

20Moves_______________________________________________ 21BNew Job______________________________________________ 22New Hours___________________________________________ 23BNew Baby ____________________________________________ 24BSerious Illness_________________________________________ 25BChange in Caregiver ____________________________________ 26BFamily Death__________________________________________ 27Loss of Pet____________________________________________

28BOther Loss____________________________________________ 29BOther________________________________________________

What was child told about family changes? _______________________________________________________________________ ___________________________________________________________________________________________________________ How did she/he react? ______________________________________________________ Does your child have any specific fears? ____________________________________

1BChild’s Health/Medical Information

30BChild’s Physician _____________________________ 31BChild’s Dentist ______________________________

32BPhone _______________________________________________ 33BPhone _______________________________________________

40BHospital Affiliation ___________________________________________

36BGENERAL HEALTH: Where or are there any physical or medical factors of which we should be aware?

34BAllergies__________________________________

Vision____________________________________ Hearing__________________________________ Eating Difficulties_________________________ Ear infections How often? Fluid? Yes No Does your child take medication regularly? Yes No Describe____________________________________

Any special instructions? ---------------------------------------------------------- Has your child ever experienced: (Give type/reason and date) Serious Illness Type/Reason___________________________Date__________ Hospitalization Type/Reason___________________________Date__________ Operation Type/Reason___________________________Date__________ Accident Type/Reason___________________________Date__________ Injuries Type/Reason___________________________Date__________

2BOther

Are there any aspects of your child’s development that are of concern to you?_____________________

_______________________________________________________________________________________________

Does your child have specific fears?_____________________________________________________________

Is there any other information you would like to provide?________________________________________

________________________________________________________________________________________________

Are there any other professionals working with your child or family?______________________________

Do you feel that collaboration would be useful? Yes No

41BParent/Guardian Signature___________________________________________

Page 6: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 6 -

CHILDREN’S LAND L e a r n i n g C e n t e r

HELP US TO KNOW YOUR CHILD BETTER

3BCHILD’S NAME ______________________________________ DATE _______________________

1. DOES YOUR CHILD HAVE ANY ALLERGIES?

2. WHAT FOODS DOES YOUR CHILD LIKE?

3. WHAT FOODS DOES YOUR CHILD DISLIKE?

4. DOES YOUR CHILD HAVE ANY SPECIAL FEARS?

5. HOW DO YOU DISCIPLINE YOUR CHILD?

6. HAS YOUR CHILD EVER BEEN IN A PRE-SCHOOL / DAY CARE SETTING BEFORE?

7. IS THERE ANYTHING ELSE WE SHOULD KNOW ABOUT THAT AFFECTS YOUR CHILD?

8. IS YOUR CHILD POTTY TRAINED?

9. IF YES, AT WHAT AGE?

10. BY WHAT NAME DO YOU CALL YOUR CHILD AT HOME?

11. WHAT CAN YOUR CHILD DO FOR HIM/HERSELF (DRESS, CHORES, ETC…)

12. DOES YOUR CHILD HAVE OTHER SCHEDULED ACTIVITIES BESIDES SCHOOL?

13. IF YOUR CHILD HAS SIBLINGS, HOW DO THEY RELATE TO EACH OTHER? ****************************************************************************************************

DEAR PARENTS:

1. Children cannot come to school if they are less than 24 hours free of vomiting, diarrhea and fever. 2. Children cannot come to school with heavy discharge from noses, pink eye, and any kind of rash on the body. 3. Children, who come to school with symptoms listed above, will be sent home. 4. Medication, both prescription and non‐ prescription, will be accepted only in its original container. a) Prescription medication shall be labeled with the full pharmacy label. Medication will be administered as required by a physician, subject to the receipt of appropriate releases from parents (Administer Medicine form). b) Over‐the‐counter (non‐prescription) medication shall be clearly labeled with child’s first and last name. The container shall be in such condition that the name of the medication and the directions for use is clearly readable. It will be administered in accordance with manufacturer’s instructions when provided by the parents with written permission (Administer Medicine form). Children, who come to school with symptoms listed above, will be sent home.

PARENT SIGNATURE __________________________DATE __________ Children’s Land at Wheeling

Page 7: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

LIST OF PERSONS AUTHORIZED TO PICK UP THE CHILD REGULARLY

I, ______________________________, as parent/guardian of ________________________, hereby authorize people listed below to pick up my child:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

Name:

Relationship:

Phone #:

Address:

ARRIVAL AND DEPARTURE POLICY

Children’s Land at Wheeling Learning Center, Inc day care center is open Monday through Friday from 6:30AM to 6:30 PM. Parents are responsible for the safe arrival of their child and must bring their child in the classroom area to the staff. Children may not enter the building unattended. When picking up children, parents will receive them from the staff. Parents are expected to observe the 6:30 PM closing time. The late pick up fee will be applied to your monthly bill: $10.00 for every 10 minutes that you are late. At that hour, staff members are eager to resume their personal lives after a very busy day. If your child is to be picked up by someone other than yourself or other authorized person, we must have a note stating with whom the child is to go. Under no circumstances will a child be releases to a person who has not been authorized. This is for your child’s safety. Persons not known to the staff may be required to provide a driver’s license or some other type of photo identification to establish their identity. Parent(s)/Guardian(s) Signature:____________________________________ Date: ______________________

Page 8: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 8 -

CHILDREN’S LAND L e a r n i n g C e n t e r

PERMISSION FORM FOR ATHLETIC ACTIVITIES AND DANCING

I agree to my child’s participation in any school athletic activities such as but not limited to running, playing games, using outdoor and indoor athletic equipment. This will also include up to 1 hour as much as three times a week of an aerobic/dancing exercise session. In consideration for any reasonable precaution being taken by the school staff to ensure the safety and well – being of the child. I hold employees and officers harmless of any potential injuries or claims.

I hereby give my permission to administer first aid to my child. In case of emergency, the Children’s Land, Inc staff will promptly contact the paramedics to treat and transport my child to the nearest hospital, then attempt to contact the parent(s).

I hereby give permission to the hospital’s selected physician to administer emergency services. In case of an emergency and I cannot be reached, you may contact:

Parent Name: _________________________

Child’s Name: __________________________________________

****************************************************************************************************

4BPROGRAM PERMISSION FORM

1. I give permission for my child __________________________________ To receive appropriate medical attention from Children’s Land staff, such as First Aid, CPR, Heimlich maneuver, etc., or, it is determined that my child needs immediate professional medical care, I authorize Children’s Land to transport him or her to the nearest emergency hospital. Parents will be contacted immediately. I understand that I will be responsible for all of his/her expenses in relation to emergency medical services. 2. I hereby give permission for Children’s Land staff to contact my Pediatrician for any information needed about my child. I authorize my pediatrician to release such information to Children’s Land, Inc. 3. I understand that I am legally responsible for my child while he or she is on route to and from Children’s Land programs.

Parent’s Signature ___________________________________ Date______________________

****************************************************************************************************

PERMISSION FORM FOR PHOTOS, FILM, VIDEOS, AND FIELD TRIP

I agree to my child’s participation in any school photo taking, film, and videos. In consideration for any reasonable precaution being taken by the school staff to ensure the safety and well – being of the child. I hold employees and officers harmless of any potential injuries or claims.

During a field trip I hereby give my permission to administer first aid to my child. In case of emergency, the Children’s Land, Inc staff will promptly contact the paramedics to treat and transport my child to the nearest hospital, then attempt to contact the parent(s).

I hereby give permission to the hospital’s selected physician to administer emergency services. In case of an emergency and I cannot be reached, you may contact:

Parent Signature:_________________________ Date_____________

Child’s Name: _____________________________________________

Page 9: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 9 -

CHILDREN’S LAND L e a r n i n g C e n t e r

CONFIDENTIALITY Children's Land Policy is to keep any information about the families strictly confidential. • Any digital images (such a photo/video) or information about other children are not allowed on the website or Facebook, Instagram, Flickr etc. or share the digital images using a Smartphone. Photos shared on the Internet can remain public indefinitely. • If a parent/guardian specifically request a picture of their child to be send to them during the day Children's Land Centers needs to have a parent/guardian written Request. • No other child can be identified in the picture. • Any parents or visitors are not allowed to take pictures or video of children on the Children's Land Centers premises without Children's Land Administration approval *. • All employee are not allowed to take pictures of children without Children's Land Administration approval. • The purpose of the video cameras installed in the classrooms is to provide a live feed to parents located in the lobby outside the classroom environment. In order to protect individual privacy the video surveillance at Children’s Land Centers does not collect and retain data • Our Privacy Policy prevents Children's Land Centers from releasing any information about the parents in the Children's Land Centers program. If parents decided to announce the families' events (such a birthday celebration etc.) the flyers would be to put in the children’s cubbies with Children's Land Administration approval only. *Will be approved for the holidays performances only. Supervision and Monitoring Authorized employees of Children's Land Centers (Director, Assistant Director or Member of the Board of Directors) have the right to monitor the use of information technology resources (such as company smartphones or tablet) and to examine, use and disclose any data found. Any parent who violates the Children's Land Centers Photography/Publicity and Confidentiality Policy will not be permitted on Children's Land Centers property thereafter.

****************************************************************************************************

IMPORTANT INFORMATION

On your child’s first day of attendance, your child will need the following items:

1. Change of Clothing – pants, shirt, underclothes and socks. Please make sure that your child’s change of clothes are always weather appropriate.

2. Small pillow for nap time – We provide and wash the cot sheets and blankets weekly. If you would like to have your child’s pillow and blanket washed, please let your child’s teacher and they can leave it out on Fridays. Please make sure that you bring them back on Monday morning. The center does not keep extra pillows or blankets.

3. Diapers and wipes if your child is not potty trained.

Page 10: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

- 10 -

CHILDREN’S LAND L e a r n i n g C e n t e r

COPY OF BIRTH CERTIFICATE

Dear Parent/Guardian,

Per state law a copy of your child’s birth certificate is needed for enrollment to our childcare center.

Thank you,

Director

****************************************************************************************************

PARENT-PROVIDER CHILD CARE CONTRACT

1. The following contract is between: Mother/legal guardian _________________________________________________________________________________ Father/legal guardian __________________________________________________________________________________ School name _________________________________________________________________________________________ for the care of:________________________________________________________________________________________ Child’s name and birth date Starting date of this contract_______________________ Ending date of this contract _________________ 2. Standard Rates and Payment Policies:

Registration fees - $100.00 (Not refundable. Does not apply as discount or part of payment to any other fees). The parent/guardian who applies for financial assistance will have to co-pay the difference between the provider’s weekly charges and the financial assistance from Action for Children. In case a parent decides to terminate the contract, provider must get a 2 week written notice. If parent/guardian will fail to provide the termination notice, provider will report parent/guardian to collection agency with payment due, for the period of time that child was absent plus the two weeks.

43BPayment is due [ ] weekly [ ] monthly

The provider will provide: Breakfast, Morning snack, Lunch , Afternoon snack

Page 11: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

The parent / guardian will provide diapers, wipes, and change of clothes. Parent / guardian must supply a current medical form, completed by the child’s doctor and updated every other year.

3. Rates for holidays, absences, vacations, overtime:

Care will not be provided, but payment is due, on the following holidays when they occur on a day the child(ren) is/are regularly scheduled for care:

New Year day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas day

In case if provider will not receive weekly payment on time, a $10.00 per day late fee will be charged in addition to your next weekly payment. Payment invoices will be mailed to the parent/guardian household on weekly/monthly basis. The provider has be notified by 8:00 am if the child(ren) will be absent for that day. Payment for absences:

Provider will deduct 10% off if child is sick for entire week. Fees for parent / guardian’s vacation:

Provider will deduct 10% off if the child is on vacation. Payment for vacation time is due one week prior to vacation for entire vacation time. If payment is not received by the provider, the child(ren)’s place in the center will be terminated.

If the parent / guardian picks up later than the 6:30 pm, the following overtime rate will be charged: $10.00 for every 10 minutes.

4. Termination procedure: This contract may be terminated by either parent / guardian or the provider by giving 2 weeks written notice. The provider may terminate the contract without notice if the parent / guardian is over 1 week(s) late with scheduled payments. Provider has a right to place the parent/guardian for collection. The parent/guardian who is applying for financial assistance through Action for Children has to co-pay every week. In case if provider will not receive 1-week co-payment, the child(ren)’s place in the center will be terminated and parent will be reported for collection.

Signatures: By signing this contract, all parties agree to all of the above terms and policies, including financial responsibility for care provided. The provider is responsible for giving / sending all signers a copy of this signed contract. Provider’s signature Date ___________________________________________________________________________ Mother / Legal guardian signature Date ___________________________________________________________________________ Father / Legal guardian signature Date ___________________________________________________________________________

Page 12: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

Parent Policy Handbook Receipt The Parent of _________________________________________________________________ I have received a copy of the Children’s Land at Wheeling Learning Center Parent Policy Handbook. Parent's Name_________________________________________________________________ Parent's Signature ______________________________________________________________ Date _______________________________

****************************************************************************************************

Page 13: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

CONSENTS TO DAY CARE PROVIDERS NAME OF CHILD________________________________________________________________ THESE CONSENTS ARE FOR NON-DCFS WARDS ONLY AND MAY ONLY BE USED FOR DAY CARE SERVICES. Parent(s) or legal guardian placing the child may sign any or all of the following consents:

EMERGENCY MEDICAL CARE This authorizes Children’s Land at Wheeling Learning Center__________________________________________ to secure EMERGENCY medical care for my/our child when I/we cannot be immediately reached at the time of emergency. I/we will be responsible for the emergency medical charges upon receipt of the statement. ___________________________________________________ is the preferred doctor/clinic/hospital.

Date______________________ ___________________________________________

Signature of parent/guardian ___________________________________________ Relationship to child

ADMINISTER PRESCRIPTION MEDICINE I/we authorize Children’s Land at Wheeling Learning Center to administer prescribed medicine to my/our child as specified in the prescription's directions for administration. Date______________________ ___________________________________________

Signature of parent/guardian ___________________________________________ Relationship to child

ADMINISTER OVER-THE-COUNTER MEDICINE (Administer only in accord with the appropriate standards for licensure)

I/we authorize Children’s Land at Wheeling Learning Center to administer over-the-counter medicine to my/our child as specified in written instructions. Date______________________ ___________________________________________

Signature of parent/guardian ___________________________________________ Relationship to child

Page 14: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

DISCIPLINE AND BEHAVIOR MANAGEMENT

Discipline involves setting limits and correcting undesirable behavior. We believe that discipline is necessary in children’s lives to help them develop self-control and assume responsibility for their own acts. It is also a necessary element in teaching children to think for themselves and helping them to feel good about themselves. Children’s Land main goal in disciplining children is to always remember to do so with love and understanding. This goal is the reason we believe in “disciplining” children rather than “punishing” them. Punishment is any action taken by an adult to change a child’s behavior by making him or her suffer physically or emotionally. Punishment

often leads to embarrassment, frustration, and repetition of negative behavior. Punishment tactics will only result in a temporary change in the child’s behavior, while discipline will result in a permanent change.

Discipline of a given child will be the responsibility of adults who have an ongoing relationship with that child. The most integral part of effective discipline is that it must be done with love. Therefore, regardless of age, under no circumstances will any child be subjected to any of the following: corporal punishment (hitting, spanking, swatting, beating, shaking, pinching, and anything intended to induce physical pain or fear) threatened or actual withdrawal of food, rest, or restroom privileges; abuse or profane language; public or private humiliation; discipline for toilet accidents; or emotional abuse (shaming, rejecting, terrorizing, or isolating). In addition, the adults responsible for the children will provide a consistent environment that fulfills the children’s basic needs. Another integral part of effective discipline is to always take the child’s age into consideration. For this reason, Children’s Land follows these discipline guidelines based on age.

Age Appropriate Discipline Guidelines.

Twenty-four Months and Older – Preschoolers and School- Age Children.

Two-year-old may be consider either Toddlers or Preschoolers. Therefore, they must be disciplined based on their level of development.

Preschoolers and School-Age children are able to understand rules. To effectively discipline these children, the limits and consequences of inappropriate activity must be clear and easy for the children to understand. These limits and consequences must also be consistently enforced and explained to the child before and as part of any disciplinary action. Appropriate discipline consists of the following steps.

1. The adults should alert the child to what he or she is doing and what he or she should do to correct the behavior.

2. Give the child a chance to correct the behavior.

3. If the child does not correct the behavior, alert him again and inform him of the consequences that will follow if he does not correct the behavior.

4. If the child still does not respond, the adult may use negative consequences.

5. The adult should consider reducing the negative consequences if the child takes responsibility for his action, is able to apologize and takes the steps needed to change the problem.

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850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

Time Out or removal of a child from the group to help a child gain control will not exceed one minute per year of age. The adult should provide positive reinforcement for acceptable behavior. In addition, to help children learn self-discipline, preschool-age children will have reasonable opportunity to resolve their own conflicts.

Parent involvement in the guidance and discipline process is essential. Parents are encouraged to discuss their child’s home behavior and discipline procedures with the child’s teacher in order to gain a level of consistency. On the other hand, teachers are encouraged to discuss the child’s at school behavior and discipline procedures with the child’s parents to further this level of consistency. The consistent reinforcement of appropriate behavior and discouragement of inappropriate behavior both at home and at day care is imperative. Communication between the parents and the teacher is the key to this consistency. To aid in the communications process the child’s teacher is encouraged to give daily, verbal reports of the child’s behavior to the parents. Moreover, the child’s parents are encouraged to make the time to listen to these reports. This will allow both the parents and the teacher the opportunity to offer further positive reinforcement of desired behavior and the opportunity to address undesired behavior.

Parents must always remember that they are the most important role models in their children’s lives. Thus, parents must lead by example; staying calm, willingness to admit wrongs, apologize, and take corrective actions will in tern teach children the same. Furthermore, parents must always keep their expectations concerning their children realistic. If a child’s behavior becomes a consistent problem, a meeting between the director, the child’s teacher, and the child’s parents will be required. Every effort will be made at this meeting to resolve the problems. If it is necessary to develop a specific plan for dealing with a child’s pattern of unacceptable behavior, all staff will be aware of the plan and cooperate in implementing it. Any clinical behavior plan must be developed by a professional clinical physician and the parent. The director must document the plan in the child’s file, and all staff will receive training on implementing the plan.

State law mandates that “Any child who, after attempts have been made to meet the child’s individual needs, demonstrates inability to benefit from the type of care offered by the facility, or whose presence is detrimental to the group, will be discharged from the facility.” It is our policy to strenuously pursue the best interests of the child and this can hardly be achieved by ridding ourselves of the so-called “problem child” by terminating the child’s enrollment. Terminating a child’s enrollment can only lead to feelings of rejection and a poor self-image. Conversely, we do realize that there are facilities available, which are better suited than Children’s Land, to deal with certain children’s needs. Should the need arise, we will find more suitable alternatives to our own center and will always keep the child’s needs paramount. We encourage future contact between Children’s Land and the family in the form of letters, phone calls, visits, or part-time enrollment so that the child realizes that he/she has not been rejected. Thus, the child will gain the self-confidence and self-assurance necessary for self-discipline.

In conclusion, it is most important to remember to keep expectations realistic and to always discipline with love.

Child’s Name: _______________________________________________________

Parent’s Signature:___________________________________________________

Today’s Date:_______________________________________________________

Page 16: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

ACKNOWLEDGMENT DOCUMENTS: Tuition Payment Policy--Effective March 5, 2018 Dear Parents: According to the tuition policy of the Center (for full policy please refer to page 6 of the Parent Handbook) the following rules will be enforced without exception effective March 5, 2018: 1. Tuition has to be paid on a weekly basis. Payments must be made NO LATER than the first day of

attendance of each week to be eligible for our services. 2. A late fee of $25.00 will be added to any account that payment has not been made by Friday. 3. If a payment is not made by the first day of attendance of the following week daycare services will be

terminated until the account is paid in full. 4. Re-enrollment into the Center will be based on the availability of spots and will require a new registration

fee to be paid. 5. Parents applying for the Action for Children will be charged full tuition until the application is approved.

Once the Center is reimbursed by the Action for Children, your account will be credited. 6. The balance between the tuition and the anticipated Action for Children reimbursement has to be paid on a

weekly basis following the general tuition payment rule. When reimbursement checks are received by the center, your balance will be adjusted accordingly.

There is no credit given for scheduled school holidays, child illness, or for closings due to emergency situations, inclement weather, power outages or other incidents which are beyond our control. Parents are welcome to call the center to verify if we are open or not. I have read and agree to the Tuition and Policy agreement. Parent’s Name ______________________________________________________ Child’s name ________________________________________________________ Parent’s Signature: ___________________________ Date __________________

Page 17: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

ARRIVAL AND DEPARTURE Arrival/Transition in the Morning A short good-bye in a positive confident manner convey to the child an unspoken message that you know he is being left in a safe place you picked out just for him. Parents set the pace for a child’s success at school. A short, cheerful good-bye from you can help your child feel there is nothing to be concerned about. Children must be dropped off promptly no later than 8:45 AM. It is critical to the morning transition time that you support your child’s need to begin actively participating in classroom dynamics. Punctuality makes it possible for your child to settle smoothly into his routine primarily because your child will receive appropriate greeting time with his teachers and peers. Being late is disruptive to your child and the class. It establishes poor habits, and creates an atmosphere of discomfort for your child. Tardiness not only gets a child’s day off to a rocky start, but it breaks the other children’s concentration. Please be sure to contact the Children's Land Administration or the teacher if you are going to arrive late, if your child will be out for the day, or for any schedule changes.

Pick-up

Please inform the staff in writing, of anyone other than regular care providers or parents picking up your child. Parents must pick up their children on time. Please remember that our staff must go home to their families, and children must be picked up no later than 6:30 pm. If you arrive after 6:30 pm a late charge fee of $1.00 per minute will be charged to your child’s school account. If your child has not been picked up by 6:30pm and we are unable to reach you after 3 attempts, we will contact the local police department. Effective immediately this policy will be fully enforced. Please note that calling or texting to notify of either will not excuse late fee. No drop off before 6:30am or pick after 6:30pm will be permitted. Should you have a temporary change in your schedule for any reason and need care outside of our normal hours of operation, a 48 hour advance notice must be given in writing and fee may apply. When dropping off or picking up your child, please keep your time in the classroom brief and playground. Children must be dropped off and picked up promptly. This is for a variety of reasons, but most importantly for the safety and security of our clients. Please remember our classrooms and playground is setup for children//staff only and shall not at any time exceed the capacity approved by DCFS.

-Our classroom and playground setup for children and facility staff and not designated for parents. -Children's Land needs be in compliance with the DCFS staff/child ratios and classroom capacities. -All Children's Land associates going through certain screening including background and health exam. Provider can NOT force parents to take a background check, therefore the laws say the parents have access to their child, parents do not have access to other children. - Behaviors escalated when kids see one parent and want to see their own. A child having their own parent in the room can stress over who is "in charge" and display serious behaviors. I have read and agree to the Arrival/Transition in the Morning and Pick-up agreement. Parent’s Name ______________________________________________________ Child’s name ________________________________________________________ Parent’s Signature: ___________________________ Date __________________

Page 18: Children’s Land at Wheeling Learning Center Registration File€¦ · e-mail: wheeling@childrensland.us - 2 - CHILDREN’S LAND L e a r n i n g C e n t e r MARITAL STATUS: MARRIED-----SEPARATED-----DIVORCED----WIDOWED-----SINGLE

850 McHenry Road, Wheeling, IL 60090 p.: 847.537.3340 f.: 847.537.3341

e-mail: [email protected] www.childrensland.us

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CHILDREN’S LAND L e a r n i n g C e n t e r

DISMISSAL Suspension Plan The following occurrences of behaviors will be used as grounds for a child’s suspension:

• Kicking or swearing at a teacher or anyone within The Children's Land Center • Hitting or throwing objects at others • Repeatedly biting a teacher or fellow students • Consistent temper tantrums or willful behavior resulting in the destruction of property or harm to

teachers and members of Children's Land Learning Center If any of the above behavior occurs, the following steps will be taken.

First offense:

• Parent will be called to meet with the staff for a conference and a behavior plan of action will be established

• If a parent fails to appear for the appointed conference, an email with a return receipt will be sent requesting a re-scheduled conference within three (3) days. If the parent takes no action, the child will be given a ten (10) days termination notification.

Second offense:

• If a child persists in inappropriate behavior after the teacher-parent conference, a behavior plan was established and executed as well as social service referral given, then one (1) day suspension will occur. After the one day suspension, the parent must bring the child back

• If after five (5) days the child has shown no improvement and plans have been implemented, then the child will be given a ten (10) days termination notice.

Grounds for Dismissal We assist children and parents through many difficult circumstances. However, Children's Land Learning Center environment may not be the best choice to accommodate certain learning differences, developmental needs, or disabilities, or serious and disruptive behavioral disorders. The Children's Land Administration may terminate a child’s enrollment if it is determined that the program does not serve the child’s or the family’s needs, or if the child or the family do not fit into our program/environment. I have read and agree to the Dismissal Policy agreement. Parent’s Name ______________________________________________________ Child’s name ________________________________________________________ Parent’s Signature: ___________________________ Date __________________