Child File Monitoring Checklist
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus 1st or second year student? Child File labeled correctly / 2017-2018 Folder Checklist Date of birth printed on child file label SECTION ONE: Enrollment Table of Contents Inspection of Confidential Records Change of Status * Child Plus Application form: Family Information, Income, & Contacts signed
Child Plus Application form: Applicant & Family Member Information Child's Primary Language as listed on Child Plus Application Head Start Eligibility Verification - signed and completed / Eligibility category Applicant Eligibility & Enrollment Info. -or-Individual Systematic Selection Form
Points giving for Disabliity? Income source documentation used - Income, Homeless, Foster, No income
Notification letter * Acknowledgement of Parent Handbook signature form Date of birth on birth certificate -must match child file label Copy of Social Security card Copy of Photo ID Proof of Residency Legal Documents* Optional/Other Forms
1
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION TWO: Health Table of Contents Consent for Head Start Services Health Coverage Form - and - copy of insurance card Child Health History Child Nutrition Assessment Release of Information-Dental - name of dentist Dental exams / dates Release of Information-Physical - name of doctor Physical exam / dates Head Start / WIC Permission for Release and Exchange of Information Hemoglobin/Hematocrit screening date and results Lead screening date and results Vision date and results or screener Hearing date and results or screener Immunization record Risk Assessment for Lead Exposure: Parent Questionnaire Questions About Your Child & TB Child Plus Growth Charts (end of year) and/or BMI letters Optional/Other Forms Any delays/problems? (check h/v, physical, dental, labs) If YES, documentation of follow-up and plan
2
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION THREE: Social Services Table of Contents Progress Notes Center-based Family Partnership Agreement Family Partnership Agreement, Goals, and Outcomes Assmt date - Fall/Spring
Head Start Family Goals - date and signed by staff and parent In House Referral * Permission for Release and Exchange of Information * Optional/Other Forms SECTION FOUR: Parent Involvement Table of Contents Parent Education and Interest Questionnaire Parent Communication Log Child Tardy/Attendance Logs Attendance Documentation / Referral? Notes from parent/guardian * Tardy/Absent Acknowledgement * Tardy/Absent Notification Letter * Need for Transportation/Enrollment * Optional/Other Forms *
3
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION FIVE: Education Table of Contents DIAL 4 report / date DIAL 4 Parent Questionnaire DECA report / date Head Start Work Samples Anecdotal Notes - filed at the end of the school year CLI Progress Monitoring Reports - WAVE 1,2,3 Home Visit/Parent Conference form - filed at the end of the school year Transition Plan Field Trip Permission forms In House Referral * Any delays/problems? (check DIAL, DECA, GOLD) If YES, documentation of follow-up and plan Optional/Other Forms
4
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION SIX: Mental Health Table of Contents Parental Consent for Mental Health/Behavioral Services - date signed Progress Notes* In House Referral * Individual Mental Health Observations * Positive Guidance Plan and follow up * Permission for Release and Exchange of Information * Optional/Other Forms SECTION SEVEN: Special Education Table of Contents In House Referral * IFSP/IEP/Section 504 Plans or Disclaimer * Parent Permission * SST Documentation * ARD * Optional/Other Forms
COMMON ERRORS - please check all files for these errors
5
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus 1st or second year student? Child File labeled correctly / 2017-2018 Folder Checklist Date of birth printed on child file label SECTION ONE: Enrollment Table of Contents Inspection of Confidential Records Change of Status * Child Plus Application form: Family Information, Income, & Contacts signed
Child Plus Application form: Applicant & Family Member Information Child's Primary Language as listed on Child Plus Application Head Start Eligibility Verification - signed and completed / Eligibility category Applicant Eligibility & Enrollment Info. -or-Individual Systematic Selection Form
Points giving for Disabliity? Income source documentation used - Income, Homeless, Foster, No income
Notification letter * Acknowledgement of Parent Handbook signature form Date of birth on birth certificate -must match child file label Copy of Social Security card Copy of Photo ID Proof of Residency Legal Documents* Optional/Other Forms
1
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION TWO: Health Table of Contents Consent for Head Start Services Health Coverage Form - and - copy of insurance card Child Health History Child Nutrition Assessment Release of Information-Dental - name of dentist Dental exams / dates Release of Information-Physical - name of doctor Physical exam / dates Head Start / WIC Permission for Release and Exchange of Information Hemoglobin/Hematocrit screening date and results Lead screening date and results Vision date and results or screener Hearing date and results or screener Immunization record Risk Assessment for Lead Exposure: Parent Questionnaire Questions About Your Child & TB Child Plus Growth Charts (end of year) and/or BMI letters Optional/Other Forms Any delays/problems? (check h/v, physical, dental, labs) If YES, documentation of follow-up and plan
2
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION THREE: Social Services Table of Contents Progress Notes Center-based Family Partnership Agreement Family Partnership Agreement, Goals, and Outcomes Assmt date - Fall/Spring
Head Start Family Goals - date and signed by staff and parent In House Referral * Permission for Release and Exchange of Information * Optional/Other Forms SECTION FOUR: Parent Involvement Table of Contents Parent Education and Interest Questionnaire Parent Communication Log Child Tardy/Attendance Logs Attendance Documentation / Referral? Notes from parent/guardian * Tardy/Absent Acknowledgement * Tardy/Absent Notification Letter * Need for Transportation/Enrollment * Optional/Other Forms *
3
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION FIVE: Education Table of Contents DIAL 4 report / date DIAL 4 Parent Questionnaire DECA report / date Head Start Work Samples Anecdotal Notes - filed at the end of the school year CLI Progress Monitoring Reports - WAVE 1,2,3 Home Visit/Parent Conference form - filed at the end of the school year Transition Plan Field Trip Permission forms In House Referral * Any delays/problems? (check DIAL, DECA, GOLD) If YES, documentation of follow-up and plan Optional/Other Forms
4
Child File Monitoring Checklist
Not applicable / Not due yet Form present but has errors/has been flagged Not in chart highlighted dates do not match Child Plus SECTION SIX: Mental Health Table of Contents Parental Consent for Mental Health/Behavioral Services - date signed Progress Notes* In House Referral * Individual Mental Health Observations * Positive Guidance Plan and follow up * Permission for Release and Exchange of Information * Optional/Other Forms SECTION SEVEN: Special Education Table of Contents In House Referral * IFSP/IEP/Section 504 Plans or Disclaimer * Parent Permission * SST Documentation * ARD * Optional/Other Forms
COMMON ERRORS - please check all files for these errors
5
