Au Pair & Host Family Household Guide Family Name: _________________ Household Guide Contents ! Host Information & Welcome 3 ! Host Children Information 4 ! Host Children Information 5 ! Our Family at A Glance 6 ! Emergency Information 7 ! Safety & Health Instructions 8 ! Childcare Supervision & Safety 9 ! Injury Report 10 ! Au Pair Compensation 11 ! Weekly Stipend Payment Log 12 ! Au Pair Dietary Preferences 13 ! Technology & Household Amenities 14 ! Vehicle & Driving Policy 15 ! Driving Practice 16 ! Driving Practice Log 17 ! Au Pair Duties Guidelines 18 ! Au Pair Duties List 19 ! Daily Childcare Plan 20 ! Meal Planning for Children 21 ! The Au Pair & Host Child Relationship 22 ! Child Behavior & Discipline 23 ! Child Behavior Plan 24 ! Au Pair Scheduling Guidelines 25 ! Au Pair Weekly Schedule 26 ! Vacation & Travel 27 ! Holidays & Sick Days 28 ! Language & Cultural Exchange 29 ! Etiquette, Dress Code, Hygiene 30 ! Guest Policy, Curfew & Dating 31 ! Our Community & Public Transportation 32 ! Weekly Meeting Checklist 33 ! Conflict Resolution 34 ! Problem Solving Sheet 35 ! Education Requirement 36 ! Monthly Meetings 37 ! Certificate of Monthly Meeting Attendance 38 ! Au Pair Online Resources 39 ! ______________________________________ 40 ! ______________________________________ 41 2 Host Information & Welcome Home Address: _______________________ City, State: _______________________ Zip Code: _______________________ HOST Name: ____________________ Name: ____________________ Birthday: __________________ Birthday: ___________________ WORK Job Title: ________________ Job Title: __________________ Employer: _______________ Employer: __________________ Work Hours: ________________ Work Hours: ________________ Work Phone: ______________ Work Phone: _______________ CONTACT Personal Cell: ______________ Personal Cell: ______________ Email: Email: __________________________ _________________________ __________________________ _ ________________________ ABOUT _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ The French term au pair, means "at par" or "equal to“. Mi casa es su casa, “make yourself at home”. ___________________________________________________________________ _______________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ 3 Host Children Information CHILD Name: ____________________ Name: ____________________ Birthday: ___________________ Birthday: ___________________ MEDICAL __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ BEHAVIOR & __________________________ __________________________ DISCIPLINE __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ SCHOOL / DAYCARE __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ ABOUT __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ SPECIAL __________________________ __________________________ INSTRUCTIONS __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ 4 Host Children Information CHILD Name: ____________________ Name: ____________________ Birthday: ___________________ Birthday: ___________________ MEDICAL __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ BEHAVIOR & __________________________ __________________________ DISCIPLINE __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ SCHOOL / DAYCARE __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ ABOUT __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ SPECIAL __________________________ __________________________ INSTRUCTIONS __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ 5 Our Family at A Glance _____________________________________________ CULTURE & VALUES ___________________________________________ ____________________________________________ ____________________________________________ FAITH & RELIGIOUS PRACTICE ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ GOALS FOR OUR CHILDREN ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ EXPECTATIONS FOR OUR AU PAIR ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ COMMUNITY GROUPS & SOCIAL ____________________________________________ ACTIVITIES ____________________________________________ ____________________________________________ ____________________________________________ FAMILY MEALS ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ COMMUNICATION STYLE ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ EXPRESSING CONCERNS ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ 6 Emergency Information OUR HOME ADDRESS _______________________________________ _______________________________________ _______________________________________ 911 EMERGENCY In case of life-threatening emergency, dial 911 _______________________________________ _______________________________________ _______________________________________ POSION CONTROL Call 1-800-222-1222 in case of poisoning Available 24 hours everyday nationwide _______________________________________ _______________________________________ PEDIATRICIAN / DOCTOR _______________________________________ _______________________________________ _______________________________________ ______________________________ NEIGHBORS _______________________________________ _______________________________________ _______________________________________ _______________________________________ FAMILY MEMBERS _______________________________________ _______________________________________ _______________________________________ AGENT AU PAIR EMERGENCY If an emergency occurs after business hours NUMBER and you can’t reach your local rep or agency management, call 1-415-376-0202 OFFICE OF PRIVATE SECTOR Always contact Agent Au Pair first. If EXCHANGE additional emergency assistance is required, participants can contact the State Department at any time via the hotline 1-866-283-9090 PRINT THIS PAGE & POST IN HIGHLY VISIBLE AREA 7 Safety & Health Instructions FIRE SAFETY & EVACUATION SEVERE WEATHER PLAN Fire Extinguishers: Our Weather Climate: _______________________________________ _______________________________________ _______________________________________ _______________________________________ Emergency Exits: Weather Precautions: _______________________________________ _______________________________________ _______________________________________ _______________________________________ Family Meeting Place: Sirens / Alarms: _______________________________________ _______________________________________