Child Impact Assessments: Sample Tools

Tools Developed by Kids Impact Initiative

Downloadable Child Impact Assessment Form:

This sample form can be downloaded and filled in. For greatest ease-of-use, the design is simple with minimal formatting. It can be adapted to meet individual goals and needs.

Sample Child Impact Assessment Form

Examples of Completed Child Impact Assessment Forms:

State Level:

Texas Broadband Development

Local Level:

Housing Anti-Discrimination: Short Form

Housing Anti-Discrimination: Full Form

Housing Anti-Discrimination: Additional Child Equity Questions

Other Sample Assessment Forms

New Brunswick Government, Child Rights Impact Assessment Tool

New Zealand Government, Child Impact Assessment Tool

Seattle Public Schools, Racial Equity Analysis Tool

Other Examples of Completed Child Impact Assessments

New Brunswick Office of Child and Youth Advocate, A Child Rights Impact Assessment of Bill 39, An Act Respecting Proof of Immunization

Santa Clara County, Sample Child Impact Statement Linked to Children’s Agenda Indicators

Scottish Government, Heat Networks Bill, Child Rights and Wellbeing Impact Assessment

Scottish Government, Impact of COVID-19 restrictions on children and young people, Child Rights and Wellbeing Impact Assessment

Scottish Government, links to all Child Rights and Wellbeing Impact Assessments completed between November 2020 and January 2021

Shelby County Office of Early Childhood and Youth, Child Impact Statement for Defending Childhood Initiative

Sample Bill of Rights for Children & Youth

Convention on the Rights of the Child/UNICEF

City of Portland/Multnomah County (Oregon), Our Bill of Rights: Children + Youth

San Joaquin County (California), Children and Youth Bill of Rights

San Mateo County (California), Bill of Rights for Children and Youth

Santa Clara County (California), Bill of Rights for Children and Youth

Sample Guidance

New Zealand Ministry of Social Development, Improving the wellbeing of children and young people in New Zealand: Child Impact Assessment Guide