Tri-State Nannies - Recommending a Nanny

General Information

Your Name:
Your Email Address:	Telephone #:
	(If no email address is provided, you will not receive an email confirmation of this recommendation.)
Nanny Name:

How do you know this nanny?

How long have you known her/him?

Are you related to her/him and if so, how?

Rating the Nanny

How would you rate the individual on the following competencies? (Possible ratings for each competency are "Excellent," "Very Good," "Good," "Fair," or "Poor.")

1)	Is reliable?	Excellent	Very Good	Good	Fair	Poor
	Explain.
2)	Relates well to children?	Excellent	Very Good	Good	Fair	Poor
	Explain.
3)	Is honest?	Excellent	Very Good	Good	Fair	Poor
	Explain.
4)	Lives her values?	Excellent	Very Good	Good	Fair	Poor
	Explain.
5)	Has sufficient energy to keep up with active children?	Excellent	Very Good	Good	Fair	Poor
	Explain.
6)	Is a hard worker?	Excellent	Very Good	Good	Fair	Poor
	Explain.

Other Questions

7)	Have you ever observed this individual inappropriately discipline a child or take her frustrations out on a child?	Yes	No
	Explain.
8)	Has the prospective nanny ever been in trouble with the law?	Yes	No
	Explain.
9)	Does this individual have a temper, angry outbursts or difficulty managing emotions?	Yes	No
	Explain.
10)	How would you describe her personality?
	Explain.
11)	What is this individual like on a bad day, i.e., a day when things are not going well?
	Explain.
12)	Is she easy to work with?	Yes	No
	Explain.
13)	Is she organized and reasonably neat in her personal habits?	Yes	No
	Explain.
14)	Does she have any health problems that would make it difficult for her to perform her duties as a full time live-in nanny?	Yes	No
	Explain.
15)	Any negatives or concerns about her as a childcare provider?
	Explain.
16)	What attributes does she have that would make her effective as a nanny?
	Explain.

17)	How do you think this individual will do as a nanny?	Excellent	Very Good	Good	Fair	Poor
	Explain.