InterMountain ESD

2020-2021
Kindergarten Transition Survey

This form is for private Child Care and Preschool Providers to share information with School Districts.
Prior to completing this survey, you will need to confirm permission with parents to share information.
Ensure you have the following information before starting: home address or school the child will attend Kindergarten at, the child's attendance %, length of time in your program, and knowledge of academic skills.

General Information

If you would like to remain anonymous use "N/A"

Which school will the child attend for Kindergarten

Identify the school the child will be attending Kindergarten

Child's home language *
Does the family need materials in another language? *

Social Emotional Development

Does s/he observe rules and follow directions without reminders? *
Can s/he concentrate when working on a task and is not easily distracted by the environment? *
Is s/he willing to share toys or materials with other children when playing? *
Does s/he express hostility to others verbally or phsycially? *
Does s/he cooperate with playmates when participating in group play? *
Does s/he comply with adult directives, giving little resistance? *
Does s/he separate from parents and engage in activities with ease? *

Cognitive and Physical Development

This could include adaptive seating, fidget tools, or sitting close to the teacher.

Is the child able to communicate with others? *
Can the child take care of their own bathroom needs? *
Can the child tie their shoes and zip their coat *

Academic skills (select yes or no)

Legibly write first name? *
Count to 10 *
Identify 10 letters *
Name 4 shapes *
Name 6 colors *
Would you recommend this child to attend a 2-3 week Kindergarten Preparation Program in Aug? *

This is an intensive program focused on high risk children who need extra supports to be ready for the first day of Kindergarten