4.3
Conducting the Enrollment Meeting
The following forms are found in the initial Enrollment Packet. The forms that only need to be completed when changes are made will not print out in the returning Enrollment Packet.
Enrollment Cover Sheet
The enrollment cover sheet acts as a table of contents for the Enrollment Section. All forms and documents should be filed according to the cover sheet. The first column “Initial Enrollment” is used when an Initial Enrollment is completed. The date each form was completed by the parent/guardian will be recorded next to each document. If a child is returning, the date each annual form is completed by the parent/guardian will be recorded in the “Ongoing Entry” column.
Action to be taken: The Enrollment Cover Sheet does not need to be signed by parent/guardian or staff and is placed in the Child File binder as the first page.
Note: Custody outside of a biological parent must have court or county documents stating who has physical/legal custody of the child. If custody is held by someone other than a biological parent a blue sticker dot will be placed on the spine of the child file.
File Check Out
The file check out form is used by individuals that do not have regular access to the child file such as for monitoring purposes. The individual will document the date, time they checked the child file out, time they turned the child file in, their name and purpose for access to the file.
Action to be taken: The File Check Out does not need to be signed by parent/guardian or staff and is placed in the Child File binder as the second page.
Emergency Card (Completed annually, Initial Enrollment and Returning)
Shasta Head Start is legally responsible to ensure the safety of all enrolled children. This includes receiving authorization from the legal parent or guardian designating in writing who has permission to pick up their child from school or in case of an emergency. At enrollment an Emergency Card will be completed with the names of those individuals authorized to be contacted in case of emergency and/or those authorized to pick up the child. Identification will be verified through driver’s license or other form of official identification at initial pick up.
Action to be taken:
The parent/guardian will complete the Emergency Card (EM) during the enrollment process. After the parent completes the EM Card, the Family Worker will:
- File the original EM card in the back of the Child Sign In/Out binder located in the classroom
- If a busing site, a copy will also be filed in the Bus Driver’s traveling file
The Family Worker will enter emergency contacts in Child Plus (CP) within 3 business days (see entering Emergency Card in CP). Once entered, the Family Worker will:
- Print a CP report 1520 by classroom (link to running CP 1520)
- File the CP report 1520 by classroom in the Center Licensing File
- Print a CP report 1520 by individual (link to running CP 1520 report by individual) and file each child’s report in their child file
Updates to the EMERGENCY CARD (EM)
If parent/guardian needs to make changes to the EM card, Family Worker will:
- Give the parent/guardian access to make those changes to the original EM card located in the back of the Child Sign In/Out binder
- Initial under “staff initial” on the emergency card
- Immediately place the EM Card back in the Child Sign In/Out binder.
The Family Worker will then update Child Plus (CP) within 3 business days and:
- Print the updated CP report 1520 by classroom (link to running CP 1520)
- File the updated CP report 1520 by classroom in the Center Licensing File
- Print an updated CP report 1520 by individual (link to running CP 1520 report by individual) and file each child’s report in their child file
Note: If Family Worker is not available, Teacher/Caregiver or Associate Teacher will provide the parent access to make the changes to the EM card following the instructions above. They will then make a copy of the updated Emergency Card and give to the Family Worker.
Note: Parents can initiate changes to the EM card with the bus driver at busing sites. The bus driver will provide the parent access to make the changes to the EM card following the instructions above. The Bus Driver will make two copies and give one to the Teacher and one to the Family Worker.
** In order for a person to be added to the EM Card as an emergency contact and allowed to pick up a child from a Shasta Head Start Center, they must be at least 18 years old and have a photo ID
Permission to Share: (Completed annually Initial Enrollment and Returning)
Shasta Head Start maintains all family information in a confidential and secure manner. At various times throughout the school year we may be asked to share information about a child or family. If a parent/guardian would like to give permission for SHS staff to share this information with others, they will document who we can share information with, and what may be shared on the permission to share form.
Action to be taken: The Permission to Share form will be copied, the copy will be filed in the back of the Child Sign In/Out binder located in the classroom and the original will be filed in the child file according to the Enrollment Cover Sheet.
Authorization to Release Health Information (Completed annually, Initial Enrollment and Returning)
This form is used to obtain permission for the specified health facility to release information to Shasta Head Start in compliance with HIPPA (Health Insurance Portability and Accountability Act). The parent/guardian will initial next to the information being requested and sign during the enrollment meeting thereby giving permission for FS staff to request information from a medical or other provider (i.e., Health Care Providers, Dentists, Mental Health, WIC, County Health Department).
Action to be taken: Once the Authorization to Release Health Information has been completed and signed by parent/guardian, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Parents Rights (LIC 995 9/08) (Completed at Initial Enrollment and if/when changes are made)
This licensing form is to notify parent/guardian of their rights and to comply with Community Care Licensing requirements. During the enrollment meeting a brief explanation of the parent/guardian rights will be explained and parent/guardian signature will be gathered. Explain to parent/guardian there is a copy of signed forms in the Family Handbook.
Action to be taken: Once the Parents Rights have been reviewed and signed by the parent/guardian, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Personal Rights (LIC 613A 8/08) (Completed at Initial Enrollment and if/when changes are made)
This licensing form is to notify parent/guardian of their rights and to comply with Community Care Licensing requirements. During the enrollment meeting a brief explanation of the parent/guardian rights will be explained and parent/guardian signature will be gathered. Explain to parent/guardian there is a copy of signed forms in the Family Handbook.
Action to be taken: Once the Personal Rights have been reviewed and signed by the parent/guardian, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Admission Agreement (Completed at Initial Enrollment and if/when changes are made)
This agreement between parent/guardian and Shasta Head Start (SHS) is a licensing requirement as well as an explanation of the basic and optional services offered or facilitated by SHS. The Admission agreement must have a parent/guardian and SHS staff signature.
Action to be taken: Once the Admission Agreement has been reviewed, signed by the parent/guardian and SHS staff, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Photo and Media Release (Completed at Initial Enrollment and if/when changes are made)
This form allows SHS to photograph/video a child and use the photograph/video on the SHS Website, SHS Facebook, SHS Newsletter, Community News Media, Learning Genie, and if in Family Child Care, SHS Family Child Care SharePoint Provider Portal. It also, if approved by the parent/guardian, allows SHS staff to use texting as a form of communication. It is the parent/guardians right to grant permission by initialing yes or to not grant permission by initialing no.
Action to be taken: Once the Photo and Media Release has been reviewed, initialed, and signed by the parent/guardian, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Participation of Days and Meals (Completed annually, Initial Enrollment and Returning)
This form is a federal requirement for the CACFP program. The CACFP requires that a child’s days of enrollment and meals served be documented and signed by a parent/guardian. A child’s Enrollment and Entry date will need to be added to the form once the child’s enrollment/entry date is (Enrollment and Entry dates are the same date, the first date the child shows up to class).
Action to be taken: Once the Participation of Days and Meals has been completed, signed by parent/guardian, and signed by SHS staff, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Family Demographics (Completed annually, Initial Enrollment, and Returning)
This form is used as a way of gathering information needed each year for the Program Information Report (PIR) and to identify and understand each child’s language background to support and strengthen their language development.
Action to be taken: Once the Family Demographics has been completed interview-style and signed by SHS staff, the form will be scanned to Language Services scan folder, entered into ChildPlus (refer to SOP 8.6.3 Family Demographics for instructions), and filed in the child file binder according to the Enrollment Cover Sheet.
If the child is a Dual Language Learner, see SOP 8.6.4 Dual Language Learner Module Entry for ChildPlus data entry instructions.
Notice of Enrolled Dual Language Learner (DLL) (Completed annually, Initial Enrollment, and Returning)
This form is used to inform the Language Services Coordinator of enrolled Dual Language Learners so Bilingual Aides can be appropriately assigned and SHS can properly track the number of dual language families that are being served. This form is also used to identify and understand each child’s language background to support and strengthen their language development. Regardless of the child’s ability to speak English, if another language is spoken by parents, grandparents, siblings, extended family, or others living in or visiting the home, this form must be completed.
Action to be completed: Once the form has been completed by the Family Worker (FW), they will scan the form (front and back) to the Language Services Coordinator. The form will be filed in the child file binder according to the Enrollment Cover Sheet. If there is not another language spoken by parents, grandparents, siblings, extended family, or others living in or visiting the home, you do not need to complete this form and “N/A” can be written on the Enrollment Cover Sheet. The Language Services Coordinator will complete the Family Language and Culture Interview located on the back of the Notice of Enrolled Dual Language Learner form. Refer to the Language Services SOP for additional steps that must be completed for the Family Language and Culture Interview process.
Handbook Parent Signature
Center Base Parent Handbook: English Spanish
The Family Handbook provides an outline of the program, policies, and procedures important to SHS and copies of the documents the parent signed during the enrollment process. There are some specific topics Family Services staff will share with the family during the enrollment appointment.
Parent Handbook – Items to Share
- Introduce the Teaching Pyramid (page 8 of the Family Handbook)
- Attendance
- Health Requirements (Physical & Immunizations)
- Illness & Daily Health Checks
- Keep Me Home If
- Parent Handouts
- Personal Rights LIC613A
- Notification of Parents Rights LIC995
- Caregiver Background Check Process LIC995E
- Admission Agreement
- Effects of Lead Exposure PUB515
- California Child Passenger Safety Law PUB269
- Kaitlyn’s Law
- Car Seat Safety Tips
- Car Seat Checklist for Parents
- Pedestrian Safety Tips
- 20 Facts About Child Abuse PUB411
- Tell Me What to Do Instead
Action to be completed: Once the family has received the Handbook and signed the Parent Signature Page as receipt of the handbook, the form will be filed in the child file binder according to the Enrollment Cover Sheet.
Health Section
This section is used to organize completed health and nutrition related documents, including:
Head Start Health Coversheet (Pink Header) or Early Head Start Health Coversheet (Pink Header)
Summary
The health cover sheet acts as a table of contents for the Health Section. All forms and documents should be filed according to the cover sheet. The health coversheet is also used as a hardcopy to fill out and track health events and screener results as they are completed.
Action to be completed:
The sunscreen permission form section should be completed during enrollment. The form will be filed in the child file binder after the Enrollment section.
Health, Developmental, Nutritional Assessment (HDNA)
The HDNA is used to gather important health, developmental and nutritional information on each child within 30 days of enrollment. The HDNA is written to be answered in an interview format, do not give it to parents to fill out. This is a chance for you to learn more about the family and child you are enrolling. For initial enrollments complete the full three-page HDNA, for returning children complete the abbreviated returning children HDNA.
Action to be completed:
Scan to SHS health department as part of the Health Packet [30/45/60/90 Day – Go to 30-day Requirement] The form will be filed in the child file binder according to the Health Cover Sheet.
Medical Statement to Request Special Meals and/or Accommodations
This form to be completed by a medical provider when it has been determined from the HDNA or parent, that the child has a special dietary need that requires a cook’s diet order.
Action to be completed:
Follow instructions from [Special Dietary Needs], as needed. The form will be filed in the child file binder according to the Health Cover Sheet.
Parent/Guardian’s Form for Declining a Provider’s Infant Formula (EHS only)
This form to be used when a parent requests a formula that is not offered in the center and does not meet the Child Adult Care Food Program requirements.
Action to be completed:
Follow instructions from [Bottle Feeding], as needed. The form will be filed in the child file binder according to the Health Cover Sheet.
Parental Request for a Fluid Milk Substitution for Children in Child Care
Complete this form when parents would like to request a fluid milk substitution for their child. (Soy or Lactaid)
Action to be completed:
Follow instructions from [Special Dietary Needs], as needed. The form will be filed in the child file binder according to the Health Cover Sheet.
Parental Request for a Religious/Vegetarian Exemption
Complete this form when parents would like to request a religious or vegetarian exemption and substitution.
Action to be completed:
Follow instructions from [Special Dietary Needs], as needed. The form will be filed in the child file binder according to the Health Cover Sheet.
School Medication Authorization Form
This form to be completed by a medical provider when it’s been determined that a child will need medication administered during class time.
Some children may have a health concern that requires an accommodation other than medication, in these instances, contact Shasta Head Starts registered nurse to determine if the child will need an individual health plan (IHP) before beginning.
Action to be completed:
Follow instructions from [Administering Medication], as needed. The form will be filed in the child file binder according to the Health Cover Sheet.
CHDP/Well Child Requirement [Prior to Day 1]
Give this to parents to inform them of the physical exam required by Community Care Licensing and Head Start Performance Standards.
Action to be taken:
Form is given to parent
Dental Exam Form [30/45/60/90 Day – Go to 90-Day Requirements]
Give this to parents to inform them of 90-day dental requirements. Parents can take it to their dental provider to be filled out at their next appointment.
Action to be taken:
Form is given to parent
Education Section
Education Coversheet (Purple Header)
This form acts as a table of contents for the Education Section. [Child Files/Education]
Action to be taken: The Education Cover Sheet does not need to be signed by parent/guardian or staff and is placed in the Child File binder as the first page of the Education section.
Disabilities and Mental Health Section
This section is used to organize completed disabilities and mental health related documents, including:
Disabilities and Mental Health Coversheet (Orange Header)
This coversheet acts as a table of contents for the Disabilities and Mental Health Section and is used to track Disabilities/Mental Health events, screeners and assessments.
Action to be taken:
This coversheet must be placed in the Child File binder after the Education Section. Family Service staff will document Disabilities/Mental Health events, screeners and assessments as received or completed.
Notice of Enrolled Child with Special Needs
If an enrolling child (initial or returning) has an IFSP or IEP, this form will inform the Disabilities/Mental Health department of their enrollment.
taken:
Complete the Notice of Enrolled Child with Special Needs, if you have the IFSP/IEP scan it along with the Authorization to Release Health Information to the Disabilities/Mental Health scan folder and file this form in the Disabilities and Mental Health Section according to the coversheet.
Authorization to Release Health Information
This form is used to obtain permission for the specified agency to release information to Shasta Head Start regarding services an enrolled child may be receiving. (ie., IFSP/IEP, assessments, etc.)
Action to be taken:
Fax the appropriate agency for the IFSP/IEP, and any assessment reports they may have. (See below) Once the IFSP/IEP is received, scan it to Disabilities/Mental Health scan folder along with the Authorization to Release Health Information. The original documents will be filed in the child file in the Disabilities and Mental Health section according to the coversheet.
Under 3 years: FNRC
Over 3 years: Shasta County, Siskiyou County, Trinity County
Family Services Section
Family Services Coversheet (Green Header)
The family services cover sheet acts as a table of contents for the family services section. All forms and documents should be filed according to the cover sheet. This cover sheet and related documents are kept in the parent contact binder for Family Workers and the travel file for Home Visitors. See Family Partnership Process and Printing FS Section in CP