Education and Care Service Indoor and Outdoor Space

National Quality Framework Education and care service indoor and outdoor space Space Measurement Form | May 2015 Area Measurements This form should be used to verify the indoor and outdoor space of an education and care service in accordance with regulation 107 and regulation 108 of the Education and Care Services National Regulations 2011 (National Regulations), at the time of application for service approval – centre-based or application for amendment of service approval. If you require more space to record the measurements, please photocopy additional pages and attach them to the application. Details of education and care service

1. Name of education and care service

2. Address of education and care service premises (PO boxes cannot be accepted) Unit, floor, street number and street name Suburb/Town State Postcode

Details of person conducting and certifying the area measurements

3. Title (Mr etc) Family Name Given names

Daytime telephone number Email address

4. Is the education and care service premises on a school site providing education and care to children over preschool age or an education and care service relocating to alternative premises for not more than 12 months? No  Go to question 5 Yes  Go to question 6

5. What type of building practitioner are you? Building surveyor Building inspector Building certifier Licensed surveyor Draftsperson Architect

Other Please specify:

What is your registration number? Where are you registered or licensed to practice?

Area measurements – Indoor Space 6. Space requirements – indoor space Room number or name (must match Unencumbered area Number of children the room number or name on the Floor area (sqm) divided by 3.25 sqm. service plans)* Office use only

1 (Office use only) Total

7. Are there any areas of indoor space set aside permanently for the use and storage of cots? No  Go to question 9 Yes  Go to question 8 8. Area/s set aside permanently for use and storage of cots Indoor room number/name provided on floor plan Number of cots permanently Total floor area (sqm) deducted or diagram* stored from area measure

9. Is there any area of verandah space included in the indoor space measurement? No  Go to question 11 Yes  Go to question 10 10. Please complete

Verandah Space (must match the number or Unencumbered area Number of children area (sqm) name on the service plans)* divided by 3.25 sqm. Office use only

Area measurements – Outdoor Space 11. Space requirements – outdoor space

Outdoor space (must match the number Unencumbered area Number of children Outdoor area (sqm) or name on the service plans)* divided by 7 sqm. Office use only

(Office use only) Total

12. Measurements of indoor space being used as outdoor space - only applicable for services that educate and care for children over preschool age

Indoor space number provided on floor Number of children Floor area (sqm) Divide area by 7 sqm. plan or diagram* Office use only

(Office use only) Total

Certification and signature of person conducting measurements I certify that the information in this application is true and correct and the measurements were conducted in accordance with the Education and Care Services National Law Act 2010 and Education and Care Services National Regulations 2011. I confirm that in calculating the areas of unencumbered indoor and outdoor space that areas prescribed in the National Regulations have been excluded.

Signature Date X