Respite and routines · Foster & Kinship Resources
A one-page handoff for a respite caregiver: routines, comfort, medical needs, and who to call.
Fill this out before a respite stay, a visit, or any time another adult is caring for the child. It is a worksheet, not an agency form. Update it when routines change.
Name ____________________________________ Preferred name ________________
Date of birth ______________ Pronouns ______________
Name ____________________________________ Phone ________________
Backup adult ____________________________________ Phone ________________
Wake ______________ School or daycare ______________ Home ______________
Meals and snacks the child counts on:
________________________________________________________________
Bedtime routine, including what helps them settle:
________________________________________________________________
Comfort items: __________________________________________________
What helps after a hard moment: ____________________________________
What to avoid: __________________________________________________
Words or topics that are private: ____________________________________
Allergies ________________________________________________________
Medications, dose, and time ________________________________________
Doctor ________________________________ Phone ________________
How the child takes medicine: _______________________________________
Call the caregiver first. If it is an emergency, call 911, then the caregiver.
Caseworker, if any __________________________ Phone ____________
Notes for this stay: ________________________________________________
Worksheet from Foster & Kinship Resources. Not an official agency form and not legal advice. Updated 2026-10-10.