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This form is used to track the sleep positions of infants in accordance with NC Licensing Rule 10A NCAC 09 .0606 and should remain on file for a minimum of one month.
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How to fill out infant safe sleep chart
How to fill out Infant Safe Sleep Chart
01
Gather necessary information on the infant's sleep environment.
02
Record the infant's name, date of birth, and any relevant medical conditions.
03
Document the type of sleep surface being used (e.g., crib, bassinet).
04
Indicate whether the sleep surface meets safety standards.
05
Note the presence of any soft bedding, toys, or blankets in the sleep area.
06
Specify the baby's sleeping position (e.g., back, side, stomach).
07
Record the sleep location (e.g., parent's room, separate room).
08
Provide information on sleep practices (e.g., co-sleeping, room-sharing).
09
Ensure that all entries are accurate and legible.
10
Review the chart for completeness before submission.
Who needs Infant Safe Sleep Chart?
01
Parents or caregivers of infants.
02
Healthcare providers working with families.
03
Childcare centers and professionals.
04
Anyone involved in planning infant care and safety.
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What is Infant Safe Sleep Chart?
The Infant Safe Sleep Chart is a tool used to document and promote safe sleep practices for infants, helping to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths.
Who is required to file Infant Safe Sleep Chart?
Caregivers, child care providers, and medical professionals who are responsible for the care of infants are required to file the Infant Safe Sleep Chart.
How to fill out Infant Safe Sleep Chart?
To fill out the Infant Safe Sleep Chart, caregivers should record details such as the infant's name, date of birth, sleep position, sleep location, and any other relevant observations about the sleep environment.
What is the purpose of Infant Safe Sleep Chart?
The purpose of the Infant Safe Sleep Chart is to ensure that infants are placed in safe sleep environments, track their sleep habits, and promote adherence to safe sleep guidelines.
What information must be reported on Infant Safe Sleep Chart?
The information that must be reported on the Infant Safe Sleep Chart includes the infant's name, date and time of sleep, sleep position, sleep location (e.g., crib, bassinet), and details about any sleep aids used.
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