This is an example of the type of progress report that licensees and educators may use to document the progress of each child.
Use of this form is not required. Educators may use this sample as is, adapt it to their program, or design a form that satisfies the
same requirements.
Name of Child: ____________________________________
Age of Child: _______________
Full or Part Time Care: ______________________
The following best describes ________________________:
(name of child)
Likes to do this favorite activity: ____________________________________________
Shows independence by: _________________________________________________
Staff appreciates this special quality: ________________________________________
Peers appreciate this special quality: ________________________________________
Shows leadership ability in this area: ________________________________________
Is working hard to improve on this: _________________________________________
GOAL FOR NEXT YEAR:
________________________ has requested to learn or improve the following skill:
(name of child)
______________________________________________________________________
______________________________________________________________________
The staff will help in the following way: _______________________________________
______________________________________________________________________
______________________________________________________________________
Signature of Staff: _______________________________________________________
Date of Report: ______________________________