Annual Child-Record Update Checklist

Version 2026.1 · Effective August 23, 2026

Child

• Child’s full name: ______________________________________________
• Date of birth: ____________________
• Review year: ____________________

Parent and emergency information

• [ ] Parent/guardian names and contact information reviewed
• [ ] Emergency contacts reviewed
• [ ] Authorized pickup list reviewed
• [ ] Custody or court-order information reviewed, if applicable
• [ ] Home address and email information reviewed

Health information

• [ ] Healthcare provider and hospital information reviewed
• [ ] Allergies and medical conditions reviewed
• [ ] Medications and topical products reviewed
• [ ] Individual health plans reviewed or renewed, if applicable
• [ ] Dietary restrictions and meal instructions reviewed
• [ ] Immunization or exemption documentation reviewed
• [ ] Emergency medical authorization reviewed or renewed

Conditional authorizations

• [ ] Safe-sleep acknowledgment reviewed, if applicable
• [ ] Alternate sleep-position authorization reviewed, if applicable
• [ ] Swaddling authorization reviewed, if applicable
• [ ] Transportation and field-trip authorization reviewed, if applicable
• [ ] Medication/topical-care authorization reviewed, if applicable

Parent confirmation

☐ No information has changed.

☐ The attached forms document changes.

Changes or notes: __________________________________________________

__________________________________________________________________

• Parent/guardian signature: ______________________________________
• Date: ____________________

Provider completion

• [ ] Updated forms received and filed securely
• [ ] Outdated forms removed from active use
• [ ] Required signatures and dates checked
• [ ] Follow-up items documented
• [ ] Provider initials: ____________________
• [ ] Completion date: ____________________