Program Quality Indicators = Quality Early Learning and Quality ...

CHILDREN SERVICES: PQI - PRE-VISIT INFORMATION FORM
Date: Name of Centre: Location:____________________
Name & Title of Person Completing This Form: ____________________________________________________________________________
1. Does your centre use a valid assessment tool YES / NO
If yes, list the name(s) of the assessment tool(s)._____________________________________________________________________________
____________________________________________________________________________________________________________________
2. Complete the table below and include all programs offered at this location. (An additional page with this form is attached if more
space is required.)
Infant
Group
Date of
Assessment
Evaluation
Names of Staff
Completing Assessment
Evaluation
Areas Requiring Improvement
Action Plan to Implement
Improvements & Expected
Completion Date
Toddler
1.
2.