Reference Check Form for nanny position

Name of Referee:

Referee address:

Phone:

Name of Nanny:

Position Held:

Dates of Employment (include months and years):

Age and Sex of Children at Commencement of Employment:

Describe the childcare duties performed:

Was there a balanced mix of age-appropriate activities both at home and outside?

Describe the nanny's demeanor and affection towards the children:

Attitude towards discipline and responsiveness to parental instructions:

Ability to cook for and provide balanced meals for the children:

How would you describe the nanny's personality:

What were the nanny's notable strengths:

Please provide constructive criticism or mention any weaknesses:

Ability to handle illnesses and emergencies:

Safety and driving skills, if applicable:

Do you have any reservations about the nanny's childcare capabilities in any situation?

Please rate the nanny on the following aspects:

Number of Days Off Sick (in last 12 months):

Comments

Reason for leaving:

General comments:

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