document: accident and injury report -...

Shine Access Premium: All Resources

Document: 90-Day Performance Evaluation

Description: This form is used at the end of a new employee's 90-day introductory period.

Topics: HR, Performance Evaluation

Available Downloads: 90-Day Performance Evaluation

Document: Accident and Injury Report

Description: This form is used to document any injury to a child at the program.

Topics: Health, Accidents

Available Downloads: Accident and Injury Report

Document: Accounting & Financial Policies & Procedures Manual

Description: This finance focused manual covers information and provides policies & procedures for: the role of the Board & Policy Council, Business Conduct, Fraud Policy, Security, Technology and Electronic Communications, General Ledger and Chart of Accounts, Revenues and Cash Receipts, Billing/Invoicing, Cash Receipts, Accounts Receivable Management, Purchasing, Political Intervention, Accounts Payable Management, Credit Card Procedures, Travel and Business Entertainment, Cash Disbursements, Payroll, Cash and Cash Management, Prepaid Expenses, Fixed Asset Management, Accrued Liabilities, Notes Payable, Fiancial & Tax Reporting, Financial Management, Annual Audit, Insurance, Functional Expense Allocations, Federal Awards, and Charging of Costs to Federal Awards.

Topics: Policies and Procedures, PDM, Fiscal

Available Downloads: Accounting & Financial Policies & Procedures Manual

Document: Achievement Gap Brochure & Workshop Package

Description: Full supporting materials to help your family services teams implement effective workshops on the achievement gap and family life practices. Achievement Gap booklets in English and Spanish

Copyright 2014, Shine Early Learning, Inc.


Topics: Achievement Gap Workshops, Family Services

Available Downloads: AG Workshop Package, AG Brochure (English), Achievement Gap Booklet (Spanish)

Document: Animals & Pets

Description: This policy clearly defines the procedures we use for children’s interactions with animals and animal in the classrooms. Information about Classroom Animals & Pets, Visiting Animals & Pets and Class Trips involving Animals & Pets can all be found within this policy and procedure.

Topics: Policies and Procedures, Education

Available Downloads: Animals & Pets

Document: Annual Community Assessment Guidelines & Survey

Description: This questionnaire will help your management team gather information from families as well as staff members. The tool includes a procedure of how this can be implemented at your various child care sites, with home-based parents, and in various support operations department whenever feasible. It also provides a list of questions that might be asked and a form to gather and summarize the findings from the questionnaire. Use this tool along with the Community Assessment by Service Area tool to get a comprehensive view of your community.

Topics: Community Assessment, Family Services

Available Downloads: Annual Community Assessment Guidelines & Survey

Document: Application Cover Letter EHS

Description: Attach this letter (available in English and Spanish) to your application form to inform families of what documentation is necessary to provide in order to enroll their child in the Early Head Start program.

Topics: Family Services

Available Downloads: Application Cover Letter EHS



Document: Application Cover Letter HS

Description: Attach this letter (available in English and Spanish) to your application form to inform families of what documentation is necessary to provide in order to enroll their child in the Head Start program.


Available Downloads: Application Cover Letter HS

Document: Application for Program Participation - Early Head Start

Description: This form is used by parents/guardians to apply for a spot in the Early Head Start program. It is available in English and in Spanish (two tabs of the spreadsheet).


Available Downloads: Application for Program Participation - Early Head Start

Document: Application for Program Participation - Head Start

Description: This form is used by parents/guardians to apply for a spot in the Head Start program. It is available in English and in Spanish (two tabs of the spreadsheet).


Available Downloads: Application for Program Participation - Head Start

Document: ASQ and ESI-R Screening Information Cover Sheet

Description: ASQ and ESI-R Screening Information Cover Sheet

Topics: Screenings, Education

Available Downloads: ASQ and ESI-R Screening Information Cover Sheet



Document: ASQ and ESI-R Screening Procedures

Description: ASQ and ESI-R Screening Procedures

Topics: Screenings, Education

Available Downloads: ASQ and ESI-R Screening Procedures

Document: Assessment Coaching Cycle Protocol

Description: Assessment Cycle coaching protocol for teachers and education staff

Topics: Coaching, Assessment, Education

Available Downloads: Assessment Coaching Cycle Protocol

Document: Assistant Teacher Success Rubric

Description: The Head Start Teacher Success Rubrics (TSR and ATSR) were developed to (1) clearly articulate the expectations for being a successful teacher with Acelero Learning and (2) provide all teachers with a developmental path to achieve mastery in specific components of their work.

Topics: Education, coaching

Available Downloads: Assistant Teacher Success Rubric

Document: At-Home Family Volunteer Hours

Description: This form is used to record time parents spend at home on activities specifically directed at extending their child’s learning

Topics: In-kind, Family Services

Available Downloads: At-Home Family Volunteer Hours



Document: Attendance

Description: This Policy and Procedure covers Attendance, sign out, tardiness, monitoring attendance via daily sign in sheet, absences, absence is due to medical reasons a doctor’s note is required, and Chronic Absenteeism HEAD START PROGRAM PERFORMANCE STANDARDS: 1305.8(a)-(c)—Attendance

Topics: Policies and Procedures, Education, Attendance

Available Downloads: Attendance

Document: Attendance Letter

Description: This template will allow your Family Advocates to quickly and effectively communicate with families about their child’s attendance in the Head Start program. Customize the letter to meet your needs and reflect your agencies implementation of the Performance Standards. This letter is also available in Spanish.

Topics: Attendance, Education

Available Downloads: Attendance Letter, Attendance Letter (Spanish)

Document: Board Meeting Sample Agenda

Description: Board meeting sample agenda

Topics: Governance

Available Downloads: Board Meeting Sample Agenda

Document: Board of Directors Resource Guide

Description: This handbook is a resource guide for new or existing Board members and reviews their roles and responsibilities, as well as key information about Head Start and the program.

Topics: Governance

Available Downloads: Board of Directors Resource Guide



Document: Business Travel Expenses

Description: This policy sets forth the standards and procedures used to reimburse an employee for those necessary and reasonable expenses incurred in the performance of his/her job-related responsibilities. The guidelines and procedures outlined in this document will assist in fulfilling the requirements of both Head Start and Internal Revenue Service (IRS) code regarding legitimate and necessary business expenses.

Topics: Policies and procedures

Available Downloads: Business Travel Expenses

Document: CACFP Monitoring Form

Description: CACFP monitoring form (modeled off of Nevada forms -- each stae is different)

Topics: Operations

Available Downloads: CACFP Monitoring Form

Document: Case Conferencing Tool

Description: Tool for Family Advocates to collect information about the family current situation (marital status, health etc.) as well as begin the goal setting process.


Available Downloads: Case Conferencing Tool

Document: Center Options Page for Application

Description: If your program provides part/full day services or extend hours or has multiple locations, this form can help you identify which families are most in need of your services. Availabe in English and Spanish.



Topics: Operations

Available Downloads: Center Options Page for Application, Center Options Page for Application (Spanish)

Document: Challenging Behavior Incident Report

Description: Challenging Behavior Incident Report is filled out after each incident and covers issues such as: Was physical harm caused (or could it have been caused) by the child’s behavior in this incident?

Topics: Mental health

Available Downloads: Challenging Behavior Incident Report

Document: Challenging Behavior Tracking Tool

Description: This tool is used to track challenging and disruptive behavior including: Loud/disruptive environment, Sensory-related – touch, Physical/verbal aggression, Property destruction, Provoking/teasing others, Running away, Screaming/tantrum, Self-injurious behavior, Hit/kick peers, Hit/kick adults, Spitting, Sudden/extreme withdrawal, Interruption/blocking, Physical discomfort relieved, Physical redirection to activity, Removed from room/area, Hug hold, Called parent, Called parent/sent home

Topics: Mental health

Available Downloads: Challenging Behavior Tracking Tool

Document: Child Find Head Start Withdrawal/Drop Notification

Description: Used to notify Child Find that a child with disabilities has withdrawn from Head Start.

Topics: Enrollment

Available Downloads: Child Find Head Start Withdrawal/Drop Notification



Document: Child Release

Description: This policy covers policies on how and when to release a child. Topics include: Release of children to other than parent or legal guardian, Extended Day, and Child Release Contingency. The document refers to HEAD START PROGRAM PERFORMANCE STANDARDS: 1310.10(g)— Child Release

Topics: Policies and procedures, education

Available Downloads: Policies and Procedures: Child Release

Document: Child Source of Medical Care

Description: Child source of medical care forms

Topics: Health

Available Downloads: Child Source of Medical Care

Document: Child Transition Report EHS

Description: This tools is designed to plan and document a thorough process for transitioning children out of Early Head Start centers. Please check with your supervisor or education team to determine if/how these forms are used in your program.

Topics: Transition, EHS

Available Downloads: Child Transition Report EHS

Document: Child Transition Report HS

Description: This tools is designed to plan and document a thorough process for transitioning children out of your program's Head Start center. Please check with your supervisor or education team to determine if/how these forms are used in your program.

Topics: Transition

Available Downloads: Child Transition Report HS



Document: Child Transition-In Report (Disabilities)

Description: This report is to be used for children with disabilities transitioning into/from another program

Topics: Disabilities

Available Downloads: Child Transition-In Report (Disabilities)

Document: Classroom Animal Experience Form

Description: The Classroom Animal Experience Form should be signed by a parent before a child is exposed to an animal in the classroom. Ideally it is included in the enrollment package

Topics: Education

Available Downloads: Classroom Animal Experience Form

Document: Classroom Materials Bilingual Labels

Description: Create a print-rich environment in your classroom by labeling materials in each interest area. This document includes labels for dozens of common materials, with a. picture and word (in English and Spanish)each. Remember, the same label should go on the container and the location where it is stored. PDF version is recommended for printing, or use the Word version as a template to create additional ones of your own. *Formatted to print on 2-by-4-inch mailing labels (Avery 5163).

Topics: Education, Spanish

Available Downloads: Classroom Materials Bilingual Labels, Classroom Materials Bilingual Labels - PDF

Document: Classroom Sanitation Tracker

Description: Classroom sanitation tracker form



Topics: Operations

Available Downloads: Classroom Sanitation Tracker

Document: Classroom Visit Report

Description: This tool will allow your staff to document brief, informal or non-supervisory classroom visits. A great tool for Central Administration staff to use, when visiting the various classrooms or centers. The form identifies pluses (positive things) that were seen during the visit as well as deltas (constructive criticism)/Questions. There is even a section to communicate with the onsite Director to ensure that information is communicated appropriately. Topics such as Child Health and Safety, Child Behavior and Adult Behavior are identified within this tool.

Topics: Education

Available Downloads: Classroom Visit Report

Document: Coaching System & Tools

Description: These materials are best used by Center Directors, Education Coordinators and teachers to implement the coaching system. The Partnership Agreement is signed annually by coach and teachers; the Coaching Conference Form guides and documents the meeting after a classroom observation. The Success Criteria outlines expectations for coaching and other tools are used less frequently or as-needed.


Available Downloads: Coaching Conference report, Coaching Teacher Reflection, Coaching Success Criteria, Coaching of Coaches, Coaching Narrative Notes, Home-based Coaching Conference Report, PDP Coaching Agreemennt

Document: Community Assessing by Service Area

Description: Use this tool to help gather Community Assessment information from your management team members. Since these staff members have a unique perspective in determining the strengths and needs of the community and the program, their input is extremely valuable.




Available Downloads: Community Assessing by Service Area

Document: Community Partnership Development Planner

Description: Optional resource: provides framework for developing new community partnerships to meet program needs.


Available Downloads: Community Partnership Development Planner

Document: Community Partnership Index

Description: This cover sheet/index should be used with the Community Partnerships master binder to index the program's partnerships.


Available Downloads: Community Partnership Index

Document: Confidentiality

Description: This policy and procedures outline the various steps and information that must remain confidential at all times. Confidentiality information is also located in the Employee and Parent Handbooks.

Topics: Policies and Procedures

Available Downloads: Confidentiality

Document: Curriculum Collaboration Meetings



Description: The first form, Curriculum Collaboration Meeting, is used to guide and document the curriculum-focused meeting that should be held monthly at each center. The second form, Activity Analysis, is an exercise to help teachers better understand and implement behaviors related to the CLASS Instructional Support dimensions, while implementing upcoming curriculum activities with fidelity.

Topics: Education, Curriculum

Available Downloads: Curric Collab Meetings - Sample exercise, Curriculum Collaboration Meeting

Document: Curriculum Planning (Early Head Start)

Description: This policy and procedure highlights how our Early Head Start center-based programs plan for the infants and toddlers. This information incorporates specific observations of children; the developmental goals of the Creative Curriculum®; and knowledge of what activities and interactions are developmentally appropriate for infants and toddlers.

Topics: Policies and Procedures, Education, Curriculum

Available Downloads: Curriculum Planning (Early Head Start)

Document: Curriculum Plans - Theme 1: All About Us

Description: "All About Us" is a 4-week theme focused on helping children get to know their classroom, teacher and each other. The Activities packet includes guides to Planned Read-Alouds and Small-Group Time activities.


Available Downloads: All About Us, Activities, Week 1, All About Us, Activities, Week 2, All About Us, Activities, Week 3, All About Us, Activities, Week 4, All About Us, Curriculum Guide, Week 1, All About Us, Curriculum Guide, Week 2, All About Us, Curriculum Guide, Week 3,

Document: Curriculum Plans - Theme 10: Insects & Spiders



Description: "Insects & Spiders" is a 3-week course to round out a summer curriculum. A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Insects & Spiders, Activities, Week 1, Insects & Spiders, Activities, Week 2, Insects & Spiders, Activities, Week 3, Insects & Spiders, Curriculum Guide, Week 1, Insects & Spiders, Curriculum Guide, Week 2, Insects & Spiders, Curriculum Guide, Week 3, Ins

Document: Curriculum Plans - Theme 11: Roads, Rails & Rivers

Description: "Roads, Rails & Rivers" is a 4-week course to enhace a summer curriculum. A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Roads, Rivers & Rails, Activities, Week 1, Roads, Rivers & Rails, Activities, Week 2, Roads, Rivers & Rails, Activities, Week 3, Roads, Rivers & Rails, Activities, Week 4, Roads, Rivers & Rails, Curriculum Guide, Week 1, Roads, Rivers & Rails, Curriculum

Document: Curriculum Plans - Theme 2: Fairy Tales & Nursery Rhymes

Description: This is a 2-week unit that introduces children to classic fairy tales and nursery rhymes. A Curriculum Plan is provided for each week, as well as an Activities packet with guidance for read-alouds and small-group activities. The Unit Map gives an overview of the entire theme.


Available Downloads: Fairy Tales & Nursery Rhymes, Activities, Week 1, Fairy Tales & Nursery Rhymes, Activities, Week 2, Fairy Tales & Nursery Rhymes, Curriculum Guide, Week 1, Fairy Tales & Nursery Rhymes, Curriculum Guide, Week 2, Fairy Tales & Nursery Rhymes, Unit Map

Document: Curriculum Plans - Theme 3: Family and Friends



Description: This is a 3-week unit, focusing mostly on families but including some discussion about friends (which will be revisited in Theme 7, Mail & Friendship). A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Family & Friends, Activities, Week 1, Family & Friends, Activities, Week 2, Family & Friends, Activities, Week 3, Family & Friends, Curriculum Guide, Week 1, Family & Friends, Curriculum Guide, Week 2, Family & Friends, Curriculum Guide, Week 3, Family &

Document: Curriculum Plans - Theme 4: Farms, Markets & Food

Description: A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Farms, Markets & Food, Activities, Week 1, Farms, Markets & Food, Activities, Week 2, Farms, Markets & Food, Activities, Week 3, Farms, Markets & Food, Activities, Week 4, Farms, Markets & Food, Activities, Week 5, Farms, Markets & Food, Curriculum Guide,

Document: Curriculum Plans - Theme 4: Farms, Markets & Food

Description: A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Farms, Markets & Food, Activities, Week 5, Farms, Markets & Food, Curriculum Guide, Week 1

Document: Curriculum Plans - Theme 5: Neighborhood



Description: This is a 3-week theme that explores neighborhood places and community helpers, with additional focus on trash & recycling. A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. See "Unit Map" for an overview of the entire theme.


Available Downloads: Neighborhood, Activities, Week 1, Neighborhood, Activities, Week 2, Neighborhood, Activities, Week 3, Neighborhood, Curriculum Guide, Week 1, Neighborhood, Curriculum Guide, Week 2, Neighborhood, Curriculum Guide, Week 3, Neighborhood, Unit Map

Document: Curriculum Plans - Theme 6: Light & Shadow

Description: A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. The "Unit Map" gives an overview of the entire theme, and the "Family Letter" provides an introduction for families (in English and Spanish).


Available Downloads: Light & Shadow, Activities, Week 1, Light & Shadow, Activities, Week 2, Light & Shadow, Activities, Week 3, Light & Shadow, Curriculum, Week 1, Light & Shadow, Curriculum, Week 2, Light & Shadow, Curriculum, Week 3, Light & Shadow, Parent Letter, Light &

Document: Curriculum Plans - Theme 8: Water, Wind & Weather

Description: A Curriculum Plan is provided for each week, along with an Activities packet containing guidance for read-alouds and small-group activities. The "Unit Map" gives an overview of the entire theme, and the "Family Letter" provides an introduction for families (in English and Spanish).


Available Downloads: Water, Wind & Weather, Activities, Week 1, Water, Wind & Weather, Activities, Week 2, Water, Wind & Weather, Activities, Week 3, Water, Wind & Weather, Activities, Week 4, Water, Wind & Weather, Curriculum, Week 1, Water, Wind & Weather, Curriculum, Week

Document: Data-Driven Problem-Solving Tool



Description: This tool facilitates using data to solve problems. It provides a simple framework that identifies the issue, brainstorms solutions, creates an implementation plan, and creates a monitoring plan.

Topics: PDM

Available Downloads: Data-Driven Problem-Solving Tool

Document: Developmental and SE Screening Protocol

Description: Use this protocol as a guide to the "who", "what" and "when" of developmental and social-emotional screening requirements.

Topics: Education

Available Downloads: Developmental and SE Screening Protocol

Document: Direct Assessment Tasks

Description: These tasks are designed to be administered individually to each child, for the purpose of assessing specific literacy & math objectives.

Topics: Education, Assessment

Available Downloads: Direct Assessment: Letters, Direct Assessment: Retelling, Direct Assessment: Numbers

Document: Disabilites Process Checklist

Description: This document was developed to ensure a consistent set of steps is used for all children in the disabilities referral process.


Available Downloads: Disabilites Process Checklist



Document: Disabilities Checklist - EHS

Description: This checklist allows you to record all stages of the process from referral to diagnosis. Subtopics such as Referral for Internal Review, Internal Action Plan, IFSP/IEP Development, and Ongoing Monitoring all have indicators and a place to add dates and initials of staff members who are tracking this process. Especially helpful for Disabilities / Education Specialist.

Topics: Disabilities, EHS

Available Downloads: Disabilities Checklist - EHS

Document: Disabilities Coordinator-Consultant: Meeting Agenda

Description: Disabilities coordinator - consultant agenda form


Available Downloads: Disabilities Coordinator-Consultant: Meeting Agenda

Document: Dishwasher Temperature Log

Description: Dishwasher temperature log document

Topics: Operations

Available Downloads: Dishwasher Temperature Log

Document: Documentation of Dental Care

Description: This form, which is given to families to bring to the dentist, should be completed at the next visit. The form identifies what treatment was completed during the visit and if any additional services are required.

Topics: Health

Available Downloads: Documentation of Dental Care



Document: Documentation of Family Declining Health Services/Referral

Description: While Head Start programs must assist parents to obtain age-appropriate child health exams, screenings, and follow-up care, occasionally we run into families who refuse. Use this template to document a family’s refusal or declination of services.

Topics: Family Services, Health

Available Downloads: Documentation of Family Declining Health Services/Referral

Document: Documentation of Prenatal Education

Description: Use this form to record all educational material/information you provide to pregnant woman in your program. As required by Performance Standards, Pregnancy related topics: Health issues, Nutrition, Substance Abuse, and Fetal Development (including risks from smoking and alcohol) are included. Birth and Postpartum Related Topics: Labor and Delivery, Post-partum care, Post-partum recovery (including maternal depression), and the Benefits of breastfeeding can all be found in this easy to use form.

Topics: Family Services, Health, EHS

Available Downloads: Documentation of Prenatal Education

Document: Documentation of Prenatal Medical Care

Description: This form can be given to Expectant Mothers when they have a Doctor’s or Dentist’s appointment scheduled. This one tool captures both medical and dental information for Expectant Mothers and allows the program to document what services have been provided to date.

Topics: Family Services, Health, EHS

Available Downloads: Documentation of Prenatal Medical Care



Document: Early Head Start Policy Council By Laws

Description: Policy Council bylaws sample

Topics: Governance

Available Downloads: Early Head Start Policy Council By Laws

Document: EHS Integrated Service Plan for Disabilities (G)

Description: The disabilities Integrated Service Plan covers the following topics: G-1. Disabilities Services Plan G-2. Provision of Disabilities Services G-3. Interagency Collaboration with Part C Agencies G-4. Identifying Children with Disabilities: Screening, Referral & Evaluation G-5. Disabilities Budgeting G-6. Disabilities Recruitment, Enrollment, and Transition G-7. Disabilities Transition G-8. Developing and Implementing Individualized Family Service Plans G-9. Communication & Service Coordination to Serve Children with Disabilities G-10. Record-Keeping for Disabilities G-11. Disabilities Supervision & Monitoring G-12. Disabilities—Parent Involvement G-13. Disabilities—Transportation

Topics: EHS, PDM, ISP

Available Downloads: EHS Integrated Service Plan for Disabilities (G)

Document: EHS Integrated Service Plan for Health (J)

Description: The Early Head Start Health Integrated Service Plan covers the following topics: J-1. Health Services Advisory Committee J-2. Managing Health Screenings and Requirements J-3. Health Services Ongoing Monitoring and Management J-4. Health Services Follow-Up and Ongoing Care J-5. Record-Keeping for Health Services J-6. Health Services Communication and Service Coordination J-7. Health and Safety Policies and Procedures J-8. Reporting Suspected Child Abuse and Neglect J-9. Medical Exclusion and Accommodation J-10. Medication Administration J-11. Parent Communication and Involvement in Health Services J-12. Support for Pregnant Mothers and Newborns


Available Downloads: EHS Integrated Service Plan for Health (J)



Document: EHS Integrated Service Plan for Nutrition (K)

Description: The Nutrition Integrated Service Plan covers the following topics: K-1. Nutrition Consultant – Role, Management and Monitoring K-2. Nutrition Assessment K-3. Menu Planning K-4. Meals in Classrooms: Family-Style Dining and Infant Feeding K-5. Food Services Administration


Available Downloads: EHS Integrated Service Plan for Nutrition (K)

Document: EHS Child File cover page

Description: Early Head Start Child File cover sheet. This document calculates due dates for health events based on birth date and enrollment date as appropriate.

Topics: EHS, Family Services

Available Downloads: EHS Child File cover page

Document: EHS Daily Experience Sheet

Description: The Daily Experience Sheet is used to document, and share with parents’, important details of a child’s day in the EHS program – including feeding, napping and diaper-changing.

Topics: EHS, Education

Available Downloads: EHS Daily Experience Sheet, EHS Experience Utilization Guide, EHS Daily Info Sheet

Document: EHS Family Handbook

Description: The purpose of this handbook is to provide parents, guardians and families with information regarding the services, policies, procedures and regulations of our agency and the Early Head Start program .

Topics: EHS, Family Services



Available Downloads: EHS Family Handbook

Document: EHS Home-Based Child Files Cover Checklist

Description: This document is designed to facilitate the organization of the Early Head Start center based child's file. It breaks the file into the relevant sections such as the Application, Family Services, Health, Education, Disabilities, and Internal Audit. Each section has the required documentation as well as a place to mark their status. This document will provide an overview of all required documents as well as their current status and who received it. For example, has income verification been complete? Have height and weights been completed? Note, this is not the form for heights and weights, rather it provides a place to check that it has occured, the date, and who completed it. The file checklist will highlight services or required documents that have not yet been completed or received.

Topics: EHS, Home-based

Available Downloads: EHS Home-Based Child Files Cover Checklist

Document: EHS Home-Based Voluneer Log

Description: Early Head Start (EHS) home-based volunteer logs

Topics: EHS, Home-based

Available Downloads: EHS Home-Based Voluneer Log

Document: EHS Integrated Service Plan Education (F)

Description: The Education Integrated Service Plan covers the following topics: F-1 Classroom Curriculum and Approach F-2 Classroom Staffing and Supervision of Children F-3 Classroom Environment and Materials F-4 Teacher Supervision, Monitoring and Support F-5 Individualization F-6 Positive Discipline & Guidance Policy for Children F-7 Developmental Screening of Children F-8 Developmental Assessment of Children F-9 Record-Keeping for Education F-10 Using Child Outcomes Data F-11 Parent-Teacher Conferences F-12 Teacher Home Visits F-13 Home-School Connections F-14 Transitioning into Early Head Start F-15 Transitioning out of Early Head Start F-16 Home-Based Curriculum and Educational Approach F-17 Home-Based Group Socializations F-18



Home-Based Teacher Supervision, Monitoring and Support F-19 Record-Keeping for Home-Based Services

Topics: EHS, ISP, Education

Available Downloads: EHS Integrated Service Plan Education (F)

Document: EHS Integrated Service Plan for ERSEA (M)

Description: The Eligibility, Recruitment, Selection, Enrollment, and Attendance (ERSEA) Integrated Service Plan covers the following topics: M-1. Recruitment M-2. Eligibility and Selection M-3. Enrollment and Entry M-4. Child and Family Intake M-5. ERSEA Record-Keeping & Monitoring M-6. Maintaining Enrollment and Waiting List M-7. Monitoring Attendance and Absenteeism

Topics: EHS, ISP, ERSEA

Available Downloads: EHS Integrated Service Plan for ERSEA (M)

Document: EHS Integrated Service Plan for Facilities (L)

Description: The Early Head Start Integrated Service Plan for Facilities covers the following topics: L-1. Physical Facilities and Environment (general) L-2. Facilities Maintenance and Monitoring L-3. Licensing and Inspections L-4. Fire and Safety Drills L-5. Required Information to Post in Centers L-6. Record-keeping for Facilities L-7. Supporting Families with Transportation

Topics: EHS, ESP, Operations

Available Downloads: EHS Integrated Service Plan for Facilities (L)

Document: EHS Integrated Service Plan for Family and Community Partnerships (I)

Description: Early Head Start (EHS) Integrated service plan for family services

Topics: EHS, ISP, Family Services

Available Downloads: EHS Integrated Service Plan for Family and Community Partnerships (I)



Document: EHS Integrated Service Plan for Governance (D)

Description: The Early Head Start Integrated Service Plan for Governance covers the following topics: D-1-2. Board & Policy Council general responsibilities according to Head Start Performance Standards D-3. PC approvals, D-4.PC Composition and Formation, D-5. Board and PC Training and Support, D-6. Board and PC Communication, D-7. Shared Decision Making D-8. Parent Committees and D-9 Advisory committees.

Topics: EHS, ISP, Governance

Available Downloads: EHS Integrated Service Plan for Governance (D)

Document: EHS Integrated Service Plan for Mental Health (H)

Description: The Early Head Start Mental Health Integrated Service Plan covers the following topics: H-1. Mental Health Consultant — Role H-2. Mental Health Consultant – Management and Monitoring H-3. Mental Health Education for Staff and Families H-4. Identifying Children with Mental Health Concerns: Screening, Referral & Evaluation H-5. Record-Keeping for Mental Health Services

Topics: EHS, ISP, Mental Health

Available Downloads: EHS Integrated Service Plan for Mental Health (H)

Document: EHS Integrated Service Plan for Monitoring (B)

Description: The Integrated Service Plan for Monitoring provides an overview of the types of data that should be monitored as well as the frequency. The document introduces the MBI (Manage by Information), MBO (Manage by Outcomes), and Master Binders. It also covers the types of data that should be collected and the frequency.

Topics: EHS, ISP, Monitoring

Available Downloads: EHS Integrated Service Plan for Monitoring (B)

Document: EHS Integrated Service Plan for Planning (A)



Description: Early Head Start Integrated Service Plan for Planning and Assessment. Areas covered include the Community Assessment, Strategic Planning, Self Assessment, and Budgeting. The document includes time lines and general guidance.

Topics: EHS, ISP, Planning

Available Downloads: EHS Integrated Service Plan for Planning (A)

Document: EHS Integrated Service Plan Record Keeping (C)

Description: This document provides an overview of what record are kept and how they are kept. Topics include: 1) Student Information System (Child Plus) 2) Master Binders 3) Child and Family Files 4) Tracking Non-Federal Share 5) Completing the Program Information Report (PIR) 6) Fiscal Record-keeping and Reporting 7) Purchasing, Reimbursements, and Supply Ordering

Topics: EHS, ISP, Recordkeeping

Available Downloads: EHS Integrated Service Plan Record Keeping (C)

Document: EHS Integrated Service Plans Human Resources (E)

Description: This service area plan is focused on Human Resource issues and focuses on the following areas: 1) Human Resources Policies and Procedures 2) Staff Qualifications and Competencies 3) Leadership Staff Roles and Qualifications 4) Staff Hiring 5) Staff Orientation 6) Staff Training and Development 7) Staff Communication 8) Performance Reviews 9) Record-keeping for Human Resources 10)Record-keeping for Human Resources

Topics: EHS, ISP, Human Resources

Available Downloads: EHS Integrated Service Plans Human Resources (E)

Document: EHS Teacher Success Rubric

Description: The Early Head Start Teacher Success Rubric (EHS-TSR) was developed to (1) clearly articulate the expectations for being a successful EHS teacher and (2) provide all teachers with a developmental path to achieve mastery in specific components of their work.



Topics: Education, Human Resources, EHS

Available Downloads: EHS Teacher Success Rubric

Document: Eligibility Verification

Description: This policy and procedure highlights our process to identify if a family is eligible for Head Start services. Since we are providing Head Start services to children and families most in need of services, all staff members need to be made aware of our guideline and regulations. This procedure outlines the steps necessary to verify family’s income, calculate yearly income and verify eligibility for services. Additional tools are available within the SARGE library to help maintain documentation in this area.

Topics: Policies and Procedures, ERSEA

Available Downloads: Eligibility Verification

Document: Eligibility Verification Form

Description: Staff should use this form during the application and selection process to determine if participants are eligible for (E)HS services based on age, living address, categorical eligibility and/or income. Updated and improved Jan 2011 with new Federal Poverty Guidelines.

Topics: ERSEA

Available Downloads: Eligibility Verification Form

Document: Embedded Assessment Activities

Description: These activities are designed to be used with a small group of children, to enable teachers to observe specific skills.


Available Downloads: Embedded Assessment: Writing, Embedded Assessment: Rhyming, Embedded Assessment: Alliteration and Syllables, Embedded Assessment: Classification, Embedded Assessment: Patterns, Embedded Assessment: Gross Motor



Document: Emergency Consent: Authorization for Medical Care for Minor Child

Description: Gather parental permission for various emergency situations in this one form.

Topics: Family Services, Health

Available Downloads: Emergency Consent: Authorization for Medical Care for Minor Child

Document: Emergency Contact Sheet

Description: Also part of the application and intake packet


Available Downloads: Emergency Contact Sheet, Emergency Contact Sheet (Spanish)

Document: Emergency Food Requisition Sheet

Description: Emergency Food requisition form sample

Topics: Operations, Fiscal

Available Downloads: Emergency Food Requisition Sheet

Document: Emergency Information & Consent -Pregnant Women

Description: Contact sheet and agreement to notify the program of changes in any contact information for pregnant women and teens. Provided in English and Spanish.


Available Downloads: Emergency Information & Consent -Pregnant Women, Emergency Information & Consent -Pregnant Women (Spanish)



Document: Emergency Notification & Response

Description: This policy identifies the response our agency would take in case of an emergency. Emergency response postings, contact information, emergency evacuation routes, and safety procedures for emergencies are included in this document.

Topics: Operations

Available Downloads: Emergency Notification & Response

Document: Employee Accident/Injury Report

Description: To be completed in the event of staff injury or accident.

Topics: Human Resources

Available Downloads: Employee Accident/Injury Report

Document: Employee Disciplinary Notice

Description: Employee disciplinary notice sample


Available Downloads: Employee Disciplinary Notice

Document: Employee Handbook

Description: Updated for 2011: Expanded Conflict of Interest policy, Updated Dress Code policy, New Paid Time Off payout policy, New No Smoking policy, Military Spouse Leave of Absence/Blood


Available Downloads: Employee Handbook



Document: Employee Reference Check Form

Description: The Reference Check form is used to document that a new employee's references have been checked.


Available Downloads: Employee Reference Check Form

Document: Employee Refernce Check Form

Description: Use this form when calling and verifying an new/potential employee's references.


Available Downloads: Employee Refernce Check Form

Document: Employee Reimbursement

Description: This policy identifies the steps necessary for an employee to create and submit an expense report as well as highlight the expense that are allowable for reimbursement. The employee reimbursement procedure is designed to ensure effective internal controls that are compliant with all federal regulations and safeguard federal funds.

Topics: Policies and Procedures, Human Resources

Available Downloads: Employee Reimbursement

Document: Employee Termination Notice

Description: Employee termination notice sample


Available Downloads: Employee Termination Notice



Document: Employee Timesheets

Description: This policy and procedure highlights the process that an Acelero Employee follows for keeping track of their time. We use ADP’s ezLaborManager system to make the timekeeping and labor management process. This procedure is designed to ensure effective internal controls that are compliant with all federal regulations and safeguard federal funds.


Available Downloads: Employee Timesheets

Document: Employment Verification

Description: The Employment Verification form can be used to request documentation from an employee's former employer.


Available Downloads: Employment Verification

Document: Enrollment Verification

Description: This letter available in English and Spanish, serves as verification that a child was/is enrolled in the Head Start/Early Head Start program. There is a place provided for the parents as well as staff members to authorize the release of this information.

Topics: ERSEA

Available Downloads: Enrollment Verification, Enrollment Verification (Spanish)

Document: Extended Day Billing

Description: This policy and procedure highlights the steps necessary for setting up and maintaining extended care services in your Head Start program. System Set-Up, Setting up New Families and Ongoing Billing & Payments are just a few of the topics you will see outlined in this document.

Topics: Policies and Procedures, Fiscal



Available Downloads: Extended Day Billing

Document: External Site Visit Tool

Description: This tool is designed to guide the site visit and document key information, which will be used for feedback and follow-up on site; to determine any training needed for visitors; and to monitor effectiveness of site visit program. The form provides specific guidance on ratios, health and safety, classroom setup, child teacher interactions, and file audits

Topics: Operations

Available Downloads: External Site Visit Tool

Document: Family Advocate Success Rubric

Description: Family Advocate Success Rubric table of contents and baseline

Topics: Family Services, Human Resources

Available Downloads: FASR TOC and Baseline, FASR Tool

Document: Family Feedback Form/Parent Survey

Description: Use this survey to elicit family feedback. It is specifically designed for use in the spring, but could be edited for implementation in any season.


Available Downloads: Family Survey Spring / Center-based, Family Survey Spring (Spanish), Family Survey Spring / Home-Based, Family Survey Spring (home-based, spanish)

Document: Family Goal Setting Resource

Description: This resource provides a list of over 60 family goals which cover the vast majority of all areas where Head Start programs sets goals with families on family partnership agreements. Each



goal has established benchmarks for attainment – indicating what precisely constitutes major, moderate, some or none. By providing a common framework for goal attainment, we have been able to clear measure family progress toward accomplishing their goals.

Topics: Family Services, Goals

Available Downloads: FGS: Family Life Practices, FGS: Family Life Practices 2, FGS: SFC, FGS: SC, FGS: Family Self Sufficiency, FGS: Family Self Sufficiency, FGS: SFF, FGS: SF, FGS: Home-Based, Goal-Setting Resource: Balnk, Family Goal Setting Resource (home-based, Spanish),

Document: Family Involvement Agreement

Description: Shortly after families enroll or at the beginning of the year, use this form to communicate expectations for their involvement. O


Available Downloads: Family Involvement Agreement, Family Involvement Agreement (Spanish)

Document: Family Involvement Contract

Description: As a commitment to engage parents as full partners to achieve their child’s school readiness goals is initiated during intake by signing a Parent Involvement Contract. This contract secures parent’s commitment to: • Bring their children to school on time, every day • Attend Parent Committee meetings, and other program based workshops/activities • Volunteer at least 24 hours/year in our program • Read to their children every night.


Available Downloads: Family Involvement Contract, Family Involvement Contract (Spanish)

Document: Family Partnership Agreement Refusal Form

Description: Family Partnership Agreement refusal sample form




Available Downloads: Family Partnership Agreement Refusal Form

Document: Family Partnerships Supervision & Monitoring Tool

Description: This form should be completed by Family Services Coordinator monthly, in advance of supervision meetings with individual Family Advocate or the Social Service team. The form allows you to document quantitative data as well as qualitative information. There is even a section for Summary & Analysis.


Available Downloads: Family Partnerships Supervision & Monitoring Tool

Document: Family Services Supervision Agenda

Description: This agenda template can be used for individual supervision or group meetings with Family Advocates or Home-Based Teachers. This one form allows you to track information and document it all on this one simple to use form.


Available Downloads: Family Services Supervision Agenda

Document: Family Strengths Assessment: Simplified Scoring

Description: Complete this assessment using information obtained from the family; staff observation and knowledge; other information collected during the application and intake process; and any existing family plans from community providers. Strengths and needs identified should form the basis for determining the kind of support provided to family.


Available Downloads: Family Strengths Assessment: Simplified Scoring, Family Strengths Assessment (Spanish)



Document: Family Volunteering Contract

Description: As a commitment to engage parents as full partners to achieve their child’s school readiness goals is initiated during intake by signing a Parent Involvement Contract. This contract secures parent’s commitment to: • Bring their children to school on time, every day • Attend Parent Committee meetings, and other program based workshops/activities • Volunteer at least 24 hours/year in our program • Read to their children every night.


Available Downloads: Family Volunteering Contract, Family Volunteering Contract (Spanish)

Document: FCP Training Workshop #1: Introduction to Acelero Learning Family Services Approach

Description: FCP Training Workshop #1: Introduction to Acelero Learning Family Services Approach


Available Downloads: FCP Training Workshop #1: Introduction to Acelero Learning Family Services Approach

Document: FCP Training Workshop #2: Contracting with Parents to Close the Achievement Gap

Description: FCP Training Workshop #2: Contracting with Parents to Close the Achievement Gap


Available Downloads: FCP Training Workshop #2: Contracting with Parents to Close the Achievement Gap

Document: FCP Training Workshop #3: Family Life Practices and Goal Setting



Description: FCP Training Workshop #3: Family Life Practices and Goal Setting


Available Downloads: FCP Training Workshop #3: Family Life Practices and Goal Setting

Document: FCP Training Workshop #4: Enhancing Family Life Practices to Achieve School Readiness Goals

Description: FCP Training Workshop #4: Enhancing Family Life Practices to Achieve School Readiness Goals


Available Downloads: FCP Training Workshop #4: Enhancing Family Life Practices to Achieve School Readiness Goals

Document: FCP Training Workshop #5: Promoting Family Self Sufficiency Through Targeted Assessment, Goal-Setting and Community Partnerships

Description: FCP Training Workshop #5: Promoting Family Self Sufficiency Through Targeted Assessment, Goal-Setting and Community Partnerships


Available Downloads: FCP Training Workshop #5: Promoting Family Self Sufficiency Through Targeted Assessment, Goal-Setting and Community Partnerships

Document: Fire/Safety Drill Report

Description: Fire / safety drill report

Topics: Operations

Available Downloads: Fire/Safety Drill Report



Document: First Aid Kit Checklist

Description: This form can be kept inside each first aid kit. At least monthly, a staff member will use this form to audit the first-aid kit and verify that all items listed are present.

Topics: Operations

Available Downloads: First Aid Kit Checklist

Document: First Aid Kits

Description: We ensure that all staff members have access to well-supplied, age-appropriate, and portable first-aid kits. This policy clearly defines our procedures for stocking and checking our first aid kits to ensure they are always well stocked and ready for use.

Topics: Policies and Procedures, Operations

Available Downloads: First Aid Kits

Document: Food Service & Safety

Description: Our programs are committed to delivering high quality nutritional services. Our policy and procedures reflects the need for safety in food service and ensures that through Posted Evidence of Compliance, Nutrition Staff Training and On-going Monitoring, this is completed consistently in all centers. Various tools are available to support the implementation of the policy.


Available Downloads: Food Service & Safety

Document: Food Temperature Logs

Description: Food temperature log

Topics: Operations



Available Downloads: Food Temperature Logs, Food Temperature Logs for Site

Document: Freezer Temperature Log

Description: Freezer temperature log

Topics: Operations

Available Downloads: Freezer Temperature Log

Document: Governance Tool Grievance Form

Description: This form as part of a consistent process to ensure that any grievance with the Head Start program is heard and adequately addressed. This is to be filled out by parents or other community members with a grievance.

Topics: Governance

Available Downloads: Governance Tool Grievance Form

Document: Governance Tool Required Approval Checklists

Description: This checklist specifies the items requiring Policy Council-approvals as well as the approval date.

Topics: Governance

Available Downloads: Governance Tool Required Approval Checklists

Document: Hand-washing & Universal Precautions

Description: This policy defines our procedures for hand-washing disinfecting and other sanitation processes which can stop the spread of many germs and significantly reduce health risk to children and adults.



Topics: Policies and Procedures, Health

Available Downloads: Hand-washing & Universal Precautions

Document: Head Start Home Based ChildFiles Cover Checklist

Description: This document is designed to facilitate the organization of the home based child's file. It breaks the file into the relevant sections such as the Application, Family Services, Health, Education, Disabilities, and Internal Audit. Each section has the required documentation as well as a place to mark their status.

Topics: HBV

Available Downloads: Head Start Home Based ChildFiles Cover Checklist

Document: Health and Safety Monitoring Checklist

Description: The health and safety monitoring checklists has the following sections: 1) INDOOR MAINTENANCE &SANITATION 2) KITCHEN & FOOD STORAGE PROVISIONS FOR EMERGENCIES & MEDICATION 3) HEALTH, SAFETY & NUTRITION PRACTICES 4) OUTDOOR MAINTENANCE, SANITATION & PLAYGROUND FACILITIES 5) INFANTS & TODDLERS 6) ITEMS TO BE REVIEWED ANNUALLY

Topics: Health and Safety

Available Downloads: Health and Safety Monitoring Checklist

Document: Health Requirements Update Letter

Description: This letter (available in English and Spanish) should be used to inform parents of outstanding health requirements in a child's file.

Topics: Health

Available Downloads: Health Requirements Update Letter, Health Requirements Letter (spanish)



Document: Health Screening Results Tracker

Description: Used to document the results of children’s health screenings.

Topics: Health

Available Downloads: Health Screening Results Tracker

Document: Health Services Monitoring Tool

Description: This resource can be used by Health Coordinator to guide and document monitoring of health services with family advocate(s).

Topics: Health

Available Downloads: Health Services Monitoring Tool

Document: Health/Nutrition Follow-up Form

Description: Used track ongoing follow up and communication with family advocates related to children's health/nutrition concerns.

Topics: Health, Nutrition

Available Downloads: Health/Nutrition Follow-up Form

Document: Hiring and Exiting an Employee

Description: This personnel policy details the steps taken to bring new staff members onboard consistently. It also addresses steps to take when an employee decides to leave the agency either voluntary or involuntary.


Available Downloads: Hiring and Exiting an Employee



Document: Home Visit Plan & Record

Description: This form is intended to plan, guide and document weekly visits in the Home-Based program.

Topics: HBV, EHS

Available Downloads: Home Visit Plan & Record

Document: Home Visit Tool (1st Visit)- EHS

Description: For a newly enrolled child, should be completed before entry if possible, or within 30 days

Topics: HBV, EHS

Available Downloads: Home Visit Tool (1st Visit)- EHS

Document: Home Visit Tool (1st Visit)- HS

Description: This form should be used by teachers to guide and document the first home visit of the year (or with a new child). Completed form should be filed in child's file.

Topics: HBV

Available Downloads: Home Visit Tool (1st Visit)- HS

Document: Home Visit Tool (2nd Visit)

Description: This form should be used by teachers to guide and document the 2nd home visit of the year (or subsequent visits with returning children). Completed forms should be filed in child's file.

Topics: HBV

Available Downloads: Home Visit Tool (2nd Visit)



Document: Home-Based Family Involvement Contract

Description: Home-based family involvement contract

Topics: HBV

Available Downloads: Home-Based Family Involvement Contract

Document: Home-Based Home Safety Checklist

Description: This checklist, used by Home Visitors during Home Based Visits, clearly identifies 12 areas of safety in the home environment.

Topics: HBV

Available Downloads: Home-Based Home Safety Checklist

Document: Home-Based Parent Check-In

Description: This document is designed to assist Home Visitors/ Home Based Teachers with their mid year visit with families. Staff members should note any important information in the space provided. Questions are provided to assist staff members in identifying the families need and participation in the program.

Topics: HBV

Available Downloads: Home-Based Parent Check-In

Document: Home-Based Program Agreement

Description: This letter details the purpose of the Home-Based Program and outlines the requirements and expectations of both the agency and the families.

Topics: HBV

Available Downloads: Home-Based Program Agreement



Document: Home-Based Visit Plan & Record

Description: Use this form to plan and guide home-based visits.

Topics: HBV

Available Downloads: Home-Based Visit Plan & Record

Document: Home-Based Visit Planning Chart

Description: Home-based visit initial visit start-up

Topics: HBV

Available Downloads: Home-Based Visit Planning Chart

Document: HS Family Handbook

Description: The purpose of this handbook is to provide parents, guardians and families with information regarding the services, policies, procedures and regulations of our agency and the Head Start program .

Topics: Family Services, Spanish

Available Downloads: Family Handbook (HS, Spanish), HS Family Handbook

Document: HS Integrated Service Plan for Disabilities (G)

Description: The Head Start Integrated Service Plan for Disabilities covers the following topics: G-1. Disabilities Services Plan G-2. Provision of Disabilities Services G-3. Interagency Collaboration with LEAs G-4. Identifying Children with Disabilities: Screening, Referral and Evaluation G-5. Disabilities Budgeting G-6. Disabilities Recruitment and Enrollment G-7. Disabilities Transition G-8. Developing and Implementing Individualized Education Plans G-9. Communication and Service Coordination to Serve Children with Disabilities G-10. Record-Keeping for Disabilities G-11. Disabilities Supervision and Monitoring G-12. Disabilities—Parent Involvement G-13. Disabilities—Transportation



Topics: ISP, Disabilities

Available Downloads: HS Integrated Service Plan for Disabilities (G)

Document: HS Integrated Service Plan for Education (F)

Description: The Head Start Integrated Service Plan for Education covers the following topics: F-1. Classroom Curriculum and Approach F-2. Classroom Staffing and Supervision of Children F-3. Classroom Environment and Materials F-4 Teacher Supervision, Monitoring and Support F-5. Individualization F-6. Positive Discipline and Guidance for Children F-7. Developmental Screening of Children F-8. Developmental Assessment of Children F-9. Record-Keeping for Education F-10. Using Child Outcomes Data F-11. Parent-Teacher Conferences F-12. Teacher Home Visits F-13. Home-School Connections F-14. Transitioning into Head Start F-15. Transitioning out of Head Start F-16. Home-Based Curriculum and Educational Approach F-17. Home-Based Group Socializations F-18. Home-Based Teacher Supervision, Monitoring and Support F-19. Record-Keeping for Home-Based Services

Topics: ISP, Education

Available Downloads: HS Integrated Service Plan for Education (F)

Document: HS Integrated Service Plan for ERSEA (M)

Description: The Head Start Integrated Service Plan for ERSEA (Eligibility, Recruitment, Selection, Enrollment and Attendance) covers the following topics: M-1. Recruitment M-2. Eligibility and Selection M-3. Enrollment and Entry M-4. Child and Family Intake M-5. ERSEA Record-Keeping and Monitoring M-6. Maintaining Enrollment and Waiting List M-7. Monitoring Attendance and Absenteeism

Topics: ISP, ERSEA

Available Downloads: HS Integrated Service Plan for ERSEA (M)

Document: HS Integrated Service Plan for Facilities (L)



Description: The Head Start Integrated Service Plan for Facilities covers the following topics: L-1. Physical Facilities and Environment – General L-2. Facilities Maintenance and Monitoring L-3. Licensing and Inspections L-4. Fire and Safety Drills L-5. Required Information to Post in Centers L-6. Record-Keeping for Facilities L-7. Supporting Families with Transportation

Topics: ISP, Operations

Available Downloads: HS Integrated Service Plan for Facilities (L)

Document: HS Integrated Service Plan for Family and Community Partnerships (I)

Description: The Head Start Integrated Service Plan for Family and Community Partnerships covers the following topics: I-1. Family Services—General I-2. Family Partnership Agreements: Assessing Needs, Setting Goals, and Following Up I-3. Referrals to Community Resources I-4. Communication and Service Coordination for Family Services I-5. Record-Keeping for Family Services I-6. Family Services Supervision, Monitoring and Support I-7. Parent Involvement – General I-8. Parent Involvement – Events and Funding I-9. Parent Education I-10. Family Communication I-11. Community Partnerships I-12. Parent and Community Volunteers

Topics: ISP, Family Services

Available Downloads: HS Integrated Service Plan for Family and Community Partnerships (I)

Document: HS Integrated Service Plan for Governance (D)

Description: The Head Start Integrated Service Plan for Governance covers the following topics: D-1-2. Board & Policy Council general responsibilities according to Head Start Performance Standards D-3. PC approvals, D-4.PC Composition and Formation, D-5. Board and PC Training and Support, D-6. Board and PC Communication, D-7. Shared Decision Making D-8. Parent Committees and D-9 Advisory committees.

Topics: ISP, Governance

Available Downloads: HS Integrated Service Plan for Governance (D)



Document: HS Integrated Service Plan for Health (J)

Description: The Head Start Integrated Service Plan for Health covers the following topics: J-1. Health Services Advisory Committee J-2. Managing Health Screenings and Requirements J-3. Health Services Ongoing Monitoring and Management J-4. Health Services Follow-Up and Ongoing Care J-5. Record-Keeping for Health Services J-6. Health Services Communication and Service Coordination J-7. Health and Safety Policies and Procedures J-8. Reporting Suspected Child Abuse and Neglect J-9. Medical Exclusion and Accommodation J-10. Medication Administration J-11. Parent Communication and Involvement in Health Services

Topics: ISP, Health

Available Downloads: HS Integrated Service Plan for Health (J)

Document: HS Integrated Service Plan for Human Resources (E)

Description: The Head Start Integrated Service Plan for Human Resources covers the following topics: E-1. Human Resources Policies and Procedures E-2. Staff Qualifications E-3. Leadership Staff Roles and Qualifications E-4. Staff Hiring E-5. Staff Orientation E-6. Staff Training and Development E-7. Staff Communication E-8. Performance Reviews and Feedback E-9. Record-Keeping for Human Resources E-10. Staff Grievance Procedure

Topics: ISP, Human Resources

Available Downloads: HS Integrated Service Plan for Human Resources (E)

Document: HS Integrated Service Plan for Mental Health (H)

Description: The Head Start Integrated Service Plan for Mental Health covers the following topics: H-1. Provision of Mental Health Services H-2. Mental Health Management and Monitoring H-3. Mental Health Education for Staff and Families H-4. Identifying Children with Mental Health Concerns: Screening, Referral & Evaluation H-5. Record-Keeping for Mental Health Services

Topics: ISP, Mental Health

Available Downloads: HS Integrated Service Plan for Mental Health (H)



Document: HS Integrated Service Plan for Monitoring (B)

Description: The Head Start Integrated Service Plan for Monitoring covers the following topics: B-1. Monitoring – General B-2. Manage By Information Report (MBI) B-3. Supervision of Staff B-4. Staff Input and Feedback

Topics: ISP, Monitoring, PDM

Available Downloads: HS Integrated Service Plan for Monitoring (B)

Document: HS Integrated Service Plan for Nutrition (K)

Description: The Integrated Service Plan for Nutrition covers the following topics: K-1. Nutritionist – Role, Management and Monitoring K-2. Nutrition Assessment K-3. Menu Planning K-4. Meals in Classrooms: Family-Style Dining K-5. Food Services Administration

Topics: ISP, Nutrition

Available Downloads: HS Integrated Service Plan for Nutrition (K)

Document: HS Integrated Service Plan for Planning (A)

Description: The Integrated Service Plan for Planning covers the following topics: A-1. Head Start Grant Application and Management A-2. Integrated Service Planning A-3. Community Assessment A-4. Strategic Planning A-5. Self-Assessment A-6. Budgeting

Topics: ISP, PDM

Available Downloads: HS Integrated Service Plan for Planning (A)

Document: HS Intregated Service Plan for Record Keeping (C)

Description: The Head Start Integrated Service Plan for Record Keeping covers the following topics: C-1. Record-Keeping and Reporting – General C-2. ChildPlus C-3. Master Binders C-4. Child and Family Files C-5. Tracking Non-Federal Share C-6. Completing the Program Information Report (PIR) C-7. Fiscal Record-Keeping and Reporting C-8. Purchasing, Reimbursements, and Supply Ordering



Topics: ISP, PDM

Available Downloads: HS Intregated Service Plan for Record Keeping (C)

Document: Human Resources Resource Guide

Description: This is a guide for internal Human Resources staff members which outlines all related roles and HS compliance responsibilities (including helpful reference tools). *Please note that the HR processes mentioned are specific to the programs/states that we serve and are meant to give a general sense/overview of our Human Resources operating procedures.*


Available Downloads: Human Resources Resource Guide

Document: IEP Review: Action Plan

Description: This one page tool will allow you to follow up on IEP objectives, goals and center modifications made for children with an IEP. With this form the Disabilities Coordinator can track IEP meetings, what actions steps were identified in the meeting and what follow up is required. Use this one form to help track all that information.

Topics: Education

Available Downloads: IEP Review: Action Plan

Document: IEP/IFSP Action Plan

Description: To follow up on IEP objectives, goals and center modifications

Topics: Education

Available Downloads: IEP/IFSP Action Plan

Document: Illness



Description: We are committed to accommodating children’s health care needs as fully as possible. This policy clearly defines our procedures for short-term exclusion. Elements of this policy/procedure are also included in the Parent Handbook.


Available Downloads: Illness

Document: Individual Health/Nutrition Care Plans

Description: These forms are intended to be used by Health Coordinator or Nutritionist, in collaboration with parent(s), to identify follow-up/support needed for an individual child’s health issue


Available Downloads: ICP Allergies, ICP Anemia, ICP Asthma, ICP Obesity, ICP Seizure, ICP Sickle Cell, ICP Underweight, ICP ead

Document: Individual Health/Nutrition Plan

Description: This form is used by the Health Coordinator or Nutritionist, in collaboration with parents, to identify follow-up/support needed for an individual child’s health issue.


Available Downloads: Individual Health/Nutrition Plan

Document: Infant Feeding & Bottle Feeding

Description: We recognize that mealtimes and feeding routines are essential to children’s healthy development and socialization. This policy defines our procedures to ensure safe and effective bottle feeding for the infants we serve.

Topics: Policies and Procedures, EHS, Nutrition

Available Downloads: Infant Feeding & Bottle Feeding



Document: Infant Feeding Plan

Description: This one page form allows EHS staff members to record the time, foods to be given and amount of food provided to the infants in their program.

Topics: Policies and Procedures, EHS, Nutrition

Available Downloads: Infant Feeding Plan

Document: In-Kind (Non-Federal Share) Documentation and Valuation

Description: Non-federal share is defined as any contribution to the program from a non-federal third party, whether in the form of real property, equipment, supplies and other expendable property, or the value of goods and services directly benefiting and specifically identifiable to the project or program. This policy and procedure will help you identify which types of documentation can be gathered in the following categories: professional services, Board & Policy Member services, donated goods and weekly volunteer logs.

Topics: Policies and Procedures, In-Kind, PDM, Fiscal

Available Downloads: In-Kind (Non-Federal Share) Documentation and Valuation

Document: In-Kind Documentation Form: Goods

Description: Use this form to record donated or discounted goods for non-federal share.


Available Downloads: In-Kind Documentation Form: Goods

Document: In-Kind Documentation Form: At Home Parent Time

Description: Use this form to record parent time spent at home on activities specifically directed at extending the learning experiences that his/her child has had in the classroom. NOTE - there should be a specific link to parent activities and the curriculum or this is likely not an allowable contribution




Available Downloads: In-Kind Documentation Form: At Home Parent Time

Document: In-Kind Documentation Form: Meeting Agenda & Sign In Sheet

Description: This form serves as a sign in sheet and allows you to document various meetings (Board, Policy Council, HSAC, Parent Meeting and Family Night) in order to identify in-kind resources. The form also contains a section where you can add the agenda or topics for the meeting. Easy to maintain and complete.


Available Downloads: In-Kind Documentation Form: Meeting Agenda & Sign In Sheet

Document: In-Kind Documentation Form: Services

Description: Use this form to record donated or discounted services for non-federal share.


Available Downloads: In-Kind Documentation Form: Services

Document: In-Kind Valuation and Monthly Report

Description: This form facilitates the collection and calculation of the value of in-kind contributions. Specific sections include 1) Classroom Volunteer Hours and Home-Based Visits 2) Parent Committee Meetings/Parent Education Events/Group Socializations/Family Nights 3) Policy Council/Board/HSAC Meetings 4) Donated or Discounted Goods 5) Donated or Discounted Professional Services (Time only) 6) Donated Mileage


Available Downloads: In-Kind Valuation and Monthly Report



Document: Intake Process & Paperwork: Center-Based

Description: This tool, used for center based care, highlights the intake process and what information should be completed at various stages. From Application to Selection to Orientation, all necessary documentation is listed on this form and will assist your staff in ensuring that all files are complete and up to date. There is even a section for Home Visits which can be used for returning children.


Available Downloads: Intake Process & Paperwork: Center-Based

Document: Intake Process & Paperwork: Home-Based

Description: This tool, used for home -based care, highlights the intake process and what information should be completed at various stages. From Application to Selection to Orientation, all necessary documentation is listed on this form and will assist your staff in ensuring that all files are complete and up to date.


Available Downloads: Intake Process & Paperwork: Home-Based

Document: Interagency Agreement to Serve Children with Special Needs

Description: A sample Local Education Agency Agreement is provided for you. This sample is specific to Head Start programs working with the LEA to service children with special needs.


Available Downloads: Interagency Agreement to Serve Children with Special Needs

Document: Interview Guides

Description: Determine if your potential employee possesses skills in these areas: Position & Company Fit, Operating & Managing Skills, and Relationship Skills which are all addressed in this tool.




Available Downloads: IG: AR/AP, IG: Admin Assistant, IG: Bookkeeper, IG: Center Director, IG: Cook, IG: Director of Health & Nutrition, IG: Director of Operations, IG: Education coordinator, IG: Facilities Assistant, IG: Family Advocate, IG: Family Services Coordinator / Assi

Document: ISP & PP: (A) Planning & Self-Assessment

Description: ISP: Planning (General)

Topics: ISP, PDM

Available Downloads: ISP A - Planning (General), PP A-01 - Program Planning, PP A-02 - Budgeting Process

Document: ISP & PP: (B) Ongoing Monitoring

Description: ISP: Monitoring (General)

Topics: ISP, PDM

Available Downloads: ISP B - Monitoring (General), PP B-01 - Monitoring

Document: ISP & PP: (C) Record-Keeping & Reporting

Description: ISP: Recordkeeping

Topics: ISP, PDM

Available Downloads: ISP C - Recordkeeping, PP C-01 - Maintaining Emergency Contacts, PP C-02 - In-Kind

Document: ISP & PP: (D) Governance

Description: ISP: Governance (General)



Topics: ISP, PDM

Available Downloads: ISP D - Governance (General), PP D-01 - Shared Governance Impasse, PP D-02 - Parent Community, PP D-03 - PC Travel reimbursement

Document: ISP & PP: (E) Human Resources

Description: ISP: Human Resources (General)

Topics: ISP, Governance

Available Downloads: ISP E - Human Resources (General), PP E-01 - Confidentiality, PP E-02 - Hiring and Exiting, PP E-03 - Teacher Qualifications, PP E-04 - Volunteering, PP E-05 - Staff Grievance

Document: ISP & PP: (F) Education

Description: ISP: Education (General)

Topics: ISP, Education

Available Downloads: ISP F - Education (General), PP F-01 - Positive Guidance, PP F-02 - Transitions, PP F-03 - Pedestrian Safety, PP F-04 - Administering the Teacher Success Rubric (TSR), PP F-05 - Center Directors as Educational Leaders, PP F-06 - Developmental Screenings (

Document: ISP & PP: (G) Disabilities

Description: Policies and Procedures: Disabilities (general)

Topics: Policies and Procedures, Disabilities

Available Downloads: ISP G - Disabilities (Genearl), PP G-01 - Transitionsing in (Disabilities), PP G-02 - Disabilities and Mental Health Service Coordination, PP G-03 - Referral Action Plan, PP G-04 - IEP & IFSP Action Plans

Document: Job Description: Assistant Teacher



Description: Job Description: Assistant Teacher

Topics: Human Resources, Job Descriptions

Available Downloads: Job Description: Assistant Teacher

Document: Job Description: Center Director

Description: Job Description: Center Director


Available Downloads: Job Description: Center Director

Document: Job Description: Clerk

Description: Job Description: Clerk


Available Downloads: Job Description: Clerk

Document: Job Description: Director of Analysis and Quality Assurance

Description: Job Description: Director of Analysis and Quality Assurance


Available Downloads: Job Description: Director of Analysis and Quality Assurance

Document: Job Description: Director of Human Resources

Description: Job Description: Director of Human Resources




Available Downloads: Job Description: Director of Human Resources

Document: Job Description: Director of Monitoring and Compliance

Description: Job Description: Director of Monitoring and Compliance


Available Downloads: Job Description: Director of Monitoring and Compliance

Document: Job Description: Director of Operations

Description: Job Description: Director of Operations


Available Downloads: Job Description: Director of Operations

Document: Job Description: Director of Program Design and Management

Description: Job Description: Director of Program Design and Management


Available Downloads: Job Description: Director of Program Design and Management

Document: Job Description: Early Learning / Disabilities Specialist

Description: Job Description: Early Learning / Disabilities Specialist


Available Downloads: Job Description: Early Learning / Disabilities Specialist



Document: Job Description: Education Administrative Assistant

Description: Job Description: Education Administrative Assistant


Available Downloads: Job Description: Education Administrative Assistant

Document: Job Description: ERSEA Assistant

Description: Job Description: ERSEA Assistant


Available Downloads: Job Description: ERSEA Assistant

Document: Job Description: Executive Assistant

Description: Job Description: Executive Assistant


Available Downloads: Job Description: Executive Assistant

Document: Job Description: Executive Director

Description: Job Description: Executive Director


Available Downloads: Job Description: Executive Director

Document: Job Description: Facilities Engineer

Description: Job Description: Facilities Engineer




Available Downloads: Job Description: Facilities Engineer

Document: Job Description: Family Advocate

Description: Job Description: Family Advocate


Available Downloads: Job Description: Family Advocate

Document: Job Description: Family Engagement Advocate

Description: Job Description: Family Engagement Advocate


Available Downloads: Job Description: Family Engagement Advocate

Document: Job Description: Family Services Coordinator

Description: Job Description: Family Services Coordinator


Available Downloads: JD: Family Service Coordinator, Job Description: Family Services Coordinator

Document: Job Description: Floater

Description: Job Description: Floater


Available Downloads: Job Description: Floater



Document: Job Description: Food Services Coordinator

Description: Job Description: Food Services Coordinator


Available Downloads: Job Description: Food Services Coordinator

Document: Job Description: Head Start Lead Health Coordinator

Description: Job Description: Head Start Lead Health Coordinator


Available Downloads: Job Description: Head Start Lead Health Coordinator

Document: Job Description: Health and Nutrition Coordinator

Description: Job Description: Health and Nutrition Coordinator


Available Downloads: Job Description: Health and Nutrition Coordinator

Document: Job Description: Health Coordinator

Description: Job Description: Health Coordinator


Available Downloads: Job Description: Health Coordinator

Document: Job Description: Health Disabilitiess Advocate



Description: Job Description: Health Disabilitiess Advocate


Available Downloads: Job Description: Health Disabilitiess Advocate

Document: Job Description: HR Administrator

Description: Job Description: HR Administrator


Available Downloads: Job Description: HR Administrator

Document: Job Description: Preschool Resource Teacher II

Description: Job Description: Preschool Resource Teacher II


Available Downloads: Job Description: Preschool Resource Teacher II

Document: Job Description: Preschool Resource Teacher III

Description: Job Description: Preschool Resource Teacher III


Available Downloads: Job Description: Preschool Resource Teacher III

Document: Job Description: Programmatic Analysis and Reporting Manager

Description: Job Description: Pogrammatic Analysis and Reporting Manager




Available Downloads: Job Description: Programmatic Analysis and Reporting Manager

Document: Job Description: Social Worker

Description: Job Description: Social Worker


Available Downloads: Job Description: Social Worker

Document: Job Description: Substitute Teacher

Description: Job Description: Substitute


Available Downloads: Job Description: Substitute Teacher

Document: Job Description_Teacher

Description: Job Description: Teacher


Available Downloads: Job Description_Teacher

Document: Job Descriptions

Description: Job Description: Administrative Assistant


Available Downloads: JD: Admin Assistant, JD: Assistant Cook, JD: Cook, JD: Education Coordinator, JD: EHS Teacher, JD: Finance Coordinator, JD: Head Start Home-Based Visitor (HBV), JD: Lead EHS Teacher, JD: Mental Health & Disabilities Coordinator, JD - Nutrition Consultant,



Document: Lead Risk Assessment Questionnaire

Description: This questionnaire is used to assess each child’s individual risk of lead exposure, which should be done yearly from 6 months to 5 years of age. This is only necessary in states where EPSDT does not require actual lead blood tests.

Topics: Health

Available Downloads: Lead Risk Assessment Questionnaire , Lead Risk Assessment Questionnaire (Spanish)

Document: Maintaining Emergency Contact Information

Description: This policy and procedure identifies the steps needed to gather emergency contact information for each child, along with parental authorization for emergency care. This information is made readily available in each classroom and center, and updated regularly to ensure accuracy In addition to this policy and procedure, the Emergency Information, Authorization & Consent form captures the following information for each center-based child: Parent/Guardian contact information. Authorized Contacts: at least two individuals (other than parents/guardians) who can be contacted in an emergency situation if the parent is not available, and who are permitted to pick up children from the center. Medical Information and Consent for Emergency Medical/Dental Care. The home-based program option uses a variation of this form with less authorized contact information, since a parent or guardian is always present with the child and home-based teacher.

Topics: Policies and Procedures, Recordkeeping

Available Downloads: Maintaining Emergency Contact Information

Document: Manage By Information (MBI) Template

Description: The Manage By Information report is an easy way to organize the indicator data for your program into one place. It's easy to read, and provides a birds-eye view as a first step in your monitoring efforts. Includes sections on enrollment, attendance, education, HR, health, disabilities, and family services. *Replace generic center names with your own centers, and add or delete columns and rows as necessary *Some cells have pink conditional formatting to more quickly see deficient or



low performing areas*Each column has a corresponding ChildPlus report number (some with an F= filter)

Topics: PDM

Available Downloads: Manage By Information (MBI) Template

Document: Manage By Information Plus (MBI+) Template

Description: This template is meant to give a starting point to report larger, overall program data on a monthly basis. *Each ChildPlus report is listed in the yellow section of the columns

Topics: PDM

Available Downloads: Manage By Information Plus (MBI+) Template

Document: Manage By Outcomes (MBO) Template

Description: This template is used as a starting point in which to develop your program-specific MBO report. Please note that there are several tabs along the bottom of this document, each tab represents a page of the report.

Topics: PDM

Available Downloads: Manage By Outcomes (MBO) Template

Document: Master Binder System

Description: The Master Binder System was created to provide a structure for clear, comprehensive documentation of Head Start program management. Through this system, a wide range of information and key activities can be documented in an organized and logical way, for easy review by staff as well as external audiences as needed. The Master Binder System consists of a series of binders, each with a defined set of contents related to a specific area of program management. For multi-site grantees, the system specifies which binders should be maintained at the center level, and which program-wide. While primarily intended for ongoing Head Start staff use and reference, the Master Binder System is also designed to align with the Federal Monitoring Records Request, thus simplifying preparation for



the Federal Monitoring review. The second link is the Parent Education & Training Index which corresponds to documentation for binder #3- Parent Involvement.

Topics: PDM

Available Downloads: Master Binder System

Document: Medical Statement for Food Substitutions

Description: This form documents a family need for a food substitution for their child.

Topics: Nutrition

Available Downloads: Medical Statement for Food Substitutions

Document: Medication Administration

Description: This policy clearly defines our procedures for administering medication and medical procedures. Related tools include the Medication Administration Record and Parent Authorization for Medication.


Available Downloads: Medication Administration

Document: Medication Administration Record

Description: This log allows you to document the medication that is provided at the Head Start center. This form supports the implementation of the Medication Administration Permission form. This updated Med Admin form has a column to document that a parent had been notified each time the medication is administered.**This updated Med Admin form has a column to document that a parent had been notified each time the medication is administered.

Topics: Health

Available Downloads: Medication Administration Record



Document: Medication Authorization

Description: This one page form given to the medical provider and parents to authorize the administration of medication at the Head Start center.

Topics: Health

Available Downloads: Medication Authorization

Document: Medication Conference Form

Description: This tool documents completion of conference/training on proper administration of medication.

Topics: Health

Available Downloads: Medication Conference Form

Document: Meeting Minutes Template

Description: Applicable to any meeting type

Topics: PDM

Available Downloads: Meeting Minutes Template

Document: Mental Health Services Log

Description: Mental Health Services Log

Topics: Mental Health

Available Downloads: Mental Health Services Log

Document: Menu Substitution Log



Description: Menu Substitution Log

Topics: Nutrition

Available Downloads: Menu Substitution Log

Document: Milk Machine Temperature Log

Description: Milk machine temperature log document

Topics: Operations, Kitchen

Available Downloads: Milk Machine Temperature Log

Document: New Classroom Checklist

Description: This checklist is intended for staff who are opening a new classroom or center, and lists all required health/safety supplies and classroom postings. SEE ALSO “Basic Materials & Equipment Checklists” for early learning materials that should be present in the classroom.

Topics: Education

Available Downloads: New Classroom Checklist

Document: New Parent Orientation Presentation

Description: PowerPoint presentation for onboarding new parents and families.


Available Downloads: New Parent Orientation Presentation, New Parent Orientation Presentation (Spanish)

Document: New Staff Orientation and Training : Teachers and Assistant Teachers



Description: This tool includes a list of training topics that a new employee should expect during his/her first three months with the agency. Head Start requirements, general state child care licensing regulations and agency policies and procedures are all addressed. Additional trainings may be added to the list at the discretion of supervisor or program leadership, based on specific state/local licensing requirement. A form is embedded within this tool, which will allow you to document when the training occurred.

Topics: Human Resources, Education

Available Downloads: New Staff Orientation and Training : Teachers and Assistant Teachers

Document: New/Transferred/Terminated Child Form

Description: Use this form to alert appropriate staff when a child with special needs/concerns begins at their center. It can also be used to inform teachers of a new child entering their classroom, or to inform appropriate staff when a child is withdrawn.

Topics: Family Services, Enrollment

Available Downloads: New/Transferred/Terminated Child Form

Document: Newborn Home Visit Assessment

Description: Use this form to record information at the 2-week visit. Home Visitors will be provided with questions and topics such as the delivery history and complications during the birth. In addition questions are provided to determine the nature of the home environment, are basic care materials present and if the family needs anything. Questions related to Newborn development, feeding patterns, and a brief assessment of parenting skills, are all included in this comprehensive tool.

Topics: Family Services, EHS

Available Downloads: Newborn Home Visit Assessment

Document: Nutrition Assessment & Questionnaire



Description: Use this questionnaire with the parent/guardian during the first home visit. For more guidance, refer to the Nutrition Assessment Protocol, Section II, “Administering and Interpreting the Nutrition Questionnaire”, following assessment form.

Topics: Nutrition

Available Downloads: Nutrition Asssessment Form, Nutrition Assessment & Questionnaire (Spanish), Nutrition Assessment Protocol

Document: Nutritional Assessment for Expecting Mothers

Description: This form can be used during the intake process with Expectant Mothers. Identify their eating patterns and individual nutritional needs while Pregnant.

Topics: EHS, Nutrition

Available Downloads: Nutritional Assessment for Expecting Mothers

Document: Nutritionist Check-in Agenda

Description: This form is used by Health Coordinator as part of individual meetings with Nutritionist to discuss status of children with suspected or diagnosed nutritional need. The tool identifies various sources of information and then allows you to develop a follow-up plan that can be monitored throughout the year.

Topics: Nutrition

Available Downloads: Nutritionist Check-in Agenda

Document: Ongoing Monitoring

Description: Ongoing monitoring is a process in which an agency analyzes its programmatic and fiscal services. This monitoring is based not only on federal, but also on state and local requirements. Within this policy and procedure you will find information on: Early Childhood Monitoring, Health, Safe Environments, and Nutrition Monitoring, Disabilities and Mental Health Monitoring and Family and Community Partnerships Monitoring. A step by step description of how to monitor information is



provided for you. Each page contains essential information needed to generate meaningful reports and enable thorough monitoring in your agency.

Topics: Monitoring

Available Downloads: Ongoing Monitoring

Document: Operations Pocket Checklist

Description: Assess the center environment on arrival, during the visit inside the building and at departure with this quick and easy checklist.

Topics: Operations

Available Downloads: Operations Pocket Checklist

Document: Parent and Community Grievance

Description: In the instance that a parent or community member has a grievance with the program, we have put in place a formal process to ensure that the concern is both heard and adequately addressed. This procedure includes various steps including: meet with appropriate staff person, meet with appropriate manager, capture complaint in writing, share with Program Director, share concern with Policy Council and Board, collaboration between Policy Council, Board and communication back with the Parent (originator). The procedures outlined within this document is approved by the Policy Council and reviewed annually or as needed to ensure they meet the needs of the program and community.

Topics: Governance, Family Services

Available Downloads: Parent and Community Grievance

Document: Parent Center Committee Agenda

Description: Optional resources to support planning of Parent Committee meetings.

Topics: Governance, Family Services



Available Downloads: Parent Center Committee Agenda

Document: Parent Education tools

Description: Parent education tools / training index


Available Downloads: Parent Education tools

Document: Parent Fees

Description: Our program is committed to providing outstanding free-of-charge Head Start services to each child and family we serve. However if the program incurs expenses to compensate employees for the care of a child after the Head Start program has ended, parents may be charged a reasonable fee for “after care.” This policy identifies the appropriate steps to take to recover these funds.


Available Downloads: Parent Fees

Document: Parent Interest Survey

Description: Parent Interest Survey


Available Downloads: Parent Interest Survey

Document: Parent Workshop Evaluation

Description: Parent Workshop Evaluation


Available Downloads: Parent Workshop Evaluation, Parent Workshop Evaluation (Spanish)



Document: Parent-Child Activity Calendars

Description: In English & Spanish. Can be used with At-Home Parent Volunteer Hours form


Available Downloads: Parent-Child Activity Calendars: April (Curriculum guided), Parent-Child Activity Calendars: April (general), Parent-Child Activity Calendars: December (Curriculum guided), Parent-Child Activity Calendars: December (general), Parent-Child Activity Calenda

Document: Parent-Teacher Conference Tool

Description: Parent-Teacher Conference Tool


Available Downloads: Parent-Teacher Conference Tool

Document: Performance Appraisal Form - Admin

Description: These position-specific appraisals should be used to evaluate employees' performance during the annual review period.

Topics: Human resources

Available Downloads: Performance Appraisal Form - Admin

Document: Performance Appraisal Form - Assistant Director of Education





Available Downloads: Performance Appraisal Form - Assistant Director of Education

Document: Performance Appraisal Form - Assistant Director of Family Services



Available Downloads: Performance Appraisal Form - Assistant Director of Family Services

Document: Performance Appraisal Form - Facilities



Available Downloads: Performance Appraisal Form - Facilities

Document: Performance Appraisal Form - Family Advocate Supervisor



Available Downloads: Performance Appraisal Form - Family Advocate Supervisor

Document: Performance Appraisal Form - Finance Coordinator





Available Downloads: Performance Appraisal Form - Finance Coordinator

Document: Performance Appraisal Form - HBV



Available Downloads: Performance Appraisal Form - HBV

Document: Performance Appraisal Form - Health Coordinator



Available Downloads: Performance Appraisal Form - Health Coordinator

Document: Performance Appraisal Form - HR Coordinator



Available Downloads: Performance Appraisal Form - HR Coordinator

Document: Performance Appraisal Form - HR Director





Available Downloads: Performance Appraisal Form - HR Director

Document: Performance Appraisal Form - Mental Health & Disabilities



Available Downloads: Performance Appraisal Form - Mental Health & Disabilities

Document: Performance Appraisal Form - Ops Coordinator



Available Downloads: Performance Appraisal Form - Ops Coordinator

Document: Performance Appraisal Form - Security Guard



Available Downloads: Performance Appraisal Form - Security Guard

Document: Performance Appraisal Forms - Cook





Available Downloads: Performance Appraisal Forms - Cook

Document: Performance Appraisal Review Acknowledgement

Description: Performance Appraisal Review Acknowledgement


Available Downloads: Performance Appraisal Review Acknowledgement

Document: Performance Improvement Plan

Description: Performance Improvement Plan


Available Downloads: Performance Improvement Plan

Document: Permission for Program Activities

Description: Use this form to get families permission for a variety of things that take place in a Head Start program. Walking trips, permission to photograph and videotape the children, to share information, conduct observations and for screenings and assessments of the children. Information is provided for families and a place for parent’s signature is all included in the form.


Available Downloads: Permission for Program Activities

Document: Permission for Program Activities (for pregnant teenagers – under age 18)



Description: Because some of our expectant mothers may be teenagers, under 18 years old, you would use this form to get their families permission for a variety of things that take place in a Early Head Start program. Authorizations to be photographed and videotaped, to share information, conduct observations and screenings and to participate in assessments of their child’s needs. Information is provided for families and a place for parent’s signature is all included in the form.


Available Downloads: Permission for Program Activities (for pregnant teenagers – under age 18)

Document: Permission to Observe Child

Description: This form grants permission for a focused observation of a child. Parents are provided a detailed description of the reason for the observation.

Topics: Family Services, Education

Available Downloads: Permission to Observe Child

Document: Personnel Records Checklist

Description: This Excel tool allows you to track when information is completed/submitted for personnel files. This multi-tabbed file addresses all aspects of documentation for both new and existing employees. Hiring, Benefits, Orientation and Training and Employment History are all included in this tool.


Available Downloads: Personnel Records Checklist

Document: Petty Cash

Description: The Petty Cash policy and procedures identifies the guidelines used within the agency to define and determine appropriate use of Petty Cash. It also articulates the steps and appropriate staff members responsible for Petty Cash within the agency.

Topics: PDM, fiscal



Available Downloads: Petty Cash

Document: Policy Council Resource Guide

Description: This handbook is a resource guide for new or existing Policy Council (PC)members and reviews their roles and responsibilities, as well as key information about Head Start and the program.

Topics: Governance

Available Downloads: Policy Council Resource Guide

Document: Positive Discipline & Guidance for Children

Description: This policy and procedure emphasizes our programs approach to discipline and guidance that emphasizes respect for each child; developmentally appropriate expectations of children’s behavior; and the use of positive discipline and guidance strategies. This policy is included in the Parent Handbook as well as the Employee Handbook and is posted in a central location in each center.


Available Downloads: Positive Discipline & Guidance for Children

Document: Program Governance: Information to Share with Board and Policy Council

Description: Based on the Head Start Act, this document highlights information that should be shared with the Board and Policy Council to allow them to successfully perform their duties, resulting in an improved Head Start Program and services for the children and families.

Topics: Governance

Available Downloads: Program Governance: Information to Share with Board and Policy Council



Document: Program Planning

Description: This policy and procedure is used for program planning. An active, ongoing cycle that contributes to the design of program goals; the plans for implementing services; and to the continuous improvement of those services. The planning cycle includes consultation with the Board of Directors, Policy Council, program staff and community organizations. The elements of the planning cycle include the following: Community Assessment, Self-Assessment, Strategic Planning: Long Term Goals and Short Term Priorities, Updating the Integrated Service Plan, Budget Development and Grant Application.

Topics: Policies and Procedures, PDM

Available Downloads: Program Planning

Document: Purchasing

Description: This policy and procedure for purchasing is designed to ensure effective internal controls that safeguard federal funds and comply with all federal regulations. Elements of this policy include Requisition & Approval, Ordering, and Verifying Receipt of Goods/Services. The Expense Watch sections includes procedures for Creating a Requisition, Approval, Ordering, Verification of Receipt and Check Requests.

Topics: Policies and Procedures, PDM, fiscal

Available Downloads: Purchasing

Document: Record of Disaster: Evacuation and Fire Drills

Description: Record of Disaster: Evacuation and Fire Drills


Available Downloads: Record of Disaster: Evacuation and Fire Drills

Document: Referral Action Plan



Description: Used To follow up on referral/consultation. The Referral Action Plan should be developed collaboratively by the teacher, MH/Disabilities Coordinator and Center Director after a child/classroom observation/consultation has been completed.

Topics: Policies and Procedures, Disabilities, Mental Health

Available Downloads: Referral Action Plan

Document: Referral for Internal Review

Description: This form can be used in your agency to document a concern with an individual child/family that requires further review by the appropriate coordinator/specialist. For example: 45-day screening indicates possible developmental delay; observation of child suggests allergy; information from family or physician suggests social service concern; etc. The following topics are addressed in this one tool: Mental Health, Special Needs, Health, Nutrition, and Social Service.

Topics: Policies and Procedures, Disabilities, Mental Health

Available Downloads: Referral for Internal Review

Document: Release of Information (general)

Description: This document can be used to get family's general permission for release of information. Included in the application/enrollment packet for all new families. See also Permission to Request/Release Info.

Topics: PDM

Available Downloads: Release of Information (general)

Document: Reporting Suspected Child Abuse and Neglect

Description: As mandatory reporters, this policy and procedure outlines the steps employees should take in case they need to report a suspected case of child abuse or neglect of a child in the program.




Available Downloads: Reporting Suspected Child Abuse and Neglect

Document: Request for Evaluation

Description: This form identifies and documents who is requesting an evaluation of a child to the LEA, Part-C Agency, or outside Mental Health Services. It also provides a section where the agency is able to document the reasons for the referral and for the parent to authorize the evaluation.


Available Downloads: Request for Evaluation

Document: Request for Salary Action Form

Description: To be used by managers when making a formal adjustment to current employee salaries.


Available Downloads: Request for Salary Action Form

Document: Required Postings for Centers

Description: This form highlights the information that must be posted in our center

Topics: Operations

Available Downloads: Required Postings for Centers

Document: Review of Child Observation and Assessment

Description: This form is used to document the process of monitoring and supporting the quality of child observations and assessment. It should be completed after each checkpoint and used as part of ongoing coaching with teacher(s).



Topics: Education

Available Downloads: Review of Child Observation and Assessment

Document: Rodent & Insect Control

Description: This policy highlights both internal procedures and if necessary external services that would be contracted to address any rodent/insect concerns.


Available Downloads: Rodent & Insect Control

Document: Sanitation Checklist

Description: There are 2 tabs in this spreadsheet- one for monthly and one for daily kitchen cleaning


Available Downloads: Sanitation Checklist

Document: School Readiness Goals : Alignment Charts (HS)

Description: These documents meet Head Start requirements to demonstrate how Acelero's School Readiness Goals are aligned with our program's curriculum and assessment, as well as State standards. These documents shows alignment with three different child assessment systems and with state standards for NJ, PA and NV.

Topics: Education

Available Downloads: SRG Aligned Assessment, SRG Aligned Standards

Document: Selection & Intake Form

Description: Selection & Intake Form




Available Downloads: Selection & Intake Form

Document: Selection Criteria (B2)

Description: This form helps to calculate the number of points a family receives based on eligibility criteria. This can be customized to meet the program eligibility criteria


Available Downloads: Selection Criteria (B2)

Document: Self Assessment: Board Invite Letter

Description: This sample letter is provided as a template for you to modify. This letter can help clarify what you are asking Board Members to do during the Self Assessment process.

Topics: Governance

Available Downloads: Self Assessment: Board Invite Letter

Document: Shared Governance and Impasse Resolution

Description: This policy and procedure is intended to help facilitate a process for the Board and Policy Council to work collaboratively to ensure that both governing bodies perform their respective duties and that shared governance is implemented effectively The Governing Board and Policy Council have clearly articulated responsibilities as laid out in the Head Start Performance Standards. In addition, to effectively provide oversight, the Governing Board and the Policy Council must not only serve the functions described in the Standards; they must work collaboratively and cooperatively together to practice effective shared decision making. Topics such as composition and responsibilities: of both Board and Policy Council members, Systems for Shared Decision Making, Activities for Shared Decision Making and Impasse Procedure can all be found in this policy and procedure.

Topics: Policies and Procedures, Governance

Available Downloads: Shared Governance and Impasse Resolution



Document: Sharing Information About Children’s Nutrition (Early Head Start)

Description: This policy identifies the procedures we use to ensure that Early Head Start staff and families have ongoing, two-way, individualized communication related to children’s nutrition. Additional tools: Nutrition Questionnaire, Infant Feeding Plan and Daily Information Sheet should also be referenced in order to support the full implementation of this policy.

Topics: Policies and Procedures, Nutrition

Available Downloads: Sharing Information About Children’s Nutrition (Early Head Start)

Document: Short and Long Term Exclusion

Description: In keeping with our organization value of inclusiveness, we will not exclude a child from program participation unless that child demonstrates an inability to benefit from the services offered by the program, and/or the child’s presence is harmful to the group. This policy and procedure highlight the steps that we will take when considering excluding a child from program services.

Topics: Policies and Procedures, Family Services

Available Downloads: Short and Long Term Exclusion

Document: Significant Incident Report

Description: Significant Incident Report


Available Downloads: Significant Incident Report

Document: Significant Incident Reporting



Description: This policy is not a substitution for a comprehensive crisis manual. The purpose of this policy is to support agency staff (particularly Managers) in dealing consistently and effectively with challenging situations that may affect the health, safety and well-being of the children and employees. Information is provided on the following topics: Child Medical Emergency, Employee Injuries, Parent/Third Party Injuries, Child Left Unattended, Child Abuse Alleged of Staff (sexual or physical), Contagious or Serious Illness, Food, Medication, Formula or Breast Milk Issues, Unannounced Visit from Police or Child Protective Services, Allegations of Discrimination, Media Contact and Child’s Safety Upon Release. In addition, you will find procedures for handling Facilities, Transportation, and Weather Emergencies such as Fire, Bomb Threats, Earthquake, Tornado, Van or Bus mechanical failure and witnessing a road accident. The Significant Incident Report form can be used for internal reporting and documentation of any serious incident (e.g. risk or potential risk to child health/safety, employee health/safety, or agency).

Topics: Policies and Procedures, Health and Safety

Available Downloads: Significant Incident Reporting

Document: Site Orientation Checklist

Description: Ensure that new staff members receive a comprehensive orientation to your center with this checklist. This tool should be used in conjunction with Staff Orientation & Training Guide during Days 1-2 of employment. Topics included are Welcome & Grounding and Logistics & Operations.


Available Downloads: Site Orientation Checklist

Document: Site Visits: Policy & Procedure

Description: This policy and procedure outlines the steps taken to conduct a site visit, by Central Administration staff members. The Site Visit Guide and Report are the tools that support the implementation of this policy.

Topics: Policies and Procedures

Available Downloads: Site Visits: Policy & Procedure



Document: Special Diet Substitution Log

Description: Special Diet Substitution Log

Topics: Nutrition

Available Downloads: Special Diet Substitution Log

Document: Staff Development Record

Description: This 3 page forms allows you to document all trainings provided to the staff members. Use in tandem with the employees professional development plan. This tool includes: where/how the training was delivered, the title/topic of the presentation and who the presenter was and the number of hours of the training. In addition to that, the form goes on to include space for training that is provided in these categories: Child Growth & Development, Positive Guidance & Discipline, Health and Safety Procedures, Technology, Recordkeeping & Reporting, Leadership & Management, and any other program/employee identified staff development opportunities.


Available Downloads: Staff Development Record

Document: Staff Emergency Contact List

Description: To be used in new employee files during the hiring and on-boarding process


Available Downloads: Staff Emergency Contact List

Document: Staff Physical Examination Form

Description: Staff Physical Examination Form


Available Downloads: Staff Physical Examination Form



Document: Staff Records Checklist (New Employee Requirements)

Description: This resource lists all documents completed during the application/enrollment process for new families. Intended for staff training & reference.


Available Downloads: Staff Records Checklist (New Employee Requirements)

Document: Staff Satisfaction Survey

Description: Survey for employees to be used as a means of feedback regarding how the company is doing as a whole to provide to their employees and get an overall idea as to where the company can improve.


Available Downloads: Staff Satisfaction Survey

Document: Staff Training Event Planner

Description: A resource to help guide the planning for a professional development day, in-service or pre-service training. Includes a recommended list of planning steps, roles and timeframes, which can be used to customize your workplan for a particular event.


Available Downloads: Staff Training Event Planner

Document: Staff Training Sign-In

Description: Staff Training Sign-In




Available Downloads: Staff Training Sign-In

Document: Staffing Protocol

Description: Used to document all necessary steps have been taken to serve child with disabilities.


Available Downloads: Staffing Protocol

Document: Strengths and Needs Assessment for Pregnant Mothers

Description: This tool, used for Expectant Mothers is a supplemental document to their Family Needs Assessment. Use with Mothers before the birth of their child to help identify their medical health, mental health, self care and relationship with family and friends.

Topics: Family Services, Early Head Start

Available Downloads: Strengths and Needs Assessment for Pregnant Mothers

Document: Subjective Hearing / Vision Screening Tracking Tool

Description: Subjective Hearing / Vision Screening Tracking Tool

Topics: Family Services, Health,

Available Downloads: Subjective Hearing / Vision Screening Tracking Tool

Document: Supervision Agenda & Record

Description: This form should be used by supervisor to guide and document formal supervision meetings. Topics such as: reflection on recent activities & performance, review of documentation/reports, upcoming priorities & goals and confirming next steps & deadlines are all included in this tool.




Available Downloads: Monitoring Tool - Individual Supervision

Document: Supervision Tracker

Description: This tool is used to plan and document your supervision meetings. Keep track of when and with whom those meeting occurred with this form. In addition, use the Supervision Agenda & Record to conduct supervision meetings.


Available Downloads: Supervision Tracker

Document: Teacher Qualifications

Description: This policy and procedure for both HS and EHS programs, outlines the steps the agency will take to ensure they are hiring teaching staff members who have the necessary credentials to fulfill their job. Information is also provided on what to do to ensure that existing staff members meet the necessary requirements. Use the Teaching Staff Education Verification form to assist you in implementing this policy.


Available Downloads: Teacher Qualifications

Document: Teacher Reflection- Assessment Focused

Description: After a coaching observation, you can prepare for the post-observation conference by reflecting on the questions listed in this document.


Available Downloads: Teacher Reflection- Assessment Focused



Document: Teacher Success Rubrics

Description: The Head Start Teacher Success Rubrics (TSR and ATSR) were developed to (1) clearly articulate the expectations for being a successful teacher with Acelero Learning and (2) provide all teachers with a developmental path to achieve mastery in specific components of their work.


Available Downloads: Teacher Success Rubrics

Document: Teaching Staff Education Verification

Description: This form (updated to reflect the Head Start Act of 2007) helps to identify the credentials of each teaching staff member. Classroom and Home-Based Teachers, Assistant Teachers and Floaters/ Assistants are all included in this form.


Available Downloads: Teaching Staff Education Verification

Document: Three Compartment Sink Log

Description: Three Compartment Sink Log

Topics: Operations

Available Downloads: Three Compartment Sink Log

Document: Tips for Home-Based Visit Planning

Description: Tips for Home-Based Visit Planning

Topics: Home-based

Available Downloads: Tips for Home-Based Visit Planning



Document: Toileting & Diapering

Description: This policy defines our procedures to ensure safe, healthy diapering and toileting of the children we serve.


Available Downloads: Toileting & Diapering

Document: Tooth-brushing

Description: Proper, daily tooth-brushing promotes good dental hygiene and helps children establish consistent routines. This policy defines our procedures to ensure safe and effective tooth-brushing for the children we serve.


Available Downloads: Tooth-brushing

Document: Top 10 Components of an Excellent Lesson Plan

Description: This resource can be used for teacher training or by Center Directors, as a reference when approving weekly lesson plans.

Topics: Tools

Available Downloads: Top 10 Components of an Excellent Lesson Plan

Document: Training/Conference Application Template

Description: Application used by any staff member as a formal request to attend a conference or training event. Can be filed in employee Staff Supervision Master Binders

Topics: Training

Available Downloads: Training/Conference Application Template



Document: Transition from Early Head Start: Indivudual Transition Plan

Description: This tool is designed to plan and document a thorough process for transitioning children out of Early Head Start

Topics: Transition, Early Head Start

Available Downloads: Transition from Early Head Start: Indivudual Transition Plan

Document: Transition to Kindergarten: Individual Transition Plan

Description: These tools are designed to plan, track and document a thorough process for transitioning children out of your program's Head Start centers. Please check with your supervisor or education team to determine if/how these forms are used in your program.

Topics: Transition

Available Downloads: Transition to Kindergarten: Individual Transition Plan

Document: Tuition Reimbursement Request Form

Description: This form, used by employees to request reimbursement for training/tuition, identifies the need for the training and an explanation of what the employee hopes to learn. The form also identifies a schedule of how much the employee would have to repay, if they leave before their 3 years of service to the agency. A section for approvals is also included.


Available Downloads: Tuition Reimbursement Request Form

Document: Volunteer Application

Description: Volunteer Application

Topics: Volunteers



Available Downloads: Volunteer Application

Document: Volunteer Management, Documentation & Training

Description: Documenting volunteer hours and training is a critical element of all Head Start programs. This policy and procedure identifies the various aspects that help support strong and through documentation for any agency. Since we document volunteer hours as Non-Federal Share (in-kind) contributions we want to ensure that this procedure is comprehensive and followed consistently. In this document you will find procedures for Classroom Volunteer Logs, Volunteer Orientation and Training, Long-Term Volunteers and Human Resources Management of Volunteers.

Topics: Policies and Procedures, Family Services

Available Downloads: Volunteer Management, Documentation & Training

Document: Weekly Volunteer Log

Description: Weekly Volunteer Log

Topics: Family Services, Education, In-Kind

Available Downloads: Weekly Volunteer Log

Document: Workshop Evaluation (Generic)

Description: Workshop Evaluation (Generic)


Available Downloads: Workshop Evaluation (Generic)

Document: Year-End Family Celebrations: Guidelines

Description: Year-End Family Celebrations: Guidelines




Available Downloads: Year-End Family Celebrations: Guidelines


document: accident and injury report -...

Documents