Preschool Bus Violation Form
Preschool
Handbook
2011-2012
Table of Contents
Overview of Program .................................................................... 3
Enrollment ...................................................................................... 4
Assessments and Components ................................................. 15
Using Assessment Outcomes (Data) ......................................... 32
Childplus IEP Information ........................................................... 40
OSEP-TSG .................................................................................... 49
Orientation and Records ............................................................. 50
A Positive Social Emotional Environment ................................ 63
Instructional Guidance ................................................................ 72
Team Information ........................................................................ 94
Helping Hands ........................................................................... 108
Transitioning Into and Out of Preschool ................................. 131
Policies ....................................................................................... 136
Health and Nutrition .................................................................. 139
Meals and Food Service ............................................................ 173
Transportation ........................................................................... 182
Forms and Procedures ............................................................. 190
Worker’s Compensation ........................................................... 219
Revised July 2011 2
Overview of Preschool Program
It is our goal to provide a comprehensive preschool experience for…
Revised July 2011 3
Enrollment
Revised July 2011 4
Table of Contents
How Children Are Accepted Into the Preschool Program........................................ 6
Registering Students After the School Year Has Started ........................................ 9
Guidance for Children Coming from the Infant/Toddler Program ......................... 12
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How are children accepted into the preschool program?
1. The school based preschools have a single point of entry, meaning that we all use the same application and all applications come into one central location.
2. Applications are completed by families. The family identifies family factors when answering the application questions.
3. The preschool application is scored based on family factors for school success. We have grant funding that considers income and funding that does not consider income. Our goal is to serve as many children as possible.
4. Acceptance begins in early May. All funded slots must be filled. Acceptance may vary based on the risk factors of those who apply. Four year olds who demonstrate the greatest need per the self-reported family factors are considered first.
5. For a list of risk factors, please see a preschool application here or at www.augusta.k12.va.us/preschoolenrollment
Questions frequently asked by parents
“What do you look at when processing applications?”
Preschool is funded by local, state and federal funds. In order to qualify for state and federal money, we must follow guidelines provided by the state and federal government. The same application is filled out by all families applying for preschool. The application is then scored and families with the highest scores for at-risk factors, according to their self report are offered placement first.
Unfortunately, funding and space is limited. A waitlist is maintained throughout the year for those children who are not accepted. Accepted applicants meet one or more of the criteria of the local, state, and federal government. Specifically: 1. Multiple family factors reported by parents on last page of the application. 2. Child has been identified with a disability and school division specifies preschool class placement for services. 3.
Family meets requirements of income eligibility, identified homeless status, foster care status, or are receiving
TANF or SSI.
“ How old does my child need to be?”
Priority is given to those children who will be 4 years of age by September 30 of the school year. Children who are 3 years of age by September 30 of the school year may apply but have a much greater chance of being waitlisted due to the 4 year old priority school division policy.
“If I apply early does that increase my child’s chances of enrollment?”
This program is a need-based program, so acceptances are not first come, first serve. A portion of each classroom is filled beginning in the spring with applicants who meet the criteria noted above. Space is filled each following month with those applicants who meet the criteria until the funded slots for each classroom are full.
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“ What documents are required?”
A completed application, income verification, and residency verification are the documents requested to be placed on the waitlist and considered for enrollment. If a child is accepted, the following documents are required: birth certificate copy, social security card copy, physical/immunization record.
“Can I apply for the school near my caregiver?”
No, school division policy requires that your child attend the school district of your permanent residency.
Special permission inquiries must be directed to the central office of your school division.
“Are there many children in the classroom with disabilities?”
The number of children with disabilities varies and reflects the population of the school community.
“I have heard that public preschool programs only serve underprivileged children, is this true?”
Our preschool program is for children that are at- risk for school success. “At risk” includes a wide variety of factors: divorced families, children with significant medical issues, the family lives at the poverty level or below, etc.
“What happens if I move? Will my child automatically transfer to their new school?”
No, due to a limited number of preschool slots a child does not transfer to another school when they move. The child will be placed on the waiting list and if a slot does become available, the child will be reconsidered for placement at the new school.
“What does ‘waitlisted’ mean?”
Applicant is placed on the waiting list if no slots are available at their home school or if the acceptance process has not begun for the next year.
“ What does ‘accepted’ mean?”
Applicant has been offered a slot.
“What does ‘enrolled’ mean?”
Applicant has met all requirements and has begun preschool.
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Two Ways to Begin School
Entering on the first day of school
Summer Enrollment
–
During the summer (specific dates per school division), parents meet with the FSA’s to complete school and program registration. At that time they will receive the ASQ and
ASQ: SE, optional supply list, calendar of Fridays when children do not attend, and emergency care card. Needed information will be returned before school starts.
For children entering after school has started for the year
1. Child is accepted into preschool program per Enrollment criteria for selection.
2. After a child is accepted through the Enrollment office the Family Service Advocate will contact the family about registration requirements. The teacher and principal where the child has been accepted will be notified when registration is complete.
3. If the family accepts the spot the FSA arranges to meet the family at the school, intake center, or home visit to conduct registration and orientation meeting. This includes the emergency care card and school data form. (Within five days of being notified child is accepted.) See page nine for more information.
4. Transportation for children is arranged per your division’s procedures.
5. Once the emergency care card is given to the teacher, the teacher will give the emergency care card to the office. The school nurse will notify all appropriate personnel regarding any medical needs of a child.
6. Children entering after school begins will come to the classroom for a transition visit. The teacher and the Family Service Advocate will arrange the details for this visit together. The teacher will schedule a parent conference for 2 weeks after the child’s start date in which the screening will be scored and discussed.
7. The child will begin school within five days of completed registration.
8. Teacher will email preschool office the date the child enrolls.
9. All registration information will be taken to the appropriate school by the end of the first week of August.
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Instructions for Registering Students after the School Year Starts
The Family Service Advocate who is assigned to the classroom will:
*Receive the application folder from the Enrollment Staff and call a parent
….
1) To confirm that the child will be attending.
2) To schedule a first visit/meeting within 5 days.
*Facilitate this first visit/meeting with the parent in order to ….
Collect the following information:
Record and initial the following on the school registration form:
Birth Certificate Number
Social Security Number
Collect the following information:
Physical form
Dental form
(All forms except the Dental form is required by the school system before a child can begin attending preschool.)
Have the family complete the following information:
ASQ/ASQ SE (return to classroom)
Emergency Care Information
School Registration Form
Parent Interest Questionnaire
Transportation Contract and Request
Free or Reduced Lunch form (if applicable)
The release forms from the divisions’ student handbook
Schedule the transition/classroom orientation visit for the family to come to the classroom prior to the child’s first day in attendance.
*Give the forms to the school or program staff that needs them.
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Regular Enrollment/Screening Process
Parent is given an application to complete.
The completed application is sent to
Fishersville’s Central Office.
Applicants accepted per consortium selection criteria.
An acceptance letter packet is sent to the parent. School officials are notified (Teacher, FSA, and Principal) when class lists are verified and completed during the mass enrollment and as children are accepted throughout the school year.
The child does NOT qualify. Parents are notified.
Parent must return all paperwork at the registration meeting conducted by the FSA before the child may start preschool.
The Family Service Advocate oversees the completion of the transportation/pedestrian training, the family partnership assessment/agreement, and insurance information.
Preschool Office notifies school officials that all paperwork is complete. ALL PAPERWORK
MUST BE COMPLETED before starting preschool .
Teacher calls the parent to introduce themselves, set the transition visit and child’s start date. Transportation arrangements and parental supervision requirements is confirmed.
At transition visit, teacher gives parent the ASQ and ASQ-SE to be completed in the home.
Child starts preschool.
Teacher completes a ‘Results of Screening’ letter and makes a copy: 1 for parent and 1 for student folder.
Teacher schedules a conference, 2 weeks after the child starts preschool. ASQs results are shared and a parent signature page is implemented and signed.
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Sensory Screening Process
All children enrolled in the preschool program go through a series of screenings that include the following:
1. ASQ (physical development)
2. ASQ SE (social/emotional development)
3. Vision
4. Hearing
5. Growth assessment (height, weight)
6. Physical (lead, blood pressure, etc.)
7. Dental
8. Nutrition
School health staff and/or the Preschool Program RN will perform height, weight, vision, and hearing screenings where applicable. Family Service Advocates will assist as needed. Results will be recorded on school-based forms where applicable. This information will be kept in the scholastic record folder or cumulative file. This information will also be entered into school wellness databases
(i.e. Welligent) where applicable. School-based forms will be forwarded to the appropriate staff per division who will enter these results into the ChildPlus database. There are some instances in which
Family Service Advocates will enter the information into ChildPlus, but this process is division specific. If results have been entered into school databases, the Program RN can obtain the information from the school database.
If a student has had a physical within 45 days prior to the child’s first day of school, the vision and hearing results performed by the pediatrician can be utilized as the official screening. All children will receive height/weight screenings regardless of whether or not these results are also recorded on the physical. Height/weight screenings are repeated in the spring.
In some instances speech and language pathologists will assist with hearing screenings, but this is division specific.
This same procedure will be followed for all children, regardless of enrollment time during the school year.
Attendance Concerns
The FSA will work with the family to address any attendance concerns. Please e-mail the FSA after the 3 rd consecutive absence so FSAs can initiate the appropriate family support procedures.
When chronic absences are noted, the preschool program will follow the school division’s attendance policies and procedures. Concerns about attendance should be brought by the teacher and FSA to the principal’s attention after discussion with the parent(s).
Decisions regarding student removal from the preschool program for absences will be made jointly by the building principal and the divisions’ supervisor for preschool programs.
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Guidance for Children Coming from the Infant/Toddler Program
Children transitioning out of the Part C program who are found eligible for Part B will receive services in accordance with their IEP.
Children who previously received services under the Part C program and who are not found eligible for Part B services will follow standard enrollment procedures.
For Staunton City Schools, Augusta County Schools, and Waynesboro City Schools Only:
Children who are entering the preschool class that are 3 years old after September 30th are considered 2 year olds for school purposes (because as of September 30, the child was still 2 years old). They should begin attending preschool 1 to 2 half days per week and gradually move up so that by the end of the school year, they are attending full time in preparation for the next school year when they would be coming 5 full days a week.
Children who are 3 by September 30th may start out transitioning into the classroom part-time but a plan should be written to increase their time as quickly as possible. Most 3 year olds come to preschool full time. This decision needs to be based on what is best for the child, not on status related to disability or any other factor.
For Harrisonburg City Schools Only:
Children with identified disabilities who are 3 years old after September 30 are considered 2 years olds for school purposes (because as of September 20, the child is still 2 years old). Children who are 2 years old begin receiving services in their natural setting (which is most often their home or possibly a caregiver’s home/center). They would then transition to school based services, as the IEP team deems appropriate.
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Central Directory: 1 (800 234-1448
TTY/TTD 1(804) 771-5877
Infant & Toddler Connection of Augusta-Highland 6 John Lewis Road
Fishersville, Virginia 22939
(540) 245-5133
Part C Transition Procedures
The Infant & Toddler staff works together with families to plan their transition out of early intervention services as soon as a child’s initial IFSP is written. From that point forward, transition discussions are held regularly so the family is informed of their options when their child will no longer be eligible for Part C services. It is essential that we make transition out of Part C as seamless and efficient for families as possible. Explaining the differences between the Part C and Part B systems is vital for this transition process. Families must understand that not all children with an IFSP will be eligible for an IEP. Having this information will assist them in making the best decisions for their family.
Transition must be discussed during the initial IFSP and at all IFSP meetings thereafter. The Transition page of the IFSP, page 7, must be individualized for each child and must include steps to assist the family in making progress towards the time of transition.
It is important that the service coordinator and family explore a variety of community options as they are planning for the transition process. Some children may not need to transition to another program and if that is the case, this decision should be documented clearly on the IFSP and in contact notes.
All families who will be transitioning out of Part C must have a transition conference no later than 90 days prior to the date the child turns 3 years of age or is eligible for Part B services. The transition conference must include the family, Part C personnel, Part B personnel, and other individuals or resources if necessary (if the family is not interested in Part B referral, but are interested in another community program upon leaving Part C). Service coordinators must obtain written permission for the transition conference in the form of Parental Prior Notice form. This form must be included in the child’s permanent Part C file. All transition options should be discussed at this time, and timelines for both systems should be clearly explained to the family.
If a parent would like to have a referral to the Part B system, the official referral is sent to the home school RTISS/TAT chairperson. The referral paperwork is also kept in the child’s permanent file.
The referral should include copies of all IFSP documents and evaluations. In addition, the Part C therapists involved with the child will be asked to complete a summary update if appropriate, which includes a developmental skills update. The Service Coordinator should include this summary with the referral information to be shared with the school system.
In order to be referred for Part B services, the child must be 2 years of age on or before September 30 th of that school year. Two year olds (with a birthday prior to Sept 30 th
) may be eligible for school services from the LEA. If eligible, the IEP team will determine the appropriate placement. These young children may be served in a community placement, in the preschool classroom, or the parent may bring
the child to school for services without placement in the preschool classroom. Families may always choose to remain in Part C until the child turns 3 years old.
When appropriate, as part of the transition and decision-making process, children who are referred to
Part B may make multiple visits in the preschool classroom with permission from the preschool teacher
(for a maximum of 60 calendar days, and parent must bring a copy of the child’s immunizations). This should be coordinated with all parties (C & B) involved. No transportation, nor IFSP entitled services, will be provided inside the classroom.
If eligible for both Parts C & B, parents must decide whether their child remains in Part C or transitions to Part B. A child may not receive Part C & Part B services concurrently. However, a child can be found eligible for Part B services and have an IEP written with a start date of the 1 st
day of school, and therefore still receive Part C services up to the 1 st
day of school.
For children from Part C who are found eligible for Part B, Service Coordinators should be part of the
IEP team.
Augusta County Part C Staff:
Andrea Riegel, Supervisor
Sara Minigh, System Manager
Alison Blanco, Developmental Service Provider/Service Coordinator
Rachel Grimm, Service Coordinator
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Assessments and
Components
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Table of Contents
Teaching Strategies GOLD Assessment System ................................................... 25
Revised July 2011 16
Overview of Screenings to Ensure Success and Monitor a
Child’s Progress
I.
Parent-teacher conferences are held four times a year. Information concerning the
child’s
Screening Results is shared between the Family Service Advocates and teachers during the
monthly team communication meeting or other agreed upon time.
II.
Ages & Stages Questionnaires and Ages & Stages Questionnaires: Social-Emotional
III.
This literacy assessment developed by the University of Virginia is administered in
English to all preschool children who are 4 years old by September 30.
IV.
Teaching Strategies Gold Assessment System (TSG)
– TSG is an authentic, observational assessment system for children from birth through kindergarten. It is designed to help you get to know children well – what they know and can do, and their strengths, needs, and interests. With this information, you can guide children’s learning by intentionally planning high quality experiences that are responsive to individual and group needs.
English Acquisition Outcomes Reports – These screenings will be administered to children to assess English language proficiency. Refer to your division for which specific screen to use (TSG has 2 objectives for use to assess English language proficiency).
Harrisonburg Only : children who live in homes where English is not the primary language are tested prior to the first day of school to determine their English language level. The tool used is the Pre-IPT.
V. iSTEEP Pre-K Math assessment (Augusta County only) – This assessment is done three times a year (fall, winter, spring). The assessment consists of six different assessments for pre-school students in math. Measures include counting objects, selecting numbers, naming numbers, selecting shapes, counting, and visual discrimination.
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Parent Conferences/Home Visits for Teachers
Through parent conferences and home visits, the Child Progress Report (which is completed using
TSG) will be shared with the family member(s). The bottom section on the report is completed by the teacher and the family member. This is an opportunity for the parents to have input into the curriculum development.
Note: Parent Signature Page is signed at each conference/visit.
If a child has an IEP, it is permissible to conduct the spring conference and cover both the
Child Progress Report and the IEP progress notes, contingent on all pertinent parties being in agreement with this and being able to attend the conference.
Parent Conferences/Home Visit Schedule for Teachers
Initial Parent Conference – The first parent conference is conducted two weeks after the child has started school. The parent completes the ASQ/ASQ: SE questionnaire prior to this conference and the teacher will share the Results at this initial parent conference.
Fall
– The first home visit will be conducted in the fall in conjunction with your school system. At that time, teacher and parent signatures are required on Child Progress Report and a copy is given to the family member.
Winter – The second home visit will be completed in February/March. Again, the Child Progress
Report will be completed by February 1 st and the same procedure is followed for meeting and sharing information with the parent. Formal transition plans will be discussed.
Spring – The second parent conference is conducted in May. The Child Progress Report needs to be completed prior to the conference. Follow the parent conference procedure.
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Regional School-Based Preschool Network
6 John Lewis Road
Fishersville, Virginia 22939
(540) 245-5162
Results of Screenings
Child’s Name: Date of Screening: Click here to enter a date.
School:
Results of Questionnaire: ASQ /ASQ-SE
Date of Letter: Click here to enter a date.
Complete
Communication
Gross Motor
Fine Motor
Problem Solving
Personal Social
ASQ:SE
Action/Recommendation: Click here to add comments.
Continue to Monitor
(Child Plus)
Please contact your child’s teacher if you have any questions or comments about your child’s screening results.
Copy to Parent/Classroom Record
Regional School-Based Preschool Network
Parent Signature Page
Parent Conference (Beginning of School)
ASQ/ASQ-SE results were reviewed. The Results of Screening Letter was received.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Teachers : Three attempts must be made to conduct a home visit. If a home visit did not occur, document the three attempts.
Attempt 1: _________________ Attempt 2: _________________ Attempt 3: _________________
Parent/Guardian did not attend this conference and the above documents were mailed home on ________.
First Home Visit (Fall)
Completed Results of Screening Letter was reviewed with parent/guardian. (Only applicable if not completed at the Beginning of School Parent Conference)
PreK-PALS “Letter to Parent” was received and reviewed.
Math screening was reviewed (if applicable).
Child’s Progress Report was received and reviewed.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Second Home Visit (Winter)
Child’s Progress Report was received and reviewed.
Transition Plan was discussed with parent.
PreK-PALS “Letter to Parent” was received and reviewed.
Math screening was reviewed (if applicable).
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Parent Conference Visit (Spring)
PreK-PALS “Letter to Parent” was received and reviewed.
Child’s Progress Report was received and reviewed.
I have reviewed my child’s educational record for this school year.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Ages & Stages Questionnaire (ASQ) and Ages & Stages Questionnaire (ASQ-SE)
The Ages and Stages was developed to be administered to a child on their birthday, but can also be used as a one-time screening instrument. The ranges for the ASQ and ASQ-SE are printed on the front page of the questionnaire for your reference.
The FSA will use the acceptance date to determine the child’s age and then subsequently which questionnaire to give to parents.
For children accepted during the summer, the FSA will use July 1 to determine the child’s age.
Children whose age falls in the middle of two questionnaires and there is reason for concern, the teacher may need to complete both the lower age questionnaire and the upper range.
Parents receive information on this screening during registration or home visit from the Family
Service Advocate. Family Service Advocates are available to assist parents in completing screenings.
Guidelines
The ASQ and ASQ-SE CDs and manuals are in the classroom.
When copying and completing, we do not use the demographics page (page 2).
Parents are given the ASQs at the time that the child is registered for school by the FSA. As well as a screening instrument, it is an opportunity for parents to give input into how they see their child’s development.
The parent completes the ASQs and returns them to the classroom teacher.
If, for some reason the parent does not return the ASQ and repeated attempts to get this completed form fail, it is the teacher’s responsibility to conduct the ASQ within the first 30 calendar days of the child’s enrollment.
The teacher scores the ASQs and sets up a conference within 2 weeks after receipt of the ASQ to go over the results with the parent(s). o Tools needed for this conference include:
ASQs
ASQ Information Summary Sheets
Results of Screening form
Parent signature page
(Possibly) Intervention activities printed from the ASQ CDs
Any missing paperwork from the parent
Parents who do not come for the conference will have the results of screening explained at the home visit.
Note: When the score sheet says, “If the child’s total score falls within the gray area, talk with a professional,” the classroom teacher IS the professional.
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If the child falls in the gray area and the teacher does not agree with the parent’s scoring, it is a great opportunity to discuss interventions with the parent and say, we will monitor this. Scenarios that may occur are when the teacher observes the child functioning at a higher level than the parent’s score or when the teacher observes the child functioning at a lower level than the parent score. Either way, the teacher should view this as an opportunity to work with the parent.
If the teacher and the parent have the same level of concern, they should discuss this and decide whether or not to go to your school based child study team, but continual monitoring is essential.
It is okay to monitor a child and revisit the concerns at the next conference/home visit to determine if you should go to your school based child study team.
If a preschooler is referred to the Guidance department at your school, please email the Early
Childhood Development Coordinator so that this information can be tracked on the Mental Health tab of ChildPlus. This is process is division specific —please check with your Preschool Supervisor or the Early Childhood Development Coordinator.
After the teacher scores and completes the information summary, the screening results must be recorded on ChildPlus immediately.
When entering scores on ChildPlus, use P for
“pass” and M for “monitor.” Please do not enter numerical scores.
If a child is noted as having an
“M” in regard to Social/Emotional function, the Early Childhood
Development Coordinator will notify each school Guidance Counselor and Family Service
Advocate to insure continued monitoring.
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PALS Pre-K
PALS (Phonological Awareness Literacy Screening) Pre-K is a phonological awareness literacy screening that measures young children’s literacy knowledge. The tasks of the assessment reflect those skills that are predictive of children’s future reading success. This literacy screening tool was researched and developed by the University of Virginia’s Curry School of Education. All preschool classrooms administer this screening in English to all children who are 4 years old by September 30.
There are seven literacy tasks within the assessment:
1. Rhyme
2. Alphabet Knowledge
3. Beginning Sounds
4. Verbal Memory
5. Print Knowledge
6. Concept of Word
7. Name Writing
Procedure for Administering
1. Teacher must be trained: Video and Presentation.
2. Confirm your PALS password, log on name, and practice going online to assure it is working properly. DO THIS EARLY!
3. Obtain state testing number for each child. This can be obtained through the school office.
4. Who do you screen? PALS Pre-K will only be used with children who are four years old or older by
September 30; i.e. they are Kindergarten eligible.
5. Confirm a two-week period for administering this screening. It is given in the fall, winter and spring. (at predetermined 2 week time frames).
6. PALS Pre-K may be given in the classroom during the day. This screening will now be completed online. The Online Wizard is available as an entry option for all divisions but is required for
Augusta County Preschools.
7. All children who enter between August and March will be given the PALS Pre-K. If it is past the
PALS required screening window, the results cannot be entered into the web-based system.
However, this literacy screening will be administered and used as baseline data.
8. Print off year-end summary and place in each student’s scholastic record.
Scoring
1. Follow the scoring procedure outlined in the PALS handbook.
Print off the personalized parent letter to be given to parents at the fall, winter and spring conferences. This must be documented on the Parent Signature Page . Family Service Advocates are available to assist with helping parents understand assessment.
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Accessing Your PALS Account
1. After entering the PALS website, click on the Enter PALS Scores button.
2. At the login box for returning visitors, log in using your first name, last name and password.
3. Your account screen should appear with your name at the top. Select the date you began the assessment and click Submit.
4. To enter fall scores click Add a Student. For each child, enter their personal information ( you must obtain this information from your division’s preschool coordinator and/or the Early Childhood
Development Coordinator in Fishersville ) at the top of the screen and enter the task scores in the boxes at the bottom.
5. Click Send Scores to UVA once the child’s information has been entered.
6. After entering data for the entire class, you may click View Class Summary to view and print a class summary sheet.
7. After clicking the Click When Done Entering Scores button, you may view the report page and print out Student Summary Reports, Parent Letters and a Class Report.
8. Exit your account by choosing Click When Finished Viewing Reports . An outline survey is available for your comments.
9. Teachers may add children. DO NOT delete or transfer any child. This will be done by Central
Office staff. Deletions and transfers will be based on teachers’ submitted withdrawal forms.
Hundreds of Activities!
The PALS site also contains hundreds of activities that directly relate to early literacy fundamentals such as rhyming, beginning sounds, letter recognition, print awareness and writing. Teachers are encouraged to share great literacy ideas by adding their own activities to the site.
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Teaching Strategies GOLD Assessment System (TSG)
Using this assessment tool, staff will document each child’s progress in the 36 objectives (plus 2 additional objectives for English Language Learners) listed in TSG. These are automatically correlated with the Developmental Domains, Domain elements and Indicators listed in the Head Start
Child Outcomes Framework as well as the Virginia Foundation Blocks.
Instructional staff must ensure that every child has been observed/assessed in all 36 objectives during a reporting period (as well as the 2 objectives for English Language Learners if applicable).
This should be accomplished using authentic assessment methods including the collections of work samples, anecdotal records, family input, and counts/tallies.
Using the data collected, teachers will finalize checkpoints for fall, winter, and spring and generate a
Child Progress Report to be shared at scheduled conferences or home visits.
A. Tools for Collecting Observations
1. Each teaching team may use one of the following methods for keeping their daily objective observations of the children in their class:
Clipboard list of all children with observations noted for each child
Notebook with a section or page for observations about each child in each of the developmental areas
Cards or mailing labels with observations of child progress inserted about each child at the end of the day during which that child was observed
All classrooms are expected to put observations into TSG (in Harrisonburg City Schools and Staunton City Schools this is optional)
2. TSG Observation entry
To use the TSG observation entry option, observations will need to be entered frequently. You would do the following:
Log on to TSG
Document and Assess
Observation Notes
Add new by child’s name or group observation
Complete steps 1 – 7 and submit
3. Portfolio
A portfolio is a purposeful collection of a child’s work to document progress over time. Each child will have a portfolio in which work samples, photographs, and anecdotes will be collected. A sample of each will be collected on a monthly basis and will document the child’s progress in each of the TSG domains.
More specific examples can be found in Authentic
Assessment Process.
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B. Analyzing and Evaluating Facts
This stage of the assessment process involves organizing your notes and making a judgment about what the observations and work samples tell you about a child’s progress toward each of the 36 continuum objectives (38 as applicable for English Language Learners).
Analyze facts by:
Looking at work samples and observations and match them to the continuum
Determine exactly where the child is developmentally
It is best practice to have 5 to 7 observations to support mastery of any level of the objective
Enter the preliminary data on TSG.
Teachers may meet with Family Service Advocates to arrange for parents to access the family support informational section on the TSG.
Authentic Assessment Process
The information collected through the authentic assessment process will be used in individualized instruction for children and to complete documentation in TSG.
Three ways to purposefully collect work samples and document observations:
1. Through spontaneous experience throughout the day that occur during regular routines.
To assure that each child receives an intentional focus, select 4
– 5 children weekly to “target” for observation. The observations should be varied and recorded with enough detail to yield data for multiple curriculum objectives. Each child should be a focus for one week each month using this plan. A pattern should emerge when reviewing portfolios. Teachers can self-assess by examining their variety and the amount they obtain using this method and pace themselves accordingly.
Example: If they are not getting enough information to accurately rate the children they should also target areas to observe and try to get a certain amount each day.
2. Part of Portfolio: Portfolio entries
– At a minimum, Observations, Data Collections, and Work
Samples should be collected monthly. Examples of work samples are:
Drawings
Paintings
Writing
Dictated stories
Books made by the child
Photographs/pictures
Graphs or drawings from a science experience
Completed Blueprint Theme Portfolio Sheets that follow each theme .
This information should be use to individualize instruction.
Revised July 2011 26
Teachers will collect work samples and observations monthly to clearly track each child’s development in the following areas:
Fine Motor – scissor cutting (at various levels), writing and drawing attempts, and using manipulatives.
A Portfolio Writing Sample will be completed with each theme. See explanation and guide to
assess.
Check with revised BluePrint.
Caution: These observations and work samples must be collected through authentic observation. Teachers should avoid setting up testing situations.
3. Through daily recall time of approximately 10 minutes. The teachers will devote a ten-minute period each day after the children leave to “reflect” on the events of the day and write down any significant recall observations.
Assessment-Driven Instruction
When developing lesson plans it is the expectation that objectives will be written for the following activities during the following parts of the day. Small Groups, Read- A -Loud, Teacher Directed
Activities and/or Extensions, Theme activities in Centers and one Gross Motor time. (These activities are driven by a variety of things, including Creative Curriculum, Blueprint, I AM Moving, I AM
Learning, and CSEFEL). These objectives will be based in the TSG.
During the children’s participation in these activities observations and data will be collected as well as work samples.
The teacher will review the collected information and determine if the child has mastered the objective or if the child needs more group or individual instruction and again after instruction document the results.
Individual or small group instruction and practice can take place at many different times throughout the day.
This allows for instruction that is based on on-going authentic assessment.
Example Objectives:
The child will – TCW, (then the verb) – cut 4 circles to make a caterpillar.
TCW count 10 bears with one to one correspondence.
TCW name 4 kinds of farm animals
– cow, pig, sheep, and horse.
It is recommended that the objective number from TSG be recorded with the objective. This will make it much easier to organize and review observations.
Revised July 2011 27
Directions for Using TSG
1. Obtain your login name and password from the Early Childhood Development Coordinator (if you don’t have one).
2. Enter each child’s name by going to Set up and Maintain Your Classes and Children. Click on children and then Add a New Child. The ethnicity and funding source must match the child plus data sheet. To confirm accuracy, ask your FSA (Family Service Advocate). After entry completion, click Submit.
3. After you have added your students, then you are ready to enter observation notes, portfolio work samples, and/or preliminary data.
How to Enter Observation Notes
If you are using the TGS observation entry option, there is no need to save the hard copies. You would do the following:
1. Log on to teachingstrategies.com
2. Document and Assess
3. Observation Notes
4. Add new by child’s name
5. This may be completed by the teacher and teacher assistant
How to Enter Portfolio Work Samples
1. Insert your pictures disk / save pictures to a folder on the computer.
2. Log on to teachingstrategies.com.
3. Document and Assess
4. Portfolios
5.
Child’s Name
6. Add new file
7. Browse and find the picture you want to add. Watch the size of the picture or scan as they are sometimes too large. It will let you know. After you select the picture you want, go to #2 and give it a name. If a file is too big, sometimes you can resave it in a smaller size.
8. Then submit
9. If you want to view the picture, click on the picture’s name.
10. This may be completed by the teacher and teacher assistant
How to Enter Progress Checkpoints (Preliminary Data)
1. Log on to teachingstrategies.com.
2. Document and Assess
3. Progress checkpoints
4. Choose a child and one of the developmental areas
5. Enter preliminary data based on your observations and work samples. If you have entered your observations on teachingstrategies.com, to the right of the objective you will see the word “observations”. Click on “observations” and all the entered observations matching that objective will appear for that child.
Revised July 2011 28
6. Click submit but DO NOT check the finalize box.
7. Only completed by the teacher.
How to Complete the Child Progress Report
1. Log on to teachingstrategies.com
2. Click
“Document and Assess”
3. Click “Progress Checkpoints”
4. Proofread and finalize your preliminary assessments
5. Type the comments you want to have available in the Child Progress Report
6. When complete, check the finalize box and submit
7. Then go to Family Communications
Child Progress Report
Select a Child
Edit
8. Select the objective steps you wish to include on the Progress Report
9. Click Submit
Print 2 hard copies , one for your files and one for the parent to keep. During the home visit or conference, the bottom two sections on the report are completed by the teacher and the family member . This is an opportunity for the parents to have input into the curriculum development. BOTH signatures are required on both copies and one copy is given to the family member and the other is filed in the student’s record file.
End of the Year
1. All work samples will be given to the parent
2. Complete the Child Progress Report and present at the parent conference
3. Print the individual child profile. One copy is needed for the cumulative record. Steps for printing the individual child profile:
Go to Planning Tools
Click on Individual Child Profile
Select a child
Select the
‘printer friendly’ icon
Review this at the May conference but keep the copy and file in the student’s cumulative record.
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Portfolio Writing Sample
The Portfolio Writing Sample is to be completed with each classroom theme. Teachers will use the
Emergent/Early Writing Checklist (below) as a guide for supporting the child’s writing. It is also important to include information such as which hand a child writes with and pencil grip.
Emergent/Early Writing Checklist
Uses a picture to write
Uses scribbles or symbols
Random use of letters, symbols
L to R directional movement
Understands that writing symbolizes talk written down
Enjoys free writing in the writer’s corner
Enjoys writing in personal journal
Writes words and friends names from around the room
Writes in response to literature
Willing to “read” personal story
Willing to dictate story to adult
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Portfolio Writing Sample
To be completed with each theme
See Blueprint Manual for monthly theme sheet
Name: ______________________________ Date: ____________
Classroom: ______________________________
Theme: ______________________________
Portfolio Prompt: Draw a picture of ________________________on the back of this paper. Write your name. Write about your picture.
Teacher Comments:
Using Assessment
Outcomes (Data)
Augusta County teachers see supplemental for RTI information.
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Table of Contents
Revised July 2011 33
Individualization/Differentiation
It is best practice that the teacher will get to know each child through these assessment and monitoring techniques and will individualize using an interdisciplinary approach throughout the day.
Individualization is ongoing for every child, every day.
One child, One need.
Baseline
Time Frame – First four weeks the child attends.
Based on the following information
– Parent Conferences, Screening, Portfolio
(Observations and Student Work Samples)
Add information to teachingstrategies.com
under preliminary . You may not have information for every objective but this will give you a path to go on.
Week One
Beginning of school, begin building student portfolio by observing and collecting work samples on
Day one.
Week Two through Four
Set Individual Objectives such as:
Social Emotional Skills,
Followed Routines / Rules, and
Independence.
Divide children in classroom by five. Assign each group of five a day for individualization observations.
You may want to divide alphabetically.
Process
– Individualization Observation
1. Review observations from week one.
2. Set objectives for each child based on observations.
3. In lesson plan, assure that there are opportunities to practice objectives that have been identified.
4. Record observations of that objective on the teachingstrategies.com
.
Teacher or TA assigned will determine who will observe.
5. Continue through week four.
Week Five through Seven
– add PALS Pre-K to Portfolio
Generate Developmental Area and Class Profile reports from cc.net for each child for each developmental area. (4 reports)
Identify an objective from Developmental Area report
“next steps” that needs individual support. For example:
Children who need additional instruction to grasp a concept or skill.
Children who are way ahead of expected skill levels and need additional facilitated experiences.
On the Developmental Area report, identify and date an Individual Objective in comments section of
Dev. Area Report per child. (bottom of page). The child’s initials and the objective number must be written on the lesson plan.
Revised July 2011 34
Based on developmental level, some children may have 1 objective identified while other children may have multiple objectives.
Continue to the end of the reporting period.
At the end of the first reporting period
Generate Class Summary from teachingstrategies.com
Go to home page on teachingstrategies.com
Click on Group Reports
Click on Class Summary Worksheet
Click on Academic Year
Turn on Expanded Forerunner
Click Submit (It may take up to 2 minutes to submit)
Click on View Class Summary
At this point all 50 objectives need to be documented in the child’s portfolio with observations and student data.
In order to assess a child’s level research supports that you have to observe a child doing a skill 5 -7 times.
For each child
Complete Individual Child Profile and teacher section of Child Progress and Planning.
Review Class summary from teachingstrategies.com to look for:
Children who are way behind or way ahead overall or in one area
Whole classroom patterns identify specific areas where groups of children are way behind or ahead
Developmental areas where no growth is documented. (Move to Jan.)
Check for consistency with info from other sources about the child.
Use this information to set individual objective and activities for the child.
Start again (Week 5)
2 nd Reporting
Repeat Class Summary Report
Patterns of growth in individual children (Move to Jan.)
Children who are way behind or way ahead overall or in one area
Whole classroom patterns identify specific areas where groups of children are way behind or ahead
Developmental areas where no growth is documented. (Move to Jan.)
Check for consistency with info from other sources about the child.
Start again
Definitions
Observations – basis of all good teaching and foundation of assessment system. Involves looking objectively at what a child does and says to learn about the child. A series of objective and factual observations will lead you to useful conclusions.
Revised July 2011 35
Individualization Objectives – provides an intentional learning need for each child. The objective is based on prior observations and is linked to the lesson plan. Outcomes of objectives are documented and used for further planning.
On-going Assessment – starts with screening. It is a system in which the teacher observes, documents, and organizes information to plan for the development of the whole child.
Portfolio – a system for organizing samples of a child’s work to document progress over time.
Intentionally placed items should measure same skills even though activities may be different. This concrete example of a child’s efforts, achievements, and approaches to learning must be dated and have written observations of a child’s performance. The portfolio contains… o Work Samples
Individualization – planning for and teaching each child at their developmental level so they will progress to the next developmental level. This involves determining the present level of performance, creating opportunities to facilitate learning for all children, and creating intentional opportunities for next steps. Consider: strengths, weaknesses, parent input, learning style.
TSG – Teaching Strategies Gold. This is our online assessment for evaluation a child’s development.
Individualization Worksheet A
Individualization Worksheet B
Revised July 2011 36
Date: ___________________
Individualization Worksheet – A
Day Objective Targeted Children Center T/TA/P
M
M
W
W
TH
TH
F
T
T
F
Materials
Activity
Focus Children
Individualization Worksheet – B
Ideas for Meeting the Needs of Each Child
Child’s Name Individual Needs Classroom Area Comment/Obs
Child Study/Student Support Teams
Called different names in different localities, student support teams are school-based teams. Their purpose is to determine what steps need to take place to meet the needs of a child.. This team helps the classroom staff develop strategies and techniques to meet the child’s needs. When the child is of school age (2 by Sept. 30), teacher’s plans and individualized objectives are developed and implemented in the classroom before a child goes to child study/student support team meeting.
These strategies are a part of your documentation that you take to the child study meeting.
Best practices dictate that strategies and interventions should be implemented as soon as a child demonstrates difficulties in any area.
Reminder: Strategies and interventions for each child need to be entered into ChildPlus under the
“education” tab.
Process and definition of teams is division specific.
In Augusta County Preschools, Response to Intervention is used.
Revised July 2011 39
ChildPlus IEP
Information
Revised July 2011 40
Table of Contents
Revised July 2011 41
ChildPlus IEP Information
All children that have an IEP need to have it documented in ChildPlus.
In the Disability window, click on Add IEP/IFSP . The screen will look like the example above.
Under IEP/IFSP Name in the center of the screen, for the Initial IEP, enter Initial IEP… for Annual
Review IEP’s enter Annual Review IEP. You will enter in the Date field, the date of the IEP meeting and the Valid Until field, the last day of the IEP. If the student has a history of IEP’s each can be entered as explained above.
See the example below for a student who has more than one IEP in his Special Education History.
Revised July 2011 42
In the example above, in the middle of the screen click on the “Include Diagnosis” button. It will provide a pop-up window with the student’s disability. Select the disability and it will add that information to the screen.
See the examples that follow.
Revised July 2011 43
Revised July 2011 44
You may also add any notes relating to the IEP meeting in the box in the example below.
Members attending the IEP meeting can be listed as well.
Revised July 2011 45
Click on the Disability tab.
Add Diagnosis:
The diagnosis is the result of the eligibility meeting (eligibility category).
Add date: The date is the date of the eligibility meeting with qualified the student for special education services.
Check the box for Primary for the primary disability only. If the student has been found eligible under more than one category or has related services, you will need to add a diagnosis for each category. Do not mark the secondary disability or the related services as primary.
In diagnosis notes:
1. Click the clock icon. Date and name will appear in notes box.
2. Type a statement reflecting the decision of the eligibility team; noting all related services that are recommended. Please make sure the date is included. End the statement with your name and the date that you entered the information. The statement might look like this:
“John was found eligible for special education services on 1/22/10 under the category of
Speech Language Impairment for sound errors. Tammy Sours 3/10/10 .”
Revised July 2011 46
Disabilities Data Entry “Cheat Sheet” for ChildPlus
Under the
“Disabilities” tab under “Services”:
“Diagnosis” Tab:
Diagnosis
Diagnosis Date
This is the primary diagnosis for this individual (this is a checkbox
—make sure to check if it applies)
“IEP/IFSP” Tab:
IEP/IFSP Name
IEP/IFSP Date
Valid Until: Date
IEP/IFSP Eligibility Determined and/or Signed by LEA or Part C Agency (checkbox
—make sure to check it if it applies)
“Additional Info” Tab:
Amount of Special Education or Related Services Received, or Part C Services Received
(Choices are Constant, Fair, Little, or No Special Service Required/Accepted)
The best rule of thumb for this would be: o Constant=50%+ (of course a full IEP would be 100%, which is constant) o Fair=30% to 50% o Little=less than 30% o None would typically mean parent refusal or no services needed.
There is a Concerns tab also in ChildPlus, but this is not a PIR requirement (albeit helpful). It is up to you whether or not to put information on the concerns tab. Please make sure all information entered in the tabs is done so accurately and as soon as possible after the IEP or eligibility meeting.
Revised July 2011 47
Augusta County Only Disabilities Data Entry “Cheat Sheet” for ChildPlus
Under the
“Disabilities” tab under “Services”:
Ignore “Concerns” Tab
“Diagnosis” Tab:
Diagnosis
Diagnosis Date-(eligibility date)
This is the primary diagnosis for this individual-check the box
This is all you have to do for this tab.
“IEP/IFSP” Tab:
IEP/IFSP Name-Indentify either: IEP or IFSP
IEP/IFSP Date-date of IEP meeting
Valid Until: Date
IEP/IFSP Eligibility Determined and/or Signed by LEA or Part C Agency (checkbox
—make sure to check this box)
This is all you have to do for this tab.
“Additional Info” Tab:
Amount of Special Education or Related Services Received, or Part C Services Received
(Choices are Constant, Fair, Little, or No Special Service Required/Accepted)
From the service Tab in IEP online the service is calculated based on the services you enter in the IEP. Use that percentage to determine one of the below. o Constant=51% o Fair=30% to 50% o Little=less than 30% o None = typically means parent refusal
Revised July 2011 48
OSEP-TSG
This section is for Augusta County only.
OSEP exist must happen with May finalization.
Revised July 2011 49
Orientation and
Records
Revised July 2011 50
Table of Contents
Cumulative Record/Scholastic Record Contents ................................................... 62
Revised July 2011 51
**SAMPLE**
Welcome to Preschool Orientation at School Name
Teacher:
Teaching Assistant:
Family Service Advocate:
Date:
Phone:
Phone:
Principal:
Agenda
Registration and review of missing documents-Individual
Collection of ASQ and ASQ-SE questionnaires-Individual
Welcome and Introductions
Teacher
School Hours, Pick-up/ Drop-off Procedures
Transportation Information and Bus Stickers
Children’s Daily Schedules
*Calendar and Fridays Closed Reminder
ASQ and ASQ-SE Screenings and Results
Conferences and Teacher Home Visits
The Creative Curriculum
Blueprint for Early Literacy
*Family Style Dining Explanation
On-going assessment/Child Progress Reports/Data
Backpack and Weekly Folder Procedures Check them regularly!
School
Visitors’ Procedure and Volunteering in the Classroom
Field Trip Guidelines
Attendance/Tardy Expectations and Illness Policy
*School/Student Handbooks
—signature pages in the back
School Supplies
Appropriate Clothing and a Change of Clothes
Break for Teachers and Children to go to the Classrooms
Family Service Advocate
Family Fun Events and Center Meetings
Parent Bulletin Board
Emergency Boards and Postings
*School Lunch Forms
*Health Requirements for Preschool —
Complete Immunizations and Physicals are
Emergency Care Information-how to update
Helping Hands: Forming Family Partnerships in Preschool Education
*Involving Parents in Planning and Policy —Governance Explanation
Election of Officers for Policy Planning —
District Planning Meets Every Other Month
Policy Council — Meets Every Month
Assistance with form completion
Break for Parents to go to the Classrooms
* A form or additional information is included in the folder.
Revised July 2011 52
**SAMPLE**
Welcome to Preschool Orientation at School Name
Date —This is the Harrisonburg Version/English
Teacher: Phone:
Family Service Advocate: Phone:
Principals:
Agenda
Registration and review of missing documents
Collection of ASQ and ASQ-SE questionnaires
Welcome and Introductions
Take note:
*School Handbook —signature page in the back
*Calendar and Fridays Closed Reminder
*Transportation/Pedestrian Training
*Change of Information Form
Attendance Expectations and Illness Policy
School Hours and Pick-up/Drop-off procedures
School Supplies
Backpack and Weekly Folder Procedures Check them regularly!
Appropriate Clothing and a Change of Clothes
School Visitors and Volunteering Procedure
Conferences
ASQ and ASQ-SE screenings
Assistance with form completion
Results will be discussed at the first conference.
Special meeting for parents in the Head Start program
* A form or additional information is included in the folder.
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**SAMPLE**
Bienvenidos a la Orientación Prekinder de la
Escuela Primaria
Fecha
— This is the Harrisonburg Version/Spanish
Maestra:
Trabajadora de servicios a la familia:
Teléfono:
Teléfono:
Directores:
Agenda
Inscripción y repaso del archive para documentos que se le faltan
Colección de los cuestionarios ASQ y ASQ-SE
Bienvenida
Recuerdos:
*Manual de reglas escolares —hoja para firmar
*Calendario escolar y nota sobre el segundo viernes del mes
*Entrenamiento sobre el bus
*Formulario para cambios de información
Expectativas para la asistencia y política sobre enfermedades
Horario escolar; instrucciones para transporte en carro de estudiantes
Utiles escolares
Rutina para la mochila y la carpeta semanal
Sugerencias para ropa y la muda extra de ropa
¡Revíselas regularmente!
Reglas para visitas a la escuela
Conferencias entre padres y maestros
Cuestionarios ASQ y ASQ-SE Hablarán de los resultado en la primera cita.
Ayuda para completar formularios, si es necesario
Habrá una reunión especial para los participantes del programa Head Start.
* Un formulario o información adicional esta incluido en el paquete.
Revised July 2011 54
Supply List
Preschool Classroom
Optional items for individual children:
Backpack
Change of clothes (in case of accidents/spills)
Small blanket or towel for rest time
Optional items to be donated for whole class use:
Glue sticks
White school glue
Fat crayons
Fat pencils
Washable markers
Facial tissues
Baby wipes
Zip storage bags (gallon or sandwich size)
Non-Discrimination Notice
The Augusta County School Board does not discriminate on the basis of race, color, national origin, religion, age, disability, or gender in its programs and activities. The following persons have been designated to handle inquiries regarding non-discrimination policies:
Title IX Coordinator Section 504 Coordinator
Dr. Eric Bond Mr. George R. Earhart
Assistant Superintendent for Operations Assistant Superintendent for Administration
6 John Lewis Rd. 6 John Lewis Rd.
Fishersville, VA 22939 Fishersville, VA 22939
(540) 245-5100 (540) 245-5100
Revised: 8-5-11
Revised July 2011 55
Lista de Útiles
Para los del Pre-Escolar
Artículos opcionales para los niños individuales:
Mochila
Cambio de ropa (en caso de accidentes o si se ensucia)
Cobija o toalla pequeña para la hora de dormir
Cosas opcionales para el uso de la clase entera:
Palos de pegamento/resistol
Pegamento blanco de la escuela
Creyones gordos
Lápices gordos
Marcadores lavables
Papel de nariz
Toallitas húmedas (que se usa para bebé)
Bolsas de plástico: tamaño de galón o sándwich
Non-Discrimination Notice
La Tabla de la Escuela del Condado de Augusta no discrimina por carrera, por el color, por origen nacional, por la religión, por la edad, por la incapacidad, ni por el género en sus programas y actividades. Las personas siguientes han sido designadas a manejar indagaciones con respecto a políticas de no discriminación:
Title IX Coordinator Section 504 Coordinator
Dr. Eric Bond Mr. George R. Earhart
Assistant Superintendent for Operations Assistant Superintendent for Administration
6 John Lewis Rd. 6 John Lewis Rd.
Fishersville, VA 22939 Fishersville, VA 22939
540-245-5100 540-245-5100
Revised 8-5-11
Revised July 2011 56
Classroom Spending
All monies for classroom spending will be accessed through the school’s office/bookkeeper. Each classroom will receive a designated amount of money two times per year (August & January).
Teachers are expected to complete the Classroom Spending Sheet and send in with your December
monthly reports and May monthly reports. All money should be spent. You may not stockpile funds.
Spending should follow specific school division procedures.
Art orders may be submitted to your school principal.
Money is to be used to cover health supplies (bleach, etc.), classroom supplies, field trips, cooking, etc.
Revised July 2011 57
December Classroom Spending
Site: School Name
Please check the spending category that applies .
Date Spending Category
Beginning Amount
Amount
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
This needs to be copied and returned to Central Office with your December monthly reports.
May Classroom Spending
Site: School Name
Please check the spending category that applies .
Date Spending Category
Beginning Amount
Amount
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
This needs to be copied and returned to Central Office with your May monthly reports.
Keeping Children Safe
Please post in classroom
1. Transitions
– Nobody passes the teacher – Adult in front and back walking in line.
Count children at all times/Keep awareness of all children at all times.
Playground
Leaving Room
Loading Buses
Cafeteria
Bathroom
End of Day
2. Ratio
– Maintained at all times 1 school division personnel – 9 children
*
3. Volunteers (Non-school division personnel) must be supervised by school division personnel.
4. Playground Supervision
3 Ws: Watching, Walking, Warning
5. Food – Store bought, pre-packaged
Food not prepared by the cafeteria needs to be store bought and pre-packaged.
6. Morning and afternoon survey room with quick sweep:
Plugs in outlets
Toys away
Cots Up - sheets
Cleaning products in locked cabinet at all times.
Daily clutter straightened.
Heaters clear of all materials
Any product that says “Keep Out of the Reach of Children” needs to be kept in a locked cabinet.
7. Inform principal of broken items. Room, modular, furniture, etc.
*Head Start Classrooms Only: 1 school division personnel – 10 children
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Classroom Record Contents (Division Specific)
To be stored in a locked filed cabinet in the classroom:
ASQ
ASQ-SE
ASQ- ASQ-SE Summary Sheets
PALS Pre-K summaries
Math Assessment Summary; minimum requirement
—see division for specifics
TSG Progress Reports for Fall, Winter and Spring*
Change of Information and Transportation *
Notes from Parents **
Volunteer Standards and Confidentiality Forms *
Fall, winter, and spring portfolio samples when record is being transferred.
If applicable:
IEP (copy) **
*
*These documents are to be shredded at the end of the school year.
**These documents DO NOT transfer with the child.
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Cumulative Record/Scholastic Record Contents
The following information should be given to school staff for placement in each child’s scholastic record:
Physical
Immunizations
Dental Information
Parent Handbook Signature Page(s)
Sensory Screening Form (school nurse/clinic aide or Program RN completes)
If applicable:
Custody/Court Orders
Health Care Plan Forms
Child Study Team Minutes
IEP (original)
IEP Progress Notes
For Augusta County Only
Student Assessment Folder created at the end of school year to give to the kindergarten teacher:
Year end Pre-K Pals
Year end Pre-K Numeracy
Year end TSG
Check with your division for additional information that may be required for cumulative records and transfer of other information.
The following records are kept in School Health Clinic, if applicable:
Medication Logs
Parent Permission for Giving Medication
Accident Reports (Reminder: send copy of accident reports to Fishersville office)
Health Care Plans (to include Asthma plans, etc.)
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A Positive Social
Emotional Environment
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Table of Contents
Differences between a Quiet/Cozy Spot and Time Out ............................................. 70
Revised July 2011 64
Social/Emotional Development
As teachers and teaching assistants, we want the preschool children in our classrooms to reach the following goals as they exit the program to enter kindergarten. These goals were developed by preschool staff.
Independent
Lifetime learners
Positive outlook on life
Believe they can do it
Self Confidence
Contribute to community
Respectful
Problem solving
Responsible
Be their best
Be risk takers
Express themselves comfortably
Self control
Feel safe and loved
The development of the skills needed to reach these goals is supported by a positive social and emotional environment as described in the Virginia Foundation Blocks, the Creative Curriculum
Continuum, and CSEFEL as aligned with the Head Start Child Development and Early Learning
Framework. Our program has agreed to adopt the Pyramid Model for Promoting the Social and
Emotional Development of Infants and Young Children. Guidance for environments, teacher/student interaction, and behaviors are found on the CSEFEL website, www.vanderbilt.edu/csefel and below.
Revised July 2011 65
Pyramid Model
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What is a Quiet/Cozy Spot?
A Quiet/Cozy Spot is a small learning center designed for one child to use at a time to help that child recognize and label his/her emotions, discuss his/her emotions, and/or learn ways to appropriately respond to his/her emotions.
How is a quiet/cozy spot set up?
Create a Learning Center for one at a time.
Make a Quiet Spot a learning center. Treat this like other centers (e.g., make this a place a child may choose to go to when choosing centers, etc.)
Locate the Quiet/Cozy Spot in a quiet area of the class.
Consider putting the Quiet/Cozy Spot between other quiet areas such as the book area and table toys.
Enclose the space.
Create a small, cozy space that is enclosed on three sides. Make it within view of wherever large group activities take place as this is an activity that children may choose to opt out of.
Make it sturdy.
Consider locating a Quiet/Cozy Spot in a corner and use a heavy bookshelf or file cabinet to create a third side.
Provide soft elements.
A Quiet/Cozy Spot should offer only a large pillow and/or a sturdy rocking chair and/or a large stuffed animal. Consider having children name the stuffed animal, choose what kind of chair or pillow to put in, etc.
Label the area (e.g., “QUIET/COZY SPOT”) and add a picture to the label.
Provide picture/written expectations.
Guide children to agree on the rules for its use. Help children identify expectations such as: One child at a time and toys stay outside. Have the children help make these rules in picture and written form and post them at the Quiet/Cozy Spot.
Use the Turtle Technique from CSEFEL as a guide.
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How Is A Quiet/Cozy Spot Used?
Introduce the Quiet/Cozy Spot
Explain the Quiet/Cozy Spot is an area for one child to go to for some alone time. Explain that everyone needs alone time for different reasons. Give examples and ask children to give examples of times when people want time to themselves.
Model How to Use a Quiet/Cozy Spot
Demonstrate how to use a Quiet/Cozy Spot by appearing frustrated, angry, sad, or in need of time alone. Explain you want to go to the Quiet/Cozy Spot. For example, during a particularly loud circle, try saying, “Wow, I need some quiet time. Things are too busy in here.” Then go to the Quiet/Cozy Spot, sit down, and take a few deep breaths. Explain you feel like being with the group again and return.
Teach Children How to Use a Quiet/Cozy Spot
1. Calmly label the child’s feelings (e.g., “You seem angry.”)
2. Offer, in a supportive & caring manner, a way for the child to maintain or regain self-control
(e.g., “Let’s go to the Quiet Spot until you are calm.”)
3. Go with the child to the Quiet/Cozy Spot until the child is able to go alone.
4. Stay with the child and encourage him/her to respond with words in the future. Or, if the child prefers to be alone or was seeking attention through misbehavior, invite the child to rejoin the class when ready (e.g., “When you’re calm we want you to come back.”) and quickly leave.
5. Let the child decide when to return to the group. (Note: If a child does not want to return, consider having a different adult invite the child back to the group or set up a novel activity and invite the child back to the group.)
6. Welcome the child back to the group.
How to Tell if the Quiet/Cozy Spot is Working:
Children will:
choose to go there
enjoy their time there
stay there until they feel better
leave there and resume play
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Ways Children May React To a Quiet/Cozy Spot and Potential Solutions
When a Child Refuses to go to the Quiet/Cozy Spot
Ask yourself : Does the child think
I’m punishing him/her? Are my facial expressions or body language revealing my frustration? If so, change your behavior.
Consider giving the child two choices of ways to go to the quiet spot (e.g., “Walk by yourself or hold my hand?”). If no response, then repeat the choices one time. If no response, then explain to the child that because he/she is having trouble making a choice you will make a choice for the child and physically assist the child to the Quiet/Cozy Spot. Make sure to repeat one of the previously given choices (e.g.,
“Let’s hold hands on the way to the Quiet/Cozy
Spot.”) NOTE: By only repeating the choices two times and then making a choice for the child, the goal is for the child to realize that he/she can make his/her own choice if he/she does it before the teacher does.
When a Child Refuses to Stay in the Quiet/Cozy Spot
Consider stating your expectation:
“Remember, calm means you walk out quietly with your hands down.” Younger children may run out while still angry. If so, assist the child back to the quiet spot and say, “When you’re calm you may come back. Calm means you walk out with your mouth closed and your hands down.” NOTE: A child should only sit in the quiet spot as long as is needed to calm him/herself down. Avoid asking the child to stay there to show you that he/she is “really” calm as this can easily turn into another struggle.
When a Child Refuses to Leave the Quiet/Cozy Spot
If a child refuses to leave the Quiet/Cozy Spot, wait and see if it lasts. If so, set a time limit and redirect the child to a preferred activity.
Explain to children that the Quiet/Cozy Spot may no longer be needed by the end of the school year. Make the expectation be that self-selected group removal is a short-term solution; the goal is for each child to learn to use words and choose appropriate outlets to express his/her emotions.
When a Child Needs Support to Calm Down
1. Prevent yourself from engaging in battle of wills.
2. Stay calm: By staying calm you are demonstrating how to stay calm. Being calm provides others a safe shelter.
3. If the child is escalating and has not hit crisis mode, assist in problem solving or redirection.
4. Use reflection: what triggered the behavior escalate. Be sure you are not the stimulus. If you believe you are, have a code for the other staff member to switch places.
5. If child escalates to crisis mode, ensure safety to himself/herself and others. Do not engage in conversation or maintain eye contact.
6. Once a child starts to deescalate plan ahead. Move slowly and smoothly.
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7. Be nonjudgmental. This is not the time to express displeasure or disappointment.
Support the child back into the environment by offering choices of activities or quiet time.
Reference: Mandt, David & Hines, Randall & Bowmen, Bob. Building Healthy Relationships
Differences between a Quiet/Cozy Spot and Time Out
Quiet/Cozy Spot Time Out
A learning center designed to help children recognize and label their emotions, discuss their emotions, and learn ways to
A time away from stimulation appropriately respond to their emotions
The child stays a child-determined time The child stays a teacher-determined time
The teacher may stay and talk with the child
The child stays alone
Teacher interactions may be warm, supportive, and nurturing or neutral depending on the underlying function of the child’s behavior.
While in the quiet spot or after leaving the quiet spot, the teacher and child may brainstorm other ways the child could handle the situation next time
Teacher interactions are neutral
After time out, there is no discussion about the inappropriate behavior or what to do instead next time
Viewed by the child as a learning center
Used before or after a child uses inappropriate behavior
Typically viewed by the child as punishment
Used after a child uses inappropriate behavior
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Use of Consistent Praise: Try it… you’ll like it!
1. Specify what skill was observed.
2. Provide Praise statements 5 to 15 times for every negative statement made to a class or individual.
3. Use words that highlight the child’s accomplishment versus your pleasure with the behavior
(e.g., you remembered to put your tissue in the trash can versus I like the way you threw the tissue away).
4. Use words that specify the particulars of the behavior (e.g., you remembered to walk with your buddy in the hall).
5. Show spontaneity, variety, and other signs of credibility (e.g., high five for remembering, pat yourself on the back, take a deep sigh of relief, feel proud of what you did, you feel better when you’re prepared).
6. Make the student aware of the thinking, problem-solving and emotional control he/she used
(e.g., you figured it out, you thought it through, you solved your own problem, you stuck to it until you figured it out).
7. Use the student’s prior accomplishments as the context for describing present accomplishments (e.g., because you remembered the class rules, you remembered to use your words).
8. Verbally reward effort (you’re standing in line patiently, this is very hard and you’re keeping at it, you took a break and then came back to solve this problem, you waited until it was your turn).
9. Orient the student to his/her feeling while accomplishing the task (e.g., you’re working hard because you enjoy the challenge, you’re sticking to it because you want to learn how to tie your shoes).
10. When the task or event is over, remind the student about the external rewards he/she experienced while exhibiting the expectation.
11. Make sure much of your individual praise is done in private versus in front of the large group.
Adapted from Marzano, R.J., Pickering, D.J., & Pollock, J.E. (2001). Reinforcing effort and providing recognition. In R.J. Marzano, D.J. Pickering and J.E. Pollock (Eds.), Classroom instruction that works: Research-based strategies for increasing student achievement (pp. 49-
59). Alexandria, VA: Association for Supervision and Curriculum Development and Brophy, J.
(1981). Teacher praise: A functional analysis. Review of Educational Research, 51, 5-32.
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Instructional Guidance
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Table of Contents
Recommendations for Making and Schedule/Writing Lesson Plans .................... 86
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Introducing the Learning Centers and Using Them to Teach
At the beginning of every school year we all have a strong temptation to dazzle the children and their families with our wonderful materials and learning opportunities. To achieve this, we often lean towards putting toys and materials on every shelf, in every center. It is very difficult to look around your classroom at empty shelves and feel confident that the children will be engaged in intentional learning.
Although it seems counter-intuitive, the best way to create an environment of children engaged in learning and growth is to go slow and show ! Taking the time to think about what your professional expectations are for each learning center and then carefully thinking through how to reach those expectations, is an invaluable process to starting the school year. Children need to be taught how to use the centers and the materials, how to engage with them appropriately, and how to respect and care for them.
Below are some guidelines for opening and teaching each learning center. It is important to remember that materials should be added gradually , both to make sure that the existing materials have been taught and to maintain children’s interest in the centers. Some sample materials have been listed, which have been specified by The Creative Curriculum as items typically found in each learning center. Each classroom has some variation in the materials they have for any one center, so the suggestions are meant as guidelines. Keep in mind, as you add materials or change out materials throughout the year you will need to provide instruction on how to use the new materials as well.
Remember…it is well worth taking the time during these first few weeks to create a strong foundation in the Preschool Program Framework!
Learning Centers
Note: not ALL centers will be introduced in the first week!
SCIENCE
– introduce basic tools (magnets, etc.) and demonstrate how to use. During clean-up teach children how to return materials to designated and labeled areas. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials include, but are not limited to magnifying lenses and a balance/scale. Additional, theme related materials should then be added to core materials with each theme.
Don’t forget your literacy and writing components!
BLOCKS
– talk about differences in blocks (shapes, materials, etc), practice building and being respectful of each other’s work and clean-up by returning materials to designated and labeled areas.
Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, a variety of building blocks (waffle blocks, foam blocks, etc.), pictures of a variety of buildings, cars/trucks, etc. Additional, theme related materials should then be added to the core materials with each theme. Don’t forget your literacy and writing components!
HOUSE – begin with only a few pieces (i.e. 4 or 5 refrigerator food pieces and 4 plates and cups) and practice using, emphasize pretending to eat versus actually putting the food in our mouths and talk about why we can’t put the food in our mouths (can introduce Germ Bucket). Then practice cleaning
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by putting food in fridge and plates/cups in cupboard to match with labels. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, additional place setting pieces (forks, spoons, etc.), pots and pans, additional pieces of food, dress up clothes for role-play, etc. Additional, theme related materials should be added to the core materials with each theme.
Don’t forget the literacy and writing components!
IMAGINATION
– set up 4 chairs and a circular object (paper plate, Frisbee) to create a bus with 3 riders and one driver. Practice role playing, talk about safe riding skills (sitting, etc.) can sing Wheels on the Bus . When finished, practice putting props back in designated and labeled places. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the
“core” of the center. Materials to add include, but are not limited to, a painted cardboard box, additional chairs, backpacks, etc. Materials should be switched with each theme to maintain relevance with the children. Don’t forget the literacy and writing components!
ART – set out plain white paper and markers or crayons and allow children to draw pictures and practice writing their names. During clean-up the children can practice color sorting the crayons and/or making sure all marker lids are clicked on as well as replacing materials to their designated and labeled places. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, glue, scissors, collage materials, magazines, etc. Additional, theme related materials should be added to the core materials with each theme.
Don’t forget the literacy and writing components!
COOKING – introduce play dough and basic utensils (4 cookie cutters). Practice dividing the dough to share with others, keeping the dough mostly off the floor, and putting the dough back into sealed container during clean-up. Container is then returned to designated and labeled area. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, measuring cups, rolling pins, mixing bowls, etc. Additional, theme related materials should be added to the core materials with each theme. Don’t forget the literacy and writing components!
MESSY TABLE
– introduce beans with 2 funnels or other types of toys. Practice keeping the items in the table and sweeping up during clean-up. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, scoops, measuring cups, cups, etc.
Additional, theme related materials should be added to the core materials with each theme. Don’t forget the literacy and writing components!
SAND/WATER TABLE – introduce a small bit of water with as many toys as children are allowed to use the center. Practice pouring water while keeping it in the table and standing on footprints (if using) to hold space. During clean-up practice returning smocks to designated and labeled place.
Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not
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limited to, cups, water toys, buckets, shovels, etc. Additional, theme related materials should be added with each theme.
Don’t forget the literacy and writing components!
TABLE TOYS – introduce 4 puzzles and model how to work puzzles. During clean-up teach how to put puzzles back in designated and labeled area without the pieces falling out. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the
“core” of the center. Materials to add include, but are not limited to, manipulative toys, self-correcting puzzles, lacing cards, etc. Additional, theme related materials should be added with each theme. Don’t forget the literacy and writing components!
ABC
– introduce letter stampers that are the first initial of the class (not the full 26) and ink pads with plain white paper. Practice using the stampers on their own paper (not the table, not someone else’s) and being gentle with the stampers. During clean-up, practice putting lids tightly on the ink pads and returning materials to their designated and labeled areas. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, children’s name cards, magnetic letters, letter dough stampers, etc. Additional, theme related materials should be added with each theme.
Don’t forget the literacy and writing components!
WRITING – introduce paper, pencils, crayons, and markers and guide children to practice writing.
During clean-up encourage the children to pay careful attention to putting each item back with its matches in their labeled areas. Over the course of the first month, gradually add additional materials
(which have been labeled, as well as the storage place) to create the
“core” of the center. Materials to add include, but are not limited to, note cards, envelopes, children’s name cards, etc. Additional, theme related materials should be added with each theme. Don’t forget the literacy and writing components!
LIBRARY
– read the book Reading Makes You Feel Good with each group, then give each child a book and talk about book handling rules (gently turn pages, etc.) and at clean-up practice putting books carefully back onto labeled bookshelf. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, board books, picture books, class books, etc.
Additional, theme related materials should be added with each theme.
Don’t forget the literacy and writing components!
MATH – introduce color cubes (unifix) and model appropriate use, which includes (but not limited to) stacking two columns and comparing length, sorting all blocks by color, extending or creating simple patterns, counting blocks, etc. During clean-up teach the children to replace all the blocks carefully
(i.e. not throwing) to the designated and labeled area. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, manipulative counters, shapes, number magnets, etc. Additional, theme related materials should be added with each theme. Don’t forget the literacy and writing components!
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LISTENING
– introduce tape player with headphones, teach green button means PLAY and red button means STOP, during clean-up teach children to return all materials to designated and labeled areas. Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, books on tape, music tapes/CDs, etc. Additional, theme related materials should be added with each theme.
Don’t forget the literacy and writing components!
MUSIC/MOVEMENT
– introduce as many instruments as children can be in center. Teach children how to use the instruments, different sounds that can be made, practice how to make soft, quiet sounds. During clean-up teach children to put instruments away in the designated and labeled areas.
Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the
“core” of the center. Materials to add include, but are not limited to, variety of music tapes/CDs, scarves, break-proof mirror, etc. Additional, theme related materials should be added with each theme. Don’t forget the literacy and writing components!
COMPUTER – introduce basic mouse movement concepts with program like KidPix, teach children how to click and drag and to watch for the cause and effect, as well as discussing what the children should do if they accidentally exit the program. During clean-up teach the children the level of shut down they will be responsible for and to push in their chairs (if applicable). Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, Living Books on CD,
Sammy’s/Bailey’s/Millie’s, etc. Additional, theme related materials should be added with each theme.
Don’t forget the literacy and writing components!
CIRCLE CARPETS – introduce floor puzzle and teach children how to take turns with the pieces as well as how to “read” the box top to work the puzzle. During clean-up teach the children to gently take apart the puzzle and put the pieces back into the box, then return to designated and labeled area.
Over the course of the first month, gradually add additional materials (which have been labeled, as well as the storage place) to create the “core” of the center. Materials to add include, but are not limited to, floor puzzles, large manipulatives, train sets, etc. Additional theme related materials should be added with each theme. Don’t forget the literacy and writing components!
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Blueprint for Early Literacy
Blueprint for Early Literacy is a literacy based curriculum. It is organized into 10 themes. The 10 themes are as follows:
1. Welcome to School
2. Living Together
3. People, Place, and Pets
4. Changes Around Us
5. Markets and Foods
6. Daily Life in Many Lands
7. Folk Stories on the Farm
8. Measure Up
9. Seeds, Plants, and Gardens
10. Exploring Pond Life
Literacy, mathematics, science, history and social science, physical and motor development, and personal and social development are integrated within each theme ensuring comprehensive instruction in all areas of development.
Message Time Plus, a modeled writing and shared reading instructional program, is integrated within
Blueprint to promote phonemic awareness, phonics vocabulary, fluency, and comprehension in a meaningful context.
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Guidance for Blueprint
Specific to Augusta County and Staunton City Schools. Refer to your school for specific guidelines
1. One Read-A-Loud per day-includes author, title, illustrator and specific vocabulary. The
Pacing Guide allows for approximately four Read- A- Loud books per theme. The daily read aloud should follow the outline as listed below:
Day 1- Introduce book, title, author, and illustrator. Conduct a book walk to interpret meaning from pictures. Ask open-ended questions to encourage discussion and to make predictions.
Day 2-Recall parts of a book and review the predictions from day one. Read the story. First day reading should be fun to hear the flow of the story. Use facial expressions and intonation.
Day 3- Review title, author, illustrator, setting and vocabulary. Read book. Teacher models retelling of the story. (props, puppets, flannel boards, draw and tell, act it out, musical instruments, etc.)
Day 4- Review title, author, etc. Read book. Students are encouraged to retell the story (independent oral language) using visual aids.
Day 5- Review title, author, etc. Read book.
2. Read-A-Loud books can be read in any order within the themes. The themes have to stay in order. (per Blueprint / CLI)
3. You can switch time of day that you do
“read aloud” and add another book to your beginning of center time.
4. Two other story times need to take place during the day. If at all possible, these story times should take place in small group.
Books for additional story times can be chosen from:
Author Studies
50 Book Collection
Teacher Choice/Theme Related
5. Books that introduce the applications have to be read before the application activity takes place. It can be as a read-a-loud or part of the application extension.
6. All applications per theme need to be completed.
7. Applications may be adapted and differentiated to meet the needs of the children, but the skill stays the same.
8. The teaching assistant may conduct teacher-planned lessons using the applications. It is the teacher’s responsibility to make sure the objective of the lesson is clear to the teaching assistant and instruction is differentiated.
9. You might want to focus on one column of pacing guide. Pacing does not have to be reflected in lesson plans.
10. New teachers should consult with their lead teacher about Blue Print implementation.
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Sample Schedule
8:00 – 8:30
8:30
8:40
– 8:40
– 9:10
Children unload from buses.
Children wash hands and choose a table activity such as books, legos, puzzles, etc.
Clean up song.
Transition song to get ready to go to cafeteria for breakfast.
Breakfast.
Children are given a squirt of antibacterial lotion, go through breakfast line, and eat breakfast. The first eight children will go back to room
9:10 – 9:20
9:20
– 9:30 with one adult and start brushing teeth.
Second group transition back to room .
Morning Meeting.
This should include songs to greet children, see who is at school today, and introduce concepts of day.
Message Time Plus is a modeled writing and shared reading instructional program. You will need to add this 10 minute instructional activity where applicable.
9:30
– 9:45
Read Aloud.
Small group time in which the same theme based book is read for a week. Extensions are provided during small group and center time.
9:45 – 10:45 Center Time.
One hour block of child choice activities. Teacher directed activities are held with individuals or small groups at this time.
10:45 – 10:55 Clean Up from Center Time.
It is best practice to have a consistent song or
10:55
11:10
– 11:10
– 11:40 signal for clean up.
Whole Group or Small Groups.
Time will range according to developmental ages and time of year. This can be a time to teach math, science, literacy, or phonological awareness.
Outside Play Time.
This can be a teacher directed game or free play on playground. One adult will return to the room at end of this time to set up for lunch. She will bring 8 children who are helpers with her. The children who
11:40
12:10
12:15
12:30
1:00
– 12:10
– 12:15
– 12:30
– 1:00
– 1:15 are not the lunch helpers of the day, may look at books, etc. They will then wash hands and sit at the table once lunch has been put out.
Lunch.
(Family Style Dining) The second group of children will come into the classroom and wash hands. They will then sit at the tables for lunch. When the children are finished they may look at books, legos, table toys on rug, or any other teacher assigned activity. Bathroom may be used at this time.
Children will finish cleaning up from lunch.
One adult will go to the rug.
The other adult will assist the rest of the children and help them to the rug.
Whole Group or Two Small Groups.
This can be a story time, a time of nursery rhymes, or a time for social emotional lessons.
Outside Time.
This can be free play or a teacher directed game.
Story or quiet activity preparing children for rest.
During this time children will go to the bathroom, get a drink of water, and wash hands.
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Sample Lesson Plan for the First Week of School
Arrival
Transition:
Breakfast
Transition:
SPECIALS
Read Alouds
Franklin’s First Day of
School
Vocabulary: author, illustrator, title
Transition:
Extensions/Special
Activity
Monday Tuesday Wednesday Thursday Friday
Pick up students from buses, TCW put coats/backpacks into cubbies, wash hands, hang attendance marker in appropriate place, and work with toys buckets/read books on group carpet. Prior to morning announcements TCW clean toys/books and then count who is here, which group is bigger/smaller/etc.,
TCW then participate in morning announcements.
“Stand up and put your hands in the middle”, children give hand sanitizer, then walk in line to cafeteria.
Children are encouraged to practice fine motor skills with opening milk, juice, cereal, etc. Children will need to use words and manners with teachers asking for help and with peers.
Children are lightly tapped on shoulder as name being called to take up tray, then sit against wall in a line while 1 sings the song The Wheels on the Bus (using motions) until full group is lined up. “Please stand up. Hands up high, hands out wide, hands at your side. There are other children who are learning in our school, so we need to be very quiet. Let’s walk in our quiet line”
Introduce vocabulary words, read story, ask children to compare illustrations and plot to how their first day of school.
For this week the children will be divided into groups. Each group will be color-coded and assigned to an adult. Groups will then be sent to centers.
For this week
TCW be exploring the centers and engaging with adults who will model appropriate use of each center and the items included for play in
Review vocabulary, read story, ask children to compare
Franklin’s school to their preschool.
For this week the children will be divided into groups.
Each group will be color-coded and assigned to an adult. Groups will then be sent to centers.
For this week TCW be exploring the centers and engaging with adults who will model appropriate use of each center and the items included for play in
Review vocabulary, read story, pause for children to fill in words that have become familiar
(introduction to choral reading).
For this week the children will be divided into groups. Each group will be color-coded and assigned to an adult. Groups will then be sent to centers.
For this week
TCW be exploring the centers and engaging with adults who will model appropriate use of each center
Review vocabulary, read story, pause for children to fill in words that have become familiar
(introduction to choral reading).
For this week the children will be divided into groups. Each group will be colorcoded and assigned to an adult. Groups will then be sent to centers.
For this week TCW be exploring the centers and engaging with adults who will model appropriate use of each center and the items included for play in
Review vocabulary, read story, pause for children to fill in words that have become familiar
(introduction to choral reading).
Discuss the centers that Franklin has in his school and the centers that are in your school.
Show children graphic organizer listing 3 or 4 highinterest learning centers and have them indicate their favorite center by writing their name/pasting their name under that center. Then discuss the results by counting the names in each center, talking about which center has the most and which has the least. Display organizers in classroom.
For this week the children will be divided into groups.
Each group will be color-coded and assigned to an adult. Groups will then be sent to centers.
For this week TCW be who play exploring centers engaging with adults will appropriate use of each center and the items included for in the and model those
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Monday those centers.
When the time in each center is finished, the group will practice a complete clean-up of that center prior to moving to next center in rotation.
BLOCKS- talk about differences in blocks (shapes, materials, etc), practice building and being respectful of each other’s work, and clean-up by returning materials to designated and labeled areas.
HOUSE- begin with only a few pieces (ie. 4 or 5 refrigerator food pieces and 4 plates and cups) and practice using, emphasize pretending to eat versus actually putting the food in our mouths and talk about why we can’t put the food in our mouths (can introduce Germ
Bucket). Then practice cleaning by putting food in fridge and plates/cups in cupboard to match with labels.
Tuesday those centers.
When the time in each center is finished, the group will practice a complete clean-up of that center prior to moving to next center in rotation.
BLOCKS- talk about differences in blocks (shapes, materials, etc), practice building and being respectful of each other’s work, and clean-up by returning materials to designated and labeled areas.
HOUSE- begin with only a few pieces
(ie. 4 or 5 refrigerator food pieces and 4 plates and cups) and practice using, emphasize pretending to eat versus actually putting the food in our mouths and talk about why we can’t put the food in our mouths (can introduce Germ
Bucket). Then practice cleaning by putting food in fridge and plates/cups in cupboard to match with labels.
Thursday a small bit of water with as many toys as children are allowed to use the center. Practice pouring water while keeping it in the table and standing on footprints (if using) to hold space. During clean-up practice returning smocks to designated and labeled place.
TABLE TOYS- introduce 4 puzzles and model how to work puzzles.
During clean-up teach how to put puzzles back in designated and labeled area without the pieces falling out. those centers.
When the time in each center is finished, the group will practice a complete clean-up of that center prior to moving to next center in rotation.
ART- set out plain white paper and markers or crayons and allow children to draw pictures and practice writing their names.
During clean-up the children can practice color sorting the crayons and/or making sure all marker lids are clicked on as well as replacing materials to their designated and labeled places.
SAND/WATER
TABLE- introduce
Wednesday clicked on as well as replacing materials to their designated and labeled places.
SAND/WATER
TABLE- introduce a small bit of water with as many toys as children are allowed to use the center.
Practice pouring water while keeping it in the table and standing on footprints (if using) to hold space. During clean-up practice returning smocks to designated and labeled place.
TABLE TOYS- and the items included for play in those centers.
When the time in each center is finished, the group will practice a complete cleanup of that center prior to moving to next center in rotation.
ART- set out plain white paper and markers or crayons and allow children to draw pictures and practice writing their names. During clean-up the children can practice color sorting the crayons and/or making sure all marker lids are introduce 4 puzzles and model how to work puzzles.
During clean up teach how to put puzzles back in designated and labeled area without the
Friday centers. When the time in each center is finished, the group will practice a complete clean-up of that center prior to moving to next center in rotation.
LIBRARY- read the book Reading
Makes You Feel
Good with each group, then give each child a book and talk about book handling rules
(gently turn pages, etc.) and at clean-up practice putting books carefully back onto labeled bookshelf.
WRITING- introduce paper, pencils, crayons, and markers and guide children to practice writing. During clean-up encourage the children to pay careful attention to putting each item back with it’s matches in their labeled areas.
Review previously taught centers.
82
Monday Tuesday Wednesday pieces falling out.
Thursday Friday
CENTERS (not ALL centers need to be introduced in the first week!)
SCIENCE
-
BLOCKS- Introduce and teach the first day, review and practice the second day. Talk about differences in blocks (shapes, materials, etc), practice building and being respectful of each other’s work, and clean-up by returning materials to designated and labeled areas.
HOUSE- Introduce and teach the first day, review and practice the second day. Begin with only a few pieces (ie. 4 or 5 refrigerator food pieces and 4 plates and cups) and practice using, emphasize pretending to eat versus actually putting the food in our mouths and talk about why we can’t put the food in our mouths (can introduce Germ Bucket). Then practice cleaning by putting food in fridge and plates/cups in cupboard to match with labels.
IMAGINATION-
ART- Introduce and teach third day, review and practice fourth day. Set out plain white paper and markers or crayons and allow children to draw pictures and practice writing their names. During clean-up the children can practice color sorting the crayons and/or making sure all marker lids are clicked on as well as replacing materials to their designated and labeled places.
COOKING-
MESSY TABLE-
SAND/WATER TABLE- Introduce and teach third day, review and practice fourth day. Introduce a small bit of water with as many toys as children are allowed to use the center. Practice pouring water while keeping it in the table and standing on footprints (if using) to hold space. During clean-up practice returning smocks to designated and labeled place.
TABLE TOYS- Introduce and teach third day, review and practice fourth day. Introduce 4 puzzles and model how to work puzzles.
During clean-up teach how to put puzzles back in designated and labeled area without the pieces falling out.
ABC-
WRITING- Introduce and teach fifth day. Introduce paper, pencils, crayons, and markers and guide children to practice writing. During clean-up encourage the children to pay careful attention to putting each item back with its matches in their labeled areas.
LIBRARY- Introduce and teach fifth day. Read the book Reading Makes You Feel Good with each group, then give each child a book and talk about book handling rules (gently turn pages, etc.) and at clean-up practice putting books carefully back onto labeled bookshelf.
MATH.
LISTENING-
MUSIC/MOVEMENT-
COMPUTER-
CIRCLE CARPETS-
Transition/Clean-Up:
Language Group
(small groups)
Message Time
“In just 5/4/3/2/1 minutes we’re going to clean cue children to routine.
For this week, group will be asked if they up” then sing or play clean-up music to group will gather as large group.
Following centers, learned any rules for school, ideas will be written down, and class rules will be developed and posted.
“In just 5/4/3/2/1 minutes we’re going to clean up” then sing or play cleanup music to cue children to routine.
Group will gather and talk about rules, review picture schedule that is posted with children’s photos and asked to predict what happens next in school day.
“In just 5/4/3/2/1 minutes we’re going to clean up” then sing or play clean-up music to cue children to routine.
Group will gather and review rules, review schedule, and listen to several ABC songs.
“In just 5/4/3/2/1 minutes we’re going to clean up” then sing or play clean-up music to cue children to routine.
Group will gather and review rules, review schedule, and listen to several ABC songs.
“In just 5/4/3/2/1 minutes we’re going to clean up” then sing or play clean-up music to cue children to routine.
Group will gather and review rules, review schedule, and listen to several
ABC songs.
Transition: Children will be asked to stand up and line up on yellow carpet line, then practice moving around circle in order to form line to outside.
Children will be asked to stand up and line up on yellow carpet line, then practice moving around circle in order to form line to outside.
Children will be asked to stand up and line up on yellow carpet line, then practice moving around circle in order to form line to outside.
Children will begin listening for name in rhyme to line up, singing “Willowby
Wallowby” . TCW then practice following directions by lining up on tape line by door.
Children will begin listening for name in rhyme to line up, singing “Willowby
Wallowby” . TCW then practice following directions by lining up on tape line by door.
Revised July 2011 83
Monday Tuesday Wednesday Thursday Friday
Gross Motor
Transition:
Lunch
Transition:
Rest Story
Transition:
Rest Time
Motor Time
Children will demonstrate basic gross skills while engaged in free choice play on playground. Skill set includes running, climbing, jumping, balancing, skipping, throwing balls, catching balls, hopping, etc.
Teacher calls out
“5-4-3-2-1! It’s time to go in for lunch, it’s time to go in for lunch, it’s time for all the preschool kids to go in for their lunch!” Inside, TCW look at books individually while helper children will wash hands, put on gloves and help set-up lunch. While looking at books the children are called to wash hands. When all children have finished the books are collected and the teacher reads The Wheels on the
Bus to whole group. The children are then directed to a table and lunch seat to begin family-style dining.
TCW use self-help skills and calm conversations while dining family style and discussing nutrition with adults at table.
Children are called to take up their trays, then go to group carpet and sing songs/finger plays with 1 teacher while waiting for group. Girls and boys go separately to bathroom (and possible option to brush teeth in the coming weeks). Following the tooth brushing the group will rejoin on the circle carpet to learn about rest time. One adult will set out a cot and the other will model possible rest time behaviors. The
“model” will run around the cot (ask the children if it is a safe thing to do?) Guide the children to understand that rest time is for resting. The
“model” will then call out to the other adult, then ask the children if talking loudly is a quiet restful thing? The “model” will then sit and/or lay quietly on the cot while very clearly being awake, ask the children if this is a quiet restful thing? Remind children that they do not have to sleep, they have to rest. Then
“model” will sleep on the cot, ask children if this is a quiet restful thing? All rest time expected behaviors will be reviewed again before sending children to their cots.
Read
It’s Time
Read
It’s Time
Read
It’s Time
Read
It’s Time for Bed. Can for Bed. Can for Bed. Can for Bed. Can
Read
It’s Time for Bed. Can pause on some pages to look at the illustrations and talk about how pause on some pages to look at the illustrations and talk about how pause on some pages to look at the illustrations and talk about how pause on some pages to look at the illustrations and talk about how pause on some pages to look at the illustrations and talk about how the animals are resting (“Is the bird resting? How do we know?”) to reinforce the rest behaviors that have been taught.
Children will be shown one at a time to their cots the animals are resting (“Is the bird resting? How do we know?”) to reinforce the rest behaviors that have been taught.
Children will be shown one at a time to their cots the animals are resting (“Is the bird resting? How do we know?”) to reinforce the rest behaviors that have been taught.
Children will be shown one at a time to their cots the animals are resting (“Is the bird resting? How do we know?”) to reinforce the rest behaviors that have been taught.
Then children will practice finding cots on their own. the animals are resting (“Is the bird resting? How do we know?”) to reinforce the rest behaviors that have been taught.
Then children will practice finding cots on their own. and tucked in by an adult staff and tucked in by an adult staff and tucked in by an adult staff member. member. member.
TCW rest bodies calmly and quietly while looking at books for first 10 minutes, then encouraged to rest independently for remaining rest time.
Children will practice staying on the sidewalk as
Children will practice staying on the sidewalk as
Children will practice staying on the sidewalk as
Children will practice staying on the sidewalk as
Children will practice staying on the sidewalk as they use sidewalk chalk, bubbles, and bouncey balls. they use sidewalk chalk, bubbles, and bouncey balls.
they use sidewalk chalk, bubbles, and bouncey balls.
they use sidewalk chalk, bubbles, and bouncey balls.
they use sidewalk chalk, bubbles, and bouncey balls.
Snack and Dismissal TCW eat snack if wanted, pack backpack and belongings, and prepare for bus departure.
INDIVIDUAL PLANS N - transition into classroom; #1, 2
A
– transition into classroom; #1,2
B
– transition into classroom; #1,2
F
– transition into classroom; #1,2
T - transition into classroom; #1, 2
R
– transition into classroom; #1,2
C
– transition into classroom; #1,2
K
– transition into classroom; #1,2
.
S - transition into classroom; #1, 2
J
– transition into classroom; #1,2
T
– transition into classroom; #1,2
M
– transition into classroom; #1,2
L - transition into classroom; #1, 2
H
– transition into classroom; #1,2
P
– transition into classroom; #1,2
X
– transition into classroom; #1,2
W - transition into classroom; #1, 2
Any students absent from their day will be done
Friday.
Revised July 2011 84
Sample Objectives
Read-A-loud:
TCW…
Listen to a story for enjoyment
Identify & match
Make story predictions
Read story and check predictions made the day before and conduct apple experiments
Retell the story using the book
Teacher Directed: TCW
Use fine motor skills to stamp paint with pumpkin stamps,
Dip stamp into paint to increase eye-hand coordination
Hear and repeat the nursery rhyme or song
Label
– (after it’s been taught and T is ready to assess)
Tear paper
Demonstrate positional words on rocking horse (on, off, behind, in front of)
Interest Areas: TCW
Manipulate and explore at the science table
Will put on and take off….
Will role play
Will take on the pretend role of being a ______________
Will use fine motor skills to push on picture to adhere to
“Old MacDonald Had a Farm”
Plant apple seeds in the dirt
Increase hand-eye coordination by moving the mouse
Click on _________ to play the game ___________
Increase pretend roles and make believe
Increase listening skills by playing nursery rhyme sound track game
Increase fine motor skills by manipulating a variety of table toys
Will use their 5 senses while finger painting with chocolate pudding
Small Groups: TCW
Increase listening and speaking skills
Increase general knowledge of how print works by tracking the nursery rhyme using a guider
Track the words of a memorized nursery rhyme with
‘hand over hand’ assistance
Listen to songs and act out motions of song
Associate words with actions
After singing song with teacher, TCW repeat 2 to 3 lines of song
Produce the
‘c’ sound in the song, “C is a very fine letter”
Gross Motor: TCW
Increase motor skills by kicking, throwing, and catching a ball
Throw a rope to lasso a horse
Dance to hoe down music
Move like horses and cattle to demonstrate a stampede
Revised July 2011 85
Recommendations for Making a Schedule/Writing Lesson Plans
Consult Teaching Strategies Gold
Schedule more challenging activities in the morning when children are freshest.
Maintain ratio guidelines per your division policy.
Post a picture schedule for children on the wall at their eye level.
When children first arrive at school or have been playing outside, they wash their hands before eating.
A theme is incorporated into the daily plans. Theme boxes are available for the teacher to check out.
Breakfast - Daily ( 15
– 20 minutes
).
Nutritional objective or activity (weekly) (cooking).
Opening Time/Circle Time – Daily.
Morning Meeting
– to greet, sing morning songs, introduce concepts of day (
5-10 minutes ).
Read Alouds ( 2-3 small groups )
– Small group time in which same theme based book is read for a week. Extensions are provided during small group and center time.
Message Time Plus
– a modeled writing and reading instructional program.
Center Time
– At least one hour block of child choice activities. Teacher directed activities are held with individuals or small groups at this time. (This does not include clean up.)
Small Groups
– Small groups are used to meet different children’s needs. These groups could include activities for social, cognitive, motor, or language.
Story – Daily – read 2 stories in addition to the read aloud book.
Read Aloud and Literacy extensions beyond reading a story (flannel board activity, making books, interactive books, etc.).
Songs and Fingerplays – Daily.
Phonological Awareness Activity – (Lots of rhyming, sound play, and sound awareness activity) This can be done in small group, whole group, and during transition times.
Specials with school (music, library, P.E., etc.).
Computer – Daily (This will include teaching time such as interactive books on computer and child choice time.)
Lunch – Approximately 30 minutes in length. Time between meal/snack is about two hours.
Snack – Daily – Snack can be served in the morning or afternoon depending on schedule.
Snack can be served as a “self-serve snack bar” or as a group at the tables. Please see
Creative Curriculum
– 4 th Edition for more information.
Toothbrushing
– One time per day. Should be in conjunction with meals. Staff members need to wear latex gloves.
Outside/Large Motor – The intent is the children should have 60 minutes of outside/large motor time. This should not be one continuous hour.
Examples: 15 minutes, 15 minutes, 30 minutes 30 minutes, 30 minutes.
Outside/large motor time should be at the end of the instructional morning and again in the afternoon (based on scheduling). Early morning time should be reserved for instruction and child choice learning.
Revised July 2011 86
Rest
– one hour. You may have individual children who need to rest longer, but the whole class should not be scheduled more than one hour.
Health and Safety should be incorporated into the curriculum all day, every day.
Lesson plans should be approved by your division’s preschool coordinator and/or the Early
Childhood Development Coordinator.
When writing lesson plans, large and small groups need to reflect what the teacher wants the children to learn. Lesson plans include measurable objectives that address the children’s needs based on prior observations or work samples. Once skills have been identified, activities are developed.
Measurable objectives need to be included for read aloud times, teacher directed activities, whole groups, small groups, and one gross motor time.
For example:
The child will recognize his/her name. Could be written TCW recognize name.
Sing song Miss Mary Mack
– Could be written TCW finish one line of the song.
Lesson Plan Formats
Lesson plans must be posted in your classroom.
Those classrooms doing I Am Moving and I Am Learning need to note the movement times in lesson plans.
Also see format on teachingstrategies.com.
Revised July 2011 87
Sample Lesson Plans
Arrival
7:50 - 8:15
Transition:
Breakfast
8:15- 8:45
Transition:
Morning Group
8:45-8:55
Small Groups
8:55-9:10
If You Give A
Mouse A Cookie
(Two Groups)
Read Aloud
Message Time
Transition:
(From each small group)
Monday Tuesday Wednesday Thursday Friday
Pick up children from buses. Have boys and girls wash hands during this time. Put away coats and book bags in cubbies. Check book bags for notes etc. Go to rug / tables for table toys. Children will put name from cubbie on “Look Who Is Here” chart. Sing “It’s time to go to breakfast” We all put away table toys and go to blue rug. We will sing good morning song. Children are then called 8 at a time to go to door to walk to breakfast. After getting to the cafeteria, each child receives a small dot of hand sanitizer.
Children will be encouraged to open milk, juice and cereal. Children will need to use words and manners with peers and adults.
The first eight children that are ready will clean up and walk back to the room with staff. They will do table toys and start brushing teeth. The next eight will come with the staff. They will brush teeth during center time.
When second group comes in room they go to the rug. The other group goes to rug to begin Circle.
Sing “Good Morning Preschool” including each child’s name. Introduce special activities for day. Children are called to go to two small groups for Read Alouds. Introduce / Review Theme Concept and
Idea
( playdoh, oreo game, taste) (milk mustache, whiskers) (straw paint, props) (wash dishes, act out)
(make cookies)
TCW predict story (Review Review Milk Review straw Review soap events by going on a book walk to comprehend meaning from pictures. #48
Predictions)
Call attention to title…
Read Book…
Following story,
TCW answer questions to identify voc. Word
#41
Mustache
Call attention to title..
Read Book…
TCW predict what will happen when paint with straw.
#39 activity
Call attention to title
Read Book…
TCW predict what will happen when add soap to water.
#39 activity
Call attention to title
Read Book….
TCW make a list of items needed to bake cookies.
#49
When I clap your name, pick a center…
When I clap you name pick a center…
When I say first letter in name…
When I say first letter in name…
When you hear your name with M
– Susan-Musan
SPECIAL
ACTIVITIES
(9:10-10:10)
TCW verbally describe two different cookies using word or expanded sentences #39
TCW visually discriminate shapes to match oreo cookies. #22
TCW say “______ has a milk mustache to hear
/m/ sound in word
#38
TCW cut whiskers on mouse to increase small motor. #19
TCW blow through straw to explore cause and effect while mixing paint
#25
TCW act out familiar events in book to comprehend meaning from book. #48
Using props TCW act out story to sequence events
#48
TCW explore cause and effect by adding soap and water and cleaning dishes.
#25
TCW follow oral directions to make cookies with recipe cards
#40
TCW explore cause ad effect by adding soap and water to clean dishes. #25
Centers
Art - TCW cut/glue various materials to make mice, TCW roll
“chocolate playdoh” to coordinate eye-hand movement #19,#20
Sand/Water - TCW find hidden cookies in sand, pick up with tongs and clothespins #20
Computer - TCW use eye-hand coordination to navigate :IF You Give A Mouse A
Cookie”#20
House - TCW match like cookie boxes #22.
Make Believe - TCW use If You Give a Mouse a Cookie to act out story #48
Discovery - TCW explore adding water to cookies to explore cause and effect#25
Writing - TCW use assorted writing materials to increase writing and drawing skills.#21
Listening - TCW listen to If You Give A Mouse a Cookie on Tape #44
ABC Table - TCW stamp out letters of name on cookie shapes#46
Math - TCW match symbol of number to quantitative amount #34
Blocks - TCW build a house for a mouse #20
Table Toys - TCW visually discriminate shapes to match cookies #22
Reading - TCW read Laura Numeroff and Mouse Books #44
Revised July 2011 88
10:10-10:15
Transition:
Meeting-
10:15-10:20
Two Groups
10:35-10:55-
Specials
10:55-11:25-
Gross Motor
11:25-12-05-
Lunch
12:05-12:25-
Meeting
12:05-12:35-
Gross Motor
(Planned)
12:55-2:10-
Bathrooms /
Water
2:10-2:45-
Snack and
Individual
Objectives
5 minute warning-
Clean up song
Using people graph, TCW count
# on each side
#34
After listening to If
You Take A
Mouse to School,
TCW name items at school #39
5 minute warning-
Clean up song
After reading, If
You Give a Moose a Muffin, TCW find
/m/words in book by listening to similarities/differen ces#38
5 minute warning-
Clean up song
After reading
Mouse Mess.
TCW find /m/ words in book by listening to similarities and differences #38
5 minute warning-
Clean up song
TCW produce /m/ sound in M is a very fine letter
TCW use auditory skills to pick our m word in Mouse
Mess and Stand up when heard
5 minute warning-
Clean up song
TCW produce /m/ sound in singing m…
#38
The child will find things in room that begin with letter
/m/
#38
Using construction paper circles,
TCW stand on one foot , hop on one foot etc.
#14
TCW use self help skills and calm conversations while dining family style.
TCW repeat lines in Hickory, Dickory
Dock #38
Using construction paper circles,
TCW stand on one foot , hop on one foot etc.
#14
TCW use self help skills and calm conversations while dining family style.
TCW say name in
Hickory, Dickory,
Dock when card is held up #38
Child Choice on
Playground or
Motor CD
Bathroom and
Water and Rest
Child Choice on
Playground or
Motor CD
Bathroom and
Water and Rest
TCW run, skip hop to put cookie in jar
#14
TCW use self help skills and calm conversations while dining family style.
TCW say name in
Hickory, Dickory,
Dock when card is held up #38
Child Choice on
Playground or
Motor CD
Bathroom and
Water and Rest
TCW run, skip hop to put cookie in jar
#14
TCW use self help skills and calm conversations while dining family style.
TCW hear changes in
Hickory Dickory
Dock
#38
Child Choice on
Playground or
Motor CD
Bathroom and
Water and Rest
The child wil go on cookie hunt walk around school #14
TCW use self help skills and calm conversations while dining family style.
TCW hear changes in
Hickory Dickory
Dock
#38
Child Choice on
Playground or
Motor CD
Bathroom and
Water and Rest
TCW use self help skills and words
Put symbol on calendar for day
TCW use self help skills and words for snack
Put symbol on calendar for day
TCW use self help skills and words for snack
Put symbol on calendar for day
TCW use self help skills and words for snack
Put symbol on calendar for day
TCW use self help skills and words for snack
Put symbol on calendar for day
Revised July 2011 89
Theme Boxes
Theme Boxes are available to all Preschool sites. The boxes are equipped with materials that support a multi-sensory, literacy-based approach to learning. There are materials that support the theme that go into a variety of centers (housekeeping, blocks, writing, etc.). Theme boxes are also available that correlate directly to the Blueprint theme.
There should only be one theme topic being taught at a time . Consideration should be given to teaching a theme for 2 weeks or longer. Activities should build on one another using the theme to create high interest activities to learn. This approach to learning allows for activities that are:
Meaningful, relevant and interesting
Respect cultural diversity
Reflect children’s individual needs
Allow children to construct knowledge
Are based on age appropriate expectations
Extend children’s current knowledge
Two or three theme boxes are available based on blueprint themes. Supplemental boxes are also available for experienced teachers.
A comprehensive list of theme boxes is being developed and will be available. Please ask the Early
Childhood Development Coordinator for the list if desired.
Theme Box Guidelines
NOTE: to sign up for theme boxes, please contact one of the following people at the Shenandoah
Valley Head Start Program in Fishersville at 540.245.5162.
Program Secretary: extension 110
Early Childhood Development Coordinator: extension 106
Check off contents to box when you receive and unpack the box and when you pack and return the box. Sign/initial the contents check sheet when you have checked and returned it.
Please add a copy of any activities that you find or generate to the box for others to enjoy. In addition, those activities may be posted to the preschool wiki space.
Pickup and delivery of theme boxes depends on the locality in which they are located.
It is the entire staff’s responsibility collectively to maintain these boxes. Please keep this in mind as you use them. If something is missing or broken, please note it on the content check sheet.
Please use the following codes for missing or destroyed items.
M = Missing D = Destroyed
Thank you!
Revised July 2011 90
Theme Box Planning
The theme should be integrated in the Blueprint Curriculum.
Materials needed:
Monthly Manuel with Blueprint Scope and Sequence
Theme Box.
Pages 526 and 527 from the Creative Curriculum manual (Weekly Planning Formfor the
Environment and Planning for Groups)
Creative Curriculum Continuum
1. Empty the theme box and sort the items. Pencil in what can be used in each of the interest areas.
2. Using the resource sheets in the theme box and other resource material, list the following: a. What are your theme goals? b. Review work samples, outcomes, and observations to build your objectives. c. What activities will meet these needs? d. Are the activities open ended to allow for individualization? e. What vocabulary will you teach with this theme?
3. What is the sequential order for introducing the theme (concepts)?
4. Order the goals, concepts, vocabulary, and activities by giving them a 1, 2, 3, or 4. This will establish a scope and sequence that is developmentally appropriate.
5. How will you integrate technology?
6. How will you allow for different learning styles and children with significant needs? (A.Technology)
Revised July 2011 91
Rest Time
Rest time should take place in the afternoon. It should take place in a reasonable amount of time after lunch allowing the children to have time to digest their food. It is usually very difficult to get children up from rest and to do any significant readiness instruction, but there may be times when this does work. There may be classes that children do not fall asleep. Also, some children may need to sleep one day, but not the next. Children’s needs often vary from day to day.
Rest time can be very stressful for teachers and teaching assistants if the expectation is that you are going to get a lot done. There are many reasons why a child may not sleep or be able to rest at school. You may need to teach a child to relax and do something quiet so his/her body may rest.
Like all learning activities, all children may not be able to do the same thing at the same time. Quiet alternative activities may need to be provided. It is recommended that all children lay down on their cots / mats and you reinforce those that are resting calmly with quiet activities. If a child is not able to start out being calm, you may need to start with a box of quiet activities or be in close physical proximity to them. Be careful how you teach the child to relax or go to sleep. Whatever you start
(rubbing backs, etc.) is what the child will expect you to continue. The goal is that they learn to rest and relax, giving their bodies a chance to rest on their own, if at all possible.
Rest time should not exceed one hour for the whole class. Just like there are children who may not need to rest more than 20 minutes there may be children who need to rest longer than one hour.
These are typically children who may not be getting enough rest at night or are young threes. It is a good idea to gradually decrease the amount of rest these children will need to have at school by gradually waking them up a few minutes earlier each day.
Cots/mats need to be widely dispersed in the classroom and not blocking any exits. As always, children need to be well supervised during rest time. The level of darkness should not be so great that you cannot see the children or they cannot see you. Some children are very afraid of the dark. The goal is that they learn to rest appropriately, not necessarily that they go to sleep.
It is important to remember that you can’t count on all children sleeping. Teachers should not have the expectation that work can be done during rest. It is a teaching time as well.
Alternatives to resting
Computer Activities with head phones
Listening Center
Individualization Activities with Staff
Child sized backpacks with some of the following items: o Dollar Tree Magnets/Board o ABC magnets with round pie tin to stick them in o Blank books with writing tools (supervision necessary so children do not write on cot or floor) o Bag of paper scraps with scissors (supervision necessary so children to not cut hair or cot) o Glue stick o Puzzles o Old shoe with holes for lacing
Revised July 2011 92
Playground Supervision Guidelines
Please keep in mind the following when planning to use the playground or gym for instruction:
1. Children should be given the opportunity and encouraged to use the bathroom before going outside. This will eliminate the necessity for staff members to return to the room with a small number of children and leave the bulk of the class on the playground for the teacher to supervise alone.
2. Supervision on the playground is vital. The younger the child, the greater the supervision must be.
3. Two adults must be with the children at all times. One of the adults needs to be a paid staff member.
The teacher-pupil ratio requirement must be maintained at all times* . When the playgrounds are large enough to hold more children safely, two classes may play together. This needs to be determined by the teacher and operations manager. At all times it is the classroom staff’s responsibility to adhere to ratios and maintain a safe environment.
4. Do not allow the children to play in areas where you cannot see them. Remember: walk, watch, and warn.
5. Remember that interaction with children is important. Outside time is not a time for the adults to socialize.
6. Do not allow the children to use inappropriate equipment. (Old slides, seesaw) Swings without special preschool seats are not to be used by our children.
7. Please use the playground at times that other classrooms are not present. This allows for greater supervision. If a set schedule does not exist at your site and you are unable to use the facilities independent of other classrooms, please make arrangements to meet with the principal to discuss this issue. For playgrounds that are heavily used by other classrooms, a schedule should be set by all parties involved including the principal and fellow teachers. It may be necessary for the preschool classroom to make the necessary adjustments to insure that the guidelines set by
Preschool are met in this area.
8. When set schedules are not found, it is the responsibility of the Preschool teacher to move the children to another area for play.
9. Please monitor the temperature and weather conditions closely. Follow the school guidelines as to whether outside play is appropriate. Children should be instructed and encouraged to wear hats, gloves, and coats when playing outside in cold weather. If there is a need for hats, gloves, and coats at your center, please contact your center committee for assistance.
10. One motor time per day needs to be planned with objectives for learning.
*Head Start classrooms are to maintain a 1:10 teacher-student ratio.
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Team Information
Revised July 2011 94
Table of Contents
Revised July 2011 95
Monthly Team Communication Meetings
The Family Service Advocate and the teacher(s) will meet once a month and complete the Team
Communication Meeting form . The meeting should be scheduled before or after school or during
planning time. During the meeting the FSA and the teacher will decide if there are children that the
FSA should be observing within the classroom environment. An observation could include eating habits, socialization with other children, behavioral problems, personal hygiene, or any other issue that the teacher indicates. Observations can also be used as celebrations if a child is doing particularly well with a formerly identified need. FSA’s have been given a checklist for observations to give them suggestions about what to look for in the classroom environment. If an instructional assistant is asked to participate, prior approval for overtime will be needed.
The FSA will submit the Team Communication Meeting form to the Child and Family Services
Coordinator or applicable supervisor monthly at the end of each reporting period.
At the beginning of every meeting both the Family Service Advocate and the classroom teacher(s) will complete their own copy of the Team Communication Meeting form. Both copies will need to be signed. The Family Service Advocate will submit their completed copy to the Child and Family
Services Coordinator or applicable supervisor and the teacher(s) will keep a copy in a log in the classroom. This log will be reviewed periodically by administrative staff.
The forms should be signed only if the meeting actually took place. Please do not back date if a meeting is missed. Please document why the meeting was missed on a blank form, with both the teacher and the FSA signing the form.
The most updated version of the Team Communication Meeting form follows this page. Your Family
Service Advocate also has a copy of the most updated form.
The FSA Checklist for observations includes the following:
Changes in behavior (i.e. odd behaviors toward other children or the teacher)
Changes in emotional affect (i.e. excessive crying, more angry or withdrawn than usual, overly clingy toward adults or other children, excessively euphoric, play that appears more than just imaginative)
Changes in physical appearance (i.e. dirty, bruising, unexplained cuts, personal hygiene issues that are not age appropriate)
Changes in play (i.e. more aggressive play, not playing with other children, or play involving scenes of a violent nature
—death, sexual violence, scenes about police coming to the home).
Changes in eating habits (i.e. eating out of trashcans, eating non-food items, hoarding food, asking for abnormal portion sizes, not eating at all).
Revised July 2011 96
Date: ______________
Team Communication Meeting Form
Classroom: ____________________________________
Participants: _________________________________________________________________
Participant Signature: _________________________________________________________
Participant Signature: _________________________________________________________
Participant Signature: _________________________________________________________
Participant Signature: _________________________________________________________
Location (classroom, library, cafeteria, etc.): _____________________________________
Celebrations:
Review Class List (Attach class list) :
Issues and Concerns (For example: Attendance, busing, health concerns, communications with home, parent visits to classroom, change in residence or phone number, or other staff concerns/comments) :
Action Plan (Delineate who does what) :
Announcements:
Parent Volunteers (Attach list when applicable) :
Shared Responsibility of Classroom Staff
1. Arrival at school a) Check refrigerator temperature and record it on temperature chart located on the refrigerator. b) Check and refill bleach solution bottles
– one cap bleach/fill with water. This solution is used to clean cots, diapering mats, and tables. c) Make sure to have first aid backpack with you at all times! Instructional aides check supplies once a month. Let teacher know what needs to be replaced. Items should be replaced by the school nurse/clinic aide, the preschool central office, or through using teacher supply money. Requests for items from preschool central office should be emailed directly to the Instructional Secretary who will inform the appropriate party. d) Assist with preparation for daily schedule.
2. Bus a) The times and number of buses are different at each site. b) Staff needs to be at the bus and help the children get off. The children must be with an adult.
Other staff watches inside children. Every site needs to work this out with teacher, transportation, and principal. The correct ratio of adults to children should be maintained while loading and unloading students on/off bus. c) Help with backpacks, notes, parents who bring children.
3. Breakfast a) Assist children in taking off coats, backpacks, and sitting at tables. b) Check with any late arrivals. c) Teacher or assistant helps children through cafeteria line. Check off children for snack and breakfast/lunch depending on your site’s regulations. d) Assist children with emptying trays and lining up for class.
4. Bathroom a) Some sites have bathrooms in the cafeteria…If so, then assist children as needed. May have to play quiet game or sing while others wait.
5. Class a) Assist with cubbies, notes, backpacks, and children that need encouragement to participate. b) Check roll/attendance chart. See teacher for record books. c) Sit with children who may need help managing behavior.
6. Centers a) Interact with children. Promote safe behaviors. b) Help children with small group projects. c) Welcome volunteers and make sure they sign volunteer sheet on Parent/Volunteer Bulletin
Board. d) Help children brush teeth daily. Put name on toothbrush and change brushes as required or after illness. (Let teacher know when to order cups, toothpaste, toothbrushes, and covers.
Requests for these items should be emailed from the teacher to the Instructional
Secretary.)
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e) Help with clean -up and hand washing before lunch, snack, and bathroom use. (Teacher
7. Lunch also helps in all of these areas depending on situation of the day.) a) Lunch varies by the site. If you eat lunch in the room, a cart should be brought to your room. b) The classroom staff and other designated children wear appropriate sized food service gloves to set table and get ready for lunch. c) The teacher and aide sit with the children and model appropriate use of language and proper table etiquette. d) The children are to pass at least two different foods around with help. This allows them to gain experience in family style dining. e) The clean-up of lunch should be done by individual children as much as possible. f) The tables should be cleaned with the bleach solution by an adult.
8. Playground a) Monitor opposite sides of playground from teacher. This is so that children in various areas are kept as safe as possible (maintain ratio). b) If children use tricycles they are to wear helmets. Helmets must be fitted. c) Establish an emergency procedure in the event a child gets hurt. Establish a fanny pack from the first aid bag with needed items.
9. Rest a) Discuss expectations with teacher – then work together. b) Having a naptime chart assists with placement of cots as well as for substitutes. c) Number your cots and mats and assign a number for the year. You can write the number with a permanent marker.
10. Snack a) Use food service gloves to distribute snack. Make sure children wash hands, stack cots, etc. b) Allow children independence in cleaning up mess.
11. Other a) Use sheets on cots or wipe. b) Wipe all tables with bleach solution. c) Assist with any clean up as designated by teacher.
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Instructional Aide Evaluation Criteria
1. Knowledge and Performance of Duties
Participates appropriately in planning/delivering instructions
The assistant will help the teacher plan for the daily schedule, changes in the daily schedule, theme based instruction, and individual differences.
The assistant will deliver teacher created objectives with individuals, small group, and whole group. Examples:
The assistant will help the teacher plan for his/her role in the daily schedule during the following times of the day: unloading buses, breakfast, transitions, group time, tooth brushing, center time, large motor time, lunch, rest, and the closing of the day.
The assistant will understand and help provide support during changes in the day such as early dismissals, special activities and assemblies.
The assistant will help the teacher implement a teacher planned class theme, help with centers, individual work, small group, and whole group. The assistant may be asked to make teacher directed materials to support the class theme.
The assistant will help the teacher deliver planned activities such as read aloud observations, art, reading to students, assisting students in library, writing dictations given by students, helping students locate and use materials, assisting students to follow and understand directions, encouraging students to work independently, and listening to students.
Cooperates with others in planning and using available resources
The assistant will plan with the teacher and parents of the classroom.
The assistant will help gather resources and supplementary materials. Examples:
The assistant will help encourage parent involvement so that it is an active part of the classroom program by helping with volunteers and/or the Wednesday Folders.
The assistant will help the teacher collect additional materials that pertain to the teacher’s objective and theme.
Uses a variety of techniques and materials
The assistant, with guidance from the teacher, will be able to use techniques to encourage safety habits in work and play.
The assistant will be able to use materials in the classroom to help provide success for the children. Examples:
The assistant will use positive reinforcement to control situations in the classroom.
The assistant will encourage the use of the quiet spot with the children.
The assistant will use the materials to provide a second choice for a child that is not being successful in whole group.
Maintains student time on task
The assistant will scan the room and help children find choices that are offered during the day.
Examples:
Revised July 2011 100
The assistant during center time will offer choices for centers if a child has not chosen one.
The assistant will encourage participation during whole group movement time.
Adjust instruction to the needs of students
The assistant will be able to adjust an activity and carry out the planned instruction under the guidance of the teacher. Examples:
The assistant would allow a child to hold his/her hand during a line if he/she knew that the child would run.
While reading to a child, the assistant would know which children would use board books and which children could listen to longer stories.
Provides positive reinforcement to students
The assistant, under the guidance of the teacher, will be able to use positive reinforcement to promote safety habits in work and play. Examples:
The assistant will say “I like the way you are using your words.”
The assistant will use positive reinforcement to encourage students to work independently.
The assistant will use positive reinforcement to help maintain safety in the room if the teacher is involved in another situation.
Maintains communication with the lead teacher
The assistant will be able to communicate ideas and issues with the teacher. Examples:
The assistant will verbally communicate during times of planning.
The assistant will verbally communicate with the teacher about a child’s individual need.
The assistant will verbally communicate with the teacher to provide a consistent and safe learning environment.
Supports overall school policies and programs
The assistant will support preschool and home school policies.
The assistant will participate in staff activities, if such activities pertain to the specific program and the welfare of the assistant. Examples:
The assistant will attend preschool staff development days.
The assistant will wear food service and latex gloves when needed.
The assistant will maintain confidentiality of the class.
The assistant will not withhold food for behavior purposes.
Follows sound safety procedures
The assistant will follow safe and orderly mobilization of all students. Examples:
The assistant will follow ratio.
The assistant will supervise students on the playground and during any school sponsored activity occurring during the day.
To assist with room arrangement and orderly maintenance of the classroom.
Demonstrates good classroom management skills
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The assistant, under the guidance of the teacher, will be involved in the classroom management procedures. Examples:
The assistant will use positive reinforcement.
The assistant will utilize the quiet space.
The assistant will help provide a safe and positive environment.
The assistant will encourage the children to use
“words” in situations in which they are angry, scared, etc.
Utilizes work time to the best advantage
The assistant will know the expectations of the teacher during each segment of the day.
Examples:
The assistant will use the time when the children are not in the room to plan with the teacher.
The assistant will use rest time to help individuals relax or to work on teacher generated activities.
Keeps accurate student records / submits reports on time
The assistant will render such clerical assistance, as particular situations require. Examples:
The assistant will record attendance and other information.
The assistant will collect money.
2. Personal and Professional Qualities
Respects confidentiality
The assistant will maintain confidentiality of the classroom and individual student situations.
Example:
The assistant will sign and follow the Standards of Conduct, which are listed in the
Confidentiality Agreement provided by preschool.
Displays a positive self-image and attitude
The assistant will feel good about his/her job and have an open attitude to learn new skills and practices that add to the developmental success of the classroom.
Models appropriate English grammar
Works cooperatively with others
The assistant will work cooperatively with the teacher, parents, and other school staff.
Exhibits flexibility and adaptability
The assistant will be able to adapt and adjust to new and different situations that may occur during the school year. Example:
With guidance from the teacher, the assistant will be able to change a routine or activity if the teacher feels it is necessary.
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Accepts guidance and suggestions
The assistant will be able to accept guidance and suggestions from the teacher and/or principal. Examples:
The teacher may give the assistant a new idea on how to complete a task in the room.
The teacher may give the assistant suggestions on behavior management, assisting students, encouraging safety habits, etc.
Is punctual and regular in attendance
The assistant will make every effort to attend during the school day in accordance to the policy sick and personal time leave.
The assistant will be on time to the classroom in accordance with the annual contract in which they have been issued.
Demonstrates organization and care of materials/equipment
Under the guidance of the classroom teacher, the assistant will organize and care for materials that are in the classroom. Example:
The assistant will organize and maintain materials and equipment such as art supplies, cleaning supplies, health supplies, and centers.
Reflects appearance appropriate for assignment
The assistant will wear clothes that are professional and appropriate for situations that may occur during the school year.
Demonstrates initiative and resourcefulness
The assistant will be initiative and resourceful when there is no teacher direction. Example:
The assistant will independently take over the environment if the teacher is involved in an emergency situation.
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Teacher Staff Development
All teachers are expected to complete a staff development plan with their Lead Teacher,
Preschool Supervisor, or Early Childhood Development Coordinator (depending on division).
The building principal will also work in collaboration with applicable supervisory staff to ensure that staff development plans are created within the appropriate timeframe and address the teacher’s needs.
Teachers will receive an Individual Professional Development Plan (IPDP) by September 30 th of each school year.
The IPDP will require a signature and date of review by the teach and the Lead Teacher,
Preschool Supervisor, or Early Childhood Development Coordinator.
The Lead Teacher, Preschool Supervisor, or Early Childhood Development Coordinator will communicate with the building principal the topics covered at mentor meetings including the
IPDP.
The Lead Teacher, Preschool Supervisor, or Early Childhood Development Coordinator will meet with the program administrator on a monthly basis to evaluate the need for staff development to include IPDP.
The staff person will be used the IPDP to develop targets and these targets will be approved by the building administrator.
The building administrator will conduct professional evaluations. The IPDP progress assessment will be considered as part of these evaluations.
The staff member will provide documentation that supports the completion of the IPDP.
The Consortium and Policy Council will be provided at least two staff development progress reports annually by the Head Start director in order for the governing bodies to track program staff development outcome progress.
The Consortium will support basic uniformity through the use of an IPDP form used to identify
and monitor individual staff development plans. A copy of the Individual Staff Development
follows.
Note: In Augusta County, this process begins with the Grade Level Meeting.
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Individual Staff Development Plan
Site:
Participants:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
Celebrations:
Date:
Signatures:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
Review Class List:
Goal:
Objective/Action Plan:
Review Date:
Goal:
Objective/Action Plan:
Review Date:
Goal:
Objective/Action Plan:
Review Date:
Progress on Previous Goals:
Instructional Support Team
On many occasions, preschool children exhibit behaviors or needs that can be a challenge to their families and the classroom instructional staff. The purpose of the Instructional Support
Team is to help the classroom staff develop strategies and techniques that will be implemented in the classroom. It is important that the classroom staff (teacher, teaching assistant, etc.) make attempts using their own professional knowledge to address the concerns prior to contacting the Preschool Lead Teacher or Early Childhood Development Coordinator. After the first communication, the team will decide who else to invite to following meetings, if the need is still there. This team may be a formal team set up by the school or one that is called together when needed.
Steps in the IST Process:
1. The first communication will be with the Preschool Lead Teacher or Early Childhood
Development Coordinator and the classroom staff. The point of contact for child concerns is the preschool lead teacher. The team (Lead Teacher or Early Childhood
Development Coordinator and classroom staff) will meet to discuss the issues that are of concern to the school staff or family. Specifically identify issues and create interventions to target the needs. During this meeting the team will decide if educational and/or environmental changes need to be made. If the concerns are specific to the needs of an individual then all minutes will be kept on the preschool data base. All administrative and classroom staff will have access to IST plans.
2. If concerns continue the IST would notify the principal of ongoing concerns and meet again to discuss issues and possible solutions. This team may include: Principal,
Psychologist, Guidance, Teacher, and Family Service Advocate. Parent attendance and parent input is encouraged.
3. A continued plan ( Instructional Support Team form ) will be developed by the IST team
to address concerns. This will become a part of the Child and Family Service Delivery
Log. An ongoing schedule of monitoring will be set up by the IST team.
4. If needed, through the IST team, a request for assistance can be made for additional assistance, outside of the building staff. All assistance to the child and family needs to be tracked on the Child and Family Service Delivery Log.
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INSTRUCTIONAL SUPPORT TEAM MEETING FORM
Child’s Name: ___________________________ Date: ___________
School: _____________________________________________
Participants:
__________________________ __________________________
__________________________
__________________________
__________________________
__________________________
__________________________ __________________________
__________________________ __________________________
Celebrations:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Issues and Concerns:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Action Plan:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Next Meeting Date: _______________________________________
1. This form will be filed in the student file kept in the classroom
2. Copy for Lead Teacher
Helping Hands:
Forming Family
Partnerships in
Preschool Education
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Table of Contents
Calendar of Events for
FSA’s ................................................................................. 119
Volunteer Standards of Conduct & Confidentiality Agreement ................................ 125
Home Visits and Parent/Teacher Conferences ..................................................... 127
Revised July 2011 109
Family Service Advocates wear many hats and serve
As a Partner at School
1) Conduct registration to collect information necessary for public school attendance.
2) Communicate information from the school to the family to facilitate transitioning into a school environment.
3) Participate in the planning and presentation of s chool o rientation during back-to-school meetings for preschool in August each school year.
4) Spend one day each week in the school building or school community during the program year.
5) Schedule and communicate with each classroom teacher the plan for this day based on the need for service as determined by the FSA, the teacher, and the Child and Family Services
Coordinator.
6) Assist with the Parent Board as posted in the classroom.
7) Meet with the teacher at least once a month and complete the Team Communication
Meeting Form.
8) Provide as needed for parents to attend meetings at school.
9) Serve as a liaison between home and school to assist with communication.
10) Assist in screenings for school as needed.
As a Partner to Families
1) Help plan and facilitate parent trainings and workshops.
2) Collect data to complete entering information for service to families.
3) Communicate the need for health services and support the receiving of health services
(including dental and mental health).
4) Meet with parents for pre-registration.
5) Make the first home visit to include the Family Partnership Agreement .
6) Make additional home visits as needed to continue to provide support for families.
7) Connect with parents on school-planned field trips and at school programs.
As a Partner in the Community
1) Connect families as needed to services in the community.
2) Provide service to support the continuation of community partnerships and preschool service plans.
3) Serve on agency boards and committees.
As the Parent Trainer for Governance and Policy Council
As the Data Entry Person for Health, Mental Health and Family Service Notes as Dictated by the
Child and Family Services Coordinator or the FSA’s direct Supervisor
As the liaison for families in the schools and in communities
Revised July 2011 110
The Family Service Advocate Role in Family Partnership Planning
During the summer months and until mid-October, Family Service Advocates complete initial home visits with each family. During the initial home visit FSA’s complete a Family Partnership
Agreement/Family Partnership Plan with the family. This document is entitled “Helping Hands”, and it is used to assess the overall needs of the family. The
“Helping Hands”
document is included after this section. The Family Partnership Plan is part of our comprehensive services model and serves to ensure that family needs are accurately assessed in order to better serve families regarding of mental health, nutrition, education, medical/dental needs, and goal setting. Family Service Advocates will complete additional home visits throughout the school year on an as-needed basis. Regular telephone communication with each family is also documented in ChildPlus.
Revised July 2011 111
School-Based Preschool Network
6 John Lewis Road, Fishersville, VA 22939 Phone: 540-245-5162 Fax: 540-245-5064
Service Area: Augusta, Bath, Harrisonburg, Highland, Elkton Elementary, Staunton, & Waynesboro
Placement/Funding Partners: Head Start, Virginia Preschool Initiative, Title I, & Special Education
Helping Hands/Manos Auxiliarías
Forming Family Partnerships in Preschool Education
Formando las Asociaciones Familiares en la Educación Preescolar
Regional School Based Preschool Network Family Assessment
Asesoría Familiar de La Red Preescolar Basada por La Escuela Regional
Preschool Child’s Name: _____________________________ Child’s Preferred Name: ________________
Nombre de Niño Preescolar Nombre Preferido por El Niño
Primary Adult _______________________________ Relationship to Child____________________________________
Adulto Primario Parentesco al Niño
Are you employed?
Yes No Employer _______________ Schedule ____________ Education Level ________
¿Tiene usted empleo?
Si No Empleador Horario Nivel de Educación
Secondary Adult ____________________________ Relationship to Child_____________________________________
Adulto Secundario Parentesco al Niño
Are you employed?
Yes No Employer _______________ Schedule ____________ Education Level ________
¿Tiene usted empleo?
Si No Empleador Horario Nivel de Educación
Other Adults living in the home age 18 and over / Otros Adultos viviendo en la casa que tienen 18 años o más
Name ______________________________________ Relationship to Child ___________________________________
Nombre Parentesco al Niño
Name ______________________________________ Relationship to Child ___________________________________
Nombre Parentesco al Niño
Name ______________________________________ Relationship to Child ___________________________________
Nombre Parentesco al Niño
Adult Not in Home who maintains custodial rights
*FSA will be responsible for obtaining demographic information in box one.
Adulto en Casa quien mantiene derechos custodiales *
FSA será responsable de obtener información demográfica en la caja uno
Name _____________________________________ Relationship to Child _____________________________________
Nombre Parentesco al Niño
Is There A Court Order In Place? Yes No Do They Share Custody? Yes No Frequency of Visitation __________________
¿Hay un orden de custodia en efecto? Si No ¿ Ellos comparten la custodia? Si No La frecuencia de la Visitación
Address: ______________________________________________________________ Phone ________________________
Dirección Teléfono
Other Children living in the home under the age of 18/ Otros Niños viviendo en la casa que tienen menos de 18 años
Name_________________________________ Relationship to Child _______________Age/Grade _________
Nombre Parentesco al Niño Año/Grado
Name_________________________________ Relationship to Child _______________Age/Grade _________
Nombre Parentesco al Niño Año/Grado
Name_________________________________ Relationship to Child _______________Age/Grade _________
Nombre Parentesco al Niño Año/Grado
Adult Education/La Educación Adulta
Are you enrolled in any of the following? ¿Usted se matriculó en cualquiera del siguiente?
_____GED/DEG (Diploma de Educación General) _____ 2 yr. college/ Universidad de 2 año_____4 yr. college/ Universidad de 4 año
_____Vocational Education / Educación Vocacional _____Literacy Education / Educación de lectura y escritura
Comments/Comentarios: _________________________________________________________________________________________
For Speakers of Other Languages/Para Hablantes de Otros Idiomas:
Are you currently taking classes to learn English ? ¿Usted está tomando actualmente clases en Inglés ?
_____No _____Yes / Si Comments/Comentarios: _________________________________________________________
Is there an English speaking contact person for your family? Who?
¿Hay una persona de contacto para su familia quien se habla Inglés ? ¿Quién?
Name: ___________________________ Phone: _____________________________ ___________________________________
Nombre Teléfono
Medical & Dental Care/Cuidado Médico y Dental
Does your preschooler have a regular medical provider? / ¿Tiene su niño preescolar un proveedor medico ?
_____No _____Yes / Si Comments/Comentarios: _________________________________________________________
Does your preschooler have a regular dental provider? / ¿Tiene su niño preescolar un proveedor dental ?
_____No _____Yes / Si Comments/ Comentarios __________________________________________________________
Does your preschooler have health insurance? / ¿Tiene su niño preescolar seguro medico?
_____Medicaid _____Private / Privado _____None/ Nada
Comments/Comentarios: _________________________________________________________________________________________
Do you have health insurance?/ ¿Tiene usted seguro medico?
_____No _____Yes / Si Comments/Comentarios: _________________________________________________________
Do you or any of your immediate family members have any health concerns that you want more information about?
¿Tiene usted u otros miembros familiares preocupaciones de salud a que desean tener más información?
______________________________________________________________________________________________________________
Mental Health & Wellness/Salud Mental y Bien Estar
Are you or any family members currently in counseling or therapy ?
¿Está usted u otros miembros de la familia actualmente en tratamiento de terapia o aconsejaría ?
_____No _____Yes / Si Comments/Comentarios: _____________________________________________________
Are you or any of your immediate family members receiving treatment for drug or alcohol dependence ?
¿Está usted u otros miembros de la familia recibiendo actualmente tratamiento para la dependencia en las drogas o el alcohol?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
Are you or any of your immediate family members receiving services related to domestic violence ?
¿Está usted u otros miembros de la familia recibiendo servicios relacionados a la violencia domestica ?
Comments/Comentarios: ______________________________________________________ _____No _____Yes / Si
Parenting/Siendo Padres
Are you currently participating in parenting classes ?
¿Está participando usted actualmente en clases del cuidado de niños para los padres ?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
Have you been awarded child support OR have you been court-ordered to pay child support ?
¿Está recibiendo usted pago de manutención de hijos O
ha sido usted ordenado tribualmente de pagar manutención de hijos
?
_____No _____Yes / Si _____N/A Comments/Comentarios: _________________________________________________
If yes, are you receiving your monthly payment OR are you paying your monthly payment ?
¿Si la repuesta es si, está usted recibiendo su mensualidad O está usted pagando su mensualidad ?
_____No _____Yes /Si _____N/A Comments/Comentarios: _________________________________________________
If no, would you like more information regarding child support?
¿Si no, usted desea tener más información sobre la manutención de hijos?
_____N/A Comments/Comentarios: _________________________________________________ _____No _____Yes/Si
Relationships/Parentescos
Are you participating in marriage education ? / ¿Está usted participando actualmente en la educación marital?
_____No _____Yes / Si _____N/A Comments/Comentarios: _________________________________________________
Does your child have any family members who are incarcerated ? / ¿Su hijo tiene miembros de la familia que están encarcelados ?
_____No _____Yes / Si Comments/Comentarios: _________________________________________________
If yes, are you receiving the help and information you need? /
¿Si la repuesta es si, está usted recibiendo la ayuda y información que necesita?
Comments/Comentarios: _________________________________________________ _____No
Housing/Refugio
_____Yes / Si
Are you currently receiving housing assistance ? ¿Está usted recibiendo actualmente ayuda de refugio ?
_____No _____Yes Comments/Comentarios: _____________________________________________________
Are you currently receiving energy and fuel assistance ? ¿Está usted recibiendo actualmente ayuda de energía y combustible ?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
Transportation/Transportación
Do you have a valid driver’s license
? ¿Tiene usted una licencia de manejar valida ?
_____No _____Yes / Si Comments: _________________________________________________________
Do you have dependable transportation ? ¿Tiene usted transporte fiable ?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
Disabilities/Special Needs/ Incapacidades/Necesidades Especiales
Do any of your children have a disability/special need ? ¿Tiene cualquiera de sus niños una incapacidad / necesidad especial ?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
If so, how does this disability/special need affect your family?
¿Si eso es el caso, como se ha afectada esa incapacidad / necesidad especial a su familia?
Comments/Comentarios: _________________________________________________________________________________________
Do you have any support from outside the home such as respite care (for time alone with your spouse)?
¿Usted tiene algún apoyo afuera de casa como cuidado respiro (para pasar tiempo solo con su esposo)?
_____No _____Yes /Si Comments/Comentarios: ______________________________________________________
If not, would you like more information on respite care? / ¿Si no, usted desea tener más información sobre cuidado respiro?
_____No _____Yes / Si Comments/Comentarios: ______________________________________________________
Other Community Services/Otros Servicios Comunitarios
What services are you currently receiving ? / ¿Cuáles son los servicios que usted actualmente está recibiendo ?
_____Food Stamps / Estampías de Alimento _____Childcare Assistance / Ayuda para el Cuidado de Niño
_____TANF _____WIC _____ SSI Comments/Comentarios: __________________________________________________
Do you need information about local options to assist with food ? /
¿Usted se requiere información sobre opciones locales para ayudar con alimento ?
_____No _____Yes/Si Immediate Need? / ¿Necesidad Inmediata? _____
Comments/Comentarios: _________________________________________________________________________________________
Do you need information about local options to assist with clothing ?
¿Usted se requiere información sobre opciones locales para ayudar con ropa ?
_____No _____Yes /Si Immediate Need?/ ¿Necesidad Inmediata? _____
Comments/Comentarios: __________________________________________________________________________________________
Are you a
_____No registered voter ? / ¿Usted es
_____Yes /Si un votante registrado ?
If no, are you eligible to register ? / ¿Si no, tiene usted derecho votar ?
_____No _____Yes /Si Comments/Comentarios: _____________________________________________________________
We often send home written information in the weekly folder/book bag. Is this an effective way to communicate with you?
¿A menudo, nosotros enviamos información escrito a casa en la mochila / bolsa semanalmente. ¿Esto es una manera efectivo para comunicarnos con usted?
_____No _____Yes /Si Preferred language / Lenguaje Preferido: __________
Comments/Comentarios: __________________________________________________________________________________________
Are you receiving services from another community agency ? / ¿Está usted recibiendo servicios por otra agencia comunitaria ?
_____No _____Yes /Si Agency / Agencia: ____________________________________________________________________
Case Manager Name and Contact Info / Nombre del Director del Caso y información de contacto:________________________________
Is release of information required? If so, has this been obtained?___________________________________________________________
¿Se requiere autorización para compartir información? ¿Si es así, ha sido obtenida?
Regional School Based Preschool Network Family Assessment
Asesoría Familiar de La Red Preescolar Basada por La Escuela Regional
What are some activities that your family does together? What interests does your preschool child have?
¿Cuales son algunas actividades que su familia le gusta hacer juntas? ¿Cuáles son los intereses que tiene su niño preescolar?
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
What are some things that you like most or are most proud of about your family?
¿Cuáles son las cosas que usted le gusta más o esta más orgulloso/a acerca de su familia?
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
What are some things that you like most or are most proud of about yourself?
¿Cuáles son las cosas que usted le gusta más o esta más orgulloso/a acerca de usted mismo/a?
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
What are some of your greatest concerns/difficulties for your family right now?
¿Cuáles son las preocupaciones/dificultades más grandes para su familia en este momento?
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
What are the needs of your family that we have not yet discussed? Do you have any other comments or questions?
¿Cuáles son las necesidades de su familia que todavía no hemos discutido? ¿Usted tiene otros comentarios o algunas preguntas?
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Non-Discrimination Notice
The Augusta County School Board does not discriminate on the basis of race, color, national origin, religion, age, disability, or gender in its programs and activities. The following persons have been designated to handle inquiries regarding non-discrimination policies:
La Tabla de la Escuela del Condado de Augusta no discrimina por carrera, por el color, por origen nacional, por la religión, por la edad, por la incapacidad, ni por el género en sus programas y actividades. Las personas siguientes han sido designadas a manejar indagaciones con respecto a políticas de no discriminación:
Title IX Coordinator Section 504 Coordinator
Dr. Eric Bond Mr. George R. Earhart
Assistant Superintendent for Operations Assistant Superintendent for Administration
6 John Lewis Rd. 6 John Lewis Rd.
Fishersville, VA 22939 Fishersville, VA 22939
(540) 245-5100 (540) 245-5100
Regional School Based Preschool Network Family Partnership Agreement
In the space below, and with the assistance of your Family Service Advocate, please create at least one goal for your family for the upcoming school year.
En el espacio abajo, y en colaboración con su trabajador de servicios a la familia, por favor desarrolle por lo menos una meta para su familia para el próximo año escolar.
GOAL: META:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________
Objective objectivo
Person Responsible
Persona encargada
Time Frame
Plazo de tiempo
Status progreso
Key:
Clave:
P = Parent/padre
FSA = Family Service
Advocate/trabajador
CP = Community Partner
Agencia comunitaria
C = Complete/ logrado
PN = Pending/ por terminar
IP = In Process/
en proceso
NA = No Activity/ no acción
Notes/ comentario :
All information shared with the Family Service Advocate will be kept strictly confidential within the School-Based Preschool Network unless you authorize the release of this information in writing.
Toda la información compartida con el Trabajador de Servicios a la Familia será mantenido confidencial entre el personal del Red Preescolar de las escuelas públicas amenos que usted autorice por escrito el intercambio de información.
________________________________________________ _______________________________________________
Parent/Guardian Name nombre de padre de familia Parent/Guardian Signature firma de padre de familia
________________________________________________
FSA Signature firma de Trabajador de Servicios
___________________________________
Date fecha
The Role of the Family Service Advocate in Preschool
Family Service Advocates (FSAs) are important resources for the schools and the families of our preschool children. They play a vital role in building partnerships, facilitating communication, and assisting families as the children transition into the school environment. Family Service Advocates support and connect our families to the services they need while providing them with opportunities to positively relate to their children’s learning during the first years in school.
The following information is intended to help define the responsibilities and duties of the Family
Service Advocate in your school.
A Family Service Advocate does…
Ensure that families are fully informed about program requirements and collects required preschool paperwork such as dentals, physicals, immunizations, and school registration documentation.
Assist as needed in the completion of forms required for school registration and school attendance.
Assess the needs that a family may have such as transportation, clothing, food, housing, and other information outlined in the Family
Partnership Plan.
Come to the classrooms a minimum of once per week to see the children’s interactions in the classroom environment.
Communicate appropriately with the teacher or the principal about the needs of a child or family.
Document events that reflect the service provided to children and families.
Connect families with community resources as needed and/or as requested by the families.
Follow-up on requests from the school for communication with the family.
Provide transportation when needed to secure health and mental health care.
Provide transportation for school conferences, team or committee meetings, and governance meetings as needed.
Attend special education meetings as needed or by parent request.
Work with families in the home and the community in order to establish partnerships and connect with other service providers.
Act as a liaison between the teacher, principal, or other school staff and the family.
Know specific policies and procedures that are unique to their school or school division, and helps families become familiar with those procedures.
A Family Service Advocate does not…
Place children for enrollment in the preschool classrooms or make withdrawal decisions.
Construct school files or academic folders.
Take sick children home from school.
Spend time in the classroom in order to assist in teaching or providing coverage for staff.
Assess academic performance or enter educational observations of children’s academic performance into the program database.
Evaluate teacher performance.
Engage in inappropriate conversation concerning confidential issues.
Solicit information about families without their knowledge or their permission.
Exchange health or mental health information about a child or family without the families’ consent.
Arrange for students to receive counseling from school guidance or school psychology staff.
Decide if a child needs to go home from school.
Decide on his or her own when a Family Fun
Event or other classroom activity will occur or how parents will be notified of the event.
Decide whether or not a child meets special education eligibility requirements.
Create behavioral plans for children in the classroom.
Insist that families participate in events or community services that they are not interested in receiving.
Instruct teaching staff in regard to the curriculum.
Send home communication to families in the weekly folders without making teachers aware of the information.
Revised July 2011 118
Calendar of Events for FSA’s
June
PIR documentation for closeout
End of Year Closeout
Registration for fall enrollees
*Collection of enrollment documents
July
Registration for fall enrollees
Initial FSA Home visits begin
*Collection of enrollment documents
August
Initial FSA Home visits
Orientations (these are the first Parent
Center Meetings)
Hearing & Vision Screenings may begin
*Collection of enrollment documents
September
Initial FSA Home visits
Hearing & Vision Screenings
Follow-up on missing medical information (and other enrollment documents)
DPT Training/Policy Council Elections
October
FSA Home visits are concluding
Self-Assessment kick-off
Family and Community Partnership
Committee Meeting (includes Parent
Involvement)
Parent Center Meetings/Parent
Trainings during Family Fun Events
(Male Involvement Focus in October)
November
Continue Self-Assessment
Child Development, Health & Safety
Committee Meeting
DPT Meetings
December
Continue Self-Assessment
Parent Center Meetings/Parent
Trainings during Family Fun Events
January
Meeting with Consultant to plan goals
(CQI)HS funded FSA’s only
DPT Meetings
February
Parent Center Meetings/Parent
Trainings during Family Fun Events
March
Recruitment
DPT Meetings
April
Kindergarten Transition
Parent Center Meetings/Parent
Trainings during Family Fun Events
May
Acceptance packets sent to fall enrollees
DPT Meetings
Revised July 2011 119
Family Partnership Board Checklist
One of the Instructional Aide
’s responsibilities is to work with the FSA to create this board and keep it current and relevant to families’ needs.
Parent Board is in a location where parents can see and review materials.
The parent board is required based on program standards. It should include the following:
____ Welcome sign
____ Ideas or choices for volunteering
____ Policy Council dates and minutes
____ Center Meeting/Family Fun Event dates and minutes
____ Criteria for selection
____ Job openings within preschool
____ Education and training information
____ Volunteer calendar
____ Lesson plans
____ Volunteer Standards of Conduct and Confidentiality
____ Any other appropriate information
Revised July 2011 120
**Teachers, please post the following:
Parents:
Throughout the year you are encouraged to apply for teaching assistant openings in preschool.
For an employment application call
245-5162 ext. 110.
We also encourage you to consider becoming a substitute teacher. Please see the school principal for more information on becoming a substitute.
121 Revised July 2011
Volunteering in the Classroom
Volunteer Recruitment:
Parents and family members can be recruited as follows:
At home visits, parent conferences, and orientations, teachers should emphasize the value and necessity of participating in the classroom. Parents can volunteer in and out of the classroom.
The Volunteer Calendar should be sent home monthly and posted on the classroom parent board.
Volunteering Process:
Teachers should develop a regular routine for volunteers when they arrive. For example, volunteers can be instructed to sign in at the front office, obtain a school volunteer badge, and then sign-in once
entering the classroom using the Volunteer Sign-In Sheet . On the first day a person volunteers, the
instructional assistant should guide the volunteer through this routine and show them the location of restrooms. Teachers will also cover applicable school rules concerning parking, no smoking,
volunteer who has not completed a Volunteer Standards and Confidentiality form must do so prior to volunteering in or out of the classroom. Volunteers who participate in the classroom weekly will need a tuberculin screening.
It is the Instructional
Secretary’s responsibility to enter information into the preschool database concerning volunteer name and other identifying information.
It is the FSA ’s responsibility to enter information in the preschool database concerning parents who volunteer in the classroom and in what capacity.
Teachers will submit their Volunteer Sign-In Sheets once a month to the Instructional
Secretary for documentation.
Volunteers will also be discussed when completing the Team Communication Meeting form .
Revised July 2011 122
Preschool Volunteer Calendar
Classroom______________________________ Month_______________
Monday Tuesday Wednesday Thursday Friday
Aula:
Teacher's Signature:
Date/ Fecha
Classroom:
Firma de Maestra/o:
School-Based Preschool Network Volunteer Sign-In Sheet
Print Name/ Imprimar Nombre
Month/Year:
Mes/Año:
Code/ Codigo
First Time Volunteering?/ ¿Voluntando por la Primera Vez?
CODES: P = Parent or Guardian/ Padre o Guardia C = Community Person/ Persona de la Comunidad
CODIGOS: NP = Non-parent (For example: relative or friend of the family)/ No-Padre (Por ejemplo: pariente o amigo de la familia
PLEASE WRITE LEGIBLY SO THAT WE CAN DOCUMENT YOUR ATTENDANCE.
FAVOR DE ESCRIBIR LEGIBLEMENTE PARA QUE PODAMOS DOCUMENTAR A SU ASISTENCIA.
Volunteer Standards of Conduct & Confidentiality Agreement
Regulations require that all staff/employees, consultants, and program volunteers abide by the following Standards of Conduct while in relation to school or schoolsponsored activities.
The Standards of Conduct are:
1. To respect and promote the unique identity of each child and family and refrain from stereotyping on the basis of gender, race, ethnicity, culture, religion or disability.
2. To follow school confidentiality policies concerning information about children, families, volunteers, consultants and other staff members.
3. No child will be left alone or unsupervised while under their care.
4. Will use positive methods of child guidance and will not engage in corporal punishment (spanking), emotional or physical abuse or humiliation.
While visiting or volunteering at school, you must follow the following guidelines as well:
5. Follow school policies & rules.
6. Sign in and out at the front office.
7. Follow the school dress code to model modesty (such as no short shorts, no spaghetti straps, no tops that bare the midriff, no visible undergarments, and no clothing with inappropriate messages).
8. Do not bring siblings or other children into the classroom while volunteering
9. If you have scheduled to volunteer, please arrive on time or notify the teacher of changes.
10. A Tuberculosis screening will be required if you are a regularly scheduled volunteer (if you volunteer on a weekly basis). This is available at the local Health
Department or a doctor’s office.
Please note: Individuals convicted of child abuse, sexual abuse or violent crimes may not volunteer in the preschool classroom and may visit the school only as permitted by law.
A signature acknowledges the individual’s awareness of the conduct required for any and all participation in the preschool classroom.
Preschooler
’s name:
______________________ Classroom: _________________
Parent Signature: ______________________________ Date: _____________
Witness: ______________________________________ Date: _____________
Voluntario Criterios de Conducta & Acuerdo de
Confidencialidad
Las reglas requieren que todos los empleados, consultores y voluntarios del programa, sigan los Criterios de Conducta con relación a la escuela y a las actividades de la misma.
Los Criterios de Conducta son:
1. Respetar y promocionar la identidad
única de cada niño y su familia, abstenerse de los esteriotipos de sexo, raza, etnicidad, cultura, religión o incapacidad física o mental.
2. Seguir las políticas de confidencialidad de la escuela concernientes a información acerca de niños, familias, voluntarios, consultores, y staff.
3. No se permite dejar a los niños solos o sin supervisión.
4. Se utilizaran métodos positivos para guiar la conducta y no se utilizaran castigos corporales, emocionales o psicológicos.
5. No se permite utilizar métodos de castigo que impliquen aislamiento, o la privación de las necesidades básicas, ni utilizar la comida como recompensa.
Adicional a estos criterios de conducta, los voluntarios tienen que seguir las siguientes reglas:
6. Cumplir las políticas de la escuela y sus estatutos.
7. No se permite llevar otros niños a las clases.
8. Si un voluntario está programado para trabajar, el/ella asistirá o de lo contrario informará al maestro con anticipación para realizar los cambios correspondientes.
9. Personas con antecedentes de abuso de niños, acoso sexual o crímenes violentos, no podrán trabajar en la clase de Preescolar y pueden visitar a la escuela solamente bajo condiciones permitidas por la ley.
10. Será requerida una prueba de Tuberculosis para los voluntarios regulares (está se encuentra disponible en el departamento de salud local o en un consultorio particular.)
Acepto y comprendo los criterios de conducta para la participación en la clase de
Preescolar.
Nombre de Estudiante: ______________________ Clase: _________________
Nombre de Padre/Guardián: ____________________________________
Firma: _____________________________________
Testigo: ____________________________________ Fecha: _____________
Home Visits and Parent/Teacher Conferences
Education Staff:
The teacher and teacher assistant are to conduct two home visits and two in-school conferences with parents each year. The schedule and content of the in-school and home conferences should be as follows:
August/September (or when child enrolls): In-school parent / teacher conference
Introduce yourself and share some information about an average day for the children in the program.
Discuss what the child will learn in preschool.
Share a list of the items a child should be bringing to school.
Discuss In-Kind and why we need it. Provide a list of opportunities for parents to help by donating items or volunteering in the classroom or at the center.
Review and score Ages and Stages.
Give Results of Screening letter.
Hand out and discuss: Parent Guide to Preschool booklet
Complete Parent Signature Page for this conference
October/November: First Home Visit
Discuss the initial developmental screening of their child (if not completed at the August/Sept. conference).
Provide and discuss the TSG Child Progress Report. If needed discuss activities in the classroom and how their child’s development will be monitored during the year.
Discuss individualization plans and solicit ideas from the parents for activities the child might enjoy in school.
Offer information on health and dental care and give suggestions to the parent for activities to try at home that will reinforce what you are doing in the classroom.
Invite the parent’s participation in the program. Provide a list of volunteer or in-kind opportunities.
Share child’s portfolio
Provide PALS Pre-K fall letter to parent
Complete Parent Signature Page for this home visit
February: Second Home Visit
Complete transition conferences for children who are changing classrooms or going into kindergarten.
Provide and discuss TSG Child Progress Report. If needed discuss activities in the classroom and how their child’s development will be monitored during the year
Discuss child’s progress in the classroom.
Solicit ideas for individualization in the classroom.
Share ideas for activities at home.
Revised July 2011 127
Remind parents of ways they can be involved in their child’s education.
Share child’s portfolio.
Complete Parent Signature Page for this conference
May: Second Parent/Teacher Conference
This is a conference in the classroom.
If the child is going to kindergarten, confirm that she/he has registered.
Offer parents ideas for working with their child over the summer.
Offer any wrap-up information about the child’s year.
Provide PreK PALS spring letter to parent.
Provide and discuss TSG Child Progress Report
Review child record and document on Parent Signature Page.
Parent/Guardians will receive all work samples.
Any additional home visits are coordinated to support the partnership between family and program staff. Home visits are scheduled at times that are mutually convenient for the parents or primary caregivers and staff. In cases where the parents request the visit to be conducted outside of the home or if the home situation presents a significant safety hazard for the staff, the home visit may take place in another location.
Remember to invite special education service providers if appropriate.
Family Fun Event
Purpose:
Family Fun Events are opportunities for family members to come to school and participate in special events that the children are part of based on what the children have been learning (i.e. a themebased activity). These events should include opportunities for parent/child interaction. These events do not have to be large and elaborate productions, but should focus on the parent/child enjoying the educational program. Field trips may be considered Family Fun Events, but these events must involve having an intentional parent/child activity (i.e. making crafts together). Each time your classroom sponsors a Family Fun Event, talk about the importance of volunteering and being involved.
Responsibility and Cost:
The teacher will be responsible for the child-based activity. The Family Service Advocates may help to coordinate the communication with home regarding these events. The funding for these events comes out of the classroom supply money for each individual classroom.
Revised July 2011 128
Schedule:
Family Fun Events will take place a minimum of four times a year, not to begin before October.
Family Fun Events should occur during the months of October, December, February and April. The
Family Service Advocate will conduct a Center Meeting in conjunction with the Family Fun Event.
Other Considerations:
Siblings of preschool students are not allowed to attend Family Fun Events during school hours.
However, if a Family Fun Event occurs after school, sibling attendance is permissible. No more than one of the four required Family Fun Events can occur outside of normal school hours. Preschool participation in school-wide events is encouraged but does not take the place of regularly scheduled
Family Fun Events.
Please use the Volunteer Sign-In sheet for all Family Fun Events. Remember to advise parents to sign-in at the front office as well so that they can obtain their volunteer badge.
Storybook Bags
Purpose
The purpose of the Storybook Bags are to provide a high interest story to be read to the children by a significant adult in their home to promote the importance of reading. The suggested activities come from the story and act as a way to build emerging literacy skills. The storybook bags involve parents directly in classroom curriculum as a way to promote partnerships between home and preschool.
Storybook Bags should be in your classroom in a box or crate. Contents from below are kept in individual large zip lock bags.
Contents
Storybook
Directions for parents
Sheet with different activities that can be done with parent and child after the book has been read.
These Storybook Bags should be explained in depth to the parents. This may take place at a class meeting (center meeting) or individually. The intent is that the bags would be sent home once a week. It seems best to send the bags home on the same day for each child. For example; same four children on Monday, four on Tuesday, four on Wednesday, and four on Thursday. This way the parents will be expecting them on the same day each week. It is up to you if the parents keep the bag one or two nights. It is not recommended to send the bags home over the weekend. One way to keep track of which children took which book is to make a big chart with the titles across the top and children’s names down the side.
The book bags should be checked when returned to the classroom to make sure all materials that are not consumable have been returned. This may be done by a volunteer, teaching assistant or teacher.
Revised July 2011 129
When the children return the storybook bag there is a sheet for them to do a simple
“book report”.
This is a great way to monitor their language development, memory, etc.
The Storybook Bags should begin to be sent home as soon as possible after the opening of school.
Storybook supply replacements may be purchased with classroom supply money. If a book is missing, the teacher may make a replacement bag from a book in the classroom.
Writing on the Run
Writing on the Run connects written expression from school to home. By writing at school and at home, children will begin to understand that writing is a way of communicating for a variety of purposes.
Parents will see children progress from using scribbles, shapes, or pictures to represent ideas, to using letter like symbols, to copying or writing familiar words such as their name. Children will also begin to represent stories and experiences through pictures, dictation, and play.
Writing on the Run provides:
Children with opportunities to write independently
Tools and Materials needed for writing
Basic materials for Writing on the Run are listed below. Teachers may rotate or supplement materials to meet the needs of the children. Supplies will be bought with classroom money.
Supplies may be kept in a brief case or book bag.
Things to Write On
Stationary
Plain colored paper
Notepads without lines
Receipts
Post-it Notes
Ready -made books
Textured Paper
Theme Shaped Paper
Things To Write With
Markers (Large And Small)
Pencils (Large And Small)
Colored Pencils
Crayons
Ball Point Pens
Alphabet Stamps
Gel Pens
Wallpaper Samples
Accessories
Envelopes
Tape
Ruler
Stampers
Hole Punch
Alphabet Chart In Block Letters
Scissors
Theme Word Cards
Revised July 2011 130
Transition to and from
Preschool
Revised July 2011 131
Table of Contents
Instructions for Registering Students (After School Year Starts) ....................... 134
Transition Plan Out of Preschool and into Kindergarten ..................................... 135
Revised July 2011 132
Two Ways to Begin School
Entering on the first day of school
Summer Enrollment
–
During the summer (specific dates per school division), parents meet with the
FSA’s to complete school and program registration. At that time they will receive the ASQ and
ASQ: SE, optional supply list, calendar of Fridays when children do not attend, and emergency care card. Needed information will be returned before school starts.
For children entering after school has started for the year
1. Child is accepted into preschool program per Enrollment criteria for selection.
2. After a child is accepted through the Enrollment office the Family Service Advocate will contact the family about registration requirements. The teacher and principal where the child has been accepted will be notified when registration is complete.
3. If the family accepts the spot the FSA arranges to meet the family at the school, intake center, or home visit to conduct registration and orientation meeting. This includes the emergency care card and school data form. (Within five days of being notified child is accepted.) See page nine for more information.
4. Transportation for children is arranged per your division’s procedures.
5. Once the emergency care card is given to the teacher, the teacher will give the emergency care card to the office. The school nurse will notify all appropriate personnel regarding any medical needs of a child.
6. Children entering after school begins will come to the classroom for a transition visit. The teacher and the Family Service Advocate will arrange the details for this visit together. The teacher will schedule a parent conference for 2 weeks after the child’s start date in which the screening will be scored and discussed.
7. The child will begin school within five days of completed registration.
8. Teacher will email preschool office the date the child enrolls.
9. All registration information will be taken to the appropriate school by the end of the first week of
August.
Revised July 2011 133
Instructions for Registering Students after the School Year Starts
The Family Service Advocate who is assigned to the classroom will:
*Receive the application folder from the Enrollment Staff and call a parent
….
1) To confirm that the child will be attending.
2) To schedule a first visit/meeting within 5 days.
*Facilitate this first visit/meeting with the parent in order to ….
Collect the following information:
Record and initial the following on the school registration form:
Birth Certificate Number
Social Security Number
Collect the following information:
Physical form
Dental form
(All forms except the Dental form is required by the school system before a child can begin attending preschool.)
Have the family complete the following information:
ASQ/ASQ SE (return to classroom)
Emergency Care Information
School Registration Form
Parent Interest Questionnaire
Transportation Contract and Request
Transportation Training
Free or Reduced Lunch form (if applicable)
The release forms from the divisions’ student handbook
Schedule the transition/classroom orientation visit for the family to come to the classroom prior to the child’s first day in attendance.
*Give the forms to the school or program staff that needs them.
Revised July 2011 134
Transition Plan Out of Preschool and into Kindergarten
Teachers will discuss each child’s progress with their parent at the winter home visit.
Celebrations and concerns will be addressed, and together they will develop strategies for helping the child to prepare for the transition to kindergarten.
Parents will be given the registration date and guidance for kindergarten registration specific to each division. Parents play an active role by taking responsibility for registering and providing requested documents.
Families will be provided with transition to kindergarten information and materials. In the spring, a
Transition Workshop will be held for parent to attend. The FSA will be providing parents with this information.
Parents should be encouraged to attend their home school kindergarten open house.
Elementary school principals, kindergarten teachers, or other staff (as appropriate) will be invited to visit the classroom.
Preschool children will visit a kindergarten classroom.
Preschool children will have an opportunity to eat lunch cafeteria style. Deleted rest of sentence
Individual Transition
A child may need an individual transition plan. This would be a child who requires more than the general classroom transition, in order to be successful in kindergarten. Division specific information should be utilized if necessary.
Revised July 2011 135
Policies
Revised July 2011 136
Table of Contents
Revised July 2011 137
Cell Phones
Preschool staff, parents and volunteers must have beepers and/or cell phones turned off and properly stored during the hours that children are in the classroom.
Instructional Television
Instructional television use should not be a regularly scheduled part of the day. The use of instructional television should have high educational value and be theme or movement related.
Appropriate objectives for what the children will learn should be written and reflected in the daily lesson plan.
Revised July 2011 138
Health and Safety
Revised July 2011 139
Table of Contents
Employee Medical/Emergency Care Information ................................................. 172
Revised July 2011 140
CPR and First Aid Training
All preschool teachers and instructional aides must have a current Pediatric CPR/First Aid certification. These classes will be offered through staff development or may be obtained through the
American Heart Association, Red Cross, fire department, or local hospitals. Each teacher and instructional aide is responsible for receiving this training as a condition of continued employment.
Safe Environments Checklist
This form is used by assigned Preschool staff to record observations regarding a number of health
and safety issues related to the performance standards. Feedback (oral and/or written) on the findings is given to the instructional staff through the onsite administrator or school division supervisor.
Observations are completed a minimum of once during the school year. Copies of the completed Safe Environments Checklists will be provided to the appropriate staff.
Revised July 2011 141
School Based Preschool
Safe Environments Checklist
Site
: __________________________
Date & Time
: _________________________________________
Observer
: __________________________
Staff Present
: ________________________________________
Other
: ______________________________________________
1
Safe Environments Checklist
Area #1: Classrooms
Infant/Toddler
1. Sanitation and hygiene procedures for diapering have been adopted that adequately protect the health and safety of children service by the program and staff.
Toileting Protocol for diapering should be posted in the bathroom.
2. The diaper-changing area is located away from areas used for cooking, eating, or children’s activities.
N/A
3. Diapers are disposed of in a safe and sanitary manner.
Diapers are disposed of in the following way: Soiled clothing and/or dirty diapers need to be double bagged in such a way that there is no leakage. Double-bagged diapers should then be placed into a trash can with a lid (see Toileting Protocol).
4. Infant sleeping arrangements use firm mattresses and avoid soft bedding materials such as comforters, pillows, fluffy blankets, or stuffed toys. N/A
5. Cribs are at least three feet apart from each other. N/A
6. Toys are made of non-toxic materials and are sanitized regularly.
Each classroom will have available a labeled bucket (“Germ Bucket”) for toys that children have put in their mouths. These toys will be sanitized weekly.
7. Toilet training equipment is available for children being toilet trained.
When the need arises, toileting equipment will be made available by contacting your Preschool Supervisor.
Yes No Not
Obs.
N/A
All Classrooms
1. Nonporous gloves must be used when dealing with bodily fluids.
Nonporous gloves should be used at all times when dealing with body fluids. Gloves should be stored in easily identified and accessible areas.
Examples: fanny pack, brightly colored container on cubbies or bathroom wall.
2. Staff promotes effective dental hygiene among children in conjunction with meals.
Children should brush their teeth after breakfast or lunch in a reasonable amount of time so that the children recognize the importance of brushing after meals.
Monitoring information is in Italics 2
3. Toys are stored in a "safe and orderly fashion" (e.g., in their assigned places, not out where people can trip over them).
Shelves and containers are labeled with pictures and words so that toys are stored in a safe and orderly fashion.
4. The indoor and outdoor space for infants and toddlers is separated from general walkways and areas used by preschoolers. N/A
5. Toys, materials, and furniture are safe, durable, and kept in good condition (e.g., materials free of sharp edges and loose pieces, balloons and/or plastic bags not used, no choking hazards).
Any toys or materials that are not safe will be removed from children's reach or activity areas immediately. Plastic bags must be kept out of children's reach at all times. Due to choking hazards, only mylar balloons can be used under adult supervision.
6. Center space is organized into functional areas that can be recognized by children and that allow for individual activities and social interactions.
Room is divided into centers according to the Creative Curriculum and are recognizable to children .
7. Staffing patterns support regulations regarding class size and number of adults per class.
Appropriate adult-child will be maintained at all times .
8. Staff, volunteers and children wash their hands with soap and running water after diapering or toilet use; before food-related activities; whenever hands are contaminated with blood or other bodily fluids; and after handling pets or other animals. Staff and volunteers also wash their hands with soap and running water before and after giving medications, before and after treating or bandaging a wound, and after assisting a child with toilet use.
Children and adults need to wash their hands with soap and water after toileting and before eating. If children do not go directly to the table after washing hands, then a dab of hand sanitizer should be used.
Notes: _________________________________________________________
______________________________________________________________
Yes No Not
Obs.
N/A
Area #2: Indoor Facilities
Sanitation/Hygiene
1. Facilities are available for the proper storage and handling of breast milk and formula. N/A
2. Bathroom facilities are clean, in good repair, and easily reached by children.
In buildings that have large commodes, stools will be available for children.
Monitoring information is in Italics 3
3. Bathroom facilities are separated from areas used for cooking, eating, or children’s activities. N/A.
4. Indoor and outdoor premises are cleaned daily and kept free of debris and hazardous materials and conditions.
School custodians will clean the rooms and playground daily. Classroom staff will scan the area to assure that it is safe for all children.
5. Garbage and trash are stored and disposed of in a safe, sanitary manner.
Custodian responsibility.
6. A utility sink is specifically used to clean potties.
Separate potties are not used .
Notes:____________________________________________________
_________________________________________________________
Safety
1. The facility has approved, working fire extinguishers and an appropriate number of smoke detectors and that are tested regularly.
This will be done by school custodial staff and verified by Preschool
Operations Manager or designee .
2. Windows and glass doors are constructed, adapted, or adjusted to prevent injury to children.
Preschool Operations Manager or designee monitors and informs maintenance if there is a concern.
3. Electrical plugs accessible to children are covered .
Electrical plugs accessible to children are kept covered at all times when not in use. This is the responsibility of the classroom staff.
4. The heating/cooling system is insulated to protect children and staff from potential burns. (Note: Look at pipes and/or radiators.)
Monitored by Preschool Operations Manager or designee.
5. There is an absence of highly flammable furnishings, decorations, or materials that emit toxic fumes.
Fire code calls for no wall being covered by paper more than 50% of the open space.
6. Flammable and other dangerous materials/poisons are stored in locked cabinets or facilities separate from medications and food and accessible only to authorized persons.
Any item labeled
“keep out of the reach of children” as well as bleach solution needs to be kept in a locked cabinet or locked desk when not being used by an adult. This cabinet needs to be free of food items.
Yes No Not
Obs.
N/A
Monitoring information is in Italics 4
7. Appropriate licenses (water/sewage, food/sanitation, fire codes, transportation, and vendor/contractor licenses) are posted so that parents can see them.
Food permit will be posted on the parent board in the classroom by the
Preschool Operations Manager or designee. Fire inspections will be kept on file with the Preschool Operations Manager or designee.
8. Paint coatings on both interior and exterior premises used for the care of children do not contain hazardous quantities of lead.
9. Only sources of water approved by the local or State health authority are used.
10. All sewage and liquid waste is disposed of through a locally approved sewer systems, and garbage and trash are stored in a safe and sanitary manner.
Notes:____________________________________________________
________________________________________________________
Facility Layout and Environment
1. If necessary, there is a safe and effective heating and cooling system.
The LEA maintains the heating and cooling system.
2. There is at least 35 sq. ft. of usable (i.e., not including bathrooms, halls, kitchen, staff rooms, and storage places) indoor space per child.
This is verified by the Preschool Operations Manager or designee during annual safety audit.
3. Facilities enable the safe and effective participation of children with disabilities.
LEA follows rules and regulations as established by IDEA, according to the year that the facility was built.
4. Rooms are well lit.
Rooms are well lit as verified by the Preschool Operations Manager or designee. Need for light bulb replacement should be communicated to the custodian by the instructional staff.
Notes:____________________________________________________
________________________________________________________
Provisions for Emergencies
1. Exits and/or evacuation routes are clearly marked.
Each classroom must have a poster depicting evacuation routes. Go to principal to get this information .
Yes No Not
Obs.
N/A
Monitoring information is in Italics 5
2. Emergency lighting is available.
If your school does not have emergency lighting system, you will need to have a working flashlight that you can locate immediately in your room.
Questions regarding emergency lighting should be directed to the school principal.
3. Emergency telephone numbers (e.g., EMS, fire, police, poison control) are posted.
Emergency telephone numbers are posted on the Emergency
Information Board. In case of emergency, you should follow your school policy.
4. Policies and plans of action for emergencies that require rapid response on the part of staff (e.g., a child choking) or immediate medical or dental attention are clearly posted.
Post your school policies and procedures for dealing with emergency situations on the Emergency Information Board. Posters on choking, dental, and first aid procedures need to be posted on the Emergency
Information Board. These posters will be provided.
5. A well-supplied first aid kit is available, accessible to staff, and out reach of children.
An approved first aid kit will be available in each classroom out of reach of children. This first aid kit must be taken on all field trips or outings away from the school. A list of approved items is located in the
Preschool Handbook. The first aid kit must be checked monthly. Items used should be replaced at that time. Fanny packs will be used by the classroom staff for emergency medication, Band-Aids, gloves, tissues, etc., in place of carrying the first aid bag around the school.
Notes:_______________________________________________________
___________________________________________________________
Medications Administration
1. All medications are properly labeled (i.e., name of child/staff, name of medication, dosage, name/number of pharmacy/physician).
All sites will follow the LEA’s policies and procedures for distribution of medication. In cases where following these policies and procedures is not feasible, additional policies and procedures will be developed.
2. Medications are under lock and key and out of reach of children.
Same as above.
3. Medications in need of refrigeration are refrigerated.
Same as above.
Notes:_______________________________________________________
___________________________________________________________
Yes No Not
Obs.
N/A
Monitoring information is in Italics 6
Area #3: Outdoors
1. There is at least 75 sq. ft. of usable outdoor space per child.
This is verified by the Preschool Operations Manager or designee and/or principal at the annual safety audit.
2. The playground equipment is in good repair and safe condition (e.g., adequately secured to the ground, free of sharp edges and/or splinters, soft falling surface).
Same as above.
3. The outdoor play area is arranged such that no child can leave the premises or go into unsafe or unsupervised areas.
Same as above.
Notes:_______________________________________________________
___________________________________________________________
Yes No Not
Obs.
N/A
Monitoring information is in Italics 7
Comments/Observations
Strengths:
Recommendations/Follow-Up:
8
Toileting Protocol —
bagged or placed into a red biohazard bag (if applicable). Recycled.
Posted in every classroom bathroom
1. Treat child with dignity, respect, and the right to privacy.
2. Gloves must be worn by the person helping to clean the child.
3. If needed, a mat may be used to make changing the diaper/pull-up easier. This mat can only be used for this purpose. It must be bleached after each use. Use the bleach solution (in the spray bottle that is made fresh daily with a 1:10 dilution).
4. After changing the diaper or pull-up, the child’s skin is then cleansed with baby wipes to remove any urine or stool.
5. The dirty diaper/pull-up, wipes used during cleaning the child, and soiled gloves must be double- plastic grocery bags are acceptable as long as there are no holes in the bags. There should be no leakage from the bags. Once items are placed into the bags, they should be placed into a trash can that has a plastic liner and a lid. Trash containing soiled items must be emptied daily by custodial staff.
6. If the child has soiled clothing, the child’s soiled clothes are changed. The soiled clothing items should be emptied and are placed in a double-bag as explained above, or they can be placed into a large Ziploc bag. All children need to have extra clean clothes on hand
– including socks and underwear that parents bring at the beginning of the school year. Students who do not have extra clothing may access the school clothes closet to obtain a clean set of clothes.
7. After the toileting procedure is finished, both the child and the adult need to thoroughly wash their hands.
8. Self-help skills need to be encouraged for each child during this process.
Revised July 2011 150
Emergency Info Bulletin Board
The following are mandatory items for use on the emergency information bulletin board:
Index card stating where the emergency care card copies are kept in the classroom (for example, top drawer of a file cabinet). The originals of the emergency care cards are kept in the school office.
First aid guide for school emergencies.
Dental emergency poster (the “pickle” poster).
Medical Emergency Plan with all blanks completed.
The phone number for the Blue Ridge Poison Center, which is 1-800-222-1222.
A choking poster with a pictorial of what to do in case a child starts to choke.
The Health Department food service certification for each school.
It is recommended that the emergency information bulletin board have a background that is red in color with gold metallic lettering. The items listed above may be obtained from the Child and Family
Services Coordinator. Every item on the bulletin board needs to be seen clearly and should not be overlapped with any other papers.
Revised July 2011 151
School-Based Preschool Medical Emergency Plan
PROCEDURE FOR EMERGENCY SITUATION
1. Remain calm and survey the scene. An adult should remain with the child at
all times.
2. Appoint an adult to notify the school office or call 9-1-1 for medical
assistance.
3. A phone is available (give location and directions):
______________________________________________________________________
4. Have child’s emergency care card available; it will be needed by hospital/emergency staff.
The child’s emergency care card may provide the only available parental consent for treatment.
The emergency care card must be taken to the hospital with the child .
Children’s emergency care cards are kept __________________________________________
The first aid bag(s) is kept ____________________________________________________
Emergency medicines are kept _________________________________________________
List of students with allergies & what to do are kept _________________________________
Emergency Information
Emergency Lighting is ____________________________________________________
If it is a flashlight, where is it kept? ____________________________________
Intercom, 2-way radio system, (or other):
What does this classroom have? _______________________________________
Where is it located? _________________________________________________
How is it operated? Be specific. ____________________________________________
______________________________________________________________________
______________________________________________________________________
EMERGENCY PHONE NUMBERS
Emergency 9-1-1
Poison Control: 1-800-222-1222
School Office phone number: _______________________
First Aid Kits
Classroom first aid kits need to have the following items:
Non-latex gloves* (2 pairs at least)
Bandage tape
Triangular or ace bandage
Small plastic or metal splints (finger)
Non-latex Band-aids*
Cotton ball, cotton swabs, or cotton squares*
Cold pack (once the instant cold pack is used, it must be replaced)
Gauze pads
Scissors
First aid text or guide
CPR pocket mask (in each first aid bag)
Kleenex and Ziploc bag (optional items, but very useful)
Copies of Emergency Care Cards
(*) These items should be obtained from the school nurse or clinic aide.
For quick access, the first aid text/guide and a copy of the emergency care cards must be kept in an easily accessible pocket of the first aid bag.
The first aid bags need to be kept out-of-reach of the children. A door knob or a low cubby is not outof-reach.
If the children and staff leave school property, then the first aid bag must be taken with them and must be carried by an adult. For children who receive medication at school and need it administered on a field trip, the teacher must meet with the school nurse or clinic aid to receive instruction. While the children are out of the classroom, but on school property, a fanny pack may be worn to carry gloves, tissues, and any other required prescription or emergency medications.
The instructional assistant will check the first aid bag monthly. Please record on the first aid form that an inventory check was done. When these forms are completed, they need to be filed in a folder and kept in the classroom.
Each first aid bag needs its own inventory checklist. First Aid supplies are also kept in the host school office/clinic.
If you are out of or low on a first aide item, please contact the school clinic, the preschool central office, or use supply money to purchase the items. If contacting preschool central office, please email
your requests for items to the Instructional Secretary. The First Aid Inventory checklist follows.
Revised July 2011 153
Site: _______________________
Year: _______________________ = Adequately Stocked
N
= Needed
First Aid Inventory
Checked Monthly by Instructional Assistant
Date
Bandage
Tape
Cold Pack
Cotton balls/ swabs/ squares
CPR Pocket
Mask
Emergency
Care Cards
First Aid
Guide
Gauze Pads
Non-latex
Band-aids
Non-Latex
Gloves
Scissors
Small plastic or metal splints
Triangular/A ce Bandage
The first aid bag needs to be kept out-of-reach of children. An adult needs to carry the first aid bag when outside of the classroom.
* Items will be replaced with classroom supply money or by the clinic.
Child Observation for Symptoms of Illness
This chart is used as a reference to determine whether or not to send a child to the school nurse/clinic aide. Teachers please follow your school policy regarding illness and short-term exclusion from the classroom.
Symptom Common Causes
Fever
Any viral, bacterial, or parasitic infection
Overheating
Reaction to medication
(i.e., vaccine, oral)
Revised July 2011
Complaints or What Might be Seen
Flushing, tired, irritable, decrease activity
Notes:
Fever alone is not harmful.
When a child has an infection, raising the body temperature is part of the body’s normal defense. The definition of a fever is the elevation of the body’s normal temperature (98.6 F or 37 C)
A fever is a temperature above 99.9 F orally. Other signs of fever may include: headache, reddened cheeks, glassy eyes, pale skin color and warm to the touch.
Notify
Health
Consultant
Notify
Parent
Temporarily Exclude?
If Excluded,
Readmit When?
YES No, unless:
Behavior change
Unable to participate
Care would compromise staff’s ability to care for other children.
Note: Temperatures considered meaningfully elevated above normal, leading to concern of possible disease, for children older than 4 months are:
100 F Axillary (armpit)
101 F Orally
102 F Rectally
Aural (ear) temperature equal to oral or rectal temperature
Get immediate medical attention when:
Infant younger than 4 months has an unexplained temperature of 101 F rectally or 100 F axillary. Any infant younger than 2 months with fever should get medical attention within an hour.
Able to participate
Exclusion criteria are resolved
155
Vomiting
Diarrhea
Cold
Almost any illness can cause a child to vomit including:
Usually viral, less commonly bacterial or parasitic
Viruses (Early stages of
Symptoms many viruses)
Adenovirus
Coxsackiervirus
Enterovirus
Revised July 2011 viruses, bacterial infections
Runny or stuffy nose
Scratchy throat
Coughing
Sneezing
Watery eyes
Fever
Frequent loose or watery stools compared to child’s normal pattern. (Note that exclusively breastfed infants normally have frequent unformed and somewhat watery stools, or may have several days with no stools.)
Abdominal cramps
Fever
Generally not feeling well
Sometimes accompanied by vomiting
Runny or stuffy nose
Scratchy throat
Coughing
Sneezing
Watery eyes
For one or more cases of bloody diarrhea or more than usual number of children with diarrhea in group
YES Yes, if:
Vomited more than 2 times in 24 hours
Vomiting and fever
Vomiting that appears green/bloody
No urine output in 8 hours
Recent history of head injury
Looks and acts very ill
YES Yes if:
Diarrhea not contained in toilet (All infants with diarrhea must be excluded)
After two times
Blood/mucus in stool
Abnormal color of stool for child (eg, all black or very pale)
No urine output in 8 hours
Jaundice (ie, yellow skin or eyes)
Fever with behavior change
Looks or acts very ill
Exclusion criteria are resolved.
by health
Cleared to return professional for all cases of bloody diarrhea and diarrhea caused by
Sigella,
Salmonella, or
Giardia.
Stool is contained in toilet (for toilettrained children)
Even if stools stay loose, the child is able to participate and the stool consistency has
YES No, unless:
Fever accompanied by behavior change
Child looks or acts very ill
Child has difficulty breathing not changed for a week
Exclusion criteria are resolved
156
Parainfluenza Virus
Respiratory Syncytial Virus
Rhinovirus
Coronavirus
Fever
Bacteria
Mycoplasma
Cough
Common cold
Lower respiratory infection
(eg, pneumonia, bronchitis)
Croup
Bronchiolitis
Asthma
Sinus infection
Dry or wet cough
Runny nose (clear, white, or yellow-green)
Sore throat
Throat irritation
Hoarse voice, barking cough
Diaper
Rash
Eye
Irritation
Pinkeye
Irritation by rubbing of diaper material against skin wet with urine or stool
Infection with yeast or bacteria
Bacterial infection of the membrane covering the eye and eyelid (bacterial conjunctivitis)
Viral infection of the membrane covering the eye and eyelid (viral conjunctivitis)
Allergic irritation of the membrane covering the eye and eyelid (irritant conjunctivitis) eg, swimming in heavily chlorinated water, air pollution
Redness
Scaling
Red bumps
Sores
Cracking of skin on diaper region
Pink color instead of whites of eyes and thick yellow/green discharge. May be irritated, swollen, or crusted in the morning.
Pinkish/red irritated swollen eyes; watery discharge; possible upper respiratory infection.
Tearing, itchy eyes; runny nose, sneezing; watery discharge.
YES
Revised July 2011
Child has blood red or purple rash not associated with injury
YES No, unless:
Severe cough
Rapid and/or difficult breathing
Wheezing if not already evaluated and treated
Cyanosis (ie, blue color of skin and mucous membrane)
YES No, unless:
Oozing sore that leak body fluids outside the diaper
Exclusion criteria are resolved.
Exclusion criteria are resolved.
YES For bacterial conjunctivitis YES
For other forms , No, unless:
The child meets other exclusion criteria.
Note: One type of viral conjunctivitis spreads rapidly and requires exclusion. If more than 1 or 2 children in the group have watery red eyes without any known chemical irritant exposure, exclusion may be required and health
For bacterial conjunctivitis, on medication at least 24 hours (if indicated).
Exclusion criteria are resolved.
157
Sore
Throat
Hand-
Foot-and-
Mouth
Disease
Common cold viruses
(upper respiratory infection)
Strep throat
Verbally children will complain of sore throat: younger children may be irritable with decreased appetite and increase drooling (refusal to swallow).
May see symptoms associated with upper respiratory illness such as runny nose, cough, and congestion.
Strep infection usually does not result in cough or runny nose. Signs of the body’s fight against infection include red tissue with white patches on sides of throat, at back of tongue (tonsil area), and at back wall of throat. Tonsils may be large, even touching each other. Swollen lymph nodes (sometimes incorrectly called “swollen glands”) occur
A common viral infection that causes outbreaks of the disease in the summer and fall. Despite its scary as body fights off the infection.
Tiny blisters in the mouth and on the fingers, palms of the hands, buttocks, and soles of feet that last a little longer
name, this illness generally is mild.
Incubation period: 3-6 days
Contagious period: Virus than a week (one, few or all of these may be present).
May see common cold signs or symptoms with fever, sore throat, runny nose, and may shed for several weeks after the infection cough.
The most troublesome finding starts; respiratory often is the blisters in the
Revised July 2011 authorities should be notified.
YES No, unless:
Inability to swallow.
Excessive drooling with breathing difficulty.
Fever with behavior change.
The child meets other
Able to swallow
Able to participate
On medication at least 24 hours (if strep)
Exclusion criteria are resolved.
YES No, unless:
Child is unable to participate
The child meets other exclusion criteria, such as a fever with behavior change.
Note: Exclusion will not reduce disease transmission because some children may shed
Exclusion criteria are resolved.
158
Flu shedding of the virus is
The flu is a contagious respiratory illness caused mouth which make it difficult usually limited to a week or less.
for the child to eat or drink.
Other signs such as vomiting, diarrhea can occur but are less frequent.
by influenza viruses. It can cause mild to severe illness, and at times can lead to death. Young children, and people with dry cough, sore throat, runny or stuffy nose, and muscle aches.
Nausea, vomiting, and diarrhea.
certain health conditions, are at high risk for serious complications from the flu.
Earache
Bacteria or viruses
Often occurs in context of common cold
Include fever (usually high), headache, extreme tiredness,
Fever
Pain
Difficulty hearing
“Blocked ears”
Drainage
Swelling around ear the virus without becoming recognizably ill, and the virus may be shed for weeks in the stool after the child seems well.
YES Yes, if:
Child develops a fever
(100 F or higher under the arm, 101 F orally, or
102 F rectally) and chills, cough, sore throat, headache, or muscle aches.
YES No, unless:
Unable to participate
Care would compromise staff’s ability to care for other children.
Fever with behavior change.
Note: Ear infections are not contagious. By the time a middle ear infection develops, the infection is much less contagious than in the
Head Lice days before the ear symptoms develop.
Follow school policy
This symptoms chart is based on the American Academy of Pediatrics Managing Infectious Diseases in Child Care and Schools.
Exclusion criteria are resolved.
Exclusion criteria are resolved.
Revised July 2011 159
*
Post on Parent Bulletin Board
You will be notified by the school office if your child needs to be picked up due to illness or injury. The decision to send a child home is made by the school nurse or clinic aide, not the teacher or instructional assistant.
A parent or guardian will be notified to pick up a child for the following symptoms:
1. Rashes or unexplained sores on body
2. Vomiting
3. Uncontrolled diarrhea
4. Temperature (follow whatever your division specific guideline recommend)
5. Symptoms of contagious disease (for example: pink eye, chicken pox).
6. Nosebleeds (or any bleeding) that will not stop.
7. Cuts which might require stitches.
8. Possible fractures – if there is bleeding or the child is in severe pain.
9. Head lice
Hand Washing
Staff, children, and volunteers must wash their hands:
1. Before food preparation, handling, or serving
2. After toileting or changing soiled clothes/diapers
3. After assisting a child with toilet use
4. After handling pets or animals
5. Any other time hands are contaminated with body fluids
(e.g. sneezing, blowing nose)
6. After removing gloves
Thorough hand washing has been effective in preventing disease transmission.
1. Wash hands vigorously with soap under a stream of running water for a minimum of 10 to
20 seconds.
2. Rinse hands well with running water and thoroughly dry with paper towels.
3. If soap and water are unavailable, anti-bacterial wipes or an instant hand cleaner may be used. Once soap and water become available, please wash hands.
Revised July 2011 161
Tooth Brushing
Supervised tooth brushing is a part of the daily classroom experience. This will take place once a day, after a meal or an otherwise appropriate time during the day. Each child is shown how to brush their own teeth correctly.
Use a pea-size dab of fluoridated toothpaste and have each child rinse well. The toothpaste “dab” is placed in a disposable cup for each child. Toothpaste is never put directly on a toothbrush from the toothpaste tube.
To prevent the spread of bacteria and viruses, toothbrushes should be handled carefully. They must be stored so that they do not drip or touch another toothbrush; bristles should be allowed to dry.
Children should not be allowed to play with or handle other toothbrushes. Each child’s brush should be labeled with their name. Toothbrushes should not be covered and need to air dry.
Every three months all toothbrushes are discarded and replaced with new ones. Also, if a child has been sick with strep throat or any infectious disease, the old toothbrush is replaced with a new one.
A dental emergency plan is posted on the “Emergency Info” bulletin board found in each classroom.
This is the
“pickle poster” from the Virginia Department of Health.
Revised July 2011 163
Classroom Hygiene
Daily cleaning is another step towards disease prevention.
Mix ½ teaspoon of bleach to one quart of water daily . There are divisions who use an alternative disinfectant —check with your supervisor if you are unsure. Periodically, the Child and Family
Services Coordinator and Preschool Operations Manager will monitor the concentration of the bleach in the water with chlorine test strips. The bottle should be labeled
“Sanitizer” and be locked up when not in use. It should not be stored near food supplies. Spray soiled surface and leave solution for at least 1 minute. Wipe with sponge/paper towel or let air-dry. Any substitute for bleach has to be approved. Please note letter from Health Department on the next page.
Caution: Bleach solution may stain clothing.
Use bleach or alternative disinfectant solution to sanitize:
Table tops before and after meals and snacks and when otherwise soiled. (Never
spray when children are at the table.)
Sink and counter areas once a day (at a minimum).
Rest cots (twice a week) – Both sides of the cot need to be wiped down with a rough-sided sponge.
Sheets/bedding should be washed weekly.
Floors must be swept after meals and when otherwise appropriate. A broom, mop, and bucket are available to the classroom for spills. Children should be encouraged to help clean as appropriate.
Children must never use the bleach spray.
Rest cots should be labeled with each child’s name or numbered (number assigned to each child).
Diseases can be transmitted by sharing personal items. Thoroughly sanitize rest cots before a new child uses.
Sponges and mop refills need to be changed regularly.
Note: Augusta County uses a bleach alternative.
All cleaning supplies must be kept locked at all times. Child-proof locks are acceptable. This also includes any diluted bleach (sanitizer). Do not store cleaning supplies in the same cabinet with any type of food. A measuring spoon will be provided to measure the bleach.
Revised July 2011 164
Water Play Table
When water is used in the water table, the following health measures need to be observed.
1. Fresh drinking water
2. Wash and sanitize (with diluted bleach or bleach substitute solution) the emptied basin and toys at the end of the school day.
3. The addition of bleach to the water is not recommended.
4. Fillers such as cut-up construction paper, uncooked noodles, rice, sand, or leaves can be substituted for water.
Animals in the Classroom
Before you get a classroom pet, please discuss with your principal.
Animals may be in the classroom if the following conditions are met:
There is written documentation (health history form) that no child in the classroom has an allergy or asthma trigger for a certain animal
The animal and cage are kept clean
Animal food is kept out of reach of the children
Animals are healthy
Due to the risk of salmonella infection in children under the age of five, reptiles – such as snakes, turtles, and lizards – may not be brought into the classroom.
Revised July 2011 166
Accidents
Accidents happen quickly and frequently with children of preschool age. During any accident, adults should remain calm and know the proper procedures.
After an accident on school property, whether during the school day or at an evening event, the child will be taken to the school office where the student accident report is completed by the school nurse/clinic aide. Details about the accident are provided to the school nurse/clinic aide by the teacher. Check with your school office for a copy of the student accident report. If there is no school nurse or clinic aide in the school office at the time of the accident, the teacher may complete the accident report. One copy of this report should be placed in the child’s classroom record, one copy sent to the school principal, and one copy faxed to the Child and Family Services Coordinator at 540-
245-5064 once the school administrator signs the report. For all serious accidents, the teacher is to contact the Family Service Advocate immediately.
Additional requirements:
Complete the appropriate accident report for your school system.
The accident report is to be completed the same day as the accident.
Please complete the designated Head Injury form for all head injuries.
A school administrator must sign off on all accident reports or head injury forms.
The nurse or someone from the school office is to notify the child’s parents by phone the day of a head or other serious injury.
For all injuries, it is recommended that teachers send a note/form home explaining the injury.
Please use other languages when applicable. This note home does not require administrative signature.
Revised July 2011 167
Head Injury
In case of head injury, the child must be seen by the school nurse or designee. This includes anything from a minor bump on the head to a more severe incident. School staff should watch for signs of head injury complications that may develop later in the day.
Symptoms to be alert for:
Severe headache
Nausea and/or vomiting
Double vision, blurred vision, or pupils of different sizes
Bleeding, no matter how insignificant, from the ear, nose, or mouth
Any liquid in the ears
Dizziness, disorientation, or confusion
Loss of consciousness or convulsion
If these symptoms are observed following the incident, call the clinic aide, school nurse, or your school office immediately!
The following is the Head Injury form in English. For other languages, the school liaison is to be
utilized or check with your division to obtain a Head Injury Form in another language. The Head
Injury Form will be given to the teacher by the school nurse or designee and will be sent home to the parent. The form must be sent home to parents any time a child has any kind of injury – no matter how slight it appears
– to the head region.
Teachers need to:
1. Send the original form to the parent/guardian.
2. Make a copy for the child’s classroom record and send a copy to the Child and Family
Services Coordinator (fax: 540-245-5064).
3. An accident report still needs to be completed.
Depending on protocol in your division, your school division Head Injury Form may be substituted for the following preschool form. Regardless of which form is used, the Head Injury Form must accompany an accident report if there was an incident involving a blow to the head.
Revised July 2011 168
Regional School-Based Preschool Network
6 John Lewis Road
Fishersville, VA 22939
(540) 245-5162 * Fax (540) 245-5064
Dear Parent:
Your child hit their head today at school. He/she was attended to by school staff and had no problems at the time. Please continue to watch for the following symptoms in the next 12
– 24 hour period:
1. Severe headache
2. Nausea and/or vomiting
3. Double vision, blurred vision or pupils of different sizes
4. Bleeding, no matter how small, from the ear, nose or mouth
5. Dizziness or disorientation
6. Loss of consciousness or convulsion
** It is important that you contact your doctor or emergency room if you notice any of the above symptoms.**
Name of Student: _______________________________________________________
School: _______________________________________________________________
Time: ____________________ Date: _____________________________
Details of injury:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
I am available for questions. Sincerely,
__________________________________
Teacher or School Nurse/Clinic Aide
__________________________________
Date
Medication
Please review the medication guidelines for your individual school. LEA medication and administration guidelines must be followed.
Severe Allergies and/or Epi-pens
(Food, latex, or bee stings)
If a child has an allergy to food, bee stings, latex or anything that may be potentially life threatening, they may not start until a Health Care Plan is in place. The Health Care Plan may be initiated by the school / program nurse (or designee) or the Child and Family Services Coordinator. Only after parent input, proper documentation, and training is in place may a child start.
If a child transfers to another preschool site, the child can not start until all documentation and training takes place at the new site.
Children that have significant allergies or medical needs will need to have information reviewed by health nurse, who will determine if a health care plan is needed.
Lice
Each school system has a different protocol for head lice. Follow your individual school’s policy.
When a student has chronic head lice, (two episodes in one month or three in one semester) the teacher may contact the school nurse/clinic aide or the Program RN to request individual training with the child’s parent. Requests for trainings in divisions that do not have a school nurse/clinic aide can be emailed to the Child and Family Services Coordinator.
Revised July 2011 170
Universal Precautions
Every school has a Universal Precautions Manual that is specific to that site’s school system. Staff members are expected to be familiar with their host school’s policy and procedures regarding
Universal Precautions and reportable incidents. Preschool staff are offered annual training in
Universal Precautions during the school year by qualified school staff and are informed that they may receive the series of Hepatitis B immunizations free of charge. The Hepatitis B immunizations may not be required for staff in all school divisions. Check with your school division for availability.
Summary of Universal Precautions
Since medical history and examination cannot readily identify all individuals infected with blood borne pathogens, blood and body-fluid precautions should be consistently observed for all situations.
These routines are known as “Universal Precautions” and are the steps that can reduce the chance of passing on infection from one person to another. It is very important that universal precautions be carried out within all preschool sites.
Universal Precautions include, but are not limited to, the following procedures:
1. Hands should be washed before and after all procedures – even when gloves are used. If skin is touched by a body fluid, wash immediately with soap and water.
2. Gloves should be worn when contact with any body fluid, tissues, or contaminated surfaces are anticipated.
3. Sharps should be handled in such a manner to prevent accidental cuts or punctures. Never recap, bend, or break needles. Needles should be discarded intact immediately after use into an impervious needle disposal box which should be readily accessible.
4. Mouth pieces, resuscitation bags or other ventilation devices should be strategically located in areas where their need is predictable in order to minimize the need for emergency mouth-tomouth resuscitation.
5. Body wastes should be discarded directly into the toilet. Wastes containing blood on disposable pads should be discarded into double plastic bags before disposal.
6. Spills of blood or body fluids should be cleaned up promptly with a disinfectant solution such as a 1:10 dilution of bleach or other chemical germicides.
7. Gowns, smocks, or plastic aprons are indicated if the presence of blood or body fluid is likely.
Revised July 2011 171
Personal Protective Equipment
Included in this group are: disposable non-latex gloves, protective eye wear, masks, and gowns. All approved personal protective equipment will be provided, repaired, cleaned, and disposed of by the employer at no cost to employees.
Employees shall wear personal protective equipment when doing procedures in which exposure to the skin, eyes, mouth, or other mucous membranes is anticipated. All personal protective equipment shall be removed prior to leaving the immediate work area.
Glove Usage
1. It is required that gloves be worn when direct care of the student may involve contact with blood or body fluid.
2. It is required that gloves be worn for contact with urine, feces, and respiratory secretions.
3. Gloves should be disposed of after each use and not reused.
4. Gloves should be worn when changing a diaper or catheterizing a student.
5. Gloves should be worn when providing mouth, nose, or tracheal care.
6. Gloves should be worn if the care-giver has broken skin on the hands (even around the nails).
It is highly recommended that as a precaution that gloves always be used to prevent contamination and/or infection.
7. Gloves should be worn when cleaning up spills of blood or body fluids and wastes, and soiled supplies.
8. Gloves should be placed on clean hands so they cover wrists and hands.
9. Storage of gloves should be clearly marked and visible and easily accessible.
Employee Medical/Emergency Care Information
All employees are encouraged to fill out an Employee Medical/Emergency Care Information form.
This form should be kept onsite in accordance with HIPPA protocol. This is contact information if a medical emergency would occur.
Revised July 2011 172
Meals and Food
Service
Revised July 2011 173
Table of Contents
Revised July 2011 174
Special Dietary Needs
The
Physician’s Statement for Students with Special Dietary Needs form
Department of Education School Nutrition Programs, needs to be completed when a child needs any dietary modification. Family Service Advocate will complete the Food Allergy & Food Restrictions
Form with the family during registration or the initial home visit. For example, a child may have a peanut/milk allergy or may need pureed foods. A physician or a health care provider will need to sign. This form must be updated annually.
Preschool will also use the internal Food Allergy & Food Restrictions Form when a child is a vegetarian or has special dietary needs due to their religion. In these cases, the parent or staff member will complete the form. A physician signature is required for this form only if there is a documented allergy or modification that also requires the
Physician’s Statement for Students with
Special Dietary Needs form.
Each family should complete a form, if applicable. The FSA will give the teacher the completed form.
The teacher will then distribute copies of the form to the cafeteria manager and the school clinic aide/nurse. A copy of this form will then be forwarded to Preschool Central Office, but this is division specific.
Snacks
Snacks are provided by the Blue Ridge Area Food Bank. The classroom staff need to be aware of expiration dates on the food. If there is an over abundance of snacks that are about to expire, please send these snacks home in children’s back packs prior to their expiration date. Snack time needs to be at the end of the day after children wake up from rest time.
Teachers are responsible for ensuring that students with allergies DO NOT receive snack foods that contain allergens. Please check labels.
Please see following page for the Physician's Statement for Students with Special Dietary Needs.
Your respective
Revised July 2011 175
Student's Name:
Name of School:
Regional School-Based Preschool Network
Virginia Department of Education Form
Physician's Statement for Students with Special Dietary Needs*
Grade Level:
Age:
Classroom:
Yes Does the child have a disability? If Yes, describe the major life activities affected by the disability.
Does the child have special nutritional or feeding needs?
If Yes, complete Part B of this form and have it signed by a licensed physician.
Yes
If the child is not disabled, does the child have special nutritional or feeding needs? If
Yes, complete Part B of this form and have it signed by a recognized medical authority.
Yes
If the child does not require special meals, the parent can sign at the bottom and return the form to the school food service.
PART B
List any dietary restrictions or special diet:
List any allergies or food intolerances to avoid:
List foods to be substituted:
List foods that need the following change in texture. If all foods need to be prepared in this manner, indicate "All".
Cut up or chopped into bite size pieces:
Finely ground:
Pureed:
List any special equipment or utensils that are needed:
Indicate any other comments about the child's eating or feeding patterns:
Parent’s Signature Date:
Physician or Medical Authority's Signature:
*This statement must be updated annually.
Date:
No
No
No
Guidelines for Refreshments
Please limit the amount of fat, sugar, and salt in refreshments when possible. Please follow your division’s policy for healthy eating at school. Most divisions have a school wellness policy that should be included in their school handbook.
Daily afternoon snacks are provided by the local food bank free of charge to the student or parent(s).
Should parents desire to bring special snacks into the classroom, only commercially packaged snacks are permitted.
Parents need to plan with teachers before bringing special snacks into the classroom.
Potlucks and covered dish meals should only occur after school hours with a maximum of two of these meals per year. During these events, parents and/or guardians must be present to monitor their children’s food choices.
Additional Considerations:
Staff must always be aware of allergies and plan accordingly in the classroom during any meal time.
Parents and staff need to be aware of potential choking hazards such as grapes, nuts, raw carrots, popcorn, hot dogs, spoonfuls of peanut butter, etc.
Food Service Guidelines
All containers of food shall be protected during storage and service. This includes mechanical refrigerated storage when necessary. Foods under refrigerated storage must be at 40 degrees
F or below. An accurate thermometer must be provided in all refrigeration units and the temperature checked daily. Non-refrigerated foods need to be stored in an airtight container in a dry cool area
– not in the bathroom or in direct sunlight. To protect food from pests, items should be stored 6 inches from the ground and 6 inches from the wall.
The facility must have a lavatory with running water so that hands may be washed prior to handling any food item. A supply of hand washing soap and single-use towels must be provided.
There must be no bare hand contact with food. Servers may use suitable utensils such as spatulas, tongs, deli paper, or disposable plastic gloves.
Due to the potential for being a fire hazard, hot plates and burners are not allowed in the classroom.
Revised July 2011 177
Food Procedures for Family Style Dining
Purposes/Goals of Family Style Dining:
Enjoy nutritious food
Develop positive attitudes about food
Develop good eating habits
Encourage independence and responsibility
Enhance socialization
Expand language and thinking skills
Refine fine motor skills
Enhance self-esteem
Be exposed to new foods
Family Style Dining Philosophy
Mealtime should be used to introduce new foods and to provide an opportunity for encouraging independence and socialization of children. Before school starts, families will be introduced to this philosophy and will be discouraged from packing lunches for preschool children. Teachers should contact the Family Service Advocate or Child and Family Services Coordinator if a child regularly arrives with a packed lunch.
During family style dining, small groups of children and adults sit and eat together. Children are encouraged to participate in all aspects of the meal from table setting through clean up. Children assist in bringing appropriate food from the cart (when applicable), setting the tables, passing the food to one another, serving themselves from bowls and platters, making choices about what and how much they want to eat, and stacking their dirty dishes. When spills occur, children assist in cleaning up, but must not be required to do so as a punishment.
Staff participates in family style dining. Staff will sit at different tables and eat with the children to encourage, assist, and model good nutrition and eating habits. The intent is to provide a relaxing, social, and self-help skills time for children.
Family style meals are one of the basic aspects of developmental programming and can foster cognitive, emotional, social, and physical development in children. Children learn one-on-one correspondence and counting, develop small motor skills, interact with other children and adults, develop a sense of satisfaction from mastering new skills and gain concrete, real life experiences.
Revised July 2011 178
Meal Procedures during Family Style Dining:
Breakfast – Breakfast is eaten in the cafeteria together as a class.
Lunch – Lunch should be served family style in an environment appropriate for preschool children.
See earlier for information on Family Style Dining. Discussion during lunch should be focused on food, nutrition and table manners. All aspects of the lunch (even dessert) are to be put on the child’s tray. Children should not be required to finish every item on their plate in order to get dessert.
Health Requirements:
All tables should be wiped down with bleach water solution prior to use.
Adults and children involved in set up and serving must wash hands and wear food service gloves if they will be directly touching the food (i.e. handing out rolls).
Food must be kept at appropriate temperature while waiting to be served.
Implementation of Family Style Dining:
Below is a suggested schedule on how to implement Family Style Dining throughout the year.
August/September - Introduce the concept of helpers. Teach each job to the child. Examples of jobs include passing out napkins, milk, silverware, or rolls. Let children wear gloves during center time to get use to the idea of wearing them. Children will not be passing food during this time because they are not familiar enough with the concept. Staff will put bread, cold, and individually wrapped foods on the tray first. Warm foods come after children sit down or right before.
Low fat chocolate milk is allowed during meals. Starting at the middle or end of September, small groups of children can set up meals. Other children can work with table toys and look at books while waiting. Please allow children ample time to eat their meals and do not allow them to leave the table until they have had enough time to eat.
October – Start implementing helpers. Continue to teach jobs, starting one at a time until the children are comfortable with the routine. Once all jobs are implemented, start with passing an easy, cold food such as applesauce. Be sure to talk about the concept of passing food. Continue working in small steps until all of the elements of a family style meal are in place.
April – Beginning in April, as a part of transitioning, modification to the above procedures may be made to assist the students in preparing to enter Kindergarten. This is also a time during which children eating in classrooms can transition to the cafeteria where applicable.
completed quarterly by the lead teacher in your division.
Revised July 2011 179
Site:
Location of meal:
Meal:
Date:
Established schedule
Tasks
Family Style Meal Checklist
Yes
Menu:
No
Not
Obs. N/A Remarks
Enlist at least two helpers
Children, volunteer, staff wash hands before meals
Transition activity
Table wiped down before meal
Bowl(s) with serving spoon(s) are placed in center of table
Food gloves used appropriately by staff, children and volunteers
Children clean up their own spills
Children serve themselves
Pleasant conversation emphasizing adult/child verbal interaction
Adults encourage children to taste all foods
Adults talk to children about food and nutrition
Food is not used as a reward or punishment
Adults are sitting with children eating at the same time
Meals are pleasant, not rushed
Children clear off individual settings
Children clean faces and hands after meals as needed.
Children brush teeth after one meal
Adults wipe table down with sanitizing solution after meal
Completed by:
________________________________________________________
Picky Eater: Classroom Strategies
Never force a child to eat. A child is never punished for not eating.
Food is not used as a medium for bargaining or discipline.
The caregiver’s role is to offer healthy foods at appropriate intervals.
The child’s role is whether or not to eat and how much to eat from what is offered.
Enthusiastic teacher modeling
(“Mmm! I love carrots!”) helps a child with new food acceptance.
Place child at table with “good” eaters. Peer influence can be very effective.
Make sure the child is not filling up with fluids before a meal or snack.
Note if P.E. or outside playtime is right before a meal. If a child is thirsty from playing hard they can fill up very quickly on fluids.
Involve the child in meal or snack time activities.
It takes about 10 to 12 exposures of a new food before some children will attempt to eat. Exposures can be seeing the food, touching the food, seeing a picture of the food, etc.
Give a small portion of food. Some children are overwhelmed by a large portion
– like a pizza slice that covers the whole plate. Cut the slice in half or thirds. Then allow them to have more.
If a child has recently moved to this country it will take time to get used to the new foods. Try having a
“cooking” activity that showcases a food from the child’s country.
Read books to the class like D.W. the Picky Eater , Gregory the Terrible
Eater , and Green Eggs and Ham . Allow the children time to ask questions and make comments.
Offer all foods in a neutral manner. Desserts are not “special” or to be treated as rewards for a clean plate.
Do not overreact if the child refuses certain foods. Do not make an issue out of a child’s dislike of a food.
Make meal or snack time a relaxed and positive environment.
Revised July 2011 181
Transportation
Revised July 2011 182
Table of Contents
Change of Information & Transportation Form .................................................... 185
Revised July 2011 183
Transportation Forms
Transportation Request forms are for new students only. These forms are completed by the Family
Service Advocates during registration and/or home visits. Teachers are not required to complete these forms; therefore, they have been removed from the handbook. Please consult with your Family
Service Advocate if you would like to receive a hard copy of the updated form.
The Change of Information form is for students who are already enrolled. This form is completed
by teachers and/or Family Service Advocates when changes to busing and other important information are noted.
Revised July 2011 184
Change of Information and Transportation Form
(This form needs to be kept in child’s folder.)
Child’s Name: __________________________ Child’s School: __________________
Report Changes Below
Address: ________________________________________________________
City: ________________________________ Zip: _____________________
Phone: __________________ Cell: ________________ Message: _______________
I am requesting a change in transportation. I will need my child picked up at the address:
______________________________________________________________________________
______________________________________________________________________________
I will need my child dropped off at the address: _________________________________________
________________________________________________________________________________
Adults authorized to put the child on and/or take the child off of the bus or contacted in an emergency :
Name____________________________________ Phone________________________
Name____________________________________ Phone________________________
Name____________________________________ Phone________________________
Date: _____________________ Signature:________________________________________
Augusta County Changes: Send to building Principal or Assistant Principal and a copy to Preschool
Operations Manager and bus driver.
All other changes need to be sent to the Central Office Preschool Operations Manager immediately.
Note: Teacher should give a copy to the bus driver.
For Office Use Only :
AM Bus # ___________________ Time: _______________
PM Bus # ___________________ Time: _______________
Bus Violation Procedures
Staunton City Schools bus violations will be handled by the Preschool Center Administrator.
Waynesboro City will be handled by Preschool Center Administrator.
Harrisonburg City bus violations will be handled by the school Principal or designee.
County School Divisions will be handled by the school Principal or designee.
Behavior issues will be handled by the principal in consultation with the designated preschool supervisor and according to the school division’s policy. Every effort will be made to teach the child to ride the bus safely. A plan will be put in place to ensure successful transportation outcomes.
If a child needs to be removed from the bus due to behavior concerns, the Preschool Administrator needs to be notified.
Bus Violation forms are included in this section for all school divisions except Harrisonburg.
Revised July 2011 186
Preschool Bus Violation Form
FIRST BUS VIOLATION
Child: __________________________________
Classroom: ______________________________
Date: ___________________________________
Parent or Guardian: ________________________
_____ You or an authorized person did not accompany child to the bus on
_______________________.
_____ You or an authorized person were not available to pick up your child at your scheduled bus stop on _____________________.
Your Family Service Advocate will contact you to help you develop a plan for your child’s safety.
If a second bus violation occurs, your child will not be allowed to ride the bus for four (4) consecutive school days, and it will be your responsibility to get your child to and from the preschool classroom.
A third violation will result in a loss of bus privileges for your child up to thirty (30) school days or the remainder of the school year if not as much as 30 days left in school year.
Please be sure that you or an authorized person is available to pick up your child. cc: Family Service Advocate
Preschool Operations Manager
FOR OFFICE USE ONLY
Check one:
_____Letter mailed
_____Hand-delivered
To: __________________
Preschool Bus Violation Form
SECOND BUS VIOLATION
Child: _____________________________________
Classroom: _________________________________
Date: ______________________________________
Parent or Guardian: _______________________
_____ This is the second time you or an authorized person did not accompany child to the bus on _______________________.
_____ This is the second time you or an authorized person were not available to pick up your child at your scheduled bus stop on _____________________.
Your child is not allowed to ride the bus for four (4) school days. Bus service will resume for your child on ________________________. You are responsible for transporting your child to and from school for the next four (4) school days.
The hours for children in your child’s classroom are from ______ to ______. Your child must be at the classroom and picked up from the classroom within a five (5) minute range of the stated time. Teachers will not accept children earlier. You must see that your child is taken to the classroom. Children are not to be dropped off and sent to their classrooms by themselves.
Regular attendance must be maintained for continued enrollment in the Program.
Please be sure that you or an authorized person is available to pick up your child. If this occurs again, your child will lose bus privileges for up to thirty (30) school days or the remainder of the school year if not as much as 30 days left in the school year. cc: Family Service Advocate
Preschool Operations Manager
FOR OFFICE USE ONLY
Check one:
____ Letter mailed
____Hand-delivered
To: ____________________
Preschool Bus Violation Form
THIRD BUS VIOLATION
Child: _________________________________
Classroom: _____________________________
Date: __________________________________
Parent or Guardian _______________________:
_____ This is the third time you or an authorized person did not accompany child to the bus on _______________________.
_____ This is the third time you or an authorized person were not available to pick up your child at your scheduled bus stop on _____________________.
Third violation will result in a loss of bus privileges for your child for:
_____ fifteen (15) school days or
_____ thirty (30) school days or remainder of school year if not as much as thirty days left in school year.
Bus service will resume for your child on ____________________. You are responsible for transporting your child to and from school for the next ________ school days.
The hours for children in your child’s classroom are from ______ to ______. Your child must be at the classroom and picked up from the classroom within a five (5) minute range of the stated time. Teachers will not accept children earlier. You must see that your child is taken to the classroom. Children are not to be dropped off and sent to their classrooms by themselves.
Regular attendance must be maintained for continued enrollment in the Program.
FOR OFFICE USE ONLY cc: Family Service Advocate
Preschool Operations Manager
Check one:
_____ Letter mailed
_____Hand-delivered
To: __________________
Forms and Procedures
Revised July 2011 190
Table of Contents
English Volunteer Standards of Conduct & Confidentiality Agreements ........... 193
Change of Information and Transportation Form ................................................. 205
Augusta County Interpreter/Translation Services Form ...................................... 211
Revised July 2011 191
Regional School-Based Preschool Network
Parent Signature Page
Parent Conference (Beginning of School)
ASQ/ASQ-SE results were reviewed. The Results of Screening Letter was received.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Teachers : Three attempts must be made to conduct a home visit. If a home visit did not occur, document the three attempts.
Attempt 1: _________________ Attempt 2: _________________ Attempt 3: _________________
Parent/Guardian did not attend this conference and the above documents were mailed home on ________.
First Home Visit (Fall)
Completed Results of Screening Letter was reviewed with parent/guardian. (Only applicable if not completed at the Beginning of School Parent Conference)
PreK-PALS “Letter to Parent” was received and reviewed.
Math screening was reviewed (if applicable)
Child’s Progress Report was received and reviewed.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Second Home Visit (Winter)
Child’s Progress Report was received and reviewed.
Transition Plan was discussed with parent.
PreK-PALS “Letter to Parent” was received and reviewed.
Math screening was reviewed (if applicable)
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Parent Conference Visit (Spring)
PreK-PALS “Letter to Parent” was received and reviewed.
Child’s Progress Report was received and reviewed.
I have reviewed my child’s educational record for this school year.
Parent Signature:______________________________________________ Date: _________________
Teacher Signature:_____________________________________________ Date: _________________
Attempt 1: _________ Attempt 2: _________ Attempt 3: _________ Info Mailed: _________
Volunteer Standards of Conduct & Confidentiality Agreement
Regulations require that all staff/employees, consultants, and program volunteers abide by the following Standards of Conduct while in relation to school or schoolsponsored activities.
The Standards of Conduct are:
1. To respect and promote the unique identity of each child and family and refrain from stereotyping on the basis of gender, race, ethnicity, culture, religion or disability.
2. To follow school confidentiality policies concerning information about children, families, volunteers, consultants and other staff members.
3. No child will be left alone or unsupervised while under their care.
4. Will use positive methods of child guidance and will not engage in corporal punishment (spanking), emotional or physical abuse or humiliation.
While visiting or volunteering at school, you must follow the following guidelines as well:
5. Follow school policies & rules.
6. Sign in and out at the front office.
7. Follow the school dress code to model modesty (such as no short shorts, no spaghetti straps, no tops that bare the midriff, no visible undergarments, and no clothing with inappropriate messages).
8. Do not bring younger children into the classroom while volunteering
9. If you have scheduled to volunteer, please arrive on time or notify the teacher of changes.
10. A Tuberculosis screening will be required if you are a regularly scheduled volunteer (if you volunteer on a weekly basis). This is available at the local
Health Department or a doctor’s office.
Please note: Individuals convicted of child abuse, sexual abuse or violent crimes may not volunteer in the preschool classroom and may visit the school only as permitted by law.
A signature acknowledges the individual’s awareness of the conduct required for any and all participation in the preschool classroom.
Preschooler’s name:
______________________ Classroom: _________________
Parent Signature: ______________________________ Date: _____________
Witness: ______________________________________ Date: _____________
Voluntario Criterios de Conducta & Acuerdo de Confidencialidad
Las reglas requieren que todos los empleados, consultores y voluntarios del programa, sigan los Criterios de Conducta con relación a la escuela y a las actividades de la misma.
Los Criterios de Conducta son:
1. Respetar y promocionar la identidad única de cada niño y su familia, abstenerse de los esteriotipos de sexo, raza, etnicidad, cultura, religión o incapacidad física o mental.
2. Seguir las políticas de confidencialidad de la escuela concernientes a información acerca de niños, familias, voluntarios, consultores, y staff.
3. No se permite dejar a los niños solos o sin supervisión.
4. Se utilizaran métodos positivos para guiar la conducta y no se utilizaran castigos corporales, emocionales o psicológicos.
5. No se permite utilizar métodos de castigo que impliquen aislamiento, o la privación de las necesidades básicas, ni utilizar la comida como recompensa.
Adicional a estos criterios de conducta, los voluntarios tienen que seguir las siguientes reglas:
6. Cumplir las políticas de la escuela y sus estatutos.
7. No se permite llevar niños más jóvenes a las clases.
8. Si un voluntario está programado para trabajar, el/ella asistirá o de lo contrario informará al maestro con anticipación para realizar los cambios correspondientes.
9. Personas con antecedentes de abuso de niños, acoso sexual o crímenes violentos, no podrán trabajar en la clase de Preescolar y pueden visitar a la escuela solamente bajo condiciones permitidas por la ley.
10.
Será requerida una prueba de Tuberculosis para los voluntarios regulares (está se encuentra disponible en el departamento de salud local o en un consultorio particular.)
Acepto y comprendo los criterios de conducta para la participación en la clase de
Preescolar.
Nombre de Estudiante: ______________________ Clase: _________________
Nombre de
Padre/Guardián:
____________________________________
Firma: _____________________________________
Testigo: ____________________________________ Fecha: _____________
Regional School-Based Preschool Network
6 John Lewis Road
Fishersville, Virginia 22939
540-245-5064 (fax)
540-245-5162 (office)
Exchange of Information
I, ____________________(parent/guardian), give permission for the exchange of all confidential information including, psychological, socio-cultural, educational, and medical information between:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________ and Preschool/public school staff. I understand that the information is to be used for educational planning and child management as related to
_________________________________ (child’s name) potential development through the public schools. The specific reason for the release of confidential information is:
______________________________________________________________________
______________________________________________________________________
The parent or eligible student has the right to examine, obtain copies, or question all confidential data that has been gathered as a part of the scholastic record.
Personally identifiable confidential information from student records may be disclosed to a third party only on the condition that said party will not disclose such information without written consent of the parent or eligible student.
I consent to the exchange of information on this student:
Student Name: ______________________________________________
Date of Birth: ______________________________
Address: ___________________________________________________
Preschool Classroom: _______________________
Parent/Legal Guardian ________________________________________
Date _____________
This document becomes invalid one year from the date signed.
To be filed in student record
Regional School-Based Preschool Network
6 John Lewis Rd. 540-245-5064 (fax)
Fishersville, VA 22939 540-245-5162 (phone)
Intercambio de Información
Exchange of Information - Spanish
Yo, ________________________________________ (nombre del padre/o madre/o del guarda del niño) doy permiso por el intercambio de toda la información confidencial, incluye la información psicológica, socio-cultural, educativa, y médica entre:_________________________________________________________________
______________________________________________________________________
______________________________________________________________________ y la personal de Head Start. Entiendo que la inf ormación sólo debe ser utilizado para la gerencia del planeamiento educativa con respeto al desarrollo potential de
_________________________________________ (nombre del niño) por medio de las escuelas públicas. La razón especifica por permitir el uso de información confidencial es:___________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Los padres o estudiante elegible tienen el derecho de examinar, obtener copias, hacer preguntas sobre toda la información que ha sido obtenido como parte del archivo
Categoría II (confidencial). Información confidencial que puede ser identificado con una persona especifica del archivo de los estudiantes puede ser abierto a otra persona solo en caso de que la persona no use tal información sin permiso escrito por los padres o el estudiante eligible.
Consiento al intercambio de información sobre este estudiante.
Nombre del estudiante: _______________________________________
Fecha de nacimiento: ________________________________________
La dirección: _______________________________________________
Head Start sala de clase: _____________________________________
Padre o del guarda legal: ______________________________________
La fecha: _______________________________
Este documento se pone inválido un año después de la fecha de firma.
C O N S E N T T O E X C H A N G E I I N F O R M A T I I O N
I understand that different agencies provide various services and benefits. Each agency must have specific information to provide these resources. By signing this form, I am allowing agencies to exchange information so it will be easier for them to work together to provide or coordinate these services or benefits.
I, ______________________________ (FULL PRINTED NAME of PARENT/LEGAL GUARDIAN) , am signing this form for
_________________________________ (FULL PRINTED NAME OF CHILD) .
___________________________________________________________________ (CHILD’S HOME ADDRESS)
(Child’s Date of Birth) ____________________ (Child’s Preschool Classroom) ____________________
My relationship to the client is: □ Self □ Parent □ Power of Attorney
□ Guardian □ Other Legally Authorized Representative
I give permission to release the following confidential information regarding the child or family members:
YES NO
Assessment Information
Financial Information
Medical/Dental
Other:
YES NO
Educational Records
Family Information
Employment Records
Parent’s Educational Records
I give my consent for the Regional School-Based Preschool Network to exchange this information with:
Name of Agency: ____________________________________________
Agency Address: ____________________________________________
___________________________________________________________
Agency Phone Number: ______________________________________
Agency Fax: ________________________________________________
This consent form is good until one year from date of signature:
_______________________________________
I can withdraw this consent form at any time by informing the referring agency as soon as possible. This will stop listed agencies from sharing information after they are made aware the withdrawal of my consent form. I have the right to know what information about me or my child is shared, and why, when, and with whom it is shared. Each agency will provide me with this information at my request.
I wish for all agencies to accept a copy of this document as a valid consent to share information. If I do not sign this form, information will not be shared, and I must personally contact each agency to obtain requested information.
Signature:__________________________________________ Date: ________________________
(Parent or Legal Guardian)
Signature:__________________________________________ Date: _______________________
(Person Requesting Consent)
Person Explaining Form/Witness:
_________________________________________________________________________________
(Name) (Title) (Phone Number)
Parent Preschool Transportation/Pedestrian Training
2011-2012 School Year
General Safety Rules
Who can get your child off the bus? Only the
Parent/Guardian or
Authorized Person
(18 years of age or older) on your Emergency
Card.
Photo ID
may be required by the driver if they have not seen the person before.
Parent/Guardian or Authorized Person must accompany child to the bus doors when loading or unloading and to help the child on and off the bus, if necessary.
Use Backpacks.
Dangling drawstrings on child’s jacket and other clothing is not allowed on school bus or in classrooms.
Dress for bad weather and be on time.
Take a direct route to bus stop, walking off the road and facing traffic.
Wait for driver’s signal to begin boarding.
Keep out of the DANGER ZONE.
IF ANYTHING IS DROPPED, DO NOT TRY TO GET IT WITHOUT
THE
DRIVER’S PERMISSION.
Sit in seat facing front, holding items in your lap.
Keep Aisle clear.
1
Stay inside bus, keeping your arms, hands, feet, legs, and head inside.
Know where to go when leaving the bus and report there immediately.
If transporting child to school, ask the Principal or Teacher where the drop off or pickup location is and what time.
Danger Zone Rules
Take 10 giant steps away from the bus.
Maintain eye contact with the bus driver.
Leave items that are dropped!
Wait for the driver’s permission before picking up anything!
Driver can’t see children…
o
behind the bus;
o
around or behind the tires;
o
bending over to pick up something;
o
close enough to touch the bus.
2
Danger Zone
Rules for Getting ON the Bus
Form a single line.
Approach the bus after it has come to a complete stop.
If crossing the street to get on the School Bus at the bus stop, parent or authorized person must accompany child, wait for the driver’s signal that it is safe to cross.
Wait for driver’s signal before boarding.
Allow younger students to get on first.
Use handrail.
Take steps one at a time.
3
Parent or Authorized person to assist the child onto the school bus if need be.
Go directly to a seat.
Rules for Getting OFF the Bus
Wait until bus stops before getting out of your seat.
Those closest to the front should leave first.
Move quickly without pushing or shoving.
Use handrail, taking steps one at a time.
Parent or Authorized person to assist child off the school bus if needed.
If crossing the street to get off the School Bus at the bus stop parent or authorized person must accompany child, wait for the driver’s signal that it is safe to cross.
Go directly and immediately to your home or other designated place.
Evacuation Rules
Prepare to exit.
Listen to instructions.
Follow your safety leader.
4
Leave your belongings on the bus.
Move quickly without pushing.
Stay in single file.
When exit is from the front, use the handrail.
When the exit is from the rear or side, place your hands on the shoulders of the helpers or sit down and slide out.
Go to the designated area at least 100 feet from the bus.
Remain in a group.
Wait quietly for additional instructions.
Evacuation Drills
5
Emergency Equipment
Fire Extinguisher
First Aid Kit
Reflective Triangles
6
Transportation Contract & Training Signature Page
2011-2012
I have reviewed and understand the Preschool Transportation Contract and the Parent Preschool Transportation/Pedestrian Training that has been given to me.
____________________________ _______________________
Child’s Name School Attending
______________________ ___________
Parent Signature Date
Filed in F.S.A. Family File
7
Change of Information and Transportation Form
(This form needs to be kept in child’s folder.)
Child’s Name: ____________________________ Child’s School: ________________
Report Changes Below
Address: ________________________________________________________
City: ________________________________ Zip: _____________________
Phone: __________________ Cell: ________________ Message: _______________
I am requesting a change in transportation. I will need my child picked up at the address:
__________________________________________________________________________
__________________________________________________________________________
I will need my child dropped off at the address: ____________________________________
___________________________________________________________________________
Adults authorized to put the child on and/or take the child off of the bus or contacted in an emergency :
Name____________________________________ Phone________________________
Name____________________________________ Phone________________________
Name____________________________________ Phone________________________
Signature:________________________________________ Date:__________________
Augusta County Changes: Send to building Principal or Assistant Principal and a copy to Preschool
Operations Manager and bus driver.
All other changes need to be sent to the Central Office Preschool Operations Manager immediately.
Note: Teacher should give a copy to the bus driver.
For Office Use Only :
AM Bus # ___________________ Time: _______________
PM Bus # ___________________ Time: _______________
Monthly Report from Preschool Teachers
Monthly Reports Cover Sheet
(Due by the 3 rd of each Month)
(Send to Central Office
– Attn: Program Secretary)
School: ________________________ Teacher(s): ____________________
Please Attach the Following:
_____ Student Withdrawal Form
_____ First Aid Bag has been checked
_____ Yes
_____ No
_____ Interpreter Report
_____ Family Fun Event
Date: ___________
Number Attended: _______
_____ Custodial Report
_____ Time Report
_____ Volunteer Sign-In Sheet
_____ Substitute Report
_____ Travel Reimbursements Documents
_____ Other (As Needed)
_____ Special Education Service
Providers Sheets
Custodial Services for School-Based Preschoo l
Month:________________________ School:_____________________________
Custodian to fill out daily and sign.
Date
Vacuum
Rugs
Sweep
Classroom
Clean
Classroom
Mop
Bathroom
Signature
Mop
Classroom
T eacher’s Signature: ____________________________________ Date: _________________
REGIONAL SCHOOL-BASED PRESCHOOL NETWORK
REPORT OF ABSENCE/REPORT OF SUBSTITUTES
LAST NAME: ______________________ FIRST NAME: __________________ SS#: ________________
SCHOOL: _________________________________ MONTH/YR: ______________________________
Type of Leave Used
SICK LEAVE
Dates (Specify Partial Time if Applicable) Total Days Missed
PERSONAL LEAVE
PLANNING
(HOME VISITS)
T/TA STAFF MEETING
TA Workdays (3 per year) Day 1 _____ Day 2 _____ Day 3 _____
PROFESSIONAL LEAVE
(List Type)
Needs to be pre-approved
OTHER LEAVE
Civil/Jury Duty
Military
Leave without pay
Worker’s Compensation
Employee Signature ___________________________________________________ Date ________________
Principal/Dept Manager _________________________________________________ Date ________________
SUBSTITUTE INFORMATION
NAME _________________________________ NAME ___________________________________
SS# ___________________________________
ADDRESS _____________________________
______________________________________
DATES WORKED ________________________
_______________________________________
TOTAL DAYS WORKED ___________________
X DAILY RATE OF PAY ____________________
PAYMENT AMOUNT DUE __________________
BUDGET CODE __________________________
SS# _____________________________________
ADDRESS ________________________________
_________________________________________
DATES WORKED ___________________________
_________________________________________
TOTAL DAYS WORKED ______________________
X DAILY RATE OF PAY ______________________
PAYMENT AMOUNT DUE ____________________
BUDGET CODE ____________________________
NOTE: Reports are due by the 3 rd of each month. Please use one form per month. If more than two (2) substitutes are used in a month, only fill in bottom of second sheet. Do not duplicate leave information. (June 2007)
Acceptable Receipts for Reimbursement
The Internal Revenue Service requires precise documentation when submitting expenses for reimbursement. Acceptable receipts are as follows:
Receipt from vendor showing name of employee, date paid, and full amount paid. Receipts / Invoices for hotel bills and restaurants MUST BE ITEMIZED TO SHOW ALL ITEMS RECEIVED . If payment is for more than one person, note the names of those involved. Note: The $30/day meal allotment is for the approved individual only. Do not include meal purchases for spouses/others.
OR
Copy of a credit card invoice which itemizes each expense. You may need to ask for itemized documentation.
OR
Copy of cancelled check for registration with a copy of registration form stating cost.
Any questions regarding the above guidelines should be directed to:
Mark E. Lotts
Director of Business and Finance
Revised July 2011 209
Interpreter Usage Form
Site:
Staff Person Who Scheduled Interpreter(s):
Name of Interpreter:
Mailing Address:
Phone Number:
Social Security Number:
Language Interpreting: Rate per Hour:
Reason for Interpretation:
Date:
Time:
Location:
Total Hours: Total Amount:
E-mail this form to the appropriate person.
This form is division specific to Augusta County Schools.
Please arrange for an interpreter with the school’s Principal.
REQUEST FOR INTERPRETER/TRANSLATION SERVICES
ALL SERVICED MUST BE PRE-APPROVED
( ) Patricia Devitt, Director of Pupil Services, for ASL Interpreters
( ) Tina Kiracofe, ESL Supervisor, for Translation Services
PART A: REQUEST
Student’s Last Name First MI School
Home Language Date of needed service Time of day Anticipated hours of service
PROGRAM:
___ Identified ESL ___Identified Sp.Ed. ___ Pre-Program Evaluation ___ Hearing Impaired
___Other
Grade Homeroom teacher Sp. Ed./ ESL Teacher
Reason for requested service
Principal’s Signature Date
PART B: SERVICE APPROVAL (This form will be returned to the principal upon approval)
Request ( ) Approved ( ) Not Approved Reason: _______________________________________
Director/Supervisor _______________________________________ Date ________________________
NOTE: Interpreters must have Va-4, W-4, and I-9 forms on file in the Finance Office before payment can be processed.
Interpreter’s Name SS #
Street Address
City/ State
Augusta County Schools employee?
___YES ___NO
ZIP Pay Rate
Mileage over 25mi.
If NO, tax forms are
___ on file ___attached ___will be sent to
Finance
PART C: PAYMENT AUTHORIZATION (Principal approves payment and returns this form to the Director of Pupil Services or the ESL Supervisor upon completion of service)
Date: _______ Hrs. of Service ______ Amount Due _________ Principal_________________________
CENTRAL OFFICE:
Supervisor _________________________ Account: 41 . __ __ __ __ . __ __ __ __ . __ __ __ .__ __ __
Blue Ridge Area Health Education Center
Harrisonburg only
Program of the Institute for Innovation in Health and Human Services
James Madison University MSC 9009 Harrisonburg, VA 22807 Phone: 540.568.3011 Fax: 540.568.3172 interpreter@jmu.edu
INTERPRETER REQUEST FORM —Head Start
BRAHEC office use only
Date/Time received ________ /____ /__________
Request #
Interpreter assigned _______________________
Confirmed with site ________________________
(date, time, person)
Language/Dialect ______________________________________
Student's name (print) _________________________________ Male ____ Female ____
Parent’s Name(s) ____________________________ Home Phone # _________________
Alternate phone #__________________ Can we leave a message? Yes___ No ___
DOB____________________
Address_____________________________________________________________________
Medicaid Y____N___ if YES, MEDICAID #_______________________
School ____________________________________________
Date of appt. ___/___/_____ Time of appt. ___:___ Duration of appt.__________ hr.
Type of appt. __________________________________________________________
(i.e. child study, eligibility, IEP, sociocultural, etc.)
Appt. location __________________________________________________________
Contact person _________________________________________________________
Contact person’s telephone number _________________________________________
Person submitting request (print name) _____________________________________
Person submitting request (signature) _____________________________________
Contracting Agency (which requests interpreter) __ Shenandoah Valley Head Start _____
Requestor’s telephone number ( ___ )____-_____ Fax number ( ___ )____-_____
COMMENTS:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Service Provider Sheet
Student Name : ____________________________ Disability : __________________
Site: _____________________________ Month: ____________________
IEP Requirement
Service/Therapy ___________________ Times Per Week ___________________ Amount of Time ___________________
Service/Therapy ___________________ Times Per Week ___________________ Amount of Time ___________________
Service/Therapy ___________________ Times Per Week ___________________ Amount of Time ___________________
Service/Therapy ___________________ Times Per Week ___________________ Amount of Time ___________________
Actual Service Provided
Name of
Provider
Service/Therapy
Provided
Date Time In Time Out
_________________________________________ _________________________
Teacher Signature Date
Withdrawal Procedures
For teachers:
1. All ChildPlus data for a child who is leaving must be entered within 3 days.
2. Within 10 days of child leaving the class, TSG data needs to be entered. A child’s information
will be archived after Teacher Withdrawal Form is received by the Early Childhood
Development Coordinator in Fishersville. Information will be held in the archives in case the child is re-enrolled at a later time. If the child is withdrawn from the class within 3 weeks of the final data entry time, information should be entered as final, not preliminary.
3. Put observation and portfolio information in child’s classroom record. This information will follow the child to the new preschool but this will happen through the Central Office in
Fishersville.
4. The completed child’s record is to be given to the Family Service Advocate as soon as possible within 10 days of the child’s leaving.
5. Complete electronic Withdrawal Form below and e-mail to Central Office.
For FSAs and the Enrollment Office:
1. FSA will verify that the child is not returning and will complete an FSA Withdrawal Form. (A child with an IEP will not be withdrawn until after the Special Education staff of the school division contacts the Child and Family Services Coordinator in the division where the child is leaving.)
2. The FSA Withdrawal Form will be attached to the child’s Classroom Record and the Family
File and will be given to the Child and Family Services Coordinator so that the file will be entered with “abandoned/withdraw” status.
3. If a student is accepted in a different classroom the Child and Family Services Coordinator will begin the process of enrolling with the FSA.
Revised July 2011 214
REGIONAL SCHOOL-BASED PRESCHOOL NETWORK
TEACHER WITHDRAWAL FORM
Teachers: When re-enrolling a child who has been in Preschool anywhere, contact the
Early Childhood Development Coordinator. Copy to Central Office - Copy in child record (front of file)
Record needs to be completed within 14 days of the withdrawal date. Child record needs to be sent to Central Office.
Please email the Family Service Advocate information for withdrawal and/or reenrollment.
Date: ____________________
Child: ___________________________
Date Withdrawn: ___________________
Site: _________________________
Reason Withdrawn: _____________________________________________________
PALs Pre-K? _______________
CC.Net completed and put in folder
All information added to record (Date): ________________________
Attendance
Observations & Portfolios
Contact Notes
Medication Log
ASQ / ASQ:SE Completed Yes No
Developmental or Sensory Concerns
Does child have IEP?
Yes
Yes
No
No
Re-enrolled Site: ____________________ Start Date: _____________
Should a child be withdrawn from the program, please email this completed form to
Catherine Bejarano
at
bejarano.c@augusta.k12.va.us
.
December Classroom Spending
Site: School Name
Please check the spending category that applies .
Date Spending Category
Beginning Amount
Amount
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
This needs to be copied and returned to Central Office with your December monthly reports.
May Classroom Spending
Site: School Name
Please check the spending category that applies .
Date Spending Category
Beginning Amount
Amount
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
____Health_____ Classroom _____Field Trip
This needs to be copied and returned to Central Office with your May monthly reports.
Field Trips
Funds -- Each classroom has an annual allotment for field trips per semester per child.
To clarify the money that can be used for field trips - the $4.00 per child is the amount we use to plug a figure into the budget. You can split this into two trips, etc... or use some of it to pay for parents, but you have to stay within the budgeted amount. We can ask parents who would like to attend if they can pay for themselves. If they cannot pay this but would like to attend that is when we have to find some money for them.
Purpose of Field Trips -- Funds are to be used to provide a trip experience for students that is educational. Theme-based activities and a part of the total instructional plan must support trip requests. Consideration should be given to providing experience for preschool children served that might not be available to the family under normal circumstances.
Include your Family Service Advocate -- When planning your field trip calendar please share the times and dates with your Family Service Advocate. This is a partnership opportunity for Family
Service Advocates and whenever possible they will be attending field trips.
Use of Field Trip Funds -- Field trip funds may be used for such activities as entrance fees to museums, attendance at a wool festival, lunch at a cultural attraction and similar experiences.
Payment of Field Trip Fund -- Purchase orders may be requested in advance for payment of goods and/or services associated with an approved field trip. Purchase orders may be obtained through the site-based school office. All other expenditures are to be handled using the Augusta County School reimbursement voucher form for items or services paid for by the employee using personal funds.
Field Trip Guidelines -- Classroom staff follows the host school guidelines for field trips. Parents must sign a field trip permission form. Updated emergency care info should be carried in the First Aid bag on each field trip.
Parents are to be notified in writing information concerning the field trip prior to participation by the child.
Transportation -- The host school division provides transportation for most field trips. Any other form of transportation follows the local school division policy.
Field trips must have ample numbers of chaperones attending to assure proper adult supervision.
The host school principal must approve the number of chaperones as verification of proper adult supervision .
Special Field Trip Requests -- Field trip requests that have special or unique requirements must be submitted in writing to the principal for approval at least two months before the trip is to be taken.
Special requests that do not allow ample time to be considered and approved by the grantee will be denied.
Revised July 2011 218
Worker’s
Compensation
This section is for Federally Funded Employees.
Revised July 2011 219
Table of Contents
Preferred Provider Panel Consent Form ............................................................... 224
Revised July 2011 220
Worker Compensation Claims Procedures
For all federally funded preschool teachers or instructional aides, you must follow the Augusta County
Schools Workers’ Compensation procedures. See below:
You were injured at work. What now?
If you’ve suffered a workplace injury or illness, you may be eligible for workers’ compensation benefits. This packet is designed to assist you in reporting work-related injuries.
What is Workers’ Compensation?
Benefits payable to an employee by his or her employer without regard to liability in the case of injury, disability, or death as a result of occupational hazard.
Who is covered?
All employees, full or part-time.
What is covered?
Injury sustained by an accident arising out of and in the course of employment if the accident was the prevailing factor in causing the medical condition and disability.
Time of coverage?
Coverage begins the first minute an employee is on the job and continues while the employee is working.
What about Occupational Diseases?
It must arise out of and in the course of employment.
It cannot be an “ordinary disease of life”, unless it follows as an incident of an occupational disease.
The occupational exposure was the prevailing factor in causing the medical condition and disability.
What are the
Workers’ Compensation Benefits?
Medical care to cure and relieve the effects of the injury. This includes doctor’s fees, hospital costs, lab tests, x-rays, pharmacy charges, etc.
Payments based on lost wages. These payments are for “temporary disability”, or inability to work, authorized by a physician. Payments may also be made if there is a permanent disability.
Rehabilitation services such as physical therapy or vocational rehabilitation.
How much are payments for lost wages?
Two-thirds of your weekly wage up to a maximum set by law. Payments will not be made the first seven days unless the disability exceeds fifteen days.
Revised July 2011 221
How to Get Benefits
1. Report injuries to your immediate supervisor and the Preschool Operations Manager as soon as possible. Employees must complete the following forms:
Employee Accident Summary Form
Preferred Provider Panel Consent Form (if medical treatment is necessary)
2. If medical treatment is required, select a physician/practice from the Preferred Provider Panel
and seek medical care. The
Workers’ Compensation Carrier will not pay for medical treatment you receive from unauthorized medical providers.
3. Unless it is an emergency, do not seek aid without informing your employer and going to an authorized medical provider.
4. If it is an emergency, seek initial treatment at the nearest hospital emergency room. Notify your employer as soon as possible.
5. Advise the doctor or medical provider that you have a work-related injury (give them a
Workers’ Compensation Physician Report Form
included in this packet). For emergency
services, give the name, address and phone number of the employer.
6. DO NOT PAY for medical care yourself and DO NOT use your school division health insurance plan. Bills are paid by the insurer unless the
Workers’ Compensation Board disallows your case. Providers are paid while cases are in dispute.
7. Time missed from work will require written certification from a medical provider indicating the days you should be off due to the injury. Keep your supervisor informed of your work status.
IMPORTANT CONTACT INFORMATION:
Ohio Casualty Claims Department:
(800) 382-1223 or (717) 763-7331
Augusta County School Board Benefits Department:
Debby Berrington (540) 245-5126
Annie Harvey (540) 245-5273
Revised July 2011 222
Augusta County Schools
Workers’ Compensation
Employee Accident Summary
Complete this form and give to your Principal/Supervisor within 24 hours of reporting the injury, incident, or illness.
Personal Information
Name Social Security No.
Mailing Address
Home Phone
Job Title
School/Department
Cell Phone
Accident Information
Date of Injury
Describe what happened
Time of Injury
Authorization Information
Employee Signature Date
Date Form Revised: 2/9/2010
AUGUSTA COUNTY SCHOOLS WORKERS’ COMPENSATION
Preferred Provider Panel Consent Form
(To be signed by the employee after the accident)
I have reviewed the Panel of Physicians provided to me by my employer and have selected the medical provider listed below to receive medical treatment for my workrelated injury.
I understand that if I fail to use one of the recommended medical providers, excepting a medical emergency, I shall be liable for the cost of the medical care as provided for in
Section 65.1-89 of the Virginia Workers’ Compensation Law.
I understand that I am to inform the medical provider that the treatment is for a workrelated injury and the claims administrator is Sedgwick CMS.
Employer Name:
Employer Address:
Employee Name:
Employee Social Security No.:
Augusta County Schools
6 John Lewis Road, Fishersville, VA 22939
Physician selected:
Physician address:
Physician telephone number:
Employee Signature: Date:
Return completed form to Augusta County Schools, Finance Department, 6 John Lewis
Road, Fishersville, VA 22939.
PRACTICE
Associated Physicians, Inc.
Augusta Eye Associates
Augusta Eye Associates
Augusta Orthopedic Surgery
Augusta Surgery - AMC
Carilion Family Medicine -
Dayton
Carilion Family Medicine - Fort
Defiance
Carilion Health Systems -
Bridgewater
Carilion Health Systems -
Harrisonburg
Carilion Urgent Care -
Harrisonburg
Emergicare - Waynesboro
Hess Orthopedic Center &
Sports Medicine
Orthopedic Associates - AMC
Orthopedic Surgery -
Harrisonburg
Patient Care Plus
Plastic Surgery of
Charlottesville
RMH - Neurosurgeon
Staunton Eye Clinic
Stuarts Draft Family Practice
UVA Department of
Neurosurgery
West Augusta Family Practice
Preferred Provider Panel
ADDRESS
428 S. Magnolia
Avenue
42 Lambert Street,
Ste 111
425 S. Linden Street
108 MacTanly Place
70 Medical Center
Circle, Ste 308
15 Killdeer Lane
1371 Lee Hwy, PO
Box 8
200 High Street
644 University Blvd,
Ste B
1661 S. Main Street
2611 W. Main Street
4165 Quarles Court
70 Medical Center
Circle, Ste 110
1015 Harrison
Street, Ste 4
934 N. Augusta
Street
914 E. Jefferson St,
#202
1745 S. Main Street
2010 N. Augusta
Street
24 Gloucester Road
PO Box 800121
CITY/ST/ZIP
Fort Defiance, VA
24437
Bridgewater, VA
22812
Harrisonburg, VA
22801
Harrisonburg, VA
22801
Waynesboro, VA
22980
Harrisonburg, VA
22801
Fishersville, VA
22939
Harrisonburg, VA
22801
Staunton, VA
24401
Charlottesville, VA
22902
Harrisonburg, VA
22801
Staunton, VA
24401
Stuarts Draft, VA
24477
Charlottesville, VA
22908
PHONE
Waynesboro, VA
22980
Staunton, VA
24401
Waynesboro, VA
22980
Staunton, VA
24401
Fishersville, VA
22939
540-949-8241
540-885-8814
540-949-5050
540-885-1281
540-932-5909
Dayton, VA 22821 540-879-2585
21 Scenic Hwy, Ste
101
Churchville, VA
24421
540-248-3413
540-828-2634
540-434-7600
540-433-3992
540-932-7120
540-434-1664
540-932-5850
540-433-2600
540-885-6789
804-296-3622
540-434-7749
540-885-8186
540-337-3710
434-924-2203
540-337-6002
PHYSICIAN (If
Applicable)
Richardson, Peter B. MD,
PC
Gillespie, James E. MD
McKibbin, Douglas W.,
MD, FACS
Hanna, H. Michael Jr. MD
LaGrua, James C. II DO
Seemuller, Michael D. MD
Wachspress, Daniel MD
Huffman, Rufus C. MD
Chappell, G. Edward Jr.,
MD
Boatright, Kenneth A. MD
Burgess, David A. MD
Pereles, Thomas R. MD
Craun, Galen G. Jr. MD
Kenney, John G. MD,
FACS
Gillespie, Richard MD, PC
Stathos, John A. Jr. MD
Clevenson, David MD
Forbes, John W. III MD
Hatter, Dennis MD
Hostetter, Samuel MD
Miller, Richard B. MD
Troiano, Jason J.
Shaffrey, Mark E. MD
Helm, Gregory A. MD
Smith, Justin MD
Elsea, Richard W. MD
Revised July 2011 225
AUGUSTA COUNTY SCHOOLS
Workers’ Compensation Physician Report
Physical Capabilities Form
To the Employee: Give this form to physician upon seeking medical attention. Return completed form to Augusta County Schools, Finance Department, 6 John Lewis Road,
Fishersville, VA 22939.
Employee Name: Birth Date:
Injury Date:
Injury/Complaint(s):
FOR PHYSICIAN USE ONLY
Complaint(s) / Diagnosis:
Is complaint(s) / diagnosis work related? Yes No
Patient may return to work: Regular Restricted
Work Restrictions (include part of body involved):
Length of restrictions (number of days):
Medications prescribed:
Does medication prevent patient from working on or around moving equipment, machinery, or driving?
Yes No
If answer is “yes”, explain:
Date of follow-up appointment:
If referred, physician’s name:
Tetanus Booster Yes No
Other comments:
Name/Address of
Physician:
Date of last booster:
Date: Signature of Physician:
MAIL OR FAX ALL BILLS TO:
Bankers Insurance
PO Box 510
Staunton, VA 24402
Phone: 540-213-2320; FAX: (540) 886-8225
