Digital Form User Guide

Car seat checks provide caregivers with the opportunity to receive education, either in-person or virtually, about the correct use of their car seat. Best practice is to document a car seat check regardless of how it is conducted. The National Digital Car Seat Check Form is a useful tool to guiding and documenting a car seat check.

The NDCF digital platform can be used in the following ways:

• Web-based check form (requiring internet access) on a computer, tablet, or phone.
• Mobile App available for Apple. Android and Kindle in iTunes, Google Play, or Amazon app stores. Prior to starting a car seat check, verify the most current version of the NDCF is being used by visiting carseatcheckform.org.

An approved and active account is required to begin tracking seat check data using any of the electronic platforms. Nationally certified Child Passenger Safety Technicians and Instructors can create a free account.

• Visit www.carseatcheckform.org to begin the process.

• Allow 1 to 3 business days to activate a new account. Technicians will receive an email to confirm account activation and log in information. CPSTs must plan ahead to ensure their account has been approved and is active prior to a car seat check event. Technicians are strongly encouraged to practice using the NDCF prior to their first event.

• Program managers, regardless of certification can request access to agency data by emailing [email protected].

New NDCF account holders will be sent an email containing a username and password once the account has been approved. The username and password must be changed on initial login.

• Proof of certification is required. When recertifying, users must upload a new certification card with the new certification information. User account will be suspended until current proof of certification has been submitted. Upload an original copy of the updated wallet card found in individual Safe Kids online certification profiles.
• Note: Other forms of certification verification will not be accepted.

Browser

The NDCF has been extensively tested using Google Chrome and is the preferred browser when working with the web application, however it will operate on other current browsers. To enable the autofill feature, consult the user guide for your preferred browser.

PRO TIP: The app is designed to be used in areas without Wi-Fi.

• Apps cannot be used until an account has been approved on the web based platform at carseatcheckform.org 

Mobile Apps are available for Apple. Android and Kindle in iTunes, Google Play, or Amazon app stores.

Devices must have an operating system of 8.0 or newer to run smoothly.

Downloading the App

Android Devices (Samsung, Google, HTC, etc.)    Go to the Play Store.

• Search “Car Seat Check Form”.
• Download the “Car Seat Check Form” app; which can be identified by the green icon from the developer “National Safety Council”. 
• Use the following link from a mobile device:  https://play.google.com/store/apps/details?id=org.nsc.checkform&hl=en_US

iOS Devices (Apple)

• Go to the App Store.
• Search “Car Seat Check Form”.
• Download the “Car Seat Check Form” app; which can be identified by the green icon under the category “Utilities”.
• Use the following link from a mobile device:  https://itunes.apple.com/us/app/car–seat–check–form/id1460697145?mt=8

App Login

The app is designed to be used in areas without Wi-Fi.  Once the app has been downloaded onto a device, sign into the app using your NDCF user login information. Note: Initial login must be completed while connected to Wi-Fi.

• Once the initial login is complete, the device should be placed in airplane mode to eliminate the potential for any app failures because it will continually search for Wi-Fi.
• Car seat check forms completed offline can be uploaded into the user account when the device is reconnected to Wi-Fi. Car seat checks are stored within the app and do not take up additional memory on the device until uploaded into the user account.
• Sign into the app, connect to Wi-Fi and begin downloading stored car seat checks.
• Reconnect to Wi-Fi before each use of the app to verify agency liability statement and technician information. Once information has been verified, the app may be used without Wi-Fi.
• If technicians are sharing the same device, log out or close the app prior to the next car seat check if a different technician is using the device.

Create a Check Form

Select Create New Check Form. All fields containing an asterisk (*) are required. Multiple children may be added to one check form connected to the caregiver.

NDCF Homepage Menu Agency

• Request Custom PD
• Agency List
• Add your Agency
• Request Admin Account
• NDCF for Program Managers

Resources

• Check Form Download- English and Spanish
• Sign In sheet- with and without liability statement
• Version updates and Terms/Conditions

How-To

• National Child Passenger Safety Board Webpage
• NDCF Use Methods
• User Guides
• Supporting Documents
• FAQ’s

Data NDCF Dashboards

Dashboards use cleaned data and statistical analysis to produce visualizations of misuse, car seat information, and vehicle information.

• Technicians and program managers can download a cleaned data file.  
• Download raw data and clean data
• View- Number of forms, Number of accounts
• User Page
• Update Profile

Search Check Forms

Each check form created receives a unique Form ID number. Once a seat check has been submitted, the seat checks are saved by the assigned Form ID number. Seat checks are listed on the Home Page by date of inspection.

• Additional children may be added to a saved check form connected to the caregiver by selecting the Form ID number.
• Form ID numbers are listed in order of date completed.
• Search for completed check forms by entering the event date or Form ID number.

Caregiver Information

Interview the caregiver to complete the information. Local level data not captured on the NDCF paper form may be collected separately or documented in the Documentation Box at the end of the form.

• City – enter the caregiver’s city.
• State – select the caregiver’s state from the dropdown menu.
• PRO TIP: The NDCF provides an opportunity to practice using the form prior to a live seat check. Always select “Practice” for any practice checks or mock seat check sign offs for recertification.
• County: Select the caregiver’s county from the dropdown menu.
• Zip: Enter the caregiver’s zip code.

All information in this section must be completed prior to beginning the car seat check.

• Complete the vehicle information even if the caregiver received a ride to the car seat check from someone else (e.g. friend, relative, support program, etc.). If the caregiver did not arrive in a passenger vehicle (e.g. public transportation, on foot, etc.), select No Vehicle Present.

What model year is this vehicle?

• 2011 or newer
• 2010 or older

Enter make, model, and year. See Vehicle Make/Model/Model Year/Trim below.

NOTE: If the vehicle does not appear in menu, select “2010 or older” and manually enter the information. 

Verify vehicle information:

• Verify the vehicle year by checking for the vehicle manufacture date on the driver side door frame, front of the A-pillar.
• Vehicle information can be verified by entering the license plate number into Check To Protect vehicle recall search service.

Visit checktoprotect.org to check for open vehicle recalls. Encourage the caregiver to use their cell phone (if available) or other electronic device to enter the vehicle license plate number to search for open vehicle recalls. Encourage the caregiver to call the local dealership to schedule an appointment have the recalled repaired for free. If the caregiver is unable to do so, search for the caregiver. If a recall is found, ask the caregiver to use the Check To Protect website to located a dealership to repair the recall for free. Internet connection required.

Vehicle Make/Model/Model Year/Trim

• Select the vehicle make, model, and year from the dropdown menus or enter it into the appropriate text boxes. Then enter the trim level of the vehicle model. The car trim level is also sometimes referred to as the trim package. The trim level specifies a vehicle model’s level of performance, features, options, and extras.

Note: If the vehicle make or model does not appear in the drop down menu, verify all the vehicle information has been entered correctly.

What Agency is hosting this seat check?

Document the agency providing the car seat check. Begin typing the agency name in the box until it appears in the list and select it.  

• Agency affiliation is not required to use the NDCF. Any currently certified technician can use the NDCF to track seat check data. Independent technicians should select “No Agency Affiliation”.
• If your agency does not appear in the menu, go to Agency and select “Add Your Agency”. This must be done on the web-based platform by visiting carseatcheckform.org. All new agencies will be verified before being added to the current agency list. Please plan ahead.
• Note: To avoid duplication of agencies, always confirm and select the correct agency name listed in the NDCF. Once an agency has been added, it will be saved and does not need to be added again.

Select Liability Statement

The caregiver must read the liability statement (or have it read to them), sign, and date the form prior to the car seat check.

Liability statement options:

• General liability statement: The NDCF general liability statement is available in English and Spanish.
• Agency liability statement: A customized liability statement may be added to an agency account in English and Spanish. Once uploaded, it will automatically appear as a menu option. Select your agency liability statement.
• Agencies may request a customized NDCF form with an agency liability statement in both English and Spanish. Complete the Custom PDF form or contact [email protected] for more information.

Caregiver Signature

Present the caregiver with the device to electronically capture a signature. The caregiver signature may also be collected on a paper form and recorded by checking “Signature is on the  paper check form”.

Virtual Seat Check

Check this box if the car seat check information is being collected as part of a virtual car seat check or a virtual car seat sign off for recertification. Follow the guidelines in the National Digital Car Seat Check Form Guidance Document: Virtual Car Seat Checks to capture caregiver signature and acknowledgement of the liability statement.

Inspection Date

The digital form automatically displays the current date. If the seat check information was collected on the NDCF paper form and is being entered into the digital platform, the date can be edited to reflect the date of the seat check.

Event

Provide a description of the event. (e.g. Seat Check Saturday, one-on-one appointment, etc.).

Use this field to differentiate between multiple events hosted by an agency on the same day.

• Technicians may use this field to record additional agencies hosting the event.

Has the caregiver attended a car seat check previously?

• Document the caregiver’s response.

Additional Techs Attending to This Caregiver

Document all technicians who participated in the car seat check. Begin typing the last name of the technician. The field will auto populate. Select the technician’s name.

• NOTE: If the technician does not appear on the list, record the name(s) in the Documentation Box at the end of the form. Only technicians who have active accounts can access seat check data.
• Do not include the account holder in the list. If the seat check will be used for re-certification, be sure to add the instructor or proxy name.
• If multiple Technicians are assisting a caregiver but not participating in the assessment of all the children in the caregiver vehicle, record the name of the Technician(s) who performed the assessment in the documentation box.

What state is this seat check taking place in? 

Select the state or IHS area in which the seat check is occurring.  

• Virtual seat checks: Select the state where the technician is located.
• Always select “Practice” for any practice checks or mock seat check sign offs for recertification.

 What brought the caregiver to the seat check?

Document how the caregiver learned about the car seat check.  

• If “Other”, briefly describe how the caregiver heard about the seat check.

Who is entering the data into the NDCF page?

• Self- CPST/I with an account who was present and completed the check.
• NDCF preparer- Administrator, Event Coordinator, CPST/I who did NOT complete the check, etc.

Save

Click the Save button. Any required fields left blank will be highlighted in red and must be completed before the form can be created and saved.

Once the form has been successfully saved, a new page appears with the Form ID number.

This number may be recorded for future reference.

• When using the app, Form ID numbers are not issued until the seat check has been uploaded into the user account.
• All children identified with the caregiver will have the same online Form ID number.

Add Child

Select “add child” to begin adding children to the check form.

1. Vehicle Present

Identify if the caregiver arrived in a passenger vehicle that is available to perform inspection. If the caregiver arrived by public transportation, on foot, etc., select No.

2. Child Location in Vehicle

Document where the CHILD is located in the vehicle on arrival, even if the child is unrestrained. This location may be different than the location of the child’s CAR SEAT as documented in #7.

• Driver represents the driver’s location.
• 2nd Row: If the vehicle only has one back row (e.g. sedan), use this option and leave 3^rd row blank.
• No Child Present: Select if there is no child present at the time of the car seat check.
• 4th Row: Select this option for larger vehicles with more than three rows (e.g. 15- passenger vans).
• Add additional location information for the 4th row to the Documentation Box.
• Note: If the child arrived in a different vehicle but will also be assessed in this vehicle, instruct the caregiver to secure the child as they normally would and proceed with the seat check.

3. Child’s Age in Years

Select the age range of the child even if the child is not present.

Unborn: Select if this is a prenatal seat check.

0<1: Select if child’s age is less than one year. Complete #3a.

3a. If child is under 1, select the age in months

Complete this question only if the child is born and less than 1 year old. Select the child’s age range in months.

4. Weight (lbs.)

Document the child’s weight in pounds. If the weight is unknown, report an estimated weight and document that the weight is estimated in the Documentation Box at the end of the form.

5. Height (in.)

Document the child’s height in inches. If the height is unknown, report an estimated height and document that the height is estimated in the Documentation Box at the end of the form. A     offers additional information about converting centimeters to inches.

6. How was weight and height collected?

• Caregiver Reported/Other Source- Select whether the caregiver reported the child’s weight and height, or information was verified by another source (e.g. hospital records, WIC document, etc.).
• Measured at Car Seat Check– Child was present and measured at the car seat check.

7. Child Secured Using

Select how the CHILD is secured on arrival. If the child is secured using a booster seat or seat belt, answer 7a. Child Seat Belt Correct.

7a. Child Seat Belt Correct

This question only appears if the child arrived in a booster seat or is using a seat belt.

No: select all that apply.

• Incorrect Fit on Child: Select if the seat belt across the neck, shoulder, or stomach, etc.
• Shoulder Belt: Select if the shoulder belt is misrouted when used with a booster, placed behind the back or tucked under the arm, too loose, etc.
• Lap Belt: Select if the lap belt is misrouted when used with a booster, too loose, etc.
• If a description of seat belt error is not listed, provide a brief description in the “other” box. If more detail is necessary, describe in the Documentation Box.

All forms can be saved at any time by selecting “save draft.” Select “next page’ to begin collecting CS On Arrival information.

8. CS Location in Vehicle

Document where the CAR SEAT (CS) is located in the vehicle on arrival. This location may be different than the location of the CHILD as documented in #2, Child Location in Vehicle.

• Driver represents the driver’s location.
• 2nd Row: If the vehicle only has one back row (e.g. sedan), use this option and leave 3^rd row blank.
• No CS: Select if the child does not have a car seat and proceed to #34.
• Uninstalled: Select if the car seat is present but not secured in a seating position (e.g. in vehicle trunk, in a box).
• 4th Row: Select this option for larger vehicles with more than three rows (e.g. 15- passenger vans).

Add additional location information for the 4th row to the Documentation Box at the end of the form.

• Note: If the child arrived in a different vehicle but will also be assessed in this vehicle, instruct the caregiver to secure the child as they normally would and proceed with the seat check.

9. CS Restraint Type

Document the restraint type being used on arrival.  Note: If the car seat is an All-in-one, choose the option that best describes how it was installed. (e.g. RF Convertible, FF with Harness, Backless Booster, High Back Booster).

CS= Car Seat     RF= Rear-Facing   FF= Forward-Facing

RF Only without Base: Any rear-facing only car seat designed for use only by a young child in a semireclined rear-facing position; not permitted by manufacturer to be used forward-facing; also referred to as infant car seat; only the carrier is present.

High Back Booster: Booster seat (or combination or all-in-one car seat being used in the booster mode) with a shell that provides head, neck, and back support for the child; raises and positions the child using a lap-and-shoulder belt.

RF Only with Base: Any rear-facing only car seat designed for use only by a young child in a semi reclined rear-facing position; not permitted by manufacturer to be used forward-facing; also referred to as infant car seat; the carrier and detachable base are present.

Backless Booster: Booster seat (or combination or all-in-one car seat being used in the booster mode) that uses the vehicle’s seat back or head restraint for head, neck and back support for the child; raises and positions the child using a lap-and-shoulder belt; also referred to as low-back booster seat or no-back booster seat.

Base Only: Detachable base for rear-facing only car seat; the carrier is not present.

Adaptive Restraint: Car seats and booster seats obtained through a specialized provider for use with children who have adaptive transportation needs.

RF Convertible: Car seat that can be used rearfacing and forward facing. Select this option when the car seat is being used rear-facing

Vest: A harness system used in place of a car seat or booster seat; work with either the vehicle seat belt system or LATCH.

FF with Harness: Forward-facing car seat being used with harness including convertible, combination, all-in-one, forward-facing only, and integrated car seats.

Other: Document restraint type if it does not fit any of the options above.

10. CS Harness Correct

Document if the car seat harness is being used correctly on arrival.  If the child arrived in a car seat/booster seat/seat belt and has been removed prior to assessment, instruct the caregiver to place the child back into the car seat/booster seat/seat belt without providing any instruction to accurately document all misuse.

If No, select all misuse that applies.

• If unborn and harness errors are observed, select NO.
• If a description of harness error is not listed, provide a brief description in the “Other” box. If

more detail is necessary, include it in the Documentation Box at the end of the form.  

• N/A: Check if child arrived in a booster or seat belt only.

11. CS Installed Using

If the car seat is uninstalled, Skip to #22.

Document the ways the car seat is installed in the vehicle on arrival; select all that apply.   Document additional findings in the Documentation Box at the end of the form.

Booster Use: Select how the booster was secured to the vehicle (e.g. lower anchors, top tether, uninstalled etc.).

• If child present, choose the best response option to describe how the booster was secured. Example: Child present, booster secured using LA, select LA and seat belt type that is used to secure the child.
• If the child was not present, select how the booster was secured.

12. Recline Angle Correct

Document if the car seat is reclined according to the car seat manufacturer’s instructions on arrival. No: Select misuse

• Too Upright
• Too Reclined

N/A: Select if recline angle does not apply to this car seat.

13. Lower Anchors Correct

If the car seat is installed using lower anchors, document if the lower anchors are used correctly on arrival according to the car seat and vehicle manufacturer. No: select all misuse that applies.

• If a description of lower anchor misuse is not listed, provide a brief description in the “other” box. If more detail is necessary, include it in the Documentation Box at the end of the form.

N/A: Check if the car seat is not installed with lower anchors.

14. Seat Belt Correct

If the car seat is installed using a seat belt, document if the seat belt is used correctly on arrival.   If No, select all misuse that applies.

• If a description of seat belt misuse is not listed, provide a brief description in the “Other” box. If more detail is necessary, include it in the Documentation Box at the end of the form.   N/A: Check if the car seat is not installed with a seat belt.

15. Tether Correct

Document if the tether is used per the car seat and vehicle manufacturer’s instructions on arrival.   No: Select all misuse that applies.  

• If a description of tether misuse is not listed, provide a brief description in the “Other” box.

If more detail is necessary, include it in the Documentation Box at the end of the form.

N/A: Check if the car seat does not have a tether or if a tether is present and not being used per the car seat and vehicle manufacturer’s instructions (e.g. a convertible seat in the rear-facing position).

16. Handle Position

Document if the carry handle is being used according to the car seat manufacturer’s instructions on arrival.

N/A: Check if the car seat does not have a carry handle.

17. Load Leg

Document if the load leg/foot prop is being used according to the car seat and vehicle manufacturer’s instructions on arrival.

N/A: Check if the car seat does not have load leg/foot prop.

18. Anti-Rebound Bar

Document if the anti-rebound bar is being used according to the car seat manufacturer’s instructions on arrival.

N/A: Check if the car seat does not have an anti-rebound bar.

19. Are there non-approved products?

Document if the caregiver is using any non-approved products on, under, or next to the car seat or on the seat belt on arrival.

Yes: Document additional information in the Documentation Box at the end of the form.

20. CS Correct Direction Per Manufacturer’s Instructions

Based on the child information and the car seat and vehicle manufacturer’s instructions, document if the car seat is installed facing the correct direction on arrival.

21. CS Secured Per Manufacturer’s Instructions

Based on the information collected in #11 through #20, document if the car seat is installed according to the car seat and vehicle manufacturer’s instructions on arrival.

Unknown: Check if the car seat instruction manual or vehicle owner’s manual is unavailable to verify if the car seat is installed according to the car seat and vehicle manufacturer’s instructions.

22. CS Correct for Child Age, Weight, and Height per Manufacturer’s Instructions

Based on information collected in #1-#3, and the car seat manufacturer’s instructions, determine if the child meets the age, weight, and height requirements of the car seat. Measure on site or discuss with caregiver to determine child’s weight and height.

Unborn Child: Select yes if the car seat can be used rear facing.

Unknown: Check unknown if the car seat instruction manual is unavailable and verification of weight and height is not possible.

23. CS Correct Per State’s Law

Based on the information collected, determine if the car seat is appropriate/used according to the current state law.

N/A: Check if the state law does not apply to the current car seat check.  To view your State’s CPS law, visit https://www.ghsa.org/state–laws. Internet connection is required.

24. Car Seat (CS) Labels Missing

Document if the car seat being used on arrival is missing labels needed to identify general use information.

Yes: Complete as much information as possible in #24 through #30.

25. Car Seat MFR

Select the manufacturer name of the car seat being used on arrival from the dropdown menu.

• If the manufacturer information cannot be determined, select “Unknown”.
• If the manufacturer is not listed (i.e. foreign car seat or non-FMVSS 213 approved) or you suspect a counterfeit car seat, select “Other” and enter the manufacturer information.

26. Model Name

Select the model name of the car seat being used on arrival. If the model name cannot be determined, select “Unknown”.

27. Model Number

Document the model number of the car seat being used on arrival. If the model number cannot be determined, enter “U” in the text box.

28. MFR Date

Document the date of manufacture of the car seat being used on arrival.

29. Expiration Date

Document the expiration date, if available, of the car seat being used on arrival. Leave this field blank if the expiration date cannot be determined.

30. CS Expired

Determine and document if the car seat being used on arrival is expired.   Unknown: Check if unable to determine if the car seat is expired.

31. CS Recalled

Using the car seat information collected, identify any recalls on the car seat being used on arrival and document them in the Documentation Box.

Unknown: Check if unable to determine if the car seat is recalled. To view the most recent recall link, visit NHTSA.gov. Internet connection required.

32. Car Seat History Known

Determine and document if the history of the car seat being used on arrival is known.

33. CS Involved in a Crash

Determine and document if the car seat being used on arrival has been involved in a crash. Note: If the car seat has been involved in a crash or if the history of the car seat is unknown, consider the need to replace the car seat.  For more information: NHTSA Car Seat Use After A Crash

34. CS Registered

Determine and document if the car seat being used on arrival is registered with the car seat manufacturer, using the caregiver’s current address. If the car seat is not registered or if it is unknown if the car seat is registered, provide guidance to the caregiver on how to register the car seat. Consider registering the car seat on-site prior to the caregiver leaving the car seat check.

35. Child/CS Location in Vehicle

Document where the CHILD and the CAR SEAT are located in the vehicle on departure.  These should be the same location in the vehicle.

• Driver represents the driver’s location.
• 2nd Row: If the vehicle only has one back row (e.g. sedan), use this option and leave 3^rd row blank.
• 4th Row: Select this option for larger vehicles with more than three rows (e.g. 15- passenger vans).

Add additional location information for the 4^th row to the Documentation Box at the end of the form.

• Demonstration Only: Check if the car seat is installed on a vehicle demonstration seat, not in a vehicle. Installation on a vehicle demonstration seat should only be done when no other options are available.

36. Restraint Type

Check restraint type being used on departure. Note: If the car seat is an All-in-One, choose the option that best describes how it was installed. (e.g. Rear-Facing (RF) Convertible, Forward-Facing (FF) with Harness, Backless Booster, High Back Booster)

CS= Car Seat     RF= Rear-Facing   FF= Forward-Facing

RF Only without Base: Any rear-facing only car seat designed for use only by a young child in a semireclined rear-facing position; not permitted by manufacturer to be used forward-facing; also referred to as infant car seat; only the carrier is present.

High Back Booster: Booster seat (or combination or all-in-one car seat being used in the booster mode) with a shell that provides head, neck, and back support for the child; raises and positions the child using a lap-and-shoulder belt.

RF Only with Base: Any rear-facing only car seat designed for use only by a young child in a semi reclined rear-facing position; not permitted by manufacturer to be used forward-facing; also referred to as infant car seat; the carrier and detachable base are present.

Backless Booster: Booster seat (or combination or all-in-one car seat being used in the booster mode) that uses the vehicle’s seat back or head restraint for head, neck and back support for the child; raises and positions the child using a lap-and-shoulder belt; also referred to as low-back booster seat or no-back booster seat.

Base Only: Detachable base for rear-facing only car seat; the carrier is not present.

Adaptive Restraint: Car seats and booster seats obtained through a specialized provider for use with children who have adaptive transportation needs.

RF Convertible: Car seat that can be used rearfacing and forward facing. Select this option when the car seat is being used rear-facing

Vest: A harness system used in place of a car seat or booster seat; work with either the vehicle seat belt system or LATCH.

FF with Harness: Forward-facing car seat being used with harness including convertible, combination, all-in-one, forward-facing only, and integrated car seats.

37. Child Secured Using

Select how the CHILD is secured on departure.

No Child Present: Select if no child is present at the car seat check.

38. CS Installed Using

Document how the CAR SEAT is installed in the vehicle on departure; select all that apply. Document additional findings in the Documentation Box at the end of the form.

• Uninstalled: Select if the car seat is present but not secured in a seating position (e.g. in vehicle trunk, in a box).
• No CS: Check if a child left without a car seat. Proceed to #46.

39. Is this the same CS as “On Arrival”?

Document if the same car seat is used on arrival and departure.

Yes: If the same car seat is used on arrival and departure, skip to #45.

• If No, CS provided by: Document who provided the car seat for the child on departure.

39b. Meets Eligibility Requirements

Check box if the caregiver meets the eligibility requirements to receive the car seat provided by the donor in #39a. Document any additional local information in the Documentation Box. If there are no eligibility requirement, leave blank.

40. CS MFR

Document the manufacturer name of the car seat being used on departure.  If the manufacturer information cannot be determined, enter “Unknown” in the text box. If the manufacturer is not listed, select “Other” and enter the manufacturer information.

41. Model Name

Document the model name of the car seat being used on departure. If the model information cannot be determined, enter “U” in the text box.

42. Model Number

Document the model number of the car seat being used on departure. If the model number cannot be determined, enter “U” in the text box.

43. MFR Date (MM/YYYY)

Document the expiration date, if available, of the car seat being used on departure.

44. Expiration Date

Document the expiration date, if available, of the car seat being used on departure.

Other: Document restraint type if it does not fit any of the options above.

45. CS Registered for Recalls By

Document who is responsible for registering the car seat being used on departure.  N/A: Select if no car seat is being used on departure.

46. Is the CS compatible with the vehicle?

Document if the car seat being used on departure is compatible with the vehicle.  Note: If there was any incompatibility on arrival, document issues in the Documentation Box.

• Yes, without difficulty: Proceed to #47.
• Yes, with difficulty: Answer #46a.
• No, a different car seat is/was needed: Answer #46a.
• CS uninstalled: Proceed to #47

46a. What difficulties did you encounter?

Select all difficulties that you encountered when installing the car seat being used on departure.   Other: If a description of the installation difficulty is not listed, provide a brief description in the “Other” box. If more detail is necessary, describe in the Documentation Box on page 2.

47. Child/CS Correct on Departure

Document if all corrections are made to the car seat prior to departure. Complete this question even if there is no child present.

No: Provide an explanation as to why all corrections are not made in the Documentation Box. Only select “No” if the seat is not correct for the child or the seat is otherwise unusable (expired, damaged, or incorrect seat selection – age, height, weight).

Documentation Box

Document seat check details. Do not put personal information in the box.

Check all topics discussed with caregiver.

Nationally certified CPS Technicians can access the 2020 National Child Passenger Safety Technician Certification Training Technician Guide (TG) for additional information about the following topics as indicated below.

• Airbags: Location and potential danger of airbags to children and out of position occupants (TG Module 5).
• Unused seat belts: Strangulation dangers of unused seat belts. Additional information is available at org/car–seat–safety/car–seatsafetyentanglement/.
• Projectiles: Loose objects in the vehicle that can cause injury (TG 3-2).
• Premature transition: Potential risks from moving from rear-facing to forward-facing and harness to booster seat too soon (TG Modules 7-10).
• Heatstroke: Prevention tips to avoid hot car deaths (TG 12-5). Additional information is available at cpsboard.org/heatstroke.
• Next steps: Change of direction from rear-facing to forward-facing, transition to next car seat stage, etc. (TG Modules 7-10).
• Best practice vs. state law: Guidance on best practice recommendations vs. state law (TG 2-4 and 7-3).
• Safety in and around cars: Dangers of leaving children unattended in and around cars (TG 12-5). Additional information is available at cpsboard.org/heatstroke.
• CS recycled: What to do with a car seat when it reaches its expiration date. Encourage caregivers to check with local recycling programs. Refer caregivers to car seat manufacturer information on car seat recycling.
• Bulky clothing: Dangers of securing a child in a car seat with bulky winter clothing. Additional information is available at AAP Recommendations.
• Vehicle recall: Find out if the caregiver’s vehicle has an open recall. It’s free to check and free to repair at a dealer. Visit Check to Protect.
• Safe Sleep: Infant sleep safety recommendations available at healthychildren.org.

48. I harnessed a child/doll in a Car Seat.

The caregiver indicates if he/she harnessed a child/doll in the car seat. If the car seat check information is being collected as part of a virtual car seat check, the technician will select the appropriate response based on the caregiver’s actions.

No: Provide an explanation in the Agency Documentation Box.   N/A: Check if there is no child or doll present.

49. I installed my car seat today.

The caregiver indicates they installed the car seat today. If the car seat check information is being collected as part of a virtual car seat check, the technician will select the appropriate response based on the caregiver’s actions.

No: Provide an explanation in the Agency Documentation Box.

N/A: Select if the car seat is not installed in a vehicle or it is installed on a vehicle demonstration seat.

50. Caregiver’s Initials

The caregiver acknowledges #48 and #49 by signing his/her initials. For a virtual seat check, enter the letters “VR”.

51. Caregiver Donation

Document if the caregiver provided a donation.

Yes: If yes, enter the donation amount in the “Caregiver Donation Amount” box.

52. Educational materials given?

Document if educational materials are provided.

53. Final Inspection Sign-Off

Document a final sign-off by a senior checker, an Instructor, or a Technician Proxy prior to departure, if required. If not required, leave blank.

54. Is this check for recertification? Check the appropriate box.

54a. Document if the technician passed or failed the seat check for recertification.

54b. Mock Seat Check

Check the appropriate box. Mock seat checks are not a formal seat check and are typically done with another adult in a role-playing exercise. Note: The NDCF program supports the National Child

Passenger Safety Board’s guidance that best practice for seat check sign offs is to observe interactions and education at an actual event with caregivers in attendance. Mock seat checks should be the final resort to meet any required seat check sign off. For more information about seat sign offs. Please visit Safe Kids Certification.

Agency Documentation Box    

Document seat check details. Do not put personal information in the documentation box.

Car seat check forms can be stored in draft and edited until the form is submitted. To protect the fidelity of the information collected, the form cannot be edited once submitted.  

Submit

Once the form has been reviewed and is ready to be submitted, select “Submit”. If a data field must be corrected, submit a request through the “Report Feedback” tab in carseatcheckform.org. A record is kept of changes made to the submitted form.

Note: If there have been substantial changes to the overall check form, consider starting a new form to avoid errors in reporting.

Error

Forms cannot be submitted with missing data fields.

• A dialogue box will appear with all incomplete fields.
• The form will redirect the user to all incomplete fields highlighted in red.
• Once all information has been entered, complete the form by clicking submit.

 App Users

If Wi-Fi is not available, check forms(s) will be saved in the app until a Wi-Fi is available.

User will be prompted to reconnect to the internet before being able to submit. Click “Okay” to return to the app. Once you have a Wi-Fi, you must log in to submit check form(s).

View or Submit Saved Check Forms

Select the “View or Submit Saved Check Forms” button on the home page menu.

• To view the check form(s) for a caregiver, select the vehicle information. To review check forms associated with the caregiver, select “Child List” on the Caregiver Information page.
• To submit a check form to the NDCF database, select the green “Submit” button.

WI-FI/Data Connection

If there is no Wi-Fi available, car seat check forms will be saved in the app until a Wi-Fi/data connection is available.

• All caregiver information and check forms are saved in the app.
• If Wi-Fi is unavailable, you will be prompted to reconnect to Wi-Fi and log in before submitting check forms.
• Select “Okay” to return to the app.
• Note: Be sure airplane mode is off before logging in when preparing to submit the check forms.
• When check forms are successfully submitted to the NDCF database they will be labeled “Submitted” under vehicle info and can be deleted from the device app.

  Tutorial video: https://youtu.be/pmDs0sHWwAE