2.2.1
Preparing for the Application and Eligibility Interview
Families often call or visit a center location or Admin office to obtain more information about our program or schedule an application and eligibility interview to place their child(ren) on the waiting list. During the application and eligibility interview, designated and trained SHS employees work with families to complete the necessary applications and forms to apply for Head Start.
When a family contacts you to set up the first meeting:
- Outlying Areas (Mt Shasta, Burney, McArthur, and Weaverville)
- Ask the family if they would like to complete the application and eligibility interview in person at the center or if they would like to complete a phone interview and use DocuSign to submit documents and sign forms
- If the family wants to complete a phone interview and use DocuSign, please complete a Short Sheet, scan the document to ERSEA, and provide the family with ERSEA’s business card
- Follow up with the ERSEA department to ensure the scan was received
- Shred Short Sheet after receipt confirmation
- When the family chooses to complete the application and eligibility interview in person, please ensure that you have thirty minutes to an hour to complete the interview; otherwise, schedule a date and time that is convenient for the family to return
- Reference SOP 1.1.4 Walk-ins and Call-ins for guidance regarding interviews
- For all other locations, the ERSEA department completes application and eligibility interviews for your center
- Complete a Short Sheet, scan the document to ERSEA, and provide the family with ERSEA’s business card
- Follow up with the ERSEA department to ensure the scan was received
- Shred Short Sheet after receipt confirmation
- If the family wants to complete a phone interview and use DocuSign, please complete a Short Sheet, scan the document to ERSEA, and provide the family with ERSEA’s business card
- Ask the family if they would like to complete the application and eligibility interview in person at the center or if they would like to complete a phone interview and use DocuSign to submit documents and sign forms
Intake Forms
SHS staff who complete applications and eligibility interviews must complete the following standardized forms while interviewing families who want to waitlist their child(ren).
- EL001-Application for Services English | Spanish
- EL002-Eligibility Form (1 per program year) English | Spanish
- EL003-Income Calculation Worksheet & Staff Statement English
Supporting Documentation (Required as applicable)
- EL004-Third Party Verification Consent Form English | Spanish
- EL005-Zero Income Statement English | Spanish
- EL006-Family Income Self-Declaration Form English | Spanish
- EL007-Foster Care Verification Form English
- EL008-Income Verification from Employer English
In addition, the family must provide:
- Age verification
- Birth certificate
- Hospital record
- Medi-Cal/Partnership card
- Verification of Benefits
- Other official forms/records (e.g., court orders)
- Self-declaration from parent/guardian when other documents are not available
- Any current court papers or restraining order
- Current IEP/IFSP paperwork
Parent Handouts
Provide the parent or guardian with relevant resources, including current flyers for services in the local community.
- 2-1-1 Card – Social Services Reference Card. This card directs the family to other useful resources
- Refer to Partnership Healthplan of California – Community Resources (https://www.partnershiphp.org/Pages/PHC.aspx)
- Waitlist and Selection Facts for Parents Card
- Shasta Head Start Parent Newsletter
- In addition, prepare any materials you need to explain the options available to the family. These include:
- A location map to help determine the best location for the family to receive services. You can view the map Shasta Head Start’s website
- Information about the various program options and eligibility requirements:
Any questions regarding eligibility, contact the ERSEA department by phone or email.