Head Start Forms
- Early Head Start
- Head Start
- Migrant Seasonal Head Start
- Fiscal
- Human Resources
- In-Kind/Non-Federal Share
- Monitoring
- Playground and Facilities
- Recruitment Forms
- Transportation Forms
- USDA
- East Yakima Summer Program
- Miscellaneous
Early Head Start
- EHS Pregnant Women Forms
- Child File
- Enrollment
- Child Development
- Family Support
- Special Services
- Mental Health
- Health and Safety
EHS Pregnant Women Forms
EHS #1-Nutritional Assessment Pregnant Women-English
EHS #1-Nutritional Assessment Pregnant Women-Spanish
EHS #2-Prenatal Needs Assessment-English
EHS #2-Prenatal Needs Assessment-Spanish
EHS #3-Prenatal History-English
EHS #4-Two Week Post Natal Visit-English
EHS #5-Pre Postnatal Checklist-English
EHS #5-Pre Postnatal Checklist-Spanish
Child File
Child File #1-Family Cover Sheet Center Based
Child File #2-Family Cover Sheet Home Based
Child File #3 Family Cover Sheet
Child File #5-Binder Spine EHS-HB
ChildFile #5-Binder Spine EHS-CB
Child File #7-File Log In Home Based
Child File #7-File Log In Center Based
Child File #8-EHS Child File Checklist 2022-2023
Child File #9-Emergency Information Form 2023-2024
Child File #10-Family Photo Cover Page EHS
Child File #11a-Additional Emergency Permission Form EHS
Child File #11b-Additional Emergency Permission Form EHS
Child File #14- Correspndence Log
Child File #15-Consent to Release or Exchange Information
Child File #16-Referral Form Typeable
Child File #20-Designation of Another Person to Consent for Head Start Activities
Child File #21-Parent Sign In/Out Sheet
Child File #22-Emergency Binder Cover Sheet
Child File #22-Emergency Binder Cover Sheet Transportation
Child File #23-Emergency Binder Cover Sheets for Receptionist
Enrollment
- Enrollment # 2-Eligibility Comment Sheet
- Enrollment #3-EHS ERSEA Checklist
-
Enrollment # 4-Center Based Enrollment Verification Checklist
- Enrollment # 5-Family Enrollment Profile
- Enrollment # 6-Eligibility Income Verification
- Enrollment # 10-Income Story
- Enrollment # 12-Self Declaration of Family Income
- Enrollment # 13-Statement of No Income
- Enrollment # 22-Title 1 Migrant Form
- Enrollment # 26-File Transfer Authorization Form
- Enrollment # 27-Transfer Authorization log
- Enrollment # 28-Enter and Exit Plan EHS
- Enrollment # 29-Color Code EHS
- Enrollment # 30-Income Cover Sheet
- Enrollment # 33-Memo Form
-
Enrollment #36-EHS Online Enrollment Form Checklist 2022-2023
- Enrollment # 37-Enrollment Agreement Packet CB-HB ENG 2022-2023
- Enrollment # 37-Enrollment Agreement Packet CB-HB SPAN 2022-2023
- Enrollment # 38-Eligibility Disclaimer of Documentation
- Enrollment Resource - Race and Ethnicity
- Enrollment Resource - Social Security Fact Sheet
- Enrollment Resource - What to Count as Income
Parent Letters
Child Development
Required Postings
-
- Safety Sam Book
- ABC Poster
- Active Supervision Poster-English
- Active Supervision Poster-Spanish
- Active Supervision Back Handout-English
- Active Supervision Back Handout-Spanish
- Bulletin Board Education Poster
- Cubby Label Example
- Daily Schedule Example
- In and Out Board Example
- Label Example
- Label Material Example
- Management Charts
- Nursery Rhymes
- Who's Here
- Zoning Staff Chart
- HS/EHS Program Postings & Availability
Staff Resources
-
- Child Development #4-Toileting Plan
- Child Development #5-Transition Plan
- Child Development #5-Transition Plan Infant to Toddler Example
- Child Development #11-Field Trip Permission Form
- Child Development #11-Field Trip Request Form
- Child Development #14-Food Experience Permission Form
- Child Development #16-ASQ-3 Result Form
- Child Development #18-Family Engagement Packs: Check-Out Form
- Child Development #19-Child Data Outcomes Form
- Family Support #15-EHS Planning and Documentation Form Example
- Child Development #22-Plants in the Classroom Guidance
- Child Development #23-Teacher Hatch Dashboard Form
- Child Development #29-Guided Worksheet for Identifying Language in the Classroom
- Hatch Dashboard Guide
- How Do I Log In to Ready Rosie Step by Step
- All About Me Poster
- Child Outcomes Data Checkpoint Comparison
- Inputting ASQ and ASQ SE Scores Online
- ChildPlus Teacher Manual
- Remote Visit Guidance
- TS Gold Help Guide on Funding Source
- TS Gold How to Guide
- TS Gold Progressions-English
- TS Gold Progressions-Spanish
- Early Head Start Center Based Timeline 2021-2022
- Early Head Start Home Based Timeline 2021-2022
- Observation Help Sheet
- First EHS Center Based Parent Teacher Conference Guide 21-22
- Adjustments to the First Center Based Home Visit Guide 2021-2022
- Second Head Start and EHS-Center Base Parent Teacher Conference Checklist Guide 2021-2022
- Second Head Start and EHS-Center Base Home Visit Checklist Guide 2021-2022
Family Support
- Family Support #3-Family Needs Assessment-Eng/Span.
- Family Support #5-Family Partnership Plan Family Goal
- Family Support #8-Action Plan
- Family Support #8-Action Plan Attendance Example
- Family Support #10-Family Leave of Absence Agreement-Eng/Span.
- Family Support #11-Record Request
- Family Support #12-Classroom Attendance with Daily Health Check
- Family Support #14-Family Outcomes Assessment ENG 2022
- Family Support #14-Family Outcomes Assessment SPAN 2022
- Family Support #16-EHS Center Newsletter Template
- Family Support #17-Family Night Sign In Sheet
- Family Support #18- Parent Evaluation
- Family Support #19-Los Ninos Bien Educados Referral
- Family Support #20-Home Safety Checklist EHS
- Family Support #21-Socialization Attendance with Daily Health Check
- Title 1 Part C Migrant Education Program Form
Resources Folder
Special Services
-
- Special Services #4-Referral Checklist English
- Special Services #4-Referral Checklist Spanish
- Special Service #5-Speech and Language Checklist Birth to Three-English
- Special Service #5-Speech and Language Checklist Birth to Three-Spanish
- Special Services #6-Speech and Language Checklist Preschool-English
- Special Services #6-Speech and Language Checklist Preschool-Spanish
- Special Services #7-Observation Permission Form
- Special Services #8-Staffing Notes
- Special Service #9-Special Services Log
- Special Service #13-IFSP/IEP Information Guidance Sheet
- Special Service #14-Intervention Plan
- Special Services #15-Consent to Release or Exchange Information Form
- Child Development #16-ASQ-3 Result Form
- Child File #16-Referral Form
- Special Service Poster
- Special Services Visit/Guidance
Mental Health
- Mental Health #2-Mental Health Referral Packet Checklist
- Mental Health #3-Observation Permission Form
- Mental Health #6-ASQ-SE-2 Results
- Mental Health #9-Infant & Toddler Observation Checklist
- Mental Health #9-Infant & Toddler Observation Checklist-Spanish
- Mental Health #11-Frequency Chart
- Mental Health #12-Employee Training Documentation for Child Guidance
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
Health and Safety
Health Forms
-
- Health/Dental/Nutrition #2-Health History Annual Update-Eng/Span.
- Health/Dental/Nutrition #4-Medical Dental Home Form
- Health/Dental/Nutrition #5-Monthly Classroom Health and Safety Checklist
- Health/Dental/Nutrition #7-Referral to Health Care Provider
- Health/Dental/Nutrition #10-Medication Consent and Chart
- Health/Dental/Nutrition #11-Medication Log
- Health/Dental/Nutrition #12-ADHD Medication Effectiveness
- Health/Dental/Nutrition #18-Accident Injury Report Form
- Health/Dental/Nutrition #19-Health Screening Card
- Health/Dental/Nutrition #20-Initial Health History
- Health/Dental/Nutrition #22-Nutrition History & Assessment Infants & Toddlers
- Health/Dental/Nutrition #25-Vision Screening Birth to Three
- Health/Dental/Nutrition #26-Hearing Screening Birth to Three
- Health/Dental/Nutrition #29-Sunscreen Log
- Health/Dental/Nutrition #30-Classroom Allergy List
- Health/Dental/Nutrition #33-Immunization Letter English-Spanish
- Health/Dental/Nutrition #36-Health Status Determination
- Health/Dental/Nutrition #53-Daily Diaper Changing Chart
- Health/Dental/Nutrition #65-Record of Administration Continuation
- Health/Dental/Nutrition #67-Class Pet Parent Permission Form Eng-Span/fs/resource-manager/view/204f4245-b8f3-4f76-83a0-c35650686a13
- Health/Dental/Nutrition-Transportation Medication Label
- Child File #16-Referral Form
- Yakima Valley Resource Guide
- EHS #6 Post Natal Depression Scale
- Keep Me at Home-English
- Keep Me at Home-Spanish
Nutrition Education for Parents
-
- Choose My Plate-English
- Choose My Plate-Spanish
- Growing Healthy Postcard-Eng/Span.
- Healthy Eating
- Healthy Eat
- Healthy Eating for Preschoolers Mini-Poster
- Nutrition Terms-Spanish
- Food Safety-Spanish
- Child Diabetes-Eng.Span.
- Exercise & Nutrition-Eng/Span.
- MCN Healthy Foods-Eng/Span.
- MCN Nutrition-Eng/Span.
- MCN Read Nutrition Label-Eng/Span.
- MCN Small Changes-Eng/Span.
- Healthy Eating for Preschoolers English
- Healthy Eating for Preschoolers Spanish
- Recipes for Healthy Snacks
Health and Safety Checklist
Immunization Forms
-
- Health/Dental/Nutrition #33-Letter to Parents Immunizations Needed-Eng/Span.
- Certificate of Exemption-English
- Certificate of Exemption-Spanish
- DOH Conditional Immunization Status-English
- DOH Conditional Immunization Status-Spanish
- DOH Immunization Exclusion-English
- DOH Immunization Exclusion-Spanish
Lead Forms
-
- Health/Dental/Nutrition #31-Lead Screening Results-English
- Health/Dental/Nutrition #31-Lead Screening Results-Spanish
- Health/Dental/Nutrition #38-Parent Request for Lead Screening
- Blood Lead Level Reporting Form
- Lead Dirt Alert Arsenic-English
- Lead Dirt Alert Arsenic-Spanish
- Lead Flyer-Eng/Span.
- Lead Poisoning-Eng/Span.
Health Care Plans Medical Alerts
Required Postings
-
- Safety #7-Site Emergency Information
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-English
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-Spanish
- How to Change a Diaper-English
- How to Change a Diaper-Spanish
- Health/Dental/Nutrition #37-CPR-First Aid Cards
- Germ Buster Flyer-Eng/Span.
- Classroom Information Board
Nutrition Education for Parents
Health Information/Resources
-
- Marijuana and Pregnancy-English
- Marijuana and Pregnancy-Spanish
- Yakima County Food Banks-English
- Yakima County Food Banks-Spanish
- Checklist Health and Safety
- Eye Screening for Children-English
- Eye Screening for Children-Spanish
- Introducing Glasses to Young Children- Eng./Spa.
- Yakima Valley Resource Guide
- Keep Me at Home-English
- Keep Me at Home-Spanish
- Health Concerns-Wildfire Smoke Air Quality
- What is Hearing Loss in Children-English
- What is Hearing Loss in Children-Spanish
- Screening and Diagnosis of Hearing Loss-English
- Screening and Diagnosis of Hearing Loss-Spanish
- Hearing Screening Parent Information-English
- Hearing Screening Parent Information-Spanish
- Bed Bugs-Managing Information
- Weather Chart
- Air Quality Handout
Covid 19 Information
-
- Health/Dental/Nutrition #54-Daily Temperature Log
- Health/Dental/Nutrition #59-Covid 19 Authorized Visitor Record
- Health/Dental/Nutrition #60-When What and Why to Wear Required PPE
- Health/Dental/Nutrition #61-Covid 19 Health Check Attestation -English
- Health/Dental/Nutrition #61-Covid 19 Health Check Attestation -Spanish
- Health/Dental/Nutrition #64-Sanitation Bag Checklist
- How to Use a Mask
- Cover Your Cough Poster-English
- Celcius to Farenheight-Print
- Stop the Spread of Ilness Poster-English
- Stop the Spread of Ilness Poster-Spanish
- What Can You Do Poster-English
- What Can You Do Poster-Spanish
- What You Need to Know about Covid 19-English
- What You Need to Know about Covid 19-Spanish
- Stay Safe, Stay Healthy, Stay Vaccinated Poster
- Your Child's Doctor Can Help Your Not Alone Poster
- Toothbrushing and Covid 19 English-Spanish
- Checklist #1-Safety and Sanitation Checklist
- Health Room Checklist
- When What and Why To Wear Required PPE
- Health/Dental/Nutrition #66 Tracking Form COVID Test Handout
Covid 19 Education
- How to Use a Mask
- Cover Your Cough Poster-English
- Celcius to Farenheight-Print
- Stop the Spread of Ilness Poster-English
- Stop the Spread of Ilness Poster-Spanish
- What Can You Do Poster-English
- What Can You Do Poster-Spanish
- What You Need to Know about Covid 19-English
- What You Need to Know about Covid 19-Spanish
- Stay Safe, Stay Healthy, Stay Vaccinated Poster
- Your Child's Doctor Can Help Your Not Alone Poster
- Toothbrushing and Covid 19 English-Spanish
Head Start
- Child File
- Enrollment
- Child Development
- Family Support
- Special Services
- Mental Health
- Health and Safety
Child File
-
- Child File #1-Center Based Family Cover Sheet
- Child File #3 Family Cover Sheet
- Child File #4-Binder Spine HS
- Child File #7-File Log In Centerbased
- Child File #8- HS Child File Checklist 2022-2023
- Child File #9-Emergency Information Form 2023-2024
- Child File #14-Correspondence Log
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
- Child File #16-Referral Form Typeable
- Child FIle#20-Designation of Another Person to Consent for Head Start Activities
- Child File#21-Parent Sign In/Out Sheet
- Child File#22-Emergency Binder Cover Sheet
- Child File #22-Emergency Binder Cover Sheet Transportation
- Child File #23-Emergency Binder Cover Sheets for Receptionist
Enrollment
Enrollment Forms
-
- Enrollment # 1-Basic Information Form 2023-2024
- Enrollment #2-Eligibility Comment Sheet
- Enrollment #3-HS ERSEA Checklist
- Enrollment 4-CB Enrollment Verification Checklist
- Enrollment #5-Family Enrollment Profile
- Enrollment #6-Eligibility Income Verification
- Enrollment #10-Income Story
- Enrollment #12-Self Declaration of Family Income
- Enrollment #13-Statement of No Income
- Enrollment #22-Title 1 Migrant Form
- Enrollment #26-File Transfer Authorization Form
- Enrollment #27-Transfer Authorization Log
- Enrollment #29-Color Code HS
- Enrollment #30-Income Cover Sheet
- Enrollment # 32-Referral to Seedlings Center
Parent Letters
-
- Parent Letter #1-List of Needed Documents HS/EHS
- Parent Letter #2-Overwhelming Interest Letter
- Parent Letter #3-Complete Application Letter
- Parent Letter #4-Ineligible - Over Income Letter
- Parent Letter #5-Ineligible - Out of District
- Parent Letter #6-Ineligible - Age Requirement
- Parent Letter #7-HS-EHS Acceptance Letter
- Parent Letter #8-Acceptance Letter for Returner
- Parent Letter #9-Waitlist Letter
- Parent Letter #10 - Attendance Letter
- Parent Letter #12 - Notice of Disenrollment
Child Development
HS-Staff Resources/ Forms
-
- Child Development #4-Toileting Plan
- Child Development #5-Transition Plan
- Child Development #5-Transition Plan Infant to Toddler Example
- Child Development #6-Monthly Home Visit Conference Log
- Child Development #11-Field Trip Permission Form
- Child Development #11-Field Trip Request Form
- Child Development #14-Food Experience Permission Form
- Child Development #15-Classroom Baseline Tool English
- Child Development #15-Classroom Baseline Tool Spanish
- Child Development #16-ASQ-3 Result Form
- Child Development #17-End of Year Inventory List
- Child Development #18-Family Engagement Packs: Check-Out Form
- Child Development #19-Child Data Outcomes Form
- Child Development #22- Plants in the Classroom Guidance
- Child Development #23-Teacher Hatch Dashboard Form
- Child Development #26-Kinder Assessment Transition Form
-
Child Development #26-Kinder Assessment Transition Form Spanish
-
Child Development #29-Guided Worksheet for Identifying Language in the Classroom
- Hatch Dashboard Guide
- How Do I Log In to Ready Rosie Step by Step
- All About Me Poster
- Child Outcomes Data Checkpoint
- CLASS Dimensions Guide-English
- CLASS Questions
- Home Language Survey
- How to Print Observations in TS Gold
- Inputting ASQ and ASQ-SE Scores Online
- Kinder Transition Meal
- Management Charts
- Teachers Manual
- Remote Visit Guidance
- TS Gold Help Guide on Funding Source
- TS Gold How to Guide
- Head Start Timeline 2019-2020
- Observation Help Sheet
Active Supervision Forms
Required Postings/ Labels
-
- Operations#3-Classroom Sign In and Out Log
- Safety Sam Book
- ABC Poster
- Active Supervision Back Handout-English
- Active Supervision Back Handout-Spanish
- Active Supervision Poster-English
- Active Supervision Poster-Spanish
- Bulletin Board Education Poster
- Classroom Sign In Cover Sheet
- Cubby Label Example
- Daily Schedule Example
- In Out Board Example
- Label Material Example
- Management Charts
- Morning Message Example
- Nursery Rhymes
- Who's Here
- Zoning Staff Charts
- HS/EHS Program Postings & Availability
- Lesson Plan Cover Sheet
- Child Protection Unit Letters-English
- Child Protection Unit Letters-Spanish
Home Visit/Parent Teacher Conference Forms
-
- Child Development #10-Home Goals In-Kind Form
- Child Development #13-VIP Letter
- TS Gold Objectives and Dimensions-English
- TS Gold Objectives and Dimensions-Spanish
- TS Gold Progressions-English
- TS Gold Progressions-Spanish
- Preparing Your Child for Kindergarten-Eng/Span.
- Transition Information for Parents
- Kinder Transition Form
- A Parent Guide to Preparing Your Child for School
- Head Start Timelines 2021-2022
- First Parent Teacher Conference Guide 2021-2022
- Adjustments to the First Center Based Home Visit Guide 2021-2022
- Second Head Start and EHS-Center Base Parent Teacher Conference Checklist Guide 2021-2022
- Second Head Start and EHS-Center Base Home Visit Checklist Guide 2021-2022
Family Support
HS - Family Support Forms
-
- Family Support #3-Family Needs Assessment
- Family Support #5-Family Partnership Plan: Family Goal
- Family Support #8-Action Plan
- Family Support #8-Action Plan-Attendance Example
- Family Support #10-Family Leave of Absence Agreement-Eng/Span.
- Family Support #11-Record Request
- Family Support #12-Classroom Attendance with Daily Health Check
- Family Support #14-HS Family Outcomes Assessment-English
- Family Support #14-HS Family Outcomes Assessment-Spanish
- Family Suppport #16-Head Start Center Newsletter Template
- Family Support #17-Family Night Sign In Sheet
- Family Support #18- Parent Evaluation
- Family Support #19-Los Ninos Bien Educados Referral
- Title 1 Part C Migrant Education Program Form
Resources Folder
Special Services
Special Services Forms
- Special Services #4-Referral Checklist English
- Special Services #4-Referral Checklist Spanish
- Special Service #5-Speech and Language Checklist Birth to Three-English
- Special Service #5-Speech and Language Checklist Birth to Three-Spanish
- Special Services #6-Speech and Language Checklist Preschool-English
- Special Services #6-Speech and Language Checklist Preschool-Spanish
- Special Services #7-Observation Permission Form
- Special Service #9-Special Services Log
- Special Service #13-IFSP/IEP Information Guidance Sheet
- Special Services #14-Intervention Plan
- Special Services #15-Consent to Release or Exchange Information Form
- Child Development #16-ASQ-3 Result Form
- Child File #16-Referral Form
- Special Service Poster
- Special Services Visit/Guidance
- Special Services #08 Staffing Notes
Mental Health
Mental Health Forms
-
- Mental Health #2-Mental Health Referral Packet Checklist
- Mental Health #3-Observation Permission Form
- Mental Health #6-ASQ-SE-2 Results
- Mental Health #10-Preschool Observation Checklist
- Mental Health #10-Preschool Observation Checklist-Spanish
- Mental Health #11-Frequency Chart
- Mental Health #12-Employee Training Documentation for Child Guidance
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
Health and Safety
HS-Health Forms
- Health/Dental/Nutrition #4-Medical Dental Home Form
- Health/Dental/Nutrition #5-Monthly Classroom Health and Safety Checklist
- Health/Dental/Nutrition #7-Referral to Health Care Provider
- Health/Dental/Nutrition #10-Medication Consent and Chart
- Health/Dental/Nutrition #11-Medication Log
- Health/Dental/Nutrition #12-ADHD Medication Effectiveness
- Health/Dental/Nutrition #18-Accident Injury Report Form
- Health/Dental/Nutrition #19-Health Screening Card
- Health/Dental/Nutrition #29-Sunscreen Log
- Health/Dental/Nutrition #30-Classroom Allergy List
- Health/Dental/Nutrition #33-Immunization Letter English-Spanish
- Health/Dental/Nutrition #53-Daily Diaper Changing Chart
- Health/Dental/Nutrition #65-Record of Administration Continuation
- Health/Dental/Nutrition #67-Class Pet Parent Permission Form Eng-Span/fs/resource-manager/view/7a339cb8-5d40-4998-8543-3706d9dace35
- Health/Dental/Nutrition-Transportation Medication Label
- Child File #16-Referral Form
- Keep Me at Home-English
- Keep Me at Home-Spanish
Health Care Plans/ Alerts
- Health/Dental/Nutrition #12-HCP Instructions for Parents
- Health/Dental/Nutrition #13-HCP Letter to Provider
Lead
- Health/Dental/Nutrition #31-Lead Screening Results-English
- Health/Dental/Nutrition #31-Lead Screening Results-Spanish
- Health/Dental/Nutrition #38-Parent Request for Lead Screening
- Blood Lead Level Reporting Form
- Lead Dirt Alert Arsenic-English
- Lead Dirt Alert Arsenic-Spanish
- Lead Flyer-Eng/Span.
- Lead Poisoning-Eng/Span.
Lice
- Health/Dental/Nutrition #39-Head Lice Notice English
- Health/Dental/Nutrition #40-Head Lice Notice-Spanish
- Health/Dental/Nutrition #41-Head Lice Instructiions
Health and Safety Checklist
- Health/Dental/Nutrition # 50-Health and Safety Checklist
- Fire Safety and Emergency Drills Form
- Checklist #1- Daily Safety and Sanitation Checklist
- Checklist #3- Classroom First Aid Checklist
- Checklist #4- Backpack Kit Checklist
- Checklist #05 Monthly Classroom Health and Safety Checklist
- Health Room Checklist
- Head Start Monthly Classroom Health and Safety
Required Postings
Classroom Postings
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-English
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-Spanish
- Health/Dental/Nutrition #37-CPR-First Aid Cards
- Classroom Information Board
- Germ Buster Flyer-Eng/Span.
- How to Change a Diaper-English
- How to Change a Diaper-Spanish
Binder Cover Sheets
- Dental Exam Cover Sheet
- Health Care Plans & Medical Alerts
- Health Screenings Cover Sheet
- Other Health Cover Sheet
- USDA CACFP Cover Sheet
- Vaccines Cover Sheet
- Well Child Exam Cover Sheet
- Referrals Cover Sheet
- Miscellaneous Health Information Cover Sheet
Nutrition Education for Parents
-
- Choose My Plate-English
- Choose My Plate-Spanish
- Growing Healthy Postcard-Eng/Span.
- Healthy Eating
- Healthy Eat
- Healthy Eating for Preschoolers Mini-Poster
- Nutrition Terms-Spanish
- Food Safety-Spanish
- Child Diabetes-Eng.Span.
- Exercise & Nutrition-Eng/Span.
- MCN Healthy Foods-Eng/Span.
- MCN Nutrition-Eng/Span.
- MCN Read Nutrition Label-Eng/Span.
- MCN Small Changes-Eng/Span.
- Healthy Eating for Preschoolers English
- Healthy Eating for Preschoolers Spanish
- Recipes for Healthy Snacks
Health Information/Resources
-
- Marijuana and Pregnancy-English
- Marijuana and Pregnancy-Spanish
- Yakima County Food Banks-English
- Yakima County Food Banks-Spanish
- Eye Screening for Children-English
- Eye Screening for Children-Spanish
- Introducing Glasses to Young Children- Eng./Spa.
- Yakima Valley Resource Guide
- Keep Me at Home-English
- Keep Me at Home-Spanish
- Health Concerns-Wildfire Smoke Air Quality
- Flu Information English
- Flu Information Spanish
- What is Hearing Loss in Children-English
- What is Hearing Loss in Children-Spanish
- Screening and Diagnosis of Hearing Loss-English
- Screening and Diagnosis of Hearing Loss-Spanish
- Hearing Screening Parent Information-English
- Hearing Screening Parent Information-Spanish
- Bed Bugs-Managing Information
- Weather Chart
- Air Quality Handout
Immunizations
-
- Health/Dental/Nutrition #33-Letter to Parent Immunization Needed-Eng/Span.
- Health/Dental/Nutrition #55-Immunization Record Requirements
- Certificate of Exemption-English
- Certificate of Exemption-Spanish
- DOH Conditional Immunization Status-English
- DOH Conditional Immunization Status-Spanish
- DOH Immunization Exclusion-English
- DOH Immunization Exclusion-Spanish
Covid 19 Information
-
- Health/Dental/Nutrition #54-Daily Temperature Log
- Health/Dental/Nutrition #59-Covid 19 Authorized Visitor Record
- Health/Dental/Nutrition #60-When What and Why to Wear Required PPE
- Health/Dental/Nutrition #62-Tracking Form for Combining Rooms
- Health/Dental/Nutrition #64-Sanitation Bag Checklist
- How to Use a Mask
- Cover Your Cough Poster-English
- Celcius to Farenheight-Print
- Stop the Spread of Ilness Poster-English
- Stop the Spread of Ilness Poster-Spanish
- What Can You Do Poster-English
- What Can You Do Poster-Spanish
- What You Need to Know about Covid 19-English
- What You Need to Know about Covid 19-Spanish
- Stay Safe, Stay Healthy, Stay Vaccinated Poster
- Your Child's Doctor Can Help Your Not Alone Poster
- Toothbrushing and Covid 19 English-Spanish
- When What and Why To Wear Required PPE
- Health/Dental/Nutrition #66 Tracking Form COVID Test Handout
Covid 19 Education
- How to Use a Mask
- Cover Your Cough Poster-English
- Celcius to Farenheight-Print
- Stop the Spread of Ilness Poster-English
- Stop the Spread of Ilness Poster-Spanish
- What Can You Do Poster-English
- What Can You Do Poster-Spanish
- What You Need to Know about Covid 19-English
- What You Need to Know about Covid 19-Spanish
- Stay Safe, Stay Healthy, Stay Vaccinated Poster
- Your Child's Doctor Can Help Your Not Alone Poster
- Toothbrushing and Covid 19 English-Spanish
Migrant Seasonal Head Start
- Child File
- Enrollment
- Child Development
- Family Support
- Special Services
- Mental Health
- Health and Safety
Child File
-
- Child File #3 Family Cover Sheet
- Child File #6-Binder Spine MSHS
- Child File #7-File Log In Centerbased
- Child File #8-MSHS Child File Checklist 2023
- Child File #-9-Emergency Information Form 2022-2023
- Child File #14-Correspondence Log
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
- Child File #16-Referral Form Typeable
- Child File #20-Designation of Another Person to Consent for Head Start Activities
- Child File #21-Parent Sign In and Sign Out
- Child File #22-Emergency Binder Cover Sheet
- Child File #22-Emergency Binder Cover Sheet Transportation
- Child File #23-Emergency Binder Cover Sheets for Receptionist
Enrollment
Enrollment Forms
-
- Enrollment # 1-Basic Information Form 2023-2024
- Enrollment #2-Eligibility Comment Sheet
- Enrollment #3-MSHS Online ERSEA Checklist
- Enrollment #4-CB Enrollment Verification Checklist
- Enrollment #5-Family Enrollment Profile
- Enrollment #6-Eligibility Income Verification
- Enrollment #10-Income Story
- Enrollment #12-Self Declaration of Family Income
- Enrollment #13-Statement of No Income
- Enrollment #22-Title 1 Migrant Form
- Enrollment #23-Migrant Verification Form
- Enrollment #26-File Transfer Authorization Form
- Enrollment #27-Transfer Authorization Log
- Enrollment #29-Color Code MSHS
- Enrollment #30-Income Cover Sheet
- Enrollment #31-Parent Handbook MSHS English 2021
- Enrollment #31-Parent Handbook MSHS Spanish 2021
- Enrollment #33-Memo Form
- Enrollment #37-MSHS Enrollment Agreement Packet Eng
- Enrollment #37-MSHS Enrollment Agreement Packet Span
- NAICS Manual 2017
- What to count as income
- SSI vs Social Security
- Race and Ethnicity
Parent Letters
Child Development
Staff Resources/Forms
-
- All About Me Poster
- ASQ Online-Printing Blank Questionnaire Guidance
- CLASS Dimension Guide English
- CLASS Questions
- Help Sheet for Early Achievers-ECERS
- Help Sheet for Early Achievers-Ltters
- How to Print Observations in TSG
- Inputting ASQ and ASQ SE Scores Online
- Teachers Manual
- Remote Visit Guidance
- TS Gold Help Guide on Funding Source
- TS Gold How to Guide
- Child Development #4-Toileting Plan
- Child Development #5-Transition Plan
- Child Development #5-Transition Plan Infant to Toddler Example
- Child Development #11-Field Trip Permission Form
- Child Development #11-Field Trip Request Form
- Child Development #12-Talk About Touch Permission Form Eng/ Span.
- Child Development #14-Food Experience Permission Form
- Child Development #15-Spanish Classroom Baseline
- Child Development #16-ASQ-3 Result Form
- Child Development #17-End of the Program Year Inventory List
- Child Development #18-Family Engagement Packs: Check-out Form
- Child Development #19-Child Data Outcomes Form
- Child Development #22-Plants in the Classroom Guidance
- Child Development #23-Teacher Hatch Dashboard Form
- Child Development #25-Child Outcomes Data Form
- Child Development #26-Kinder Assessment Transition Form
-
Child Development #26-Kinder Assessment Transition Form Spanish
-
Child Development #29-Guided Worksheet for Identifying Language in the Classroom
- Hatch Dashboard Guide
- How Do I Log In to Ready Rosie Step by Step
- DEL Sleep Log In Protocol
- Observation Help Sheet
Active Supervision Forms
Parent Letters
Required Postings/ Labels
-
- Safety Sam Book
- ABC Poster
- Active Supervision Poster English
- Active Supervision Poster Spanish
- Back To Sleep Crib Labels
- Bulletin Board Education Poster
- Classroom Sign In Sheet Cover
- Copy of Morning Message Example
- Cubby Label Example
- Daily Schedule Example
- In and Out Board Example
- Label Material Example
- Management Charts
- Nursery Rhymes
- Who's Here
- Zoning Staff Chart
- MSHS Program Postings & Availability
- Lesson Plan Cover Sheet
- Child Protection Unit Letters-English
- Child Protection Unit Letters-Spanish
Home Visit/Parent Teacher Conference Forms
-
- Child Development #10-Home Goals Inkind Form
- Child Development #13-VIP Letter
- Education #1-1st Visit Checklist Form English MSHS
- Education #1-1st Visit Checklist Form Spanish MSHS
- Education #1-2nd Visit Checklist Form MSHS
- Education #6-Monthly Home Visit Conference Log
- Education #7-Kinder Transition Form
- Child Passenger Safety Card-English
- Child Passenger Safety Card-Spanish
- TS Gold Objectives and Dimensions-English
- TS Gold Objectives and Dimensions-Spanish
- TS Gold Progressions-English
- TS Gold Progressions-Spanish
- Home Language Survey
- MSHS Second Home Visit Guide 2021
Family Support
Family Support Forms
-
- Family Support #1-Family-Staff Contact Log
- Family Support #3-Family Needs Assessment
- Family Support #5-Family Partnership Plan Family Goal
- Family Support #8-Action Plan Attendance Sample
- Family Support #8-Action Plan
- Family Support #10-Family Leave of Absence Agreement English-Spanish
- Family Support #11-Record Request
- Family Support #12-Classroom Attendance with Daily Health Check
- Family Support #13-Family Staff Contact Log Cover Sheet
- Family Support #14-Family Outcomes Assessment 2021 English
- Family Support #14-Family Outcomes Assessment 2021 Spanish
- Family Support #16-Center Newsletter Template MSHS
- Family Support #17-Family Night Sign In Sheet
- Family Support #18-Parent Evaluation
- Family Support #19-Los Ninos Bien Educados Referral
- Title 1 Part C Migrant Education Program Form
Resource Folder
Special Services
Special Services Forms
-
- Special Services #4-Referral Checklist English
- Special Services #4-Referral Checklist Spanish
- Special Service #5-Speech and Language Checklist Birth to Three-English
- Special Service #5-Speech and Language Checklist Birth to Three-Spanish
- Special Services #6-Speech and Language Checklist Preschool-English
- Special Services #6-Speech and Language Checklist Preschool-Spanish
- Special Services #7-Observation Permission Form
- Special Services #8-Staffing Notes
- Special Services #9-Special Services Log
- Special Services #13-IFSP/IEP Information Guidance Sheet
- Special Services #14-Intervention Plan
- Special Services #15-Consent to Release or Exchange Information Form
- Child Development #16-ASQ-3 Result Form
- Child Development #16-ASQ SE-2 Result Form
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
- Special Services Poster
- Special Services Visit/Guidance
- Special Services Content Specialist Observation Form
Mental Health
Mental Health Forms
-
- Mental Health #2-Mental Health Referral Packet Checklist
- Mental Health #3-Observation Permission Form
- Mental Health #6-ASQ-SE-2 Results
- Mental Health #9-Infant and Toddler Observation Checklist
- Mental Health #9-Infant and Toddler Observation Checklist-Spanish
- Mental Health #10-Pre-School Observation Checklist
- Mental Health #10-Pre-School Observation Checklist-Spanish
- Mental Health #11-Frequency Chart
- Mental Health #12-Employee Training Documentation for Child Guidance
- Child File #15-Consent to Release or Exchange Information
- Child File #16-Referral Form
Health and Safety
Health/Dental/Nutrition
-
- Health/Dental/Nutrition #2-Health History Annual Update Form
- Health/Dental/Nutrition #4-Medical-Dental Home Form
- Health/Dental/Nutrition #7-Referral to Health Care Provider
- Health/Dental/Nutrition #10-Medication Consent and Chart
- Health/Dental/Nutrition #11-Medication Log
- Health/Dental/Nutrition #12-ADHD Medication Effectiveness
- Health/Dental/Nutrition #18-Accident Injury Report Form
- Health/Dental/Nutrition #19-Health Screening Card
- Health/Dental/Nutrition #20-Initial Health History
- Health/Dental/Nutrition #21-Nutrition Assessment- Preschool
- Health/Dental/Nutrition #22-Nutrition History and Assessment- Infants & Toddlers
- Health/Dental/Nutrition #25-Vision Screening Birth to Three
- Health/Dental/Nutrition #26-Hearing Screening Birth to Three
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-English
- Health/Dental/Nutrition #28-Stand Up Diapering Procedure-Spanish
- Health/Dental/Nutrition #29-Sunscreen Log
- Health/Dental/Nutrition #30-Classroom Allergy List
- Health/Dental/Nutrition #31-Lead Screening Results-English
- Health/Dental/Nutrition #31-Lead Screening Results-Spanish
- Health/Dental/Nutrition #32-Health Classroom Monitoring
- Health/Dental/Nutrition #33-Immunization Letter English-Spanish
- Health/Dental/Nutrition #36-Health Status Determination
- Health/Dental/Nutrition #37-CPR-First Aid Cards
- Health/Dental/Nutrition #38-Parent Request for Lead Screening
- Health/Dental/Nutrition #39-Head Lice Notice English
- Health/Dental/Nutrition #41-Head Lice Instructiions
- Health/Dental/Nutrition #47-Medication Chart-Diaper Ointment
- Health/Dental/Nutrition #53-Daily Diaper Changing Chart
- Health/Dental/Nutrition #65-Record of Administration Continuation
- Health/Dental/Nutrition #67-Class Pet Parent Permission Form Eng-Span
- Health/Dental/Nutrition-Transportation Medication Label
- Allergy List Cover Sheet
- Certificate Immunization Status Form
- Certificate of Exemption-English
- Certificate of Exemption-Spanish
- Child File #16-Referral Form
- Dental Sealant Program
- DOH Conditional Immunization Status-English
- DOH Conditional Immunization Status-Spanish
- DOH Immunization Exclusion-English
- DOH Immunization Exclusion-Spanish
- Farmworker Permission Form
- Food Substitution Classroom Cover Sheet
- Germ Buster Flyer- Eng/Span.
- Health Information Cover Sheet
- How to Change a Diaper- English
- How to Change a Diaper- Spanish
- Blood Lead Level Reporting Form
- Lead Dirt Alert Arsenic-English
- Lead Dirt Alert Arsenic-Spanish
- Lead Flyer-Eng/Span.
- Lead Poisoning Eng/Span.
- New Advocate Training Checklist
- New Classroom Staff Training Checklist
- Parents are your Kids Ready for School Immunizations
- Safety and Sanitation Checklist Cover Sheet
- Yakima Valley Resource Guide
- Keep Me at Home-English
- Keep Me at Home-Spanish
Health Care Plan Forms
Immunizations
Covid 19 Information
-
- Health/Dental/Nutrition #11-Covid 19 Medication Log
- Health/Dental/Nutrition #54-Daily Temperature Log
- Health/Dental/Nutrition #56-Covid 19 Health Check Questionnaire -English
- Health/Dental/Nutrition #56-Covid 19 Health Check Questionnaire -Spanish
- Health/Dental/Nutrition #56-Covid 19 Health Check Symptoms
- Health/Dental/Nutrition #57-Covid 19 Daily Child Attendance Record for Children
- Health/Dental/Nutrition #59-Covid 19 Authorized Visitor Record
- Health/Dental/Nutrition #60-When What and Why to Wear Required PPE
- Health/Dental/Nutrition #61-Covid 19 Health Check Attestation -English
- Health/Dental/Nutrition #61-Covid 19 Health Check Attestation -Spanish
- Health/Dental/Nutrition #62-Tracking Form for Combining Rooms
- Health/Dental/Nutrition #64-Sanitation Bag Checklist
- How to Use a Mask
- Cover Your Cough Poster-English
- Celcius to Farenheight-Print
- Stop the Spread of Ilness Poster-English
- Stop the Spread of Ilness Poster-Spanish
- What Can You Do Poster-English
- What Can You Do Poster-Spanish
- What You Need to Know about Covid 19-English
- What You Need to Know about Covid 19-Spanish
- Stay Safe, Stay Healthy, Stay Vaccinated Poster
- Your Child's Doctor Can Help Your Not Alone Poster
- Toothbrushing and Covid 19 English-Spanish
- Checklist #1-Safety and Sanitation Checklist
- Health Room Checklist
- When What and Why To Wear Required PPE
- Health/Dental/Nutrition #66 Tracking Form COVID Test Handout
Child Binder Cover Sheets
Nutrition Education for Parents
-
- Choose My Plate-English
- Choose My plate-Spanish
- Healthy Children-English
- Healthy Children-Spanish
- Kids Health-English
- Kids Health-Spanish
- MCN Nutrition-Eng/Span.
- MCN Read Nutrition Label-Eng/Span.
- MCN Small Changes-Eng/Span.
- MCN Healthy Foods-Eng/Span.
- Nutrition Terms-Eng/Span.
- Nutrition-English
- Nutrition-Spanish
- Food Safety-Spanish
- Child Diabetes-Spanish
- Health Tips-Eng/Span.
- Basic Guide Healthy Foods-Eng/Span.
- Healthy Eating for Preschoolers English
- Healthy Eating for Preschoolers Spanish
- Recipes for Healthy Snacks
Classroom Postings
Health Information/Resources
-
- Marijuana and Pregnancy-English
- Marijuana and Pregnancy-Spanish
- Yakima County Food Banks-English
- Yakima County Food Banks-Spanish
- Checklist Health and Safety
- MSHS Emergency Binder Contents
- Eye Screening for Children-English
- Eye Screening for Children-Spanish
- Introducing Glasses to Young Children- Eng./Spa.
- Keep Me at Home-English
- Keep Me at Home-Spanish
- Health Concerns-Wildfire Smoke Air Quality
- Flu Information English
- Flu Information Spanish
- What is Hearing Loss in Children-English
- What is Hearing Loss in Children-Spanish
- Screening and Diagnosis of Hearing Loss-English
- Screening and Diagnosis of Hearing Loss-Spanish
- Hearing Screening Parent Information-English
- Hearing Screening Parent Information-Spanish
- Bed Bugs-Managing Information
- Weather Chart
- Air Quality Handout
Health and Safety Checklist
Required Postings
Nutrition Education for Parents
-
- Choose My Plate-English
- Choose My Plate-Spanish
- Growing Healthy Postcard-Eng/Span.
- Healthy Eating
- Healthy Eat
- Healthy Eating for Preschoolers Mini-Poster
- Nutrition Terms-Spanish
- Food Safety-Spanish
- Child Diabetes-Eng.Span.
- Exercise & Nutrition-Eng/Span.
- MCN Healthy Foods-Eng/Span.
- MCN Nutrition-Eng/Span.
- MCN Read Nutrition Label-Eng/Span.
- MCN Small Changes-Eng/Span.
- Healthy Eating for Preschoolers English
- Healthy Eating for Preschoolers Spanish
- Recipes for Healthy Snacks
Fiscal
Human Resources
In-Kind/Non-Federal Share
In-Kind/Non-Federal Share
-
- In-Kind #1-In-Kind Gift Contribution Form
- In-Kind #2-Consultant Billing Form
- In-Kind #4-Insects NFS In-Kind Form
- In-Kind #5-My Healthy Heart Form
- In-Kind #7 In-Kind Rate Sheet
- In-Kind #10-BOD In-Kind
- In-Kind #13-Gift Certificate In-Kind Form
- In-Kind #14-Parent/Site Volunteer In-Kind Form
- Child Development #10-Home Goals In-Kind Form
- List of MDSE from Distribution Center
Monitoring
- Monitoring #1 Seedlings Team Self Monitoring EHS Home Based Form
- Monitoring #1- Seedlings Team Self-Monitoring HS-MSHS
- Monitoring #1- Seedlings Team Self-Monitoring EHS Center Based
- Monitoring #2- Center Manager Staffing Report
- Monitoring #3- ERSEA and Center Family Engagement Staffing Report
- Monitoring #4- Family Services Staffing Report
- Monitoring #5- Health, Dental, Nutrition Staffing Report
- Monitoring #6- Mental Health Staffing Report
- Monitoring #7- School Readiness Staffing Report
- Monitoring #7- Birth to Three EHS Staffing Report
- Monitoring #7 EHS Home Base and Center Base Staffing Report
- Monitoring #8-Special Services Staffing Report
- Monitoring #10- Active Supervision Monitoring Form
- Monitoring #10- Active Supervision Kid Zone Monitoring Form
- Monitoring #10- Active Supervision Socialization Monitoring Form
- Monitoring #11- Monitoring Form for Education
- Monitoring #12- Safe Environment Observation Form
- Monitoring #13- Multi-Disciplinary Child Service Plan
- Monitoring #14- ELN Health Staffing Report
- Monitoring #15- ChildPlus Center Manager Report Checklist
- Monitoring #16- Monitoring Flow Chart
- Monitoring #28- EHS Enter and Exit Plan Typable
Playground and Facilities
Recruitment Forms
Transportation Forms
- Transportation #1-Transportation Procedures for Parents
- Transportation #2-Child returned to School Report
- Transportation #3-Final Third Return Transportation Letter
- Transportation #4-Final Fourth Return Transportation Letter
- Transportation #5-Sign in and out Sheet
- Transportation #6- Medication Labels
- Transportation #24-Bus Roster
- Transportation #25-Transportation Request and Attendance Roster
- EHS Health and Transportation Safety and Classroom Sign In/Out Procedures
USDA
USDA Forms
-
- Food Service #00 Food Service Form
- Food Service #01 Childcare Monitoring Form for Sponsor Use
Food Service #02 Classroom Mealtime Observation - Food Service #03 Weekly Meal Count
- Food Service #04 Meal Count Bubble Sheet
- Food Service #05 Weekly Meal Counts-EHS Kid Zone
- Food Service #06 Daily Infant Meal Form
- Food Service #07Classroom Meals Needed
- Food Service #08 Enrollment Form English
- Food Service #08 Enrollment Form- Spanish
- Food Service #09 CACFP Infant Meal Form
- Food Service #10 USDA Parent Request for Assistance
- Food Service #11 Study Month Letter to Parent EHS English
- Food Service #11 Study Month Letter to Parent EHS Spanish
- Food Service #12 CACFP Attendance Roster EHS
- Food Service #13 Temperature Monitoring Log
- Food Service #14 Food Temperature Log
- Food Service #15 Daily Kitchen Cleaning Schedule
- Food Service #16 Monthly Kitchen Cleaning Schedule
- Food Service #17 Kitchen Equipment Inventory
- Food Service #18 Kitchen Inspection
- Food Service #19 Food Service Agreement
- Food Service #20 Food Service Provider Compliance
- Food Service #21Civil Rights Complaint Procedures and Form
- Food Service #22 Request for Special Dietary Accommodations English
- Food Service #22 Request for Special Dietary Accommodations Spanish
- Food Service #23 Request for Fluid Milk Substitution - English
-
- Approved Non-Dairy Beverages
- Classroom Mealtime Procedure
- EHS Daily Infant Meal Record
- EHS Non-Reimbursable Meal Count Sheet
- Feeding of Infants Procedure
- Food Handlers Cards Cover Sheet
- Food Production Procedure
- Food Safety & Sanitation Procedure
- Food Substitution Cover Sheet
- Kinder Transition Meal
- Meal Count Procedure
- Meal Purchasing Procedure
- Permitted Food Procedure
- Reference Sheets Civil Rights
- Signed Menu HS
- English Menu RX & MSHS
- Spanish Menu RX & MSHS
- USDA #13-Actual Meal Served
- USDA Enrollment Forms Procedure
- USDA Non-Discrimination Procedure
- USDA Ordering Procedure
- Volunteers Meals Procedure
- Meal Pattern for Children
- USDA Ethnic and Racial Children Identities
- WIC Outreach Poster English
- WIC Outreach Poster Spanish