ERSEA Information
Section One: Enrollment
2025-2026 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
Fiscal (see Chief Financial Officer / R9 Employee Handbook)
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