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Entrevista Padres

Entrevista Padres

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Published by: ester on Jul 30, 2009
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11/17/2015

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FICHA DE IDENTIFICACIÓN DEL NIÑO PREESCOLAR

(Entrevista Inicial)
______ de ____________ del !!"
#$% DATOS &ENERALES
N'()re del ni*'+ _____________________________________________________________________
A,ellid' ,atern' A,ellid' (atern' N'()re(s)
L-.ar / 0ec1a de naci(ient'+ ___________________________________________________________
Ci-dad A*' 2es D3a
Tie(,' de residir en el estad'+ ________ a*'s ________ (eses$
D'(icili'+ ___________________________________________________________________________
Calle N4(er' C'l'nia C$P$
Tel50'n'+ _________________ En cas' de e(er.encia avisar a+ _______________________________
C'n d'(icili'+ _________________________________________ Tel50'n'+ _____________________
&r-,' san.-3ne'+ _______________________ Servici' (edic' 6-e c-enta+ _____________________
Lateralidad+ Diestr'+ ________________ 7-rd'+ ______________ N' de0ine a-n+ _______________
$% DATOS FA2ILIARES
N'()re Edad Esc'laridad Oc-,aci8n
Padre ' t-t'r
2adre ' t-t'r
Es,eci0icar+
Pers'nas 6-e viven en casa+
Padre 2adre Her(an's A)-el's T3's Pri('s Otr's
EDAD DE LOS FA2ILIARES+
9A car.' de 6-ien 6-eda el ni*' c-and' n' est:n l's ,adres; ________________________________
Parentesc'+ ____________________________________Edad+ ________________________________
L-.ar 6-e 'c-,a entre l's 1er(an's+ ______________
El ni*' 9Sa)e s- n'()re; S3 ___ N' ___ En casa 9c8(' l' lla(an;___________________________
9S- d'(icili'; S3 ___ N' ___ 9Tel50'n'; Si ___ N'___
<$% CARACTERISTICAS DE LA =I=IENDA > CO2?NIDAD
Casa s'la ____ De,arta(ent' ____ C-art' ____ Pr',i' ____ Rentad' ____ Otr' ____
N-(er' de c-art's+ _______________ Ti,' de c'nstr-cci8n+ _________________________________
9Carece de al.4n servici' la vivienda; S3 ____ N' ____ 9C-:les; _____________________________
Servici's c'n l's 6-e c-enta la c'(-nidad+
Al-()rad' ,4)lic' ____ Calles ,avi(entadas ____ Drena@e ____ Tel50'n' ,4)lic' ____
Tras,'rte ,4)lic' ____ Centr' de sal-d '
Dis,ensari' (edic' ____
Par6-es ' -nidades
de,'rtivas ____
A$% HISTORIA DEL DESARROLLO DEL NIÑO
E()araB'+ ,lanead' ________ n' ,lanead' ________ n'r(al _________ c'n ,r')le(as _________
Part'+ n'r(al ________ c'n ,r')le(as ________ 9C-:les; __________________________________
Lactancia+ 9t'(' ,ec1'; ____ 9C-:nd' l' de@'; ____ Ci)er8n ____ 9C-:nd' l' de@'; ____
9Presenta al.4n ,r')le(a 03sic'D de sal-d ' aler.ia;
2enci'ne+ ___________________________________________________________________________
En0er(edades 6-e 1a ,adecid'+ _________________________________________________________
9Le 1an realiBad' a s- ni*' al.-na detecci8n; =is-al ________ A-ditiva ________ C-cal ________
Ort',5dica ,'st-ral ________ N-trici'nal ________ Otras ________
P'see cartilla de vac-naci8n+ 2eEicana ________ A(ericana ________ Otra _________
Edad de c'ntr'l de es03nteres+ Di-rn' ____ N'ct-rn' ____ 9=a s'l' al )a*'; Si ____ N' ____
9C-:ntas 1'ras d-er(e el ni*'; D3a ____ N'c1e ____ 9A 6-e edad e(,eB8 a d'r(ir s'l'; _______
Ti,' de s-e*'+ Tran6-il' ________ Intran6-il' ________
D-er(e en+ C-art' s'l' ________ C'(,artid' ________ 9C'n 6-ien; ________________________
Ali(ent's 6-e ,re0iere+ ________________________________________________________________
Ali(ent's 6-e rec1aBa+ ________________________________________________________________
9C-:ntas veces c'(e al d3a; ____________________ 9C8(' es s- len.-a@e; ____________________
9C8(' ca(ina; _____________________ 9C8(' c'rre; ____________________________________
9C8(' s-)e las escaleras; ______________________________________________________________
F$% COND?CTA > SOCIALI7ACION
9C8(' es; (car:cterD c'nd-ctaD se.-r') ___________________________________________________
9G-5 actividades 1ace ,'r si s'l'; _______________________________________________________
9G-5 es l' 6-e 1ace d-rante el d3a; ______________________________________________________
9G-5 c'n'ci(ient's esc'lares tiene; _____________________________________________________
9C-:les s'n s-s ca,acidades; ___________________________________________________________
9C8(' res-elve l's ,r')le(as 6-e se le ,resentan; _________________________________________
9C8(' a,rende; (O)servand'D 1aciend' las c'sasD ,re.-ntand' / analiBand' etc$)
_____________________________________________________________________________________
O)servaci'nes+ _______________________________________________________________________
Reli.i8n / c-lt' 6-e ,ractica la 0a(ilia+ ___________________________________________________
9Ha ,resentad' el ni*' al.-nas de las si.-ientes c'nd-ctas c'n cierta 0rec-encia;
Cerrinc1es _________ Rec1aB' de ali(ent's ________ S-cci8n del ,-l.ar _________
A.resividad ________ 2'rderse las -*as __________ Orinarse en la ca(a ________
A las c'nd-ctas anteri'res 9C8(' reacci'nan;
Pa,:+ _______________________________________________________________________________
2a(:+ ______________________________________________________________________________
9Tiene di0ic-ltad ,ara relaci'narse c'n al.-ien; ____ 9Le te(e a al.'; ____ 9A 6-e; ____________
9Ha/ en casa al.-na ,ers'na c'n ,r')le(as de sal-d ' adicci'nes;D 9G-i5n; ___________________
9EEiste en el 1'.ar al.-na sit-aci8n ,r')le(:tica 6-e c'nsidere a0ecte al ni*'; Si ____ N' ____
9C-:l; ______________________________________________________________________________
9C'n 6-ien / d'nde s-ele @-.ar s- 1i@'(a);________________________________________________
Si el @ard3n t-viera ','rt-nidad de )rindar ,l:ticas a l's ,adres de 0a(ilia ,ara (e@'rar el
a()iente 0a(iliarD 9G-5 te(as le .-star3a esc-c1ar;
_____________________________________________________________________________________
_____________________________________________________________________________________
Ed-cad'ra+ ______________________
N'ta+ C-al6-ier ')servaci8n adici'nalD 1acerla en -na 1'@a en )lanc' / aneEarla$

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