Name

First Last

Email*

How do you know (candidate name)?*

How long did he/she work for you?*

What was (candidate's name) hourly or salary rate? Did he/she also get benefits?*

What were his/her specific responsibilities?*

Was he/she detail-oriented?*

Did he/she do any laundry? If so, how were his/her laundry skills?*

Did he/she do any cooking? If so, how would you rate his/her cooking?*

How many children did (candidate's name) care for? What were the ages of the child(ren) upon hire?*

How was he/she in terms of being punctual and reliable?*

What was his/her greatest strength?*

Did he/she help with any additional household tasks (light cleaning, laundry, errands, etc)?*

What types of activities did he/she initiate with your child(ren)?*

How did your child(ren) relate to his/her?*

Anything he/she can work on or try to improve?*

Why and when did the position end?*

Do you have any additional comments for (candidate's name) future employer?*

What were some of his/her responsibilities? And can you tell me about your experience with her/him?*

How long did he/she work for you and is he/she still employed?*

What would be some words you would use to describe her/his strengths in this position?*

Do you allow her/him to drive with your children?*

If given the opportunity, would you rehire her/him? If not, why?*

Did she/he communicate well and present herself/himself professionally?*

Do you believe she/he is passionate about working with children?*

Was she/he creative in coming up with fun activities, projects and outings to do with your children?*

Was she/he flexible and able to adapt and accommodate for your needs and schedules?*

Do you feel she/he displayed good initiative and if so, could you give me an example?*

Was she/he reliable? (Was lateness ever an issue?)*

How would you describe her/his stamina and energy level regarding the work done for you?*

Is there an area that you feel she/he needs to improve on regarding the work done for you?*

Would you feel comfortable recommending her/him?*

Is there anything else you would like to share with us before we consider her/him for employment?*