Revised: San Antonio Independent School District - SAISD · PDF fileVerification Tool Form...

Eligibility, Recruitment, Selection, Enrollment, Attendance (ERSEA)

Policy ID: ERSEA 001

Subject: Eligibility: Age of Children

Head Start Performance Standards: 1305.4 (a)

To be eligible for Head Start services, a child must be at least three years old by the date used to determine eligibility for public school in the community in which Head Start program is located, except in cases where the Head Start program’s approved grant provides specific authority to serve younger children. Examples of such exemptions are programs serving children of migrant families and Early Head Start Programs.

Procedures:

Children are determined to be age eligible for the Head Start program by public school guidelines of the San Antonio

Independent School District. Child must be 3 or 4 years old by September 1st of the upcoming school year. Acceptable

forms utilized to determine age is as follows:

birth certificate;

driver's license;

passport;

school ID card, records, or report card;

military ID;

hospital birth record;

adoption records;

church baptismal record; or

any other legal document that establishes identity

San Antonio Independent School DistrictDate Revised:

Date Approved:






Procedures:




birth certificate;

driver's license;

passport;


military ID;


adoption records;



San Antonio Independent School District

Date Revised:

Date Approved:



Subject: Eligibility: Over Income

Head Start Performance Standards: 1305.4 (b1 & 2)

(b1) At least 90 percent of children who are enrolled in each Head Start program must be from low‐income families.

(b2) Up to 10% of the children enrolled may be children who are enrolled children from familes that exceed the low‐income guidelines but who meet the criteria that the program has establish for selecting such children and who would benefit from Head Start Services.

Procedures:

Income verification for all families must be completed prior to waitlist placement. All families whose income exceeds

federal poverty guidelines must receive prior approval for acceptance/enrollment from the ERSEA Coordinator.

Over income families with children with disabilities who have been determined eligible under Head Start Performance

Standard 1308.3 will be accepted/enrolled and approved by the Disabilities Coordinator and ERSEA Coordinator.


Date Revised:

Date Approved:



Subject: Eligibility: Income Verification for New and 3rd Year

Head Start Performance Standards: 1305.4 (c)

The family income must be verified by the Head Start program before determining that a child is eligible to participate in the program.

Procedures:

1. Verification of income must include examination of any of the following documents:

Individual Income Tax Form 1040

W‐2

Pay stubs

Written statements from employers

Documentation showing current status as recipients of public assistance

Unemployment

Workers Compensation

Social Security Benefits

Child Support/Alimony

Adoption Assistance

Foster Care Reimbursement

TANF

SSI

Veteran’s Benefits

Pension

Grants/Scholarships

Fellowships/Assistantship

Net Rental Income

Regular Insurance or Annuity Payments

Net Royalties, Gambling or Lottery Winnings

Interest/Dividends

No Income (Complete Statement of Income)


Date Approved:

Income Does NOT include

Capital Gains

Sale of Property

A house or car

Tax refunds, gifts, loans, lump sum inheritances

One time insurance payments or compensation for injury

Medicare

Medicaid

Food Stamps

School Lunches

Housing Assistance

2. During the first verification process, Parent Advocates will complete an Interview Worksheet and Income

Verification Tool Form (IVT) during the family application interview. Parent Advocate and Parent/Guardian will

sign the IVT confirming the accuracy of the completed form.

3. Interview Worksheet and the IVT form along with income source documents must be scanned and attached to

the child’s application in Child Plus and saved as Income Documentation under the Enrollment tab.

4. Parent Advocate will then notify their assigned 2nd Verifier to review the IVT income source documents for

errors and accuracy.

5. 2nd Verifier will print out Interview Worksheet and IVT form and review for completeness, errors and accuracy.

2nd Verifier will approve the IVT by signing the form. 2nd verifier will then scan the Interview Worksheet and IVT

along with income source documents and attach them to the child application in Child Plus and saved as

“updated Income” under the Enrollment tab.

6. Children/Families will then be placed on the waitlist pending acceptance and selection.



Subject: Completing the Income Verification Tool

Head Start Performance Standards: 1305.4 Age of children and family income eligibility. (a) To be eligible for

Head Start services, a child must be at least three years old by the date used to determine eligibility for public school in

the community in which the Head Start program is located, except in cases where the Head Start program’s approved

grant provides specific authority to serve younger children. (b) At least 90 percent of the children who are enrolled in

each Head Start program must be from low‐income families. Up to ten percent of the children who are enrolled may be

children from families that exceed the low‐income guidelines but who meet criteria the program has established for

selecting such children and who would benefit from Head Start services. (c) The family income must be verified by the

Head Start program before determining that a child is eligible to participate in the program. (d) Verification must include

examination of any of the following: Individual Income Tax Form 1040, W‐2 forms, pay stubs, pay envelopes, written

statements from employers, or documentation showing current status as recipients of public assistance. (e) A signed

statement by an employee of the Head Start program, identifying which of these documents was examined and stating

that the child is eligible to participate in the program, must be maintained to indicate that income verification has been

made.

Procedures

1. Print child’s first, middle, and last name.

2. Print child’s date of birth.

3. Print child age before September 1st.

4. Print family size.

To define number in family use standard 1305.2(e) which states: “Family means all persons living in the same household who are:

i. Supported by the income of the parent(s) or guardians of the child enrolling or participating in the program and

ii. Related to the parent(s) or guardian(s) by blood, marriage, or adoption.

5. Print total family annual income received for previous 12 months or previous calendar year.

6. Ask parent/guardian what source of income she/he received for the previous 12 months or previous

calendar year using the listing provided on form. Check appropriate box.

7. Check appropriate box of income parent/ guardian stated she or he received (Ref. 2011 Head Start

Poverty Guidelines – Performance Standard 1305.4). Left side for PA‐Primary Adult and/or Right side for

SA‐Secondary Adult.

8. Enter date and month used to determine income. (Previous or last calendar year).


9. Print a description of family income situation and how family received income. Ex. 1) Parent still

employed at same for 2 years and provided tax form 1040 and has received SSI since 2009 or Ex. 2)

Parent worked from January to September 2010 and provided a W2. Parent also receives 200 a month

child support since March 2010 which helped her while she was off from work. Parent will start a new

job in June 2011.

10. Ensure parent reviews form and understands disclosure on providing false information before signing

and dating form.

11. If paid cash request parent/guardian complete a declaration of income.

12. 1st Verifier will print name and title, then sign and date.

13. 2nd verifier will print name and title, then sign and date after verifying all income documents and

calculating income.

14. Use Notes/Contact Log to print communication on income status of family. May use as a worksheet to

calculate income.

15. Form must be completed and entered in Child Plus before child is enrolled.



Subject: New Application

Head Start Performance Standards: 1305.2 (b) Enrollment means the official acceptance of a family by a Head Start

program and the completion of all procedures necessary for a child and family to begin receiving services. 1304.51(g)

Record‐keeping systems. Grantee and delegate agencies must establish and maintain efficient and effective record‐

keeping systems to provide accurate and timely information regarding children, families, and staff and must ensure

appropriate confidentiality of this information

Procedures

Application is designed to be completed by staff in a face to face interview format with parent/guardian for child’s

enrollment to the program:

1. Enter Child Plus ID ‐ A Child Plus number will systematically be selected for each child as family

information is completed in the system. Input that Number on this line

2. Enter date of entry: Enter the date of the first day child is present in the classroom.

3. Enter Participation Year: Enter if the child participation year is 1st yr., 2nd yr, or 3rd yr.

4. Enter School Year: 2011‐2012

5. Enter name of school/center.

6. Enter applying child’s first, middle and last name as noted on the Birth Certificate.

7. Enter nickname (if applicable)

8. Enter date of birth using mm/dd/yyyy format. Date of birth must be verified.

9. Check what applies: M – Male or F ‐ Female

10. Enter Child’s Social Security Number. (Social Security # is not required for services).

11. Check Applicant’s Race: Asian, American Indian/Alaska Native, Black, Hawaiian/Pacific Islander, White,

Mutli‐Racial or Other.

12. Enter Applicant’s ethnicity: Ex. Hispanic, Black, African American, Caucasian etc.

13. Check if child has an IEP, IFSP or a doctor suspected disability. If an item is checked request documents

from Parent of Doctor, Therapist, Psychologist, and School District etc.

14. Check Primary Health Coverage that applies: CHIP, Medicaid, CHIP/Medicaid, Private, State‐Only Funded,

None or Other.


Date Revised:

Date Approved:

15. Enter Insurance number.

16. Enter Other Health Coverage.

17. Check Y‐yes or N‐no if applicant is currently enrolled in Early Head Start.

18. Check if Applicant is Not Eligible, on Medicaid, or Potentially Eligible.

19. Enter Medicaid Number. (If applicable.)

20. Enter Doctor Name, Clinic Name, Doctor Office phone number, and Doctor Office address.

21. Enter Dentist Name, Clinic Name, Dentist Office phone number, and Dentist office address.

22. Enter Family Living Address complete with city, and zip code.

23. Check if mailing address. If different enter mailing address with city, state, and zip code.

24. Enter Primary Phone number. Check what applies Cell, Home, Work, and other.

25. Enter notes: Ex. Call cell phone from 8:00 am to 2:00 pm, call home number after 5:00 pm etc.

26. Enter Secondary and Alternate Phone number: Check what applies Cell, Home, Work, and other. (If

applicable.)

27. Enter notes: Ex. Call cell phone number after 5:00 pm, Call work number 8:00 am to 4:00 pm etc.

28. Enter Parent Status by checking what applies: Is it a one parent home or a two parent home?

29. Enter Primary Language spoken at home.

30. Check yes or no if Refuge or Military family.

31. Check yes or no if referred by Child Welfare Agency.

32. Check yes or no if receiving Supplemental Nutrition Assistance Program.

33. Check TANF Status (Yes, no or formerly)

34. Check yes or no if receiving SSI (Security Supplement Income)

35. Check yes or no if receiving WIC. If applicable enter WIC ID #.

Primary Adult Information:

36. Enter Primary Adult’s Name

37. Enter the Primary Adult’s date of birth

38. Check Primary Adult gender: M‐male or F‐female.

39. Enter Primary Adult Social Security number

40. Check Primary Adult English Proficiency: P‐Proficient, M‐Moderate, L‐Little or N‐None

41. Enter Primary Adult other language, if applicable.

42. Enter the highest grade the Primary Adult has completed.

43. Check Primary Adult employment status: Full time‐FT, Part time‐PT, Full time & training‐FT, Part time &

training –PT, Retired/Disabled, Seasonal, Training/School, or Unemployed.

44. Check child’s relationship to Primary Adult: Natural/Adopted/Step, Foster, Grandchild, Niece/Nephew,

or other.

45. Check if Primary Adult has custody of Applicant: Y‐yes or N‐no.

46. Check if Primary Adult lives with Applicant’s family: Y‐yes or N‐no.

47. Check if Primary Adult financially supports Applicants: Y‐yes or N‐no.

48. Check if Primary Adult is active military: Y‐yes or N‐no.

49. Check if Primary Adult is deployed military: Y‐yes or N‐no.

50. Enter Secondary Adult’s Name

51. Enter Secondary Adult date of birth.

52. Check Secondary Adult gender M‐male or F‐female

53. Check what applies if Secondary Adult is married to Primary Adult –Y‐ yes or N – no

54. Check Secondary Adult English Proficiency – P Proficient, M‐Moderate, L‐Little, or N‐None

55. Enter Secondary Adult other language, if applicable

56. Enter the highest grade the Secondary Adult has completed.

57. Check Secondary Adult employment status: Full time‐FT, Part time‐PT, Full time‐ FT & training‐, Part

time ‐PT & training, Retired/Disabled, Seasonal, Training/School, or Unemployed.

58. Check child’s relationship to Secondary Adult: Natural/Adopted/Step, Foster, Grandchild, Niece/Nephew,

or other.

59. Check if Secondary adult has custody of Applicant: Y‐yes or N‐no

60. Check if Secondary Adult lives with Applicant’s family: Y‐yes or N‐no

61. Check if Secondary Adult financially supports Applicant: Y‐yes or N‐no

62. Check if Secondary Adult active duty military: Y‐yes or N‐no

63. Check if Secondary Adult deployed military: Y‐yes or N‐no

Additional Family Members Living in Household Information:

64. Enter A‐adult or C‐child to identify the additional family member(s) living in the household.

65. Enter name of the additional family member(s) living in the household.

66. Add date of birth of the additional family member(s) living in the household.

67. Enter the relationship the additional family member(s) is to Primary Adult.

68. Check if the additional family member is related to the Primary Adult by B‐blood, M‐marriage, or A‐

adoption.

69. Check if additional family member is supported by the income of Primary Adult: Y‐yes or N‐no

To define number in family use standard 1305.2(e) which states:

“Family means all persons living in the same household who are:

(1) Supported by the income of the parent(s) or guardians of

the child enrolling or participating in the program and

(2) related to the parent(s) or guardian(s) by blood, marriage

or adoption.”

70. Enter if the additional family members receive TANF (Temporary assistance for Needed

Families and/or SSI (Security Supplement for Income).

71. Parent/Guardian signs and dates application after review.

72. Enter Application information in the Child Plus system.



Subject: Recruitment

Head Start Performance Standards: 1305.5 (a) (b) (c)

(a) In order to reach those most in need of Head Start services, each Head Start grantee and delegate agency must develop and implement a recruitment process that is designed to actively inform all families with Head Start eligible children within the recruitment area of the availability of services and encourage them to apply for admission to the program. This process may include canvassing the local community, use of news releases and advertising, and use of family referrals and referrals from other public and private agencies. (b) During the recruitment process that occurs prior to the beginning of the enrollment year, a Head Start program must solicit applications from as many Head Start eligible families within the recruitment area as possible. If necessary, the program must assist families in filling out the application form in order to assure that all information needed for selection is completed.

(c) Each program, except migrant programs, must obtain a number of applications during the recruitment process that occurs prior to the beginning of the enrollment year that is greater than the enrollment opportunities that are anticipated to be available over the course of the next enrollment year in order to select those with the greatest need for Head Start services.

Procedures:

1. Recruitment will begin in January and continue throughout the summer, while acceptance of applications will be

ongoing through the school year.

2. All Head Start Staff members and Family Service Parent Advocates will participate and actively recruit.

3. All recruitment

4. Recruitment efforts can include:

Fliers – backpack, school and communities

Posters

Street Banners

School Marquees

Door to Door

Community Outreach and Events

Festivals, Fairs, Summits, Conferences

Newspapers, Radio

Child Care Providers


Date Approved:

Community Meetings and Centers

Social Media such as school websites, Facebook, and Twitter

WIC Offices

Hospitals, Clinics

Community Health Centers

TANF Agency, job training agencies

Public Housing

Laundromats

Grocery Stores

Homeless Shelters

Libraries

Bus Lines



Subject: Home Language Survey: Bilingual Testing

Head Start Performance Standards: Not applicable

Procedures:

When an applicant family completes a Home Language Survey and selects “Spanish” for questions 1, 2, or 3, this

automatically requires the child be tested to help determine the best instructional program for the child. It is

the goal of the SAISD Head Start Program to best meet the needs of each student and provide a quality

educational program for all students.

When completing an application in Child Plus the applicant’s status should be coded as Needs Bilingual Testing

(NBT). This will allow the ERSEA Team to identify applicants that require bilingual testing. The ERSEA Team will

provide a weekly NBT status report to the bilingual testing coordinator.

Head Start office will hire part‐time Certified Bilingual Testers for school year 2012‐2013. Part‐Time

Employment will be from the time period of March – Sept (As needed). A list of students will be provided for

each test administrator. Each test administrator must have previous training regarding how to administer the

WMLS Tests in English and Spanish (Form A) for initial placement into the bilingual program. All test

administrators will review the procedures for filling out the necessary paperwork on each student prior to

testing any students. Head Start and the Bilingual Dept. will provide training to review testing procedures and

responsibilities.

One test administrator will be assigned at each main site – Tynan, Carroll, Carvajal and Knox. They will also

provide testing support to the sub – centers. Testing to determine educational placement will be based on the

home language survey provided by the parent/guardian on the application.

The test administrator will:

1) Check the Home Language Survey to Determine testing needs and Make a copy of the Home Language

Survey

2) Contact the parent/guardian by phone

3) Schedule testing date, location and time at the centers and/or sub‐centers

4) Complete and return all WMLS forms back to the Head Start Coordinator


Date Approved:

The test administrator MUST fill out the following information on the WMLs forms:

1) Student’s Last Name

2) Student’s First Name

3) Student’s Sex – male or female

4) Subject ID ‐ (If assigned prior to testing)

5) Group ID – (if assigned prior to testing)

6) Student’s Date of Birth

7) School (if assigned prior to testing)

8) Teacher/Department – Test Adm. will write “Head Start”

9) Date of Testing

10) Grade – PK

11) Examiner’s Name

12) Additional Information area to be filled out:

Does the subject have glasses?

Were they used during testing?

Does the subject have a hearing aid?

Was it used during testing?

Other information

Language Exposure Information:

Country in which subject was born: (if information is available) – Test Administrator will check the birth

certificate from the application packet.

13) Language Use Questionnaire:

All 5 questions – The test administrator will obtain the information from the parent/guardian.

14) Test Session Observations Checklist‐ To be filled out after the child has been tested.

15) Test Administrator will administer Test 1 Picture Vocabulary and Test 2 Verbal Analogies in both English

and Spanish – Form A.

16) Test Administrator will tally up the total and mark in the box the Number Correct for each test.

17) Test Administrator will return all complete testing forms to the Head Start Coordinator for scoring.

Head Start Staff will:

1) Input the data and run the WMLS report with the CALP levels.

a. If the student scores a 4 or higher on the English portion of the assessment, the student does NOT

qualify for Bilingual Services and will be placed in an English classroom.

b. If the student scores a 1, 2 or 3 on the English portion of the assessment, they do qualify for

Bilingual Services and will be placed in a Bilingual classroom.

2) The student is then placed on the Bilingual list for the center closest to their home campus.

3) If space is not available and/or parent declines the next closest available vacancy, the student will be

placed on a waiting list.

The LPAC Coordinator and LPAC Committee will:

1) Schedule and conduct an LPAC meeting at the beginning of the school year ‐ 10 days from the child’s

entry date.

2) All Parent denials will be addressed through the LPAC committee procedures.

3) A LEP folder for each bilingual student (including parent denials) will be established at each center and/or

sub‐center by the designated LPAC Coordinator at the campus level.



Subject: ERSEA: Student Residency Questionnaire (SRQ)

Head Start Standards:

Procedure:

The completion of the Student Residency Questionnaire is a required form that must be completed by every SAISD Head Start Program applicant. The questionnaire is intended to address the McKinney‐Vento Education Act, 42 U.S.C. 11435. The applicant answers will help determine if they are eligible for McKinney‐Vento Services through the Transitions Program. Eligible McKinney‐Vento student status remains active for one academic year.

1. If the parent/guardian answered “YES” on SRQ form to question: a. Is this a temporary address due to a financial loss or other hardship?

i. A Head Start staff member who has been McKinney‐Vento trained will then follow up with the family to pre‐determine if they qualify under the McKinney‐Vento Act. If it is pre‐determined that the family qualifies, the Head Start staff member will scan and email the completed SRQ to the Transitions office for review and approval.

ii. The transitions Office will then email the SRQ and indicate in the bottom portion of the form if the family has meets the McKinney‐Vento Act requirements.

iii. If the family qualifies for the McKinney‐Vento Act the family is categorically eligible for Head Start Services.

iv. If the family does not qualify for the McKinney‐Vento Act the application will be processed in accordance to application procedures.

2. Determination of McKinney Vento: a. Individuals who are homeless lack a fixed, regular and adequate nighttime residence is homeless.

Families are also considered homeless if they are: i. sharing the housing of other persons due to loss of housing, economic hardship, or a similar

reason; ii. living in motels/hotels, trailer parks, or camping grounds due to lack of alternative adequate

accommodations; iii. living in emergency or transitional shelters; iv. abandoned in hospitals;

awaiting foster care placement; v. having a primary nighttime residence that is a public or private place not designed for or

ordinarily used as a regular sleeping accommodation for human beings such as a back porch, garage, drainage ditch, etc.

vi. living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings or

vii. Children placed with relatives or other adults under a “Safety Plan” signed by the parent through Child Protective Services are considered homeless.


Date Approved:



Subject: ERSEA: Transfers: Head Start to Head Start Partner

Head Start Performance Standards:

The Head Start/Early Head Start program will follow a transfer process from partner to partner.

Procedure:

1. When the Center Director, Principal, Teacher, or Head Start staff member becomes aware of a child requesting a transfer from the Head Start program, the Parent Advocate will be notified within 24 hours.

2. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to recover the child by either retaining their current enrollment or assisting in transferring the child to another Head Start Program.

3. The Parent Advocate will attempt to determine the reason why the family requesting a transfer and will work with the parent to eliminate or reduce any problems identified relating to the potential transfer of the child.

4. If a transfer is identified, the Parent Advocate will contact their Supervisor along with an ERSEA team member to help coordinate a transfer to another Head Start location.

5. To help coordinate a smooth transfer, families will be asked to provide proof of new address. The Parent Advocate will then scan and attach proof of new address to the child electronic file in Child Plus.

6. The Parent Advocate will notify an ERSEA team member to assist with the transfer to another Head Start Program.

7. An ERSEA team member will make contact with the receiving Head Start Program to coordinate the requested transfer. If a vacant slot is available the SAISD ERSEA team member will code the child in Child Plus and transfer the child to the receiving Head Start Program. If a slot is not available, the child will be coded properly in Child Plus and will be waitlisted at the receiving Head Start Program.

8. The Parent Advocate will contact the family and relay all actions relating to the transfer and will be provided contact information of the receiving Head Start Program.

9. The parent will be required to complete SAISD withdrawal paperwork at the SAISD campus. 10. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the

child’s electronic file in the Child Plus Software.


Date Approved:



Subject: ERSEA: Transfers: Head Start to Head Start within SAISD


The Head Start/Early Head Start program will follow the SAISD Pre‐Kindergarten In‐District Transfer Request (SAISD FORM F27‐D).

Procedure:

1. No out of district children will be accepted. 2. A parent/guardian living in the SAISD boundaries may request that the child be placed at another campus for

one year if the program is not offered at the home campus, if the home school does not have room or for a hardship reason the parent may express.

3. The parent/guardian must complete the SAISD Pre‐Kindergarten In‐District Transfer Request (FORM F27‐D) at the home campus.

4. The principal shall review the Terms & Conditions with the parent, sign section C, and send to the ECE office. 5. The request will be reviewed and approved at the ECE office. Please note that the approval is for the transfer

request. The home campus is responsible for processing Head Start applications. The receiving campus will be notified of the request. The receiving campus will verify that the Head Start application is complete and valid before admitting the student.


7. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to determine the reason why the family is requesting a transfer and will work with the parent to eliminate or reduce any problems relating to the transfer request of the child.

8. If a transfer is identified, the Parent Advocate will contact their Supervisor along with an ERSEA team member to help coordinate a transfer to another SAISD Head Start location.

9. If there is not a vacant slot at the requested campus, the child will be placed on the Head Start waitlist until a slot becomes available.

10. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the child’s electronic file in the Child Plus Software.


Date Approved:



Subject: ERSEA: Withdrawals


The Head Start/Early Head Start program will follow a withdrawal process.

Procedure:

1. When the Center Director, Principal, Teacher, or Head Start staff member becomes aware of a child requesting a withdrawal from the Head Start program, the Parent Advocate will be notified within 24 hours.

2. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to recover the child by either retaining their current enrollment or assisting in transferring the child to another Head Start provider.

3. The Parent Advocate will attempt to determine the reason why the family is withdrawing to work with the parent to eliminate or reduce any problems relating to the potential withdrawal of the child and encourage the parent to remain in the Head Start program.

4. If a transfer is identified, the Parent Advocate will contact an ERSEA team member to help coordinate a transfer to another Head Start provider.

5. If the family follows through the withdrawal process the parent will be required to follow the SAISD withdrawal procedures at their assigned SAISD campus.

6. The Parent Advocate will also inform the family that any child withdrawn from the Head Start program will require the family to re‐apply for services.

7. The Parent Advocate will notify ERSEA team members of the withdrawal from the Head Start Program. 8. The ERSEA team member will review notes in Child Plus and change status of child to Abandoned. 9. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the

child’s electronic file in the Child Plus Software


Date Approved:






Procedures:




birth certificate;

driver's license;

passport;


military ID;


adoption records;




Date Revised:

Date Approved:



Subject: Eligibility: Over Income

Head Start Performance Standards: 1305.4 (b1 & 2)

(b1) At least 90 percent of children who are enrolled in each Head Start program must be from low-income families.

(b2) Up to 10% of the children enrolled may be children who are enrolled children from familes that exceed the low-income guidelines but who meet the criteria that the program has establish for selecting such children and who would benefit from Head Start Services.

Procedures:

Income verification for all families must be completed prior to waitlist placement. All families whose income exceeds federal poverty guidelines must receive prior approval for acceptance/enrollment from the ERSEA Coordinator.

Over income families with children with disabilities who have been determined eligible under Head Start Performance Standard 1308.3 will be accepted/enrolled and approved by the Disabilities Coordinator and ERSEA Coordinator.


Date Revised:

Date Approved:



Subject: Eligibility: Income Verification for New and 3rd

Head Start Performance Standards: 1305.4 (c)

Year

The family income must be verified by the Head Start program before determining that a child is eligible to participate in the program.

Procedures:

1. Verification of income must include examination of any of the following documents: • Individual Income Tax Form 1040 • W-2 • Pay stubs • Written statements from employers • Documentation showing current status as recipients of public assistance • Unemployment • Workers Compensation • Social Security Benefits • Child Support/Alimony • Adoption Assistance • Foster Care Reimbursement • TANF • SSI • Veteran’s Benefits • Pension • Grants/Scholarships • Fellowships/Assistantship • Net Rental Income • Regular Insurance or Annuity Payments • Net Royalties, Gambling or Lottery Winnings • Interest/Dividends • No Income (Complete Statement of Income)


Date Revised:

Date Approved:

Income Does NOT include

• Capital Gains • Sale of Property • A house or car • Tax refunds, gifts, loans, lump sum inheritances • One time insurance payments or compensation for injury • Medicare • Medicaid • Food Stamps • School Lunches • Housing Assistance

2. During the first verification process, Parent Advocates will complete an Interview Worksheet and Income Verification Tool Form (IVT) during the family application interview. Parent Advocate and Parent/Guardian will sign the IVT confirming the accuracy of the completed form.

3. Interview Worksheet and the IVT form along with income source documents must be scanned and attached to the child’s application in Child Plus and saved as Income Documentation under the Enrollment tab.

4. Parent Advocate will then notify their assigned 2nd

5. 2

Verifier to review the IVT income source documents for errors and accuracy.

nd Verifier will print out Interview Worksheet and IVT form and review for completeness, errors and accuracy. 2nd Verifier will approve the IVT by signing the form. 2nd

6. Children/Families will then be placed on the waitlist pending acceptance and selection.

verifier will then scan the Interview Worksheet and IVT along with income source documents and attach them to the child application in Child Plus and saved as “updated Income” under the Enrollment tab.



Subject: Completing the Income Verification Tool


Procedures

1305.4 Age of children and family income eligibility. (a) To be eligible for Head Start services, a child must be at least three years old by the date used to determine eligibility for public school in the community in which the Head Start program is located, except in cases where the Head Start program’s approved grant provides specific authority to serve younger children. (b) At least 90 percent of the children who are enrolled in each Head Start program must be from low-income families. Up to ten percent of the children who are enrolled may be children from families that exceed the low-income guidelines but who meet criteria the program has established for selecting such children and who would benefit from Head Start services. (c) The family income must be verified by the Head Start program before determining that a child is eligible to participate in the program. (d) Verification must include examination of any of the following: Individual Income Tax Form 1040, W-2 forms, pay stubs, pay envelopes, written statements from employers, or documentation showing current status as recipients of public assistance. (e) A signed statement by an employee of the Head Start program, identifying which of these documents was examined and stating that the child is eligible to participate in the program, must be maintained to indicate that income verification has been made.

1. Print child’s first, middle, and last name.

2. Print child’s date of birth.

3. Print child age before September 1st

4. Print family size.

.

To define number in family use standard 1305.2(e) which states: “Family means all persons living in the same household who are:

i. Supported by the income of the parent(s) or guardians of the child enrolling or participating in the program and

ii. Related to the parent(s) or guardian(s) by blood, marriage, or adoption.

5. Print total family annual income received for previous 12 months or previous calendar year.

6. Ask parent/guardian what source of income she/he received for the previous 12 months or previous

calendar year using the listing provided on form. Check appropriate box.

7. Check appropriate box of income parent/ guardian stated she or he received (Ref. 2011 Head Start

Poverty Guidelines – Performance Standard 1305.4). Left side for PA-Primary Adult and/or Right side for

SA-Secondary Adult.

8. Enter date and month used to determine income. (Previous or last calendar year).


9. Print a description of family income situation and how family received income. Ex. 1) Parent still

employed at same for 2 years and provided tax form 1040 and has received SSI since 2009 or Ex. 2)

Parent worked from January to September 2010 and provided a W2. Parent also receives 200 a month

child support since March 2010 which helped her while she was off from work. Parent will start a new

job in June 2011.

10. Ensure parent reviews form and understands disclosure on providing false information before signing

and dating form.

11. If paid cash request parent/guardian complete a declaration of income.

12. 1st

13. 2

Verifier will print name and title, then sign and date. nd

14. Use Notes/Contact Log to print communication on income status of family. May use as a worksheet to

calculate income.

verifier will print name and title, then sign and date after verifying all income documents and

calculating income.

15. Form must be completed and entered in Child Plus before child is enrolled.



Subject: New Application

Head Start Performance Standards: 1305.2

Procedures

(b) Enrollment means the official acceptance of a family by a Head Start program and the completion of all procedures necessary for a child and family to begin receiving services. 1304.51(g) Record-keeping systems. Grantee and delegate agencies must establish and maintain efficient and effective record-keeping systems to provide accurate and timely information regarding children, families, and staff and must ensure appropriate confidentiality of this information

Application is designed to be completed by staff in a face to face interview format with parent/guardian for child’s enrollment to the program:

1. Enter Child Plus ID - A Child Plus number will systematically be selected for each child as family

information is completed in the system. Input that Number on this line

2. Enter date of entry: Enter the date of the first day child is present in the classroom.

3. Enter Participation Year: Enter if the child participation year is 1st yr., 2nd yr, or 3rd

4. Enter School Year: 2011-2012

yr.

5. Enter name of school/center.

6. Enter applying child’s first, middle and last name as noted on the Birth Certificate.

7. Enter nickname (if applicable)

8. Enter date of birth using mm/dd/yyyy format. Date of birth must be verified.

9. Check what applies: M – Male or F - Female

10. Enter Child’s Social Security Number. (Social Security # is not required for services).

11. Check Applicant’s Race: Asian, American Indian/Alaska Native, Black, Hawaiian/Pacific Islander, White,

Mutli-Racial or Other.

12. Enter Applicant’s ethnicity: Ex. Hispanic, Black, African American, Caucasian etc.

13. Check if child has an IEP, IFSP or a doctor suspected disability. If an item is checked request documents

from Parent of Doctor, Therapist, Psychologist, and School District etc.

14. Check Primary Health Coverage that applies: CHIP, Medicaid, CHIP/Medicaid, Private, State-Only Funded,

None or Other.


Date Revised:

Date Approved:

15. Enter Insurance number.

16. Enter Other Health Coverage.

17. Check Y-yes or N-no if applicant is currently enrolled in Early Head Start.

18. Check if Applicant is Not Eligible, on Medicaid, or Potentially Eligible.

19. Enter Medicaid Number. (If applicable.)

20. Enter Doctor Name, Clinic Name, Doctor Office phone number, and Doctor Office address.

21. Enter Dentist Name, Clinic Name, Dentist Office phone number, and Dentist office address.

22. Enter Family Living Address complete with city, and zip code.

23. Check if mailing address. If different enter mailing address with city, state, and zip code.

24. Enter Primary Phone number. Check what applies Cell, Home, Work, and other.

25. Enter notes: Ex. Call cell phone from 8:00 am to 2:00 pm, call home number after 5:00 pm etc.

26. Enter Secondary and Alternate Phone number: Check what applies Cell, Home, Work, and other. (If

applicable.)

27. Enter notes: Ex. Call cell phone number after 5:00 pm, Call work number 8:00 am to 4:00 pm etc.

28. Enter Parent Status by checking what applies: Is it a one parent home or a two parent home?

29. Enter Primary Language spoken at home.

30. Check yes or no if Refuge or Military family.

31. Check yes or no if referred by Child Welfare Agency.

32. Check yes or no if receiving Supplemental Nutrition Assistance Program.

33. Check TANF Status (Yes, no or formerly)

34. Check yes or no if receiving SSI (Security Supplement Income)

35. Check yes or no if receiving WIC. If applicable enter WIC ID #.

Primary Adult Information:

36. Enter Primary Adult’s Name

37. Enter the Primary Adult’s date of birth

38. Check Primary Adult gender: M-male or F-female.

39. Enter Primary Adult Social Security number

40. Check Primary Adult English Proficiency: P-Proficient, M-Moderate, L-Little or N-None

41. Enter Primary Adult other language, if applicable.

42. Enter the highest grade the Primary Adult has completed.

43. Check Primary Adult employment status: Full time-FT, Part time-PT, Full time & training-FT, Part time &

training –PT, Retired/Disabled, Seasonal, Training/School, or Unemployed.

44. Check child’s relationship to Primary Adult: Natural/Adopted/Step, Foster, Grandchild, Niece/Nephew,

or other.

45. Check if Primary Adult has custody of Applicant: Y-yes or N-no.

46. Check if Primary Adult lives with Applicant’s family: Y-yes or N-no.

47. Check if Primary Adult financially supports Applicants: Y-yes or N-no.

48. Check if Primary Adult is active military: Y-yes or N-no.

49. Check if Primary Adult is deployed military: Y-yes or N-no.

50. Enter Secondary Adult’s Name

51. Enter Secondary Adult date of birth.

52. Check Secondary Adult gender M-male or F-female

53. Check what applies if Secondary Adult is married to Primary Adult –Y- yes or N – no

54. Check Secondary Adult English Proficiency – P Proficient, M-Moderate, L-Little, or N-None

55. Enter Secondary Adult other language, if applicable

56. Enter the highest grade the Secondary Adult has completed.

57. Check Secondary Adult employment status: Full time-FT, Part time-PT, Full time- FT & training-, Part

time -PT & training, Retired/Disabled, Seasonal, Training/School, or Unemployed.

58. Check child’s relationship to Secondary Adult: Natural/Adopted/Step, Foster, Grandchild, Niece/Nephew,

or other.

59. Check if Secondary adult has custody of Applicant: Y-yes or N-no

60. Check if Secondary Adult lives with Applicant’s family: Y-yes or N-no

61. Check if Secondary Adult financially supports Applicant: Y-yes or N-no

62. Check if Secondary Adult active duty military: Y-yes or N-no

63. Check if Secondary Adult deployed military: Y-yes or N-no

Additional Family Members Living in Household Information:

64. Enter A-adult or C-child to identify the additional family member(s) living in the household.

65. Enter name of the additional family member(s) living in the household.

66. Add date of birth of the additional family member(s) living in the household.

67. Enter the relationship the additional family member(s) is to Primary Adult.

68. Check if the additional family member is related to the Primary Adult by B-blood, M-marriage, or A-

adoption.

69. Check if additional family member is supported by the income of Primary Adult: Y-yes or N-no

To define number in family use standard 1305.2(e) which states:

“Family means all persons living in the same household who are:

(1) Supported by the income of the parent(s) or guardians of

the child enrolling or participating in the program and

(2) related to the parent(s) or guardian(s) by blood, marriage

or adoption.”

70. Enter if the additional family members receive TANF (Temporary assistance for Needed

Families and/or SSI (Security Supplement for Income).

71. Parent/Guardian signs and dates application after review.

72. Enter Application information in the Child Plus system.



Subject: Recruitment

Head Start Performance Standards: 1305.5 (a) (b) (c)

(a) In order to reach those most in need of Head Start services, each Head Start grantee and delegate agency must develop and implement a recruitment process that is designed to actively inform all families with Head Start eligible children within the recruitment area of the availability of services and encourage them to apply for admission to the program. This process may include canvassing the local community, use of news releases and advertising, and use of family referrals and referrals from other public and private agencies. (b) During the recruitment process that occurs prior to the beginning of the enrollment year, a Head Start program must solicit applications from as many Head Start eligible families within the recruitment area as possible. If necessary, the program must assist families in filling out the application form in order to assure that all information needed for selection is completed.

(c) Each program, except migrant programs, must obtain a number of applications during the recruitment process that occurs prior to the beginning of the enrollment year that is greater than the enrollment opportunities that are anticipated to be available over the course of the next enrollment year in order to select those with the greatest need for Head Start services.

Procedures:

1. Recruitment will begin in January and continue throughout the summer, while acceptance of applications will be ongoing through the school year.

2. All Head Start Staff members and Family Service Parent Advocates will participate and actively recruit. 3. All recruitment 4. Recruitment efforts can include:

• Fliers – backpack, school and communities • Posters • Street Banners • School Marquees • Door to Door • Community Outreach and Events • Festivals, Fairs, Summits, Conferences • Newspapers, Radio • Child Care Providers


Date Revised:

Date Approved:

• Community Meetings and Centers • Social Media such as school websites, Facebook, and Twitter • WIC Offices • Hospitals, Clinics • Community Health Centers • TANF Agency, job training agencies • Public Housing • Laundromats • Grocery Stores • Homeless Shelters • Libraries • Bus Lines



Subject: Home Language Survey: Bilingual Testing

Head Start Performance Standards: Not applicable

Procedures:

When an applicant family completes a Home Language Survey and selects “Spanish” for questions 1, 2, or 3, this automatically requires the child be tested to help determine the best instructional program for the child. It is the goal of the SAISD Head Start Program to best meet the needs of each student and provide a quality educational program for all students.

When completing an application in Child Plus the applicant’s status should be coded as Needs Bilingual Testing (NBT). This will allow the ERSEA Team to identify applicants that require bilingual testing. The ERSEA Team will provide a weekly NBT status report to the bilingual testing coordinator.

Head Start office will hire part-time Certified Bilingual Testers for school year 2012-2013. Part-Time Employment will be from the time period of March – Sept (As needed). A list of students will be provided for each test administrator. Each test administrator must have previous training regarding how to administer the WMLS Tests in English and Spanish (Form A) for initial placement into the bilingual program. All test administrators will review the procedures for filling out the necessary paperwork on each student prior to testing any students. Head Start and the Bilingual Dept. will provide training to review testing procedures and responsibilities.

One test administrator will be assigned at each main site – Tynan, Carroll, Carvajal and Knox. They will also provide testing support to the sub – centers. Testing to determine educational placement will be based on the home language survey provided by the parent/guardian on the application.

The test administrator will:

1) Check the Home Language Survey to Determine testing needs and Make a copy of the Home Language Survey

2) Contact the parent/guardian by phone 3) Schedule testing date, location and time at the centers and/or sub-centers 4) Complete and return all WMLS forms back to the Head Start Coordinator


Date Revised:

Date Approved:

The test administrator MUST fill out the following information on the WMLs forms:

1) Student’s Last Name 2) Student’s First Name 3) Student’s Sex – male or female 4) Subject ID - (If assigned prior to testing) 5) Group ID – (if assigned prior to testing) 6) Student’s Date of Birth 7) School (if assigned prior to testing) 8) Teacher/Department – Test Adm. will write “Head Start” 9) Date of Testing 10) Grade – PK 11) Examiner’s Name 12) Additional Information area to be filled out:

Does the subject have glasses? Were they used during testing? Does the subject have a hearing aid? Was it used during testing? Other information Language Exposure Information: Country in which subject was born: (if information is available) – Test Administrator will check the birth certificate from the application packet.

13) Language Use Questionnaire: All 5 questions – The test administrator will obtain the information from the parent/guardian.

14) Test Session Observations Checklist- To be filled out after the child has been tested. 15) Test Administrator will administer Test 1 Picture Vocabulary and Test 2 Verbal Analogies in both English

and Spanish – Form A. 16) Test Administrator will tally up the total and mark in the box the Number Correct for each test. 17) Test Administrator will return all complete testing forms to the Head Start Coordinator for scoring.

Head Start Staff will:

1) Input the data and run the WMLS report with the CALP levels. a. If the student scores a 4 or higher on the English portion of the assessment, the student does NOT qualify for Bilingual Services and will be placed in an English classroom. b. If the student scores a 1, 2 or 3 on the English portion of the assessment, they do qualify for

Bilingual Services and will be placed in a Bilingual classroom. 2) The student is then placed on the Bilingual list for the center closest to their home campus. 3) If space is not available and/or parent declines the next closest available vacancy, the student will be

placed on a waiting list.

The LPAC Coordinator and LPAC Committee will:

1) Schedule and conduct an LPAC meeting at the beginning of the school year - 10 days from the child’s entry date.

2) All Parent denials will be addressed through the LPAC committee procedures.

3) A LEP folder for each bilingual student (including parent denials) will be established at each center and/or sub-center by the designated LPAC Coordinator at the campus level.



Subject: ERSEA: Student Residency Questionnaire (SRQ)

Head Start Standards:

Procedure:

The completion of the Student Residency Questionnaire is a required form that must be completed by every SAISD Head Start Program applicant. The questionnaire is intended to address the McKinney-Vento Education Act, 42 U.S.C. 11435. The applicant answers will help determine if they are eligible for McKinney-Vento Services through the Transitions Program. Eligible McKinney-Vento student status remains active for one academic year.

1. If the parent/guardian answered “YES” on SRQ form to question: a. Is this a temporary address due to a financial loss or other hardship?

i. A Head Start staff member who has been McKinney-Vento trained will then follow up with the family to pre-determine if they qualify under the McKinney-Vento Act. If it is pre-determined that the family qualifies, the Head Start staff member will scan and email the completed SRQ to the Transitions office for review and approval.

ii. The transitions Office will then email the SRQ and indicate in the bottom portion of the form if the family has meets the McKinney-Vento Act requirements.

iii. If the family qualifies for the McKinney-Vento Act the family is categorically eligible for Head Start Services.

iv. If the family does not qualify for the McKinney-Vento Act the application will be processed in accordance to application procedures.

2. Determination of McKinney Vento: a. Individuals who are homeless lack a fixed, regular and adequate nighttime residence is homeless.

Families are also considered homeless if they are: i. sharing the housing of other persons due to loss of housing, economic hardship, or a similar

reason; ii. living in motels/hotels, trailer parks, or camping grounds due to lack of alternative adequate

accommodations; iii. living in emergency or transitional shelters; iv. abandoned in hospitals;

• awaiting foster care placement; v. having a primary nighttime residence that is a public or private place not designed for or

ordinarily used as a regular sleeping accommodation for human beings such as a back porch, garage, drainage ditch, etc.

vi. living in cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings or

vii. Children placed with relatives or other adults under a “Safety Plan” signed by the parent through Child Protective Services are considered homeless.


Date Revised:

Date Approved:



Subject: ERSEA: Transfers: Head Start to Head Start Partner


The Head Start/Early Head Start program will follow a transfer process from partner to partner.

Procedure:


2. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to recover the child by either retaining their current enrollment or assisting in transferring the child to another Head Start Program.

3. The Parent Advocate will attempt to determine the reason why the family requesting a transfer and will work with the parent to eliminate or reduce any problems identified relating to the potential transfer of the child.

4. If a transfer is identified, the Parent Advocate will contact their Supervisor along with an ERSEA team member to help coordinate a transfer to another Head Start location.

5. To help coordinate a smooth transfer, families will be asked to provide proof of new address. The Parent Advocate will then scan and attach proof of new address to the child electronic file in Child Plus.

6. The Parent Advocate will notify an ERSEA team member to assist with the transfer to another Head Start Program.

7. An ERSEA team member will make contact with the receiving Head Start Program to coordinate the requested transfer. If a vacant slot is available the SAISD ERSEA team member will code the child in Child Plus and transfer the child to the receiving Head Start Program. If a slot is not available, the child will be coded properly in Child Plus and will be waitlisted at the receiving Head Start Program.

8. The Parent Advocate will contact the family and relay all actions relating to the transfer and will be provided contact information of the receiving Head Start Program.

9. The parent will be required to complete SAISD withdrawal paperwork at the SAISD campus. 10. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the

child’s electronic file in the Child Plus Software.


Date Revised:

Date Approved:



Subject: ERSEA: Transfers: Head Start to Head Start within SAISD


The Head Start/Early Head Start program will follow the SAISD Pre-Kindergarten In-District Transfer Request (SAISD FORM F27-D).

Procedure:

1. No out of district children will be accepted. 2. A parent/guardian living in the SAISD boundaries may request that the child be placed at another campus for

one year if the program is not offered at the home campus, if the home school does not have room or for a hardship reason the parent may express.

3. The parent/guardian must complete the SAISD Pre-Kindergarten In-District Transfer Request (FORM F27-D) at the home campus.

4. The principal shall review the Terms & Conditions with the parent, sign section C, and send to the ECE office. 5. The request will be reviewed and approved at the ECE office. Please note that the approval is for the transfer

request. The home campus is responsible for processing Head Start applications. The receiving campus will be notified of the request. The receiving campus will verify that the Head Start application is complete and valid before admitting the student.


7. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to determine the reason why the family is requesting a transfer and will work with the parent to eliminate or reduce any problems relating to the transfer request of the child.

8. If a transfer is identified, the Parent Advocate will contact their Supervisor along with an ERSEA team member to help coordinate a transfer to another SAISD Head Start location.

9. If there is not a vacant slot at the requested campus, the child will be placed on the Head Start waitlist until a slot becomes available.

10. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the child’s electronic file in the Child Plus Software.


Date Revised:

Date Approved:

SAN ANTONIO INDEPENDENT SCHOOL DISTRICT

PRE-KINDERGARTEN IN-DISTRICT TRANSFER REQUEST

School Year ________ - ________ The Pre-Kindergarten Transfer Request is to be completed by parents/guardians who request a temporary placement for a child from their residential attendance zone to another school within the San Antonio Independent School District.

The request for transfer shall require a minimum 5-day waiting period in order for administration to determine availability and/or probability of space and pupil-teacher ratios as two of the factors that shall be considered prior to approval of any transfer request. Other factors that will be considered include, but are not limited to, administration’s projection of adverse impact on the home campus and/or receiving campus and/or class; the need to maintain staffing levels and/or class size; the impact on and/or displacement of another student; adverse impact on attendance zones; facility limitations or changes, and other reasons.

The student must return to the home school the following year.

A. Parent/Guardian must complete this section. Please print.

Name of Student: Age: Last First Middle As of September 1

Address: City/State: Zip:

Home Phone: Work Phone: Students Birth Date: / /

The home school is/will be: School Grade (at time of transfer):

Does your child receive: Special Education services? Yes No Section 504 services? Yes No

Do you live within the boundaries of the SAISD? Yes No

Are either parent/guardian employees of the San Antonio Independent School District? Yes No

Name of Employee:

Current Position: Location:

Requested Schools: , ,

Reason(s) for Transfer Request: Please state your reason(s) for requesting placement.

Overcrowding at home school or no program available at home school.

Child has moved into another SAISD attendance area and is requesting to stay at current campus for the remainder of the school year.

Other parent request. Please explain:

Printed Name of Parent/Guardian:

Signature of Parent/Guardian: Date:

Please be aware that District policy requires that you be informed that presenting false information/records for identification is a criminal offense [Penal Code §37.10], and knowingly falsifying information on a form required for enrollment in the District may make the person liable for tuition or other costs as provided in District Policy FD (LEGAL) and Texas Education Code §25.001(h).

San Antonio Independent School District does not discriminate on the basis of race, religion, color, national origin, sex, or disability in providing education services, activities, and programs, including vocational programs, in accordance with Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Educational Amendments of 1972; Section 504 of the Rehabilitation Act of 1973, as amended.

Revised April 2006 Page 1 of 2 FORM F27-D


B. Parent/Guardian must carefully read the Terms & Conditions of Temporary Transfer and sign the acknowledgement of

understanding. TERMS & CONDITIONS OF TEMPORARY TRANSFER

Term of transfer: A transfer is considered valid as long as the student and parent/guardian comply with all of these conditions and the transfer is not revoked for any reason by the campus administration or Early Childhood Department.

1. A transfer student shall be responsible for complying with the policies and rules in the SAISD Student Code of Conduct and the school rules of the receiving campus and shall be subject to disciplinary consequences as established in the SAISD Student Code of Conduct.

2. A transfer student shall be responsible for maintaining attendance as required by law. The school shall take action against the parent and/or the student in accordance with compulsory attendance laws.

3. The student must return to the home school the following year. 4. The temporary transfer request applies only to the students named above and shall not be considered grounds for temporary

transfer of other family members. 5. Applicable to students placed in response to parent preference only: In the event of overcrowding at the receiving school, the

neighborhood student shall be given priority in placement over the transferred student. Therefore, the temporary transferred student could be returned to the home school based on the District’s last-in-first-out procedure. Space availability, staffing ratios, or other District factors may be cause for revocation of a temporary placement as a result of parent preference.

6. The parent/guardian shall be responsible for all transportation of the student; no District transportation is available. 7. The District official in the Early Childhood Department determines the campus placement for all approved temporary transfers.

Note: The District has the authority to verify all of the information submitted regarding this transfer request. The District reserves the right to invalidate or revoke an approved transfer which has been based upon false information knowingly submitted by the parent/guardian in the application process. As the parent/guardian, I hereby acknowledge my understanding of the Terms & Conditions as noted above.


C. Parent/Guardian must contact the home school principal. A conference is not required but either the parent/guardian or the principal may request a conference to review the request. If the program is not available or there are space limitations in the program at the home school, the parent/guardian may make a request for transfer at another school. Signature of home school principal signifies that the principal is aware of the request and that the child requesting the transfer qualifies for the Pre-K Program. Signature does not imply approval of the request.

Home School Principal Use Only: Qualifies Yes No Qualifying Criteria: Income Language Homelessness Active Military Family/Protective Services Conservatorship requirement

Signature of Home School Principal: Date:

Home school principal must send original signed form, copy of Pre-K application and supporting documentation to Early Childhood Department. Do not fax.

D. Decision of District Official: Contacted principal of requested school (date):

via phone via e-mail

Notes:

Approved Denied Placement at (name of school):

Transfer Code: Student ID #:

Signature of District Official: Date:

Early Childhood Department Use Only:

Copy to home school (date): Copy to receiving school (date): Parent notified (date):



Subject: ERSEA: Withdrawals


The Head Start/Early Head Start program will follow a withdrawal process.

Procedure:

1. When the Center Director, Principal, Teacher, or Head Start staff member becomes aware of a child requesting a withdrawal from the Head Start program, the Parent Advocate will be notified within 24 hours.

2. The Parent Advocate will attempt to contact the family in order to assist in the transition process. The Parent Advocate will attempt to recover the child by either retaining their current enrollment or assisting in transferring the child to another Head Start provider.

3. The Parent Advocate will attempt to determine the reason why the family is withdrawing to work with the parent to eliminate or reduce any problems relating to the potential withdrawal of the child and encourage the parent to remain in the Head Start program.

4. If a transfer is identified, the Parent Advocate will contact an ERSEA team member to help coordinate a transfer to another Head Start provider.

5. If the family follows through the withdrawal process the parent will be required to follow the SAISD withdrawal procedures at their assigned SAISD campus.

6. The Parent Advocate will also inform the family that any child withdrawn from the Head Start program will require the family to re-apply for services.

7. The Parent Advocate will notify ERSEA team members of the withdrawal from the Head Start Program. 8. The ERSEA team member will review notes in Child Plus and change status of child to Abandoned. 9. The Parent Advocate along will any and all Head Start staff members are required to record all notes in the

child’s electronic file in the Child Plus Software


Date Revised:

Date Approved:

SAN ANTONIO INDEPENDENT SCHOOL DISTRICT

PRE-KINDERGARTEN IN-DISTRICT TRANSFER REQUEST

School Year ________ - ________ The Pre-Kindergarten Transfer Request is to be completed by parents/guardians who request a temporary placement for a child from their residential attendance zone to another school within the San Antonio Independent School District.

The request for transfer shall require a minimum 5-day waiting period in order for administration to determine availability and/or probability of space and pupil-teacher ratios as two of the factors that shall be considered prior to approval of any transfer request. Other factors that will be considered include, but are not limited to, administration’s projection of adverse impact on the home campus and/or receiving campus and/or class; the need to maintain staffing levels and/or class size; the impact on and/or displacement of another student; adverse impact on attendance zones; facility limitations or changes, and other reasons.

The student must return to the home school the following year.

A. Parent/Guardian must complete this section. Please print.

Name of Student: Age: Last First Middle As of September 1

Address: City/State: Zip:

Home Phone: Work Phone: Students Birth Date: / /

The home school is/will be: School Grade (at time of transfer):

Does your child receive: Special Education services? Yes No Section 504 services? Yes No

Do you live within the boundaries of the SAISD? Yes No

Are either parent/guardian employees of the San Antonio Independent School District? Yes No

Name of Employee:

Current Position: Location:

Requested Schools: , ,

Reason(s) for Transfer Request: Please state your reason(s) for requesting placement.

Overcrowding at home school or no program available at home school.

Child has moved into another SAISD attendance area and is requesting to stay at current campus for the remainder of the school year.

Other parent request. Please explain:

Printed Name of Parent/Guardian:


Please be aware that District policy requires that you be informed that presenting false information/records for identification is a criminal offense [Penal Code §37.10], and knowingly falsifying information on a form required for enrollment in the District may make the person liable for tuition or other costs as provided in District Policy FD (LEGAL) and Texas Education Code §25.001(h).

San Antonio Independent School District does not discriminate on the basis of race, religion, color, national origin, sex, or disability in providing education services, activities, and programs, including vocational programs, in accordance with Title VI of the Civil Rights Act of 1964, as amended; Title IX of the Educational Amendments of 1972; Section 504 of the Rehabilitation Act of 1973, as amended.



B. Parent/Guardian must carefully read the Terms & Conditions of Temporary Transfer and sign the acknowledgement of

understanding. TERMS & CONDITIONS OF TEMPORARY TRANSFER

Term of transfer: A transfer is considered valid as long as the student and parent/guardian comply with all of these conditions and the transfer is not revoked for any reason by the campus administration or Early Childhood Department.

1. A transfer student shall be responsible for complying with the policies and rules in the SAISD Student Code of Conduct and the school rules of the receiving campus and shall be subject to disciplinary consequences as established in the SAISD Student Code of Conduct.

2. A transfer student shall be responsible for maintaining attendance as required by law. The school shall take action against the parent and/or the student in accordance with compulsory attendance laws.

3. The student must return to the home school the following year. 4. The temporary transfer request applies only to the students named above and shall not be considered grounds for temporary

transfer of other family members. 5. Applicable to students placed in response to parent preference only: In the event of overcrowding at the receiving school, the

neighborhood student shall be given priority in placement over the transferred student. Therefore, the temporary transferred student could be returned to the home school based on the District’s last-in-first-out procedure. Space availability, staffing ratios, or other District factors may be cause for revocation of a temporary placement as a result of parent preference.

6. The parent/guardian shall be responsible for all transportation of the student; no District transportation is available. 7. The District official in the Early Childhood Department determines the campus placement for all approved temporary transfers.

Note: The District has the authority to verify all of the information submitted regarding this transfer request. The District reserves the right to invalidate or revoke an approved transfer which has been based upon false information knowingly submitted by the parent/guardian in the application process. As the parent/guardian, I hereby acknowledge my understanding of the Terms & Conditions as noted above.


C. Parent/Guardian must contact the home school principal. A conference is not required but either the parent/guardian or the principal may request a conference to review the request. If the program is not available or there are space limitations in the program at the home school, the parent/guardian may make a request for transfer at another school. Signature of home school principal signifies that the principal is aware of the request and that the child requesting the transfer qualifies for the Pre-K Program. Signature does not imply approval of the request.

Home School Principal Use Only: Qualifies Yes No Qualifying Criteria: Income Language Homelessness Active Military Family/Protective Services Conservatorship requirement

Signature of Home School Principal: Date:

Home school principal must send original signed form, copy of Pre-K application and supporting documentation to Early Childhood Department. Do not fax.

D. Decision of District Official: Contacted principal of requested school (date):

via phone via e-mail

Notes:

Approved Denied Placement at (name of school):

Transfer Code: Student ID #:

Signature of District Official: Date:

Early Childhood Department Use Only:

Copy to home school (date): Copy to receiving school (date): Parent notified (date):

Revised: San Antonio Independent School District - SAISD · PDF fileVerification Tool Form...

Documents

Transcript of Revised: San Antonio Independent School District - SAISD · PDF fileVerification Tool Form...