The Texas 2947 form is a record used by child care centers to gather important information about their personnel. This form helps ensure that staff members are qualified and prepared to provide a safe and nurturing environment for children. It covers various topics, including training, health checks, and emergency procedures, all aimed at fostering positive interactions with children.
The Texas 2947 form, officially known as the Child Care Center Personnel Information Record, plays a crucial role in ensuring that child care providers meet the necessary standards for the well-being of children in their care. This form collects essential information about staff members, including their educational background, training, and experience in child care. It emphasizes the importance of age-appropriate activities and positive interactions that foster children's self-esteem. Additionally, the form addresses the critical need for training in recognizing and preventing communicable diseases, as well as the protocols for handling emergencies. By completing this form, child care personnel acknowledge their understanding of the operational policies and minimum standards set by the Texas Department of Family and Protective Services. The form also highlights the rights of individuals to review and correct their information, ensuring transparency and accountability within child care settings. Overall, the Texas 2947 form serves as a foundational tool for maintaining high-quality care and safeguarding the health and safety of children.
Texas Dept of Family and Protective Services
CHILD CARE CENTER
PERSONNEL INFORMATION RECORD
“Texas law gives you the right to know what information is collected about you by means of a form you submit to a state government agency. You can receive and review this information, and request that incorrect information about you be corrected by contacting your licensing representative.”
Form 2947 January 2005
NAME:
ADDRESS:
PHONE #:
-
DATE OF BIRTH:
DATE OF EMPLOYMENT:
DATE CHC SENT TO DFPS:
T.B. TEST DATE:
NAME OF HIGH SCHOOL:
GRADUATED?
GRADUATION DATE / GED
Yes
No
COLLEGE:
DEGREE:
CAREER PROGRAM (if applicable.):
INSTRUCTOR:
WORK SCHEDULE:
HOURS:
DAYS:
CPR
First Aid Training
Exp.Date:
ATTENDANCE MAINTAINED
Sign in log
Time sheet
PREVIOUS EXP/TRAINING WHERE AND HOW LONG
PRE-SERVICE TRAINING For Caregivers only
Check all that apply:
Staff with previous child care experience or training. (DOES NOT REQUIRE 8 HRS OF PRE-SERVICE), OR
Staff without previous child care experience or training. Before being counted in the child/caregiver ratio, I received 8 hours of pre- service training in the following areas:
Developmental stages of children. Positive guidance and discipline of children.
Supervision and Safety practices in the care of children.
Staff will not be working with children younger than 24 months. (DOES NOT REQUIRE THE TRAINING LISTED BELOW), OR Staff will be working with children younger than 24 months. Before being given counted in the child/caregiver ratio for a group of children younger than 24 months of age, I received one hour of pre-service training in:
Recognizing and preventing shaken baby syndrome and sudden infant death syndrome; and Understanding early childhood brain development.
Employee Signature
Date
Trainer Signature
EMPLOYEE AND VOLUNTEER ORIENTATION
In addition to being oriented in the understanding of children and in job expectations, I have been oriented in:
An overview of the minimum standards for child care centers.
The Center's operational policies, including discipline, guidance, and the release of children.
The use and location of fire extinguishers and first aid equipment.
The procedures to follow in handling emergencies, including fire, explosion, tornado, toxic fumes, volatile persons, and severe injury or illness of a child or adult.
An overview of symptoms of child abuse, neglect, and sexual abuse and the responsibility for reporting these.
I have received a copy of the child-care center’s operational policies.
I have received a copy of the child-care center’s written personnel policies including my job, job responsibilities, and requirements.
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