5.1.2

30/45/60/90 Day

Go to 30-Day Requirement
Go to 45-Day Requirement
Go to 60-Day Requirement
Go to 90-Day Requirement
Go to Documentation of Non-Compliance

30-Day Requirements

Health

Well Child Exam – Overview

• If a Well Child Exam was completed prior to day 1, the parent should provide exam results to SHS (copy of Child Health & Disability Prevention (CHDP) exam).
• If a Well Child Exam was not completed by day 1, they have 30 days to have the exam completed and provide a copy of the CHDP exam or, the parent must provide confirmation of a scheduled Well Child Exam appointment within 30 days (appointment date may be later than 30 days from Entry date).
• Based on CCL requirement
• Family Worker or Home Visitor completes
• See “1a Enrollment Policy” document in the Health Manual on Immunization requirements (compliance requirement) [P.S. 1304.20(a)(1)(i) & 1304.20(a)(1)(ii)(A) & (B)]

Policy: To meet Federal and State mandates ensuring all enrolled children have adequate preventive health care necessary to participate in Head Start, including EHS, Home Base, Family Child Care (FCC), and Center-based programs. Head Start programs are open to all eligible children.

1. Well Child Exam – To attend center programs or socializations, children must have a complete medical exam (CHDP PM 160 or equivalent) within one year prior to or 30 days after entry date. A valid provider-signed medical report (CHDP PM 160 or equivalent) constitutes compliance with this requirement. A child enrolling without meeting this requirement must have proof of an appointment for the exam to continue attending center or socializations.
2. Exclusion Policy – To attend center programs or socializations, children must have a complete medical exam (CHDP PM 160 or equivalent) within one year prior to or 30 days after entry date. A valid provider-signed medical report (CHDP PM 160 or equivalent) constitutes compliance with this requirement. A child enrolling without meeting this requirement must have proof of an appointment for the exam to continue attending center or socializations.

Children eligible for Head Start qualify for a free CHDP exam if they meet income eligibility for CHDP and are uninsured or have MediCal. If the child has private medical insurance, that insurance will be billed for the well child exam and parent(s) may be billed for a copay. Parents can submit a reimbursement request for the copay (see “1c. Payment of Health Services”).

Children must then follow EPSDT (CHDP in California) guidelines to continue on a schedule of ongoing well child care. See below table:

New Periodicity Table

Source of Healthcare  – need to assess within 30 days if the child has a primary care physician and that they have a source of continuous, accessible health care and health insurance coverage. Done via the HDNA completed during the enrollment process and entry CHDP.

• Performance Standard 1302.42(a)(1-2)
• Family Worker or Home Visitor completes
• Procedure: Within 30 days of entry, Staff will determine if a child has a source of continuous healthcare (medical home), by obtaining a completed CHDP exam or equivalent, and by completing a SHS Health, Developmental, and Nutritional history (HDNA). The Health Team will review these records within 90 days of entry into the program, to determine whether a child is up-to-date and to develop a plan for ongoing care and follow-up. If the child does not have a medical home, staff will work with parents to develop a strategy to obtain care through referrals and collaboration with community agencies.

Health Packet

• Procedure: Scan the “Health Packet” to health no later than 45 days of entry. Scan each child’s packet.
  • A complete “Health Packet” consists of:
    • The most recent CHDP/Well Child Exam
    • “Authorization to Release Health Information” for the Health Care Provider/Doctor who completed the exam.
    • Health, Developmental and Nutritional Assessment (HDNA) in order.
      • For new enrollments complete the entire three-page HDNA.
      • For children returning to the same program (EHS/HS) complete the “Annual HDNA for Returning Head Start/Early Head Start Children”
    • Scan any updated physicals/well baby checks to Health throughout the year.
    • Scan each child’s “Health Packet” and “updates” separately.
    • Before a CHDP/Well Child Exam is scanned into “Health” the Family Worker/Home Visitor needs to make sure that the following items are all on the CHDP/Well Child Exam:
      • Date of Service – Must be dated 1 year prior to entry date or later. Needs to be legible.
      • Hemoglobin or Hematocrit – Must be done for all children 12 months of age and older. Must be legible.
      • Height – Make sure there is a legible height.
      • Weight – Make sure there is a legible weight.
      • Provider – Make sure that the provider is listed somewhere on the CHDP/Well Child Exam form and is legible. If the signature is not legible please print who the provider is at the bottom of the form.
      • CHDP – Do Not send a HDNA into the office without the most recent CHDP.
      • CHDP is not readable – Make sure that all the components are readable.
      • HDNA – Do Not send a HDNA into the office without the most recent CHDP.
      • TB Risk Assessment  – Make sure that this is noted on the CHDP/Well Child Exam form.

To meet the requirements of Head Start and California State Licensing, and to prevent the spread of tuberculosis, all children attending any Head Start Program (center, home-based, and EHS) are required to have a TB Risk Assessment or TB skin test as determined by a health care provider.  These items are usually completed at the well-child check and may be found on the well-child exam form, PM 160, or immunization card.  If the child does not have a current TB Risk Assessment, complete the following steps:

1. 1. 1. 1. 1. Using the completed Authorization to Release Health Information, fax the child’s medical provider for the TB Risk Assessment.
            2. If Staff are unable to obtain a TB risk assessment from the provider after 10 business days, complete the Shasta Head Start TB Risk Assessment Questionnaire and scan to the Health Dept.
            3. SHS Registered Nurse will review the TB Risk Assessment Questionnaire to determine if further follow up is needed. Registered Nurse will attach reviewed/signed TB Risk Assessment into Childplus and enter TB risk assessment event.  Please allow 5 business days for entry.
            4. For children that do not pass the TB Risk Assessment, Registered Nurse will work with family, staff, and medical providers to determine next course of action.

TB Risk Assessment Questionnaire

TB Risk Assessment Questionnaire (Spanish)

• • • • Blood Lead Test – It is required for providers to test for lead at 12 and 24 months of age, regardless of risk criteria. If a blood lead test was not done at 24 months of age, it must be completed between 24 and 72 months of age.
    • Note: If any of the above is missing, the Health Clerk will send you an email informing you of what is missing with the subject line “Missing Requirements”. Remember, you must have a separate “Authorization to Release Health Information” for each provider you are requesting records from. For example, if you are requesting information from a health care provider, a dentist, and a school district, you would have three separate parent-signed authorizations.

45-Day Requirements

Health

Sensory Screenings

Purpose: To screen all enrolled children to detect possible hearing and vision problems.

Procedure:  All enrolled children will be screened within 45 days of entry by trained SHS staff (Family Workers and Home Visitors) using the Audiometric and Vision assessment procedures. Any child who fails the initial screening must be rescreened in 1 month. If the child fails the second screening, the Family Worker/Home Visitor contacts the parents regarding referral to an appropriate health care or eye care provider. A referral letter (see Forms section) is given to the parents/guardians with the results noted.  Family Workers and Home Visitors will follow-up with the family to ensure appropriate follow up has occurred.

Failed Screenings

If a child is screened for hearing or vision and is uncooperative, does not understand directions, or fails the screening, code them in ChildPlus (CP) as “Needs Re-screening, Failed 1st”.   Rescreen in 1 month, using the appropriate screening tool or the EHS Screening Tools, either Music To My Ears or EHS Vision Screener.  Rescreens may also be completed by the Registered Nurse using Sure Sight or Plusoptix (vision) or the OAE (hearing).  If the child fails the second screening use the appropriate referral letter located on the Intranet or in the Health Forms Manual.  Refer them to a health care provider for hearing follow up and/or an audiology referral.  Refer them to an optometrist for vision.  If the child needs to see an ophthalmologist, they will need a referral from their health care provider.    If the child returns with an evaluation report from a health care provider or optometrist/ophthalmologist, scan to “health”.  If a child does not get any follow-up within 3 months of the referral, you must re-screen them.  This gives the child a chance to mature and possibly complete the screening.

Steps:

1. Screen child
2. If uncooperative, unable, or fails screening record in ChildPlus as “Needs Re-screening, Failed 1st”.
3. Rescreen child in 1 month
4. If a child passes the rescreen add an action to the failed event with “Evaluation Complete, No Treatment Needed” as the status code.
5. If the child does not pass the rescreen add an action to the failed event with “Referred, Failed 2nd Screening” as the status code.
6. Check the “Parents/Guardians Notified” box and fill in the fields.
7. Send referral letter to parents with results marked.
8. After completing initial parent contact regarding referral for follow up, remind parent every other month until follow up is complete.
9. Every time you make contact with parent regarding follow up enter it in as an action to the initial failed event with “On-going SHS Contact” as the status code.

Homebase and Center Audiometric Assessment

Procedure:  The screening area should be quiet and free from distractions. Test the audiometer before use by putting on the headset and running through both ears at 15 dB at 1000, 2000, 3000 and 4000 Hz.

Sit the child in a chair and say, “We’re going to play the hearing game.”  Place the headset between you on the table.  Give the child a block with instructions to put the block in the box when they hear the beep.  Take a block yourself and give a sample tone at 90 dB.  Offer lots of praise.

1. “Let’s do it again.” Repeat the above.
2. “Now you try to beat me.”
3. Turn the decibel level down to 50 dB before putting the headphones on the child.
4. “Let’s put the headset on.” Place the headset on gently with the red headphone over the right ear.
5. Always test the right ear first.
6. Give a sample tone at 50 dB, 4000 Hz, then turn the dial down to 25 dB and give a beep at 4000, 3000, 2000 and 1000 Hz . . .
7. Switch to the left ear and give a beep at 25 dB at 1000, 2000, 3000 and 4000 Hz. Record on the Pink Health Cover Sheet.  Use a mark if the child passes, a — if they fail.

When finished, make sure the audiometer is turned off before unplugging.

Criteria for Referral

Children who have failed the screening must be rescreened within in 1 month, to be sure it is a true failure and not related to other factors that may cause the child to perform poorly.

REFER a child if they failed at any frequency for either ear.

Follow up: A Critical Part of Screening!!!

1. One month after the original referral, if you have not received a report from a health care provider of hearing follow up you should contact a parent regarding plans for taking the child for a hearing evaluation. If the parent says that an evaluation has taken place, request a copy and scan to “health”.
2. If the child has NOT had an evaluation, offer assistance to parents to make an appointment. Contact parent(s) again in 4 weeks for results.

Homebase and Center Vision Assessment

 Setting up the Screening Area

1. Choose a quiet, well-lighted area, preferably a separate room, free from distractions and clutter that has the proper distance required for screening. When using a 10foot chart for preschoolers you will need a room about 12 feet long to allow room from the screener.
2. Use the lighted box with the SYMBOLS eye chart at 3 feet from the ground. Lighted box should be clear of shadows. Always use the 10-foot Symbols chart, but record the results in the 20-foot equivalent (the numbers on the right side of the chart).
3. Place a chair next to the box, if preferred.
4. Secure “magic feet” with heels 10 feet from the lighted box or chart. The child should stand or sit with their feet on the “magic feet” or their heels on the 10-foot heel line. If possible, place a small table in front of the child with the SYMBOLS response card within easy reach of the child.

Vision Screening Procedures

1. If the child wears glasses, leave them on.
2. Tell the child you are going to play an eye game. Have them match the symbols on the card with the flash cards or by pointing to the response board.
3. Give lots of positive reinforcement.
4. When a child understands the matching game, or can name the symbols, check both eyes together first. Start at the 20/60 line and move through the line, down to at least the 20/40 line.
5. Place the occluder glasses on, covering the left eye to screen the right eye first.
6. Start at the 20/60 line and screen down to at least the 20/40 line. To pass a line, the child must correctly identify one more than half the symbols on that line (3 of 5 symbols). Record the smallest line a child can pass. If the child squints or looks around the glasses to name a symbol, do not pass that line.
7. Change the occluder glasses to cover the right eye.
8. Record the results on the Pink Health Cover Sheet and as a new event in ChildPlus.

Failed Screening

1. All children who failed a vision screening using the eye charts must be rescreened in 1 month before a referral. Record the second screening results in ChildPlus as an “action” to the first failed event.
2. A child with a visual acuity of 20/50 or worse (higher) in either or both eyes failed the screening. In other words, they must correctly identify 3 of the 5 symbols on the 20/40 line or a lower line (20/30, 20/25 or 20/20)
3. A child with a two-line difference or more in visual acuity between the eyes failed the screening. For example, if a child screen s at 20/40 in one eye and 20/20 in the other eye, they would fail the screening, even if both results are below the 20/50 cut-off.
4. Refer a child who fails two vision screenings to an eye doctor. See the referral list in the back of the health manual.

Follow up: A Critical Part of Screening!!!

1. One month after the original referral, if you have not received a report of an eye examination, you should contact a parent to inquire regarding plans for taking the child for an eye examination. If the parent says that an examination has taken place, request a copy of the exam and scan to “health”.
2. If the child has NOT had an exam, offer assistance to parents to make an appointment. Contact parent(s) again in 4 weeks for results.

Note:  If a child fails the SPOT vision screening completed by the Lions Club or a Plusoptix screening completed by Head Start, refer them directly to an optometrist without rescreen.

EHS Audiometric Assessment

Policy: To provide a basic, standardized hearing screening for all infants and children enrolled in the EHS program.  Infants and children who fail the screening will be screened again 1 month later.  Infants and toddlers who fail the second screening will be referred to their health care provider for additional diagnostic exams, using appropriate referral letters found in the Health Forms Manual or on the Intranet.

Procedure: The screening area should be quiet and free from distraction.  Age 2 to 36 months: Complete the Hearing Development and Communication Questionnaire for Screening of Infants found in the “Music To My Ears” kit.  Complete the age appropriate questions only.  Follow the instructions to complete the hearing screening using the “Music To My Ears” kit.  Scorecards are supplied in the kit.  For children 24 to 36 months old, use the 24-month age slot.  Refer any child who fails the screening to his or her health care provider for follow-up.

Major characteristics of hearing development:

• Birth to one month: Responds to sudden sound by crying, blinking eyes or opening eyes widely. Extends limbs and fans out fingers and toes; has startle reflex (Moro).  May become still if active at the time of stimulation.
• Three months: Begins to turn head to the side in an attempt to locate the sound source.
• Six months: Turns head directly to the side toward sound source.
• Nine months: Turns head to the side then downward to locate sound made below eye level. Learns to control and adjust response to sound (e.g. may delay response and listen for sound again, may not attempt localization).  Comprehends “no-no” and “bye-bye.”  Imitates sounds.
• Twelve months: Directly localizes sound to the side and below eye level. Turns head horizontally and then upward to locate sound source above eye level.  Understands simple instructions when accompanied by a gesture (e.g. “Give it to mommy” or “Say bye-bye”).  Says two or three words with meaning by one year.
• Eighteen months: Directly turns head to sound made at the side, below and above eye level. Responds to commands.
• Twenty-four months: Directly turns head to sound at all levels. Joins words together spontaneously. Developmental progression of speech and language are good indicators of normal hearing.

EHS Vision Assessment

Policy:  To provide a basic, standardized screening to detect amblyopia (lazy eye) for all infants and children enrolled in the EHS program.  Infants and toddlers who fail the first screening will be screened a second time 1 month later.  Refer infants and children who fail the second screening to their health care provider for further diagnostic evaluations.

Procedure:  Along with the parent questions complete the following:

Age 0 to 12 months:

Tracking: Lie a young infant on his or her back and put a bright object (colored diversion ball from the Music To My Ears kit) approximately 13″ from the face.  Move the ball slowly in an arc from side to side and watch for smooth equal movements as the baby attempts to follow the ball with his or her eyes.
Age 12 to 36 months:

Tracking: With child sitting on chair or in mom’s lap, hold a bright object (colored diversion ball from the Music To My Ears kit) approximately 13″ from eyes.  Move the object in an “X” pattern and look for smooth equal tracking movements.

Do this assessment once per year while the child is in the EHS program.  Refer any child who fails the screening to his or her health care provider for follow-up.  Send a copy of the referral with screening results to the Health Services Manager/Registered Nurse.

Major characteristics of vision development:

• Birth: Eyes move independently. Fixates on moving object in the range of 45 degrees. Blinks, squints, or may sneeze when exposed to bright lights.  Eye and head movements are not coordinated.  Farsighted due to the immaturity of the eyeball (visual acuity approx. 20/300).
• One month: Fixates on large, moving objects in the range of 90 degrees. Watches parents intently when they speak.  Fixates on face.  Tear glands start to function.  Intermittent strabismus (crossed eyes) may be present.
• Two months: Peripheral vision of 180 degrees. Convergence on near objects begins at six weeks (eyes begin working together).  Follows moving objects with eyes, but movements may be jerky.
• Three months: Regards hand. Well established convergence.  Follows a moving object from side-to-side.  Fixates on near objects.
• Four months: Visual acuity 20/80. Fixates on one-inch cube.  Recognizes familiar objects (e.g. feeding bottle).  Observes mirror image.  Make referral if strabismus continues by four to six months of age.
• Six months: Visual acuity 20/20 – 20/40 (measured by (VECP) visual evoked cortical response). Moves or adjusts position to see object.  Watches falling toy.  Eye-hand coordination is developing.  Smooth following eye movements in all directions.
• Nine months: Depth perception is developing. Attentive to environment.  Observes activities of people and animals with sustained interest within a distance of ten to twelve feet for minutes at a time.
• Twelve months: Follows rapidly moving objects. Recognizes familiar people at 20 feet or more.  Visual acuity 20/20 (measured by VECP).
• Eighteen months: Well established convergence (uses both eyes together). Fixates on small objects.  Sees and points to interesting objects outdoors.
• Twenty-four months: Fixates on small objects for sixty seconds. Well-developed accommodation.  Recognizes fine detail in picture books.
• Thirty-six months: Visual acuity is 20/20 as measured by VECP. Copies geometric designs, circle, cross.  Smooth convergence.

Education

• Ages & Stages Questionnaires (ASQ) 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 within 45 calendar days of when the child first attends the program or, for the home-based program option, receives a home visit.
  • Ages 1 month to 5.5 years
  • Completed within 45 of the child’s initial entry into Early Head Start and Head Start, or if a concern arises
  • Completed by Teacher/Associate Teacher, Primary Caregiver or Home Visitor
  • Completed for both center-based and home-based children in both Early Head Start and Head Start programs
  • If a referral is necessary, complete the Referral for Observation/Consultation form  (English | Spanish available)
    • When the Disabilities Department receives a referral, purple folder is distributed.
    • Refer to the SOP Prior to Day 1 under Other Screenings and Requirements for instruction.
  • ASQ:SE-2 (Social Emotional) – The ASQ:SE-2 is designed to help understand and plan appropriately for each child in the program.  The inventory provides a profile of the child in the areas of play, language, feelings, relationships, movement and coordination and regulation of body functions.  This inventory is used in conjunction with information from the health screeners, cognitive screening, the work sampling system and observations in planning curriculum, setting child goals, and in making referrals
    • Center-based – Completed with parent at the first home visit
      • If this is not possible by 45 days, staff will complete the questionnaire and review with the parent at a later time
    • Home-based – Completed with parent at the third home visit
  • For newly enrolled children:
    After entering the ASQ SE-2 results into ChildPlus, the Family Worker will scan the completed ASQ SE-2 to the Disabilities scan folder.
  • ASQ-3 (Developmental) – These screening tools are used in accurately identifying children with possible developmental and or language delays.  Screening enables teachers and administrators to seek help much earlier for a child who might be at risk than waiting for observations and documentation to accumulate before ascertaining a child’s need for intervention.  Children who require further assessment are referred as necessary to the Disabilities Department.
    • Center-based – Completed at the center by Staff with parent input as needed
    • Home-based – Completed at the fourth home visit with parent’s input as needed
  • First Home Visit – The first home visit is a continuation of the parent orientation. This is a time to go over the program, and explain paperwork on an individual basis. It is a great opportunity to see the child and family in their environment and to begin to individualize and gain an understanding of the family culture.
    • Who/When Completed: Child Development Staff in conjunction with the Family Worker whenever possible (not required). Try to schedule the home visit prior to parent orientation. Each child must be visited within 45 days of date of entry.
      • Teacher/Associate Teacher or Primary Caregiver conducts first home visit
    • Complete the First Home Visit Form. Note: If the family did not attend orientation, then the bottom section of the form must be completed at the first home visit. Check off each item as you discuss them during the visit. Add any specific site information and/or family information shared during the visit. Completed form must be kept in child’s file under the Education section.
    • Important Notes: Prior to the visit, determine if an interpreter is needed. Take a toy or activity with you to “break the ice” and to occupy the child while you are talking with the parent. Remember to document reason for no contact, attempts made, or cancellations on Education Purple Cover Sheet.
    • No Child Plus data entry required.
    •  Resources:
      • HS First Home Visit Packet
      • HS First Home Visit Packet Spanish
      • EHS First Home Visit Packet
      • First Home Visit Form – English/Spanish
    • See additional documents in the 45-day folder in these subfolders:
      • Developmental Screening documents:
        • ASQ-3 Formster
        • ASQ3 Learning Activities Formster 
        • Developmental Screening Resources document:
          • ASQ Calculator – link to website used to determine which tool to use
        • ASQ-3 16-month sample – sample of completed ASQ-3
        • Combo Age Admin Chart – cheat sheet
        • Learning Activities Sample
        • Materials Needed to Administer ASQ-3 
        • Screening Children
        • Screening Children Purpose
        • What is ASQ-3? (English/Spanish)
        • Referral for Observation/Consultation English | Spanish
      • Mental Health Screening documents:
        • ASQ-SE Formster
        • Combo Age Admin Chart – cheat sheet
        • What is ASQ:SE-2? English | Spanish
        • ASQ:SE-2 24-month Questionnaire – SAMPLE
        • ASQ:SE Learning Activities formster
          • ASQ:SE-2 Activities
        • Screening Children
      • Education Home Visit documents:
        • First Home Visit formster
          • First Home Visit Form (English/Spanish on the form – not separate versions)
        • School Readiness Goals for Infants and Toddlers English | Spanish
        • School Readiness Goals for Preschool Children
        • Center Base Parent Handbook  English | Spanish
        • Children’s Bathroom Policy English | Spanish
        • Family of the Week | Spanish
        • EHS Family Albums English | Spanish
        • Family Portrait Formster – Formster
          • Family Portrait form  English | Spanish
        • InKind | Spanish (list of items for use in classroom)

60-Day Requirements

Health

• No additional requirements

Education

• DRDP – Ongoing Assessment – Complete the first DRDP rating (as described in the Title and Performance Standard references below). Using information gathered during the enrollment process and observation of the child during the first 60 days, education staff will complete the first rating.
  • Title 5 18272(b) The Desired Results Developmental Profile required in subdivision (a) shall be completed for each child within 60 calendar days of enrollment and at least once every six months for infants, toddlers, preschoolers and school-age children. (§ 18272. Developmental Profile)
  • PPS 1302.33 Child Screenings and Assessments
• Ongoing Assessments

Other

90-Day Requirements

Health

• Health Status Determination – Staff will determine if a child is up-to-date on a schedule of primary medical care, by obtaining a completed CHDP exam or equivalent, an immunization record and by completing a SHS Health, Developmental, and Nutritional history (HDNA). The Health Team will review these records within 90 days of entry into the program, to determine whether a child is up-to-date and to develop a plan for ongoing care and follow-up. If the child does not have a medical home, staff will work with parents to develop a strategy to obtain care through referrals and collaboration with community agencies.
• Dental Status Determination – Staff will determine if each child has a source of continuous dental care by completing the Health, Developmental, and Nutritional Assessment (HDNA), obtaining a completed dental exam for all children over three years of age, or obtaining a current physical for children under three years of age. The Health Team will review these records, within 90 days of entry into the program, to determine if a child is up-to-date and develop a plan for on-going care and treatment. If a child does not have a dental home, staff will make referrals using the resources located in the back of the Health Manual.
• Dental Examinations – All SHS Children (3 and 4 year olds) must receive an annual dental examination and any treatment deemed necessary by a licensed health professional. Families are expected to make an appointment for their child within 3 weeks of enrollment and the exam must be completed within 90 days of entry. Exceptions to this policy must be approved by the Health Services Manager. All EHS children are recommended to have a completed dental exam between the eruption of their first tooth and no later than their first birthday.

Social service staff will assist families in obtaining a dental examination for enrolled children within the first 90 days of entering the program. Assistance may include linking the family with a dental home, helping families to obtain dental insurance, obtaining language services, providing transportation or requesting Head Start financial assistance as a payee of last resort. Health Services Manager should be contacted for assistance with resources to help families obtain a dental exam for their child.

CHDP PERIODICITY SCHEDULE FOR DENTAL REFERRAL BY AGE

Important Note:  A dental screen/oral assessment is required as part of every CHDP health assessment regardless of age.  It is mandatory to refer children directly to a dentist annually beginning at age three (3).  However, it is recommended that children be routinely referred to a dentist annually beginning at age one (1).  Children of any age must be referred to a dentist if a problem is detected or suspected.

Education

• No additional Requirements

Other

• Family Services Packet (See SOP Family Partnership Process)

Documentation of Non-Compliance:

When a timeline for certain events is not, or will not be met, this is considered a Non-Compliance. The following events have timelines that must be met:

• Health Packet (HDNA) (30 calendar days)
• Hearing (45 calendar days)
• Vision (45 calendar days)
• Dental Exam (90 calendar days)
• Developmental (ASQ3) (45 calendar days)
• Family Assessment
• FPA / Family Goal(s)
• Mental Health (ASQ-SE) (45 calendar days)
• Transition 2.5 yr

The purpose of documenting Non-Compliance is to track the reason why a requirement was not met or was completed late and to document detailed attempts that have been made to complete the requirement. This is your opportunity to tell the whole story of why it was not completed, and to clearly document what efforts have been made to complete the requirement. Please use detailed notes in ChildPlus.

Directions:

1. Upon knowledge of a non-compliance, schedule the event in ChildPlus (See documentation of non-compliance entry SOP).
2. Discuss all documentation of Non-Compliance with your supervisor/Area Manager.
3. Follow up with parent/guardian at least once a month to discuss the status of the requirement.
4. Staff can use Notice of Needed Ongoing Care when contacting parents.
   • Notice of Needed Ongoing Care:  English | Spanish
5. Add “Actions” and detailed “Action Notes”, each time you follow-up with the parents.
6. Contact the Health Department for further guidance when two Well Child Appointments are missed.
7. For assistance with the ChildPlus entry contact the ChildPlus Training Coordinator.

Family Workers will need to work with Education staff for full details regarding non-compliance for ASQ screeners.