M 05
Rev.09/15
WICAP HEAD START
TEACHER/ MONITOR MONITORING RECORD
Prenatal – 5 Years
Date:
Teacher/ Monitor Name:
Center:
Vehicle #:
Yes No
Teacher-Monitor accompanied children to bus.
Teacher-Monitor greeted all children by their name.
Teacher-Monitor counted all children prior to route starting.
Teacher-Monitor checked all children to see if they are seated in child restraint system
prior to route starting
Teacher-Monitor interacted positively with children while on route.
Teacher-Monitor had structured activities planned for the children.
Teacher-Monitor if needed, assisted children from the bus to the door of their home or prearranged drop off.
Teacher-Monitor will be in possession of a cellular telephone while on route.
Teacher-Monitor knew where the Emergency Consent Forms were.
Teacher-Monitor actively participated in drills (if one was scheduled).
Follow-up:
.
Observer Signature
Date
CSC Signature
Date
Routing: Children Services Coordinator
M 05
Rev.09/15
CSC Follow-up:
CSC
Date
Teacher Monitor
Date
Comments:
Routing: Children Services Coordinator