Early Childhood Observation Checklist Form
Document key observations and developmental indicators during an early childhood classroom visit.
Child's Full Name
*
First Name
Last Name
Observation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Observer's Name
*
First Name
Last Name
Classroom or Setting Observed
*
Age Group of Child
*
Please Select
Infant (0-12 months)
Toddler (1-3 years)
Preschool (3-5 years)
Kindergarten (5-6 years)
Social-Emotional Development
*
Rows
Not Observed
Emerging
Developing
Consistently Demonstrated
Interacts positively with peers
1
2
3
4
Manages emotions appropriately
5
6
7
8
Shows empathy
9
10
11
12
Language and Communication Skills
*
1
2
3
4
5
Cognitive/Problem-Solving Abilities
*
1
2
3
4
5
Physical/Motor Skills Checklist
Walks steadily
Uses hands for fine tasks
Participates in active play
Other
Additional Comments or Observations
Submit Observation
Should be Empty: