Head Start Scaled Family Assessment for Parent, Family and Community Engagement Outcomes
This page -score Fall by November, Spring in May
Family Name ________________________________________________ Family Service Worker __________________________ Year ______-______
F
1.
Family Well Being- (Score Fall in September, Spring in May)
Score
Fall
Spring
Family Well Being Continued
I. Health: Medical, Dental, Vision
Family has access to total health care and follows through with care
and referrals
Child has health insurance, family utilizes medical resources
Child has health insurance, adult has no health insurance or resources
Family reports inadequate or inaccessible care
Medical problems not being addressed, family does not follow through
with care or referrals
II. Mental Health
Family has no mental health concerns, no domestic issues, no child
abuse or neglect issues, nor current substance or alcohol abuse.
Family is currently receiving assistance or treatment for mild to
moderate mental health concerns, domestic violence, or
substance/alcohol abuse with good results, and there are no
continuing concerns for child abuse/neglect.
Family is receiving treatment for domestic violence, working with CPS
for child abuse/neglect, receiving care for severe mental health
concerns, and seeking treatment for alcohol/substance abuse with
some progress.
Family needs assistance with mental health issues, escalating mental
health issues, domestic violence, and substance or alcohol abuse.
There are concerns for child abuse/neglect. Parents are willing to
make some changes or seek treatment.
There are concerns with mental health, domestic violence, substance
or alcohol abuse, child abuse/neglect and family is unwilling or unable
to seek help.
IV. Finances
5
4
3
2
1
Tenancy is secure for more than one year/payments reasonable
Tenancy is secure for six months to one year/payments reasonable
Housing is temporary or transitional/payments difficult/lives with
others by choice
Homeless or on the verge of homeless/living with others not by choice
Saving regularly and building assets, has retirement savings
Income meets basic needs, some savings
Minimally adequate income, no savings
Poor credit, debt, relies on financial assistance
No money, cannot meet basic needs
5
4
3
2
1
V. Employment
5
Stable employment with benefits, steady income, meets family needs
4
5
4
Income meets basic needs, job advancement, some benefits
3
3
Minimally adequate income, seeking better employment
2
2
Employment needed, has skills
1
Unemployed or not interested in employment, limited skills, cannot meet
basic needs
VI. Transportation
1
5
Has automobile, driver’s license, and ability to maintain vehicle
5
4
Has automobile and driver’s license
4
3
Has regular access to transportation
3
2
Transportation problems, no driver’s license
2
1
No access to transportation
1
III. Housing
Housing is safe, stable and affordable, and meets family’s needs
Score
VII. Childcare
Quality childcare is utilized or child care is not needed by family
Adequate childcare is utilized
Inconsistent childcare, multiple caregivers
5
4
3
Childcare or caregiver problems, limited resources for back up childcare
Inappropriate childcare is utilized or lack of available child care
2
1
Fall
Spring
This page -score Fall by November, Spring in May
2. Positive Parent-Child Relationships
Positive, enhanced, parenting practices, meets child’s needs, shows
affection, confident with parenting, consistent daily routines
Meets child’s needs, effective method of discipline, seeks parental
resources, basic parenting skills, age appropriate practices, improving
daily routines
Some daily routines, inconsistent or ineffective discipline, unsure of
parenting role
Minimal routines, inappropriate discipline, lack of appropriate
parenting skills, minimum understanding of child development or
needs
No routines, poor/harsh discipline, no understanding of child
development or needs are not met
5. Family Engagement in Transitions
5
4
3
2
1
Communicates effectively with all program staff, attends teacher
conferences and transition activities, understands parent and school
responsibilities for transition, seeks transition resources
Communicates appropriately with all program staff, attends teacher
conferences and some transition activities, understands parent and school
responsibilities for transition, seeks some transition resources
Communicates with all program staff, meets program minimum
requirements for transition, some understanding of parent and school
responsibilities for transition
Minimal communication with program staff, inconsistent involvement in
transition activities, minimum understanding of parent and school
responsibilities for transition
Little or no communication with program staff, no involvement in
conferences or transition activities, unable to determine parent
understanding of transition responsibilities
3. Families as Lifelong Educators
6. Family Connections to Peers and Community
Partners with teachers to set educational goals and develop strategies
at home, seeks educational resources and opportunities, promotes
lifelong learning , met all parent goals for school readiness
Actively participates in child’s education, advocates for educational
needs, seeks educational opportunities for child and met most parent
goals for school readiness
Participates and engages in program, church or community activities,
establishes peer relationships, utilizes and shares community resources with
peers and program, strong family or peer support
Participates in child’s education, supports educational goals, seeks
some educational resources, met few parent goals for school readiness
Limited ability or interest to participate in child’s educational
development, meets mandatory educational requirements, limited
participation in goals for school readiness
5
4
3
2
1
No participation in child’s educational development
4. Families as Learners
Obtained or pursuing degree, certification, or other higher learning
opportunity, participates in program opportunities regularly
High school diploma/GED, sets goals for lifelong learning, participates
in program or other community trainings
No diploma & seeking GED or has diploma & sets goals for other
learning, participates in some program or community trainings
No diploma, limited ability to set educational or personal development
goals, limited participation in program or community trainings
Limited to no formal education, unable or unwilling to participate in
educational activities
Participates in program, church, or community activities, establishes some
peer relationships, utilizes community resources, family or peer support
Attends program, church, or community activities, establishes limited peer
relationships, utilizes community resources as needed, limited peer or family
support
Limited attendance in program, church, or community activities, establishes
minimal peer relationships, needs assistance with obtaining community
resources , little peer or family support
Little or no attendance in program, church, or community activities, little or
no peer relationships or family support, community resources not utilized or
misused,
5
4
3
2
1
5
4
3
2
1
7. Families as Advocates & Leaders
5
4
3
2
1
Engaged in program, classroom or outside leadership/ volunteer
opportunities. Advocates for program excellence and improved educational
opportunities for children, seeks or refers resources
Participates in some leadership/volunteer opportunities. Advocates for
program. Seeks ways to expand leadership/advocacy opportunities
Limited ability to participate in program or outside leadership opportunities,
seeks alternative ways to assist
Limited ability to participate in program but advocates for program
No interest in leadership or advocacy opportunities
5
4
3
2
1
This page -score Fall by November, Spring in May