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 Employees 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 .......................................................................................... 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/Individual Attendance Analysis .................................................................... 80 Classroom Attendance Analysis Form .......................................................................... 81 Individualized Attendance Agreement Plan ................................................................... 82 Individualized Attendance Agreement Plan 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 childs behavior. Such suspensions may only be temporary in nature. A program cannot expel or unenroll a child from Head Start because of a childs 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 Standards 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). Members of the ERSEA Team should plan on meeting at least every other month at a date and time set by the team. Expectations of members are:

1. Obtain input to represent during meetings. 2. Attend meeting or send an alternate. 3. Review and analyze data from the Community Assessment, Self- Assessment,

PIR, Parent Questionnaires and other monitoring tools for planning purposes. 4. Build on existing recruitment strategies. 5. Review and update selection criteria annually. 6. Ensure that at least 10% of enrollment opportunities are made available to

children with disabilities. 7. Monitor number of children that are not income eligible. 8. Identify strategies to meet and maintain funded enrollment. 9. Review reports and strategize ways to reach and maintain a minimum of 85%

average daily attendance. 10. 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 childs center and central office file. Verification of age is documented on the Head Start application. Verification of Income:

One entire month of current pay stubs.

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 childs 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 familys 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

Childs 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 the following: Rent/House Payment: ________________ Utilities: ___________________________ Food: _____________________________ Transportation: _____________________ Daycare: ___________________________

Place of last employment? Name: ___________________________________ Telephone: _______________________ Address: _________________________________ Last day of work ______/______/______ City: _____________________________________ State: ____________________________ If you sold merchandise to pay bills (ie: Facebook, yard sales, or flea market): 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 Early Head Start/Head Start and could have serious legal consequences for me. ____________________________________ ___________________________ Parent/Guardian Signature In-Take Staff Signature ____________________________________ ___________________________ Date Date

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

Childs 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: __________________________________________________ Name of Third Party #2:___________________________ Phone Number:________ Title of Third Party: ______________________________________________________ Affiliation of Third Party: __________________________________________________ Name of Parent/Guardian: ________________________________________________ Signature of Parent/Guardian: _____________________________________________ Name & Signature of Staff Obtaining Information: ______________________________ (Office Use Only) Explain how familys income was calculated: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

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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 childs parent(s) or guardian(s) income; and 2) Related to the childs parent(s) or guardian(s) by blood, marriage, or adoption; or 3) The childs 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 both parts one and two or three of the definition. If the child is in Foster Care a family will consist of one member. 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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Southern Seven Head Start/Early Head Start

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 have this confidential information. If the family submits a copy of their taxes, please use total income for calculation purposes. Income is: Income is not:

Cash receipts before taxes; net income from farm or self-employment

Capital gains

Money wages or salary before deductions & 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 SNAP

Child support School Lunches

Military family allotments Housing Assistance

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

Savings

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.

2017 Federal Income Guidelines Persons in Family Poverty Guideline

1 $12,060

2 $16,240

3 $20,420

4 $24,600

5 $28,780

6 $32,960

7 $37,140

8 $41,320

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/Guardians Signature Date For Staff Use Only In accordance with the Head Start Performance Standard 45 CFR 1302.12, 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

Childs 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 2017 FAMILY INCOME GUIDELINES

FAMILY SIZE

Income Eligible Over Income

100-75% 75-50% 50-25% 25-0% 1-30% 30-50% 50% & Over

Below Below Below Below Above Above

1 0 - 3,015 6,030 9,045 12,061 15,679 18,091

3,014 6,029 9,044 12,060 15,678 18,090 & Above

2 0 - 4,060 8,120 12,180 16,241 21,113 24,361

4,059 8,119 12,179 16,240 21,112 24,360 & Above

3 0 - 5,105 10,210 15,315 20,421 26,547 30,631

5,104 10,209 15,314 20,420 26,546 30,630 & Above

4 0 - 6,150 12,300 18,450 24,601 31,981 36,901

6,149 12,299 18,449 24,600 31,980 36,900 & Above

5 0 - 7,195 14,390 21,585 28,781 37,415 43,171

7,194 14,389 21,584 28,780 37,414 43,170 & Above

6 0 - 8,240 16,480 24,720 32,961 42,849 49,441

8,239 16,479 24,719 32,960 42,848 49,440 & Above

7 0 - 9,285 18,570 27,855 37,141 48,283 55,711

9,284 18,569 27,854 37,140 48,282 55,710 & Above

8 0 - 10,330 20,660 30,990 41,321 53,717 61,981

10,329 20,659 30,989 41,320 53,716 61,980 & Above

For families with more than 8 persons, add $4,180 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. Complete the survey with a parent signature and a staff signature.

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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

Childs 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 Persons 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 before the place you currently left and why did you leave? ______ ______________________________________________________________________

How long did you live there? _______________________________________________

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 couldnt 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:

Verification of Support (3rd Party Release) Name of Homeless Liaison in the Familys 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

Parents Signature: ______________________________ Date:___________________

Staff Signature: _________________________________ Date:___________________

I have discussed the Living Situation with the ERSEA Specialist. Date:___________________

Administrative Approval: __________________________ Date:___________________ (For Office Use Only): Meets homeless eligibility: Yes No

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Southern Seven Head Start/Early Head Start

VERIFICATION OF SUPPORT FOR FAMILY LIVING SITUATION

Childs Name:___________________________ Center:_____________________ Name: ___________________________________________________________________ Relationship: ______________________________________________________________ Address: _________________________________________________________________ Phone: __________________________________________________________________ _______________________________________ _____________________ Signature (person providing housing) Date

Third Party Release and Documentation I,_______________________________________ (Parent/Guardian), give consent to Southern Seven Head Start/Early Head Start Staff, 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: __________________________________________________ Name of Third Party #2:___________________________ Phone Number:________ Title of Third Party: ______________________________________________________ Affiliation of Third Party: __________________________________________________ Name of Parent/Guardian: ________________________________________________ Signature of Parent/Guardian: _____________________________________________ Name & Signature of Staff Obtaining Information: ______________________________ (Office Use Only) Describe efforts made to verify the specific conditions under the homeless definition: _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

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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 Sevens 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 childs 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 childs 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

Childs Name (as appears on birth certificate):

(Last Name) (First Name) Date of Birth Birth Verified by: Hospital or Certified Birth Certificate Other:

Family Income

Verified by: Date Verified: / /

Family Member Amount Per (week, month, year)

Annual Amount *Description **Verification Notes

$ $

$ $

$ $

$ $

Income Notes (including Documentation of No Income)

*Description: 0 Dollar; Award Letter; Court Document; Job; Pension; Social Security; SSI; TANF **Verification: Check Stub; Child Support; Employer Letter; Foster Care Reimbursement; Income Tax Form 1040;

School Grant; Self Declaration; SSI Documentation; TANF; Unemployment; W2

Eligibility

Program Term Initial Status Status Date Updated Status / Date (for ERSEA Only)

New Todays Accepted Date: Waitlisted Date:

Releases Signed Date Signed Site Funding

Yes No EHS HS

Application Date Application Status Application Number / Initials Participation Year

Complete & Verified Too Young Other specify in notes

Eligibility Date Number in Family Eligibility Income Child Eligible to Participate in Program

Yes No

Type of Eligibility Interview Income Status Documentation Used to Determine Eligibility

In-Person Telephone

Foster Child Homeless Eligible (below 100%) Over Income Public Assistance

Income Tax Form 1040 W-2 TANF Documentation Pay Stub/Pay Envelopes Unemployment

Written Statements from Employers Foster Care Reimbursement SSI Documentation Other

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Southern Seven HS/EHS RECRUITMENT Service Area: ERSEA Procedure: Recruitment Plan References: Head Start Performance Standards - 1302.13 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.

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. Childrens 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 Specialist completes Recruitment Training during the All Staff Training in January.

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 countys 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. The Sites set goals for the number of applications needed for the following school year.

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. 9) Parent Coordinators will work with families to complete 3rd year re-verifications as

applicable.

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) ERSEA Specialist schedules Summer Registrations with Health Departments. 5) 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 years 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 - 1302.13 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 years 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 ____________(Year)

Site:___________________________ Month:________________________

Plan of Action/Events Describe Results

Week What Who When What Who Outcome

Example: Contact Wal-Mart to see if we

can set up a table. Alice & Mary March 17th

Completed 5 Information Worksheets

Family A; B; C; D; & E

Set appointments to complete intakes with the families.

1

2

3

4

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Recruitment Roster Month:

(Site Name/Home Based) Week Ending:

Childs Name

(Last Name, First Name) Parent or

Guardians Name Phone

Number Age as

of 9/1/17

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 1302.12 1302.12 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) If Intake Staff are available, begin the application process. 2) If Intake Staff are not available, complete an Information Worksheet and assure the family

that they will receive a call in one to two business days. 3) Provide Appointment Reminder to the family to include items needed for the Intake. 4) 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: Childs 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, one entire month of 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 dont 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 familys 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 Guardians Name: __________________________________________________________________

Street Address: _________________________________________________________________________________

Mailing Address (if different): _____________________________________________________________________

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

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

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

______________________________________________________________________________________________

Childs Name: _________________________ Date of Birth: ____ / ____ / ____

Childs Name: _________________________ Date of Birth: ____ / ____ / ____

Childs 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. Mail this form to: Southern Seven Head Start You may drop off at any Southern

Attn: Enrollment Seven Head Start and/or Health

37 Rustic Campus Drive OR Department Clinic Ullin, IL 62992

FOR OFFICE 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:

Childs 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, one entire month of 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 investigacin sobre nuestro programa de Head Start y su inters en inscribir a su hijo. Enviamos un recordatorio amigable de su cita para reunirse con el personal y completar el proceso de la aplicacin. La Citaes es ___________________________ en_____________________________. (el dia y la hora) (la ubicacin) Es importante que traiga la informacin que le pedimos abajo para completar su proceso de aplicacin. Si tiene alguna pregunta o inquietud, por favor, llame al centro al ___________________. Atentamente,

Las cosas que necesita traer el da de la cita:

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

Documentacin de ingresos : formulario de impuesto(1040), W-2, one entire month of current pay stubs, o por escrito una carta de su empleadores, el estado actual de la documentacin que muestra de SSI/TANF, pensin alimenticia, manutencin, becas y subvenciones, Seguridad Social, etc.

Si usted tiene los siguientes disponibles por favor traiga:

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

Registros de salud (si est disponible): registro de inmunizacin, exmenes fsicos/dental, tarjeta mdica, etc.

Otra informacin (si procede): referencias de Agencia de servicio Social (s), custodia y tutela documentacin, 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 aplicacin con (Southern Seven Head Start). Todas las solicitudes de entrada en el programa deben pasar por un proceso de seleccin que ayuda a servir a los nios y familias mas necesitadas para nuestros servicios. Este proceso de seleccin ya esta en marcha.

Le informaremos lo antes posible si su hijo ha sido seleccionado para la inscripcin. Si su hijo/a esta seleccionado nos permitir saber que pasos son necesarios para completar el proceso de inscripcin. 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 2017 - 2018 SELECTION CRITERIA

CHILDS NAME (Last, First):

AGE (maximum 95 points) Subtotal Age

Points:

(HS) Child is 4 (or will turn 4) by 9/1/17 95

(HS) Child is Transitioning from EHS 85

(HS) Child is 3 (or will turn 3) by 9/1/17 85

(HS) Child turned 3 (or will turn 3) after 9/1/17 75

(EHS) 0 - 15 Months 95

(EHS) 16 24 Months 75

(EHS) 25 30 Months 55

(EHS) 31 - 36 Months 25

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

Low Income 50 25% Below Poverty Guidelines 75

Low Income 25 0% Below Poverty Guidelines 65

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:

Referral from Social Service Agency 30

Incarcerated Parent 30

Child on Wait List from Last Program Year 30

Parent Loss of Job or Dislocated Worker 30

Parent w/Disability 30

Parent in School or Training 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) 10

English is Second Language 10

Expecting Mothers 10

CHILD DISABILITY (maximum 95 points) Subtotal Child

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

Teen Parent 65

One Parent in Household 60

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: 01/09/17 Date Approved by Board of Health: 02/23/17

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Southern Seven HS/EHS Service Area: ERSEA Procedure: Selection Process References: Head Start Performance Standards 1302.14 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 May, 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 - 1302.14(c)

Children that are not selected for enrollment are placed on the waiting list. Families receive notification of this by a letter. The childs 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 months 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 - 1302.12(d);

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 familys 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: Employees Families The Early Childhood Administrator will review all employees childrens 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 - 1302.12;

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 childs 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 sites 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 Specialists 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 Specialists 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 Specialists 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 Specialists 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 childs 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 childs 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 aplicacin de su hijo, _________________, ahorita no podemos procesar la solicitud en este momento. Enve los siguientes elementos que estn () marcado debajo. Son necesarios para completar el proceso de la aplicacin. Estos elementos deben ser recibidos antes de que proceda la aplicacin de su hijo. ______ Prueba de ingresos familiares (copia W2 del 20____ o impuestos, taln de cheque 20_____ o declaracin de SSI, TANF, etc.) ______ Copia del Certificado de nacimiento del nio ______ Copia de la tarjeta medica, (si tiene una) ______ Otro, por favor pngase en contacto con migo Esperamos ver a su hijo en nuestro programa. Si necesita informacin adicional, por favor sintase 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 _________________.

Revised: 07/17, rm

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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 (childs 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 Coordinators 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.

Revised: 07/17, rm

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

Childs 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)* _______ ASQ-SE (parent) _______ ASQ-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

___________

___________

Revised: 07/17, rm

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Southern Seven Head Start CENTER CHART CHECKLIST

Childs Name: ______________________________________________________________________ Last First Entry Year: _______________________________ Birthdate: ___________________________

Section 1

_____ Chart Checklist _____ Case Notes (copy) _____ Entry Date for 17-18 HS _____ Transition Date to Other HS Site

Section 2 _____ Consents From Application (original) (transportation, screening, & guidance) ____ Dental Consent Form _____ Inform