- CP Forms
- FSW Forms
- FSW Forms in Spanish
- Health Start Manager Forms
- Job Descriptions
- Miscellaneous Form
- Performance Appraisals
- Policies and Procedures
| CP1 |
Enrollment/Drop Form |
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Child Health & Development Tracking - 45 days |
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Child Health & Development Tracking - 90 days |
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Change of Status |
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Family Service Transaction Form |
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Training Evaluation Log |
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PIR Addendum Questions |
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Disability Worksheet |
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| CP 9 | ERSEA Definitions |
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Mental Health |
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Eligibility Priority Criteria |
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| CP 15 | Child Plus Data Entry Procedure |
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Staff Health Policy |
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Policy Council Fuel Stipend |
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Site Visit Checklist Agenda |
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Property Log & Inventory |
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Professional & Personal Development Plan |
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| 1-6 | Personnel Committee Referral Form |
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Child Abuse and Neglect Report |
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| Procedure 1-8 | Head Start In-House Transfer Procedure |
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Health and Safety Policy |
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| Policy 1-9 sp | Health and Safety Policy ( Spanish) |
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Bus Mileage |
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Inclement Weather Policy |
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Inclement Weather Policy (Spanish) |
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Child Abuse and Neglect Policy (CAN) |
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Child Abuse and Neglect Policy (Spanish) |
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Head Start Recruitment Policy and Criteria |
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Head Start Recruitment Policy and Criteria (Spanish) |
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Enrollment & Attendance Policy |
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Enrollment & Attendance Policy (Spanish) |
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Intern Evaluation |
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Vernonia Head Start Mulit-Service Building |
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Time log for Hours Away from Worksite |
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Child Education Record Policy |
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Client Confidentiality (Program) |
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Client Confidentiality (Volunteer/Parent) |
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Client Confidentiality (Volunteer/Parent) (Spanish) |
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Long Distance Calls |
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Parent Reimbursement for Child Care and/or Travel |
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Transportation Policy for Staff |
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Financial Assistance Tracking Form |
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Personnel Information Sheet |
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Statement of Health |
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Compensation and Professional Development |
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Certification & Licenses |
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College Planning Sheet |
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Petty Cash Reconciliation |
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Staff Conference Form |
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| 1-31 | College Expense Special Request Form |
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Civil Rigths Complaint Procedure |
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Civil Rights Training Questions |
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Hiring Procedure |
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Disbursement Voucher |
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Bus Monitor Training Record |
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Accident Investigation Report |
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CAT Board & Policy Council Responsibilities |
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Computer Procedure |
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Building Security and Key's Policy |
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Procedure for Forms, Procedures and Policy Revision |
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Payroll Advance (Draw) Request |
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Parent-Employee Guidance Procedure |
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End of Year Procedure for Sending in Child Files, CACFP Menu Production Records and Menus to Rainier Admin |
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Evaluation |
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Procedure for Safe Guard Star Seat Installation on the Bus |
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Transportation Policy for Participants |
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Head Start Transportation Information |
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Grant Summary |
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Training & Technical Assistance |
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Staff Children Policy |
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Orientation Checklist for New Employees |
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| 1-51a | Employee Action Checklist |
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Employee Action Notice |
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Plan for Improvement |
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Child Arrival & Departure Procedure |
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Classroom Daily Check In/Out Log |
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Recommendation for Employment |
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Purchase Order for Cook (Shopping List) |
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Procedure for Contract Development |
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Pre-Employment Reference Form |
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Driver’s Daily Pre-Trip Check Sheet |
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Procedure for Monitoring Child Outcomes |
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Evaluation Questionnaire |
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| 1-61 sp | Evaluation Questionnaire (Spanish) |
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Personal Leave Cash Out |
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Employee Application |
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Time Report |
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Travel Expense Statement |
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| 1-66 | Key Receipt |
| Procedure for Maintaining Child Plus Data Entry | |
| 1-68 | Area supervisor's File Review Monitoring Checklist and Program Self-Assessment Data |
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Policy for Hiring Substitute Center Staff Person |
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Policy for Hiring Substitute Center Staff Person (Spanish) |
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Support and Training Review |
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| Form 1-70 a | Support and Training Reflections |
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Volunteer Declaration Form |
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Volunteer Declaration Form (Spanish) |
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| 1-72 | Exit Interview Checklist |
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Procedure for Addressing Program Concerns |
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First Aid Supplies Checklist |
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In-House Student Transfers |
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Insect & Pest Control |
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Procedure for Verifying Applicant Qualifications |
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Payment for Meals |
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Payment for Meals (Spanish) |
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Head Start Child Care Payment Policy |
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Procedure for Days of Service and Days of Class |
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Sign-In Sheet for Child’s File |
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Parent/Community Grievance Policy |
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Parent/Community Grievance Policy (Spanish) |
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Accessing CFDP CDA Advisor |
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Computer Password Tracker |
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Per Diem Request |
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Travel Reimbursement |
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Non-Enrolled Participation Policy |
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| Policy 1-89 | Tobacco Free Environment |
| Policy 1-89 sp | Tobacco Free Environment (Spanish) |
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Voluntary Personal Leave Transfer Request |
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Income Documentation for Multi-Service Building at Vernonia Head Start |
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Head Start Ongoing Monitoring Procedure |
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Dispute Resolution |
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| 1-94 | Employee Leave Request |
| 1-95 | Employee Disciplinary Action |
| 1-96 | Plan of Assistance |
| Procedure 1-97 | USDA Non-discrimination Procedure for CACFP Compliance |
| Procedure 1-98 | Child Health, Safety and Supervision Procedure |
| Procedure 1-99 | Procedure for Reporting to CAT Board and Policy Council |
| Procedure 1-100 | Procedure for Completing the Report to the Public |
| Form 1-101 | 15 Hours Teacher Training Declaration of Understanding and Tracking Form |
| Procedure 1-102 | Educational Financial Aid Procedure |
| 1-103 | Financial Assistance Agreement |
| 1-104 | Tuition Payroll Advance Request |
| Procedure 1-105 | Sharing Training Procedure and Individual Training Request Form |
| 1-106 | CDA Planning Sheet |
| Monthly Planning Form | ||
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Weekly Planning Form |
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Child Learning Profile–Interest & Goals |
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| 2-2 sp | Child Learning Profile-Interest & Goals (Spanish) | |
| 2-3 | CCDC Questions 51 & 52 | |
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About my Family |
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About my Family (Spanish) |
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Field Trip Plan Program Authorization |
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Head Start Field Trip Report |
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Head Start Home Visit Form |
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Head Start Home Visit Form (Spanish) |
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Individual Child Planning Form |
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Individual Child Planning Form (Spanish) |
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DECA Documentation and Level Planning Procedure |
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Monitoring & Data Entry Guide Procedure for CCDC and CCNet |
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Bus and Walking Field Trips |
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Specific Field Trip Permission Slip |
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Specific Field Trip Permission (Spanish) |
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Home Visit Agreement |
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Spanish Home Visit Agreement |
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| Procedure 2-13 | Health/Safety Checklist Procedure | |
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Health/ Safety Checklist (Teachers) |
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Health/Safety Checklist (CM) |
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Health/Safety Checklist (Cooks & Custodians) |
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Home Visit Policy |
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Home Visit Policy (Spanish) |
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| Guidance 2-15 | Teaching Strategies Gold (TSG) Report Analysis | |
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Procedure for Classroom Home Visits and Lesson Plan Review |
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Procedure for Parent Teacher Conference Guidance |
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Parent Teacher Conference Guidance |
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Talk about Touching Letter |
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Talk about Touching Letter (Spanish) |
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Home Visit Pamphlet |
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Home Visit Pamphlet (Spanish) |
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Notice of Family Contact |
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Home Visit Forms Evaluation |
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Home Visit Summary |
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Care and Maintenance of Animals in the Classroom |
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Bus Evacuation Procedure |
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Fire Drill Observation/Evaluation |
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Earthquake Drill Observation/Evaluation |
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Bus Evacuation Drill Observation/Evaluation |
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Home Visit Observation Checklist |
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ECERS Technical Assistance Plan |
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Child Guidance (Staff) |
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Child Guidance (Parents) |
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Child Guidance Parents (Spanish) |
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General Walking Trip Permission Slip |
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General Walking Trip Permission Slip (Spanish) |
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Data Entry Guide for CCDC Class Summary Worksheet |
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Authorization to Act as Parent |
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Authorization to Act as Parent (Spanish) |
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| 2-32 | Implementation Checklist Progress and Planning Form | |
| 2-34 | PBIS Action Plan (Tier II) | |
| Example 2-34 | Filled out example of Form 2-34 | |
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School Bus Safety Education |
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School Bus Safety Education (Spanish) |
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| Procedure 2-36 | Program-wide Positive Behavioral Intervention & Support |
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Ouch Band-Aids and Hugs Form |
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Ouch Band-Aids and Hugs Form (Spanish) |
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Expectations for HSAC |
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Lead Checklist |
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Lead Checklist (Spanish) |
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Emergency Health Concerns Tracking Form |
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Referrals Procedure |
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Child Nutrition Screening Survey |
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Nutrition Survey (Spanish) |
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Parent/Guardian Consent to Exchange Confidential Information |
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Parent/Guardian Consent to Exchange Confidential Information (Spanish) |
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Medication Policy |
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Medication Policy (Spanish) |
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Medication Permit and Log |
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Medication Permit (Spanish) |
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Health Services Policy |
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Health Services Policy (Spanish) |
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Parent Request for Food Substitution |
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Parent Request for Food Substitution (Spanish) |
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Emergency Form |
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Emergency Form (Spanish) |
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Medical Statement for Food Substitution |
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Medication Labeling & Storage |
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Management Guide for Responding to an Occupational Exposure Incident |
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Policy for Dealing with Students Having a Bloodborne Pathogen |
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Bloodborne Pathogens (Students) |
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Bloodborne Pathogens (Staff) |
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Bloodborne Pathogens Rumor Control (Staff & Students) |
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Staff Accommodations (Bloodborne Pathogens) |
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Infection Control - Bloodborne Pathogens |
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Infection Control - Spanish |
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Bloodborne Pathogens (Press/media) |
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Medical/Dental Items not Completed (letter to parent) |
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Health Status and Screening Guide |
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| 3-17a | Vision Screening Form |
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Head Lice/Nits Policy |
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Head Lice/Nits Policy (Spanish) |
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Treatment of Headlice in the Home |
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Treatment of Headlice in the Home (Spanish) |
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Policy and Procedure for Excluding Ill Children |
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Policy and Procedure for Excluding Ill Children (Spanish) |
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Exclusion Form |
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Exclusion Form (Spanish) |
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Yearly Screening Guidance |
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Report of Accident to a Participant |
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Dental Statement |
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Health Statement Documentation |
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Toothbrush Procedure |
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Denial of Consent for Medical - No Thank You Letter |
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Denial of Consent for Medical - No Thank You Letter (Spanish). |
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Handwashing Procedure |
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Log of Injuries & Accidents |
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Nutrition Policy |
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Family Style Meal Service Procedure |
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Food Budget Control |
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Medical Home Policy |
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Toileting, Toileting Assistance and Diapering Procedure |
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Emergency Medical/Dental Action Plan |
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Your Child's Food Record |
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| 3-34 sp | Your Child's Food Record (Spanish) |
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Nutrition Information Summary |
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Fluoride Policy |
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Fluoride Policy (Spanish) |
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HSAC Contract |
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USDA Recipe Form |
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Menu Production Record |
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Assisting Families with Health Services and Documentation |
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Health & Safety Log |
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Child & Family Health History |
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Child & Family Health History (Spanish) |
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Sanitation Linen, Bedding & Cots |
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Individual Care Plan |
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Health Screening Letter |
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| 3-47 sp |
Health Screening Letter (Spanish) |
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Asthma Information Form |
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| 3-48 sp | Asthma Information Form (Spanish) |
| 3-49 (NCR) |
Cook's Point of Service Meal Count |
| Procedure 3-50 | Infection Control Procedures (Universal Precautions) |
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Parent Committee Center Training Plan |
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Child Care Payment Request |
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In-Kind Processing Policy |
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Policy Council Committee Meeting |
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Space Evaluation for In-Kind |
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In-Kind |
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In-Kind Donations and Services |
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Policy Council Membership Credential |
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Procedure for Maintaining a Working Relationship with SCF and Community Agencies |
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Parent Activity Fund Guidelines |
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Family Interest Survey |
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Family Interest Survey (Spanish) |
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End of Year Parent Survey |
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End of Year Parent Survey (Spanish) |
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CTA Application Form |
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CTA Application Form (Spanish) |
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CTA Volunteer Program Placement Form |
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CTA Monthly Work Plan |
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Time/In-Kind Record for CTA Volunteer |
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CTA Checklist |
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CTA Final Evaluation |
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Social Service Observation Form |
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Parent Volunteer Policy |
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| Policy 4-11 sp | Parent Volunteer Policy (Spanish) |
| 4-11a | Volunteer Training |
| 4-11b | CTA Program Overview |
| Policy 4-11c | Community Volunteer Policy |
| Policy 4-11 c sp | Community Volunteer Policy (Spanish) |
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Policy Council 2-Way Communication Form |
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| 4-13 | Policy Council Training Verification |
| 4-14 | Policy Council Confidentiality Agreement |
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Permission Slip for Children |
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Permission Slip for Children (Spanish) |
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Contact Sheet |
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Family Interest Assessment Resource and Handout List |
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Family Goal Worksheet |
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Family Goal Worksheet (Spanish) |
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Media Permission Slip |
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Media Permission Slip (Spanish) |
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Child Application |
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Child Application (Spanish) |
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Head Start Eligibility Verification |
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Procedure for Maintaining Working Relationship with CSD and Community Agencies |
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Policy Council Meeting Notes |
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Drop Form |
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Drop Form (Spanish) |
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SOAP |
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Signature Sheet for SOAP Files |
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SOAP Table of Contents |
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Staffing Recording/Staff Meeting Minutes/Site Visit Monitoring |
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| 5-11 (for computer) | Staff Record/Staff Meeting Minutes you can use computer to fill out |
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Self Declaration Form |
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Self Declaration Form (Spanish) |
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Referral for Mental Health Counseling |
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| 5-13 sp | Referral for Mental Health Counseling (Spanish) |
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Child File Set-Up |
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| Procedure 5-15 | Verification of Training and Eligibility Requirements |
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Absentee Follow-up Report |
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Selection Letter |
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Selection Letter (Spanish) |
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Waiting List Letter |
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Waiting List Letter (Spanish) |
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Second Year Welcome Letter |
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Second Year Welcome Letter (Spanish) |
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Income Verification Letter - Child Support |
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Income Verification Letter - Child Support (Spanish) |
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Income Verification Letter - Foster |
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Income Verification Letter - Foster (Spanish) |
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TANF Income Verification Letter |
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TANF Income Verification Letter (Spanish) |
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Court Procedure & Information Disclosure |
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| 5-23 (NCR) | Head Start Social Service Home Visit Form |
| 5-23sp (NCR) | Head Start Social Service Home Visit Form (Spanish) |
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Transition Meeting Summary |
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| 5-25 | Social Service Home Visit Summary |
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Transition Policy |
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Transition to Kindergarten Procedure |
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Parent Gas Stipend |
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Parent Gas Stipend (Spanish) |
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| Procedure 5-28 | Family Partnership Agreement Procedure |
| Form 5-29 | Selection Letter Notification sent to Case Worker |
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Parent Gas Stipend |
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| 5-65 sp | Parent Gas Stipend (Spanish) |
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Parent Gas Stipend Policy |
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| Policy 5-66 sp | Parent Gas Stipend Policy ( Spanish) |
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Parent Notification of IEP Meeting |
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| Procedure 6-2 | Recruitment, Referral, Selection and Services for Children with Diagnosed Disabilities |
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Parent Permission for Evaluation |
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Diagnostic or Interim IEP |
| Assistant Teacher |
| Associate Director |
| Bilingual Assistant |
| Bilingual Assistant for Healthy Start |
| Building Manager |
| Bus Driver |
| Bus Monitor |
| Center Manager |
| Center Volunteer |
| Cook |
| Court Parenting Specialist |
| Custodian |
| Director |
| Family Advocate |
| Family Worker |
| Floating Aide |
| Healthy Start Family Assessment & Support Worker |
| Healthy Start Program Manager |
| Nutrition Aide |
| Office Support |
| Office Support Specialist |
| Parent Support Coordinator |
| Prep Cook |
| Teacher |
| Work Study Assistant |
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ASQ Tracking Table |
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State Healthy Start Forms can be found here: www.oregon.gov/OCCF/webapps.shtml |
