Introduction: Accurate fever assessment depends on correct temperature measurement, yet many caregivers rely on touch and have uncertainty about thermometer use and antipyretic dosing. Objectives: To assess caregivers’ practices and knowledge on temperature measurement and fever management, and to provide brief education on correct thermometer use and safe paracetamol dosing. Methods: A cross-sectional clinical audit was conducted at the Mother and Child Health Unit, Teaching Hospital Kalutara (wards, OPD and clinics) from 1st April to 31st May 2024. Parents/caregivers completed a self-administered questionnaire. Education was provided after completion. Institutional permission was obtained. Results: We included 1,000 caregivers (inward 405, clinics 220, OPD 375). Only 35% used athermometer at home; 12% owned one but did not use it due to lack of knowledge, and 64% relied on tactile assessment. Correct thermometer technique was known by 25%; common gaps included reading interpretation, required placement time and need for repeat readings. Knowledge and use were lower among caregivers educated below Ordinary Level and were significantly associated with economic status (p < 0.01). For fever management, 794 (79%) used paracetamol at home. Among users, 85% calculated the dose by weight; 19% estimated without calculation. Dosing intervals were 6-hourly in 65% and 4-hourly in 8%. Ten per cent sought medical advice at first detection of fever. Conclusions: Major gaps exist in caregiver knowledge and practices on temperature measurement and home fever management. Targeted caregiver education, especially for lower educational and socioeconomic groups, may improve safe antipyretic use and reduce unnecessary healthcare visits.