Daily Routine and Leisure Time Activities
Date: ___________________________
Foster Family: ______________________
SUN
MON
TUE
WED
THU
FRI
SAT
Awake
Breakfast
Room Clean-up
Bath/Shower/Dress
Off to School/Day Care/Pre-school
School (results)
Home from School/Day Care/Pre-school
Leisure Time (Therapeutic Recreation Log)
Homework
Chores (list)
Job
Lunch
Dinner
Family Activities (list)
Bedtime
Other (list)
Please return this form to Kids First, Inc. by the 30th day of a child’s placement. We also need an updated routine
at the beginning of the school year (Sept. 1), and at the beginning of the summer (June 1).
SAMPLE TASKS:
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ARISE
HYGIENE
ROOM CLEAN-UP
BREAKFAST
SCHOOL BUS
SCHOOL
ARRIVE HOME
SNACKS/FREE TIME
HOMEWORK
CHORES
SUPPER
CHORES
RECREATION
FAMILY TIME (DEVOTIONS, MEETING, TV, BOARD GAMES, ETC.)
SHOWERS
LIGHTS OUT
Please return this form to Kids First, Inc. by the 30th day of a child’s placement. We also need an updated routine
at the beginning of the school year (Sept. 1), and at the beginning of the summer (June 1).