My son goes to a half day preschool only. What I have done it give them one container of the shot and the emergency info in a ziploc baggie. This is kept in the director's office with other medical info. I have instructed them (with fever, vomitting) to call parents immediately. With lethargy or possible bone break..to evaluate behavior and see if calling 911 isn't warranted. I don't know how to give the shot and have never even used it. I am on my second refill just because it expired. I will add that we did have a case where our son broke his arm (at home) and the shot was never needed. I gave him a stress dose before we went to the hospital..just in case... and he was fine. But I have heard parents tell of their kids' behavior changing very quickly at stressful times. I htink it varies from child to child. I think the preschool that we use is a good example of a place the truly 'cares' for my son. His big sister was attending when he was born and they are fully aware of his history. Wherever you put her.....keep in mind that the turnover rate should be VERY low. The caregiver should know what it normal for your child in order to assess any changes. Good luck!