Washington County Forms

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Parent Evaluation (Child Care Licensing)

  1. Washington County is required to solicit evaluations from parents before relicensing family child care providers. Information provided will be part of the agency's assessment and maintained in the provider's file. If you provide information that indicates possible licensing violations, we are required to conduct an investigation. We hope you will take the opportunity to complete this form which will provide us with input regarding your child(ren)'s child care provider and environment.

  2. License Capacity
    • A:  10 total children of which 6 may be under school age; no more than 3 under age 2.
    • C1:  10 total children of which 8 may be under school age; no more than 3 under age 2.
    • C2: 12 total children of which 10 may be under school age; no more than 2 under age 2.
    • C3:  (2 adults needed) 14 total children of which 10 may be under school age; no more than 4 under age 2.
      • *OR must operate as a C1 or C2 if only 1 adult present
  3. Do you currently have a child(ren) enrolled in this home?*
  4. Please rate the provider:

  5. Provides an adequate supply of age-appropriate materials and activities.*
  6. Provides nutritious meals and snacks.*
  7. Provider changes diapers as frequently as needed.*
  8. I am satisfied with communication with the provider.*
  9. The provider is able to adequately care for the number and age distribution of children in his/her care.*
  10. Provider guides behavior in a constructive, age-appropriate manner.*
  11. The provider's home is clean and safe for children.*
  12. The children are taken outdoors on a daily basis, weather premitting.*
  13. Provider adequately supervises children inside and outside.*
  14. The outdoor play area is safe and free from hazards.*
  15. Have you been provided with a copy of your provider's policies including grievance and chemical use?*
  16. Do you authorize the release of this information to the provider?*

    (The licensor may share the actual form with the provider.)

  17. Do you have a fantastic child care provider?

    Want to nominate them for the Washington County Provider of the Year?

    If yes, see our online nomination form on the Child Care Licensing website.

  18. Leave This Blank:

  19. This field is not part of the form submission.