For Child Care Providers
Sample Policies and Procedures for Child Care Centers or Homes
Sample Policy: Asthma
English (pdf) (MS Word)
Spanish (pdf) (MS Word)
Source: Caring for Our Children.
Sample Policy: SIDS Policy for Child Care Centers
English (pdf)
Spanish (pdf)
Source: American Academy of Pediatrics.
Sample Policy: Toothbrushing
English (pdf) (MS Word)
Spanish (pdf) (MS Word)
Source: Caring for Our Children.
Sample Policy: Using, Storing, and Replacing Toothbrushes
English (pdf) (MS Word)
Spanish (pdf) (MS Word)
Source: Caring for Our Children.
Sample Form: Toothbrushing Permission Slip
English (pdf) (MS Word)
Spanish (pdf) (MS Word)
Source: Sonoma County Department of Health Services.
California Health and Safety Forms
Designed to assist child care providers with a variety of health and safety issues.
Source: California Department of Social Services.
California School Immunization Record
Downloadable version of the blue school immunizations form.
Some documents on this Web Site are saved in Adobe Acrobat format. If you do not own a copy of Acrobat Reader, you may download it for free.
For more information, please contact:
Maternal, Child, Adolescent Health
625 5th Street
Santa Rosa, CA 95404
Phone: 707-565-4552
Toll Free: 800-427-8982