IN-HOME CARE PROVIDER
Telephone Reference Check

Name of applicant:
Phone number of applicant:

Name of Reference person:
Phone number:

• Relationship to applicant.
• How long have you known applicant?
• Have you seen them work with young children and in what capacity?
• If the applicant has cared for your child, can you tell what type of work arrangement you had with them? What type of activities did the caregiver do with your child regularly?
• What were the ages and gender of your child/children when the applicant cared for them?
• What would you consider to be their strengths?
• Do you feel they need improvement in any areas?
• Do you consider the applicant to be reliable and mature?
• Did they ever have to handle an emergency situation? If so, how did they respond?
• If you needed a caregiver, would you hire the applicant?
• Overall would you recommend the applicant as a caregiver?
• Any other feedback you would be willing to share?