Early Childhood Program Readiness Assessment Form
Use this Early Childhood Program Readiness Assessment Form to evaluate a child's preparedness for participation in an early childhood program.
Child's Full Name
*
First Name
Last Name
Child's Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Has the child attended a group program before?
*
Yes
No
Please rate the child's readiness in the following areas:
*
Rows
Not Yet
Emerging
Consistent
Separates easily from caregiver
1
2
3
Follows simple instructions
4
5
6
Participates in group activities
7
8
9
Expresses needs verbally
10
11
12
Engages in play with peers
13
14
15
How would you rate the child's ability to communicate with adults?
*
1
2
3
4
5
How would you rate the child's self-care skills (e.g., hand washing, eating independently)?
*
1
2
3
4
5
Does the child follow daily routines with minimal assistance?
*
Always
Sometimes
Rarely
Please rate the child's attention span during group activities.
*
1
2
3
4
5
Do you have any additional comments about the child's readiness?
Submit Assessment
Should be Empty: