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CSI Head Start Program
D: DISABILITIES
D-a Performance Standards List
D-i Disabilities Service Area Plan
D-1 Disability Services Written Plan
D-2 Parental Consent for Participation during IEP/IFSP Process
D-3 Speech Screening and Referral
D- 3a EHS 318 DIAL-4 Classroom Profile – 45 Day Mandate/Rescreener
D-4 Parental Consent for Initial Evaluation
D-4a EHS 301 Parental Consent for Initial Evaluation for Special Services
D-5 Individualized Services during Evaluation Process
D-5a Individualized Service Plan
D-6 Parent Rights in Special Education Policy
D-6a EHS 303 Parent Letter
D-6b Parental Rights in Special Education
D-7 Recruitment of Disability Children
D-8 Diagnosed/Suspected Disability
D-8a EHS 302 Provider Letter
D-8b Referral/ Diagnostic Report
D-9 Information Release Request
D-9a EHS 304 Outside Agency Medical Information Letter
D-10 Disabilities File Maintenance
D-11 Monthly Confirmation of Treatment/Progress Report
D-11a EHS 313 Monthly Confirmation of Treatment
D-11b EHS 314 Special Services Progress Report
D-12 Referral to LEA Part B/ BCW Part C Agency
D-13 Refusal of Authorization for Health Services/Special Services
D-14 Individual Health Care Plan
D-15 Transitioning from EHS to HS and/or HS to Kindergarten
D-16 Emergency Evacuation
D-16a EHS 316 Emergency Evacuation for Children with Disabilities.
CSI Head Start Program
This information will be incorporated into the overall monitoring systems.
1302.13 Recruitment: In order to reach those most in need of services, a program must
develop and implement a recruitment process designed to actively inform all families
with eligible children within the recruitment area of the availability of program
services, and encourage and assist them in applying for admission to the program. A
program must include specific efforts to actively locate and recruit children with
disabilities and other vulnerable children, including homeless children and children
in foster care.
1302.33
(a)(1)
Screening: In collaboration with each child’s parent and with parental consent, a
program must complete or obtain a current developmental screening to identify
concerns regarding a child’s developmental, behavioral, motor, language, social,
cognitive, and emotional skills.
1302.33
(b)(1)
Assessment for Individualization: A program must conduct standardized and
structured assessments, which may be observation-based or direct, for each child that
provide ongoing information to evaluate the child’s developmental level and progress
in outcomes aligned to the goals described in the Head Start Early Learning Child
Outcomes Framework: Ages Birth to Five. Such assessments must result in usable
information for teachers, home visitors, and parents and be conducted with sufficient
frequency to allow for individualization within the program year.
1302.33
(b)(3)
If warranted from the information gathered from paragraphs (b)(1) and (2) of section
1302.33 and with direct guidance from a mental health or child development
professional and a parent’s consent, a program must refer the child to the local
agency responsible for implementing IDEA for a formal evaluation to assess a
child’s eligibility for services under IDEA as soon as possible.
1302.33
(c)(1)
Screenings and assessments must be valid and reliable for the population and purpose
for which they will be used, including by being conducted by qualified and trained
personnel, and being age, developmentally, culturally and linguistically appropriate,
and appropriate for children with disabilities, as needed.
1302.41 Collaboration and Communication with Parents:
(a) For all activities described in this part, programs must collaborate with parents as
partners in the health and well-being of their children in a linguistically and culturally
appropriate manner and communicate with parents about their child’s health needs and development concerns in a timely and effective manner.
1302.41
(b)(1)
(b)
At a minimum, a program must obtain advance authorization from the parent or other
person with legal authority for all health and developmental procedures administered
through the program or by contract or agreement, and, maintain written documentation if
they refuse to give authorization for health services.
1302.42
(c)(2)
Ongoing Care: A program must implement periodic observations or other appropriate
strategies for program staff and parents to identify any new or recurring developmental,
medical, oral, or mental health concerns
1302.42
(d)(1)
Extended Follow-Up: A program must facilitate further diagnostic testing, evaluation,
treatment, and follow-up plan, as appropriate, by a licensed or certified professional for
each child with a health problem or developmental delay, such as elevated lead levels or
abnormal hearing or vision results that may affect child’s development, learning, or
behavior.
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1302.44
(a)(1)
Nutrition Services Requirements: A program must design and implement nutrition
services that are culturally and developmentally appropriate, meet the nutritional needs of
and accommodate the feeding requirements of each child, including children with special
dietary needs and children with disabilities
1302.47
(b)(7)(vi)
Administrative Safety Procedures: Child specific health care needs and food allergies that
include accessible plans of action for emergencies. For food allergies, a program must
also post individual child food allergies prominently where staff can view wherever food
is served.
1302.60
Full Participation in Program: A program must ensure enrolled children with disabilities,
including but not limited to those who are eligible for services under IDEA, and their
families receive all applicable program services delivered in the least restrictive possible
environment and that they fully participate in all program activities.
1302.61 (a)
Programs must ensure the individualized needs of children with disabilities, including but not limited to those eligible for services under IDEA, are being met and all children have access to and can fully participate in the full range of activities and services.
1302.61 (a) Programs must provide any necessary modifications to the environment, multiple and varied formats for instruction, and individualized accommodations and supports as necessary to support the full participation of children with disabilities.
1302.61 (a)
Programs must ensure all individuals with disabilities are protected from discrimination under and provided with all services and program modifications required by section 504 of the Rehabilitation Act (29 U.S.C. 794), the Americans with Disabilities Act (42 U.S.C. 12101 et seq.), and their implementing regulations.
1302.61 (b)
Services During IDEA eligibility Determination: While the local agency responsible for implementing IDEA determines a child’s eligibility, a program must provide individualized services and supports, to the maximum extent possible, to meet the child’s needs. Such additional supports may be available through a child’s health insurance or it may be appropriate or required to provide the needed services and supports under section 504 of the Rehabilitation Act if the child satisfies the definition of disability in section 705(9)(b) of the Rehabilitation Act. When such supports are not available through alternate means, pending the evaluation results and eligibility determination, a program must individualize program services based on available information such as parent input and child observation and assessment data and may use program funds for these purposes.
1302.61 (c)(1)(i)
To ensure the individual needs of children eligible for services under IDEA are met, a
program must work closely with the local agency responsible for implementing IDEA, the
family, and other service partners, as appropriate, to ensure services for a child with
disabilities will be planned and delivered as required by their IFSP or IEP, as appropriate.
1302.61 (c)(1)(ii)
To ensure the individual needs of children eligible for services under IDEA are met, a
program must work closely with the local agency responsible for implementing IDEA, the
family, and other service partners, as appropriate, to ensure children are working towards
the goals in their IFSP or IEP.
1302.61 (c)(1)(iii)
To ensure the individual needs of children eligible for services under IDEA are met, a
program must work closely with the local agency responsible for implementing IDEA, the
family, and other service partners, as appropriate, to ensure elements of the IFSP or IEP
that the program cannot implement are implemented by other appropriate agencies, related
service providers and specialists.
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1302.61 (c)(1)(iv)
To ensure the individual needs of children eligible for services under IDEA are met, a
program must work closely with the local agency responsible for implementing IDEA, the
family, and other service partners, as appropriate, to ensure IFSPs and IEPs are being
reviewed and revised, as required by IDEA.
1302.61 (c)(1)(v)
To ensure the individual needs of children eligible for services under IDEA are met, a
program must work closely with the local agency responsible for implementing IDEA, the
family, and other service partners, as appropriate, to ensure services are provided in a
child’s regular Early Head Start or Head Start classroom or family child care home to the
greatest extent possible.
1302.61 (2)(i)
Plan for Transition Services: For children with an IFSP who are transitioning out of Early
Head Start, collaborate with the parents, and the local agency responsible for
implementing IDEA, to ensure appropriate steps are undertaken in a timely and
appropriate manner to determine the child’s eligibility for services under Part B of IDEA.
1302.61 (2)(ii)
Plan for Transition Services: For children with an IEP who are transitioning out of Head
Start to kindergarten, collaborate with the parents, and the local agency responsible for
implementing IDEA, to ensure steps are undertaken in a timely and appropriate manner to
support the child and family as they transition to a new setting.
1302.62 (a)(1)
Parents of All Children with Disabilities: A program must collaborate with parents of
children with disabilities, including but not limited to children eligible for services under
IDEA, to ensure the needs of their children are being met, including support to help
parents become advocates for services that meet their children’s needs and information
and skills to help parents understand their child’s disability and how to best support the
child’s development.
1302.62 (a)(2)
Parents of All Children with Disabilities: A program must assist parents to access services
and resources for their family, including securing adaptive equipment and devices and
supports available through a child’s health insurance or other entities, creating linkages to
family support programs, and helping parents establish eligibility for additional support
programs, as needed and practicable.
1302.62 (b)(1)
Parents of children eligible for services under IDEA. For parents of children eligible for
services under IDEA, a program must also help parents understand the referral,
evaluation, and service timelines required under IDEA.
1302.62 (b)(2)
Parents of children eligible for services under IDEA. For parents of children eligible for
services under IDEA, a program must also help parents actively participate in the
eligibility process and IFSP or IEP development process with the local agency responsible
for implementing IDEA, including by informing parents of their right to invite the
program to participate in all meetings
1302.62 (b)(3) Parents of children eligible for services under IDEA. For parents of children eligible for
services under IDEA, a program must also help parents understand the purposes and
results of evaluations and services provided under an IFSP or IEP.
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1302.62 (b)(4)
Parents of children eligible for services under IDEA. For parents of children eligible for
services under IDEA, a program must also help parents ensure their children’s needs are
accurately identified in, and addressed through, the IFSP or IEP.
1302.63 (a)
A program must coordinate with the local agency responsible for implementing IDEA to
identify children enrolled or who intend to enroll in a program that may be eligible for
services under IDEA, including through the process described in §1302.33(a)(3) and
through participation in the local agency Child Find efforts.
1302.63 (b).
A program must work to develop interagency agreements with the local agency
responsible for implementing IDEA to improve service delivery to children eligible for
services under IDEA, including the referral and evaluation process, service coordination,
promotion of service provision in the least restrictive appropriate community-based
setting and reduction in dual enrollment which causes reduced time in a less restrictive
setting, and transition services as children move from services provided under Part C of
IDEA to services provided under Part B of IDEA and from preschool to kindergarten.
1302.63 (c)(1)
A program must participate in the development of the IFSP or IEP if requested by the
child’s parents, and the implementation of the IFSP or IEP. At a minimum, the program
must offer to provide relevant information from its screenings, assessments, and
observations to the team developing a child’s IFSP or IEP;
1302.63 (c)(2)
A program must participate in the development of the IFSP or IEP if requested by the
child’s parents, and the implementation of the IFSP or IEP. At a minimum, the program
must offer to participate in meetings with the local agency responsible for implementing
IDEA to develop or review an IEP or IFSP for a child being considered for Head Start
enrollment, a currently enrolled child, or a child transitioning from a program.
1302.63 (d)
A program must retain a copy of the IEP or IFSP for any child enrolled in Head Start for
the time the child is in the program, consistent with the IDEA requirements in 34 CFR
parts 300 and 303.
1302.70 (b)(1)
Timing for transitions. To ensure the most appropriate placement and service following
participation in Early Head Start, such programs must, at least six months prior to each
child’s third birthday, implement transition planning for each child and family that takes
into account the child’s developmental level and health and disability status, progress
made by the child and family while in Early Head Start, current and changing family
circumstances and, the availability of Head Start, other public pre-kindergarten, and other
early education and child development services in the community that will meet the needs
of the child and family.
1302.70 (e) Transition services for children with an IFSP. A program must provide additional
transition services for children with an IFSP, at a minimum, as described in subpart F of
this part.
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1302.71 (b)(1)
Family collaborations for transitions. A program must collaborate with parents of
enrolled children to implement strategies and activities that will help parents advocate for
and promote successful transitions to kindergarten for their children, including their
continued involvement in the education and development of their child.
1302.71 (b)(3)
Family Collaborations for transitions. Prepare parents to exercise their rights and
responsibilities concerning the education of their children in the elementary school setting,
including services and supports available to children with disabilities and various options
for their child to participate in language instruction educational programs.
1302.71 (e)
Transition services for children with an IEP. A program must provide additional
transition services for children with an IEP, at a minimum, as described in subpart F of
this part.
1302.101 (b)(3)
The full and effective participation of all children with disabilities, including but not
limited to children eligible for services under IDEA, by providing services with
appropriate facilities, program materials, curriculum, instruction, staffing, supervision,
and partnerships, at a minimum, consistent with section 504 of the Rehabilitation Act and
the Americans with Disabilities Act.
1303.75 (a)
A program must ensure there are school buses or allowable alternate vehicles adapted or
designed for transportation of children with disabilities available as necessary to transport
such children enrolled in the program. This requirement does not apply to the
transportation of children receiving home-based services unless school buses or allowable
alternate vehicles are used to transport the other children served under the home-based
option by the grantee. Whenever possible, children with disabilities must be transported in
the same vehicles used to transport other children enrolled in the Head Start or Early Head
Start program.
1303.75 (b)
A program must ensure special transportation requirements in a child’s IEP or IFSP are
followed, including special pick-up and drop-off requirements, seating requirements,
equipment needs, any assistance that may be required, and any necessary training for bus
drivers and monitors.
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1305.1 Purpose
The purpose of this part is to define terms for the purposes of this subchapter.
1305.2 Terms.
For the purpose of this subchapter, the following definitions apply:
ACF means the Administration for Children and Families in the Department of Health and
Human Services.
Act means the Head Start Act, Sec. 635 et seq., Pub. L. 97-35, 95 Stat. 499-511 (codified as
amended at 42 U.S.C. Section 9801, et seq.).
Agency means the body that receives the Head Start grant.
Aggregate child-level assessment data means the data collected by an agency on the status and
progress of the children it serves that have been combined to provide summary information about
groups of children enrolled in specific classes, centers, home-based or other options, groups or
settings, or other groups of children such as dual language learners, or to provide summary
information by specific domains of development.
Allowable alternate vehicle means a vehicle designed for carrying eleven or more people,
including the driver, that meets all the Federal Motor Vehicle Safety Standards applicable to
school buses, except 49 CFR 571.108 and 571.131.
Budget period means the interval of time, into which a multi-year period of assistance (project
period) is divided for budgetary and funding purposes.
Case plan is defined as presented in 42 U.S.C. 675(1) which, in summary, is a written document
that must include a number of specified items including, but is not limited to, a plan for safe and
proper care of the child in foster care placement, health records, and a plan for ensuring the
educational stability of the child in foster care.
Child-level assessment data means the data collected by an agency on an individual child from
one or more valid and reliable assessments of a child's status and progress, including but not
limited to direct assessment, structured observations, checklists, staff or parent report measures,
and portfolio records or work samples.
Child records means records that:
(1) Are directly related to the child;
(2) Are maintained by the program, or by a party acting for the program; and
(3) Include information recorded in any way, such as print, electronic, or digital means, including
media, video, image, or audio format.
Child restraint system means any device designed to restrain, seat, or position children that meets the current requirements of Federal Motor Vehicle Safety Standard No. 213, Child Restraint Systems, 49 CFR 571.213, for children in the weight category established under the regulation, or any device designed to restrain, seat, or position children, other than a Type I seat belt as defined at 49 CFR 571.209, for children not in the weight category currently established by 49 CFR 571.213.
Child with a disability is defined in the same manner as presented in the Head Start Act, 42 U.S.C. 9801.
CLASS: Pre-K means The Classroom Assessment Scoring System (CLASS). The CLASS is an observational instrument that assesses classroom quality in preschool through third grade classrooms. This tool meets the requirements described in 641(c)(1)(D) and 641A(c)(2)(F) of the Head Start Act (42 U.S.C. 9836(c)(1)(D) and 9836a(c)(2)(F)). The CLASS assesses three domains of classroom experience: Emotional Support, Classroom Organization,
Child restraint system means any device designed to restrain, seat, or position children that meets
the current requirements of Federal Motor Vehicle Safety Standard No. 213, Child Restraint
Systems, 49 CFR 571.213, for children in the weight category established under the regulation, or
any device designed to restrain, seat, or position children, other than a Type I seat belt as defined
at 49 CFR 571.209, for children not in the weight category currently established by 49 CFR
571.213.
Child with a disability is defined in the same manner as presented in the Head Start Act, 42
U.S.C. 9801.
CLASS: Pre-K means The Classroom Assessment Scoring System (CLASS). The CLASS is an
observational instrument that assesses classroom quality in preschool through third grade
classrooms. This tool meets the requirements described in 641(c)(1)(D) and 641A(c)(2)(F) of the
Head Start Act (42 U.S.C. 9836(c)(1)(D) and 9836a(c)(2)(F)). The CLASS assesses three
domains of classroom experience: Emotional Support, Classroom Organization, and Instructional
Support.
(1) Emotional Support measures children’s social and emotional functioning in the classroom,
and includes four dimensions: Positive Climate, Negative Climate, Teacher Sensitivity
and Regard for Student Perspectives. Positive Climate addresses the emotional connection,
respect, and enjoyment demonstrated between teachers and children and among children.
Negative Climate addresses the level of expressed negativity such as anger, hostility, or
aggression exhibited by teachers and/or children in the classroom. Teacher
Sensitivity addresses teachers’ awareness of and responsivity to children’s academic and
emotional concerns. Regard for Student Perspectives addresses the degree to which teachers’
interactions with children and classroom activities place an emphasis on children’s interests,
motivations, and points of view.
(2) Classroom Organization measures a broad array of classroom processes related to the
organization and management of children’s behavior, time, and attention in the classroom. It
includes three dimensions: Behavior Management, Productivity, and Instructional Learning
Formats. Behavior Management addresses how effectively teachers monitor, prevent, and redirect
behavior. Productivity addresses how well the classroom runs with respect to routines and the
degree to which teachers organize activities and directions so that maximum time can be spent on
learning activities. Instructional Learning Formats addresses how teachers facilitate activities and
provide interesting materials so that children are engaged and learning opportunities are
maximized.
(3) Instructional Support measures the ways in which teachers implement curriculum to
effectively support cognitive and language development. It includes three dimensions: Concept
Development, Quality of Feedback, and Language Modeling. Concept
Development addresses how teachers use instructional discussions and activities to
promote children’s higher order thinking skills in contrast to a focus on rote instruction. Quality
of Feedback addresses how teachers extend children’s learning through their responses
to children’s ideas, comments, and work. Language Modeling addresses the extent to which
teachers facilitate and encourage children’s language.
(4) Assessments with the CLASS involve observation-based measurement of each dimension on
a seven point scale. A score ranging from 1 (minimally characteristic) to 7 (highly characteristic)
is given for each dimension and represents the extent to which that dimension is characteristic of
that classroom. Relevant dimension scores are used to calculate each domain score.
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3) Instructional Support measures the ways in which teachers implement curriculum to
effectively support cognitive and language development. It includes three dimensions: Concept
Development, Quality of Feedback, and Language Modeling. Concept
Development addresses how teachers use instructional discussions and activities to
promote children’s higher order thinking skills in contrast to a focus on rote instruction. Quality
of Feedback addresses how teachers extend children’s learning through their responses
to children’s ideas, comments, and work. Language Modeling addresses the extent to which
teachers facilitate and encourage children’s language.
(4) Assessments with the CLASS involve observation-based measurement of each dimension on
a seven point scale. A score ranging from 1 (minimally characteristic) to 7 (highly characteristic)
is given for each dimension and represents the extent to which that dimension is characteristic of
that classroom. Relevant dimension scores are used to calculate each domain score.
Commercial Driver's License (CDL) means a license issued by a state or other jurisdiction, in
accordance with the standards contained in 49 CFR part 383, to an individual which authorizes
the individual to operate a class of commercial motor vehicles.
Construction means new buildings, and excludes renovations, alterations, additions, or work of
any kind to existing buildings.
Continuity of care means Head Start or Early Head Start services provided to children in a
manner that promotes primary caregiving and minimizes the number of transitions in teachers
and teacher assistants that children experience over the course of the day, week, program year,
and to the extent possible, during the course of their participation from birth to age three in Early
Head Start and in Head Start.
Deficiency is defined in the same manner as presented in the Head Start Act, 42 U.S.C. 9801.
Delegate agency is defined in the same manner as presented in the Head Start Act, 42 U.S.C.
9801.
Development and administrative costs mean costs incurred in accordance with an approved Head
Start budget which do not directly relate to the provision of program component services,
including services to children with disabilities, as set forth and described in the Head Start
program performance standards (45 CFR part 1304).
Disclosure means to permit access to or the release, transfer, or other communication of PII
contained in child records by any means, including oral, written, or electronic means, to any party
except the party identified as the party that provided or created the record.
Double session variation means a center-based option that employs a single teacher to work with
one group of children in the morning and a different group of children in the afternoon.
Dual benefit costs mean costs incurred in accordance with an approved Head Start budget which
directly relate to both development and administrative functions and to the program
component services, including services to children with disabilities, as set forth and described in
the Head Start program performance standards (45 CFR part 1304).
Dual language learner means a child who is acquiring two or more languages at the same time,
or a child who is learning a second language while continuing to develop their first language. The
term "dual language learner" may encompass or overlap substantially with other terms frequently
used, such as bilingual, English language
Enrolled (or any variation of) means a child has been accepted and attended at least one class for
center-based or family child care option or at least one home visit for the home-based option.
Enrollment year means the period of time, not to exceed twelve months, during which a Head
Start program provides center or home-based services to a group of children and their families.
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learner (ELL), Limited English Proficient (LEP), English learner, and children who speak a
Language Other Than English (LOTE).
Early Head Start agency means a public or private non-profit or for-profit entity designated by
ACF to operate an Early Head Start program to serve pregnant women and children from birth to
age three, pursuant to Section 645A(e) of the Head Start Act.
Enrolled (or any variation of) means a child has been accepted and attended at least one class for
center-based or family child care option or at least one home visit for the home-based option.
Enrollment year means the period of time, not to exceed twelve months, during which a Head
Start program provides center or home-based services to a group of children and their families.
Facility means a structure, such as a building or modular unit, appropriate for use in carrying out
a Head Start program and used primarily to provide Head Start services, including services to
children and their families, or for administrative purposes or other activities necessary to carry
out a Head Start program.
Family means all persons living in the same household who are supported by the child’s
parent(s)’ or guardian(s)’ income; and are related to the child’s parent(s) or guardian(s) by blood,
marriage, or adoption; or are the child’s authorized caregiver or legally responsible party.
Federal interest is a property right which secures the right of the federal awarding agency to
recover the current fair market value of its percentage of participation in the cost of the facility in
the event the facility is no longer used for Head Start purposes by the grantee or upon the
disposition of the property. When a grantee uses Head Start funds to purchase, construct or
renovate a facility, or make mortgage payments, it creates a federal interest. The federal interest
includes any portion of the cost of purchase, construction, or renovation contributed by or for the
entity, or a related donor organization, to satisfy a matching requirement.
Federal Motor Vehicle Safety Standards (FMVSS) means the National Highway and Traffic
Safety Administration's standards for motor vehicles and motor vehicle equipment (49 CFR part
571) established under section 30111 of Title 49, United States Code.
Financial viability means that an organization is able to meet its financial obligations, balance
funding and expenses and maintain sufficient funding to achieve organizational goals and
objectives.
Fixed route means the established routes to be traveled on a regular basis by vehicles that
transport children to and from Head Start or Early Head Start program activities, and which
include specifically designated stops where children board or exit the vehicle.
Foster care means 24-hour substitute care for children placed away from their parents or
guardians and for whom the state agency has placement and care responsibility. This includes,
but is not limited to, placements in foster family homes, foster homes of relatives, group homes,
emergency shelters, residential facilities, child-care institutions, and pre-adoptive homes. A child
is in foster care in accordance with this definition regardless of whether the foster care facility is
licensed and payments are made by the state or local agency for the care of the child, whether
adoption subsidy payments are being made prior to the finalization of an adoption, or whether
there is federal matching of any payments that are made.
Full-working-day means not less than 10 hours of Head Start or Early Head Start services per
day.
Funded enrollment means the number of participants which the Head Start grantee is to serve, as
indicated on the grant award.
Going concern means an organization that operates without the threat of liquidation for the
foreseeable future, a period of at least 12 months.
Grantee means the local public or private non-profit agency or for-profit agency which has been
designated as a Head Start agency under 42 U.S.C. 9836 and which has been granted financial
assistance by the responsible HHS official to operate a Head Start program.
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Full-working-day means not less than 10 hours of Head Start or Early Head Start services per
day.
Funded enrollment means the number of participants which the Head Start grantee is to serve, as
indicated on the grant award.
Going concern means an organization that operates without the threat of liquidation for the
foreseeable future, a period of at least 12 months.
Grantee means the local public or private non-profit agency or for-profit agency which has been
designated as a Head Start agency under 42 U.S.C. 9836 and which has been granted financial
assistance by the responsible HHS official to operate a Head Start program
Head Start agency means a local public or private non-profit or for-profit entity designated by
ACF to operate a Head Start program to serve children age three to compulsory school age,
pursuant to section 641(b) and (d) of the Head Start Act.
Head Start Early Learning Outcomes Framework: Ages Birth to Five means the Head Start Early
Learning Outcomes Framework: Ages Birth to Five, which describes the skills, behaviors, and
knowledge that programs must foster in all children. It includes five central domains:
Approaches to Learning; Social and Emotional Development; Language and Literacy; Cognition;
and Perceptual, Motor, and Physical Development. These central domains are broken into five
domains for infants and toddlers and seven domains for preschoolers. Infant and Toddler
domains are Approaches to Learning; Social and Emotional Development; Language and
Communication; Cognition; and Perceptual, Motor, and Physical Development. Preschool
domains are Approaches to Learning; Social and Emotional Development; Language and
Communication; Literacy; Mathematics Development; Scientific Reasoning; and Perceptual,
Motor, and Physical Development. Domains are divided into sub-domains with goals that
describe broad skills, behaviors, and concepts that are important for school
success. Developmental progressions describe the skills, behaviors and concepts that children
may demonstrate as they progress. As described in the Head Start Act, the Framework is central
to program operations that promote high-quality early learning environments (42 U.S.C.
9832(21)(G)(iv)(II)(aa), 42 U.S.C. 9835(o), 42 U.S.C. 9836(d)(2)(C), 42 U.S.C. 9836a(g)(2)(A),
42 U.S.C. 9837(f)(3)(E), 42 U.S.C. 9837a(a)(3), 42 U.S.C. 9837a(a)(14), 42 U.S.C.
9837b(a)(2)(B)(iii), 42 U.S.C. 9837b(a)(4)(A)(i), and 42 U.S.C. 9837b(a)(4)(B)(iii)).
Homeless children means the same as homeless children and youths in Section 725(2) of the
McKinney-Vento Homeless Assistance Act at 42 U.S.C. 11434a (2).
Home visitor means the staff member in the home-based program option assigned to work with
parents to provide comprehensive services to children and their families through home visits and
group socialization activities.
Hours of planned class operations means hours when children are scheduled to attend.
Professional development, training, orientation, teacher planning, data analysis, parent-teacher
conferences, home visits, classroom sanitation, and transportation do not count toward the hours
of planned class operations.
Income means gross cash income and includes earned income, military income (including pay
and allowances, except those described in Section 645(a)(3)(B) of the Act), veteran’s benefits,
Social Security benefits, unemployment compensation, and public assistance benefits. Additional
examples of gross cash income are listed in the definition of “income” which appears in U.S.
Bureau of the Census, Current Population Reports, Series P-60-185 (available
at https://www2.census.gov/prod2/popscan/p60-185.pdf).
Indian Head Start agency means a program operated by an Indian tribe (as defined by the Act) or
designated by an Indian tribe to operate on its behalf.
Individualized Education Program is defined in the same manner as presented in the Individuals
with Disabilities Education Act (20 U.S.C. 1400 et seq.).
Individualized Family Service Plan is defined in the same manner as presented in the Individuals
with Disabilities Education Act (20 U.S.C. 1400 et seq.).
organization may be established under applicable state or federal law.
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Indian Head Start agency means a program operated by an Indian tribe (as defined by the Act) or
designated by an Indian tribe to operate on its behalf.
Indian tribe is defined in the same manner as presented in the Head Start Act, 42 U.S.C. 9801.
Individualized Education Program is defined in the same manner as presented in the Individuals
with Disabilities Education Act (20 U.S.C. 1400 et seq.).
Individualized Family Service Plan is defined in the same manner as presented in the Individuals
with Disabilities Education Act (20 U.S.C. 1400 et seq.).
Legal status means the existence of an applicant or grantee as a public agency or organization
under the law of the state in which it is located, or existence as a private nonprofit or for-profit
agency or organization as a legal entity recognized under the law of the state in which it is
located. Existence as a private non-profit agency or
Major renovation means any individual or collection renovation that has a cost equal to or
exceeding $250,000. It excludes minor renovations and repairs except when they are included in
a purchase application.
Migrant family means, for purposes of Head Start eligibility, a family with children under the age
of compulsory school attendance who changed their residence by moving from one geographic
location to another, either intrastate or interstate, within the preceding two years for the purpose
of engaging in agricultural work and whose family income comes primarily from this activity.
Migrant or Seasonal Head Start Program means: (1) With respect to services for migrant farm
workers, a Head Start program that serves families who are engaged in agricultural labor and who
have changed their residence from one geographic location to another in the preceding 2-year
period; and, (2) With respect to services for seasonal farmworkers, a Head Start program that
serves families who are engaged primarily in seasonal agricultural labor and who have not
changed their residence to another geographic location in the preceding 2-year period.
Minor renovation means improvements to facilities, which do not meet the definition of major
renovation.
Modular unit means a portable prefabricated structure made at another location and moved to a
site for use by a Head Start grantee to carry out a Head Start program, regardless of the manner or
extent to which the modular unit is attached to underlying real property.
National Driver Register means the National Highway Traffic Safety Administration's automated
system for assisting state driver license officials in obtaining information regarding the driving
records of individuals who have been denied licenses for cause; had their licenses denied for
cause, had their licenses canceled, revoked, or suspended for cause, or have been convicted of
certain serious driving offenses.
Parent means a Head Start child's mother or father, other family member who is a primary
caregiver, foster parent or authorized caregiver, guardian or the person with whom the child has
been placed for purposes of adoption pending a final adoption decree.
Participant means a pregnant woman or child who is enrolled in and receives services from a
Head Start, an Early Head Start, a Migrant or Seasonal Head Start, or an American Indian and
Alaska Native Head Start program.
Personally identifiable information (PII) means any information that could identify a specific
individual, including but not limited to a child’s name, name of a child’s family, member, street
address of the child, social security number, or other information that is linked or linkable to the
child.
Program means a Head Start, Early Head Start, migrant, seasonal, or tribal program, funded
under the Act and carried out by an agency, or delegate agency, to provide ongoing
comprehensive child development services.
Program costs mean costs incurred in accordance with an approved Head Start budget which
directly relate to the provision of program component services, including services to children
with disabilities, as set forth and described in the Head Start Program Performance Standards (45
CFR part 1304).
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Program means a Head Start, Early Head Start, migrant, seasonal, or tribal program, funded
under the Act and carried out by an agency, or delegate agency, to provide ongoing
comprehensive child development services.
Program costs mean costs incurred in accordance with an approved Head Start budget which
directly relate to the provision of program component services, including services to children
with disabilities, as set forth and described in the Head Start Program Performance Standards (45
CFR part 1304).
Purchase means to buy an existing facility, including outright purchase, down payment or
through payments made in satisfaction of a mortgage or other loan agreement, whether principal,
interest or an allocated portion principal and/or interest. The use of grant funds to make a
payment under a capital lease agreement, as defined in the cost principles, is a purchase subject to
these provisions. Purchase also refers to an approved use of Head Start funds to continue paying
the cost of purchasing facilities or refinance an existing loan or mortgage beginning in 1987.
Real property means land, including land improvements, buildings, structures and all
appurtenances thereto, excluding movable machinery and equipment.
Recruitment area means that geographic locality within which a Head Start program seeks to
enroll Head Start children and families. The recruitment area can be the same as the service area
or it can be a smaller area or areas within the service area.
Relevant time period means: (1) The 12 months preceding the month in which the application is
submitted; or (2) During the calendar year preceding the calendar year in which the application is
submitted, whichever more accurately reflects the needs of the family at the time of application.
Repair means maintenance that is necessary to keep a Head Start facility in working condition.
Repairs do not add significant value to the property or extend its useful life.
Responsible HHS official means the official of the Department of Health and Human Services
who has authority to make grants under the Act.
School readiness goals mean the expectations of children's status and progress across domains of
language and literacy development, cognition and general knowledge, approaches to learning,
physical well-being and motor development, and social and emotional development that will
improve their readiness for kindergarten.
School bus means a motor vehicle designed for carrying 11 or more persons (including the driver)
and which complies with the Federal Motor Vehicle Safety Standards applicable to school buses.
Service area means the geographic area identified in an approved grant application within which
a grantee may provide Head Start services.
Staff means paid adults who have responsibilities related to children and their families who are
enrolled in programs
Termination of a grant or delegate agency agreement means permanent withdrawal of the
grantee's or delegate agency's authority to obligate previously awarded grant funds before that
authority would otherwise expire. It also means the voluntary relinquishment
the grantee or delegate agency. Termination does not include:
(1) Withdrawal of funds awarded on the basis of the grantee's or delegate agency's underestimate
of the unobligated balance in a prior period;
(2) Refusal by the funding agency to extend a grant or award additional funds (such as refusal to
make a competing or noncompeting continuation renewal, extension or supplemental award);
(3) Withdrawal of the unobligated balance as of the expiration of a grant;
(4) Annulment, i.e., voiding of a grant upon determination that the award was obtained
fraudulently or was otherwise illegal or invalid from its inception.
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of that authority by the grantee or delegate agency. Termination does not include:
(1) Withdrawal of funds awarded on the basis of the grantee's or delegate agency's underestimate
of the unobligated balance in a prior period;
(2) Refusal by the funding agency to extend a grant or award additional funds (such as refusal to
make a competing or noncompeting continuation renewal, extension or supplemental award);
(3) Withdrawal of the unobligated balance as of the expiration of a grant;
(4) Annulment, i.e., voiding of a grant upon determination that the award was obtained
fraudulently or was otherwise illegal or invalid from its inception.
Total approved costs mean the sum of all costs of the Head Start program approved for a given
budget period by the Administration for Children and Families, as indicated on the Financial
Assistance Award. Total approved costs consist of the federal share plus any approved non-
federal match, including non-federal match above the statutory minimum.
Transition period means the three-year time period after December 9, 2011, on the Designation
Renewal System during which ACF will convert all of the current continuous Head Start and
Early Head Start grants into five-year grants after reviewing each grantee to determine if it meets
any of the conditions under §1304.12 that require recompetition or if the grantee will receive its
first five-year grant non-competitively.
Transportation services means the planned transporting of children to and from sites where an
agency provides services funded under the Head Start Act. Transportation services can involve
the pick-up and discharge of children at regularly scheduled times and pre-arranged sites,
including trips between children's homes and program settings. The term includes services
provided directly by the Head Start and Early Head Start grantee or delegate agency and services
which such agencies arrange to be provided by another organization or an individual. Incidental
trips, such as transporting a sick child home before the end of the day, or such as might be
required to transport small groups of children to and from necessary services, are not included
under the term.
Verify or any variance of the word means to check or determine the correctness or truth by
investigation or by reference.
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The CSI Disabilities Service Area uses the following plan to assure that all educational and transition
requirements of the Head Start Performance Standards are met for all children and families. The
Disabilities Specialist, Center Coordinators/Lead Teachers, and teaching staff will work in coordination
with other service area staff, school principals, other district staff, parents, and community partners to
provide a holistic and complete array of services for Head Start children.
Activity Timeframe Responsibility Documentation
1. Designate a coordinator of
services to children with
disabilities and their families
who will update the plan as
needed in conjunction with
parents, and relevant
coordinators
1302.6
August -May Head Start Director Program
Organization
Chart
Disabilities
Plan
2. Ensure enrolled children with disabilities, including but not limited to those who are eligible for services under IDEA, and their families receive all applicable program services delivered in the least restrictive possible environment and that they fully participate in all program activities.
1302.60, 1302.61(a)(b)
August -May Disabilities Specialist
Teaching Staff
Disabilities Specialist
Disabilities
Plan
Lesson plans
Individual
Child Plan
“
3. The full and effective participation
of all children with disabilities,
including but not limited to
children eligible for services under
IDEA, by providing services with
appropriate facilities, program
materials, curriculum, instruction,
staffing, supervision, and
partnerships, at a minimum,
consistent with section 504 of the
Rehabilitation Act and the
Americans with Disabilities Act;.
1302.101 b (3)
August -May Disabilities Specialist
Other Service Area
Staff
Case
conference
notes,
IEP goals,
Lesson plans
Specialized
Facitlites/equip
ment
4. In collaboration with each child’s
parent and with parental consent, a
program must complete or obtain a
current developmental screening to
identify concerns regarding a
child’s developmental, behavioral,
motor, language, social, cognitive,
and emotional skills.
1302.33 (a)(1-3), (b) (1-2), (c) (1)
Within 45 days
of entry into program
Disabilities Specialist
Education Specialist
QAMs
Education Staff
Dial-4
Tool
Ages & Stages
Tool
Anecdotals
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Activity Timeframe Responsibil
ity Documentation
5. Referral to the local agency
responsible for implementing IDEA
for a formal evaluation to assess the
child’s eligibility for services under
IDEA as soon as possible, and not to
exceed timelines required under
IDEA. 1302.33 (3)(i), 1302.33 (b)(3)
30 days of
initial
screening &
evaluation
completed
within 60
days after
obtaining
parental
consent for
full
evaluation by
LEA
Disabilities
Specialist
Center
Coordinators/
Lead Teachers
Program Organization
Chart
Disabilities Plan
Referral to LEA
6. Programs must provide any necessary
modifications to the environment,
multiple and varied formats for
instruction, and individualized
accommodations and supports as
necessary to support the full
participation of children with
disabilities. 1302.61 (a), 1302.62
(a)(1-2)
Ongoing Disabilities
Specialist
Facilities
Specialist
Teaching
Teams
Center
Coordinators/
Lead Teachers
Quality
Assurance
Monitors
Local
Education
Agency
Babies Can’t
Wait
Disabilities Plan
Lesson plans
Individual Child
Plan
Health Plans
Individual training
notes
7. Plan and implement the transition
services for children with an IFSP
who are transitioning out of Early
Head Start, or for children with an IEP
who are transitioning out of Head
Start to kindergarten, or from other
programs to Head Start. 1302.61
(c)(2)(i)(ii), 1302.63 (c) (2)
Update
yearly
Disabilities
Specialist
Education
Specialist
Teaching Teams
LEA Personnel
Babies Can’t
Wait
Case conference
notes,
IEP goals,
Lesson plans
Individualized Service
Plan
Health Plans if necessary
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Activity Timeframe Responsibility Documentation
8. To ensure the individual needs of
children eligible for services under
IDEA are met, a program must work
closely with the local agency
responsible for implementing IDEA,
the family, and other service
partners, as appropriate. 1302.61 (c)(1)(i)(ii)(iii)(iv)(v)
Within 30
days of
completion of
an IEP
Disabilities
Specialist
LEA Personnel
Teaching Staff
Babies Can’t
Wait Personnel
Classroom Inventory
Checklist Financial Receipts Meeting notes and
agenda Updated Transition
Plans Information sent
to receiving schools Parent contact notes
9. A program must work to develop
interagency agreements with the
local agency responsible for
implementing IDEA to improve
service delivery to children eligible
for services under IDEA, including
the referral and evaluation process,
service coordination, promotion of
service provision in the least
restrictive appropriate community-
based setting and reduction in dual
enrollment which causes reduced
time in a less restrictive setting, and
transition services as children move
from services provided under Part C
of IDEA to services provided under
Part B of IDEA and from preschool
to kindergarten.
1302.63 (b)
Ongoing Disabilities
Specialist
Education
Specialist
LEA Personnel
Babies Can’t Wait
Personnel
Signed and updated Interagency Agreements
IEP/IFSP
10. The community assessment must use
data that describes community
strengths, needs, and resources and
include, at a minimum the number of
eligible infants, toddlers, preschool age
children, and expectant mothers,
including their geographic location,
race, ethnicity, and languages they
speak, including Children with
disabilities, including types of
disabilities and relevant services and
resources provided to these children by
community agencies.
1302.11 (b)(i)(c)
April/May Head Start Director
Mental Health
Counselor
Disabilities
Specialist Family
Advocate Specialist
Family Advocates
PIR report
Childplus data
IEP/IFSP files
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Activity Timeframe Responsibility Documentation
11. Eligibility
Establishes and implements outreach, and enrollment
policies and procedures to ensure it is meeting the needs of
eligible pregnant women, children, and children with
disabilities, before serving
pregnant women or children who do not meet the criteria in
paragraph (c) of this selection. 1302.12 (d)(1)(i),
Ongoing Disabilities
Specialist
Family Advocate
Specialist
Family Advocates
Other Specialist in
different areas
Grid for Points
System
IEP/IFSP
documentation
Flyers
Newspaper articles
Interagency
agreements/
interactions
Board Meeting
Minutes
12. In order to reach those most in
need of services, a program must develop and implement a
recruitment process designed to actively inform all families with
eligible children within the
recruitment area of the availability of program services,
and encourage and assist them in applying for admission to the
program. A program must
include specific efforts to actively locate and recruit
children with disabilities and other vulnerable children,
including homeless children and children in foster care.
1302.13
Ongoing Disabilities Specialist
Family Advocate
Specialist
Family Advocates
Other Specialists
Flyers
Newspaper
articles
Community
meetings
Interagency
Agreements
13. A program must offer opportunities for parents and family members to be involved in the program’s education services and implement policies to ensure teachers inform parents, about the purposes of and the results from screenings and assessments and discuss their child’s progress.
1302.34 (b)(6)
Screening
within 45
days of
child’s first
day of
classroom
attendance
Education Specialist
Disabilities Specialist
Quality Assurance
Monitors
Teaching Staff
Dial-4 form
Ages &
Stages form
Center/Home visit
forms
Authorizations
Notification of
Screening Form
Results of
Screening Form
Parental Consent
for Referral
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Activity Timeframe Responsibility Documentation
14. A program must train all
governing body, policy council,
management, and staff who
determine eligibility on applicable
federal regulations and program
policies and procedures at a
minimum to incorporate strategies
for treating families with dignity
and respect and for dealing with
possible issues of domestic
violence, stigma, and privacy.
1302.12 (m)(1) (ii)
90 days for
new staff
determining
eligibility,
within 180
days for
governing
body and
policy
council
members at
the
beginning
term of a
new
governing
body or
policy
council
Head Start Director Disabilities Specialist Family Advocate Specialist All Specialists in all areas of Head Start
Swearing in
of
members/minutes
Confidentiality signed form
Training
agenda/Sign in
sheet
15. Extended follow-up care. A
program must facilitate further
diagnostic testing, evaluation,
treatment, and follow-up plan, as
appropriate, by a licensed or
certified professional for each
child with a health problem or
developmental delay, such as
elevated lead levels or abnormal
hearing or vision results that may
affect child’s development,
learning, or behavior.
1302.42 (d)(1)
Within the first
45 days of
child’s first day
of classroom
time
Health Specialist Disabilities/Mental Health Specialist Family Advocate Specialist Mental Health Counselor All Specialists in all areas of Head Start
In-house referrals
LEA referrals
BCW referrals Mental
Health notes
16. A program must develop a system to track referrals and services
provided and monitor the implementation of a follow-up plan to meet any treatment needs associated with a health, oral health, social and emotional, or developmental problem.
1302.42 (d)(2)
Ongoing Health Specialist Disabilities/Mental Health Specialist Family Advocate Specialist Mental Health Counselor All Specialists in all areas of Head Start
In-house referrals
LEA referrals
BCW referrals
Mental Health
notes/follow ups
IEP/IFSP
Childplus Mental
Health REferrals
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Activity Timeframe Responsibility Documentation
17. A program must assist parents, as
needed, in obtaining any
prescribed medications, aids or
equipment for medical and oral
health conditions.
1302.42 (d)(3)
Ongoing Head Start Director
Health Specialist
Disabilities
Specialist
All Teaching Staff
Receipt of
prescriptions
from doctor
Receipt of
payment for items
18. A program must participate in the
development of the IFSP or IEP if
requested by the child’s parents,
and the and the implementation
of the IFSP or IEP; to provide
relevant information from its
screenings, assessments, and
observations to the team and to
participate in meetings with the
LEA responsible for
implementing IDEA to develop or
review an IEP or IFSP for a child
being considered for Head Start
enrollment, a currently renrolled
child, or a child transitioning from
a program.
1302.63 (c)(1)(2)
Ongoing/At
enrolment
Health Specialist
Family Advocates
Disabilities
Specialist
All Teaching Staff
Periodic
physical exams
of child
In-house
referrals
Anecdotal notes
on each child
Health
observati
ons daily
Parent
Authoriz
ation
19. A program must ensure there are school buses or allowable alternate vehicles adapted or designed for transportation of children with disabilities available as necessary to transport such children enrolled in the program. This requirement does not apply to the transportation of children receiving home-based services unless school buses or allowable alternate vehicles are used to transport the other children served under the home-based option by the grantee. Whenever possible, children with disabilities must be transported in the same vehicles used to transport other children enrolled in the Head Start or Early Head Start program.
1303.75 (a)
Ongoing Facilities Specialist
Disabilities Specialist
Head Start Director
Center
Coordinator/Lead
Teachers
Teaching Staff
IEP/IFSP Interagency
Agreements
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20. A program must ensure special transportation requirements in a child’s IEP or IFSP are followed, including special pick-up and drop-off requirements, seating requirements, equipment needs, any assistance that may be required, and any necessary training for bus drivers and monitors.
1303.75 (b)
Ongoing Facilities Specialist
Disabilities Specialist
Center
Coordinator/Lead
Teachers
Teaching Staff
IEP/IFSP
Interagency
Agreement
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Subject: Disability Services Written Plan
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council, Executive Board __________________________________________________________________________________
POLICY: The Program develops, maintains, and updates annually a Disability Services Plan
which provides strategies for meeting the special needs of children with disabilities.
PROCEDURE: The Disability Specialist, working and consulting with Program supervisors,
teachers, and parents will review the Disability Service Plan. The Plan is to assure that:
1. All areas of child and family services within the Head Start Program are appropriately involved
in the integration of services to children with disabilities.
2. That all available resources are used in the provision of services
3. The plan contains:
a. Timeline of screening for children.
b. Procedures for making referrals to LEA for evaluation.
c. Assurance of accessibility to facilities.
d. Plan to provide appropriate equipment and materials if needed.
e. Assurances that confidentiality of records is maintained.
f. Guidelines and strategies for fulfillment of the Federal mandate to dedicate 10% of the yearly
funded enrollment to children with IEPs/IFSPs.
g. Head Start/early Head Start Policies and Procedures for the inclusion of children with
disabilities are consistent with current Federal and State mandates. These include section 504 of
the Rehabilitation Act of 1976 (PL 93-112); Americans with Disabilities Act (PL 101-336); and
Individuals with Disabilities Education Improvement Act of 2004 (IDEA) (PL 108-446) including
free and appropriate public education; equal access to core curricula (developmentally appropriate
practices); and accommodations and modifications necessary for a child with an IEP/IFSP to
participate in an identical preschool experience for his/her typically developing peers.
h. Head Start/Early Head Start Programs have interagency agreements which offer children with
disabilities and their families options for services. This includes the special services provided by
LEAs.
i. Head Start/Early Head Start Programs provides identical approaches for integrating instruction,
health, mental health, and nutrition services for ALL children.
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Subject: Parental Consent for Participation during IEP/IFSP Process Section: Disabilities
Program: Head Start/ Early Head Start
Approved: Executive Director, Policy Council, Executive Board
----------------------------------------------------------------------------------------------------------------------- POLICY: A program must participate in the development of the IFSP or IEP if requested by the child’s parents, and the and the implementation of the IFSP or IEP; to provide relevant information from its screenings, assessments, and observations to the team and to participate in meetings with the LEA responsible for implementing IDEA to develop or review an IEP or IFSP for a child being considered for Head Start enrollment, a currently reenrolled child, or a child transitioning from a program.
Procedures;
1. During first home visits or center visits, the parent will initial the area for Head
Start staff to be able to participate fully in the IEP and IFSP process with the LEA on
the Parent Authorization form located in the Family Services policies and procedures
(FCP 621).
2. The lead teacher or center coordinator will collect these parental authorizations
(FCP 621) and make two copies and give them back to the teachers for their files.
3. One copy will go to the family advocates responsible for the classrooms and the
other copy will go to the Disabilities Specialist.
4. Family advocates will upload the copy into Child plus program as an attachment in
the Disabilities tab.
5. The family advocates will keep a copy in a classroom file in case of technical
difficulties.
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Subject: Screening Referrals
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council
Executive Board
POLICY: In collaboration with each child’s parent and with parental consent, a program
must complete or obtain a current developmental screening to identify
concerns regarding a child’s developmental, behavioral, motor, language,
social, cognitive, and emotional skills.
PROCEDURE:
1. For the centers where the School System/Private Speech and Language Pathologist
complete a mass speech and language screening:
a. Speech and language screening will take place within 45 calendar days of enrollment.
b. The Education Specialist and/or Disabilities Specialist will monitor the completion
of the screening process.
c. When it is determined that more extensive examinations are needed, the Speech/
Language Pathologist (private or with the school system) will ensure the consent
to evaluate is signed by the parent/ guardian.
d. If the child PASSES the speech screener and the teacher and/or parent still have a
concern, the child can still be referred for an evaluation. The teacher would
complete an In-House Referral Form (EHS 205) and submit it to the Center
Coordinator/Lead Teacher who will document the concern and direct
interventions using the Individualized Service Plan (if child has multiple
developmental delays or disabilities and if a child was not eligible for services
via BCW or LEA but showing concerns or delays after the LEA or BCW
evaluation) while referring the child for an evaluation from the LEA/BCW. The
Center Coordinator/Lead Teacher will distribute a copy of In-House Referral
Form and Referral for Special Services form signed by parent to the Disabilities
Specialist, the Family Advocates and have the original placed in the child’s
education file.
2. For the centers where the school system/private SLP does not complete the Speech
screening, the DIAL-4 language test score will be used.
3. For Early Head Start, the Ages and Stages screener will be used.
4. Place a copy of the screening tool in the child’s file.
a. DIAL-4 for Head Start; Pre-K; and those EHS enrollees who are 2years 6 months
or older.
b. Ages & Stages for Early Head Start enrollees who are younger than 2 years
6 months.
5. Complete the DIAL-4 Classroom Profile.
6. Share the screening results with the Parent/Guardian, Disabilities Specialist and the
Education Specialist.
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Head Start DIAL-4 Classroom Profile
Center: Room Number: Classroom Staff:
Child Information 45 Day Mandate/Rescreener
Name
Age as of
DOS
Yr-Mth
(e.g. 4-3)
Date DIAL
Score
DIAL
P/F
Language
P/F
Abbreviation Codes: DOS – Date of Screening P/F – Pass or Fail
If child failed screening, submit referral for evaluation by Local Education Agency/LEA.
Original Copy to Disabilities Copy Kept in Classroom
Revised 06/05/2017 Disabilities
EHS 318 D-3a
CSI Head Start Program
Subject: Parental Consent for Initial Evaluation Section: Disabilities
Program: Head Start/ Early Head Start
Approved: Executive Director, Policy Council,
POLICY:
Written permission from the child’s parent or guardian will be obtained prior to:
a. Obtaining additional screening
b. Completing an evaluation/assessing need for special services
PROCEDURE:
THIS IS TO BE USED. YOUR LEA/PART B AND BCW/PART C HAS THEIR OWN FORM
THEY WILL GET SIGNED FOR CONSENT TO EVALUATE. JUST MAKE SURE YOU
GET A COPY OF THE IEP/IFSP.
1. The Center Coordinator/Lead Teacher will complete the top portion of the “Parental
Consent for Special Services” form and then will:
a. Inform parent why further testing is needed. (ex: child scored potentially delayed
on DIAL-4).
b. Have the parent review the “Parental Consent for Evaluation” form. (EHS 301).
c. Let the parent know that he/she will be invited to a meeting to discuss the results
of his/her evaluation.
2. The Parental Consent will be completed:
**Remember only when a child is being referred to a private therapist.
a. After screening has been completed and it is determined that the child needs an
additional screening/evaluation.
b. Within two weeks after receiving the referral (including in-house referrals).
c. The Center Coordinator/Lead Teacher will file a copy in the child’s file, a copy to
the Classroom Teacher, and a copy to the Disabilities Specialist. The original will
be given to the referring agency.
06/05/2017 Disabilities
D-4
CSI Head Start Program
PARENTAL CONSENT INITIAL EVALUATION OF SPEECH SERVICES
Date: _____
Child's name:
Parent's name:
Center: _____
Dear Parent:
We would like to evaluate your child to determine if he/she may need speech services that are
available through Head Start. We believe that an evaluation is needed for educational planning.
The evaluator(s) who works with your child will use tests in the following checked areas:
( ) Speech/Language
The following agency will be evaluating your child:
Agency/Contact Person Name: ____________________________________________________
Address: _____________________________________________________________________
Phone: _______________________________________________________________________
You may agree or disagree to have your child evaluated, but your decision must be
clearly indicated on the bottom of this form and signed by you.
************************************************************************
Your written permission is required in order to conduct an evaluation. I have read or have read
to me this letter requesting permission to evaluate my child (name):
Check one below:
( ) I give my consent for the agency listed above to evaluate my child.
( ) I do not give my consent for the following reason _____________
( ) I give my consent to release my child's records to the agency listed above.
( ) I do not give my consent to release my child's records to the agency listed above.
Parent/Legal Guardian Signature Date
Revised 06/01/2017 Disabilities EHS 301 D-4a
CSI Head Start Program
Subject: Services during IDEA eligibility determination Section: Disabilities
Program: Head Start/ Early Head Start
Approved: Executive Director, Policy Council, Executive Board
Policy: When such supports are not available through alternate means, pending the
evaluation results and eligibility determination, a program must individualize
program services based on available information such as parent input and
child observation and assessment data and may use program funds for these
purposes.
Procedures:
1. When a child has a potential delay or has failed the overall DIAL-4 Assessment
tool, or has all gray in the areas of the Ages & Stages screening tool for Early Head
Start, teaching staff will individualize on the lesson plan according to the child’s
defiencies and until a complete evaluation has been completed by the LEA or BCW
program if only one concern has been identified.
2. IF the child has mutliple delays and concerns, the “Individualized Service Plan” is
to be used and attached to lesson plan.
3. IF the child does not qualify for services from the LEAs and/or Babies Can’t Wait
program and concerns are still apparent, this Individualized Service Plan will
remain in effect for the child to concentrate on the isolated areas of concerns.
When/IF the child catches up to the correct developmental age in all areas, the
Individualiztion Form will no longer be used. The Teaching Strategies Gold
assessments will be used to monitor the progress.
4. IF the child does not need the use of the Individualization Service Plan any
longer, a copy of documentation of child’s progress in Teaching Strategies Gold
and a signed letter from the teacher will be sent to the Disabilities Specialist
and Education Specialist.
06-01-2017 Disabilities
D-5
CSI Head Start Program
Individualized Service Plan
Child’s Name: ___________________________ Date: _______________________________
Teacher will write in activities to correspond with the goals in each area of delay and/or
concern.
Goals:_________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Teacher’s Signature: _________________________________________________________
Days of the Week Cognitive Motor Social/Emotional Language Adaptive Monday
Tuesday
Wednesday
Thursday
Friday
06-01-2017 Disabilities
D-5a
CSI Head Start Program
Subject: Parental Rights in Special Education
Program: Head Start
Section: Disabilities
Approved: Executive Director, Policy Council,
Executive Board
Policy:
It is the policy of CSI Head Start to provide parents a copy of Parental Rights and make sure they
understand them if LEA has not given them a copy during the IEP eligibility meeting or
beforehand.
PROCEDURE:
1. When the Local Education Agency (LEA), the public school is coordinating the IEP
meeting, they will send home the Parental Rights with their notice of the IEP meeting
and/or give them to the parents while explaining them to the parents at the IEP meeting.
06-01-2017 Disabilities D-6
CSI Head Start Program
Dear Parents:
As a parent of a child who is receiving special services benefits, you have certain rights that are
protected by state of federal law. We want you to know your rights. Your rights are attached in
outline form under eight headings.
For a further explanation of these rights, you may contact the Disabilities Specialist at the
following address:
Disabilities Specialist
Concerted Services, Inc. Head Start
2100 Riverside Avenue
Waycross, GA 31501
Phone: 912-285-6083
Cordially,
Disabilities Specialist
06-01-2017 Disabilities
D-6a
CSI Head Start Program
Parental Rights
YOUR RIGHTS AS PARENTS- REGARDING SPECIAL EDUCATION
CONCERTED SERVICES, INC. HEAD START
As a parent of a child who has been referred for special education services or who is already
receiving special education benefits, you and your child have certain rights, which are protected
by state or federal law. We want you to know about these rights.
RECORDS:
1. Right to examine all records relating to your child without unnecessary delay after
parents‟ request and before any meeting regarding an IEP or hearing and, in no
case, more than 45 days after request.
2. Right to have a representative appointed by you to review the records.
3. Right to request that the agency provide copies of the records if failure to provide those
copies would effectively prevent that parent from exercising the right to inspect and
review the records.
4. Right to have the agency presume that a parent has authority to inspect and review
records of his or her child unless agency has been advised that parent does not
have authority under state law.
5. Right to inspect and review only the information relating to their child if any education
record includes information on more than one child.
6. Right to have the public agency keep a record of parties obtaining access to education
records collected, maintained or used under this part ( except access by parents and
authorized employees of the participating agency), including the name of the party, the
date access was given, and the purpose for which the party is authorized to use the
records.
7. Right to have the participating agency search for or retrieve information without charge.
8. A parent may be charged a fee for copies of records, which are made for parents if the fee
does not effectively prevent the parents from exercising their right to inspect and review
those records.
9. Right to be informed of all types and locations of records being collected, maintained or
used by the agency.
10. Right to ask for an explanation of any item in the records.
11. Right to ask for an amendment of any record if it is inaccurate, misleading or violates the
privacy or other rights of the child.
12. Right to be informed of refusal and right to a hearing if the agency refuses to make the
requested amendment.
13. Right to have the agency decide whether to amend the information within, a reasonable
time after being asked to do so.
14. Right to be informed if the agency decides in a hearing that the information is inaccurate,
is leading or violates the child’s rights and the right to have the record amended.
15. Right to be informed of the parents‟ right to place a statement in the record commenting
on information or setting forth the parents‟ reasons for disagreeing with the agency
decision if it is decided in a hearing that information need not be amended.
06/01/2017 Disabilities
D-6b
CSI Head Start Program
Parental Rights
Page 2
16. Right to have the parents‟ explanation maintained in the record as long as the
contested record is maintained.
17. Right to have the parents‟ explanation disclosed if the contested record is disclosed.
CONFIDENTIALITY OF INFORMATION
1. Right to restrict access to your child’s records by withholding consent to disclose records.
2. Right to be notified and receive copies before information in your child’s file is
destroyed.
3. Right to be told to whom information has been disclosed,
4. Right to review and receive copies of all information sent to another agency where
your child seeks or is eligible to enroll.
INDEPENDENT EVALUATION:
1. Right to obtain an independent evaluation by a qualified examiner.
2. Right to have the independent evaluation obtained at either public or private expense
considered in either meetings where placement or program decisions are made or in
a hearing regarding a free appropriate public education.
3. Right to be told where an independent evaluation may be obtained at no expense or low
expense.
4. Right to an independent evaluation at public expense under the same criteria as those
used by the public agency under which the evaluation is obtained, including the location
of the evaluation if you disagree with the agency's evaluation, exempt that the public
agency has the right to initiate a hearing regarding the a free appropriate public
education to show that its evaluation is appropriate.
5. Right to an independent evaluation at public expense when the evaluation is requested by
a hearing officer during a hearing. "Evaluation" means procedures used in accordance
with Paragraph 300.530-300-534 to determine whether a child has a disability and the
nature and extent of the special education and related services that the child needs. This
term means procedures used 'electively with an individual child and does not include
basic tests administered to or procedures used with all children in a school, grade, or
class. "Independent educational evaluation" means an evaluation conducted by a
qualified examiner who is not employed by the public agency responsible for the
education of the child in question. "Independent educational evaluation at Public
expense" means that the public agency either pays for the full cost of the evaluation or
ensures that the evaluation is otherwise provided at no cost to the parent.
06-01-2017 Disabilities D-6b
CSI Head Start Program
Parental Rights
Page 3
NOTICE:
1. Right to be notified and present at all meetings before the agency initiates or changes (or
refuses to initiate or change) the identification, evaluation, placement or provision of a
free appropriate public education.
2. Right to have that notice in writing, in your native language, or other principal mode of
communication, at a level understandable to the general public.
3. Right to have the notice describe the proposed action, explain why it is proposed,
describe the options considered and explain why those other options were rejected.
4. Right to be notified of each evaluation procedure, tests record or report the agency
has used as a basis for any agency proposed action or basis for refusal.
5. Right to a description of any other factors, which are relevant to the agency's
proposed action or basis for refusal. 6. Right to be present at all IEP meetings.
7. Right to a notice that includes a full explanation of all the procedural safeguards available
to the parents.
8. Right of a parent, whose native language or other mode of communication is not a written
language, to have the notice translated orally or by other means in his or her native
language or other mode of communication; the right to understand the content of the
notice; and the right to written evidence that these requirements have been met.
9. Right to be notified of sources to contact to obtain assistance in understanding provisions
of Part B of the IDEA.
CONSENT:
1. Right to give consent before a pre-placement evaluation or a re-evaluation is conducted,
2. Right to give consent before initial placement can be made in special education.
3. Right to a description of the activity for which consent is requested including a list of
records (if any) which will be released and to whom.
4. Right to revoke consent at any time.
5. Right of the agency to proceed, in the absence of consent, to a hearing to determine if
your child should be evaluated or initially placed. Except for pre-placement evaluation,
reevaluation, and initial placement, consent may not be required as a, condition of any
benefit to the parent or child. "Consent" means that:
a. The parent has been fully informed of all information relevant to the activity for
which consent is sought, in his or her native language or other mode of
communication;
b. The parent understands and agrees, in writing, to the carrying out of the activity
for which his or her consent is sought, and the consent describes that activity and
lists the records (if any) which will be released and to whom; and
c. The parent understands that the granting of consent is voluntary on the part of the
parent and may be revoked at any time.
06/01/2017 Disabilities D-9
06-01-2017 Disabilities D-6b
CSI Head Start Program
Parental Rights
Page 4
HEARINGS:
1. Right to present complaints with respect to any matter relating to the identification,
evaluation, or educational placement of your child, or the provision of a free appropriate
public education to your child, The complaint must include the name of the child, the
address of the residence of the child, the name of the school the child is attending, a
description of the nature of the problem of the child relating to such proposed initiation
or change, including facts relating to such problem, and a proposed resolution of the
problem to the extent known and available to you at the time.
a. Right to present complaints if you disagree with a determination of the evaluator
that your child's behavior was not a manifestation of your child's disability.
b. Right to mediation and/ or an impartial due process hearing whenever you file a
complaint as described in 1 of the sections and to an expedited due process
hearing whenever you file a complaint as described in 1a of this section.
2. Right to be told of any free or low-cost legal and other relevant services available (e.g.,
an expert on disability conditions that may be a witness at the hearing when parent
request information or parent or agency initiates a hearing),
3. Right to a hearing conducted by the state educational agency.
4. Right to have the hearing chaired by a hearing officer who is not employed by a public
agency involved in the education of your child or otherwise personally or professionally
interested in the hearing (the hearing officer is not an employee of the agency solely
because he or she is paid by the agency to serve as a hearing officer).
5. Right to a list of the persons who serve as hearing officers, including a statement of the
qualifications of each of those persons.
6. Right of parents or parties to be advised and accompanied at the hearing by counsel and
to be accompanied by individuals with special knowledge or training in problems of
the disabled.
7. Right to have your child present.
8. Right to have the hearing opened to the public.
9. Right of parents or parties to present evidence and confront, cross-examine and compel
the attendance of witnesses.
10. Right of parents or parties to prohibit the introduction of any evidence at the hearing that
has not been disclosed at least five days before the hearing.
11. Right of parents to have a written or, at the option of the parent, electronic verbatim
record of the hearing.
12. Right of parents or parties to obtain written or, at the option of the parents, electronic
findings of facts and decisions within 45 days after the local education agency received
the initial request for the hearing, except that the hearing officer may grant a specific
extension of time at the request of either party.
06-01-2017 Disabilities
D-6b
CSI Head Start Program
Parental Rights
Page 5
13. Right of parents or parties to a final decision made by the hearing officer, unless a
party brings a, civil action.
14. Right to have a hearing or an appeal set at a time and place reasonably convenient to you
and your child,
15. Right of aggrieved parents or parties to appeal the decision of the hearing officer by
bringing a, civil action in state or federal court.
16. Right to have your child remain in his or her present educational placement until
completion of all hearing and appeal proceedings, unless you and the agency agree
otherwise.
17. Might to have child remain in his/her present educational placement until the completion
of all the proceedings,
18. Under the Disabled Children's Protection Act, P,L, 99-372 [20 [Y.S.C. 1415(e)(4)(B)),
parents who prevail in a due process hearing or a court action may recover attorney's
fees and costs as ordered by the court, Attorney's fees and costs in such cases cannot be
awarded by regional or state hearing officers.
19. At least five (5) business days prior to a hearing conducted pursuant to paragraph (1),
each party shall disclose to all other parties all evaluations completed by that date and
recommendations based on the offering party's evaluations that the party intends to use
at the hearing. A hearing officer may bar any party that fails to comply with this
provision from introducing the relevant evaluation or recommendation at the hearing
without the consent of the other party.
EVALUATION PROCEDURES:
1. Right to have a. full and individual evaluation of your child's educational needs,
2. Right to have the evaluation made by a multi-disciplinary team including at least one
specialist with knowledge in the area of the suspected disability.
3. Right to have your child assessed in all areas related to the suspected disability.
4. Right to have appropriate tests administered by qualified examiner.
5. Right to have more than one criterion used in determining the appropriate educational
program for your child.
6. Right to have the evaluation made in your child's native language or mode of
communication.
7. Right to have a reevaluation in less than three years if you or your child's teacher
requests it,
06-01-2017 Disabilities D-6b
CSI Head Start Program
Parental Rights
Page 6
LEAST RESTRICTIVE ENVIRONMENT:
1. Right to have your child educated with non-disabled children to the maximum
extent appropriate.
2. Right to have your child remain in a regular education environment, unless a special
class or separate school is needed. Removing a child from a regular class environment
should be done only when the nature or severity of the disability is such that
education in the regular class with the use of supplementary aids and services cannot
be achieved satisfactorily.
3. Right to have a continuum of alternative placements so that removal from the
regular educational program can be the least restrictive situation.
4. Right to have supplementary services such as resource room or itinerant instruction
to make it possible for your child to remain in a regular class placement.
5. Right to have placement in the school your child would attend if non-disabled, unless
the child's individualized education program requires some other arrangement, and
right to participate in non-academic and extracurricular and activities such as meals,
recess, counseling, athletics and special interest groups.
CONCLUSION:
As parents of a child with disabilities, you and your child have many rights, and with these
rights, there are certain responsibilities. The Head Start Program is responsible for safeguarding
your rights. You, in turn, should attempt to keep the Head Start Program informed of things that
affect your child's education. You also are urged to assist the school by attending Individualized
Education Program conferences and by keeping the lines of communication open at all times.
When you have concerns about your child's education, it is important to tell your school
principal or coordinator of special education.
If you would like a further explanation of any of these rights, you may contact Concerted
Services, Inc., Head Start 912-285-6083.
Revised 06-01-2017 Disabilities D-6b
CSI Head Start Program
Subject: Recruitment of Disability Children
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
POLICY:
In order to reach those most in need of services, a program must develop and implement a
recruitment process designed to actively inform all families with eligible children within the
recruitment area of the availability of program services, and encourage and assist them in
applying for admission to the program. A program must include specific efforts to actively locate
and recruit children with disabilities and other vulnerable children, including homeless children
and children in foster care.
PROCEDURE:
1. The Program will adhere to the recruitment and enrollment procedures as outlined in the Recruitment, Selection, and Enrollment policies and procedures.
2. The Disabilities staff, along with other designated staff, will communicate and
coordinate with the LEA; health professionals; mental health providers; social services
agencies; and special service professionals to solicit and initiate referrals to the Head
Start Program.
All Head Start staff who engages in recruitment and enrollment efforts will be advised
on the provisions of 45CFR Part 84; Nondiscrimination on the Basis of Disability in
Program Activities Receiving or Benefiting from Federal Financial Assistance; and of
the American with Disabilities Act of 1990.
3. The Program will access resources and a plan for placement options, such as dual
placement, use of resource staff and training, so that a child with a disability for whom
Head Start is an appropriate placement according to the child’s IEP is not denied
enrollment because of:
a. Staff attitude
b. In accessibility of facilities
c. Unfamiliarity with the disabling condition
d. Need for special equipment or personalized special services
e. No child shall be denied enrollment solely on the basis of the disability or
its severity
f. The Program’s established eligibility and selection criteria for all children applies
to children with disabilities
Revised 06-01-2017 Disabilities D-7
CSI Head Start Program
Subject: Diagnosed Suspected Disability
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council, Executive Board
POLICY:
In order to comply with ACFR mandate for reporting children with disabilities, a professional
diagnosis of any disabilities must be obtained.
PROCEDURE:
Diagnosed disabilities can only be identified through an IEP/IFSP that will be current the first
day the child starts school. If you find out a child has been receiving services from a Part C
Agency (ex: Babies Can't Wait) and has an IFSP, that child can only be coded as suspected. That
code cannot be changed until the Board of Education evaluates and you receive a copy of
the IEP that has been signed by the parent.
When completing an application, the Head Start Family Advocate will:
1. If the FA receives an IEP stating the child qualifies for services and it will be current the
first day that child starts school, the FA will go back and change the disability status
from "X" to the correct diagnosed code (this will depend on what the BOE or Private
SLP diagnoses are).
2. If the BOE or Private SLP evaluates and sends the FA an IEP stating the child does not
qualify for services, the FA will go back and change the disability status from "X" to
"R" which means referred not diagnosed,
3. If a child has a Health problem, the Family Advocate will call and discuss the
situation with the Disability Specialist before sending a Diagnostic Report.
4. If it is decided that the Family Advocate needs to send a Diagnostic Report to the
child's physician, the Family Advocate will do the following:
5. Get the request/release form signed by the parent.
6. Complete the top portion of the report put the center's address on the bottom of
the second page, attached letter.
7. Mail the request/release form and the diagnostic form to the physician. When the FA
receives this information back, they will make a copy for their files, enter information in
case notes, and send the original to the Disability Specialist. ALL DISABILITY
INFORMATION KEPT IN A LOCKED AREA.
8. If the child has a Health problem that is severe enough to be a disability, the
Disability Specialist and Health Specialist will ensure an individual health care plan is
completed for this child.
9. The Disability Specialist will make sure, through monitoring and follow-up, services are
facilitated in a timely manner according to the Performance Standards.
Revised 06-01-2017 Disabilities D-8
CSI Head Start Program
Dear-Provider:
In order for Concerted Services, Inc., Head Start Program to comply with federal mandates
and to provide services to children with disabilities, the Head Start Program must have
professional diagnosis, with written confirmation of any medical conditions that would restrict
participation in physical activities or would require a special diet.
A copy of the "Information Request/Release" form signed by the parents is enclosed.
Please complete the enclosed Diagnostic Report form and return it to the Concerted Services,
Inc., Head Start Program Disabilities Component for review. This information will be used in
developing an appropriate Individual Child Plan.
Thank you for your assistance.
The Disabilities Specialist
cc: File\
Revised 11-07-2016 Disabilities D-8a
CSI Head Start Program
DIAGNOSTIC REPORT
Date mailed: _______________________________Date Due: ___________________________
REFFERING AGENCY CHILD INFORMATION
Diagnostician: _____________________________Child’s Name: ________________________
Title: _____________________________________Date of Birth: ________________________
Agency: __________________________________Parent/Guardian: ______________________
Address: __________________________________Address: ____________________________
Telephone: ________________________________Telephone:___________________________
1. Please number the disabling condition(s) that applies in reference to primary and
secondary diagnostic criteria: (If the child has multiple disabling conditions, number
the primary conditions “I”, the secondary condition(s) “2”, etc.)
_ _ _ _ _ Bl indness /v i s ual impai rment Speech/ language impai rment
_____ Deafness/hearing impairment Health/development impairment
_ _ _ _ _ P h y s i c a l i m p a i r m e n t D e v e l o p m e n t a l l y i m p a i r e d
____ Spec i f i c l ea rn in g d i so rder Emot iona l behav io ra l d i so r de r
_ _ _ _ _ D eve lo pmen ta l l y d e l a yed T r aumat i c b ra in in ju r y
____ Intellectual Impairment
______Other:
2. Diagnosis: ________________________________________________________________
3. Please list instructions used in diagnosing this child. Please include any special
consideration given due to social-economic or cultural factures.
_________________________________________________________________________
_________________________________________________________________________
4. Severity of Impairment: _____________________________________________________
Prognosis: ________________________________________________________________
Revised 06/01/2017 Disabilities D-8b
CSI Head Start Program
Diagnostic Report
Page 2
5. List all prescription medication and dosage: ____________________________________
6. Functional Assessment: ____________________________________________________
Strengths: _______________________________________________________________
Weaknesses: _____________________________________________________________
7. Date of evaluation: ________________________________________________________
8. Date child was first diagnosed (if know): _______________________________________
7. Check the following services needed for this child:
____ Special Education _____Visual Training
_____Speech/language therapy _____Auditory training
_____Occupational therapy _____Psychotherapy
_____Physical therapy _____Family counseling
_____Change in home/school
8. Special equipment. Please list any specialized/assistive equipment that this child may
have or need to function as independently as possible. ____________________________
9. Special/restrictive instruction needed in the Head Start classroom: ___________________
10. List all agencies, of which you are aware, that currently provide services for this child
and family:
________________________________________________________________________
Revised 06/01/2017 Disabilities D-8b
CSI Head Start Program
Diagnostic Report Page 3
13. Did you recommend this child for additional services? Please note that specialized service such as speech/language, occupational, and physical therapy need an evaluation.
______Yes _____ No
If yes, state to what agency and why: ________________________________________________
Diagnostician signature/title: ______________________________________________________
Date: _________________________________________________________________________
PLEASE RETURN COMPLETED FORM TO:
Revised 06/01/2017 Disabilities D-8b
CSI Head Start Program
Subject: Information Release Request
Section: Disabilities
Program: Head Start / Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
POLICY:
The parent of legal guardian shall give written permission before CSI Head Start
Program will release and / or request information from other agencies.
PROCEDURE:
1. Specialists or Family Advocates will obtain permission in writing from
parents/guardians, from EHS 206 – “Information Release /Request”-found in the Health
Section to request information concerning the child from other agencies or health
providers or to release information to other agencies. Specialists or Family Advocates
will complete the Information Release/Request from prior to obtaining parent/guardian
permission.
Revised 06/01/2017 Disabilities D-9
CSI Head Start Program
Outside Agency Medical Information Letter
Date: ______________________________________________________
Dear _______________________________________________________ (Outside Agency)
__________________________________________________________ (Child’s Name)
Medical History is enclosed for your agency’s use for assessments and /or treatment. A copy of
the, ‟Information Release/ Request” form signed by the parent is enclosed.
Thank you in advance for your assistance.
Disabilities/Mental Health Specialist
Cc: File
Revised 06/01/2017 Disabilities D-9a
CSI Head Start Program
Subject: Disabilities File Maintenance
Section: Disabilities
Program: Head Start / Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
POLICY:
A complete file will be maintained in the Disabilities Office for all children with disabilities.
PROCEDURE:
1. The Disabilities Specialist will maintain a complete file on each child diagnosed with a disability.
2. Files maintained in the Disabilities Specialist Office will contain originals of completed diagnostic forms and copies of other forms.
3. Files will be stored in Alphabetical order by county in a locked cabinet.
4. Forms directly related to the child’s class participation, such as the “IEP‟ and the
‟Primary Profile Sheet‟ will also be filed in classroom file.
5. LEA provider will provide copies of completed forms to the teacher to place in
the child’s classroom files, appropriate.
6. Files will be maintained for at least three years after the child leaves the program.
Revised 06/01/2017 Disabilities D-10
CSI Head Start Program
Subject: Monthly Confirmation of Treatment/ Progress Report
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
POLICY:
All Professionals performing special services to Head Start/Early Head Start children must give
regular progress updates to the education staff. Parents will receive progressive reports
periodically (depending on when the LEA/Part C sends theirs out) regarding their child’s
progress and services provided. Professionals providing special services will be available to
provide one-on-one information to the parent.
PROCEDURE:
Monthly Log:
1. Professionals providing treatment to Head Start/Early Head Start students will complete
the “Monthly Confirmation of “Treatment” form, (see next page) each time services are
provided.
2. The teacher will maintain a folder with these forms in the classroom marked confidential.
3. The professional will complete and sign the “Monthly Confirmation of Treatment” form
located in the classroom each time he/she works with a child.
4. The “Monthly Confirmation of Treatment” is to be reviewed for accuracy and submitted
by the 5th day of the month by the Center Coordinator/Lead Teacher (even if a
Professional providing treatment to Head Start students did not come that Month). The
Disabilities Specialist will follow-up with Center Coordinator/Lead Teacher to assure the
form is completed and submitted to document services are provided as stated on
IEP/IFSP.
Progressive Reports:
1. The LEA will send home progress notes to the parents according throughout the year.
The LEA will give the classroom teacher a copy and the classroom teacher will forward
a copy to the Disabilities Specialist.
2. In the case the Head Start Program is providing the needed individualized services, the
teacher will provide the progress report for the parents according to the progress of the
child in regards to goals in the Individualized Child Plan.
3. Contracted professional will give the classroom teacher notes of the progress notes
accordingly throughout the year on the children they are serving to send home to the
parent (see next page for form used). The classroom teacher will forward the
Disabilities Specialist a copy.
Revised 06/01/2017 Disabilities D-11
CSI Head Start Program
Monthly Confirmation of Treatment
Month/Year: __________________Center: ____________________________ Room: ______
Service Codes:
SLP=Speech/Lang. Therapy OT=Occupational Therapy MHC=Mental Health Counseling
PIP=Sp Ed Instruction PT=Physical Therapy ABA=A. Behavior Analysis
VI =Vision Imp. Instruction HI=Hearing Imp. Instruction PA=Paraprofessional Support BOE=Board of Education BCW=Babies Can’t Wait PP=Private Provider
Date Service
Code
Time
Session
Ends
Time
Session
Begins
Child’s Name Provider/Service/Agency
List
8/5/17 S L P 9:35 9:02 J. Barnes, T. Smith EX: Susan Smith, SLP, BOE EX: Tom Snow, MHC, PP
Return to: Disabilities Specialist
Revised 06/2017 Disabilities EHS 313 D-11a
CSI Head Start Program
SPECIAL SERVICES/INDIVIDUAL CHILD PLAN PROGRESS REPORT
Child’s Name: __________________________________ Date: ____
Center: ________________________________________ Location Id:
Child was seen for: (check one)
Other (describe): _________________________________
Brief description of services rendered: _______________ _________
Brief description of child’s progress: ________________
Provider Signature Title/Agency Affiliation
Developmental Delays
Physical therapy
Occupational therapy
Speech therapy
___
___
___
___
Revised 06/01/2017 Disabilities EHS 314 D-11b
CSI Head Start Program
Subject: Referral to LEA/Part C
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board Regulation
POLICY:
ALL SUSPECTED CHILDREN WILL BE REFERRED TO LEA/PART B or BCW/PART
C
PROCEDURE:
WHEN A HEAD START CHILD SCORES OVERALL POTENTIAL DELAYED ON
THE DIAL 4 OR WHEN AN EHS CHILD SCORES IN THE GRAY AREA ON THE
AGES AND STAGES.
1. Center Coordinator/Lead Teacher will provide a copy of DIAL-4/Ages and Stages to the
Education Specialist and Disabilities Specialist.
2. The Center Coordinator/Lead Teacher will make a referral to Babies Can’t Wait within
two weeks for the children who scored in the gray area on the Ages and Stages screening
tool. For children that scored overall potential delayed on the DIAL-4, the Center
Coordinator/Lead Teacher shall document the concern, direct classroom interventions
(Individual Service Plan), and refer children to the public school system.
a. The Center Coordinator/Lead Teacher will use the Referral for Special Services
for LEAs and for Babies Can’t Wait
b. If the school system uses RTI method, they will need to provide their forms to
be filled out by Head Start/Early Head Start teachers. Also, teachers can use the
Individual Service Plan from which they can transfer the information onto the
LEA’s RTI paperwork.
3. The Center Coordinator/Lead Teacher will get the contact person form the School
System/Babies Can’t Wait to sign the Special Services Referral Sign-Off Sheet if given
in person, and/or keep a copy of the faxed forms for filing (EHS 317).
4. The Center Coordinator/Lead Teacher will file a copy of the referral form in the child’s
educational file and put the Referral Sign-Off Sheet in the Confidential Disabilities file
that is kept in a locked file Cabinet with a copy sent to the Disabilities Specialist and
Family Advocates for entrance into Childplus program.
5. The Center Coordinator/Lead Teacher will follow the referrals and the use of the
Individual Service Plan until the child has a signed IFSP/IEP, or paperwork stating the
child does not qualify for services.
Revised 06/01/2017 Disabilities EHS 317 D-12
CSI Head Start Program
CSI HEAD START PROGRAM
P.O. BOX 1965
2100 RIVERSIDE AVENUE
WAYCROSS, GEORGIA
31502 912-285-6083
REFERRAL FOR SPECIAL SERVICES
Referral Date:
Head Start Center:
To: From: (Agency/Organization) (Agency/Organization)
(Contact Person) (Contact Person)
(Address) (Address)
(City/State) (City/State)
(Phone) (Phone)
RE: Child: D.O.B.:
Age: ________
Parent(s)/Guardian(s): ____________________________________________________________
(Address) (City) (State) (Zip) (Phone)
Revised 06/01/2017 Disabilities D-12a
CSI Head Start Program
Referral for Special Services
Page2
Reason for Referral: (Please mark one of the following)
1. Suspect or failed developmental screening
2. Known medical condition (name)
3. Speech and/or language delay
4. Other
Services Presently Receiving: _____________________________________________________
My signature below gives authorization for the referring agency and/or person to release
identifying information (Vision & Hearing, Developmental Screening, Medical Records)
this includes any necessary records on my child to Babies Can’t Wait (Part C Agency) or
other agency listed here:
Parent/Guardian Signature: ________________________________Date: ___________________
Witness: ______________________________________________ Date:
Revised 06/01/2017 Disabilities D-12a
CSI Head Start Program
SPECIAL SERVICES REFERRAL SIGN-OFF SHEET
The children listed below have been referred to _________________________ (Agency’s Name)
On _____________________________ for further testing. (Date)
1.
2.
3.
4 .
5.
6.
7.
8.
9.
1 0 .
1 1 .
Revised 06/01/2017 Disabilities D-12b
CSI Head Start Program
Subject: Refusal of Authorization for Health Services or Special Services
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
REPOLICY:
Staff obtains timely informed and written parental consent for authorization of all health services
provided or arranged. When families refuse authorization, those refusals will be documented.
PROCEDURES:
1. If parents raise concerns about recommended procedures, the Health Specialist, Family
Advocate or other appropriate Specialists will speak to them concerning why they
refuse treatment and describe the benefits and reasons for the recommended procedure.
2. If the parents express discomfort working with a provider or have concerns regarding
services, the Family Advocate, Health Specialist, or appropriate Specialist assumes the
role of Services Advisory as needed.
3. If all attempts have been made to get the parent to give authorization, refusal must be
documented on the Refusal of Authorization for Health Services, EHS 221.
Revised 06/01/2017 Disabilities D-13
CSI Head Start Program
Subject: Individual Health Care Plan
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
POLICY:
Develop and implement a follow-up plan for any condition identified so that any needed
treatment would be coordinated. The individual Health Care Plan will be reviewed annually, or
as often as needed. It will be revised as needed. The confidentiality and dignity of each child will
be maintained.
PROCEDURE:
A Health Care Plan is an individualized, written communication shared by those who care for a
child with a chronic health condition. It will list specific health concern for a particular child and
outlines any steps or precautions that must be taken. Not all children who have medical needs
will require a health plan. The plan will be for children whose health condition impacts the
classroom setting. Please refer to Health section for policy and procedures. Also, the Individual
Health Care Plan form is located in Health section.
Revised 06/01/2017 Disabilities D-14
CSI Head Start Program
Subject: Transitioning from EHS to HS and/or HS to Kindergarten
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council,
Executive Board
Policy: For children with an IFSP/IEP who are transitioning out of Early Head Start or
Head Start, collaborate with the parents, and the local agency responsible for
implementing IDEA, to ensure appropriate steps are undertaken in a timely and
appropriate manner to determine the child’s eligibility for services under Part B of
IDEA and to ensure steps are undertaken in a timely and appropriate manner to
support the child and family as they transition to a new setting.
Procedures:
1. Head Start and Early Head Start teachers of the children with IFSPs and IEPs
will attend transition meetings. The Disabilities/Mental Health Specialist and
Education Specialist will attend all transition meetings as well.
2. The local county public school board personnel and the Babies Can’t Wait
personnel set up the transition meetings. Head Start Staff stated in the above
paragraph will join the transition meetings to support and help the parents
advocate for their child.
3. Also, See Education Policies and Procedures for additional transition activities.
06/01/2017 Disabilities D-15
CSI Head Start Program
Subject: Emergency Evacuation
Section: Disabilities
Program: Head Start/Early Head Start
Approved: Executive Director, Policy Council
Executive Board
POLICY:
In case of an evacuation for whatever reason (fire, tornado, etc.) during the hours of 7:30 a.m. –
3:00 p.m. the following should be done:
PROCEDURES:
The Center Coordinator/Lead Teacher or the person in charge of the Center’s operation should:
1. Ring the fire alarm bell one long time (approximately 2 minutes).
2. Teachers of each classroom should start immediately evacuating the children. This
includes children with disabilities (wheelchairs, crutches, braces, etc.) by removing them
from the premises safely to the exit nearest the classroom (lunchroom, playground). Use
the same exits you are assigned for fire drills. (Please attach fire exit plan).
3. After children with disabilities have been removed from the premises safely, a quick health check should be made.
4. The person in charge of the day-to-day operations should make a safety check to make
sure all children with disabilities have been removed from the premises and are
accounted for.
5. Evacuation plan for disabled children should be posted near the door in each classroom
(D-39/EHS 316).
Revised 06/01/2017 Disabilities D-16
CSI Head Start Program
EMERGENCY EVACUATIN FOR CHILDREN WITH DISABILITIES
In case of an emergency evacuation for whatever reason (fire, tornado, etc.) during the hours of
7:30 a.m. – 3:00 p.m., the following should be done:
The Center Coordinator/Lead Teacher or the person in charge of the center’s operation should:
1. Ring the fire alarm bell one long time (approximately 2 minutes).
2. Teachers in each classroom should start evacuating the children with disabilities
immediately (in wheelchairs, on crutches, braces, etc.) by removing them from the
premises safely to the exit nearest their classroom (lunchroom, playground, etc.). If you
are in your classroom, use the exit you are assigned for fire drills. If you are in the
lunchroom, playground, etc., please use the nearest exit.
3. After children with disabilities have been removed from the premises safely, a
quick health check should be done.
4. The person in charge of the day to day operations should do a safety check to make
sure all of the children with disabilities have been removed from the premises and are
accounted for.
Revised 06/2017 Disabilities EHS 316 D-16a