nanny / family work agreement - tammy gold nanny agency · nanny weekly compensation of $ ___ ,...
TRANSCRIPT
Family information Nanny information
Name:
Address:
Phone:
E-mail:
Agreed work days & hours Days: From: Until:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Important dates
Nanny’s Start Date of Employment
Nanny’s Annual Employment Anniversary Date
Date Family Will Complete Nanny Handbook By
Date Family Will Review Nanny Handbook with Nanny
Weekly salary Nanny weekly compensation of $ ___ , based on a __ hour work week.
Overtime is paid on hours in excess of ___ per week and is compensated at $ ___ per hour.
Weekend pay is paid on hours in excess of those listed above and is compensated at $ __ per hour.
Travel pay If family takes the nanny on vacation on a weekday, the added compensation for the extra hours worked
monday – friday will be $______ per hour or a flat fee of $____ per day. If the family takes the nanny on
vacation on a weekend, the added compensation for the extra hours worked saturday – sunday will be
$______ per hour or a flat fee of $ _____ per day.
Other unique benefits/perks
Nanny / Family Work Agreement
Time Off Sick/Personal Days:
Sick Day Policy:
Personal Day Policy:
Vacation: Please Specify # of
weeks and who chooses
Vacation Policy:
Holidays:
Missed Days Policy:
Request to Leave Early Policy:
Snow Day Policy:
Commute/Transportation:
Confidentiality Rules:
Job Description
Daily Schedule
Child Child Child Child Parents /Home
6 AM
7 AM
8 AM
9 AM
10 AM
11 AM
12 PM
1 PM
2 PM
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
9 PM
Rules for Nanny Regarding Children and Home
Daily Tasks for Nanny
Weekly Tasks for Nanny
Monthly Tasks for Nanny
Nanny Requests – Filled in by Nanny
Parent Signature
Nanny Signature
Date
Date
Child’s Information Sheet
Child’s Name (First, Middle, Last)
Nickname Age
Date of Birth SSN
Height: Weight:
Blood Type:
Medical Conditions:
Recent Surgeries:
Allergies:
Medications and dosage information
Medication:
Dosage Amount:
Time to Administer:
Notes:
Medications and dosage information
Medication:
Dosage Amount:
Time to Administer:
Notes:
Medications and dosage information
Medication:
Dosage Amount:
Time to Administer:
Notes:
Child’s Medical Information
Insurance information
Insurance Provider:
Insurance ID Number:
Group Number:
Insurance Phone:
Policy Holder Name:
Policy Holder Employer:
Insurance Address:
Doctor information
Doctor’s Name:
Address:
Phone:
Working Days/Hours:
Notes:
Hospital information
Preferred Hospital:
Address:
Phone:
Notes:
Dentist information
Dentist’s Name:
Address:
Phone:
Working Days/Hours:
Notes:
Personality Profile
What activities does this child like to do?
What toys does this child like to play with?
How can the nanny best engage this child? What can the nanny say or do to encourage interaction with this child?
Are there certain things this nanny should not do or say to this child?
What is this child’s bedtime or naptime ritual? What steps should the nanny follow when putting this child to bed?
What are the main pieces of this child’s daily schedule?
What are the main pieces of this child’s weekly schedule?
Child’s rules & discipline CHORES for this child are:
The best way to RESOLVE conflict for this child is:
(For example: Give two clear choices or give a time out to cool off)
POSITIVE reinforcements to encourage child to do what is asked of her/him
(For example: 30 minutes TV time, 30 minutes computer, extra dessert, extra book at bedtime)
NEGATIVE reinforcements when child does not do what asked of her/him
(For example: Take away TV, take away dessert, no books at bedtime)
TIME OUTS are to be used for:
(For example: Hitting siblings, bad language)
Nanny MAY CALL parents if the child does:
(For example: Please call mother if the child will not calm down)
School / Activities / Playdates
School information
School: Tel#:
Address: Fax#:
Teacher: Website:
Principal: Nurse:
Drop-off Pick-Up
Bus #: Bus Driver:
Activities Information
Activity:
Program:
Days:
Start Time: End Time:
Address:
Tel #: Contact:
Start Date: End Date:
What to Pack:
Car pool for this activity
To:
From:
Activities information, cont.
Activity:
Program:
Days:
Start Time: End Time:
Address:
Tel #: Contact:
Start Date: End Date:
What to Pack:
Car pool for this activity
To:
From:
Activity:
Program:
Days:
Start Time: End Time:
Address:
Tel #: Contact:
Start Date: End Date:
What to Pack:
Car pool for this activity
To:
From:
Activities information, cont.
Activity:
Program:
Days:
Start Time: End Time:
Address:
Tel #: Contact:
Start Date: End Date:
What to Pack:
Car pool for this activity
To:
From:
Activity:
Program:
Days:
Start Time: End Time:
Address:
Tel #: Contact:
Start Date: End Date:
What to Pack:
Car pool for this activity
To:
From:
Play Dates
Child’s Name: Telephone:
Parent’s Names:
Address:
Directions:
Notes:
Child’s Name: Telephone:
Parent’s Names:
Address:
Directions:
Notes:
Child’s Name: Telephone:
Parent’s Names:
Address:
Directions:
Notes:
Child’s Name: Telephone:
Parent’s Names:
Address:
Directions:
Notes:
Child’s Name: Telephone:
Parent’s Names:
Address:
Directions:
Notes:
Free Activities / Play Areas (These are areas where the child is allowed to go during free play time)
Activity Name:
Address:
Telephone: Hours:
Notes:
Activity Name:
Address:
Telephone: Hours:
Notes:
Activity Name:
Address:
Telephone: Hours:
Notes:
Activity Name:
Address:
Telephone: Hours:
Notes:
Activity Name:
Address:
Telephone: Hours:
Notes:
Parents’ Information
Parents’ Names:
Street Address:
Cross Streets:
City, State, Zip:
Mailing Address:
City, State, Zip:
Home Telephone:
Parent 1 Contact Details
Name:
Cell Phone:
Email:
Employer Name:
Employer Address:
Employer Phone:
Employer Fax:
Assistant:
Parent 2 Contact Details
Name:
Cell Phone:
Email:
Employer Name:
Employer Address:
Employer Phone:
Employer Fax:
Assistant:
Emergency Contacts
Family/Friend 1 Contact Details
Name:
Cell Phone:
Home Phone:
Email:
Address:
Employer Name:
Employer Phone:
Family/Friend 2 Contact Details
Name:
Cell Phone:
Home Phone:
Email:
Address:
Employer Name:
Employer Phone:
Family/Friend 3 Contact Details
Name:
Cell Phone:
Home Phone:
Email:
Address:
Employer Name:
Employer Phone:
Household Information
Security Information & Contact Details
Security Keypad Number:
Alarm Password:
Garage Door Password:
Security Company Name:
Security Company Phone:
Emergency Extra Keys are Located:
Utilities Location
Fuse Box Location:
Water Cut Off Valve Location:
Thermostat Locations:
Utility providers Account Number & Contact Details
Cable Provider:
Home Phone Provider:
Internet Provider:
Gas Provider:
Electricity Provider:
Water Provider:
Trash/Recycling Service:
Household Information
Household services Information & contact details
House cleaning:
Heating/ac repair:
Handyman:
Appliance repair:
Electrician:
Plumber:
Landscape:
Misc. Services Information & contact details
Audio/video repair:
Carpet cleaning:
Computer repair:
Contractor:
Driveway repair:
Fireplace maintenance:
Gutters:
Pest control:
Pool care:
Community services Information & contact details
Animal control:
Library:
Parks & recreation:
Place of worship:
Post office:
Town hall:
Household Information
Care & retail Information & contact details
Bakery:
Barber/salon:
Deli:
Drug store:
Dry cleaners:
Florist:
Grocery stores:
Hardware stores:
Office supplies:
Shipping center:
Veterinarian:
Other:
Other:
Other:
Other:
Child Care/General Rules for Nanny
Rules for child care in home
Rules for child care out of home
General house rules
General rules out of the home
Travel and Transportation Information
By Vehicle
Who is Allowed to Use the Vehicle
Days & Times Allowed to Use How Far Allowed to Go
Vehicle Insurance Provider:
Insurance Agent: Agent Phone:
Policy Holder’s Name: Policy Number:
Gas to be paid by:
Snacks to be paid by:
Vehicle Rules: (Examples: must use booster seat, visitors, food and drinks allowed)
By Subway / Bus
Who is Allowed to Use It Days & Times Allowed to Use How Far Allowed to Go
Lines allowed to use:
Fairs to be paid by:
Snacks to be paid by:
General rules: (Example: must sit by exit)
Travel and Transportation Information
By Cab / Taxi
Who is Allowed to Use It Days & Times Allowed to Use How Far Allowed to Go
Where allowed to go in cab/taxi:
Fairs to be paid by:
Snacks to be paid by:
General rules: (Examples: must use seatbelt, must bring car seat)
By Foot / Stroller
Who is Allowed Days & Times Allowed to Use How Far Allowed to Go
Snacks to be paid by:
General rules: (Examples: must bring diaper bag, must apply sunscreen if necessary, must bring water)
Purchasing Information Item to Buy:
Who is to Purchase:
Where to Purchase:
Amount to Spend:
Where Purchase is To Go:
Additional Notes:
Item to Buy:
Who is to Purchase:
Where to Purchase:
Amount to Spend:
Where Purchase is To Go:
Additional Notes:
Item to Buy:
Who is to Purchase:
Where to Purchase:
Amount to Spend:
Where Purchase is To Go:
Additional Notes:
Item to Buy:
Who is to Purchase:
Where to Purchase:
Amount to Spend:
Where Purchase is To Go:
Additional Notes:
Items to be Maintained by Nanny Please indicate whether item to be replaced weekly or monthly
Groceries
House Supplies
Baby/Child Supplies
Meal Guidelines
Family Weekday Meal Times
Nanny Weekday Meal Times
Prep Time Start Time Prep Time Start Time
Breakfast: Breakfast:
Lunch: Lunch:
Snack: Snack:
Dinner: Dinner:
Family Weekend Meal Times
Nanny Weekend Meal Times
Prep Time Start Time Prep Time Start Time
Breakfast: Breakfast:
Lunch: Lunch:
Snack: Snack:
Dinner: Dinner:
Weekday Preparation Weekend Preparation
Who Preps:
Who Preps:
Set Up:
Set Up:
Clean Up:
Clean Up:
Food Shopping
Who Does It?
How Often?
Petty Cash Available?
Limit To Spend:
Notes:
Food & Meal Time Rules Allergies/Special Dietary Needs by Family Member:
Food Likes/Dislikes by Family Member:
Rules for Meal Time for Family:
Rules for Meal Time for Nanny:
Snacks, Food Rewards, and Eating Out
Acceptable Snacks In The Home
Acceptable Snacks Out Of The Home
Child Name:
Child Name:
Child Name:
Child Name:
Child Name:
Child Name:
Acceptable Reward Treats
Child Name:
Child Name:
Child Name:
Child Name:
Acceptable Places To Eat Out
Place Allowed to Order Not Allowed to Order
Weekly Menu Planner Week of ______________________
Nanny Served on MONDAY Meal Options Breakfast: Notes:
Lunch:
Snacks:
Dinner:
Nanny Served on TUESDAY Breakfast Options Breakfast:
Lunch:
Snacks:
Dinner:
Nanny Served on WEDNESDAY Lunch Options Breakfast:
Lunch:
Snacks:
Dinner:
Nanny Served on THURSDAY Snack Options Breakfast:
Lunch:
Snacks:
Dinner:
Nanny Served on FRIDAY Dinner Options Breakfast:
Lunch:
Snacks:
Dinner:
Nanny Served on SATURDAY Dessert Options Breakfast:
Lunch:
Snacks:
Dinner:
Nanny Served on SUNDAY Special Instructions for Week Breakfast:
Lunch:
Snacks:
Dinner:
Daily Parent/Nanny Communication Log
For Date: ___________________ Child’s name: Child’s name: Child’s name:
Parent directions Nanny Notes Parents directions Nanny Notes parents directions
Nanny Notes
Am
Am
Am
School
School School
Activities
Activities
Activities
Meals
Meals
Meals
Pm
Pm
Pm
Notes
Notes Notes
Household notes
Cleaning Events Food
Baby Schedule Daily Log Baby’s Name: ____________ For Date:________________
Sleep Feeding Diapers Comments Awake Asleep RB LB Bottle Wet Dirty Meds (New food, play
time, crying spells, etc.) AM 6:_____ 6:______ 6:______ 6:_______ 6:____ _ 6:______ Dose________
Mins_____ Mins____ Ozs____ Med Name: _____________
AM 7:______ 7:______ 7:______ 7:_______ 7:______ 7:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
AM 8:______ 8:______ 8:______ 8:_______ 8:______ 8:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
AM 9:______ 9:______ 9:______ 9:_______ 9:______ 9:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
AM 10:______ 10:______ 10:______ 10:_______ 10:_____ 10:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
AM 11:______ 11:______ 11:______ 11:_______ 11:_____ 11:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 12:______ 12:______ 12:______ 12:_______ 12:_____ 12:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
PM 1:______ 1:______ 1:______ 1:_______ 1:______ 1:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 2:______ 2:______ 2:______ 2:_______ 2:______ 2:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
PM 3:______ 3:______ 3:______ 3:_______ 3:______ 3:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 4:______ 4:______ 4:______ 4:_______ 4:______ 4:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
PM 5:______ 5:______ 5:______ 5:_______ 5:______ 5:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 6:______ 6:______ 6:______ 6:_______ 6:____ _ 6:______ Dose________
Mins_____ Mins____ Ozs____ Med Name: _____________
PM 7:______ 7:______ 7:______ 7:_______ 7:______ 7:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 8:______ 8:______ 8:______ 8:_______ 8:______ 8:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
PM 9:______ 9:______ 9:______ 9:_______ 9:______ 9:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
PM 10:______ 10:______ 10:______ 10:_______ 10:_____ 10:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
PM 11:______ 11:______ 11:______ 11:_______ 11:_____ 11:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
AM 12:______ 12:______ 12:______ 12:_______ 12:_____ 12:______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
AM 1:______ 1:______ 1:______ 1:_______ 1:______ 1:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
AM 2:______ 2:______ 2:______ 2:_______ 2:______ 2:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
AM 3:______ 3:______ 3:______ 3:_______ 3:______ 3:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
AM 4:______ 4:______ 4:______ 4:_______ 4:______ 4:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:____________
AM 5:______ 5:______ 5:______ 5:_______ 5:______ 5:_______ Dose_________
Mins_____ Mins____ Ozs____ Med Name:_____________
____Hrs ____Hrs ______Ozs
____ Mins ____ Mins
Week of:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Child:________ *School *Activities *Carpool
Child:________ *School *Activities *Carpool
Child:________ *School *Activities *Carpool
Parent:_______ *Meetings *Plans *Appointments
Parent:_______ *Meetings *Plans *Appointments
House: *Dinner *Cleaning *Errands *Appointments
Monthly Calendar
Month of: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Notes
Notes: