ATCAA Early Head Start/Head Start/State Preschool/General Child Care
Child’s Name: ___________________________
Behavior Guidance
Early Head Start, Head Start, State Preschool and General Child Care programs promote positive, respectful
and considerate behavior in children. When a child behaves in a way that poses a threat to themselves, other
children or staff, the parent or designee may be required to spend time with the child at the site or take the
child home for the remainder of the day.
In addition a Student Study Team, consisting of the parent or designee, pertinent Early Childhood Services
(ECS) staff, and a mental health consultant, will be established to develop a behavior plan to ensure success
for the child and overall safety within the program. This may include “modifying” or limiting the days and
hours a child attends the program. The Student Study Team will continue to convene as necessary to ensure
that the child’s needs are being met and the child is a successful participant in the program.
Initial: ___________
Mandated Reporting Requirement
All ECS staff members are Mandated Reporters and required by the State of California to report any suspected
child abuse or neglect. Mandated Reporters must report known or suspected abuse immediately to Child
Welfare/Protective Services. A mandated reporter who fails to report an instance of known or suspected child
abuse or neglect is guilty of a misdemeanor and is punishable by jail time of no more than six months, and or
a fine of not more than one thousand dollars ($1,000.00), or both. All reports are confidential.
Initial: ___________
Parental Release to Photograph
I give permission for my child, ________________________________ to be photographed during program
activities. I understand that these photographs may be used for classroom displays, socializations or
scrapbooks. Photographs may also be used by ECS in promotional materials to inform the public about Early
Head Start, Head Start, State Preschool and General Child Care.
You are under no obligation to sign these consents and refusal will not affect services received from ATCAA
ECS.
Initial: ___________
Parent/Guardian Signature: ____________________________________
Date: ____________
Staff Signature: _____________________________________________
Date: ____________
Review: ____________
Revised 4/5/13
Review: ____________