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SunSmart Family Day Care Application Form

Becoming a SunSmart service tells the community that you are committed to the future health of its children.

Part 1: Centre information

 
Contact name*
 
Position*
 
Address*
Postcode*
Telephone*
Fax*
Email address*
 

Age group attending centre: (eg birth–3 years, 3–6 years, birth–6 years)

Is this form a
(choose one)

Part 2: Sun protection at your service

1. Does your service have a written skin protection policy?
(choose one)


2. Sun protection practices are in place



3. Does your service regularly review its skin protection policy?
(choose one)

(if so please state how often)



4. Sun protection is needed whenever UV is 3 and above. Is this mentioned in your policy?

5. Sun protection is not needed from May to August on days when the UV is below 3. Is this mentioned in your policy?

6.  During the months of September to April outdoor activities scheduled before 10.00 am and after 3.00pm or in shaded areas


7. At your service hat wearing is
(choose one)



8. Children at your service wear
(choose as many as applicable)




please specify:

9. On a typical day from the start of September to the end of April, approximately how many children would be wearing broad brimmed, legionnaire or bucket hats?
(Choose one)



10. If a child is not wearing a hat outside when the UV is 3 and above
(Choose as many as are applicable)





please specify:

11. Does your service consider the special sun protection needs of babies and infants?
(Choose one)



12. Do you  wear a  broad-brimmed, bucket or legionnaire hat while outside when the UV is 3 and above?
(choose one)


13. Does your service encourage parents / carers to wear a sun protective hat when participating in outdoor programs when the UV is 3 and above?
(choose one)


14. Do you ask that children wear sun protective clothing when they are outside eg shirts or dresses that cover the shoulders, shirts with collars and elbow-length sleeves, longer style shorts and skirts?
(choose one)


15. In relation to the use of SPF 30+ broad spectrum, water resistant sunscreen -
(Choose as many as applicable)







please specify:

16. Do you plan activities that focus on skin protection?
(choose one)


17. Do you actively reinforce sun protection practises in your regular interaction with children?
(choose one)


18. How do you actively reinforce sun protection with the children?
(choose  as many as applicable)








please specify:

19. How do you minimise the time spent outdoors during peak ultraviolet (UV) radiation times (10 am – 3 pm) or when the UV is 3 and above?
(choose as many as applicable)






please specify:

20. Describe the available shade at your service.
(choose as many as applicable)







???**
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Attach your policy:



 


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