ERSEA Information
Section One: Enrollment
2024-2025 Child File Checklist
Change of Status - CP
Child Plus Application:
-Family Information, Income, & Contacts
-Applicant & Family Member Information – highlight child’s language
-Applicant Eligibility & Enrollment Info
Application Checklist & Selection Criteria
Head Start Eligibility Verification Form - CP
Income Source - CP documentation: one or more of the following:
-Tax Return, Check Stubs, W-2, etc.
Birth certificate - CP
Social Security card - CP
Photo ID - CP
Proof of Residency - CP
Legal Documents - CP
Optional/Other Forms (district forms)*
Section Two: Health
Consent for Head Start Services - CP
Health Coverage Form - CP
Copy of Insurance - CP
Child Health History - CP
Child Nutrition Assessment - CP
Release of Information-Dental ENGLISH / SPANISH
Release of Information-Physical ENGLISH / SPANISH
Head Start / WIC Permission for Release and Exchange of Information - ENGLISH
Head Start / WIC Permission for Release and Exchange of Information - SPANISH
TDSHS Authorization to Release Laboratory Results ENGLISH / SPANISH
Hemoglobin/Hematocrit results - CP
Lead results - CP
Hearing and Vision Summary -or-
Screener ENGLISH / SPANISH - CP
Immunization record - CP
BMI Letter w/ Growth Charts - CP
In House Referral - CP
Optional/Other Forms*
Section Three: Family Services
Section Four: Parent Involvement
Section Five: Education
DIAL 4
DIAL 4 Parent Questionnaire
DECA Report
Head Start Work Samples first and second
Anecdotal Notes – CP
CLI Progress Monitoring Reports – Wave 1,2,and 3
Home Visit/Parent Conference form – filed at the end of the year - CP
In House Referral - CP
Optional/Other Forms*
Section Six: Mental Health
Parental Consent for Mental Health/Behavioral Services - CP
Progress Notes – CP
In House Referral - CP
Individual Mental Health Observation Form - CP
Individual Positive Guidance Plan/follow up - CP
Optional/Other Forms*
Developing Self Help Skills Handout
Section Seven: Special Education
In House Referral - CP
Local committee documentation (Care team, MTSS)
Parent Permission to evaluate
IFSP/IEP/Section 504 Plans or Disclaimer
Optional/Other Forms*
CLI Report Instructions
Class Completion Report instructions – to make sure all children have been assessed in all areas.
Class Growth Report - bar graph indicating student % meeting benchmark.
Class Summary Report - provides a summary of the scores for the class.
Parent Reports - parent reports that can be printed and sent home or viewed online by parents.
CLI Family Resources
Staff Handbook
SMORE Newsletters
Monthly Calendars
Teachers
Classroom Labels
Health
COVID 19
Developmental Checklists - Eng and Sp
FLU
LICE
POTTY TRAINING
TOOTHBRUSHING
Mental Health
7 Super Centers powerpoint
How to administer the DIAL 4 Assessment