Templates Health & Wellness Pediatric Medical Day Care Inspection Form Template

Pediatric Medical Day Care Inspection Form Template

Use This Template
Please enable JavaScript in your browser to complete this form.

Facility Information

Administrator Information

Name

Physical Environment

Cleanliness
Safety Equipment
Emergency Evacuation Plan

Care Areas

Infant Care Area
Toddler Care Area
Activity Zones (Toys, Games)

Medical Facilities

Medical Equipment
Medication Storage
Patient Records Accessibility
Special Needs Accommodations

Staff Information

Medical Training

Nutritional Care

Meal Plans
Allergy Considerations

Inspection Conducted By

Full Name

The Pediatric Medical Day Care Inspection Form Template helps assess and ensure the highest standards of care in pediatric medical day centers.

How Does the Pediatric Medical Day Care Inspection Form Template?

The Pediatric Medical Day Care Inspection Form Template is a comprehensive tool designed to thoroughly assess the quality and safety standards of pediatric medical day centers. Fields include:

  • Facility Information: This section captures core details about the center, such as the Facility Name and Address. The License Number provides insight into its official recognition, while the Date of Inspection ensures a timely review.
  • Administrator Information: Here, vital details of the center’s primary contact are collected. This includes the Administrator’s Name, Contact Number, and Email Address, simplifying communication lines.
  • Physical Environment: This section focuses on the safety and hygiene parameters. The availability of Safety Equipment, like fire extinguishers and first aid kits, and an Emergency Evacuation Plan help gauge readiness during crises.
  • Care Areas: It’s crucial to know the different areas within the center. This segment evaluates zones for different age groups, such as the Infant Care Area and Toddler Care Area. The Activity Zones are also assessed.
  • Medical Facilities: This section assesses the quality of Medical Equipment, how Medications are stored, the accessibility of Patient Records, and the provisions for children with Special Needs.
  • Staff Information: The well-being of children often hinges on the staff’s capability. It’s essential to know the Number of Staff Present and the Staff-to-Child Ratio. Further, the medical training of the staff provides clarity on their expertise.
  • Nutritional Care: Nutrition plays an essential role in children’s health. Here, the center’s Meal Plans are reviewed, along with strategies in place for Allergy Considerations.
  • Inspection Conducted By: This section provides the details of the person performing the inspection, including their Name, Phone, Email, and an area for General Remarks about their evaluation.

Sign up with WPForms today and access the Pediatric Medical Day Care Inspection Form Template to ensure that every child experiences a safe, nurturing, and medically sound environment.