Southern Seven Head Start/ Early Head StartRevised: 06/16, rm 5 Southern Seven Head Start STANDARDS OF CONDUCT Pursuant to Head Start Performance Standard 1304.52(h)(1), all employees,

Southern Seven Head Start/

Early Head Start

Eligibility, Recruitment, Selection, Enrollment, and

Attendance (ERSEA) Procedures

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TABLE OF CONTENTS Training ........................................................................................................................... 4 Standards of Conduct ...................................................................................................... 5 ERSEA Team .................................................................................................................. 6

ELIGIBILITY ................................................................................................................... 7 Eligibility Requirements ................................................................................................... 7

Eligibility Categories .................................................................................................... 8 Verification of Age........................................................................................................ 8 Verification of Income .................................................................................................. 8

Application ................................................................................................................... 9 0 Income Affidavit Form ................................................................................................ 10 Verification of Support for 0 Income Affidavit ................................................................ 11 Family Size and Income ................................................................................................ 12 Income Tip Sheet .......................................................................................................... 14

Compliance Certification Form ...................................................................................... 15

Income Worksheet Form ............................................................................................... 16 Family Income Guidelines ............................................................................................. 17

Homeless Eligibility ....................................................................................................... 18 Living Situation Survey Form ........................................................................................ 20 Verification of Support for Family Living Situation ......................................................... 22

Head Start Eligibility Verification ................................................................................... 23 Head Start Application Eligibility Verification ................................................................. 23

Head Start Eligibility Verification Form .......................................................................... 24 Application/Eligibility Verification Form .......................................................................... 25 RECRUITMENT ............................................................................................................ 26

Recruitment Plan ........................................................................................................... 26

Annual Recruitment Schedule of Events ....................................................................... 27 Recruitment Binder........................................................................................................ 28 Recruitment Plan Form ................................................................................................. 29

Poster/Flyer Locations Form ......................................................................................... 31 Intake Process .............................................................................................................. 32

Best Practices for Interviewing ...................................................................................... 33 Information Worksheet Form ......................................................................................... 34

Friendly Reminder Letter ............................................................................................... 36 Friendly Reminder Letter (Spanish Version) ................................................................. 37 Intake Follow Up Letter ................................................................................................. 38 SELECTION .................................................................................................................. 39 Selection Criteria ........................................................................................................... 39

Selection Criteria Form .................................................................................................. 40

Selection Process.......................................................................................................... 41

Waiting List .................................................................................................................... 42 Near Low and Over Income Families ............................................................................ 43 Employee’s Families ..................................................................................................... 43 Acceptance of 3 Year Olds ............................................................................................ 44 ENROLLMENT ............................................................................................................. 45 Application Process ....................................................................................................... 45 Parent Coordinator Request Letter ............................................................................... 47

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Setting Up Files/Central Office Tracking ....................................................................... 48 Central Office Chart Checklist Form .............................................................................. 49

Head Start Center Chart Checklist Form ....................................................................... 50 Early Head Start Center Chart Checklist Form .............................................................. 51 Home Based Chart Checklist Form ............................................................................... 52

Early Head Start Transition to Head Start ..................................................................... 53 Infants in the Early Head Start Classrooms ................................................................... 54 The Definition of Enrollment & Entry ............................................................................. 55 Enrollment/Re-Enrollment ............................................................................................. 56 Vacancies ...................................................................................................................... 56

Change of Status .......................................................................................................... 57 Change of Status Form ................................................................................................. 58 Weekly Enrollment Report ............................................................................................. 59 Weekly Enrollment Report Form ................................................................................... 60 Monthly Enrollment Reporting ....................................................................................... 61

Monthly Report .............................................................................................................. 62

Enrollment Report Form ................................................................................................ 63 Monthly Audit Enrollment Report ................................................................................... 65

Monthly Audit Report Form ........................................................................................... 66 Kindergarten Files ......................................................................................................... 67 Consent For Release of Information Form .................................................................... 68

ATTENDANCE ............................................................................................................. 69 Entry (First Week of School) ......................................................................................... 69

Daily Entry Report Form ................................................................................................ 70 Attendance .................................................................................................................... 71 Sample Attendance Spreadsheet .................................................................................. 73

ChildPlus.Net Center Based Attendance Entry ............................................................. 74

Child Absence Documentation ...................................................................................... 75

Child Absence Documentation Form ............................................................................. 76 ChildPlus.Net Child Absence Entry ............................................................................... 77

Home Based Weekly Visit and Monitoring .................................................................... 78 ChildPlus.Net Entry of Home Based Visits .................................................................... 79 Classroom Attendance Analysis .................................................................................... 80

Classroom Attendance Analysis Form .......................................................................... 81 Attendance Agreements ................................................................................................ 82

Attendance Agreement Form ........................................................................................ 83 Chronic Absenteeism .................................................................................................... 84 Incentives for Attendance .............................................................................................. 85

Perfect Attendance Certificate Form ............................................................................. 86 Average Daily Attendance Certificate Form .................................................................. 87

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Training References: Administration for Children & Families Program Instruction for

Head Start The ERSEA Specialist will keep up to date on Head Start Performance Standards, Program Instructions, and Information Memorandums relating to 1302 Subpart A. The ERSEA Specialist will stay current by attending conferences, trainings, webinars, monitoring the Early Childhood Learning and Knowledge Center Website, and certifications as deemed appropriate by the Early Childhood Administrator, Policy Council, and Board of Health. The ERSEA Specialist will provide the following training annually:

Eligibility (1302.12) – eligibility policies/procedures to also include eligibility requirements and categories to include McKinney Vento Homeless Assistance Act, federal poverty guidelines, definition of family and income, collecting and verifying income from families and methods of using third party sources and awareness of consequences established by Southern Seven who knowingly sign a verification form that contains false information as per Code of Conduct.

Recruitment (1302.13) – Recruitment policies/procedures to include recruitment, plans and documentation and Intake Process.

Selection (1302.14) - Selection policies/procedures to include the formal process for selecting children and families and waiting list procedures

Enrollment (1302.15) – Enrollment policies and procedures to include funded enrollment, maintaining full enrollment, vacancies, 3rd year re-verification process, and the procedure for setting up and tracking files.

Attendance (1302.16) – Attendance policies and procedures to include absence documentation, Average Daily Attendance Reports, and analysis of the causes of absenteeism.

Suspension and expulsion (1302.17) – A program must prohibit or severely limit the use of suspension due to a child’s behavior. Such suspensions may only be temporary in nature. A program cannot expel or unenroll a child from Head Start because of a child’s behavior.

Policy on fees (1302.18) – Prohibits charging of any fees for participation in the program

New hires for the positions of Parent Coordinators, Home Based Teachers/Parent Coordinators, Service Team and Site Supervisors will receive the training within 90 days of hire by the ERSEA Specialist. The ERSEA Specialist must train all governing body and Policy Council Members within 180 days of the beginning of the term.

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Southern Seven Head Start STANDARDS OF CONDUCT

Pursuant to Head Start Performance Standard 1304.52(h)(1), all employees, consultants and volunteers within the Head Start Division shall abide by the following Standards of Conduct. As a Head Start employee, I will:

respect and promote the unique identity of each child and family and refrain from stereotyping on the basis of gender, race, ethnicity, culture, religion or disability.

follow program confidentiality policies concerning information about children, families, and other staff members.

ensure that no child will be left alone or unsupervised while under my care.

use positive methods of child guidance and will not engage in corporal punishment, emotional or physical abuse or humiliation.

not employ methods of discipline that involve isolation, the use of food as punishment or reward, or the denial of basic needs.

not knowingly commit fraud or provide misleading or inaccurate information in an effort to deem a family eligible for Head Start services.

Employees violating these standards will be subject to discipline up to and including dismissal. Consultants and volunteers shall be subject to discontinuance of their services. I agree to these Standards of Conduct by my signature below. ______________________________ __________________ Employee Date ______________________________ __________________ Supervisor Date

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Southern Seven HS/EHS Service Area: ERSEA Procedure: ERSEA Team References: None This advisory/functional team is designed to review, plan, and enhance the quality of the ERSEA service area. Committee members include: Early Childhood Administrator and/or designee, Human Resource Administrator, Early Childhood Director, ERSEA Specialist, Health & Nutrition Specialist, Special Needs Coordinator, Education Team Member, Social Services Specialist, Site Supervisor, Parent Coordinator, Home Based Teacher/Parent Coordinator, Policy Council Member, and Parent(s). Meetings occur monthly and will provide advisement with the following:

Review and analyze data from the Community Assessment, Self- Assessment, PIR, Parent Questionnaires and other monitoring tools for planning purposes.

Build on existing recruitment strategies.

Review and update selection criteria annually.

Ensure that at least 10% of enrollment opportunities are made available to children with disabilities.

Monitor number of children that are not income eligible.

Identify strategies to meet and maintain funded enrollment.

Review reports and strategize ways to reach and maintain a minimum of 85% average daily attendance.

Advise and assist with planning annual required ERSEA Training(s). Information from this committee is shared with Policy Council and Board of Health for input and approval as needed.

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Southern Seven HS/EHS

Service Area: ERSEA Procedure: Eligibility Requirements References: Head Start Performance Standards - 1302.12 Eligibility Requirements 1) Families that live in the service area of Alexander, Hardin, Johnson, Massac,

Pope, Pulaski, and Union Counties.

2) Families with children ages birth to five (5) are the target population. a) Early Head Start provides services for children birth to age three (3). b) Head Start provides services for children ages three (3) to five (5). A child

must be three (3) prior to September 1st (public school cutoff date) to be considered for enrollment at the beginning of the school year. However after a child turns three (3) (after September 1st), as vacancies occur, they may be considered for an enrollment opportunity.

Eligibility Categories 1) Categorically Eligible a) Children in foster care.

b) Families who are homeless means individuals who lack a fixed, regular, and adequate nighttime residence. McKinney-Vento Act (see complete definition in Homeless Eligibility Policy).

2) Income Eligible

a) Families whose total annual income before taxes is equal to or less than the poverty income guidelines as defined by the U.S. Department of Health and Human Services. Southern Seven Head Start utilizes the most current income guidelines until they are replaced by a new version.

b) Families who are receiving income from public assistance: 1) TANF (cash benefits) 2) SSI (does not include survivor or Social Security benefits) 3) Families who in the absence of childcare would be eligible for public assistance.

3) Over Income

Ten (10) percent of enrollment may come from families in which income is above the poverty income guidelines.

4) Near Low Income If necessary to meet funded enrollment, up to thirty-five (35) percent of enrollment may come from families with an income below 130 percent of the poverty income guidelines. Southern Seven Head Start ensures that families below the poverty income guidelines receive top priority for enrollment. At this time, Southern Seven is not utilizing this option with the exception of criteria points to determine which over income families are selected.

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Children with Disabilities - Of children enrolled at least ten (10) percent of the total enrollment opportunities must be made available to children with disabilities. Criteria points are provided for children with diagnosed disabilities (IEP/IFSP) and those that are suspected with documentation. Children with disabilities are counted as listed above in eligibility categories (public assistance, foster, homeless, income eligible or over income). Eligibility Categories Verification of Age: Must include: Copy of the birth certificate or Other legal document when approved by the ERSEA Specialist. A copy of documentation of age is part of the child’s center and central office file. Verification of age is documented on the Head Start application. Verification of Income:

At least two recent paystubs or pay envelopes.

W-2 or Income Tax Forms from the previous year.

TANF or SSI documentation or letter indicating current status as recipients.

Written statement from employer(s).

“O” Dollar Affidavit - Families, who have had no income in the past twelve months verify this by completing the “O” Dollar Affidavit Form. Staff discusses the income status with the family to assess how the family is living and what support services may need to be provided. Verification of Support (found on the reverse side of the “0” Dollar Affidavit) is completed to document how family is living without income. o Staff receives a third party consent. o Staff makes reasonable effort to verify income. o Staff signs and documents effort.

Other sources when approved by the ERSEA Specialist. Copies of Income Documentation are maintained in a secure location separate from the child’s file. The period of time to be considered for eligibility is: 1) the twelve months immediately preceding the month in which application for enrollment of a child is made, 2) for the calendar year immediately preceding the calendar year in which the application is made, whichever more accurately reflects the family’s current needs or 3) as per section 645(a) of the Head Start Act, Head Start Programs are permitted to consider, at the time of enrollment, information that most accurately reflects the needs of the family. Income that is used for acceptance and enrollment purposes is good throughout all of Early Head Start. Income is good for two years for Head Start and if a child is enrolled for three years, income is re-verified for the third year of services. When a child is transitioning from Early Head Start to Head Start, a new income is submitted.

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Application: For selection and enrollment, an application must be completed. Intake Staff complete the application with the parent or guardian. Families are given the opportunity to review and make changes as needed, including those on the waitlist. When a child is transitioning from Early Head Start to Head Start, a new application is completed. If a child is enrolled in a third year of Head Start, when income is re-verified a new application is also submitted to update information.

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Southern Seven Head Start/Early Head Start

“0” INCOME AFFIDAVIT

Child’s Name: ________________________________ Center: _______________________ Please help us understand how you have been managing with little or no income by answering each question. 1) Do you receive money on a regular basis (circle one)? Yes No If yes, how often do you receive it and from what source do you receive it? 2) How have you been paying for your rent/house payment, utilities, food, and transportation expenses? 3) What other expenses, besides those listed above, do you have and how have you been

paying them?

Place of last employment? Name: ___________________________________ Telephone: _______________________ Address: _________________________________ Last day of work ______/______/______ City: _____________________________________ State: ____________________________ If you sold merchandise (ie: Garage Sales, Social Media, Scrap Metal, etc.) to pay bills: What type of merchandise? How much did you receive? _________________________________________ $ _______________________________ _________________________________________ $ _______________________________ If friends and relatives have been giving financial support, you must list their names, address, telephone numbers and the dollar amount that they have contributed. Verification of support form(s) must be completed (see back of form). I understand that this is an application for services that are paid for with federal funds and that intentionally providing misleading, inaccurate or untruthful information of a material nature could result in disenrolling my child from Head Start/Early Head Start and could have serious legal consequences for me. ___________________________________ _____________________________ Signature Staff Signature ___________________________________ _____________________________ Date Date

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Southern Seven Head Start/Early Head Start VERIFICATION OF SUPPORT FOR 0 DOLLAR AFFIDAVIT

Child’s Name:___________________________ Center:_____________________ Name:_________________________________ Relationship:________________ Address: ______________________________________________________________ Phone: _______________________________________________________________ Dollar Amount: $ _________ One Time Payment / Weekly / Monthly / Yearly (circle one) Other: _________________________________________ _______________________________________ _____________________ Signature (person providing financial support) Date

Third Party Release and Documentation

I,_____________________________________________ (Parent/Guardian/Applicant), give consent to ____________________________________, to contact the following parties to verify information solely for the purpose of determining eligibility for Southern Seven Head Start/Early Head Start services. Name of Third Party #1:_______________________________ Phone Number:_________ Title of Third Party: _________________________________________________________ Affiliation of Third Party: _____________________________________________________ Information obtained (attach documents): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Name of Third Party #2:_______________________________ Phone Number:_________ Title of Third Party: _________________________________________________________ Affiliation of Third Party: _____________________________________________________ Information obtained (attach documents): ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Name of Parent/Guardian/Applicant: ___________________________________________ Signature of Parent/Guardian/Applicant: ________________________________________ Name & Signature of Staff Obtaining Information: _________________________________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Family Size and Income References: Head Start Performance Standards – 1302.12;

Attachment for IM ACF-IM-09-02

Family Size: Family, for a child, means all persons living in the same household who are:

1) Supported by the child’s parent(s) or guardian(s) income; and 2) Related to the child’s parent(s) or guardian(s) by blood, marriage, or adoption; or 3) The child’s authorized caregiver or legally responsible party.

This definition has two important parts. In order to be considered a member of the family, a person must meet either one and two or one and three of the definition. Staff who complete Intakes receive intensive training on family size. If a child is in foster care, child is considered to be a family size of one. Family size is documented on the application, Income Worksheet, and Application Eligibility Verification Form. A brief description of the family size (i.e. mother, stepfather, and two children) is recorded on the Income Worksheet.

Income: During the Intake Process, staff review the Definition of Income (Income Tip Sheet) with the parent/guardian(s). This is documented on the Compliance Certification Form as well as the parent/guardian(s) are asked to sign to certify accuracy of information submitted. This also allows staff an opportunity to explain the selection process to the family. Income sources utilized are recorded on the Income Worksheet and are copied and attached to the Income Worksheet. All social security numbers and/or bank account information are blacked out in front of the parent/guardian so that they know that we do not use or keep that information.

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If income calculations are needed the following formulas are utilized. All math computation is shown on the form.

Calculation Formulas

Annual (12 Month) Income Monthly Income Weekly Pay X 52 Pays = Year Weekly Pay X 4.33 = Month Bi Weekly Pay X 26 Pays = Year Bi Weekly Pay X 2.15 = Month Bi Monthly Pay X 24 Pays = Year Monthly Pay X 12 Pays = Year

If family is eligible based on public assistance (SSI/TANF), foster care, or homeless no income calculations are needed. The Income Worksheet is signed by the Intake Staff and is reviewed and signed by the ERSEA Specialist (or designee). The Compliance Certification is also signed off by the Intake Staff stating that he or she has reviewed the information and is submitting the file to the ERSEA Specialist for processing.

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INCOME TIP SHEET If family provides income documentation with social security numbers or bank account information, please black out this information in front of the family so that they know we do not need this confidential information. Income is: Income is not:

Gross income before taxes; net income from farm or self-employment

Capital gains (a profit from the sale of property or investment)

Money wages or salary before deductions including tips

Assets drawn down as withdrawals from a bank

Regular payments from Social Security or railroad retirement

Sale of property

Payments from unemployment compensation

Tax refunds

Strike benefits from union funds Gifts

Workers’ Compensation Loans

Veterans benefits Lump-sum inheritance

Public Assistance (TANF & SSI) Medicaid

Training Stipends Medicare

Alimony Food Stamps

Child support School Lunches

Military family allotments (Base Pay) Housing Assistance

Other regular support from an absent family member or someone not living in the household

Military BAS (meal allowance), BAH (housing & clothing allowance), HDP (hardship duty pay)

College or university scholarships, grants, fellowships, and assistantships

Net gambling or lottery winnings

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Southern Seven Head Start/Early Head Start COMPLIANCE CERTIFICATION FORM

Eligibility and Selection Process Head Start is funded for families that fall below the income guidelines, those that are homeless, receive public assistance (TANF and/or SSI), and for children in foster care. Up to ten percent of families can be from families that are over income but only after all of the income eligible families are served. Families are selected for the program based on selection criteria points found on the back side of this form to ensure that families with the greatest need receive top priority. Children with disabilities are also a priority for enrollment.

2016 Federal Income Guidelines Persons in Family Poverty Guideline

1 $11,880

2 $16,020

3 $20,160

4 $24,300

5 $28,440

6 $32,580

7 $36,730

8 $40,890

The Head Start definition of income has been shared with me by _________________.

Staff Name By signing this form I certify to the best of my knowledge and belief that all information in the application and income submitted is true and accurate. I further understand that this is an application for services that are paid for with federal funds and that intentionally providing misleading, inaccurate, or untruthful information of a material nature could result in disenrolling my child from Head Start/Early Head Start and could have serious legal consequences for me. ____________________________________ _______________________ Parent/Guardian’s Signature Date ------------------------------------------------------------------------------------------------------------------------------- For Staff Use Only In accordance with the Head Start Performance Standard 45 CFR 1305.4, I have completed an in-person interview, examined the age and income documentation indicated, and have verified this child is eligible to participate in Southern Seven Head Start. ____________________________________ __________________________ In-Take Staff Signature Date

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Southern Seven Head Start/Early Head Start INCOME WORKSHEET

Child’s Name (last, first): (as it appears on birth verification)

Notes related to family size: Family Size:

Income Sources used for Verification:

Income Notes and Math Computation: Show all work and use PENCIL for computation. For additional space, please use back of this page.

Annual Income:

Period of Time Considered for Eligibility:

12 months preceding the month the application was made. Previous calendar year Categorically Eligible (Foster Care/Homeless) Public Assistance (TANF/SSI) Or information that most accurately reflects the needs of the family. i.e. Family is now unemployed (must include documentation on why this was used below):

Staff Signature Title Date

ERSEA Signature Date Reviewed

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Southern Seven Head Start/Early Head Start 2016 FAMILY INCOME GUIDELINES

FAMILY SIZE

Income Eligible Over Income

100-75% Below

75-50% Below

50-25% Below

25-0% Below

1-30% Above

30-50% Above

50% & Over

1 0 - 2,969 2,970 – 5,939 5,940 - 8,909 8,910 – 11,880 11,881 - 15,444 15,445 - 17,820 17,821

& Above

2 0 - 4,004 4,005 - 8,009 8,010 - 12,014 12,015 - 16,020 16,021 - 20,826 20,827 - 24,030 24,031

& Above

3 0 – 5,039 5,023 - 10,044 10,080 - 15,119 15,120 - 20,160 20,161 - 26,208 26,209 - 30,240 30,241

& Above

4 0 – 6,074 6,075 - 12,149 12,150 - 18,224 18,225 - 24,300 24,301 - 31,590 31,591 - 36,450 36,451

& Above

5 0 – 7,109 7,110 - 14,219 14,220 - 21,329 21,330 - 28,440 28,441 - 36,972 36,973 - 42,660 42,661

& Above

6 0 – 8,144 8,145 - 16,289 16,209 - 24,434 24,435 - 32,580 32,581 - 42,354 42,355 - 48,870 48,871

& Above

7 0 - 9,182 9,183 - 18,364 18,365 - 27,547 27,548 - 36,730 36,731 - 47,749 47,750 - 55,095 55,096

& Above

8 0 - 10,222 10,223 - 20,444 20,445 - 30,667 30,668 - 40,890 40,891 - 53,157 53,158 – 61,335 61,336

& Above

For families with more than 8 persons, add $4,160 for each additional person.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Homeless Eligibility References: Improving Head Start for School Readiness Act of 2007 -

Section 645 Definition of Homeless (from McKinney-Vento Homeless Assistance Act [42 U.S.C.9832(19)] “The term homeless children and youth” –

(A) means individuals who lack a fixed, regular, and adequate nighttime residence (within the meaning of section of 103 (a)(1)); and

(B) includes – (i) children and youths who are sharing the housing of other persons due

to loss of housing, economic hardship, or similar reason; are living in motels, hotels, trailer parks, or camping grounds due to the lack of alternative adequate accommodations; are living in emergency or transitional shelters; or abandoned in hospitals; or are awaiting foster care placement;

(ii) children and youths who have a primary nighttime residence that is a public or private place not designed or ordinarily used as a regular sleeping accommodation for human beings (within the meaning of section 103(a)(2)(C);

(iii) children and youths who are living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings; and

(iv) migratory children (as such term is defined in section 1309 of the Elementary and Secondary Education Act of 1965) who qualify as homeless for the purposes of this subtitle because the children are living in circumstances described in clauses (i) through (iii).

Recruitment of Families that are Homeless: Southern Seven Head Start actively pursues families that meet the above definition of homelessness by partnering with emergency, homeless, and transitional shelters as well as working with each School District Homeless Liaison. Completing Living Situation Survey: When completing an Intake, if staff suspects that family may be homeless as per McKinney-Vento Homeless Assistance Act above, staff complete “Living Situation Survey” to gain additional information to determine if family meets homeless eligibility. This information also assists with follow up.

1) Intake Staff complete the form. It is very important when interviewing parents to be thoughtful and considerate of their individual situation….. “Parent Friendly”. Do not ask if they are homeless or not. You will make that determination with the information gathered.

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2) Following Intake, staff contact the Social Services Specialist or ERSEA Specialist to discuss “family story” to determine if family meets homeless eligibility.

3) Intake Staff documents conversation (Social Services Specialist or ERSEA Specialist) along with outcome in case notes.

4) The Living Situation Survey is sent with the file to the ERSEA Specialist. The ERSEA Specialist will sign the Living Arrangements Survey or will gain signature from Social Services Specialist.

5) The Parent Coordinators assist families in gathering required documentation in a reasonable timeframe. Due to the individuality of each family, requirements for enrollment are determined on a case by case basis by the ERSEA Specialist and the Early Childhood Administrator.

This procedure was approved by the Policy Council on September 19, 2011.

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Southern Seven Head Start/Early Head Start LIVING SITUATION SURVEY

Child’s Name: __________________________________ Date of Birth: ___________________ Parent/Guardian Name(s): _________________________________________________________ Instructions: Each family who qualifies for Early Head Start/Head Start Services due to being homeless must be assisted by assessing their current living situation. What phone number should we use to reach you or leave a message for you (this number may be different than what is listed on the Emergency Release Form)? Phone Number 1: _______________________________ Phone Number 2: _______________ Contact Person’s Name: ___________________________________________________________ Where do you want us to send your mail? _____________________________________________ History

How did you lose your housing? Eviction Destruction / Damage Condemned / Uninhabitable Lease / Rental Agreement Violation Economic Hardship Other: ________________________________________________________________

Contributing factor(s) to homelessness (check all that apply) Addiction / Substance Abuse Physical / Mental Disability Divorce / Family Break Up Unable to pay rent / mortgage Domestic Violence Unemployment Illness Loss of TANF Jail / Incarceration Moved to seek work Other: ________________________________________________________________

Where were you living right before this place? ____________________________________

Why did you leave? _________________________________________________________

How long did you live in your last place? ________________________________________

How many times in the past year have you moved? ________________________________

Current Situation

Current living situation: Emergency Shelter Transitional Housing Domestic Violence Shelter Car, Camper, Etc. On the Street Relative Friend / Acquaintance Shared Housing Motel / Hotel / Campground Other: ______________________

Is your current living situation temporary or long term? _____________________________

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How long will you be at your current location? ____________________________________

Why are you staying in your current location? ____________________________________

Where would you go if you couldn’t stay where you are currently at? ___________________

Could your friends / relatives ask you to leave if they wanted to? ______________________

Do you stay in the same place every night? ______________________________________

Other Needs

Are you aware of the services and rights available to you and your child(ren) because you lost your home? ___________________________________________________________

Do you have any current personal needs? Medical / Dental Care Eye Glasses Mental Health Services Clothing Personal Care Items Food Household Goods Other: ______________________

Future Plans

Are you looking for permanent housing? ________________________________________

If so, where? ______________________________________________________________

Are you looking for another place to live (this could be another temporary living situation)? _

What prevents you from getting into permanent housing? ___________________________

What efforts have you made to address those barriers? _____________________________

What school will your child attend when they leave Head Start? ______________________

How can Head Start assist you? _______________________________________________ Family has been provided with:

Name of Homeless Liaison in the Family’s School District (current and any possible future districts)

Copy of their rights under the McKinney Vento Act (What You Need to Know to Help Your Child in School booklet)

Community Resource Directory External Referral(s), if applicable

Information still needed to complete the application: Proof of Birth Meets homeless eligibility: Yes No Parent’s Signature: _________________________________ Date: ___________________ Staff Signature: ____________________________________ Date: ___________________ Administrative Approval: _____________________________ Date: ___________________

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Southern Seven Head Start/Early Head Start VERIFICATION OF SUPPORT FOR FAMILY LIVING SITUATION

Child’s Name:___________________________ Center:_____________________ Name: ________________________________________________________________ Relationship: __________________________________________________________ Address: ______________________________________________________________ Phone: _______________________________________________________________ _______________________________________ _____________________ Signature (person providing housing) Date

Third Party Release and Documentation

I,_______________________________________ (Parent/Guardian/Applicant), give consent to ____________________________________, to contact the following parties to verify information solely for the purpose of determining eligibility for Southern Seven Head Start/Early Head Start services. Name of Third Party #1:___________________________ Phone Number:________ Title of Third Party: ______________________________________________________ Affiliation of Third Party: __________________________________________________ Information obtained (attach documents): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ Name of Third Party #2:___________________________ Phone Number:________ Title of Third Party: ______________________________________________________ Affiliation of Third Party: __________________________________________________ Information obtained (attach documents): _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Name of Parent/Guardian/Applicant: ________________________________________ Signature of Parent/Guardian/Applicant: _____________________________________ Name & Signature of Staff Obtaining Information: ______________________________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Head Start Eligibility Verification References: Administration for Children & Families Program Instruction for

Head Start As recommended by Office of Head Start, this form is utilized along with Southern Seven’s Application/Eligibility Verification Form. This form is completed by the ERSEA Specialist or assigned designee at the time an application is processed and is maintained in the Central Office File only. This form verifies child’s name, date of birth, applicable category of eligibility and what documentation was used to determine eligibility.

Southern Seven HS/EHS Service Area: ERSEA Procedure: Head Start Application Eligibility Verification References: Head Start Performance Standards - 1302.12 The ERSEA Specialist or assigned designee completes this form at the time an application is processed and is maintained in the Central Office File only. This form contains information that is entered into ChildPlus.Net which includes child’s name, date of birth, income sources and verification, verification signature, and enrollment information.

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Southern Seven Head Start/Early Head Start HEAD START ELIGIBILITY VERIFICATION

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Southern Seven Head Start/Early Head Start Application/Eligibility Verification Form

Child’s Name (as appears on birth certificate): ______________________________________________________________________________ (Last Name) (First Name) Child’s date of birth: ______________________________________________________________ Birth Verified by: Hospital or Certified Birth Certificate Other _______________________

Family Income

Date Verified: / / Verified by:

Family Member Amount Per (week,

month, year) Annual Amount

Description (Pension, Social

Security, SSI)

Verification (check stub, letter, foster care, 1040,

SSI, TANF, unemployment,

W2)

Notes

$ $

$ $

$ $

$ $

Income Notes

Eligibility Program Term Site Classroom Funding

EHS HS

Application Status Application Number Application Date Waitlisted Date

Accepted Date Releases Signed Date Signed Eligibility Date

Eligibility Income Number in Family Income Status

Eligible Foster Child Homeless Over Income Public Assistance

Participation Year Sibling Eligible Next Year

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Southern Seven HS/EHS RECRUITMENT Service Area: ERSEA Procedure: Recruitment Plan References: Head Start Performance Standards - 1305.5(a-c) The recruitment activities and plans are kept in a “Recruitment Binder”. Recruitment is an on-going process for all sites by performing the following, but not limited to:

Each center completes the Center Recruitment Monthly Plan with who, what, when, and how productive the activity was and lists any changes that will help improve the recruitment activity. Recruitment is an all staff responsibility and is discussed at all staff meetings.

Each site, with the assistance from the ERSEA Specialist, completes an annual Recruitment Plan for spring. This plan is presented to Policy Council and Board of Health for their approval.

Intake Staff complete Recruitment Rosters on all applications. These are retained in the Recruitment Binder.

Locations of posters/flyers are documented on the poster/flyer form and include dates of when posters/flyers were posted.

Staff utilize the third Friday of each month (training day) for a small group to do follow-up contacts using the information worksheets. This group will also check flyer locations to replace flyers if necessary and document on poster/flyer form the re-check date. This is only completed as needed and if there is no scheduled training.

Public Relation Committees at the sites send out press releases throughout the year to announce things that they are doing (field trips, special visitors, etc.)

Special Needs Specialist and Parent Coordinators attend Transition Meetings from children exiting Early Intervention. A Watch List is maintained by the Special Needs Specialist and shared with the ERSEA Specialist in order to offer additional criteria points for children applying with diagnosed (IEP or IFSP) or potential disabilities.

Special Needs Specialist and/or other designated staff participate in the Local Interagency Meetings (LIC) and events with Early Intervention.

Staff attend other community meetings, events (festivals, health fairs, etc.) to network and discuss the benefits of the various Head Start/Early Head Start Programs.

Home Based Teachers conduct monthly community engagement activities.

Staff maintain relationships with emergency, homeless, and transitional shelters and School District Homeless Liaisons to recruit families that are homeless.

Poster boards with pictures and reasons why Head Start/Early Head Start Programs are so beneficial to children. Children’s art work is displayed in local health clinics, video stores, pharmacy, grocery stores, etc. Flyers are available with contact information.

Staff mail letters and/or postcards, make phone calls, and do home visits to parents inviting them to visit the centers.

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Southern Seven Head Start/Early Head Start ANNUAL RECRUITMENT SCHEDULE OF EVENTS

January/February (kick off)

1) ERSEA Team completes Recruitment Training at each site and sets goals for number of applications needed for the following school year.

2) ERSEA Team assists in planning and updating of flyers for recruitment purposes and reviews the application to determine if changes are needed.

3) ERSEA Specialist gains each county’s DHS list and provides each site with their particular county for recruitment purposes.

4) ERSEA Specialist meets with each site to begin planning their specific recruitment plan to include their annual All Staff Recruitment Day (held in the Spring). This is a day set aside for making contacts with area businesses, parents and helping make the community aware of the variety of services.

5) Parent Coordinators contact current families with younger siblings to begin application process for next year.

6) Parent Coordinators begin contacting families of children on the waiting list (that were not selected for enrollment and are not kindergarten eligible) to see if they are still interested in services and to update information as needed.

7) Designated staff begin to contact LEAs to begin scheduling and planning Spring Child Find Events.

8) Recruitment materials are created and/or purchased and sent to sites.

March/April 1) Sites host “Open House,” which is a form of early registration. 2) Designated staff attend and participate in all Child Finds. 3) All Staff Recruitment Days are held at each site. 4) Parent Coordinators will work with families to complete 3rd year re-

verifications as applicable. 5) ERSEA Specialist schedules Summer Registrations with Health Departments. 6) The ERSEA Specialist provides monthly Recruitment Reports to the Policy

Council, Board of Health, and all staff.

May/July 1) Conduct Summer Registration Days with a focus on enrollment (health)

needs. 2) Sites that are not full continue to work on incompletes and on-going

recruitment. August – December

1) Recruitment is ongoing and is conducted accordingly to each site and documented in Recruitment Binder. Each site should at all times maintain full enrollment along with a waiting list.

2) ERSEA Team reviews last year’s recruitment strategies and makes recommendations for the coming year (visuals, training, etc.).

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Recruitment Binder References: Head Start Performance Standards - 1305.5(a-c) Each site maintains a Recruitment Binder (provided by the Administrative Office) to document all recruitment efforts. This binder is reviewed by Administrative staff throughout the school year and is kept up-to-date by each site. A separate binder is also kept at the Administrative Office to document recruitment efforts by the Administrative staff. All staff are responsible for recruitment, including documentation of all efforts. Due to the confidential information, this binder is kept in a locked place when not in use by staff. In January, the previous year’s information is removed for proper storage. The recruitment year begins and ends at this time. The binder should be set up as listed below: Section 1 Recruitment Plan Section 2 Recruitment Roster Forms Section 3 Information Worksheets/Information Exchange Forms from the Health Department Section 4 Monthly Planning Forms Section 5 Flyers and Posters/Flyer Location Forms Section 6 Press Releases Section 7 Waiting List (most current) Section 8 DHS List (most current) Section 9 Other Section 10 Original Forms

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Southern Seven Head Start/Early Head Start RECRUITMENT PLAN 20

Site: Month: Week:

What We Are Going To Do

What We Did

What

Who

When

What

Who

Outcome

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Recruitment Roster Month: (Site Name/Home Based) Week Ending:

Child’s Name

(Last Name, First Name) Phone Number

Age As of 9/1/15

Income *IEP/IFSP (Y or N)

Thank You

Letter

Eligible Over

1

2

3

4

5

6

7

8

9

10

11

12

*Must have IEP or IFSP included in the file.

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Southern Seven Head Start/Early Head Start POSTER/FLYER LOCATIONS

Center:___________________________

Date Business Location Re-Check Date/Comments

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Intake Process References: Head Start Performance Standards - 1305.5 1305.5 – “the program must assist families in filling out the application form in order to assure that all information needed for selection is completed.” As of February 1, 2011 all applications for Southern Seven Head Start/Early Head Start are completed during an Intake Process. On flyers, parents are requested to call for an appointment. When a family calls: 1) Complete an Information Worksheet. 2) Set an Intake Appointment at a time that is convenient for the family; all efforts are made to

complete the Intake within one week of initial contact. 3) Ask family if they prefer the Intake Appointment occurs at their home, site, or other location. 4) Mail/E-Mail an “Appointment Reminder” to the family to include items needed for the Intake. When a family walks in: 1) Complete an Information Worksheet. 2) If Intake Staff is available, begin the application process. 3) If Intake Staff is not available, schedule an Intake Appointment at family’s home, site, or

other location. 4) Provide “Appointment Reminder” to the family to include items needed for the Intake. 5) DO NOT TURN ANYONE AWAY, WITHOUT AT LEAST BEGINNING THE PROCESS!

If a staff member would like to apply for their child, the Intake will need to be completed by an Administrative Office Staff Person.

ITEMS NEEDED FOR INTAKE APPOINTMENT: Child’s Birth Certificate - If family has original certified birth certificate, please bring that and we

will make a copy. If family does not have original, please bring hospital certificate. Income Documentation – Income Tax Form (1040), W-2s, two current pay stubs, written

statements from employers, documentation showing current status of SSI/TANF, child support, alimony, scholarships/grants, Social Security, etc.

IEP/IFSP (if applicable) – If child has a suspected disability, to receive additional selection criteria

points, we must have written documentation from a professional. Health Records (if available) – immunization record, physical/dental exams, medical card, etc. Other Information (if applicable) – Referrals from Social Service Agency (s), foster care

placement, custody/guardianship documentation, etc. *If family is homeless, the above documentation is not needed at time of Intake.

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Best Practices for Interviewing

Make sure to make the family comfortable (adult chair, activities for younger children, offer a drink, etc.)

Explain a little bit about Head Start (philosophy, expectations, income guidelines, site specific information such as transportation, hours, meals, etc.)

Try to make it more conversation based versus question/answer format. Be careful on word choices to avoid parents assuming that their child has been accepted

prior to selection process. Learn the family “story” prior to begin filling out the application. Interview don’t investigate! Use this opportunity to begin building a relationship. If applicant is a family member or close friend, ask a co-worker to complete Intake due to

the eligibility requirements. Staff complete the application (pages 1-3) based on the family’s responses. All blanks

must be completed. Please print and write neatly. The remainder of the application may be completed by the parent during the appointment.

Household Size and Family Size can be different. Prior to completing pages 1-2, you will need to determine the family size. Some questions that may be helpful: Tell me about your family. How many adults and children do you have in your household? How are these individuals related to you and your child?

Additional questions that will need to be asked in order to calculate income correctly: Tell me a little about your family income. Are there any additional sources of income provided to your family (child support, SSI,

Social Security, self-employment, TANF, grants, scholarships, etc.)? How often do you get paid and do these paystubs reflect a typical pay, if not explain? How long have you been employed by this employer?

At the conclusion of the intake: Review the results with the family to ensure accuracy prior to family signing application. Explain the selection procedure (provide Intake Follow Up Letter).

DO NOT GUARANTEE FAMILY A SLOT!

LISTEN TO “THEIR STORY”

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Southern Seven Head Start/Early Head Start INFORMATION WORKSHEET

Center Based Location _______________________

Early Head Start Location _____________________

Home Based Location ________________________

Date: _____________________

Parent or Legal Guardian’s Name: ________________________________________________________________

Street Address: _______________________________________________________________________________

Mailing Address (if different): ____________________________________________________________________

City: __________________________ State: __________ Zip: _____________ County: __________________

Phone: ( ) ____-______ Home / Cell / Message (circle one) ( ) ____-______ Work / School (circle one)

E-Mail Address: _______________________________________________________________________________

Would you prefer that your appointment occur at your home, the Head Start Center, or other location?

____________________________________________________________________________________________

Are you employed? Yes / No (circle one) Do you attend school? Yes / No (circle one)

Are you receiving SSI or TANF Benefits? Yes / No (circle one)

*If you answered “yes” to any of these questions, please bring verification to the appointment.

Child’s Name: _________________________ Date of Birth: ____ / ____ / ____ Child’s Name: _________________________ Date of Birth: ____ / ____ / ____ Child’s Name: _________________________ Date of Birth: ____ / ____ / ____ Southern Seven Head Start offers an array of program options in Alexander, Hardin, Johnson, Massac, Pope, Pulaski and Union County. To find out more about the program options or have any questions, please call 1-800-698-4820.

FOR STAFF USE ONLY: Intake Appointment: Date:_________________ Time:_________________ Location:______________________ *Provide Parent with appointment reminder.

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Follow – Up Contact

DATE

FOCUS

NOTES

FOCUS CODE: HV=Home Visit L=Letter PC=Phone Call R=Referral WI=Walk In FTF=Face to Face

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Friendly Reminder

Date: ________________________ Dear _____________________________, Thank you for your recent inquiry into our Head Start program and your interest in enrolling your child. We are sending you a friendly reminder of your appointment time for meeting with staff to complete the application process. Your appointment is _________________________ at____________________________. (date/time) (location) It is important to bring the information below to complete your application process. If you have any questions or concerns, please feel to contact the center at ___________________. Sincerely,

Items Need for Intake Appointment:

Child’s Birth Certificate - If family has original certified birth certificate, please bring that and we will make a copy. If family does not have original, please bring hospital certificate.

Income Documentation – Income Tax Form (1040), W-2s, two current pay stubs, written statements from employers, documentation showing current status of SSI/TANF, child support, alimony, scholarships/grants, Social Security, etc.

If you have the following available please bring:

IEP/IFSP (if applicable) – If child has a suspected disability, to receive additional selection criteria points, we must have written documentation from a professional.

Health Records (if available) – immunization record, physical/dental exams, medical card, etc.

Other Information (if applicable) – Referrals from Social Service Agency (s), foster care placement, custody/guardianship documentation, etc.

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Recordatorio Amistoso

Fecha: ________________________ Estimado: ________________________, Gracias por su reciente investigación sobre nuestro programa de Head Start y su interés en inscribir a su hijo. Enviamos un recordatorio amigable de su cita para reunirse con el personal y completar el proceso de la aplicación. La Citaes es ___________________________ en_____________________________. (el dia y la hora) (la ubicación) Es importante que traiga la información que le pedimos abajo para completar su proceso de aplicación. Si tiene alguna pregunta o inquietud, por favor, llame al centro al ___________________. Atentamente,

Las cosas que necesita traer el día de la cita:

Certificado de nacimiento del niño - si la familia tiene el certificado de nacimiento original por favor tráigalo y le haremos una copia. Si la familia no tiene el acta de nacimiento puede traer el certificado del hospital.

Documentación de ingresos : formulario de impuesto(1040), W-2, dos talones de cheque, o por escrito una carta de su empleadores, el estado actual de la documentación que muestra de SSI/TANF, pensión alimenticia, manutención, becas y subvenciones, Seguridad Social, etc.

Si usted tiene los siguientes disponibles por favor traiga:

IEP/IFSP (si procede): si el niño tiene una discapacidad sospechosa, para recibir puntos de criterios de selección adicionales, tiene que tener una carta por escrito de un profesor.

Registros de salud (si está disponible): registro de inmunización, exámenes físicos/dental, tarjeta médica, etc.

Otra información (si procede): referencias de Agencia de servicio Social (s), custodia y tutela documentación, etc.

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Intake Follow Up Letter Date (Fecha): _________________________

Dear (Estimado): _______________________________,

Thank you for taking the time to complete the application process with Southern Seven Head Start. All applications for entrance into the program must go through a selection process which helps to serve those children and families most in need of our services. This selection process is now underway. We will inform you as soon as possible whether or not your child has been selected for enrollment. If your child is selected we will let you know what steps are required for completion for the enrollment process. Should your child not be selected, we will place your child on the waitlist until a slot becomes available. If you have any questions or concerns, please feel free to contact the center at the number listed above or our Administrative Office at 1-800-698-4820 or 618-634-9340. We look forward to working with you and your family. Sincerely; Southern Seven Head Start

Gracias por tomar el tiempo para completar el proceso de la aplicación con (Southern Seven Head Start). Todas las solicitudes de entrada en el programa deben pasar por un proceso de selección que ayuda a servir a los niños y familias mas necesitadas para nuestros servicios. Este proceso de selección ya esta en marcha.

Le informaremos lo antes posible si su hijo ha sido seleccionado para la inscripción. Si su hijo/a esta seleccionado nos permitirá saber que pasos son necesarios para completar el proceso de inscripción. Si su hijo no fue seleccionado, lo colocaremos en la lista de espera hasta que un lugar este disponible.

Si tiene alguna pregunta o inquietud, no dude en contactarnos al 1-800-698-4820 o 618-634-9340. Estamos deseosos de trabajar con usted y su familia.

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Southern Seven HS/EHS SELECTION Service Area: ERSEA Procedure: Selection Criteria References: Head Start Performance Standards - 1302.14

The Selection Criteria Form is revised annually to reflect any changes that may have impacted the communities. The ERSEA Team drafts the changes that are needed and then it is presented to the Policy Council and Board of Health for input and approval. This occurs each year in the winter. The purpose of the Selection Criteria Form is to determine which families are most in need of Head Start Services. During the intake process staff complete the Selection Criteria Form. On the form, points are given for age, income, other factors, disability, parental status, and priority. Staff should circle the point value and then write the subtotal of the points in the appropriate box. Staff should then add the points together to determine the Grand Total. This is signed and dated by the Intake Staff and is reviewed by the ERSEA Specialist. Intake Staff receive intensive training on completing the Selection Criteria Form. The Selection Criteria Form is filed in the Central Office file only.

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Southern Seven Head Start/Early Head Start 2016 - 2017 SELECTION CRITERIA

CHILD’S NAME (Last, First):

AGE (maximum 95 points) Subtotal Age

Points:

HS - Child is 4 (or will turn 4) by 9/1/16 95

HS - Child is Transitioning from EHS 85

HS - Child is 3 (or will turn 3) by 9/1/16 (and did not attend EHS) 75

HS - Child turned 3 (or will turn 3) after 9/1/16 45

EHS - Birth to 12 Months 95

EHS - 13 – 24 Months 75

EHS - 25 – 30 Months 55

EHS - 31-36 Months 15

INCOME (maximum 95 points) Subtotal Income

Points:

TANF/SSI/Foster/Homeless 95

Low Income 100 - 75% Below Poverty Guidelines 95

Low Income 75 – 50% Below Poverty Guidelines 85



Near Low Income 1 – 30% Over Poverty Guidelines* 25

Over Income 30 – 50% Over Poverty Guidelines 15

Over Income 50% and Over Poverty Guidelines 5

* Near Low Income is counted as over income.

OTHER FACTORS (maximum 95 points) (Derived from the Community Assessment)

Subtotal Other Factor Points:

Teen Parent 40

Referral from Social Service Agency 30

Incarcerated Parent 30

Child on Wait List from Last Program Year 30

Parent in School or Training 20

Parent Loss of Job or Dislocated Worker 20

Parent less than High School Diploma or less than a GED 20

Active Military Family or Veteran 20

Doubled Up (Providing housing of other persons due to loss of housing) 20

Parent w/Disability 20

English is Second Language 10

DISABILITY (maximum 95 points) Subtotal Disability

Points:

Diagnosed Disability (IEP/IFSP) 95

Potential Disability (documentation by a professional) 65

PARENTAL STATUS (maximum 95 points) Subtotal Parental Status

Points:

Foster Parent 95

Lives w/Guardian 75

One Parent in Household 65

Two Parents in Household 45

PRIORITY (maximum 95 points) Subtotal Priority

Points:

Homeless (McKinney Vento Homeless Act) 95

GRAND TOTAL:

Completed By: Date:

ERSEA Reviewed By: Date:

Date Approved by Policy Council: 01/11/16 Date Approved by Board of Health: 02/25/16

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Selection Process References: Head Start Performance Standards - 1305.6 All applications are entered into ChildPlus.Net which includes the Selection Criteria. Staff can review the priority list by viewing Enrollment Report 2025. This report ranks children by site according to Selection Criteria Points to assure children with the greatest needs are selected first. Beginning in April, the selection for enrollment process begins for the upcoming school year. During this time only applications that are categorically eligible and those that are income eligible are selected. Applications are selected based on selection criteria points and the number of vacancies at each center. The only exceptions for selecting an over income family is the following: child with a diagnosed disability (IFSP or IEP) or a child transitioning to HS from EHS. Both of these situations have to be approved by the Early Childhood Administrator or Executive Director. In July after all attempts to fill centers with income eligible families, Southern Seven will begin to review over income applications. The number of children selected for over income slots at each site is based on data from the Community Assessment and availability of remaining slots. All families that are over income are approved by the Early Childhood Administrator or Executive Director. All sites strive to be full with a waiting list the first day of school. As applications are submitted during the school year, they are processed and placed on a waiting list. When vacancies occur, selection is based on selection criteria points.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Waiting List References: Head Start Performance Standards - 1305.6

Children that are not selected for enrollment are placed on the waiting list. Families receive notification of this by a letter. The child’s and families’ information is put into the ChildPlus.Net including the selection criteria. ChildPlus.Net Enrollment Report 2025 ranks children according to selection criteria. The current month’s report is maintained in the Recruitment Binder with the income (dollar amount) blacked out. Children are chosen from the waiting list throughout the year when vacancies occur. Parent Coordinators and Home Based Teachers have access to ChildPlus.Net and should keep in contact with the families on the list especially those high on the list assisting with meeting health requirements so that when vacancies occur, the child next on the waiting list will be ready for entry. Parent Coordinators and Home Based Teachers are responsible for keeping children/families’ information current on the waiting list. If information changes, a Change of Status Form should be completed and sent to the ERSEA Specialist.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Near Low and Over Income Families References: Head Start Performance Standards - 1305.4;

Improving Head Start for School Readiness Act 2007 – Section 645

Improving Head Start for School Readiness Act of 2007, Section 645, authorized that an additional thirty-five (35) percent of children with a family income below 130% of poverty line if: Head Start agency implements policies and procedures to prioritize with criteria to ensure that it is meeting the needs of the low-income (below poverty line or eligible for public assistance) before the children up to 130% of poverty. Children whose family’s income exceeds the federal poverty guidelines may be selected for enrollment in Head Start if and when we can be assured that all income eligible children that have applied are being served. Following receipt of an application and verification of age and income, children will either be accepted for enrollment or placed on a waiting list. Acceptance for enrollment of children from middle or over income families is determined by the Early Childhood Administrator and/or Executive Director. The determination of which near low and over income children are accepted for enrollment is based on the selection criteria points. Families that fall in the near low income receive more criteria points than those from over income families. Children from families with the highest need (defined by criteria points) are served first. Southern Seven will only utilize the additional thirty five percent category if necessary to meet funded enrollment. If and when that time arises, approval will be determined by the Policy Council and Board of Health. If this occurs, a report will be provided to the Office of Head Start stating the following: 1) how we are meeting the needs of the lower-income children, 2) a copy of the Policies and Procedures, 3) the outreach efforts, 4) enrollment levels and changes from last year, and 5) eligibility categories of children on the waiting list. This procedure was approved by the Policy Council on July 14, 2008. Service Area: ERSEA Procedure: Employee’s Families The Early Childhood Administrator will review all employees’ children’s applications. Any questions regarding this policy should be directed to the Early Childhood Administrator. This procedure was approved by the Policy Council on July 14, 2008. If a staff member would like to apply for their child, the Intake will need to be completed by an Administrative Office Staff Person.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Acceptance of 3 Year Olds References: Head Start Performance Standards - 1306.32;

Office of Head Start – OHS-PC-I-015 Priority for Head Start continues to be for children who are four years old or children who are three (3) prior to September 1st so generally children will not be enrolled for more than two (2) years. However, children may be accepted for enrollment for upon their 3rd birthday.

In order to provide a classroom setting in which is appropriate for the age range of the children served, the following practices are followed:

At the start of the school year, classroom sizes are determined by the predominate age of the children enrolled. If the predominate age of the children in the classroom is three (3), the maximum size is seventeen (17) and remains the same throughout the year.

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Southern Seven HS/EHS ENROLLMENT Service Area: ERSEA Procedure: Application Process References: None Prior to submitting the application to the ERSEA Specialist, the Intake Staff will:

1. Review entire application to ensure that it is complete and begin the case note page to document all activities.

2. Submit the follow items:

Complete Application with Case Notes (required item)

Income Worksheet with copies of Income (required item)

Birth Certificate (required item) (if parent submits original certified birth certificate, please make a copy and on the copy write “copied original birth certificate with seal and your initials),

Compliance Certification/Selection Criteria Form (required item)

Medical Card (if applicable)

Health Information (if applicable)

IEP/IFSP (if applicable)

Information Worksheet (if applicable) If any of these items are missing, follow up must occur at the site, prior to sending application to the ERSEA Specialist. See sample letter in this section of Procedure Manual.

3. Submit all documents in a manila file folder with label including child’s name (last, first) and site name. Place folder in bright yellow envelope and submit to ERSEA Specialist ASAP!

Application arrives at Administrative Office:

1. ERSEA Specialist reviews application and contents to ensure that file is ready to process. If the application is incomplete, the file is returned to the site for additional follow-up prior to processing. The ERSEA Specialist contacts the person who completed the Intake to inform them that there was an error. The application must be resubmitted within one week. If it is not, then an explanation is required.

2. ERSEA Specialist processes application by completing Application Eligibility Verification Form and the Office of Head Start Eligibility Verification Form.

3. Depending upon the site’s enrollment, one of the following options are selected:

If there are openings and the child is selected: a. The ERSEA Specialist contacts the site to discuss classroom placement

and to inform the site that file is ready to be set up. b. Administrative Office Support Staff enters the application into ChildPlus.Net.

He/she writes in application number and initials on the Application Eligibility Verification Form.

c. Administrative Office Support Staff places the file in the ERSEA Specialist’s computer tray for review and additional data entry.

d. The ERSEA Specialist sends the family an acceptance letter. The letter indicates any entry needs still required prior to beginning school with a deadline for completion. The forms (physical, dental form/consent, CACFP,

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DCFS Booklet, and Birth Certificate Information Sheets) are mailed with the letter as needed.

e. The ERSEA Specialist writes case notes to document the actions and information mailed to the family.

f. The ERSEA Specialist attaches a routing slip to the application if there are any specific concerns (mental health/special needs and/or social services) noted in the application, so that the file will be routed to the Special Needs Specialist or Social Services Specialist for review.

g. The ERSEA Specialist places the file in the Health & Nutrition Specialist’s computer tray for review and health data entry. Once this is completed the Health & Nutrition Specialist places the file at the rear of the appropriate file cabinet drawer.

h. If the file included a routing slip to the Special Needs Specialist or Social Services Specialist, the Health & Nutrition Specialist places the file in the Service Team computer tray. Once it is reviewed, he/she places the file at the rear of the appropriate file cabinet drawer.

The same procedure is followed when a child is selected from the waiting list.

If child is placed on waiting list (due to full center, too young, or over income) the following occurs:

a. The ERSEA Specialist sends the family a letter indicating that the child has been placed on the waiting list (specific letter indicating the reason).

b. The ERSEA Specialist writes case notes to document the actions and information mailed to the family.

c. The ERSEA Specialist writes in the waitlist date on the Application Eligibility Verification Form.

d. Administrative Office Support Staff enters the application into ChildPlus.Net. He/she writes in application number and initials on the Application Eligibility Verification Form.

i. Administrative Office Support Staff places the file in the ERSEA Specialist’s computer tray for review and additional data entry.

j. The ERSEA Specialist places the file in the correct centers waiting list file in the ERSEA Specialist’s office.

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Parent Coordinator Request Letter Date: ____________________ Dear _____________________________, Thank you for your recent application for your child, ________________________. I am unable to process the application at this time. Please submit the following items that are checked (√) below that are needed to complete the application process. These items MUST be received before your child’s application will be processed. _____ Proof of family income (copy of 20____ W-2 or Tax Return, 20____ Check Stub, SSI or TANF statement, etc.) _____ Copy of child’s birth certificate _____ Copy of medical card, if you have one _____ Other - please contact me We look forward to having your child in our program. If additional information is needed, please feel free to call the Head Start Administrative Office at (618) 634-9340, 1-800-698-4820 or call your local Head Start center at __________________. Sincerely, Parent Coordinator Head Start Division

Gracias por la reciente aplicación de su hijo, _________________, ahorita no podemos procesar la solicitud en este momento. Envíe los siguientes elementos que están (√) marcado debajo. Son necesarios para completar el proceso de la aplicación. Estos elementos deben ser recibidos antes de que proceda la aplicación de su hijo. ______ Prueba de ingresos familiares (copia W2 del 20____ o impuestos, talón de cheque 20_____ o declaración de SSI, TANF, etc.) ______ Copia del Certificado de nacimiento del niño ______ Copia de la tarjeta medica, (si tiene una) ______ Otro, por favor póngase en contacto con migo Esperamos ver a su hijo en nuestro programa. Si necesita información adicional, por favor siéntase libre en llamar a la oficina Administrativa de Head Start al (618) 634-9340 o 1-800-698-4820 o llame al local central de Head Start en _________________.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Setting Up Files/Central Office Tracking References: None To set up a file for an selected child the Parent Coordinator or Home Based Teacher/Parent Coordinator will:

1. Obtain the file from the file cabinet drawer along with two (2) file folders (one brown and one blue)

2. Type the file folder label (correct color for entry year) for site and Central Office file folders. The label should be typed in all capital letters for last name, the first letter should be capitalized for the first name, and all letters should be capitalized for the center name. If the file is for EHS, below the center name, this should be typed. Place a label on blue and brown folders. Example: SMITH, John METROPOLIS SMITH, John CAIRO EHS SMITH, John PULASKI HOME BASED EHS

3. Obtain one Central Office Chart Checklist and one Center Chart Checklist or Home Based Chart Checklist and complete upper portions (child’s name, date of birth, entry year).

4. Document on case note page (included in manila file) the date the files were set up. 5. Copy the contents of the manila file with the exception of Application Eligibility Verification

Forms and Selection Criteria Forms. 6. Assemble two (2) charts according to the appropriate chart checklists (brown for central

office and blue for the site). 7. File the Central Office File (brown) in the appropriate file drawer in alphabetical order. If

the file is found in the Health & Nutrition Specialist or Special Needs Coordinator’s tray, please return the file to this location.

8. Take the blue file back with you to your site. As items are sent to the ERSEA Specialist after a file has been set up, the documents are placed in the appropriate Parent Coordinator box (on top of the filing cabinets) for filing/tracking when they are at Central Office the next time.

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Southern Seven Head Start/Early Head Start CENTRAL OFFICE CHART CHECKLIST

Child’s Name: ________________________________________________________________ Last First Entry Year: ___________________________ Birthdate: _______________________

Section 1 _____ Chart Checklist _____ Case Notes (original) _____ Change of Status Form (original) _____ Entry Age:____________________

Section 2 _____ Application (copy) _____ DCFS Verification of Receipt (original) _____ Information Exchange Form _____ Consent Form(s)*

Section 3 _______ Health & Nutrition Correspondence _______ Physical Form _______ Shot _______ Well Child Check* _______ Diabetes Screening ___/___ Blood Lead ___/___ Hemoglobin _______ T.B. _______ Dental _______ Hearing/Vision _______ Health Follow-Up Documentation* _______ Health History Update* _______ Individual Health Plan(s)*

Infant/Toddler Hemoglobin required at 9 & 12 months. Blood Lead required at 12 & 24 months.

Section 4 _______ Education & Special Needs Correspondence ___/___ ASQ-3 ___/___ ASQ-3 (rescreen)* _______ Ages/Stages SE (parent) _______ Ages/Stages SE (teacher)* _______ SE Letter _______ Behavior Intervention Plan*

3-5 Year Olds _______ DIAL-4 Screening _______ DIAL-4 Rescreen* _______ SE Letter _______ Behavior Intervention Plan*

Section 5 _____ ERSEA & Family Correspondence _____ Information Worksheet (original)* _____ Application/Eligibility Verification Form _____ OHS Eligibility Verification Form _____ Selection Criteria Form _____ Living Situation Survey* _____ “0” Dollar Affidavit* _____ Birth Verification (copy) _____ Medical Card (copy)* _____ Custody, Order of Protection, etc.*

Section 6 Previous Program Year(s): _____ Change of Status Form(s) _____ Previous Application* _____ Health Information _____ Education Information

*If Applicable

Allergy Box

___________

___________

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Southern Seven Head Start CENTER CHART CHECKLIST

Child’s Name: ______________________________________________________________________ Last First Entry Year: _______________________________ Birthdate: ___________________________

Section 1

_____ Chart Checklist

_____ Case Notes (copy)

_____ Entry Date for 16-17 HS _____ Transition Date to Other HS Site

Section 2 ______ Consents From Application (original)

(transportation, screening, & guidance)

_____ Dental Consent Form ______ Information Exchange Form

______ Consent Form(s)*

Section 3

_____ Application W/O Consents (original) _____ DCFS Verification of Receipt

Section 4

______ Transportation Change Form ______ Change of Status Form

______ Child Absence Documentation

Section 5

________ Health & Nutrition Correspondence ________ Physical Form

________ Shot ________ Diabetes Screening*

________ Blood Lead

________ Hemoglobin ________ T.B.

________ Dental ________ Hearing/Vision

________ Health Follow-Up Documentation*

________ Growth Chart ________ Health History Update*

________ Incident Form* ________ Medication Release Form*

________ Medical Exception Statement for Food Substitution*

________ Individual Health Plan(s)*

________ Symptoms Record*

Section 6

________ Education & Special Needs Correspondence

________ DIAL-4 / ASQ-3 Screening* ________ DIAL-4 / ASQ-3 Rescreen*

________ DIAL-4 Parent Questionnaire

________ DIAL-4 Teacher Questionnaire ________ SE Letter

________ Parent Information Request Letter ________ Home Visit/Family Staff Conference

________ Home Visit/Family Staff Conference

________ Home Visit/Family Staff Conference ________ Home Visit/Family Staff Conference

________ Assistance Request* ________ Behavior Intervention Plan*

Section 7

_____ ERSEA & Family Correspondence _____ Information Worksheet (copy)*

_____ SPD Letter* _____ Birth Verification

_____ Family Partnership Agreement

_____ Pre-K Partnership Agreement* _____ Parent Orientation Checklist

_____ Custody, Order of Protection, etc.*

Section 8

Previous Program Year(s):

______ Change of Status Form(s) ______ Previous Application (ie: 3rd Year)*


______ Health Information ______ Education Information

*If Applicable

Allergy Box

___________

___________

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Southern Seven Early Head Start CENTER CHART CHECKLIST

Child’s Name: _______________________________________________________________ Last First Entry Year: ___________________________ Birthdate: ________________________

Section 1

______ Chart Checklist ______ Case Notes (copy)

______ Entry Date ______ Transition Date to Other EHS Site

______ Entry Age:____________________

Section 2

______ Consents From Application (original) (transportation, screening, & guidance)

______ Information Exchange Form ______ Other Consent Form(s)*

Section 3

______ Application W/O Consents (original) ______ DCFS Verification of Receipt

Section 4

______ Transportation Change Form ______ Change of Status Form


Section 5

_________ Health & Nutrition Correspondence _________ Physical Form

_________ Shot _________ Well Child Check*

____/___ Blood Lead ____/___ Hemoglobin

_________ T.B.

_________ Dental _________ Hearing/Vision

_________ Health Follow-Up Documentation* _________ Growth Chart

_________ Health History Update* _________ Incident Form*

_________ Medication Release Form* _________ Nutrition Information Update*

_________ CACFP for Infant Centers*

_________ Diaper Rash Cream/Ointment Consent* _________ Individual Health Plan(s)*

_________ Medical Exception Statement for Food Substitution*

_________ Symptoms Record* Infant/Toddler

Hemoglobin required at 9 & 12 months. Blood Lead required at 12 & 24 months.

Section 6

________ Education & Special Needs Correspondence _ __/__ _ ASQ-3

_ __/__ _ ASQ-3 (rescreen)* ________ Ages/Stages SE (parent)

________ Ages/Stages SE (teacher)* ________ SE Letter

________ Parent Information Request Letter



________ Assistance Request* ________ Parent Consent*

________ Behavior Intervention Plan* ________ Transition Plan

Section 7

______ ERSEA & Family Correspondence ______ Information Worksheet (copy)*

______ SPD Letter* ______ Birth Verification

______ Family Partnership Agreement

______ Pre-K Partnership Agreement* ______ Parent Orientation Checklist

______ Custody, Order of Protection, etc.*

Section 8

Previous Program Year(s):

______ Change of Status Form(s) ______ Previous Application*


______ Health Information ______ Education Information

*If Applicable

Allergy Box

___________

___________

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Southern Seven Early Head Start HOME BASED CHART CHECKLIST

Child’s Name: _______________________________________________________________ Last First Entry Year: ___________________________ Birthdate: ________________________

Section 1 _____ Chart Checklist _____ Case Notes (copy) _____ Entry Date _____ Transition Date to Other EHS/HB Site _____ Entry Age:____________________

Section 2 _____ Consents From Application (original) (transportation, screening, & guidance) _____ Information Exchange Form _____ Other Consent Form(s)* _____ Parent/Home Based Teacher Agreement _____ Home Safety Checklist

Section 3 _____ Application W/O Consents (original) _____ DCFS Verification of Receipt

Section 4 _____ Change of Status Form _____ Child Absence Documentation _____ Home Visit Worksheets

Section 5 ________ Health & Nutrition Correspondence ________ Physical Form ________ Shot ________ Well Child Check* ________ Diabetes Screening ___/___ Blood Lead ___/___ Hemoglobin ________ T.B. ________ Dental ________ Hearing/Vision ________ Health Follow-Up Documentation* ________ Individual Growth Plan ________ Health History Update* ________ Medical Exception Statement for Food Substitution* ________ Individual Health Plan(s)*

Infant/Toddler Hemoglobin required at 9 & 12 months. Blood Lead required at 12 & 24 months.

Section 6 _______ Education & Special Needs Correspondence __/_ _ ASQ-3 __/_ _ ASQ-3 (rescreen)*

_______ Ages/Stages SE (parent) _______ Ages/Stages SE (teacher)* _______ SE Letter _______ Parent Information Request Letter _______ Assistance Request* _______ Parent Consent* _______ Behavior Intervention Plan* _______ Transition Plan

Section 7 _____ ERSEA & Family Correspondence _____ Information Worksheet (copy)* _____ Birth Verification _____ Family Partnership Agreement _____ Home Based Orientation Checklist _____ Custody, Order of Protection, etc.*

Section 8 Previous Program Year(s): _____ Change of Status Form(s) _____ Previous Application* _____ Child Absence Documentation _____ Health Information _____ Education Information

*If Applicable

Allergy Box

___________

___________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Early Head Start Transition to Head Start References: Head Start Performance Standards – 1304.41(c)(2) A Transition Planning Meeting for each child and family occurs six (6) months prior to the child’s third birthday. Parent Coordinators are invited and attend this meeting. If the family expresses an interest in transitioning into Head Start, they must apply. To apply for Head Start, the family must schedule an Intake Appointment with the Parent Coordinator or Home Based Teacher. This information is shared with them during the Transition Planning Meeting. As soon as the Intake has been completed, but at least three months prior to the child’s third birthday, the information is submitted to the ERSEA Specialist. When the ERSEA Specialist receives the information, the following occurs:

a. Reviews information and completes a new Application/Eligibility Verification Form along with Head Start Eligibility Verification Form. Criteria points are awarded for transferring from Early Head Start to Head Start.

b. Administrative Office Support Staff enters the new application information into ChildPlus.Net. The child is placed on the Head Start waiting list.

An additional Transition Meeting is held within one month of child’s third birthday. The ERSEA Specialist attends this meeting or provides enrollment information to the Education Specialist to share with the Transition Team. Depending on the eligibility and the child’s progress with transitioning, various outcomes could result, such as: transition into a Head Start slot, remain in Early Head Start until a Head Start slot is available, or if family is over income and there are income eligible families on the waiting list the child will be allowed to remain in Early Head Start for a specified amount of time so that family can make other arrangements. The individualized plan is spelled out on the child’s transition form. If child transitions into Head Start the following occurs:

a. ERSEA Specialist sends a letter to family and maintains a copy of letter for Central Office file.

b. ERSEA Specialist types new file folder labels for site and Central Office files. c. ERSEA Specialist sends site the new file folder label and a new chart checklist. d. Site returns all Early Head Start forms (not needed in site file) to Administrative Office for

storing (height/weights, dental screening, home visits, family/staff conferences, transition plans, hearing/vision screenings, and developmental screenings) and completes new chart checklist.

e. Site completes a Change of Status form (showing completion of Early Head Start), this is also documented on Weekly Enrollment Report and sends to ERSEA Specialist.

f. ERSEA Specialist removes all Early Head Start forms as listed above in Central Office file and combines with site’s paperwork to maintain for storage.

g. ERSEA Specialist completes new chart checklist and places new label on Central Office file.

h. ERSEA Specialist case notes changes and transition information into case notes.

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54

Southern Seven HS/EHS Service Area: ERSEA Procedure: Infants in the Early Head Start Classrooms References: 1304.41(c)(2) & DCFS Licensing Standards Section 407.190(d)(1)

Head Start Performance Standard 1304.41(c)(2) (2) To ensure the most appropriate placement and services following participation in Early Head Start, transition planning must be undertaken for each child and family at least six months prior to the child's third birthday. The process must take into account: The child's health status and developmental level, progress made by the child and family while in Early Head Start, current and changing family circumstances, and the availability of Head Start and other child development or child care services in the community. As appropriate, a child may remain in Early Head Start, following his or her third birthday, for additional months until he or she can transition into Head Start or another program.

DCFS Licensing Standards Section 407.190 (d)(1) Children may be combined in any of the following ways: 1) Infants, toddlers, and two-year olds may be combined. EHS centers that only have one EHS classroom: Southern Seven has decided to serve infants in the Home Based option only. This is due to the regulations above and the fact that there are very few transition placements for children that are in EHS and turn three in our communities. This is reflected in the Community Assessment. If there is no HS slot available nor Pre-K or Daycare, a three year old would not be permitted to remain in an EHS classroom if there was an infant in the room. To assure continuity of care for children turning three in EHS, children are permitted to remain in EHS for additional months until he/she can transition into Head Start or another program. Infants will be served in the Home Based option and will be able to transition into a center at age 15 months (toddler age) when center openings become available and if the family desires center based services.

EHS centers that have more than one EHS classroom: Infants will be able to attend the center based option. One classroom is set up for younger infants/toddlers and the other classroom is set up for toddlers. This will avoid a child turning three in a classroom with an infant.

This procedure was approved by Policy Council on Monday, June 17, 2013 and the Board of Health on Thursday, June 27, 2013.

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55

Southern Seven HS/EHS Service Area: ERSEA Procedure: The Definition of Accepted, Enrollment and Entry References: Head Start Performance Standards – 1305.2; 1304.20 Accepted: As per 1305.2 accepted is defined as a child meeting the eligibility criteria and has completed the enrollment process. Enrolled: As per 1305.2 enrolled is defined as the child has been accepted and attended at least one class, has received at least one home visit or has received at least one direct service while pending completion of necessary documentation for attendance in a center, based on state and local licensing requirements. Enrollment: The number of participants in the Head Start or Early Head Start Program. Entry: As per 1304.20 entry means the first day that Head Start or Early Head Start services are provided to the child. The following details how these terms are utilized for Southern Seven Head Start/Early Head Start. All children that are accepted for Head Start or Early Head Start during the Spring and Summer months are enrolled as of the first day of school for the program year. This section applies only to Center Based: Due to the Department of Children and Family Services Licensing Standards Part 407, Section 407.310; health information must be on file for a child to begin attending classes. During the Summer months, Site Supervisors & Parent Coordinators work with families to obtain this information prior to the first day. For those children that are not cleared to enter, they are considered enrolled and are given two weeks to obtain the required items, however these children are not allowed to attend class. If after the two weeks, the information is still not submitted the child is dropped and placed back on the waiting list. After the first day of school, when a child is accepted, they are provided an accepted letter along with documentation that is needed prior to being enrolled (health information as per required for child’s age and DCFS Receipt from Booklet). A two week time period is given in the letter to submit the required information. Parent Coordinators are available to assist the family in completing the required items. Once the information is submitted, the child can then enter and be considered enrolled. If the information is not submitted, the child will be placed back on the waiting list and another child will be accepted. If the family is unable to complete the health items within the two week time period, but has an appointment, an extension may be granted by the Early Childhood Administrator. The Entry Date is the first day the child attends the center. The only exception to this rule is for families that are considered homeless due to the McKinney Vento Act and special provisions are made by the ERSEA Specialist. This section applies to the home based option: The acceptance and enrollment dates are the same dates, since the Department of Children and Family Services Licensing Standards Part 407, Section 407.310; does not pertain to this option. The Home Based Teacher/Parent Coordinator begins working with families immediately which also includes working on the required health items as per the Health Procedures and Head Start Performance Standards. The Entry Date is the date of the first Home Visit. This procedure was approved by the Policy Council on September 17, 2012 and Board of Health on August 23, 2012.

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56

Southern Seven HS/EHS Service Area: ERSEA Procedure: Enrollment/Re-Enrollment References: Head Start Performance Standards – 1305.7(a) Once a child is enrolled in Head Start, the child is allowed to remain in program until kindergarten is available. If the child is enrolled for more than two (2) years, a new application is completed to update information and income must be resubmitted for re-verification for the third year. Once a child is enrolled in Early Head Start, the child is allowed to remain in program until the child turns three (3). See procedure for EHS Transfer to HS in Enrollment Section of Procedure Manual. A new application and new income must be submitted for Head Start. When a family drops Head Start/Early Head Start and then decides to re-apply, the family will need to complete a new Intake. Selection for enrollment will be determined by the ERSEA Specialist based on openings and eligibility. Random exit interviews are completed to monitor customer satisfaction by the ERSEA Specialist. The following questions are asked:

Why are you leaving?

Is there anything we can do better?

Would you recommend our program to others? This information is collected and provided to the Early Childhood Administrator. Service Area: ERSEA Procedure: Vacancies References: Head Start Performance Standards – 1305.7(b) When a vacancy exists, Southern Seven Head Start will fill the vacancy within thirty (30) calendar days. ChildPlus.Net Enrollment Report 2210 is ran on a monthly basis and is included with the monthly audit report to assure that vacancies are filled within the 30 days requirement. If the vacancy exists within less than sixty (60) calendar days prior to the end of the program year, vacancies will not be filled except when approved by the Early Childhood Administrator. Please note that Head Start/Early Head Start have different ending dates for the Program Year. The cutoff date to be selected for enrollment is decided by the Early Childhood Administrator and ERSEA Specialist.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Change of Status References: None The Change of Status Form is used for a variety of changes that pertain to a family. Anytime one of the following occurs, a Change of Status Form is completed:

A child transfers from one classroom, center, option to another

Family size increases or decreases

Address or phone number changes

Income change

Name change (child or parent) - child must have legal documentation or new birth certificate.

Withdraw (drops) – be sure to send center file along with Change of Status

Custody change (parents, grandparents, into or out of foster care, etc.)

Other The comment section is used to explain in detail why a change occurred (i.e. family moved to Tennessee). If there is a custody change legal documentation is sent with the Change of Status Form.

1. Any changes are done in red ink on child’s application at the center and the central office. Changes are initialed and dated by the person making the changes.

2. A copy of the Change of Status is filed in the correct section of the child’s file at the center.

3. The original form is forwarded to the ERSEA Specialist. The ERSEA Specialist makes a copy of the Change of Status to rotate among the Service Team (if it pertains to terminations or transfers). After it is rotated, it is returned to the ERSEA Specialist and is filed in the general information drawer according to center or option.

4. The ERSEA Specialist places the original form in the correct Administrative Office Staff’s tray for data entry. The Administrative Office Staff dates and initials the upper right hand corner to indicate completion.

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Change of Status Form Submit this form to update child and family information.

Center Name: Class: Staff: Date:

Child’s Name: (Last)

(First)

ENROLLMENT STATUS PERSONAL INFORMATION

Transfer Change Name

From Center: Class: Child Parent Date:

To Center: Class: Change From:

Effective Date: Change To:

Withdraw / Drop Reason:

Withdraw Date: Change Address / Phone

Date Last Attended: Street Address:

Reason for Withdrawal: Changed Program

Finished Program Term City: State: Zip:

Program Requirement not met Name of Person:

Moved Phone Type: Home Cell Message Other

Attending other Pre-School: Phone Number: ( )

Other: Name of Person:

Phone Type: Home Cell Message Other

Phone Number: ( )

Other

Change of Custody Change family size from to

To: Foster Natural Other

New Family Name: Specify other changes:

Parent/guardian names:

Comment Section:

Original: Administrative Office Date Received:

Copy: Child’s Center File Initials:

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Weekly Enrollment Report References: None This report is completed for each site and all options on a weekly basis. The report is emailed to the ERSEA Specialist each Friday. Each site retains a copy of the report for the center’s file. Entered: All columns are completed (health clearance, classroom, enrollment and entry date). Transferred: All columns are completed (center/classroom to and from along with the transfer date). Dropped: Direct conversation with the ERSEA Specialist must occur to determine the date.

All columns are completed (classroom, reason, and drop date). A Change of Status is also completed and is submitted to the ERSEA Specialist. The file is also returned to Central Office within one week of the drop date.

Enrolled: All columns are completed along with the status of their entry. For example, all

information was submitted on Friday, 8/31/12 child is expected to enter on Monday 9/3/12. The enrolled date is listed (which would be 8/31/12). The following week this child would be listed as entered.

Accepted: All columns are completed along with the status of their enrollment. For example, child

still needs TB results, scheduled to have TB test read on 9/4/12. The accepted date is listed.

Generally speaking, the enrolled and entry date will occur on the same date – if this is the case, the child will only be listed on the entered table along with entry and enrollment date. The numbers on the bottom of the form are completed. These numbers do not take into account children that are enrolled or selected. When the ERSEA Specialist receives the weekly enrollment report the following is done:

1) ERSEA Specialist prints the reports that are emailed. 2) Changes reflected on the Weekly Enrollment Report are made in ChildPlus.Net by ERSEA

Specialist and/or Administrative Office Staff. 3) ERSEA Specialist adds the number of children that are enrolled but not yet entered to the Weekly

Enrollment Report Administrative Office Box on the form along with received date and his or her initials.

4) ERSEA Specialist cross references numbers from the Weekly Enrollment Report and ChildPlus.Net to check for accuracy. If numbers do not match, ERSEA Specialist contacts the site/option to check for error (s). When the numbers match ChildPlus.Net Enrollment Report 2001 is printed and is used in completing the monthly audit report.

5) ERSEA Specialist records the entry number and enrollment number for each site/option is recorded on the Weekly Enrollment Report Checklist Form (monthly tracking form) which is also used in the monthly audit.

6) The weekly enrollment reports are filed in the general information drawer according to the center and option.

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Southern Seven Head Start/Early Head Start WEEKLY ENROLLMENT REPORT

Early Traditional

Center/Home Based: Week Ending:

Entered Children Information:

Child’s Name Health

Information Cleared By

Classroom Enrolled

Date Entry Date

Transferred Children Information:

Child’s Name Health Information

Cleared By From Center/ Classroom

To Center/ Classroom

Date

Dropped Children Information:

Child’s Name Classroom Reason Dropped

Date

Enrolled Children (not yet entered) Information:

Child’s Name Classroom Status (include date of most recent contact and needs)

Enrolled Date

Accepted Children (not yet enrolled) Information:

Child’s Name Status (include date of most recent contact

and needs) New Date

Previous Week’s Balance: Administrative Office Use Only

Total Number of New Children Entered for the Week: Total Enrollment:

Total Number of Children Transferred for the Week: Received Date:

Total Number of Children Dropped for the Week: Initials:

Total Number of Children Attending for the Center:

E-Mail to ERSEA Specialist at the Administrative Office each Friday.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Monthly Enrollment Reporting References: Head Start Act – Section 641A(h)(2) The ERSEA Specialist submits an enrollment report to the Office of Head Start on a monthly basis by logging into a website. This information is retrieved by utilizing the ChildPlus.Net Enrollment Report 2005. A copy of the report to reflect the numbers submitted is retained by the ERSEA Specialist. Only children who have attended at least one class or families in the Home Based Option who have received at least one home visit are counted in this report. If the actual enrollment is less than the funded enrollment, reasons are provided. When there are less than 60 days in the program year and vacancies are not filled, this information is also entered into the website with explanation. This information is entered by the 5th of each month for the previous month and is reflected in the ERSEA Specialist’s Policy Council Report as well as monthly report to his/her Supervisor.

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62

Southern Seven HS/EHS Service Area: ERSEA Procedure: Monthly Report References: None In addition to the above mentioned report, the ERSEA Specialist prepares a monthly report that is shared with Administration, all sites, Policy Council, and Board of Health. This report indicates (the center’s enrollment goal; differentiates between selected and enrolled children as well as breaking them down by income eligible and over income; and waiting lists by income eligible, over income, and not 3 yet). This report indicates the actual enrollment of the indicated day and does not take into account the thirty (30) day period allotted to replace vacancies. Therefore, often this report may indicate less than the funded enrollment but in all actuality the program has thirty (30) days to replace those vacancies. This report is compiled used many sources and is a way to cross check between site numbers and ChildPlus.Net Reports. Center’s Enrollment Goal is set during the Summer and very seldom changes unless something drastically changes within the sites and/or communities during the program year. Selected Children (Income Eligible and Over Income) is reported on the weekly enrollment report that sites prepare on a weekly basis. These children have been selected but are not yet enrolled. Enrolled Children (Income Eligible and Over Income) is reported on the weekly enrollment report that sites prepare on a weekly basis. These children have attended one class or have had one home visit. ChildPlus.Net Enrollment Report 2120 is printed to reflect enrolled and entered children and is kept with a copy of monthly enrollment report as a back-up. Children that are over income are indicated with an “O” next to their name in red ink. Waiting List is compiled from the ChildPlus.Net Enrollment Report 2025. This report is posted at each site as well as outside the ERSEA Specialist’s Office.

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63

Southern Seven Head Start/Early Head Start ENROLLMENT REPORT

Date:_____________________________________

HEAD START # Accepted # Enrolled # Entered

Total # YTD

Drops

Waitlist

Site Location

Enrollment Goal

Eligible Over

Income Eligible

Over Income

Eligible Over

Income Eligible

Over Income

Not 3

Anna

Brookport

Cairo

Cobden

Egyptian

Goreville

Hardin

Jonesboro

Metropolis

Mounds

Pope

Vienna

TOTALS:

FUNDED FOR 450

%

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64

EARLY HEAD START # Accepted # Enrolled # Entered

Total # YTD

Drops

Waiting List

Site Location

Enrollment Goal

Eligible Over

Income Eligible

Over Income

Eligible Over

Income Eligible

Over Income

Cairo

Metropolis

Mounds

Vienna

HB/Massac

HB/Pulaski

HB/Union

TOTALS:

FUNDED FOR 86

%

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65

Southern Seven HS/EHS Service Area: ERSEA Procedure: Monthly Audit Enrollment Report References: None As required by the agency’s auditor, a monthly audit is completed by the 15th of each month for the previous month. This is compiled by the ERSEA Specialist and submitted to the Early Childhood Administrator for approval. Information included in the monthly audit report is:

Weekly enrollment reports for Head Start and Early Head Start ChildPlus.Net Enrollment Report 2001.

Copy of the weekly enrollment report checklist (monthly)

Copy of the ChildPlus.Net Enrollment Report 2025 for Head Start and Early Head Start.

ChildPlus.Net Enrollment Report 2210 for Head Start and Early Head Start.

1) Weekly attendance/enrollment reports are recorded at each site and option. 2) Reports are faxed on the last day of the week to the ERSEA Specialist 3) The ERSEA Specialist maintains a tracking form to assure all reports are submitted. 4) The report is cross referenced with the ChildPlus.Net Enrollment Report 2001. 5) The waiting list is maintained in ChildPlus.Net as well as the Administrative Office. 6) The monthly audit is submitted to the Early Childhood Administrator which contains all of

the required information as listed above. 7) The Early Childhood Administrator reviews the report and signs for verification. 8) Twice a year these reports are hand counted, file by file, by the Early Childhood

Administrator to assure physical files match children’s names on the ChildPlus.Net Enrollment Report 2001.

9) All reports are kept on file for future review. The present school year’s report is kept in the ERSEA Specialist’s office and the previous school year is kept in the general information files in the work room. Other reports will be maintained in storage facilities for 5 (five) years.

In addition to the monthly audit enrollment report, Southern Seven completes an internal audit for verifying income eligibility. On a semi-annual basis, the Human Resources Administrator selects random files, and income documentation to verify income determination accuracy. A report is compiled by the Human Resources Administrator indicating the selected files, findings of the files, and recommendations for improvement. This report is provided to the Executive Director, Early Childhood Administrator, and ERSEA Specialist.

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MONTHLY AUDIT REPORT FOR:____________________

Traditional Head Start

Week of

Enrolled

Terminated

Total:

Waiting List

Eligible “E”

Over “O”

Total:

Early Head Start

Week of

Enrolled

Completed/Terminated

Total:

Waiting List

Eligible “E”

Over “O”

Total:

ERSEA Specialist Signature:___________________________ Date:___________ Early Childhood Administrator:_________________________ Date:___________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Kindergarten Files References: None Kindergarten Lists/Numbers (January)

1) ERSEA Specialist provides the ChildPlus.Net Enrollment Report 2030 to the Site Supervisors to verify for accuracy of children that will be entering kindergarten (next year). Sites write onto report which school district child will be attending. This report is returned to the ERSEA Specialist.

2) ERSEA Specialist enters which school district the child will be attending into Child Plus.

3) ERSEA Specialist provides numbers to the Education Team to assist with transition processes.

Consent for Release of Information (February)

1) Teachers complete forms with families during home visits in February. Staff complete the upper portion of the form and the parent/guardian completes the bottom portion.

2) Teachers and/or Site Supervisors review the forms to ensure accuracy. 3) For children that will be entering kindergarten that enroll after February home

visits, forms are completed as soon as possible. By March 1st the following will occur:

1) The report that was completed in January is returned to the Site Supervisor to update changes since January. This report is returned to the ERSEA Specialist.

2) The ERSEA Specialist compiles a release form with the names of all children entering kindergarten for each school district.

3) The ERSEA Specialist sends a memo to each Site Supervisor with directions for kindergarten file preparation and a date/time to do kindergarten files (after the school year is over).

Kindergarten File Date (end of the school year)

1) Site Supervisor brings children’s files (children entering kindergarten) in alphabetical order along with the original consents and copies of the consents to Central Office on their assigned date/time.

2) Central Office and Center Files are combined into one and a file is prepared for the public school (if consent is signed).

3) The Site Supervisor forwards the files to the appropriate school district. 4) Release forms (for each district) are signed by the person delivering records (Site

Supervisor) and the person accepting the records (school district staff). 5) The signed release form is returned to the ERSEA Specialist within one week of

completing kindergarten files at Central Office.

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Southern Seven Head Start/Early Head Start 37 Rustic Campus Drive

Ullin, IL 62992 (618) 634-9340

Consent for Release of Information

To: Center:

Address: Child’s Name:

Birth Date:

Reason for Release: To assist with your child’s educational, health, social and emotional growth and

development. Authorization is hereby granted to Southern Seven Head Start/Early Head Start to release to (agency or school district) and designated staff, information pertaining to services rendered to the above named child. I understand that such information may not be re-disclosed to any other person or agency without my further written consent.

SPECIFIC RECORDS and/or REPORTS RELEASED ARE

Education Health Individual Developmental Screening Tool

(DIAL-4, etc.) Vision & Hearing/Audiological Information

DIAL-4 Parent Questionnaire/Social Emotional Health Information

(physical, immunizations, dental) Kindergarten Transition Activity Checklist

Special Services Family

Copy of Birth Certificate

(please list any specific records to be released if applicable)

Yes, I hereby give consent for the above records to be released to the above named

agency.

I hereby deny consent for release of the above records. The authorization for release of information expires in 365 days from this date.

Parent/Guardian Signature:

Address: Phone:

Date:

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Southern Seven HS/EHS ATTENDANCE Service Area: ERSEA Procedure: Entry (First Week of School) References: None During the first week of the school year (August) the Office Associate and Home Based Teacher/Parent Coordinator complete the Entry Form each day verifying each child’s entry day (the first day of attendance). A child is only recorded one time on this form. All columns are completed and at the end of each day (during the first week), this form is e-mailed to the ERSEA Specialist. If no new children enter, this form still needs to be e-mailed to the ERSEA Specialist indicating that no new children entered. A new form is completed daily. Depending upon the number of children that entered during the first week, the ERSEA Specialist may request that this form be completed during the 2nd week of school. The Weekly Enrollment Report is still required to be submitted at the end of the week, however the table for entered children does not need to be completed again (just indicate that this was reported on the Daily Entry Report). After receiving the form, the ERSEA Specialist enters the entry date into ChildPlus.Net and files the form in the general information drawer according to center/option.

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Southern Seven Head Start/Early Head Start DAILY ENTRY REPORT

Center/Home Based: Date:

Child’s Name

Health Info Cleared By

(NA for HB)

Classroom

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Attendance References: None Attendance Procedure Each classroom and Home Based Teacher/Parent Coordinator has a book that includes monthly attendance sheets for the year. 1) Each month, the Teacher will print (using black ink) each child’s name (last name, first

name) in alphabetical order. If a child enters after the beginning of a month, the child is added to the bottom of the list. The following month, the child should be alphabetized accordingly.

2) Each day the teacher takes attendance using the following codes:

Code Terminology Description

A (red) Absent Child is not present at school

C Closed Agency is closed (i.e. snow day that agency closes)

D Dropped Child is dropped from program

E Entry Child’s first day of attendance

H Holiday Closed for observance of holiday

L Cancelled No class for children (i.e. snow day and classes are cancelled but agency is open, or training day with no training scheduled)

N Not Scheduled This is used if child is not present due to HS/EHS medical treatment (i.e. dental exam or follow up).

P Present Child is present

T Transfer This is used when a child transfers from one class to another (or center and/or option)

W Training Day No classes due to staff training

F Family

Cancellation This is only used for the Home Based Option

S Staff Cancellation This is only used for the Home Based Option

3) On the bottom of the page each day, the following is recorded: total number present, total

number absent, and total number entered. (total # present + total # absent = total # entered)

4) At the end of each month, the classroom teacher completes right section for each child. Each child’s total days present, total days absent, and total days entered is recorded. (Again total # present + total # absent = total # operation days). Calculate the percentages by taking the present number divided by the days of operation multiplied by 100. For example, if the child was present 6 days and absent 4 days and there were 10 operation days, take 6 divided by 10 and multiply the answer (.6) by 100 to get the percentage (60%).

5) Checks & Balances - Bottom numbers (total presents) are added together as well as right section (total presents) – numbers equal one another. The same is done with the absent numbers as well as the entered numbers. If numbers do not equal, the Teacher reviews to find error(s).

* Entry, Transferring into a classroom and Not Scheduled is calculated as a Present *Closed, Holiday, Cancelled, Training Days, No Class for Individual Child, and Transferring Out of a classroom are not calculated as present, absent, or entered numbers.

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Office Attendance Procedure for Center Based 1. Each day attendance is entered into ChildPlus.Net by designated staff. Codes from the

Teacher’s Attendance Sheet are entered. The only exceptions are: child’s entry (E) is entered as a P, child transferring into a classroom is entered as a P, child dropping is left blank, and child enrolled but not yet entered is left blank.

2. At the end of each month, the Office Associate or Site Supervisor reviews ChildPlus.Net Attendance Report 2305 to check attendance entered into ChildPlus.Net with the classroom attendance sheet. If there are any errors corrections are made.

3. At the end of each month a copy of the attendance sheets (including Home Based) are sent to the ERSEA Specialist. Due dates are determined at each site by the Site Supervisor to ensure that paperwork is received by the ERSEA Specialist by the 5th working day of month (for the previous month).

Administrative Office Attendance Procedure

1. Periodically throughout the month, the ERSEA Specialist checks to ensure attendance is being entered on a daily basis.

2. After receiving a copy of the classroom’s attendance sheets, the ERSEA Specialist checks to ensure that numbers match up to data in ChildPlus.Net Attendance Report 2305.

3. Once information has been verified, the ERSEA Specialist sends an e-mail to the site confirming accuracy of reports.

4. The ERSEA Specialist dates/initials the upper right hand corner of the classroom’s attendance sheet and places this in file in ERSEA Specialist’s office.

5. The ERSEA Specialist prints ChildPlus.Net Attendance Report 2301 to report each program’s (Head Start and Early Head Start) center based monthly average daily attendance. This is provided to each site, Policy Council, and Board of Health.

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Sample Attendance Spreadsheet

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Southern Seven HS/EHS Service Area: ERSEA Procedure: ChildPlus.Net Center Based Attendance Entry

Attendance will be entered on a DAILY basis.

1. Select the “Entry Express” Tab and click on “Attendance”. 2. Select the classroom you wish to enter in the “Classroom” box. 3. Click on today’s date. 4. Children’s names will appear on the first column in alphabetical order. 5. The second column is where you will enter the attendance for each child. See chart below.

Code Terminology Child Plus.Net Code

A (red) Absent A

C Closed In the classroom status box select Closed

D Dropped Leave a blank line

E Entry P

H Holiday In the classroom status box select Holiday

L Cancelled In the classroom status box select Cancelled

N Not Scheduled N(this for EHS/HS medical treatment)

P Present P

T Transfer P

W Training Day In the classroom status box select Teacher Workday.

If child has not entered yet, they will appear on the screen, leave a blank line.

6. If the child is absent, choose the reason under the absent column. Then in the attendance notes

section type a case note stating the reason from the parent, if known. Remember to time stamp your note before you begin typing.

7. After you complete the attendance for each child, click save changes and choose the next classroom.

End of the Month

1. At the end of the month, compare classroom’s attendance sheet(s) with Attendance Report 2305

(select Report Tab, then select Attendance, and then choose 2305 – Monthly Attendance by Classroom). On Program Term – select Head Start or Early Head Start depending upon the classroom). On Classroom, select classroom that you are checking. On Status – select Enrolled, Dropped and Completed. On Report Type – select Detail. You will need to enter the date for the month reporting on.

2. Classroom Attendance Sheets and Child Plus.Net Report 2305 must match one another. If there is an error in data entry, it needs to be corrected, if there is an error on classroom attendance sheet it needs to be corrected. Designated staff will highlight all (A’s) to represent they have checked for accuracy.

3. Attendance is due in Child Plus.Net on a daily basis. By the fifth working day of the new month, a copy of the classroom sheets, the Classroom Analysis (if applicable), and ChildPlus.Net Report 2305 and 2330 is due to ERSEA Specialist. Please submit all information listed above at the same time.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Child Absence Documentation References: Head Start Performance Standard – 1305.8(b) The Child Absence Documentation form is completed on any student that is absent for three (3) consecutive days. This form is completed by classroom teachers and indicates the reason for the child’s absence and how the information was verified. If no contact has been made from the family regarding the child’s absence, information is obtained from the following three step process: The first day a phone call is made to the family; the second day an additional phone call is made to the family; and the third day a Home Visit must be made. The form is required on the 3rd consecutive day of absence for the Parent Coordinators signature. All contact with the child’s family should be documented in the case note section of the child’s file by the teacher AND documented in ChildPlus.Net by designated staff! In order to assist with tracking completion of these forms, classroom teacher will circle the 3rd absence in red (on classroom attendance sheet) to indicate that form has been completed. If the Teacher is unable to contact the family or if special family support is needed, Parent Coordinators assist with the follow up. Office Attendance Procedure After receiving a Child Absence documentation form, the correct code (for reason of absence) is entered into Child Plus for the indicated days and comments made by the parent in the case notes section. The codes are listed on the Child Absence Documentation Form. On bottom of the form, office staff write in date that information was entered into ChildPlus.Net and initial in designated area. Following entry, a copy of the form is made (staff write in ©, date, and initials). The original form is sent to the ERSEA Specialist and a copy is maintained for the child’s file. Child Absence Documentation Forms are sent to the ERSEA Specialist as they occur or at least on a weekly basis. At the end of the month ChildPlus.Net Attendance Report 2330 (Consecutive Absences) is run to ensure that all 3 day consecutive absences did receive follow up and documentation was entered. If any data is missing, follow up occurs immediately. Administrative Usage When Absence Documentation is received by the ERSEA Specialist it is reviewed and initialed and filed in the general information drawer according to center or option. The ERSEA Specialist prints ChildPlus.Net Attendance Report 2330 and prepares a report analyzing the reasons for consecutive absences. This report is attached to ChildPlus.Net Attendance Report 2301.

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Southern Seven Head Start/Early Head Start CHILD ABSENCE DOCUMENTATION FORM

Center Name: ______________________________ Classroom: ____________________________ Child’s Name: _____________________________________________________________________

Last First First INITIAL Day of Absence: ____________ Date(s) of Absence:_______/________/_________

Excused Absence(s) Due To (typically reason is beyond Parent(s) control):

Illness to child Transportation problems, such as no vehicle available

Head Lice

Weather conditions, such as too cold, hazardous roads, storming

Illness to immediate family member Death in family

Public school break (holiday, spring break, etc.) Cultural/religious family activities

Temporary family situations, such as moving, out of town, house fire, divorce, etc.

Parent school schedule (mainly for Rustic Head Start)

Other (please indicate reason):

Unexcused Absence(s) Due To (typically reason is within Parent(s) control): Child doesn’t want to come to school Family overslept/missed bus

Other (please indicate reason):

How did you verify the reason for the child’s absence?

Staff phoned parent Date: Bus Driver Date:

Parent phoned staff Date: Home Visit Date:

Name of parent/person contacted: Child will be returning on:

Explanation/Comments:

Does there appear to be an attendance issue? Yes No If yes, what strategies and support have been offered to the family?

Person Completing Report Date

Parent Coordinator Signature Site Supervisor Initials

Data Entry Completed By ERSEA Specialist Date Reviewed

Copies: Central Office File (ERSEA) & Center

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Southern Seven HS/EHS Service Area: ERSEA Procedure: ChildPlus.Net Child Absence Entry

1. Once a Child Absence Documentation is received, you will need to select Entry Express Tab and click on Attendance (just like entering attendance).

2. Next to the A (absence) – a box will appear for absence reason. The reasons match the Absence Documentation Form. You will need to select the reason and do this for each of the three absent days. Be careful when selecting other, as there is one other that is excused and another one for unexcused.

3. After the data is entered, please complete bottom portion (data entered by) and write a c on the top right hand corner along w/the date and your initials. Make a copy and send original to ERSEA Specialist. Retain a copy for child’s blue file. This should be occurring on a regular basis, DO NOT wait until the end of the month to do this. This is also monitored on a regular basis.

End of the Month

1. At the end of the month, to check to make sure you are not missing any Child Absence Documentation, you will need to use w/Attendance Report 2330 (select Report Tab, then select Attendance, and then choose 2330 – Consecutive Absences). On Program Term – select Head Start or Early Head Start (depending upon the classroom). On Classroom, select classroom that you are checking. On Status – select Enrolled, Dropped and Completed. On Report Type – select Detail. You will need to enter the dates for beginning and ending (for example 9/1/11 -9/30/11). On Attendance Codes, Absent and Unexcused should be selected. When reviewing this report, if you find 3 consecutive absences with Unknown Reasons, this will indicate that you are missing one. This will need to be completed and entered.

2. By the fifth working day of the new month, a copy of classroom sheets and Classroom Analysis (if applicable) is due to ERSEA Specialist. Please submit all information listed above at the same time.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Home Based Weekly Visits and Monitoring References: Head Start Performance Standard - 1306.33

Each family that is enrolled in the Home Based option receives one 90 minute home visit per week. Weekly visits are scheduled at times that are convenient to the family. A monthly calendar is provided to each family with socialization dates (times and locations) and any other events, along with contact information to reach the program. Together, the family and Home Based Teacher schedule the weekly visits and also plan and discuss any other appointments they may have (WIC, well child checks, etc.). They also establish how the family is getting to the appointment. Home Based Teachers do assist families in linking them with transportation or in some cases do offer transportation as a support service to the family. The calendar is left with the family. Children/families that are enrolled in home based for an entire program year (12 months) are offered 48 visits or approximately 4 visits per month. The 48 visits allow four weeks for Christmas Break, staff training and/or staff vacation. If a child/family enrolls in the program after the start of the program year, the number of visits to be offered is calculated by the ERSEA Specialist and/or Early Childhood Administrator. This number of visits to be offered is reflected in the case notes of the child’s file upon acceptance. Home Visits that the families cancel or no shows are still considered a visit offered to the family. If the Home Based Teacher has to cancel a visit (this would not be counted as a visit offered), a make-up visit must be planned and scheduled at a time that is convenient to the family. When making up visits, no more than two home visits can be offered or counted in a one week time period. Attendance at socialization days and/or medical or social service appointments cannot be counted as a scheduled home visit. All visits are documented in ChildPlus.Net. All data is due in ChildPlus.Net for the previous month’s information by the 5th working day of the new month. At the end of each month the ERSEA Specialist prepares a report indicating the number of home visits offered and completed per each Home Based Teacher. This report is provided to the Home Based Teachers, the Early Childhood Administrator and is shared with attendance information to the Policy Council & the Board of Health.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: ChildPlus.Net Entry of Home Based Visits

In ChildPlus.Net choose a participant and completed the following steps: 1. Click on the “Family Services” tab. 2. Click on “Add Event.”

An “event” should be used to represent one month of visits. 3. Complete the following fields (this should be completed at the beginning of each month):

Initial Date (first scheduled visit of the month).

Event Type (select Home Based Home Visit).

Click in Description box. 4. Click on the blue schedule home visits prompt and complete the following:

Enter first and last scheduled visit dates for the month (using your scheduled time).

Agency Worker - usually this is prefilled but if not select yourself from the drop down box.

Total Time – this should be 1 hour and 30 min.

The “add counter” feature should be turned on and start at 1 (for the first month). For the following months, the number will start at the appropriate numbered home visit (for example, if the first month four visits were offered the next month the counter would need to start at 5).

Click the blue “schedule home visits” at the bottom of the screen. 5. In Section 2 of the screen your visits are listed. After the “actions” occur you will need to fill in the

following:

Action Date – the date the action occurred (If the family cancels use the date you received the information or if they no show use the date you were no showed. If staff cancel, list the date you notified the family).

Status – use only of one of 3 options. Action Completed – home visit occurred. Family Cancelled – this includes family cancelling and No Shows – change time to 0. Staff Cancelled – staff cancelled visit – change time to 0.

Event Notes – used for documentation such as both parents participated in home visit, family cancelled due to ill child, etc.

6. If you need to add additional or make up visits during the month:

Click on the monthly event you want (the first month of entry there will only be one to choose from).

In section 2 – click on Add Action and complete the following:

Action Type – select direct.

Scheduled – date it is to occur.

Type of Contact – Home Based Home Visit.

Description – example Home Based Home Visit #5.

Agency Worker – select your name.

Total Time – 1 hour and 30 minutes.

Follow steps in #5 to complete the data entry.

When you enter visits ChildPlus.Net transfers this to others enrolled in the “family.” ChildPlus.Net entry of scheduled visits should only occur after parent and Home Based Teacher/Parent Coordinator have agreed to monthly calendar.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Classroom Attendance Analysis References: Head Start Performance Standard – 1305.8 First Month Below 85% At the end of the month if a classroom’s attendance is below 85%, the classroom Teacher(s), Parent Coordinator, and Site Supervisor meet together to complete the Classroom Attendance Analysis form. On this form, children who have been present for less than 85% for the month are listed along with data regarding reasons for absences, patterns in attendance, and the need for family support and/or follow-up. Strategies will be set to improve attendance for the coming month. When reviewing individual children’s attendance, it may be helpful to use ChildPlus.Net Attendance Report 2330. Second Consecutive Month Below 85% If a class is below 85% for two consecutive months, the ERSEA Specialist will attend the analysis meeting. During this meeting, documentation on case notes either from ChildPlus.Net or child’s blue file regarding parent contacts will be presented. At the end of each month (if applicable) the Attendance Analysis form is submitted to the ERSEA Specialist stapled to the copy of classroom attendance sheet which is due on the 7th working day of the month. A copy is also retained for the site file.

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Southern Seven Head Start/Early Head Start CLASSROOM ATTENDANCE ANALYSIS

Site: Classroom: Month:

Classroom Attendance Percentage: % Previous Month’s Attendance Percentage: %

Staff Participating in the Meeting:

Signature Title

Children Below 85% Attendance (use extra copies of this form if needed)

Child’s Name Current Month’s

ADA

Previous Month’s

ADA

Days Present

Days Absent

Reasons

Patterns (Every

Tuesday, Friday, etc.)

Attendance Agreement in

Place? (Y or N)

Is There a Need? (Y or N)

Plan For Follow-Up

What can we do to improve attendance for next month? Are there families that need additional family support (please list specific strategies, responsible staff, and timelines for follow-up)? _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ ERSEA Specialist Review: Date:____________________________ Initials:__________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Attendance Agreements References: Head Start Performance Standard – 1305.8(b) When individual child’s attendance falls below 85% for a given month and when there is no illness or other extenuating circumstances, there may be a need for an Attendance Agreement. Parent Coordinators and Teachers contact the parent to set up a mutually convenient time to discuss attendance and to address any concerns the parent may have. Staff re-emphasize the importance of regular and consistent attendance. Parents and staff identify the reasons for the absences and together create goals and strategies to resolve the issue. It is important for staff and families to work together on this agreement. It should be individualized based on the family’s situation. The plan includes time for a follow up. It is important to schedule this during the meeting. A copy of the attendance agreement is provided to the parent, a copy is maintained in the child’s center file (correspondence section), and a copy is sent to the ERSEA Specialist. During the follow up meeting, please remember to celebrate any and all improvements. Home Based If the family cancels or no shows the Home Based Teacher/Parent Coordinator reviews the “Parent/Home Based Teacher Agreement” regarding home visits. The Home Based Teacher/Parent Coordinator re-emphasizes the importance of regular and consistent participation. Parents and staff identify the reasons for the missed appointments and create goals and strategies to resolve the issue. If additional support is needed, the Home Based Teacher/Parent Coordinator can contact the ERSEA Specialist and he/she can accompany them on a home visit and discuss this with the family too.

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Southern Seven Head Start/Early Head Start ATTENDANCE AGREEMENT

Site: _________________________________ Classroom: _______________________ Child’s Name: __________________________ Date Concern Identified: _____________ Parent’s Name: _______________________________________________________________ Number of Days Missed: _________________ Number of Days Present: ____________ Reasons for Absence: _________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Goals Agreed Upon: ___________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Planned Follow-Up Date/Time: ___________________________________________________ Staff Signature: ______________________________ Date: _________________ Parent(s) Signature: __________________________ Date: _________________

Attendance Agreement Follow-Up Date: ___________________________ Attendance Improved? Yes No Follow-Up Notes: _____________________________________________________________ ___________________________________________________________________________ Plan of Action: _______________________________________________________________ ___________________________________________________________________________ Staff Signature: ______________________________ Date: _________________ Parent(s) Signature: __________________________ Date: _________________

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Chronic Absenteeism References: Head Start Performance Standard – 1305.8(c) In the event that chronic absenteeism persists and multiple attempts to contact the family, through phone calls, home visits, and letters (that are documented), the Site Supervisor or Parent Coordinator will contact the ERSEA Specialist to request that a certified letter be sent to the parent. The ERSEA Specialist will prepare the letter, mail it to the parent, and email a copy to the site for their records. The parent will be given two weeks to contact the site or Administrative Office or for the child to return to school. If parent does not contact the site or Administrative Office, the ERSEA Specialist will seek approval from the Early Childhood Administrator for dropping the child and enrolling the next child on the waiting list. Prior to speaking the Early Childhood Administrator, the ERSEA Specialist will request a copy of any correspondence relating to attendance to review and share with the Early Childhood Administrator. Home Based For the Home Based Program, if a family is a “no show” for two consecutive weeks and does not contact the Home Based Teacher/Parent Coordinator, the Home Based Teacher/Parent Coordinator contacts the ERSEA Specialist to request that a certified letter be sent to the parent. The ERSEA Specialist will prepare the letter, mail it to the parent, and email a copy to the Home Based Teacher/Parent Coordinator for their records. The parent is provided with an additional week to contact the Home Based Teacher/Parent Coordinator to schedule a home visit. If the parent does not contact the Home Based Teacher/Parent Coordinator, the ERSEA Specialist will seek approval from the Early Childhood Administrator for dropping and enrolling the next child on the waitlist. This procedure was approved by the Policy Council on Monday, August 19, 2013 and the Board of Health on Thursday, August 22, 2013.

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Incentives for Attendance References: None In order to improve our program’s attendance, the following measures are taken.

Attendance and the importance of it, is discussed during the Intake Process with all prospective families.

Information relating to attendance is included in the Parent Handbook as well as discussed with all families during Parent Orientation (or during the school year if a child enrolls after the 1st day).

Attendance information is reviewed and discussed with all families during Home Visits and Family Staff Conferences.

ERSEA Specialist places articles in parent newsletter discussing the importance of attendance and recognizes classrooms with highest attendance for the month.

Children that have 85-100% attendance for the month are recognized in the center’s newsletter (first name and last initial only).

Attendance is discussed at Parent Meetings as well as ways to improve it.

Certificates are made for parents (Perfect Attendance as well as 85% or better) and are distributed at Parent Meetings and/or Family Fun Nights.

Average Daily Attendance Reports are provided to each site monthly that reflects each site’s percentage for the month and are posted for all staff to view.

Attendance is discussed at staff meetings and ways to improve percentages (including goal setting).

Attendance Reports (and reasons for absences) are reviewed and discussed by Management Team, ERSEA Team, Policy Council, and Board of Health.

Home Based As an incentive, a drawing for families that had all visits completed for the month is held at Socialization Days.

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CERTIFICATE OF ACHIEVEMENT!

Perfect Attendance Certificate

____________________________

Your child, ___________________ has achieved

Perfect Attendance this month!

___________________ _______________ Site Supervisor Date

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CERTIFICATE OF ACHIEVEMENT!

Average Daily Attendance Certificate

____________________________

Your child, ___________________ has assisted us in achieving our

Average Daily Attendance!

___________________ _______________ Site Supervisor Date

Documents

Southern Seven Head Start/ Early Head StartRevised: 06/16, rm 5 Southern Seven Head Start STANDARDS OF CONDUCT Pursuant to Head Start Performance Standard 1304.52(h)(1), all employees,