Request Interview

Please Note
The daycare is unable to accept subsidy
I offer an enriched program for children under 4 years old

Email
valeriesplayhouse@hotmail.com
Please note to set up an interview you need to fill out the form below

Request for interview form

* Indicates required field

Date (Month, Day, Year) *

Name of person filling out this form *

First

Last

Thank you for being interested in Valerie's Playhouse.

Parent/guardian #1 - Information

Name of Parent/Guardian #1 *

First

Last

Parent/Guardian #1 - Relationship to child *

Mother Father Grandparent Other

Parent/Guardian #1 - Email *

Parent/Guardian #1 - Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian #1 - Phone Number *

Parent/Guardian #1 - Place of Work *

Parent/Guardian #1 - Job Title *

Parent/Guardian #2

Name of Parent/Guardian #2 *

First

Last

Parent/Guardian #2 - Relationship to child *

Mother Father Grandparent Other

Parent/Guardian #2 - Email *

Parent/Guardian #2 - Address (if different from Parent/Guardian #1) *

Line 1

Line 2

City

State

Zip Code

Country

Parent/Guardian #2 - Phone Number *

Parent/Guardian #2 - Place of Work *

Parent/Guardian #2 - Job Title *

child's information

How many children do you need care for? *

1 Child 2 Children 3 Children

If you are looking for care for more then on child, you will need to fill out one form per child.
Sorry, for the inconvenience.

What are you inrquiring about? *

To set up an interview To go on the waiting list, but would like to interview now To go on the waiting list, but would like to interview when a spot becomes available

Name of child *

First

Last

Child's Date of Birth (Month/Day/Year) *

Child's age when care is needed *

Child's Gender *

Female Male Unknow at this time

A-1) Does your child walk? *

Yes No Just starting too Child isn't born yet

A-2) Does your child climb? *

Yes No Just starting too Child isn't born yet

A-3) Does your child cry, cough or gag until he/she vomits? *

Yes No CHild isn't born yet

A-4) Does your child have any speacial needs? If yes, what are they? *

A-5) Tell me about your child *

childcare information

B-1) When do you need care to start? *

B-2) When do you need care to end? (if known - Temporary Care)) *

B-3) Date Parent goes back to work? (Month/Day/Year) *

B-4) Would you like transition days? *

No, I don't want any transition days Yes, I would like one week of transition time Yes, I would like two weeks of transition time Yes, I would like some transition time, but I am unsure how long I am unsure if I want any transition time

B-5) What kind of year do you need? *

I need care all year I need care only during the school months (Sept to June) I only need care during the summer (July/August) I am looking for temporary care I am unsure

B-6) What type of hours do you need? *

B-7) Are you looking for Full-time or Part-time care? *

B-8) What time do you need care to start each day? *

Hours of Operation
Regular Full/Part-Time              Teacher hours
8:00 am to 4:00 pm                         8:00 am to 4:00 pm
8:00 am to 5:00 pm                         7:30 am to 5:00 pm
7:30 am to 5:00 pm

B-9) What time do you need care to end each day? *

B-10) What days do you need? (Check all that apply) *

Days of operation
September to June July and August
Monday to Friday Monday to Thursday

B-11) During the summer (July/August) the daycare only operates Monday to Thursday. Will it be a problem that the daycare will be closed on Fridays during the summer? *

No, I can figure something out for those Fridays No. I don't need care over ther summer No, I don't need care on Fridays Maybe. I am unsure if this will be a problem or not Yes, this is a problem. I will definity need care on Fridays during July/August

B-12) Will you need care to start before 7:30am? *

No, I don't need care to start before 7:30am Maybe, not sure at this time Yes, I will need care to start before 7:30am

B-13) Will you need care pasted 5:00pm? *

No, I don't need care past 5:00pm Maybe Yes, I will need care past 5:00pm

B-14) How long do you need care for? *

1 day (Drop-in care) 1 week of care (Temporary care) 2 to 4 weeks of care (Temporary care) 5 to 8 weeks of care (Temporary care) 9 weeks to 23 months (Temporary care) 2 years or more (Long-Term care) Unsure

B-16) What year will your child start kindergarten? *

B-17) Has your child ever attended a daycare? *

Yes No No, but has been left alone with family/friends/babysitter on occasion

B-18) If your child has attended a daycare in the past/present, why did you leave/planning on leaving? *

B-19) If your child has attended a daycare before, can I contact the daycare/provider? If yes, please providethe daycare's/providers name and contact information. *

B-20) Do you have back-up care? *

Yes No Maybe

B-22) Is there anything else I should know about your childcare needs? *

Covid-19 - Information

I am asking you to be honest in all your answers, especially the questions about covid-19. This is why I am being up front and honest with you. In this section you will see a few Full Disclosures. I answered the same questions in regards to my family and the daycare.

Full Disclosure -

My family
* My husband is a local security guard.
* My kids - are school aged. However until further notice they will be doing online home schooling.
* Myself - as a home daycare provider I am classified as an essential worker.
* We all follow safety protocols when out. We don't travel outside of the province.

Daycare Precautions
The precautions I will be taking with the daycare.
* Limiting toys
* Not going to play groups until further notice
* Outside time will consist of going for walks around the neighbourhood and in the backyard play area.
* Updated sick policies
* Drop offs and pick ups will be done at the door.
* I will be following Public Health policies whenever possible.

Is anyone in the household a Frontline or Essential Worker? *

Yes, at least one memeber is a frontline worker, in direct contact with people infected with covid-19 Yes, at least one memeber is a Frontline worker, with NO direct contact with people infected with covid-19 Yes, at least one member is an Essentail worker Yes, there is a Frontline worker and an Essentail worker No one is a Frontline worker or an Essentail Worker Unsure

What Precautions are you taking to help ensure no one in your home gets covid-19? *

What do you expect/like to see in regards to covid-19 within your child's daycare? *

Due to the size of the daycare and the ages of the children in care, there will be no social distancing. Are you okay with this *

Yes, I am okay with it No, I want my child to social daycare I am unsure what my feels are on this

Hugging, high-fiving, cuddling etc. will still be happening within the daycare. Are you okay with this? *

Yes, I am okay with this No, I don't want my child touching anyone I am unsure of my feelings on this

The City of Ottawa "Manitory" mask ruling is NOT manitory for to private home daycares. Are you okay with no one in the daycare/home wearing a mask/face covering during daycare hours? Note: All adults coming for an interview need to wear some kind of face coving. *

Yes, I am oaky with masks not being wear No, I expect the provider and her family to wear a mask during daycare hours I am unsure what my feels are on this

If your child has covid-19 symtopms will you get them tested or keep them home for the isolation period? *

Yes, our child will get tested No, our child will not be tested, our child will isolate. I am not sure what we will do at this time

Will you be willing to provide a copy of any of your child's Covid-19 test results (if one is required) for their daycare file? *

Yes, if my child requires a test, we will provide a copy of the results No, if your child requires a test, we will not provide a copy of the test results

Food

C-2) Is your child on a special diet? If yes, what is it? *

C-3) Can your child hold a bottle/sippy cup without help? *

Yes No We are working on it Child isn't born yet

naps

D-1) Does your child nap? *

Yes No Sometimes Child isn't born yet

D-2) What times does your child nap? *

D-3) How long does your child nap for? *

D-4) How does your child fall alseep? *

On his/her own Needs to be rocked/held Needs someone to lie down with him/her Child isn't born yet

Health

E-1) Does your child get immunized? Please note that this daycare only accepts children who are immunized. It is 100% legal for a private home daycare to refuse care to a child who isn't immunized. *

Yes, my child is immunized and is upto date with all immunizations Yes, my child is immunized, but on a delyed schedule No, my child doesn't get immunzied

E-2) Are you okay with providing a copy of your child's immunization records if you enrol in care? *

Yes No Unsure

E-3) Are you okay with providing a copy of your child's health card if you enrol in care? *

Yes No Unsure

E-4) I am okay with not using Baby Powder or items that contain Baby Powder, such as Pampers (The provider is highly allergic) *

Yes, Its not a problem. We will not use baby powder or products containing it No, its going to be a problem. We will be using baby powder and/or products containing it I am unsure if this will be a problem or not

E-5) Does your child have any known allergies? If yes, what are they? *

E-6) Dose your child use an Epi-Pen or other Epi-Pen type of device? If yes, why? (food, bees etc.) *

Animals

F-1) Do you have any pets at home? If yes, what? *

F-2) Does your child have any known allergies to animals? If yes, to what animal(s)? *

F-3) How is your child around animals? *

F-4) There is a cat in the house/daycare. Are you okay with this? *

Yes No Unsure

Parenting

G-1) What is your parenting style? *

G-2) Do you discipline your child? *

Yes No My child is too young

G-3) How do you discipline your child? (or how do you plan on disciplining your child) *

G-4) Do you use the word "NO" around your child? *

Yes No, and I don't want the word used around my child

G-5) Does your child have any siblings? *

Yes No Not yet, but one is on the way Not yet, but we are trying

If yes, to question G-5) what are there names and ages/ when are they due? *

G-6) Are you planning on having any more children? *

G-7) Are there any custody arrangements I should be aware of? *

Yes No Maybe

G-8) What are your expectations for childcare? *

diapers/toilet training

H-1) What does your child wear? *

H-2) Are you okay with not using Pampers diapers/pull-ups as tehy contain baby powder? *

We don't use Pampers Yes, we will not send our child in Pampers and will send another brand to be used No, we are not okay with this. We only use pampers and expect the daycare to use them as well

H-3) The daycare does not use cloth diapers. Are you okay with this? *

Yes, I am okay with this we don't use cloth diapers Our child doesn't wear diapers Yes, I am okay with this. We use cloth diapers at home, but will send disposable ones to daycare No, I am not okay with this. We only use cloth diapers and expect the daycare to also use them

H-4) Is your child toilet trained? *

No. Haven't even thought about it yet. Not yet. Going to start soon Parent Trained = NOT potty trained. The child must be told or taken to the bathroom on a regular basis. Semi Potty Trained = child takes him/herself to the bathroom or tells someone they have to go. Has occasional accidents while awake. Fully Daytime Trained = child takes him/herself to the bathroom and has no accidents while awake. Fully Daytime Trained + nap/night time trained = child takes him/herself to the bathroom. wakes up and goes to the bathroom. has no accidents during the day or night.

H-5) If your child is toilet trained when was their last accident? *

H-6) When toilet training or still having accidents, are you okay with your child wearing pull-ups? *

Yes No, I don't want my child in pull-ups at daycare Unsure

H-7) Are you willing to follow the daycares toilet training policy? (once its time to potty train) *

Yes No Maybe My child is already fully trained (no accidents in over a month)

You are almost done

fees/business information

I-1) Do you need subsidy? *

Yes, I have subsidy already Yes, I have applied for it an am waiting to hear back No, I will not be getting subsidy Unsure

I-2) The daycare charges a non-refundable enrolment fee at the time the contract is signed. Are you willing to pay this if you decide to enrol? *

Yes, I will pay it No, I will not pay it I don't understand what this is. Can you explain during the interview?

I-3) Before your child can start care, you must sign the daycare contracts. Are you okay with doing this if you enrol? *

Yes, once I have read them, and if I agree to the terms, I am willing to sign the daycare contracts No. I don;t want to sign any contracts if my child attends the daycare Unsure

I-4) The daycare's tuition payments are dure in advance of care. Are youokay with this? *

Yes, I am okay with this No, I don't want to pay before care. I will only pay after care has been provideed I don't understand. Can you explain during the interview?

I-5) Full-Time tuition payments do not vary for any reason. This means Full-Time clients pay the same amount very two weeks no matter what. Are you okay with this? *

I need part-time care, so this doesn't apply to me Yes, I understand and am okay with this No, I am not okay with this I don't understand. Can you explain during the interview?

I-6) Part-Time tuition payments only vary if extra daycare are added. This means Part-Time clients tuition payments can increase when days are added, but never decrease from the orginal contracted amount. Are you okay with this? *

I need Full-Time care, so this doesn't apply to me Yes, I understand and am okay with this No, I am not okay with this I don't understand. Can you explain during the interview?

I-7) The tuition payments are to be paid bi-weekly on the daycare's payment schedule. Are you okay with this? *

Yes, I will follow the daycare's bi-weekly payment schedule No, I want to pay monthly No, I want to pay on my own schedule I don't understand. Can you explain during the interview?

I-8) All fees are to be paid via E.M.T.'s (Electric Money Transfer). Are you okay with this? *

Yes, I have no problem paying through E.M.T.'s No I don;t want to use E.M.T.'s I will pay another way I don't know what an E.M.T. is. Can you explain during the interview?

I-9) The daycare uses a secret facebook group as its main way to communitcate throughout the day. Do you have a facebook account? *

Yes, I have a facebook account No, I don't have facebook, but will look into setting up an account No I don't have facebook. Please communicate via email, texts, face to face etc.

I-10) When at daycare your child needs to follow the daycare schedule. Are you okay with this? *

Yes, I am okay with my child following the daycare schedule when at daycare No, I want the daycare to use our schedule Unsure

I-11) Valerie's Playhouse offers a play-based program, that focuses on social skills. Are you okay with this? *

Yes, this is what I am looking for I am okay with it, but this isn't really want I am looking for I am not okay with this. I expect more structure I am not sure what I want for my child's daycare

I-12) Valerie's Playhouse is NOT a licensed daycare. Are you okay with this? *

Yes, I am okay with the daycare not bein g licensed No, I really want the daycare to be licensed I don't understand. Can you explain during the interview?

I-13) How did you hear about Valerie's Playhouse *

Now to set up the interview, then your all done.

Setting up the interview

Interviews are done Monday to Friday at 5:30pm.
I do NOT do interviews during daycare hours or on weekends.

All interviews are done at the daycare.
The only time I will do a video interview is if you are currently not in Ottawa or surrounding area or someone in the household has symptoms.

During the in daycare Interview:

   * All adults must wear either a mask or face shield. You are responsible for bringing your own.
   * Your child who needs care must attend.
* If you have other children, they can attend the interview if need be.
* You are responsible for your child during the interview.
   * The daycare toys will be off-limits, as I will not have time to clean them before you arrive.
   * Please bring a few small toys for your child to play with during the interview.
   * The house bathrooms are off-limits during the interview. There is a potty in the daycare if your child needs to
use it.

During Video interviews:

* Your child that needs care must be present (on video)
* Will be done through either Facebook video messaging or Google Meet.
With Google meet, I will send you the link once I have set it up.

What days can you come for an interview? (check at least 3 days) *

If you choose "Other" please give exact dates here. *

Interviews can be done two ways.
- One interview in person. The child needing care needs to attend.
- Two interviews. The first done via video chat. The 2nd done in person. The child needing care needs to attend the in person interview.

How would you like to do the interview? *

One interview - In person at the daycare Two interviews 1st via Google Meet (video meeting), 2nd in person at the daycare Two interviews 1st via Facebook video messager, 2nd in person at the daycare

If you would like to do the Facebook video chat please send me a Facebook friend request: Valerie MC
If you would like to do a Google Meeting I will send you the link once I have created it.

If for some reason only one parent/guardian can make the interview that is Okay.
If the parent/guardian that does attend the interview likes me and my program another interview/meeting
can be set up for the parent/guardian who was unable to attend the first interview

very important note

Once you have hit "submit" the page WILL change and you will get the following message:

Thank you for filling out my request for interview form. I will be emailing you your interview date soon.
Please check your email junk/spam folder for an email from: valeriesplayhouse@hotmail.com

If you didn't get the above message it means you missed a required question. Please go back and fill out any of the questions with a "*" that were missed. They will have a red box around them.
Thank you.

I will NOT set up an interview until I get this form.

Submit

Request for interview form

Parent/guardian #1 - Information

Parent/Guardian #2

child's information

childcare information

Covid-19 - Information

Food

naps

Health

Animals

Parenting

diapers/toilet training

fees/business information

Setting up the interview

very important note

I Would Love to Have You Visit Soon!

Regular Hours

Teacher Hours

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