ACF OPRE: Early Head Start Research and Evaluation Project (EHSRE)

APPENDIX A

IMPLEMENTATION CHECKLISTS

INDICATORS OF FULL IMPLEMENTATION FOR EARLY HEAD START PROGRAMS

Program: _______________________________

Date of Visit: ____________________________

Criteria General	Specific Indicators
SUBPART B--EARLY CHILDHOOD DEVELOPMENT AND HEALTH SERVICES
CHILD DEVELOPMENT CORNERSTONE (§1304.20 CHILD HEALTH AND DEVELOPMENT SERVICES, §1304.21 EDUCATION AND EARLY CHILDHOOD DEVELOPMENT, AND §1304.24 CHILD MENTAL HEALTH)
Program is providing all child development services required by the EHS grant announcement and HS performance standards. (§1304.20 and §1304.21)	The program is providing the following services directly, through contract with an outside provider, or through referral to an outside provider. (INDICATE THE MODE OF SERVICE DELIVERY AS FOLLOWS: DIRECT (D), CONTRACT (C), OR REFERRAL (R)): ___ Early education services (NAME OF CURRICULUM: ___________________________________) ___ Child development home visits (especially for families with newborns and other infants) ___ Parent education (NAME OF CURRICULUM: ___________________________________) ___ Parent-child activities ___ Comprehensive health services for children ___ Nutrition services ___ Mental health services for children ___ Periodic developmental assessments (NAME OF INSTRUMENT(S): ________________________) ___ Part- or full-day child care services for families that need child care ___ Referral to and coordination with Part H service providers Comments:
Program has identified criteria for high quality with respect to each of these services and has assessed the quality of the services it offers, including services provided directly and those provided through referral or coordination with other providers.	DESCRIPTION OF THE PROGRAM’S CRITERIA FOR ASSESSING SERVICE QUALITY IN THE CHILD DEVELOPMENT CORNERSTONE.
Program activities are linguistically appropriate and recognize children’s individual rates of development. Services are provided in an environment that respects gender, culture, language, ethnicity, and family composition. (§1304.21(a)(1))	Percentage of enrolled families: ___ whose primary language is not English ___ who receive child development services in their primary language SOURCE OF ESTIMATES: __________________ Program: ___ Includes activities for families that foster cultural pride ___ Provides child development services in a manner that respects families’ cultural and ethnic traditions with regard to child-rearing practices ___ Provides child development services that are tailored to the circumstances and backgrounds of individual families and children Comments:
Program activities provide opportunities for a variety of sensory and motor experiences, support social and emotional development, support emerging communication skills, support the development of self-awareness and autonomy, and promote development of gross and fine motor skills. (§1304.21(b))	Program activities and curriculum provide the following through center-based activities for children, center-based parent-child activities, or home visits (INDICATE THE MODE(S) OF SERVICE DELIVERY AS FOLLOWS: CENTER-BASED EARLY EDUCATION/CHILD CARE (C), OTHER DEVELOPMENTALLY APPROPRIATE CHILD CARE (OC), HOME VISITS WITH A CHILD DEVELOPMENT FOCUS (HV), AND/OR GROUP SOCIALIZATION ACTIVITIES THAT INCLUDE PARENTS AND CHILDREN (GS). MULTIPLE CODING IS APPROPRIATE. ___ Opportunities for a variety of sensory and motor experiences ___ Support for social and emotional development ___ Support for emerging communication skills ___ Support for development of self-awareness and autonomy ___ Opportunities for gross and fine motor skills development ___ Support for emerging cognitive skills Comments:
All children enrolled are receiving child development services on a regular basis. (§1304.21(a)(1))	Enrolled children receive child development services through the following modes of service delivery: Center-based early education services/child care ___ Hours per week or ___ Hours per month ___ Number/percentage of children Other developmentally appropriate child care ___ Hours per week or ___Hours per month ___ Number/percentage of children Home visits with a child development focus ___ Hours per week or ___Hours per month ___ Number/percentage of children Group socializations that include the parent and child ___ Hours per week or ___Hours per month ___ Number/percentage of children SOURCE OF ESTIMATE: ________________ COMPLETE FOR PROGRAMS THAT PROVIDE HOME VISITS WITH A CHILD DEVELOPMENT FOCUS: Time devoted to child development in a typical home visit is appropriated as follows: ___ Percent of time spent directly with the child ___ Percent of time spent with the parent and child together ___ Percent of time spent directly with the parent for parenting education ___ Percent of time spent on family social services ___ Percent of time spent on other activities (DESCRIBE) SOURCE OF ESTIMATE: _________________ Percentage of enrolled children who received any child development services within the past month: ___ PERCENT SOURCE OF ESTIMATE: __________________ Comments:
All parents enrolled receive parent education services. (§1304.40(c)(3))	Of those parents who have been enrolled in the program for at least one month, percentage who have received any parent education services: ___ PERCENT SOURCE OF ESTIMATE: __________________ Comments:
Center-based programs encourage the development of secure relationships by having a limited number of consistent teachers over an extended period of time. (§1304.21(b)(1)(i))	COMPLETE FOR PROGRAMS THAT PROVIDE CENTER-BASED CHILD DEVELOPMENT SERVICES. ___ Program assigns each child a primary caregiver Group size: ___ Infants ___ Number of caregivers per group ___ Toddlers ___ Number of caregivers per group ___ Percentage of direct care positions that have been filled by new staff members in the previous 12-month period Comments:
Program provides comprehensive health care for children directly; and/or program coordinates with a local health care provider to provide comprehensive health care for children, and case managers follow up to make sure that children receive comprehensive services; and/or program refers families to local health care providers for comprehensive health care for their children, and case managers follow up to ensure that children receive comprehensive services. (§1304.20(a)(1)(i))	The program: ___ Provides comprehensive health care directly; and/or ___ Coordinates with a local health care provider to provide comprehensive health care and case managers monitor service delivery; and/or ___ Refers children to local health care providers and case managers monitor service delivery ___ Collaborates with health care providers and parents to track well-child care, immunizations, and treatment plans Comments:
Program helps eligible families without health insurance to apply for Medicaid. Programs that do not provide health care directly arrange for care to be provided free or at low cost to EHS families. (§1304.20(a)(1)(i))	The program: ___ Assists EHS children and families in applying for Medicaid ___ Assists EHS families without Medicaid in obtaining free or low-cost health care Comments:
Families with infants and toddlers suspected of having a disability are promptly referred to the local Part H agency. Program coordinates with the Part H agency to develop individualized service plans for families with children with disabilities. (§1304.20(f)(2)(ii))	Percentage of children: ___ With a suspected or diagnosed disability ___ With a suspected or diagnosed disability who have been referred to Part H (IF LESS THAN 100 PERCENT, RECORD THE REASON.) SOURCE OF ESTIMATE: __________________ Program coordinates with the Part H services provider to: ___ Develop joint individualized family service plans ___ Coordinate services that families receive Comments
Program has secured the services of a mental health professional to regularly consult with program staff and parents. (§1304.24(a)(2))	Program has: ___ Secured the services of a mental health professional ___ A schedule or system in place for regular consultation with a mental health professional with program staff and parents Comments:
All children have a medical home; have up-to-date immunizations; have had a well-child examination; have received age-appropriate developmental, sensory, and behavioral screenings; have received treatment for illnesses; and have a follow-up plan for identified conditions. (§1304.20(a), (b), and (c))	Percentage of children who: ___ Have a medical home ___ Have up-to-date immunizations ___ Have had a well-child examination ___ Have received age-appropriate developmental, sensory, and behavioral screenings ___ Have received treatment for illnesses ___ Have a follow-up plan for identified conditions SOURCES OF ESTIMATES: __________________________ Comments:
Program has made arrangements for child care to be provided for all families that need it, either by providing care directly at the EHS center, by coordinating with a local child care provider to offer care at the EHS center, and/or by arranging for child care spaces in local centers and/or family child care homes.	Percentage of all program families who: ___ Need child care ___ Are receiving child care services SOURCES OF ESTIMATES: __________________________ RECORD NUMBER OF CHILDREN PARTICIPATING IN EACH TYPE OF CHILD CARE SERVICE AND DESCRIBE RATIONALE FOR REFERRAL TO EACH TYPE OF SETTING: ___ Total EHS children receiving child care ___ Center-based child care provided directly by the EHS program ___ Center-based child care provided by another agency through contract with the EHS program ___ Center-based child care provided by another agency to which families are referred by the EHS program ___ Family child care provided through contract with the EHS program ___ Family child care provided through a network of providers who are trained and managed by the EHS program ___ Family child care to which families are referred by the EHS program ___ Relative or other child care selected by the family independent of the EHS program SOURCES OF ESTIMATES: _________________________ Comments:
Program has developed a plan and criteria for assessing the quality of child care arrangements prior to placing children in care and for regularly monitoring the quality of care.	Program has identified a plan and assessment tools for: ___ Assessing the quality of child care setting prior to placing children in care (NAME OF ASSESSMENT TOOL: ___________________________) ___ Monitoring the quality of child care arrangement on a regular basis (INDICATE FREQUENCY: ______) ___ Providing training and support to the child care providers it uses Comments:
SUBPART C--FAMILY AND COMMUNITY PARTNERSHIPS
FAMILY DEVELOPMENT CORNERSTONE (§1304.40 FAMILY PARTNERSHIPS)
Program collaborates with families to develop individualized family partnership agreements. Program systematically learns about families’ involvement in other programs and, when appropriate, builds upon these plans and/or develops joint plans. Staff regularly monitor implementation and review and update the agreements. (§1304.40(a)(2-3))	Program engages families in a process of developing individualized family partnership agreements that : ___ Identify families’ goals, strengths, and needed services ___ Describe timetables and strategies for achieving goals ___ Build upon plans developed by other programs ___ Are developed jointly with other programs when appropriate ___ Are reviewed and updated regularly (RECORD FREQUENCY: _______________) Comments:
Program has developed individualized family partnership agreements with all enrolled families. (§1304.40(a)(2))	Percentage of enrolled families for whom an individualized family partnership agreement has been developed: ___ PERCENT SOURCE OF ESTIMATE: __________________ Comments:
Case managers meet with each family in their caseload at least once per month. (§1304.40(b))	Percentage of families who have had a meeting with their case manager within the past 30 days ___ PERCENT SOURCE OF ESTIMATE: __________________ Comments:
Program services offered include the full range of services specified in the EHS program announcement and the HS performance standards. (§1304.40(b)(1), (c), (e), and (f))	The program is providing the following services directly, through a contract with another agency, or through referral to another agency [INDICATE THE SERVICE DELIVERY MODE AS FOLLOWS: DIRECT (D), CONTRACT (C), OR REFERRAL (R).] ___ Case management ___ Parent support through peer support groups and other approaches ___ Child development information ___ Health care ___ Comprehensive prenatal and postpartum care ___ Prenatal education and information about breast feeding ___ Mental health services ___ Information about mental health issues such as substance abuse, child abuse and neglect, and domestic violence ___ Services to improve health behavior, such as smoking cessation classes and substance abuse prevention and treatment ___ Education and job training ___ Employment services ___ Emergency assistance ___ Transportation to program services Comments:
Program has identified criteria for high quality with respect to each of these services and has assessed the quality of services it offers, including services provided directly and those provided through referral or coordination with other providers.	DESCRIPTION OF THE PROGRAM’S CRITERIA FOR ASSESSING SERVICE QUALITY IN THE FAMILY DEVELOPMENT CORNERSTONE
Program systematically monitors service quality and works to improve quality when deficiencies are identified.	DESCRIPTION OF THE PROGRAM’S PROCEDURES FOR MONITORING SERVICE QUALITY, INCLUDING FREQUENCY OF MONITORING AND FOLLOW-UP ACTIVITIES WHEN DEFICIENCIES ARE IDENTIFIED
Program actively tries to involve all parents in the program in some capacity. (§1304.40(d))	DESCRIPTION OF OPPORTUNITIES OFFERED TO PARENTS TO BE INVOLVED IN THE PROGRAM AND METHODS USED TO ENCOURAGE PARENT INVOLVEMENT
Parents are considered for program positions when there are openings. (§1304.52(b)(3))	___ Number of staff members who are current or former EHS or HS parents Comments:
Parents volunteer for program activities. (§1304.40(d)(3))	Percentage of parents who have volunteered for program activities in the past year: ___ PERCENTAGE SOURCE OF ESTIMATE: __________________ Comments: LIST TYPES OF VOLUNTEER POSITIONS THAT PARENTS HAVE FILLED.
COMMUNITY BUILDING (§1304.41 COMMUNITY PARTNERSHIPS)
Program communicates regularly with other community providers and community organizations to secure services for program families and to work together to provide higher-quality services to all families. (§1304.41(a)(1))	___ Estimated number of other community providers with which the program communicates regularly ___ Average frequency of communications with other community providers ___ Participation in a coordinating group of community service providers SOURCE OF ESTIMATES: ______________________ Comments: DESCRIBE TYPES OF COMMUNICATIONS WITH OTHER SERVICE PROVIDERS.
Collaborative agreements are made to improve access to high-quality services by program families. (§1304.41(a)(2)	Program has in place (RECORD NUMBER): ___ Written collaborative agreements ___ Informal collaborative agreements SOURCE: __________________________________ Comments:
Program has established a Health Advisory Committee and other advisory committees as necessary. The committees meet regularly to discuss program issues. (§1304.41(b))	The program has established the following advisory committees: ___ Health Advisory Committee ___ Other (DESCRIBE) Comments:
Program has established procedures for coordination and outreach to schools and other agencies that facilitate the successful transition of children enrolled in EHS. (§1304.41(c)(1))	DESCRIPTION OF PROCEDURES FOR DEVELOPING TRANSITION PLANS
Transition plans for all children are developed at least six months prior to the child’s third birthday. (§1304.41(c)(2))	Of those children who are within six months of their third birthday, percentage who have a transition plan in place: ___ PERCENTAGE Comments:
SUBPART D-PROGRAM DESIGN AND MANAGEMENT
STAFF DEVELOPMENT CORNERSTONE (§1304.52 HUMAN RESOURCES MANAGEMENT)
Program has a staffing plan and job descriptions for each position that describe the minimum qualifications and selection criteria for the position. These criteria meet or exceed EHS performance standards. (§1304.52(a-f))	___ Job qualifications and hiring criteria meet or exceed EHS performance standards Comments:
All line and supervisory staff receive training commensurate with their education and experience at least once a year. Whenever possible, training opportunities should provide academic credit. (§1304.52(k)(2))	OBTAIN INFORMATION ABOUT TRAINING, EDUCATION, AND EXPERIENCE FROM THE STAFF QUESTIONNAIRE, DESCRIBE TRAINING RECEIVED (INCLUDING OPPORTUNITIES FOR ACADEMIC CREDIT), AND LIST STAFF WHO HAVE NOT RECEIVED APPROPRIATE TRAINING IN THE PAST YEAR.
Program staff receive adequate supervisory support and mentoring to sustain motivation and prevent staff turnover due to burnout.	RECORD A DESCRIPTION OF SUPERVISORY, MENTORING, AND OTHER STAFF SUPPORT ACTIVITIES DESIGNED TO SUSTAIN MOTIVATION AND PREVENT BURNOUT. ___ Percentage of staff who have left the program during the past 12 months due to reasons other than program downsizing
Staff development curriculum and materials demonstrate that staff development activities reflect an interdisciplinary approach and an emphasis on relationship building and employ techniques and opportunities for practice, feedback, and reflection. (§1304.52(k)(2))	Staff development plan and curriculum: ___ Reflect an interdisciplinary approach ___ Emphasize relationship building ___ Employ techniques and opportunities for practice, feedback, and reflection Comments:
Staff receive training in multiple areas. (§1304.52(k)(3))	OBTAIN TRAINING INFORMATION FROM THE STAFF QUESTIONNAIRE AND DESCRIBE THE AREAS IN WHICH STAFF HAVE RECEIVED TRAINING. LIST STAFF WHO HAVE NOT RECEIVED TRAINING IN MULTIPLE AREAS.
All program staff receive regular performance reviews and consideration for promotions. (§1304.52(i))	RECORD THE FREQUENCY OF PERFORMANCE REVIEWS AND PROVIDE A DESCRIPTION.
Staff salaries and benefits are at or above the average level for similar staff in area programs.	___ In the program director’s opinion, staff salaries and benefits for EHS staff positions are at or above the average level for similar staff in other area programs. Comments:
1304.51 MANAGEMENT SYSTEMS AND PROCEDURES
Program has developed multiyear program goals and shortterm program and financial objectives. (§1304.51(a)(1)(ii))	Program goals and objectives: ___ Were developed through a collaborative planning process ___ Reflect the findings of the program’s annual self-assessment Comments:
Program has conducted an indepth assessment of community resources and needs. (§1304.51(a)(1)(i))	___ The program has conducted an in-depth assessment of community resources and needs within the past three years. Date of most recent assessment: ______________________ Comments:
Program has developed written plans for implementing services in each of the program areas included in the HS performance standards. (§1304.51(a)(1)(iii))	___ The program has developed written plans for implementing services in each program area. Date of most recent plan revision: ______________________ Comments:
In consultation with policy groups and other community members as appropriate, program conducts an annual self-assessment of its effectiveness, its progress in meeting goals and objectives, and its implementation of the HS performance standards. (§1304.51(i)(1)	___ The program has conducted an annual self-assessment (covering areas described in J.3 of the protocol). ___ The program has used the self-assessment to make program improvements (DESCRIBE) ___ The self-assessment has been done in consultation with the policy group and other community members. Date of most recent assessment:______________________ Comments:

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