Preschool Developmental Checklist Form
Complete this checklist to record a child’s details and assess development in key preschool areas.
Child’s Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Class/Group
*
Please Select
Nursery
Pre-K
Kindergarten
Other
Language & Communication Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Follows simple directions
1
2
3
Speaks in sentences
4
5
6
Names common objects
7
8
9
Gross Motor Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Runs smoothly
10
11
12
Jumps with both feet
13
14
15
Climbs stairs
16
17
18
Fine Motor Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Draws simple shapes
19
20
21
Uses scissors
22
23
24
Builds with blocks
25
26
27
Social-Emotional Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Plays with peers
28
29
30
Shares and takes turns
31
32
33
Expresses emotions appropriately
34
35
36
Cognitive Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Identifies colors and shapes
37
38
39
Counts to 10
40
41
42
Sorts objects by category
43
44
45
Self-Care Skills
*
Rows
Not Yet
Emerging
Age-Appropriate
Uses restroom independently
46
47
48
Washes hands
49
50
51
Puts on coat/shoes
52
53
54
Attention & Task Completion
*
Rows
Not Yet
Emerging
Age-Appropriate
Listens to stories
55
56
57
Completes simple tasks
58
59
60
Follows routines
61
62
63
Additional Comments
Submit Checklist
Should be Empty: