Form PUB-5047-KO "Personalized Safety Tips and Emergency Contact Sheet for Baby Sitters" - New York (English/Korean)

What Is Form PUB-5047-KO?

This is a legal form that was released by the New York State Office of Children and Family Services - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2011;
  • The latest edition provided by the New York State Office of Children and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form PUB-5047-KO by clicking the link below or browse more documents and templates provided by the New York State Office of Children and Family Services.

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Download Form PUB-5047-KO "Personalized Safety Tips and Emergency Contact Sheet for Baby Sitters" - New York (English/Korean)

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What to do When I Cry
When I Sleep
All About Me!
Check to see if I am:
 Only place me on a firm ma ress in my crib.
My Name: _____________________________


Bored
Tired
 Remove pillows, quilts, comforters, toys,
My Address: ___________________________


Hungry
Too Cold
and other so products from my crib.
My Phone Number: _____________________


Lonely
Too Hot
 Place me on my back for naps and bed me.
My Date of Birth: _______________________


Scared
Wet
 If I need a blanket, make sure it comes up

Teething
______________________________________
no higher than my chest and is tucked under
the ma ress.
My Day
It’s OK to call my mom or dad If
 Make sure my head and face are uncovered.
Meal me: _____________________________
you’re not sure what to do!
 At all mes, provide me with a smoke‐free
Nap me: ______________________________
I like: _________________________________
environment.
Play me: ______________________________
If you get red, put me in my crib.
I don't like: ____________________________
Allergies: ______________________________
What to do if my crying
When I Play
Medica ons: __________________________
is frustra ng you
______________________________________
 Supervise me at all mes.
 Take a deep breath and stay calm.
 Place me on my tummy. It will help me
 Remember I cry to communicate with you.
Emergency Phone Numbers
strengthen my neck and shoulder muscles.
 Soothe me by rocking me gently; or take me
 My toys should be big enough that they do
My Parents Name: ______________________
for a walk.
not fit in my mouth, nose, or ears.
 Place me in a safe place like my crib, on my
Phone:________________________________
 My toys should not have sharp edges, loose
back, and take a short break.
ribbons, strings, or removable parts.
Cell: __________________________________
 Check on me every 10‐15 minutes.
 Remember, no balloons!
My Doctor: ____________________________
 Offer me a pacifier.
Messages:
_________________________
Fire Sta on:____________________________
 My crying may not stop no ma er what you
______________________________________
try.
Poison Control: 1‐800‐222‐1222
______________________________________
 Call my mom or dad or someone you trust
______________________________________
to help.
Parent Helpline:
______________________________________
Just remember my crying is
1‐800‐CHILDREN (244‐5373)
normal...so have a plan to cope.
______________________________________
When in doubt, call 911
PUB‐5047 (Rev. 8/2011)
What to do When I Cry
When I Sleep
All About Me!
Check to see if I am:
 Only place me on a firm ma ress in my crib.
My Name: _____________________________


Bored
Tired
 Remove pillows, quilts, comforters, toys,
My Address: ___________________________


Hungry
Too Cold
and other so products from my crib.
My Phone Number: _____________________


Lonely
Too Hot
 Place me on my back for naps and bed me.
My Date of Birth: _______________________


Scared
Wet
 If I need a blanket, make sure it comes up

Teething
______________________________________
no higher than my chest and is tucked under
the ma ress.
My Day
It’s OK to call my mom or dad If
 Make sure my head and face are uncovered.
Meal me: _____________________________
you’re not sure what to do!
 At all mes, provide me with a smoke‐free
Nap me: ______________________________
I like: _________________________________
environment.
Play me: ______________________________
If you get red, put me in my crib.
I don't like: ____________________________
Allergies: ______________________________
What to do if my crying
When I Play
Medica ons: __________________________
is frustra ng you
______________________________________
 Supervise me at all mes.
 Take a deep breath and stay calm.
 Place me on my tummy. It will help me
 Remember I cry to communicate with you.
Emergency Phone Numbers
strengthen my neck and shoulder muscles.
 Soothe me by rocking me gently; or take me
 My toys should be big enough that they do
My Parents Name: ______________________
for a walk.
not fit in my mouth, nose, or ears.
 Place me in a safe place like my crib, on my
Phone:________________________________
 My toys should not have sharp edges, loose
back, and take a short break.
ribbons, strings, or removable parts.
Cell: __________________________________
 Check on me every 10‐15 minutes.
 Remember, no balloons!
My Doctor: ____________________________
 Offer me a pacifier.
Messages:
_________________________
Fire Sta on:____________________________
 My crying may not stop no ma er what you
______________________________________
try.
Poison Control: 1‐800‐222‐1222
______________________________________
 Call my mom or dad or someone you trust
______________________________________
to help.
Parent Helpline:
______________________________________
Just remember my crying is
1‐800‐CHILDREN (244‐5373)
normal...so have a plan to cope.
______________________________________
When in doubt, call 911
PUB‐5047 (Rev. 8/2011)
아기가 울 때
잠잘 때
아기의 신상정보!
아기의 상태를 확인해주세요:
아기를 딱딱한 침대 매트리스에서 재워주
이름: ________________________________
세요.
주소:_________________________________

지루하다

피곤하다
아기 침대에서 배개, 담요, 이불, 장난감, 푹신
전화번호:_____________________________

배고프다

춥다
한 물건을 치워주세요.
생년월일:_____________________________


외롭다
덥다
낮잠 잘 때나 밤에 잠을 잘 때 아기를 바로
눕혀서 재워주세요.
______________________________________


무섭다
오줌을 쌌다
아기에게 이불을 덮어 줄 때는 이불을 가슴

이가 난다
하루 일과표
밑까지만 덮어주고 매트리스 밑에 밀어 넣어
주세요.
아기를 어떻게 돌봐야할지 엄마나
식사시간:_____________________________
아기의 머리와 얼굴을 덮지 마세요.
아빠에게 전화해서 물어주세요!
낮잠 시간:____________________________
아기 주변에서는 항상 금연해주세요.
놀이 시간:____________________________
아기를 돌보는 사람이 피곤해지면 아기를 아
아기가 좋아하는 것: ____________________
기 침대에 눕혀주세요.
알레르기:_____________________________
아기가 싫어하는 것: ____________________
약물:_________________________________
놀 때
______________________________________
아기가 너무 심하게 울 때 해야 할 일
아기에게서 한시도 눈을 떼지마세요.
숨을 깊이 들이쉬고 침착함을 유지하세요.
응급 연락처:
아기의 목과 어깨 근육이 튼튼해지도록 아기
아기는 울음으로 자신의 의사를 표현한다는
를 엎드려 주세요.
점을 기억해주세요.
부모 성명:____________________________
산책을 나가거나 부드럽게 흔들어서 아기를
장난감의 크기는 아기의 입, 코, 귓속으로 들
전화:_________________________________
달래주세요.
어갈 수 없을 정도로 커야 합니다.
아기 침대와 같이 안전한 장소에 아기를 바
장난감에는 뽀죡한 부분이나 헐렁한 리본,
휴대전화:_____________________________
로 눕혀 놓고 잠시 휴식을 취하세요.
줄, 탈부착이 가능한 부분이 없어야 합니다.
담당 의사:____________________________
10~15분 마다 아기 상태를 확인해주세요.
풍선은 절대 안됩니다!
소방서:_______________________________
아기에게 고무 젖꼭지를 물려주세요.
메모:
어떻게 해도 아기가 울음을 멈추지 않을 수
________________________________
도 있습니다.
독극물 통제 센터:
______________________________________
아기의 부모님 또는 도움을 얻을 수 있는 사
1‐800‐222‐1222
______________________________________
람에게 전화하세요.
부모 헬프라인:
______________________________________
아기가 우는 것은 정상이니....대처할
1‐800‐CHILDREN (244‐5373)
______________________________________
수 있는 방법을 세워보세요.
______________________________________
의심 신고 911
PUB‐5047‐K (Rev. 8/2011)
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