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Head Start / ECEAP forms and documents

CCS HS/ECEAP/EHS Policy & Procedure Manual

Agreement form CCS 97-141
Agreement form (West Boone Center) CCS 97-181 PDF | Word
Application
Asthma plan and medication orders CCS 97-165
Authorization to disclose and receive information CCS 9713
Authorization to use identifiable nametags CCS 97-157
Behavior incident report CCS 98-130
Behavior tracking report CCS 98-176
Blood lead-level handout CCS 98-137
C-Campis Programs child care discount application CCS 98-162
Child care exceptional fees CCS 9611
Child care programs application CCS 98-161 PDF | Word
Child development history CCS 98-122
Child observation and individualized positive guidance plan CCS 9901
Child Protective Services report CCS 97-104 PDF | Word
Child care reimbursement voucher CCS 9853
Class observation report CCS 98-166
Classroom planning for a child with an IEP CCS 97-163
Classroom safety plan CCS 9625 PDF | Word
Classroom sign-up and sign-out log CCS 9817
Confidentiality agreement CCS 9879
Consent for screening, assessment and exchange of information CCS 97-150
Continuing enrollment agreement CCS 98-134
Controlled substance log CCS 98-175
Curriculum plan review and feedback CCS 98-169
Curriculum planning (Full day - part 1) CCS 9891
Daily communication log CCS 9944
Dental examination record CCS 9821
Directive regarding work hours, leave usage and work attendance CCS 98-160 PDF | Word
DST classroom/family documentation CCS 98-133
DST family case management CCS 9873
DST family documentation CCS 98-132a
ECEAP forms and documents
Education activity submissions CCS 98-167
Education completion dates summary CCS 9874
Education requirements tracking form CCS 98-168
Emergency action plan diabetest type I CCS 97-164
Enrollment drop notification CCS 9856 PDF | Word
ERSEA Annual income worksheet CCS 98-173
ERSEA Attendance action plan CCS 98-163 PDF | Word
ERSEA Attendance letter CCS 9858 PDF | Word
ERSEA Declaration of no income CCS 9848 PDF | Word
ERSEA Eligibility verification CCS 9621 PDF | Word
ERSEA Family housing survey CCS 9940 PDF | Word
ERSEA Final attendance notification CCS 98-172 PDF | Word
ERSEA Priority Point checklist CCS 98-126 PDF | Word
ERSEA Transfer request CCS 9941 PDF | Word
Exempt Head Start Staff attendance directive CCS 97-173
Family service coordinator (FSC) - new employee training documentation CCS 97-174 PDF | Word
Family strengths and partnership agreement/goals worksheet CCS 98-129
Field trip permission (group) CCS 9860
Field trip permission CCS 9862 PDF
Field trip planning sheet CCS 9844
Financial agreement CCS 9610 PDF | Word
First-aid kit inventory checklist CCS 9887
First-aid kit inventory checklist - kitchen CCS 98-112
Fluoride information handout CCS 9846
Flouride information handout (Spanish)
Food request CCS 97-121
Head injury letter CCS 97-182
Health concern CCS 98-109
Health, dental and diet history (ECEAP) CCS 97-155
Health, dental and diet history (EHS) CCS 98-116
Health requirements reminder CCS 9888
Health screening information for parents CCS 9823
Home visit planning & documentation CCS 9942 PDF | Word
Home visitor - new employee training documentation CCS 97-175 PDF | Word
Immunization due notice CCS 9620
Immunization exclusion order CCS 9855
Infant/toddler child observation--double session/full day CCS 9859
Infant/toddler curriculum planning CCS 9861 PDF | Word
Infant/toddler daily staffing plan I CCS 9864
Infant/toddler daily staffing plan II CCS 9865
Infant/toddler progress record: Individualizing goals and objectives CCS 9867
In-home postpartum nursing assessment CCS 97-180 PDF | Word
Initial child development plans (CIP)
     I/T home-based CCS 98-144
     I/T center-based CCS 98-145
     PS CCS 98-146
In-kind records
     Interagency meeting CCS 9840
     Donation receipt CCS 9794
     Community volunteer CCS 9795
     Parent volunteer hours CCS 9796
Interview committee recommendations CCS 9899
Kindergarten transition checklist CCS 98-170 PDF | Word
Language line usage CCS 98-171 PDF | Word
Late arrival/pick-up contract CCS 98-120
Lead exposure risk CCS 9897
Medication administration authorization CCS 9896
Medication request form CCS 97-160
Mental health consultant documentation CCS 98-124
Mental health consultant information CCS 97-112
Mental health consultant PIR log CCS 98-125
Minor incident/accident/illness report CCS 98-123
Monthly in-kind home learning plan - infant/toddler CCS 98-153 PDF | Word
Monthly in-kind home learning plan - preschool CCS 98-151 PDF | Word
MUMPS Do Not Enter If... (Sign)
New employee orientation checklist CCS 98-136
New employee and PIR information CCS 9900
New hire orientation checklist - full time CCS 98-165
Notice of privacy (English) CCS 98-121
Notice of privacy (Spanish) CCS 98-147
Nutrition CACFP infant meal form CCS 98-179
Nutrition daily infant meal record CCS 98-180
Nutrition diet request: Food allergy/Intolerance CCS 98-141 PDF | Word
Nutrition diet request: Menu adaptations CCS 98-157 PDF | Word
Nutrition Food allergy/intolerance prescription CCS 98-155
Nutrition infant meal record: birth - 5 months CCS 98-181
Nutrition medical disability statement for food substitution(s) CCS 98-158
Nutrition request for fluid milk substitution CCS 98-154 PDF | Word
PACE
Part day teacher - new employee training documentation CCS 97-176 PDF | Word
Parent information: medications at HS/EHS CCS 97-158
Parent interest survey CCS 98-178
Parent participation sign-in sheet CCS 9885
PIR volunteer services information CCS 9880
Policy council child care information form CCS 98-174
Postcard (one) CCS 9624 PDF | Word
Postcard (four) CCS 9624 PDF | Word
Practical dress guidelines for early childhood classroom and work environments CCS 98-143
Pre-employment medical exam CCS 98-110
Pre-employment medical exam instructions CCS 98-118
Pregnancy enrollment information CCS 9622
Prenatal home visit planning & documentation CCS 9943
Preschool classroom management reflective checklist CCS 97-179
Preschool curriculum planning (Double sessions - part 1) CCS 9893
Preschool readiness checklist CCS 97-178
Records request CCS 98-128
Release of information-Holmes CCS 9902
Release of information-Woodridge CCS 9947
Release and emergency treatment authorization CCS 9828
Request for volunteer vendor number CCS 98-142
Seizure health care plan CCS 97-166
Seizure observation log CCS 97-162
Sensory/growth screening results CCS 9824
Severe allergy reaction plan & medication orders CCS 97-167
Severe allergies guidelines CCS 97-161
Special diet letter CCS 98-140
Special services summary CCS 98-159 PDF | Word
Standards of conduct agreement CCS 9878
Table of contents: Child/family file (CENTER) CCS 98-139
Table of contents: Child/family file (HOME) CCS 98-138
Teacher - New employee training documentation CCS 97-177
Topical treatment permission and application log CCS 9810 PDF | Word
Training log CCS 9939
Training request-parent CCS 9890
Training/travel request-staff CCS 98-102
Transfer/transition notes CCS 98-149
Transition plan checklist CCS 98-135
USDA child and adult care food program CCS 98-103
Waiting list update CCS 9857
Weekly in-kind home learning plan for Home Base CCS 98-152
Well-child examination record CCS 9822
WIC information request CCS 9757