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Sleep Recording Agreement

Client Details

First Name*
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Please enter first name.
Last Name*
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Please enter last name.
Client Email*
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Please enter email.

Educator Details

First Name*
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Please enter first name.
Last Name*
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Please enter last name.
Educator Email*
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SLEEP RECORDING AGREEMENT

Families must collaborate with the Educator and submit this Sleep Recording Agreement (for each child under 12months of age) relevant to the individual child, in regard to age, development stages, needs, and cultural practices (if any). Detailing method of recording and regularity of Physical Checks. Copies of this Agreement will be emailed to the Family, the Educator and filed at the Agency.
Red Nose Australia recognises regular physical checks be implemented and documented for children during sleep and rest times and is intended for use when working with children 12 months and below. ‘Regularity’ is determined by the family and how records are documented is agreed upon between educator and family. Continuation of this practice beyond 12 months of age is encouraged by Red Nose Australia but not compulsory.

SAFE SLEEP INFORMATION

CREATE YOUR SLEEP RECORDING AGREEMENT

Will any of your children sleep or rest during a session of care?*
Field is required!
Field is required!
If you answered NO, please scroll to the bottom of the form and press submit. You do not need to complete this Sleep Plan Agreement
If you answered YES, please complete the below – using the ADD CHILD button to add as many sleeping children as required.

METHODS OF RECORDING PHYSICAL CHECKS

1. MANUAL RECORDING

Educator to manually record both NORMAL and ABNORMAL Physical Checks in the Policy and Record Keeping Booklet (downloadable from Carer and Client Portals, also posted to the family residence by the Service).

2. COMBINATION OF MANUAL AND DIGITAL RECORDING

Educator store photographic evidence of NORMAL Physical Checks on a smart device and record ABNORMAL Physical Checks in the Policy and Record Keeping Booklet (downloaded from Carer and Client Portals, also posted to the family residence by the Service).

3. DIGITALLY RECORD

Family to purchase Sleep App for Educator to use to record both NORMAL and ABNORMAL Physical Checks (e.g. Huckleberry.)
If the answer is YES to all of the above, then the check is NORMAL.
If the answer is NO to any of the above, then the check is ABNORMAL.

PLEASE COMPLETE FOR EACH CHILD BELOW

Child's Name*
Please enter name.
Please enter name.
Select method of recording Physical Checks*
Field is required!
Field is required!
Select regularity of Physical Checks during NORMAL patterns of sleep*
  • - select a option -
  • Every 10 Minutes
  • Every 15 Minutes
  • Every 20 Minutes
  • Every 30 Minutes
  • Every 45 Minutes
  • Hourly
  • Every 2 Hours
Field is required!
Field is required!
Select regularity of Physical Checks during ABNORMAL patterns of sleep*
  • - select a option -
  • Every 5 Minutes
  • Every 10 Minutes
  • Every 15 Minutes
  • Every 20 Minutes
  • Every 30 Minutes
  • Every 45 Minutes
  • Hourly
  • Every 2 Hours
Field is required!
Field is required!

The child's typical sleep and rest area usually:

- Has adequate ventilation, lighting and a stable temperature.
- Is free of bumpers, positioners, incline devices, pillows, toys, and soft toys.
- Is in good repair, free of hazards, and is age appropriate.
If NO, please describe*
Field is required!
Field is required!
Describe any family values, cultural considerations or individual needs of this child which do not align with best practice (as outlined by Red Nose Australia’s leading authority on Safe Sleep)*
Field is required!
Field is required!

ADD CHILD

By submitting this form you confirm that the above plan accurately reflects your agreed upon recording method for each child, along with any other special sleeping circumstances.

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