Preschool to Kindergarten Transition Survey

Welcome

We are excited to welcome your child to Kindergarten in the Stamford Public

Schools this Fall. The form you are about to complete was created by preschool
and kindergarten staff. This form should be completed as a summary of your
child’s skills. This is not an assessment, but rather a way of gathering information
to support your child’s Transition to Kindergarten. This document will be shared
with your child’s new elementary school. It will be used as a planning tool for
teachers and administrators in placing your child in a balanced classroom, and for
preparing for the first day of school.

For each question, select the response that best fits your child’s current
functioning. There is no right or wrong answer. Every child is on their own
continuum and will be celebrated by our staff. As you read each question, answer
based on your initial reaction. You know your child better than anyone!

Thank you for taking the time to share information about our child with us. If you
have any questions about this document, please reach out to Kendra Brown by
email at kbrown@stamfordct.gov.

Welcome to Stamford Public Schools!

Child Background Questions

ID Number (provided to you in the email from SPEF) *

Child's Name *

Gender *
Female

Male

Name of child's primary guardian *

Child's date of birth *

�

Email address for child's primary guardian *

Primary guardian's phone # *

What is the primary language spoken at home? *
English French Polish

Spanish Greek Tamil

Haitian/Creole Hindi Ukrainian

Albanian Italian Urdu

Arabic Nepali Other - Write In

(Required)
Chinese Mandarin

Which elementary school is your child attending? *

Davenport Ridge
Hart Magnet
Julia A. Stark
K. T. Murphy
Newfield
Northeast
Rogers International School
Roxbury
Springdale
Stillmeadow
Strawberry Hill
Toquam Magnet
Westover Magnet

Did your child attend preschool? *

Yes

No

Which preschool did they attend? *

Home Daycare
All About Kids
Home Daycare
All About Kids
Apples
Art- Nature & Me @ Stamford Museum & Nature Ctr
Baby Cottage
Baby Cottage II
Bright Beginnings Early Childhood Program
Bright Horizons @ High Ridge Park
Bright Horizons Children's Center- Stamford
Bright Horizons Long Ridge Child Development Center
Building Blocks Early Learning Center (Camp Ave)
Building Blocks Early Learning Center (High Ridge Rd.)
Catholic Academy Of Stamford
Children's School
CLC - Franklin Commons
CLC - Lathon Wider
CLC - Lockwood
CLC - Maple Ave
CLC - Martin Luther King
CLC - Palmers Hill
CLC - Westover
CLC - William Pitt
CP Kids Early Learning Center
Davenport Elementary School
Edgewood Academy
Education Station At The IC
First United Methodist Nursery School
Gan Yeladim Early Childhood Center
Glenbrook Learning Center
Grace Daycare And Learning Center
Hubbard Heights Preschool
JCC Kindercare
JCC Jumpstart
Jewish Comm Ctr - Sara Walker Nursery School
K. T. Murphy Elementary School
Learning Center At Piper's Hill
Mark Of Excellence
Mater Salvatoris College Preparatory School
Mead School
Our Lady Of Grace Day Care Center
Play To Learn Childcare
Roxbury Elementary School
Shiny Little Stars
Sound Beach Day School
Star Center City Of Stamford
Sunrise Child Development Center
 Shiny Little Stars
Sound Beach Day School
Star Center City Of Stamford
Sunrise Child Development Center
Union Memorial Preschool
Villa Divino Amore Nursery School

Does your child receive special education services or have an Individualized

Education Plan (IEP)? *
Yes

No

Social Emotional
Page description:
For each of the following questions select the option that best represents your child's current
functioning. Answer each question based on your initial reaction. There are no right or
wrong answers.

Does your child use words to talk about how he/she is feeling *
Rarely

Sometimes

Usually

Does he/she talk about how different situations make him/her feel? *
Rarely

Sometimes

Usually

Does your child talk about how he/she is the same as and different from
others? *
Rarely

Sometimes

Usually
 Does your child ask adults for help? *
Rarely

Sometimes

Usually

Does your child play well with other children? *

Rarely

Sometimes

Usually

Does you child have conversations with other children? *

Rarely

Sometimes

Usually

Physical Health & Development

Page description:
For each of the following questions select the option that best represents your child's current
functioning. Answer each question based on your initial reaction. There are no right or
wrong answers.
 Does your child use scissors at home? *
Rarely

Sometimes

Usually

Does your child use the correct scissor grasp? *

Rarely

Sometimes

Usually

Does your child climb on playground equipment? *

Rarely

Sometimes

Usually

Is your child able to take care of basic self-care (i.e. dressing, toileting, hand
washing) without a lot of help? *
Rarely

Sometimes

Usually

Language & Literacy Development

Page description:
For each of the following questions select the option that best represents your child's current
functioning. Answer each question based on your initial reaction. There are no right or
wrong answers.

Can your child follow simple directions? *

Rarely

Sometimes

Usually

Does your child engage in conversation? *

Rarely

Sometimes

Usually

Can your child recognize the letters in his/her name? *

Rarely

Sometimes

Usually
 Can your child recognize his/her name in print? *
Rarely

Sometimes

Usually

When you read a book/tell a story with your child, does he/she follow the
story? *
Rarely

Sometimes

Usually

Do your child’s drawings show representations of him/herself, objects, or

animals? *
Rarely

Sometimes

Usually

Mathematics

Page description:
For each of the following questions select the option that best represents your child's current
functioning. Answer each question based on your initial reaction. There are no right or
wrong answers.
 Does your child count from 0-10? *
Rarely

Sometimes

Usually

Can your child put small groups of items together and then tell how many
there are in the whole group? *
Rarely

Sometimes

Usually

Does your child put objects that are the same into a group? *
Rarely

Sometimes

Usually

Cognition

Page description:
For each of the following questions select the option that best represents your child's current
functioning. Answer each question based on your initial reaction. There are no right or
wrong answers.
Is your child able to think of more than one possible way to solve a problem?
*
Rarely

Sometimes

Usually

Does your child explore new environments? *

Rarely

Sometimes

Usually

Is she/he able to stay with the same topic or activity for a while (a while being
at least 10 minutes)? *
Rarely

Sometimes

Usually

Can your child identify a pattern? (i.e. we brush teeth first then we read a
book or it might mean arranging things in a pattern, red block, blue block etc.)
*
Rarely

Sometimes

Usually
 Does your child use objects from their environment in pretend play? *
Rarely

Sometimes

Usually

Questions & Comments

Any questions or comments you'd like to leave for us please feel free to do
so below.