Head Start Forms - Early Head Start

  • INDEX:

    ABC Poster – Child Development EHS

    Acceptance Letter 2020 – Parent Letter #7 Enrollment EHS

    Accident Injury Report Form – Health/Dental/Nutrition #18 EHS

    Action Plan – Family Support #8 EHS

    Action Plan Attendance Example – Family Support #8 EHS

    Active Supervision Back Handout-English – Child Development EHS

    Active Supervision Back Handout-Spanish – Child Development EHS

    Active Supervision Poster-English – Child Development EHS

    Active Supervision Poster-Spanish – Child Development EHS

    Additional Emergency Permission Form – Child File #11a EHS

    Additional Emergency Permission Form – Child File #11b EHS

    Air Quality Handout – Health EHS

    All About Me Poster – Child Development EHS

    Applicant of a Staff Person Referral – Enrollment #7 EHS

    ASQ-3 Result Form – Child Development #16 EHS

    ASQ-SE-2 Results – Mental Health #6 EHS

    Basic Information Form 2021-2022 – Enrollment #1 EHS

    Basic Information Form Typeable 2021-2022 – Enrollment #1 EHS

    Bed Bugs-Managing Information – Health EHS

    Binder Spine Center Based – Child File #4 EHS

    Binder Spine Home Based – Child File #5 EHS

    Blood Lead Level Reporting Form – Health EHS

    Bulletin Board Education Poster – Child Development EHS

    Celsius to Fahrenheit-Print – Health EHS

    Center Based Attendance Letter – Parent Letter #11 Enrollment EHS

    Center Based COVID-19 Enrollment Agreement Packet ENG – Enrollment #37 EHS

    Center Based COVID-19 Enrollment Agreement Packet SPAN – Enrollment #37 EHS

    Certificate Immunization Status – Health EHS

    Certificate of Exemption-English – Health EHS

    Certificate of Exemption-Spanish – Health EHS

    Change of Enrollment Status Report – Enrollment #19 EHS

    Child File Checklist 2020-2021 – Child File #8 EHS

    Child File Checklist 2021-2022 – Child File #8 EHS

    Child Outcomes Data Checkpoint – Child Development #19 EHS

    Child Outcomes Data Checkpoint Comparison – Child Development EHS

    ChildPlus Teacher Manual – Child Development EHS

    Classroom Allergy List – Health/Dental/Nutrition #30 EHS

    Classroom Attendance with Daily Health Check – Family Support #12 EHS

    Classroom Information Board – Health EHS

    Classroom Roll Call Sheet – Child Development EHS

    Classroom Sign In Cover Sheet – Child Development EHS

    Clinics Addresses – Family Support EHS

    Color Code EHS – Enrollment #29 EHS

    Communication Letter During COVID-19 – Parent Letter #15 Enrollment EHS

    Community Resources for Yakima County – Family Support EHS

    Complete Application Letter – Parent Letter #3 Enrollmennt EHS

    Consent to Release or Exchange Information – Child File #15 EHS

    Consent to Release or Exchange Information Form – Special Services #15 EHS

    Copy of Zoning Areas – Child Development EHS

    Correspondence Log – Child File #14 EHS

    Cover Your Cough Poster-English – Health EHS

    Covid 19 Authorized Visitor Record – Health/Dental/Nutrition #59 EHS

    Covid 19 Daily Child Attendance Record for Children – Health/Dental/Nutrition #57 EHS

    Covid 19 Health Check Questionnaire – English- Health/Dental/Nutrition #56 EHS

    Covid 19 Medication Log – Health/Dental/Nutrition #11 EHS

    CPR-First Aid Cards – Health/Dental/Nutrition #37 EHS

    Cubby Label Example – Child Development EHS

    Daily Safety and Sanitation Checklist – Checklist #1 Health EHS

    Daily Schedule Example – Child Development EHS

    Daily Temperature Log – Health/Dental/Nutrition #54 EHS

    Dental Cover Sheet – Health EHS

    Designation of Another Person to Consent for HS Activities – Child File #20 EHS

    DOH Conditional Immunization Status-English – Health EHS

    DOH Conditional Immunization Status-Spanish – Health EHS

    DOH Immunization Exclusion-English – Health EHS

    DOH Immunization Exclusion-Spanish – Health EHS

    Early Head Start Timeline 2019-2020 – Child Development EHS

    EHS Center Newsletter Template – Family Support #16 EHS

    EHS Family Outcomes Assessment-English – Family Support #14 EHS

    EHS Family Outcomes Assessment-Spanish – Family Support #14 EHS

    EHS Online Enrollment Form Checklist – Enrollment #36 EHS

    EHS Planning and Documentation Form Example – Family Support #15 EHS

    Eligibility Comment Sheet – Enrollment #2 EHS

    Eligibility Disclaimer of Documentation – Enrollment #38 EHS

    Eligibility Income Verification – Enrollment #6 EHS

    Eligibility Selection Criteria 2020 – Enrollment #15 EHS

    Eligibility Selection Criteria 2021 – Enrollment #15 EHS

    Emergency Binder Cover Sheet – Child File #22 EHS

    Emergency Information Form 2020 – Child File #9 EHS

    Emergency Information Form 2021 – Child File #9 EHS

    Employee Training Documentation for Child Guidance – Mental Health #12 EHS

    Enrollment Cover Sheet – Enrollment #35 EHS

    Enrollment Resource - Race and Ethnicity – Enrollment EHS

    Enrollment Resource - Social Security Fact Sheet – Enrollment EHS

    Enrollment Resource - What to Count as Income – Enrollment EHS

    Enrollment Verification Checklist - Center Based – Enrollment #4 EHS

    Enrollment Verification Checklist - Home Based – Enrollment #4 EHS

    Enter and Exit Plan EHS – Enrollment #28 EHS

    Exemption Quick Reference Guide – Health EHS

    Eye Screening for Children-English – Health EHS

    Eye Screening for Children-Spanish – Health EHS

    Family Cover Sheet Center Based – Child File #1 EHS

    Family Cover Sheet Home Based – Child File #2 EHS

    Family Engagement Packs: Check-Out Form – Child Development #18 EHS

    Family Enrollment Profile – Enrollment #5 EHS

    Family Leave of Absence Agreement-Eng/Span. – Family Support #10 EHS

    Family Needs Assessment-Eng/Span. – Family Support #3 EHS

    Family Night Sign In Sheet – Family Support #17 EHS

    Family Partnership Plan Family Goal – Family Support #5 EHS

    Family Photo Cover Page EHS – Child File #10 EHS

    Federal Poverty Level 2021 – Enrollment #11 EHS

    Federal Poverty Level 2021 – Enrollment #11 EHS

    Field Trip Permission Form – Child Development #11 EHS

    Field Trip Request Form – Child Development #11 EHS

    File Log In Center Based – Child File #7 EHS

    File Log In Home Based – Child File #7 EHS

    File Transfer Authorization Form – Enrollment #26 EHS

    Fire Safety and Emergency Drills Form – Health EHS

    First Parent Teacher Conference Guide 20-21 – Child Development EHS

    Food Experience Permission from – Child Development #16 EHS

    Frequency Chart – Mental Health #11 EHS

    Germ Buster Flyer-Eng./Span. – Health EHS

    HCP 1st Aid Medical Alert Cover Sheet – Health EHS

    Head Lice Notice-English – Health/Dental/Nutrition #39 EHS

    Head Lice Notice-Spanish – Health/Dental/Nutrition #40 EHS

    Health and Safety Checklist – Health/Dental/Nutrition # 50 EHS

    Health Check Questionnaire – Health/Dental/Nutrition #55 EHS

    Health Concerns-Wildfire Smoke Air Quality – Health EHS

    Health History Annual Update-Eng./Span. – Health/Dental/Nutrition #2 EHS

    Health Info Cover Sheet – Health EHS

    Health Room Checklist – Health EHS

    Health Screening Card – Health/Dental/Nutrition #19 EHS

    Health Screenings Cover sheet – Health EHS

    Health Status Determination – Health/Dental/Nutrition #36 EHS

    Health/Dental/Nutrition-Transportation Medication Label – Health EHS

    Hearing Screening Birth to Three – Health/Dental/Nutrition #26 EHS

    Hearing Screening Parent Information-English – Health EHS

    Hearing Screening Parent Information-Spanish – Health EHS

    Home Based Attendance Letter – Parent Letter #11 Enrollment EHS

    Home Based COVID-19 Enrollment Agreement Packet ENG – Enrollment #37 EHS

    Home Based COVID-19 Enrollment Agreement Packet SPAN – Enrollment #37 EHS

    Home Goals In-Kind Form – Child Development #10 EHS

    Home Safety Checklist EHS – Family Support #20 EHS

    How to Change a Diaper-English – Health EHS

    How to Change a Diaper-Spanish – Health EHS

    How to Use a Mask – Health EHS

    HS/EHS Program Postings & Availability – Child Development EHS

    IFSP/IEP Information Guidance Sheet – Special Service #13 EHS

    Immunization Record Requirements – Health/Dental/Nutrition #55 EHS

    In and Out Board Example – Child Development EHS

    Income Calculation Worksheet A – Enrollment #8 EHS

    Income Calculation Worksheet B – Enrollment #9 EHS

    Income Cover Sheet – Enrollment #30 EHS

    Income Story – Enrollment #10 EHS

    Ineligible - Out of District – Parent Letter #5 Enrollment EHS

    Ineligible - Over Income Letter – Parent Letter #4 Enrollment EHS

    Ineligible Age Requirement – Parent Letter #6 Enrollment EHS

    Infant and Toddler Observation Checklist – Mental Health #9 EHS

    Infant and Toddler Observation Checklist-Spanish – Mental Health #9 EHS

    Initial Health History – Health/Dental/Nutrition #20 EHS

    Inputting ASQ and ASQ SE Scores Online – Child Development EHS

    Intervention Plan Example –  Special Services #14 EHS

    Introducing Glasses to Young Children- Eng./Spa. – Health EHS

    Keep Me at Home-English – Health EHS

    Keep Me at Home-Spanish – Health EHS

    Label Example – Child Development EHS

    Label Material Example – Child Development EHS

    Lead Dirt Alert Arsenic-English – Health EHS

    Lead Dirt Alert Arsenic-Spanish – Health EHS

    Lead Flyer-Eng/Span. – Health EHS

    Lead Poisoning-Eng/Span. – Health EHS

    Lead Screening Results-English – Health/Dental/Nutrition #31

    Lead Screening Results-Spanish – Health/Dental/Nutrition #31

    Lead Testing Consent – Health/Dental/Nutrition #23

    Lesson Plan Cover Sheet – Child Development EHS

    Letter to Parents Immunizations Needed-Eng/Span. – Health/Dental/Nutrition #33 EHS

    List of Homeless Shelters in Yakima – Family Support EHS

    List of Needed Documents HS/EHS – Parent Letter #1 Enrollment EHS

    Los Ninos Bien Educados Referral – Family Support #19 EHS

    Management Charts – Child Development EHS

    Marijuana and Pregnancy-English – Health EHS

    Marijuana and Pregnancy-Spanish – Health EHS

    Medical Alert Allergy – Health/Dental/Nutrition #50 EHS

    Medical Alert Asthma – Health/Dental/Nutrition #49 EHS

    Medical Alert Seizure – Health/Dental/Nutrition #51 EHS

    Medical Dental Home Form – Health/Dental/Nutrition #4 EHS

    Medication Consent and Chart – Health/Dental/Nutrition #10 EHS

    Medication Log – Health/Dental/Nutrition #11 EHS

    Memo Form – Enrollment #33 EHS

    Mental Health Referral Packet Checklist – Mental Health #2 EHS

    Miscellaneous Health Information Cover Sheet – Health EHS

    Monthly Classroom Health and Safety Checklist – Health/Dental/Nutrition #5 EHS

    Monthly Home Visit Conference Log – Education #6 EHS

    Notice of Disenrollment – Parent Letter #12 Enrollment EHS

    Nursery Rhymes – Child Development EHS

    Nutrition History & Assessment Infants & Toddlers – Health/Dental/Nutrition #22 EHS

    Nutritional Assessment Pregnant Women-English – EHS #1 EHS

    Nutritional Assessment Pregnant Women-Spanish – EHS #1 EHS

    Observation Help Sheet – Child Development EHS

    Observation Permission Form – Mental Health #3 EHS

    Observation Permission Form – Special Services #7 EHS

    Online ERSEA Checklist – Enrollment #3 EHS

    Operations #3-Classroom Sign In and Out Log – Child Development EHS

    Other Health Cover Sheet – Health EHS

    Over Income-Special Needs – Enrollment #14 EHS

    Overwhelming Interest Letter – Parent Letter #2 Enrollment EHS

    Parent Evaluation – Family Support #18 EHS

    Parent Request for Lead Screening – Health/Dental/Nutrition #38

    Parents Sign In/Out Sheet – Child File #21 EHS

    Plants in the Classroom Guidance – Child Development #22 EHS

    Portfolio Label Peppa Pig Example – Special Service #10 EHS

    Portfolio Label– Special Services #10 EHS

    Positive Behavior Support Plan – Mental Health #17 EHS

    Post Natal Depression Scale-English – EHS #6 EHS

    Post Natal Depression Scale-Spanish – EHS #6 EHS

    Pre Postnatal Checklist-English – EHS #5 EHS

    Pre Postnatal Checklist-Spanish – EHS #5 EHS

    Prenatal History-English – EHS #3 EHS

    Prenatal Needs Assessment-English – EHS #2 EHS

    Prenatal Needs Assessment-Spanish – EHS #2 EHS

    Recipes for Healthy Snacks – Health EHS

    Record Request – Family Support #11 EHS

    Referral Checklist English – Special Services #4 EHS

    Referral Checklist Spanish – Special Services #4 EHS

    Referral Form – Child File #16 Health EHS

    Referral Form Typeable – Child File #16 EHS

    Referral to Health Care Provider – Health/Dental/Nutrition #7 EHS

    Referral to Seedlings Center - Kittitas – Enrollment #32 EHS

    Referral to Seedlings Center - Yakima – Enrollment #32 EHS

    Referrals Cover Sheet – Health EHS

    Remote Visit Guidance – Child Development EHS

    Resource List Yakima – Family Support EHS

    Safety Sam Book – Child Development EHS

    Screening and Diagnosis of Hearing Loss-English – Health EHS

    Screening and Diagnosis of Hearing Loss-Spanish – Health EHS

    Second Head Start and EHS-Center Base Parent Teacher Conference Checklist Guide 2020/2021 – Child Development EHS

    See Something Comment Box Sheet – Health EHS

    See Something, Say Something Poster BP - English – Health EHS

    See Something, Say Something Poster BP - Spanish – Health EHS

    See Something, Say Something Poster CV - English – Health EHS

    See Something, Say Something Poster CV - Spanish – Health EHS

    See Something, Say Something Poster CV Outpost - English – Health EHS

    See Something, Say Something Poster CV Outpost - Spanish – Health EHS

    See Something, Say Something Poster EW - English – Health EHS

    See Something, Say Something Poster EW - Spanish – Health EHS

    See Something, Say Something Poster EY - English – Health EHS

    See Something, Say Something Poster EY - Spanish – Health EHS

    See Something, Say Something Poster JF - English – Health EHS

    See Something, Say Something Poster JF - Spanish – Health EHS

    See Something, Say Something Poster KT - English – Health EHS

    See Something, Say Something Poster KT - Spanish – Health EHS

    Self Declaration of Family Income – Enrollment #12 EHS

    Site Emergency Information – Safety #7 EHS

    Socialization Attendance with Daily Health Check – Family Support #21 EHS

    Special Service Poster – Special Services EHS

    Special Services Log – Special Service #9 EHS

    Special Services Visit/Guidance – Special Services EHS

    Speech and Language Checklist Birth to Three-English – Special Service #5 EHS

    Speech and Language Checklist Birth to Three-Spanish – Special Service #5 EHS

    Staffing Notes – Special Services #8 EHS

    Stand Up Diapering Procedure-English – Health/Dental/Nutrition #28 EHS

    Stand Up Diapering Procedure-Spanish – Health/Dental/Nutrition #28 EHS

    Statement of No Income – Enrollment #13 EHS

    Stay Safe, Stay Healthy, Stay Vaccinated Poster – Health EHS

    Stop the Spread of Illness Poster-English – Health EHS

    Stop the Spread of Illness Poster-Spanish – Health EHS

    Sunscreen Log – Health/Dental/Nutrition #29 EHS

    Three Tiered Approach – Mental Health #18 EHS

    Title 1 Migrant Form – Enrollment #22 EHS

    Toileting Plan – Child Development #4 EHS

    Toothbrushing and Covid 19 English-Spanish – Health EHS

    Tracking Form for Combining Rooms - Health #62 EHS

    Transfer Authorization log – Enrollment #27 EHS

    Transition Plan – Child Development #5 EHS

    Transition Plan Infant to Toddler Example – Child Development #5 EHS

    TS Gold Help Guide on Funding Source – Child Development EHS

    TS Gold How to Guide – Child Development EHS

    TS Gold Progressions-English – Child Development EHS

    TS Gold Progressions-Spanish – Child Development EHS

    Two Week Post Natal Visit-English – EHS #4 EHS

    USDA CACFP Cover Sheet – Health EHS

    Vaccines Cover Sheet – Health EHS

    VIP Letter – Child Development #13 EHS

    Vision Screening Birth to Three – Health/Dental/Nutrition #25 EHS

    Waitlist Letter –  Parent Letter #9 Enrollment EHS

    Weather Chart – Health EHS

    Well Child Exam Cover Sheet – Health EHS

    What Can You Do Poster-English – Health EHS

    What Can You Do Poster-Spanish – Health EHS

    What is Hearing Loss in Children-English – Health EHS

    What is Hearing Loss in Children-Spanish – Health EHS

    What You Need to Know about Covid 19-English – Health EHS

    What You Need to Know about Covid 19-Spanish – Health EHS

    When What Why and Where Required to Wear PPE – Health EHS

    Who's Here – Child Development EHS

    Yakima County Community Resources – Family Support EHS

    Yakima County Food Banks-English – Health EHS

    Yakima County Food Banks-Spanish – Health EHS

    Yakima Flyer – Family Support EHS

    Yakima Resource Guide – Family Support EHS

    Yakima Valley Resource Guide – Health EHS

    Your Child's Doctor Can Help, You’re Not Alone Poster – Health EHS

    Zoning Staff Chart – Child Development EHS