10/29/2012
!"#$%&'"()'*+,-'./01234'%/5/1'(''
)3617')0+/'$3486901'"9265624'$,1694'
!
"#$%&'!()*)+,+-)!
<Insert the name of your child care center here>!.+&#/-%0+1!)2+!%,3#.)*-&+!#4!32'1%&*$!*&)%5%)'!
4#.!'#6-/!&2%$7.+-8!9,3$+,+-)*)%#-!#4!*33.#3.%*)+!32'1%&*$!*&)%5%)'!3.*&)%&+1!1633#.)1!)2+!2+*$)2!*-7!
7+5+$#3,+-)!#4!&2%$7.+-!%-!&*.+:!*1!;+$$!*1!*11%1)%-/!%-!+1)*<$%12%-/!3#1%)%5+!$%4+1)'$+!2*<%)1!4#.!)2+!
46)6.+8!
!
"2'1%&*$!=&)%5%)'!%-!>2%$7!>*.+!
?2+!36.3#1+!#4!)2%1!3#$%&'!%1!)#!+-16.+!)2*)!&2%$7.+-!%-!&*.+!*.+!1633#.)+7!*-7!+-&#6.*/+7!)#!+-/*/+!
%-!*&)%5+!3$*':!7+5+$#3!46-7*,+-)*$!,#5+,+-)!1@%$$1!*-7!)#!2*5+!$%,%)+7!1&.++-!)%,+8!!A6.!&+-)+.!
+-&#6.*/+1!*$$!&2%$7.+-!)#!3*.)%&%3*)+!%-!*!5*.%+)'!#4!7*%$'!32'1%&*$!*&)%5%)'!#33#.)6-%)%+1!)2*)!*.+!
*33.#3.%*)+!4#.!)2+%.!*/+:!)2*)!*.+!46-!*-7!)2*)!#44+.!5*.%+)'8!9-!#.7+.!)#!3.#,#)+!32'1%&*$!*&)%5%)'!*-7!
3.#5%7+!*$$!&2%$7.+-!;%)2!-6,+.#61!#33#.)6-%)%+1!4#.!32'1%&*$!*&)%5%)'!)2.#6/2#6)!)2+!7*'!<Insert
the name of your child care center here>!;%$$B!
!
:0614';<27,,+'$104'
! C-&#6.*/+!*!$+*1)!.+1).%&)%5+:!1*4+!+-5%.#-,+-)!4#.!%-4*-)1!*-7!)#77$+.1!*)!*$$!)%,+18!
! ".#5%7+!*!7+1%/-*)+7!1*4+!#6)7##.!*.+*!4#.!%-4*-)1!D*/+1!EFGH!,#-)21I!4#.!7*%$'!#6)7##.!
3$*'8!
! ".#5%7+!)#77$+.1!D*/+1!G!)2.#6/2!H!'+*.!#$71I!;%)2!*)!$+*1)!JEFKE!,%-6)+1!#4!7*%$'!#6)7##.!
*&)%5+!3$*'!#33#.)6-%)%+1!*&.#11!H!#.!L!1+3*.*)+!#&&*1%#-18!!!
! ".#5%7+!3.+1&2##$+.1!*-7!1&2##$!*/+!&2%$7.+-!D*/+1!L!)2.#6/2!GH!'+*.!#$71I!;%)2!*)!$+*1)!
KEFGHE!,%-6)+1!#4!7*%$'!#6)7##.!*&)%5+!3$*'!#33#.)6-%)%+1!*&.#11!H!#.!L!1+3*.*)+!#&&*1%#-18!!!
! 9-&.+*1+!%-7##.!*&)%5+!3$*'!)%,+!1#!)2+!)#)*$!*,#6-)!#4!*&)%5+!3$*'!)%,+!.+,*%-1!)2+!1*,+:!
%4!;+*)2+.!$%,%)1!#6)7##.!)%,+8!
! ".#5%7+!*!5*.%+)'!#4!3$*'!,*)+.%*$1!D<#)2!%-7##.1!*-7!#6)7##.1I!)2*)!3.#,#)+!32'1%&*$!
*&)%5%)'8!!!
!
=,1/',>'!20>>'6?'$3486901'"9265624'
! M%$$!+-&#6.*/+!&2%$7.+-!)#!<+ 32'1%&*$$'!*&)%5+!%-7##.1!*-7!#6)7##.1!*)!*33.#3.%*)+!
)%,+18!!
! M%$$!3.#5%7+!NFGE!,%-6)+1!#4!3$*--+7!32'1%&*$!*&)%5%)%+1!*)!$+*1)!H!)%,+1!7*%$'!4#.!&2%$7.+-!
*/+!L!*-7!#$7+.8!
!
!9+//?'@6A/'%6A62026,?8'
! O#)!3+.,%)!1&.++-!)%,+!D+8/8:!)+$+5%1%#-:!,#5%+1:!5%7+#!/*,+1!*-7!&#,36)+.1I!4#.!%-4*-)1!
*-7!&2%$7.+-!);#!'+*.1!*-7!'#6-/+.8!
10/29/2012
"2'1%&*$!=&)%5%)'!*-7!"6-%12,+-)!!
()*44!,+,<+.1!7#!-#)!;%)22#$7!#33#.)6-%)%+1!4#.!32'1%&*$!*&)%5%)'!D+8/8:!-#)!<+%-/!3+.,%))+7!)#!
3$*'!;%)2!)2+!.+1)!#4!)2+!&$*11!#.!<+%-/!@+3)!4.#,!3$*'!)%,+I:!+P&+3)!;2+-!*!&2%$7Q1!<+2*5%#.!%1!
7*-/+.#61!)#!2%,1+$4!#.!#)2+.18!()*44!,+,<+.1!-+5+.!61+!32'1%&*$!*&)%5%)'!#.!+P+.&%1+!*1!
36-%12,+-):!+8/8:!7#%-/!3612F631!#.!.6--%-/!$*318!"$*'!)%,+!#.!#)2+.!#33#.)6-%)%+1!4#.!32'1%&*$!
*&)%5%)'!*.+!-+5+.!;%)22+$7!)#!+-4#.&+!)2+!&#,3$+)%#-!#4!$+*.-%-/!*&)%5%)%+1!#.!*&*7+,%&!;#.@8!
A6.!&+-)+.!61+1!*33.#3.%*)+!*$)+.-*)+!1).*)+/%+1!*1!&#-1+R6+-&+1!4#.!-+/*)%5+!#.!6-7+1%.*<$+!
<+2*5%#.18!!
<You may want to insert specific information here that describes the alternate
strategies your program uses to address negative or undesirable behaviors.>
!
=33.#3.%*)+!S.+11!4#.!"2'1%&*$!=&)%5%)'!!
M+!*)!<Insert the name of your child care center here>!2*5+!*!T+*7'!)#!"$*'!"#$%&'U!!
"$+*1+!<.%-/!'#6.!&2%$7!.+*7'!)#!3$*'!*-7!2*5+!46-!+*&2!7*'8!V#6.!&2%$7!;%$$!3*.)%&%3*)+!%-!<#)2!
%-7##.!3$*'!*-7!#6)7##.!3$*'8!?2+.+4#.+:!3$*'!&$#)2+1!*-7!12#+1!;2%&2!&*-!/+)!7%.)'!*-7!*$$#;!
4#.!4.++!*-7!1*4+!,#5+,+-)!*.+!,#1)!*33.#3.%*)+8!!M+!+P3+&)!3*.+-)1!)#!3.#5%7+!&2%$7.+-!;%)2!
*33.#3.%*)+!&$#)2%-/!4#.!1*4+!*-7!*&)%5+!#6)7##.!3$*'!76.%-/!*$$!1+*1#-18!
<You may want to insert information here that provides parents with specific
guidance on what your program considers “appropriate clothing”. For example: For
safety, children cannot wear open-toe shoes, sandals or flip-flops. In winter, provide
a warm jacket, snowsuit, hat, mittens and boots. In spring and fall, provide a jacket
or sweater, and boots and rain jacket on rainy days. In summer, provide light
clothing, swimsuit, towel, hat and sunscreen. Please label all outer garments with
your child’s name!> !
!
9)!%1!#6.!+P3+&)*)%#-!)2*)!&2%$7.+-!;%$$!/#!#6)1%7+!CWCTVS=VU!<You may want to insert
information here providing specific details from the ABC Standards regarding
temperature ranges and weather advisories that would prohibit outdoor play.> 94!'#6!
4++$!'#6.!&2%$7!%1!)##!1%&@!)#!/#!#6)1%7+!)2+-!2+X12+!%1!)##!1%&@!)#!<+!*)!)2+!&2%$7!&*.+!&+-)+.8!M+!
.+R6+1)!)2*)!'#6!@++3!2%,X2+.!*)!2#,+!6-)%$!)2+'!*.+!;+$$!+-#6/2!)#!/#!#6)1%7+8!
!
".#4+11%#-*$!S+5+$#3,+-)!
=--6*$!).*%-%-/!#-!3.#,#)%#-!#4!&2%$7.+-Q1!,#5+,+-)!*-7!32'1%&*$!*&)%5%)'!%1!.+R6%.+7!4#.!*$$!1)*448!
My signature below indicates that I have received a copy of the physical activity policy, it has been reviewed
with me, and I have read and understand this policy.
Signature__________________________________________ Date_______________
Please circle as appropriate:
STAFF
PARENT
If parent, name of child_________________________________________