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Head Start Forms Online

Head Start forms descriptions for these forms. (August 6, 2007)

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Administration

Fiscal Management

Approval for Meals and Refreshments

Estimate – Child Care Advance OHSA

Long Distance Log

Material Supply Request Form

Material Supply Request – Short Form

Parent Club Reimbursement – Deposit

Parent Travel Cash Advance

Personal Travel Statement

Petty Cash Verification

Property Receipt

Purchase Order for Health Services (Follow-up)

Purchase Order for Health Services (Initial Exam)

Receipt – Parent Travel & Childcare

Reimbursement Request: Non-Travel

Travel Authorization

Travel Reimbursement Request

Communication

Fax Coversheet

Information Routing Slip

Letterhead

Management Team Meeting Minutes

Weekly Center Staff Meeting Minutes

Human Resource Management

Accident Report - Employee

Accident Report - Employee – No Medical Treatment

Accident Report - Volunteer

Applicant File Form

Application for Employment

Bloodborne Pathogen Incident – Accident Report

Bloodborne Pathogen Training and Hep B Vaccination

Employee Initial Physical Exam Letter

Leave Request Form

Orientation Checklist – Adjunct Employee

Orientation Checklist - New Employee

Performance Evaluation – 45 Day

Performance Evaluation – 90 Day

Performance Evaluation – Assistant Teacher/Classroom Aide

Performance Evaluation – Management Staff

Performance Evaluation – Nutrition Aide

Performance Evaluation – Nutrition Assistant

Performance Evaluation – Teacher/Home Visitor

Plan of Assistance

Receipt of Employee Handbook

Staff and Volunteer Health Self-Appraisal

Standards of Conduct

Telephone Reference Check

Time Report - Management Time Report - Staff Weekly Work Schedule

Training and Development

Education Funding Agreement

Individual Staff Training Record

Mentor -Teacher Observation Notes

Mentor - Teacher Plan of Action

Professional Development Plan

Staff Visitation Request

Training Workshop Attendance

Training Request Form

Child Abuse and Neglect

Quality Assurance

Governance

Community Grievance

Director’s Report to Grantee Board

Supervision and Monitoring

CACFP Site Monitoring Log

Center Contact Record

Child File Checklist

Classroom Health, Nutrition and Safety Inspection

Classroom Observation

Comprehensive Staffing Form

Follow-up on File Review

Self-Assessment Checklist

Teacher Observation

Reporting

CACFP Monthly Report to Nutrition Manager

Classroom Monthly Attendance

Classroom Verification of Attendance

End-of-Year Checklist to Director

Home Visit Tracking to SD Supervisor & E&D Manager

Manager’s Monthly Report to Director

Monthly First Aid Supplies Report to Fiscal Manager

Monthly Report to Education & Disability Manager

Monthly Report to Family & Community Partnership Manager

Monthly Report to Fiscal Manager

Monthly Report to Health & Nutrition Manager

Monthly Report to Staff Development Supervisor

Monthly Safety Report to Health and Nutrition Manager

Student Accident Report

Weekly Center Cleaning Report to Health and Nutrition Manager

Link SubTwo 2

Facilities Management and Maintenance

Facilities Checklist for Ongoing Maintenance

ERSEA / Student Records

Application

Application Status Card

Child Application Form – English

Child Application Form – Spanish

Eligibility Form

Enrollment Application – Demographics

Sample Letter – Acceptance

Sample Letter – Over-Income

Sample Letter – Program Full

Sample Letter – Recruitment

Sample Letter – Second Year

Student Records

Anecdotal Record Authorization for Release of Information

Authorization to Act as Parent

Directions for Transfer of Records

Permanent Student Record

Student Withdrawal Form

Enrollment Packet Contents

A Checklist of Enrollment Forms and Materials

CACFP CIS Instructions (over-income only)

CACFP Confidential Income Statement – English (over-income)

CACFP Confidential Income Statement – Spanish (over-income)

CACFP Letter to Parents – English (over-income only)

CACFP Letter to Parents – Spanish (over-income only)

Child Health and Development

Education

Activity Format Sheet

Additional Home Visit

Assessment for Second Language Learners

Child and Family Cultural Profile

Child File Table of Contents

Child Release and Emergency Contact

Classroom Outcomes Plan

Getting to Know You

Linkage Form to Public School

Parent Permission Slip

Transition Checklist for Teachers

Transition Plan

Transition Plan Tracking

Transition Plan Tracking – Head Start

Weekly Lesson Plan Checklist

Weekly Lesson Plan Format

Disabilities and Mental Health

Behavioral Data Collection

IFSP Child File Checklist

Individualized Prosocial Guidance Plan

Mental Health Classroom Observation

Parent and Staff Action Plan

Parent Permission for Child’s Playgroup Participation

Parent Permission for Individual Child Observation

Parent and Staff Action Plan Screening Checklist - Child Find Screening Results - Hearing Screening Results - Vision Service Provider Log

Staffing Notes for Child Observation

What to Look For

Health

Child Health Care Provider

Child Health History

Child Oral Health Assessment

Child Physical Exam

Classroom Summary – Allergies and Medications

Consent for Well Child Screening

Medication Administration/Parent Update

Medication Authorization

Medication Log

Notice - Communicable Disease Exposure

Notice – Head Lice Exposure

Ouch Report

Student Accident Report

Nutrition

CACFP Enrollment Form – English

CACFP Enrollment Form – Spanish

CACFP CIS Instructions

CACFP Confidential Income Statement – English

CACFP Confidential Income Statement – Spanish

CACFP Letter to Parents – English

CACFP Letter to Parents – Spanish

CACFP Recipe – Combination Foods

CACFP Recipe Crediting Worksheet

Child Nutrition Assessment

Daily Medical Food Substitutions AM

Daily Medical Food Substitutions PM

Food and Blood Glucose Diary

Medical Statement for Food Substitutions

Monthly Report for Meals Served AM

Monthly Report for Meals Served PM

Posted Food Restrictions

Questionnaire - Anemia

Questionnaire - Lead English

Questionnaire - Lead Spanish

Release for Sharing Nutritional Information (WIC)

Family and Community Partnerships

Family Services

Application for Temporary Transportation Subsidy

Family Crest

High School Equivalency Assistance Request

Partnership Agreement - Part II

Parent Center Committee

Fundraising Approval Form

Parent Attendance Log

Parent Center Committee Agenda Format

Parent Center Committee Report to Policy Council

Parent Training Plan

Volunteers

EOU Conditions of Volunteer Service

Non-Federal Resource Voucher

Parent and Volunteer Orientation

Summary - Miscellaneous In-Kind

Summary of Volunteer Hours

Volunteer Sign-in Sheet - Miscellaneous Volunteers

Volunteer Sign-in Sheet - Parent Classroom

Volunteer Survey

ontact Information

Eastern Oregon Head Start

One University Boulevard

Ackerman Hall Room 016

La Grande, OR 97850

Phone: 541-962-3506

E-Mail: vbertels@eou.edu

Contacts at Head Start

Eastern Oregon University is a member of the Oregon University System

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