Centre type: (choose one)
long day care
sessional kindergarten
pre-school/early learning centre
occasional care
stand alone OHSC/vacation care
family day care (certificate only) (not here possibly)

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

Is this form a
(choose one)
New SunSmart centre application
Review application to continue status

Part 2: Sun protection at your centre

1. Does your centre have a written skin protection policy?
(choose one)
Yes
No

2. Sun protection practices are in place
September 1 to April 30
All year round
Terms 1 and 4
Other:

3. Does your centre regularly review its skin protection policy?
(choose one)
Yes (if so please state how often)

No
No, but we are planning to
No, this is a new application to become a SunSmart centre

4. Sun protection is needed whenever UV is 3 and above. Is this mentioned in your policy?
Yes
No

5. Sun protection is not needed from May to August when the UV is below 3. Is this mentioned in your policy?
Yes
No

6. During the months of September to April outdoor activities scheduled before 10.00 am and after 3.00 pm or in shaded areas
Yes
Whenever possible
No

7. At your centre hat wearing is
(choose one)
Compulsory
Encouraged
Neither compulsory or encouraged

8. Children at your centre wear
(choose as many as applicable)
Broad-brimmed hats
Legionnaire hats
Bucket hats (at least 5 cm brim and a deep crown)
Other: 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)
All of the children
Most of the children
Some of the children
Very few of the children

10. If a child is not wearing a hat outside when the UV is 3 and above
(choose as many as are applicable)
They must remain in the shade - play allowed
They must return indoors
They must wear a hat from a set of hats provided by the Centre
There are no consequences
Other: please specify:

11. Does your centre consider the special sun protection needs of babies and infants?
(choose one)
Yes
No
Not applicable

12. Does your centre request that all staff wear broad-brimmed, bucket or legionnaire hats while outside when the UV is 3 and above?
(choose one)
Yes
No

13. Does your centre encourage parents / carers to wear a sun protective hat when participating in outdoor program when the UV is 3 and above?
 (choose one)
Yes
No

14. Do you ask that children wear sun protective clothing when they are outside or on excursions eg shirts or dresses that cover the shoulders, shirts with collars and elbow-length sleeves, longer style shorts and skirts?
(choose one)
Yes
No

15. In relation to the use of SPF 30+ broad spectrum, water resistant sunscreen -
(choose as many as applicable)
Sunscreen is supplied by the centre for children's use
Parents/carers sign a consent form allowing staff to apply sunscreen to children
Parents/carers are encouraged to supply sunscreen for their children
Time is given for the application of sunscreen 20 minutes before children go outside when the UV is 3 and above
Older children are encouraged to apply sunscreen themselves under adult supervision
Sunscreen is re-applied every 2 hours while outside
Other: please specify:

16. Do you plan activities that focus on skin protection?
(choose one)
Yes
No

17. Do all staff actively reinforce sun protection practises in their regular interaction with children?
(choose one)
Yes
No

18. How do staff actively reinforce sun protection with the children?
(choose  as many as applicable)
Role modelling
Posters
Discussion
Picture storybooks or reference books
Play experiences, e.g. imaginative play
Songs, poems or finger plays
Games
Other: please specify:

19. How does your centre minimise the time spent outdoors during peak ultraviolet (UV) radiation times (10 – 3) or  when the UV is 3 and above.?
(choose as many as applicable)
Outdoor experiences are held outside of these hours when possible
Outdoor excursions are scheduled early or late in the day
Lunch/snack is eaten inside
Lunch/snack is eaten in shaded areas
We allow indoor/outdoor play
Other: please specify:

20. Describe the available shade at your centre.
(choose as many as applicable)
Sufficient shade
Shady trees
Some built shade structures
Some portable shade structures
Plans to increase shade in the next 12 months
No shade
Shade is not currently a priority area
Shade poses funding concerns for our centre

21. Does your centre regularly promote sun protection messages e.g. newsletters, at school activities
Yes
No

Attach your policy: