The first days of a new foster placement
A calm welcome, a warm bed and a little patience go a long way in a child’s first days with you.
By the numbers
Children arriving in care, and the first health checks.
Arriving in care
First health checks
Before the child arrives
Ask good questions and prepare a simple, welcoming space.
Placements often happen quickly, sometimes with only a few hours’ notice. You may not get every answer, but a few questions to the caseworker can make the first night much easier for the child.
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- Allergies, health conditions or urgent health needs
- Bedtime routine, comfort items and fears (like the dark or dogs)
- Clothing and shoe sizes
- Foods they like and are used to
- Language spoken at home, faith and cultural needs
- Name they like to be called, and how to say it
- School or child care, and how they will get there
- Siblings, and the plan for contact with family
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Helpful things to have
- A few clothes and pyjamas in a range of sizes
- A night-light
- A soft blanket and a toy, book or journal suited to their age
- A toothbrush, hairbrush and toiletries for their hair and skin type
- An empty drawer or box that is just for their things
- Simple snacks they can reach
Keep the room plain at first, so the child can make it their own over time.
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Tell your own children simply what is happening and what to expect. Keep the first days quiet, without big family visits or busy outings.
The arrival: the first hour
Warm, calm and quiet. No big welcome party.
Children of all ages, even babies, go through a period of adjusting to a new home. The child is trying to make sense of new people, a new house and new ways of doing things. Some arrive dirty, poorly dressed or with very few clothes.
A gentle first hour
- Greet them by name, at their eye level, with a calm voice and a smile.
- Introduce yourself and anyone else at home, briefly.
- Show them the bathroom first, then their bed, then the kitchen.
- Offer a drink and a simple snack, without pressure to eat.
- Tell them what will happen next tonight, step by step.
- Let them rest, watch a show or sit quietly. Don’t ask lots of questions.
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- “Here’s the bathroom. You don’t need to ask to use it.”
- “My name is Sam. You can call me Sam.”
- “You can ask me for anything you need, any time.”
- “You’re safe here. We’re glad you’ve come.”
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- “This is your new home forever.”
- “What happened at your house?”
- “You’ll be going home really soon.”
- “You’ll love it here!”
You don’t know the future yet, and the child may not be ready to talk about the past.
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- Any health conditions and the child’s health coverage number
- Contact numbers for the caseworker and the after-hours line
- Rules about contact with family members
- When the next visit or meeting is
In some states, a team meeting and a court hearing happen within 72 hours of an emergency placement, and a caseworker visits within the first week.
Their belongings and comfort items
Even worn or dirty things can be precious.
Don’t throw away a child’s clothes or belongings, even if they are dirty or worn out. These things may mean a great deal to them.
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A blanket or soft toy may smell like home. Ask the child before washing it, or wait a few days if they want to keep it as it is.
What to say
- “Would you like me to wash this, or keep it just how it is?”
- “This stays with you. No one will take it.”
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If a child arrives with their things in a plastic bag, or with very little, a simple bag, suitcase or box of their own shows their belongings matter.
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If you need to buy clothes or toiletries, let the child pick colours or styles. Choices help children feel some control.
Ask the caseworker about clothing allowances and keep your receipts.
Names and what to call you
Their name matters. Let them choose what to call you.
A child’s name is part of who they are and where they come from. Learn how to say it properly, and ask what they like to be called.
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What to say
- “Can you help me say your name the right way?”
- “Do you have a nickname you like?”
What not to say
- “I’ll just call you something easier.”
- “That’s an unusual name.”
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Asking a child to call you “Mom” or “Dad” can feel like a betrayal of their own parents. Offer your first name, and let them change it later if they want to.
What to say
- “Most kids call me Lisa. You can pick what feels right.”
- “If you start calling me something else one day, that’s okay too.”
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If they call their mom “Mama”, use that word too. It shows respect for their family.
The first night
Expect tears, waking or no sleep at all. Comfort is what matters.
A strange bed in a strange house can be frightening. Many children find night-time the hardest part of the first days. Sleep problems and nightmares are common signs of stress after trauma.
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Things that help
- A bath or wash only if they want one
- A night-light, and door open or closed as they choose
- Asking what they usually do before bed
- Reading a short story or playing quiet music
- Telling them where you sleep and that you’ll check on them
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A first night with little sleep is normal. Sit nearby, offer a drink of water, and keep lights low. Strict bedtime rules can wait.
What to say
- “It’s hard to sleep somewhere new. I’ll sit here for a bit.”
- “You’re not in trouble for being awake.”
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Knock and wait before going into their room or the bathroom. Tell them who will come in at night and why. Predictability helps a child feel safe.
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Bedwetting and fear of the dark can return after trauma, even in older children. Use a waterproof mattress cover and quietly help with clean sheets.
Routines and house rules in week one
Predictable days, few rules, and lots of patience.
A regular routine for meals, play time and bedtime helps a child feel safe. Prepare them ahead of time for changes or new experiences.
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Younger children may like a picture schedule on the fridge. Older children may prefer a quick chat each morning about the day ahead.
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Explain the most important rules gently, like safety rules. Others can wait. Children learn rules best once they feel safe.
What to say
- “In our house, we keep each other safe.”
- “If you’re not sure about something, just ask. You won’t get in trouble.”
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Offer foods the child knows, and tell them when the next meal is. If a child hides or gulps food, reassure rather than punish.
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Some children seem withdrawn, tearful, anxious, angry or overly playful at first. Others show no clear reaction. Respond to all of these with acceptance, warmth and understanding.
The first health check
A visit within days, then a full check within a month.
The American Academy of Pediatrics recommends a first health visit within 24 to 72 hours of placement. It focuses on urgent needs, like untreated illness or injury and ongoing health conditions, and on your questions.
A full check of physical, emotional, developmental and dental health is recommended within 30 days, with a follow-up at 60 to 90 days. Your state may have its own deadlines, so ask the caseworker.
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Health history can be pieced together from state vaccination records, the caseworker, the child’s school or child care, and the child themselves.
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Rules about consent vary by state. Work with the caseworker and the clinic so the right permissions are in place before the full check.
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What to say
- “The doctor just wants to make sure your body is healthy.”
- “You can hold my hand or squeeze this ball.”
- “You can tell the doctor to stop and wait.”
Tell the clinic ahead of time if the child is nervous of touch, needles or closed doors.
School and child care
Staying at their old school is often the default.
Under the federal Every Student Succeeds Act (ESSA), students in foster care are presumed to stay at their school of origin. If a move is in their best interest, the new school must enrol them right away, even without the usual documents.
Transportation to the school of origin must be arranged and funded while the child is in care. Talk with the caseworker before making any school change.
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When everything else has changed, a familiar classroom can be a source of stability. Many children want to see their friends and teachers.
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Things to share
- Any triggers the teacher should know, like loud voices
- That the child is adjusting to a big change
- Who can pick the child up, and who can’t
- Your contact details
Ask whether the school has a foster care point of contact.
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Tiredness, trouble concentrating and big feelings are common in the first weeks. Ask the teacher about a quiet space and a trusted adult the child can go to.
Big feelings in the first weeks
Grief, worry and relief can all show up, for the child and for you.
Expect sadness and anxiety. A child may grieve the loss of home and family, even if things there were very hard. Be patient, and don’t expect quick results.
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If a child blames themselves, reassure them that the placement is not their fault.
What to say
- “Grown-ups decided this to keep you safe. You didn’t do anything wrong.”
- “Lots of kids feel that way. It’s not true.”
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What to say
- “It’s okay to miss your family.”
- “Would you like to draw a picture for your mom?”
What not to say
- “You’re better off here.”
- “Don’t be sad, you’re safe now.”
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Feeling sad or disappointed about how a placement is going is normal, and so is needing to learn new ways of parenting.
Rest when you can, accept meals and help, and talk with other foster carers. Celebrate small wins, like a first laugh or a full night’s sleep.
When and where to get help
Who to call in the first days, day or night.
Call the caseworker or the agency’s after-hours line if…
- A parent or relative contacts you or the child unexpectedly
- The child has an injury, illness or health need you didn’t know about
- The child runs away or you can’t find them
- The child tells you about abuse or harm
- You don’t feel able to keep the child safe
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Call or text 988, or chat at chat.988lifeline.org. Text and chat are available in Spanish.
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Text HOME to 741741 in the U.S. It is free and confidential.
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Call or text 1-800-422-4453 (1-800-4-A-CHILD), 24/7, with counselors in over 170 languages. It is not a reporting line, but it can help you find your state’s.
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Find A Helpline lists free, confidential helplines in more than 175 countries. Your local children’s services can help with placement questions.
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- The Annie E. Casey Foundation (KIDS COUNT, using federal AFCARS data) (2026). Child Welfare and Foster Care Statistics
- American Academy of Pediatrics (HealthyChildren.org) (2026). Requirements for Health Screenings in Foster Care
- Georgia Division of Family & Children Services (DFCS). First Day of Placement
- Washington State Department of Children, Youth & Families (DCYF). The First Two Months of Placement
- Wisconsin Department of Public Instruction. Foster Care: Educational Stability for Students in Out-of-Home Care
- Child Welfare Information Gateway, Children’s Bureau, U.S. HHS (2025). Parenting a Child Who Has Experienced Trauma (Factsheet for Families)
- 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline
- National Institute of Mental Health (NIMH). Help for Mental Illnesses
- Crisis Text Line. Crisis Text Line
- Substance Abuse and Mental Health Services Administration (SAMHSA). Crisis Text Line (Disaster Behavioral Health Information Series)
- Childhelp. Childhelp National Child Abuse Hotline
- Child Welfare Information Gateway, Children’s Bureau, U.S. HHS. How to Report Child Abuse and Neglect
- ThroughLine (partner of the International Association for Suicide Prevention). Find A Helpline
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
