Elkhart and St. Joseph Counties Head Start Consortium Health, Nutrition, and Mental Health Service Area Plan Early Head Start & Head Start

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1 Child Health and Developmental Services (a)(1)(i) Determining Child Health Status: In collaboration with the parents and as quickly as possible, but no later than 90 calendar days from the child s entry into the program, grantee and delegate agencies must (i) Make a determination as to whether or not each child has a ongoing source of continuous, assessable health care. If a child does not have a source of ongoing health care, grantee and delegate agencies must assist the parents in accessing a source of care. At intake FACS will determine if the child has a medical and dental home. If the family does not have a medical or dental home, the FACS will try to determine barriers and note these in ChildPlus. If financial limitations are the only barrier, the parent will be given information about community resources and encouraged to apply for Hoosier Healthwise. For any families who do not have a medical or dental home established within the first 45 days of entry, there must be documentation in ChildPlus of all barriers, and all referrals. The FACS will develop a plan of action with the family. See policies and procedures 1, steps 4-8 to complete this process. Every child has a continuous, accessible health care and/or dental provider. Family and Community (FACS) Consultants Health/ERSEA Enrollment Child s File Application ChildPlus Monitoring 1

2 Child Health and Developmental Services (a)(1)(ii) Obtain from a health care professional a determination as to whether the child is upto-date on a schedule of age-appropriate preventive and primary health care which includes medical, dental and mental health. Such a schedule must incorporate the requirements for a schedule of well child care utilized by the Early and Periodic Screening, Diagnoses, and Treatment program of the Medicaid agency of the State in which they operate, and latest immunization recommendations issued by the Centers for Disease Control and Prevention, as well as any additional recommendation from the local Health Services Advisory Committee that are based on prevalent community health problems. Every child enrolled in Early Head Start/Head Start must have a complete and current (within one year) physical and dental exam, record of up-to-date immunizations, and hemoglobin/hematocrit, sickle cell, and lead lab tests. Every child enrolled in Early Head Start must have age appropriate health exams and immunizations. Physical exams are completed in the first 30 days of enrollment. Dental and labs are to be obtained within the first 80 days of enrollment. All children enrolled in the program will have a vision, speech, hearing, behavioral, and developmental screening done within the first 30 days of enrollment. At intake families are given an explanation of health and developmental screenings done throughout the year and the parent fills out a general consent release form allowing Head Start/Early Head Start to obtain information through their providers and/or conduct medical/dental services. Children will receive appropriate health-related services, which enables them to thrive during these critical years of growth and development. Health/ERSEA Consultants Data Team LEA/First Steps Community Partners Mental Health 45 day monitoring Within 90 days of enrollment ChildPlus/3015 Report Child s File 2

3 Child Health and Developmental Services (a)(1)(ii) Continued If a parent refuses permission for their child to be screened the Family and Community Specialist staff will explain to these parents why the screenings are important. If the parent still refuses permission this must be documented on a parent refusal permission form and signed, dated by parent and filed in the child s file. Minimum standards for immunizations in accordance with Indiana s Childhood Immunization Schedule will be followed, or there must be documentation stating that there is a religious or medical exemption. If the child is not up to date on immunization requirements, the FACS will work with the families to complete this process. With information gathered by the FACS, Health staff will determine if enrolled child is up-to-date on age appropriate health exams and immunizations. 3

4 Child Health and Developmental Services (a)(1)(ii)(a) For children who are not up-to-date on an age-appropriate schedule of well child care, grantee and delegate agencies must assist parents in making necessary arrangements to bring the child up-to-date (a)(1)(ii)(b) For children who are up-to-date on an ageappropriate schedule of well child care, grantee and delegate agencies must ensure that they continue to follow the recommended schedule of well child care. The Health/ERSEA will provide individual immunization records to the nurse consultant for review. If the child is not up-to-date on well child care requirements, the Consultants and/or the Specialist will work with families to complete this process and document efforts in ChildPlus case notes. FACS will assist parents in obtaining medical, dental, and mental health services as needed. FACS will make referrals to assist parents in obtaining appropriate health and dental services for enrolled children and document in ChildPlus. See policies and procedures 2, Presentations will be conducted throughout the year on the importance of continual health care for children. Reports from ChildPlus system are reviewed weekly to identify children who are and are not up-to-date on age appropriate schedules. FACS will ensure that their families have regularly-used medical and dental assistance and encourage families to continue to follow the recommended schedule of well-child care. Children will receive appropriate care including follow-up treatments. Consortium Grantee will work collaboratively with parents and providers to ensure arrangements are made for children to continue on age appropriate well child care and needed exams and immunizations and in collaboration with the Advisory Council. Health/ERSEA FACS Consultants Data Team Mental Health Executive Director Health/ERSEA Specialist Executive Director Consultant 45 day monitoring Within 90 days of enrollment ChildPlus Child s File ChildPlus Child s File 4

5 Child Health and Developmental Services (a)(1)(ii)(c) Grantee and delegate agencies must establish procedures to track the provision of health care services. Health care services are tracked and monitored weekly by the Program Service, or Data Team using ChildPlus reports. Health information will include nutrition assessment forms, current medical and dental exams, immunization records, and screenings. When needed a Registered Dietitian and Registered Nurse will individualize plans of health care services respective to their areas and based on needs. Reporting, as needed, changes provided to the staff, so that they will be aware of the status of health care provisions for their children. Identify health care needs of children. Provide a development program suited to the individual child and identify preventative and corrective care and track progress. Health/ERSEA Data Team Consultants Registered Dietician; Registered Nurse Executive Director August July Child s File 45 Day Monitoring 90 Day Monitoring ChildPlus SAT Individualization Plan Family Contact Notes 5

6 Child Health and Developmental Services (a)(1)(iii) and (iv) (iii) Obtain or arrange further diagnostic testing, exam, and treatment by an appropriate licensed or certified professional for each child with an observable, known or suspected health or developmental problem. (iv) Develop and implement a follow-up plan for any condition identified in (a) (1) (ii) and (iii) so that any needed treatment has begun. Screening results indicating specific problems are discussed at Home Visits, Parent/Teachers Conferences, SAT meetings or scheduled with parents where referrals are developed and initiated. Referrals/Consultations will be generated by the Head Start staff and s to the Health/ERSEA so that staff can assist parents in obtaining appropriate health and dental services for enrolled children and document the referral into the ChildPlus system. SAT meetings will occur to discuss the needs of the individual child with parent participation and appropriate staff and consultants. Case management conference may be generated to include management and consultants to determinate the appropriate referral process. Early Head Start and Head Start staff will provide referrals to their managers based on children s assessment scores. s will communicate referrals and concerns at the s/consultants meetings. Referral/Consultation Intervention plans will be followed and monitored. Referrals generated and appropriately processed. Children needing additional services will begin with a referral and follow-up services will be implemented. Health/ERSEA Data Team Consultants Mental Health Executive Director August July Child s File ChildPlus SAT Referral/Consultation Individualization Plan Family Contact Notes DECA 6

7 Child Health and Developmental Services (b)(1) Screening for developmental, sensory, and behavioral concerns. (1) In collaboration with each child s parent, and within 45 calendar days of the child s entry into the program, grantee and delegate agencies must perform or obtain linguistically and age-appropriate screening procedures to identify concerns regarding a child s developmental, sensory (visual and auditory), behavioral, motor, language, social, cognitive, perceptual, and emotional skills. To the greatest extent possible, these screenings and procedures must be sensitive to the child s cultural background. All children who enter the program will have a vision, speech, hearing, behavioral and developmental screening done within the first 30 days of entry. The Denver screenings will be conducted within the first 30 days upon each child s entry. Additional speech and hearing screenings will be conducted by local school districts speech and hearing therapists, and/or early intervention agencies. The Denver encompasses speech/language screenings. A speech pathologist and therapist will be available for further screenings. Vision screening will be conducted by trained staff and Community Partners within 30 calendar days of child s entry into the program. Behavioral screenings and observation will be conducted by the teaching staff and parents administer the DECA, within 30 calendar days of child s entry into the program. Screenings will be conducted in a calm and quiet environment. Screenings will be conducted in child s primary language. Refer to policies and procedures 3, steps 9-27 Screenings will be done within 45 days of child s entry. Health/ERSEA Local School District Mental Health Consultants Data Team First Steps Community Partners Within 45 days of enrollment ChildPlus DECA Denver Child s File Culture and Language Survey 7

8 Child Health and Developmental Services (b)(2) Grantee and delegate agencies must obtain direct guidance from a mental health or child development professional on how to use the findings to address identified needs. Observation will be done by Mental Health once a year and as needed. Recommendations will be provided as needed to and a report sent to the Executive Director. Mental Health will provide written documentation in ChildPlus and assist with the development of strategies as indicated. Strategies will be developed and Mental Health implemented in collaboration with families and staff for children identified with a need. Mental Health Data Team Community Partners Evaluating/Monitorin g August July As needed Child s File ChildPlus Lesson Plans Child Individualized Plan SAT Referrals (b)(3) Grantee and delegate agencies must utilize multiple sources of information on all aspects of each child s development and behavior, including input from family members, teachers, and other relevant staff who are familiar with the child s typical behavior. During the SAT I weekly meetings children are discussed among teaching team and FACS. For children experiencing developmental and behavioral issues a SAT II meeting is conducted. Parents, FACS, teachers, and Mental Health participate. This information is gathered by multiple sources: screenings, including DECA; recorded observations and anecdotal notes from teachers, FACS, Head Start staff, consultants, and parents. Children will receive individualized comprehensive services, based on information gathered from more than one source. Community Partners LEA First Steps Mental Health Classroom Observation Will occur multiple times throughout school year. SAT DECA Denver II Screenings Results COR Child Individualized Plan Home Visits/Conferences 8

9 Child Health and Developmental Services Performance Standard/Strategy (c)(1) Extended follow-up treatment. Grantee and delegates agencies must establish a system of ongoing communication with the parents of children with identified health needs to facilitate the implementation of the follow-up plan. Procedure Using the Health and Nutrition Assessment form at intake, children are identified with health and/or nutritional needs. Individual Health Care plans are developed for a child with an identified health and/or nutritional need with the Health/ERSEA and/or Consultant in collaboration with the family. The plan will include any of the following that may apply to the individual child: a. Strategies to ensure preventive and/or corrective care b. Instructions for any medications that need to be administered c. Signs and symptoms of a possible episode d. Response instructions Outcome Children will receive individualized comprehensive services, based on information gathered during screenings and enrollment. Health/ERSEA Consultants Community Partners August July Screening Assessment Results Child s File ChildPlus Health Care Plans Referrals Individualized Health Care Plan is recorded on a spreadsheet and in ChildPlus and the original kept in child s file. A copy is kept in a designated area in the classroom and available for teachers and staff. Consulting Nurse, Nutritionist and/or Health/ERSEA will work with the family as needed to ensure that they are able to obtain any prescribed medications, aid, dietary supplement and equipment for medical and dental conditions for enrolled children. Necessary referrals are made by Nurse, Nutritionist and/or Health/ERSEA and is coordinated then sent to appropriate agencies if needed to provide assistance to families and documented in ChildPlus. 9

10 Child Health and Developmental Services Performance Standard/Strategy (c)(2) Grantee and delegate agencies must provide assistance to the parents, as needed, to enable them to learn how to obtain any prescribed medications, aids or equipment for medical and dental conditions. Procedure FACS will work closely with parents to ensure that they are able to obtain medical/dental service, aids or equipment for medical and dental conditions for enrolled children. Necessary referrals will be made to the appropriate agencies to provide assistance to families and document in ChildPlus. Outcome Children will receive any medical or dental services that are required by their individualized needs. Health/ERSEA Data Officer Consultants Screening Assessments Child s File ChildPlus Health Care Plans Referrals Data Team (c)(3)(i) Dental follow-up and treatment must include: Fluoride supplements and topical fluoride treatments as recommended by dental professionals in communities where a lack of adequate fluoride levels has been determined or for every child with moderate to severe tooth decay. Dental treatment must include fluoride treatments in areas that have been determined to have a lack of adequate fluoride levels or for every child with moderate to severe tooth decay. Dental health professionals on the Health Advisory Board will help in assessing the need for supplemental fluoride treatments in the community. Dental observations must occur for children enrolled in Early Head Start on an age appropriate schedule. With the assistance of local health professionals, identification and prevention of community dental problems is addressed. Community Partners Health/ERSEA Health Advisory Board Data Team Executive Director August July Referrals Dental/Physical Child s File ChildPlus Consultant Community Partners 10

11 Child Health and Developmental Services (c)(3)(ii) Other necessary preventive measures and further dental treatment as recommended by the dental professional. If any child requires further treatment, the FACS will work with the family to ensure that treatment is ongoing and/or completed. They may work in conjunction with the /Early Head Start if necessary. The, Registered Dietician, Data Team, and Health/ERSEA, will monitor to ensure that every child is on a schedule of well-child care for dental services. Dental observations must occur for children enrolled in Early Head Start on an age appropriate schedule. Preventive dental services and treatment are designed to ensure that a child s teeth and gums are healthy and that dental health problems do not affect a child s overall health. Health/ERSEA Consultant Community Partners Registered Dietician Data Team August July Referrals Dental/Physical Child s File ChildPlus 11

12 Child Health and Developmental Services (c)(4) Grantee and delegate agencies must assist with the provision of related services addressing health concerns in accordance with the Individualized Education Program (IEP). LEA and First Step provide existing IEP/IFSP for enrolled children to Health. Children with IEP and/or IFSP with identified health services concerns are documented on the Health and Development Track Sheet. Health provides IEP/IFSP to PSM to disburse to appropriate classroom teaching teams. receives IEP/IFSP and training to ensure classroom services and environment are consistent with IEP goals and interventions. If a child is not receiving services, the PSM will notify LEA/First Steps to address barriers that are preventing services. Children and families will receive the needed services as identified in the IEP. Health/ERSEA Local School Districts Special Education Specialist First Steps Mental Health Data Officer August July CAT Child s File CLASS- HS Classroom Inventory DECA Denver SAT Individualization Plan Lesson Plans 12

13 Child Health and Developmental Services (c)(5) Head Start funds may be used for professional medical and dental services when no other source of funding is available. When funds are used for such services, grantee and delegate agencies must have written documentation of their efforts to access other available sources of funding. The Specialist will inform the Program of Head Start medical and dental payment request. Children are eligible for Head Start funds only if the following apply: a. All other means of obtaining health care coverage are exhausted. b. A letter of denial from Hoosier Healthwise (Medicaid) or private insurance are on record. The forward the above documentation to Program in additional to the: child s name, Medical or Dental Home, and the medical or dental care that is needed. The Health/ERSEA will evaluate the isolated case and generate a meeting with the Executive Director to review the case. The Executive Director must provide written authorization (before denial) Head Start funds are assessed to ensure the cost is allowable for grant funded programs. Executive Director will work with the Data Officer and medical providers to make arrangements for billing and payment. A limited amount of funds will be budgeted toward potential costs for the cases that may need funding support. Head Start funds will be used as needed so enrolled children will receive needed services. Health/ERSEA Data Officer Executive Director August July CAT Child s File CLASS - HS Classroom Inventory DECA Denver SAT Individualization Plan Lesson Plans 13

14 Child Health and Developmental Services (d) (Ongoing care). In addition to assuring children s participation in a schedule of well child care, as described in section (a) of this part, grantee and delegate agencies must implement ongoing procedures by which Head Start staff can identify any new or recurring medical, dental or developmental concerns so that they may quickly make appropriate referrals. These procedures must include: periodic observations and recordings, as appropriate, of individual children s developmental progress, changes in physical appearance and emotional and behavioral patterns. In addition, these procedures must include observations from parents and staff. Screening results indicating specific problems are discussed at Home Visits, Parent/Teachers Conferences, SAT meetings or scheduled with parents where referrals are developed and initiated. Referrals/Consultations will be generated by the Head Start staff and s to the Health/ERSEA so that staff can assist parents in obtaining appropriate health and dental services for enrolled children and document the referral into the ChildPlus system. Staff continues to assess children s physical, social, emotional, and cognitive development to ensure quick identification of health or developmental problems. Health/ERSEA Consultants Grantee Team Data Team Mental Health August - July ChildPlus day Monitoring Books Self Assessment COR Child s File SAT DECA Denver Lesson Plans CAT Referrals CLASS - HS (e)(1) (Involving parents). In conducting the process as described in sections (a), (b) and (c), and in making all possible efforts to ensure that each child is enrolled in and receiving appropriate health care services, grantee and delegate agencies must: (1)consult with parents immediately when child health or developmental problems are suspected or identified. Screening results indicating specific problems are discussed at Home Visits, Parent/Teachers Conferences, SAT meetings or scheduled with parents where referrals are developed and initiated. Referrals/Consultations will be generated by the Head Start staff and s to the Health/ERSEA so that staff can assist parents in obtaining appropriate health and dental services for enrolled children and document the referral into the ChildPlus system. Children will receive appropriate services based on suspected or identified needs. Health/ERSEA Mental Health August July ChildPlus day Monitoring Books COR Self Assessment SAT Child s File DECA Screening Summary Denver Individualization Plan CAT Referrals CLASS - HS 14

15 Child Health and Developmental Services (e)(2) Familiarize parents with the use and rationale for all health and developmental procedures administered through the program or by contract or agreement, and obtain advance parent/guardian authorization for such procedures. Grantee and delegate agencies also must ensure that the results of diagnostic and treatment procedures and on-going care are shared with and understood by the parents. See policies and procedures 3, Parents will have general knowledge about health related procedures as they relate to their child. Health/ERSEA LEA/First Steps Consultants August July Site Meetings Denver II DECA Family Summit Orientation Child s File Referrals Screening Summary Form (e)(3) Talk with parents about how to familiarize their children in a developmentally appropriate way and in advance about all of the procedures they will receive while enrolled in the program. Screenings will be conducted in an environment that is comfortable for the child. Role playing and demonstration will be used at an ageappropriate level. FACS and teaching team will meet with families about how to prepare their child in advance for the screening and how to familiarize them with procedures in an age-appropriate way. Children will be familiar with various procedures in advance without a great deal of anxiety or fear. Health/ERSEA LEA/First Steps Consultants Community Partners August July Site Meetings Denver II DECA Family Summit Orientation Child s File Referrals Screening Summary Form 15

16 Child Health and Developmental Services (e)(4) Assist parents in accordance with (f)(2)(i) and (ii) to enroll and participate in a system of ongoing family health care and encourage parents to be active partners in their children s health care process. Head Start staff will consistently encourage parents through workshops, trainings, and one-onone sessions to participate in the health care of their children. Children and parents will receive appropriate health care and will continuously participate in ongoing family health care. Health/ERSEA Community Partners LEA/First Steps Mental Health Parents Consultants Data Officer Executive Director August July Family Summit Site Meetings SAT Meetings Newsletters Flyers, Brochures Home Visits/Conferences 16

17 Child Health and Developmental Services (e)(5) If a parent or other legally responsible adult refuses to give authorization for health services, grantee and delegate agencies must maintain written documentation of the refusal. If a parent refuses permission for their child to be screened, the Specialist will explain to the parent why these screenings are important. If the parent still refuses permission, this must be documented on a Refusal for Permission Form and placed in child s file. Parents will understand the detrimental effects of refusing to give authorization for health services refusal by the guardian for the child to receive services will be documented in a written form. Health/ERSEA Community Partners LEA/First Steps Mental Health August July Child s File Screening Summary Refusal Form Acknowledgement Form/Parent Handbook Parents 17

18 Child Health and Developmental Services (f)(1) Individualization of the program (1) Grantee and delegate agencies must use the information from the screenings for developmental, sensory, and behavioral concerns, the ongoing observations, medical and dental evaluations and treatments, and insights from the child s parents to help staff and parents determine how the program can best respond to each child s individual characteristics, strengths and needs. Screening results indicating specific problems are discussed at Home Visits, Parent/Teachers Conferences, SAT meetings or scheduled with parents where referrals are developed and initiated. Referrals/Consultations will be generated by the Head Start staff and s to the Health/ERSEA so that staff can assist parents in obtaining appropriate health and dental services for enrolled children and document the referral into the ChildPlus system. Based on the results of these screenings and evaluations, activities are tailored, curriculum adapted, and the physical environment modified to support each child s learning style and be responsive to differences. Should a screening identify a child in need of further evaluation or diagnostic testing, the Program Service will review the case and begin an appropriate referral process. Program will meet the needs of all enrolled children. Parents will be able to utilize the program as a source of information and support. Health/ERSEA Data Officer LEA/First Steps Mental Health Community Partners Executive Director Consultants August July DECA Denver COR Screens Child Individualization Plan SAT Lesson Plans Child s File Portfolio 18

19 Child Health and Safety (a) (Health emergency procedures) Grantee and delegate agencies operating center-based programs must establish and implement policies and procedures to respond to medical and dental health emergencies with which all staff are familiar and trained. At a minimum, these policies and procedures must include: (1) Posted policies and plans of action for emergencies that require rapid response on the part of staff (i.e. choking or immediate medical or dental attention) (a)(2) (2) Posted locations and telephone numbers of emergency response systems. Up-todate family contact information and authorization for emergency care for each child must be readily available. All staff including new staff will participate in CPR/First Aid, ADA, and Universal Precautions training conducted annually. Prior to the first day of school or employment, all staff are trained on disabilities and child abuse and neglect. Posted in each classroom is a Health and Safety team assignment list, children allergies, CPR chart, First Aid chart, dental, child abuse and neglect reporting procedures, and emergency contact numbers. Teaching staff must post in their classrooms policies and plans of action for emergencies requiring immediate medical or dental attention. Emergency numbers of response systems are posted in each classroom. Staff must be aware of evacuation routes and safety procedures for emergencies specific to their sites. Teachers will be given these procedures by the building principals and must post them in their classrooms. Attendance will be taken and documented at the time of the Bus, Fire, tornado or any emergency drills. In emergency situations, staff members are prepared to act quickly to ensure the health and well-being of each child. Updated emergency information is kept accessible to appropriate staff. Consultants HR Data Officer Executive Director Transportation Transportation Local School Personnel Training Sign in Sheets Classroom Checklist First Aid Checklist Attendance Book Bus Log Incident Report Dental Emergency Poster Contact List Bus Evacuation Drill Evacuation Schedule Classroom Checklist Incident Report 19

20 Child Health and Safety (a)(2) Continued Head Start staff and school personal must keep up-to-date family contact information for emergencies. Contact with a parent or authorized person will be established immediately in case of an emergency involving their child. Incident reports will be filled out for all major or minor incidents and sent to the Executive Director s office immediately via fax, or scan. The principal, manager, and director will receive a copy of the incident report. State and federal mandates will be followed pertaining to suspected child abuse and neglect. All staff members are trained on the mandates, along with school system s procedures for reporting. Local school district transportation departments receive emergency up-todate family contact information for emergencies from the FACS or HS Management at least on a weekly basis or in the event of an immediate change. Director at the beginning of each school year contacts all principals with a Head Start classroom located at their site submit an emergency plan handbook. All handbooks are placed in a binder in the Director s office. 20

21 Child Health and Safety (a)(3) (3) Posted emergency evacuation routes and other safety procedures for emergencies (i.e. fire or weatherrelated) which are practiced regularly (see for additional information). Teaching staff must post in their classrooms policies and plans of action for emergencies requiring immediate medical or dental attention. Emergency numbers of response systems are posted in each classroom. Staff must be aware of evacuation routes and safety procedures for emergencies specific to their sites. Teachers will be given these procedures by the building principals and must post them in their classrooms. Attendance will be taken and documented at the time of the Bus, Fire, tornado or any emergency drills. Head Start staff and school personal must keep up-to-date family contact information for emergencies. Contact with a parent or authorized person will be established immediately in case of an emergency involving their child. Incident reports will be filled out for all major or minor incidents and sent to the Executive Director s office immediately via fax, or scan. The principal, manager, and director will receive a copy of the incident report. Children are kept safe at all times. Health/ERSEA Local School Personnel Transportation Evaluating/Monitori ng Contact List Bus Evacuation Drill Evacuation Schedule Classroom Checklist Health and Safety Checklist Plan Missing Person Policy Incident Report 21

22 Child Health and Safety Performance Standard/Strategy (a)(3) Continued Procedure State and federal mandates will be followed pertaining to suspected child abuse and neglect. All staff members are trained on the mandates, along with school system s procedures for reporting. Outcome Local school district transportation departments receive emergency up-to-date family contact information for emergencies from the FACS or HS Management at least on a weekly basis or in the event of an immediate change. Director at the beginning of each school year contacts all principals with a Head Start classroom located at their site submit an emergency plan handbook. All handbooks are placed in a binder in the Director s office. 22

23 Child Health and Safety Performance Standard/Strategy (a)(4) (4) Methods of notifying parents in the event of an emergency involving their child. Procedure Teaching staff must post in their classrooms policies and plans of action for emergencies requiring immediate medical or dental attention. Outcome Parents will be notified in the event of an emergency involving their child. Local School Personnel August July Contact List Emergency numbers of response systems are posted in each classroom. Staff must be aware of evacuation routes and safety procedures for emergencies specific to their sites. Teachers will be given these procedures by the building principals and must post them in their classrooms. Attendance will be taken and documented at the time of the Bus, Fire, tornado or any emergency drills. Report generation to Executive Director and Data Officer. Data Officer Bus Evacuation Drill Evacuation Schedule Classroom Checklist Incident Report Head Start staff and school personal must keep up-to-date family contact information for emergencies. Contact with a parent or authorized person will be established immediately in case of an emergency involving their child. Incident reports will be filled out for all major or minor incidents and sent to the Executive Director s office immediately via fax, or scan. The principal, manager, and director will receive a copy of the incident report. State and federal mandates will be followed pertaining to suspected child abuse and neglect. All staff members are trained on the mandates, along with school system s procedures for reporting. 23

24 Child Health and Safety Performance Standard/Strategy (a)(4) Continued Procedure Local school district transportation departments receive emergency up-to-date family contact information for emergencies from the FACS or HS Management at least on a weekly basis or in the event of an immediate change. Outcome (a)(5) (5) Established methods for handling cases of suspected or known child abuse and neglect that are in compliance with applicable Federal, State, or Tribal laws. Director at the beginning of each school year contacts all principals with a Head Start classroom located at their site submit an emergency plan handbook. All handbooks are placed in a binder in the Director s office. Teaching staff must post in their classrooms policies and plans of action for emergencies requiring immediate medical or dental attention. Emergency numbers of response systems are posted in each classroom. All staff is trained in child abuse and neglect observation and will report any suspected cases of abuse and neglect. All Staff School Principals or Designee HR Child Abuse and Neglect Reporting Form Sign in Sheets Personnel File Staff must be aware of evacuation routes and safety procedures for emergencies specific to their sites. Teachers will be given these procedures by the building principals and must post them in their classrooms. Attendance will be taken and documented at the time of the Bus, Fire, tornado or any emergency drills. Executive Director Head Start staff and school personal must keep up-to-date family contact information for emergencies. Contact with a parent or authorized person will be established immediately in case of an emergency involving their child. 24

25 Child Health and Safety (a)(5) Continued Incident reports will be filled out for all major or minor incidents and sent to the Executive Director s office immediately via fax, or scan. The principal, manager, and director will receive a copy of the incident report. State and federal mandates will be followed pertaining to suspected child abuse and neglect. All staff members are trained on the mandates, along with school system s procedures for reporting. Local school district transportation departments receive emergency up-todate family contact information for emergencies from the FACS or HS Management at least on a weekly basis or in the event of an immediate change. Director at the beginning of each school year contacts all principals with a Head Start classroom located at their site submit an emergency plan handbook. All handbooks are placed in a binder in the Director s office. 25

26 Child Health and Safety (b)(1) (Conditions of short-term exclusion and admittance) Grantee and delegate agencies must temporarily exclude a child with a short-term injury or an acute or short-term contagious illness, that cannot be readily accommodated, from program participation in center-based activities or group experiences, but only for that generally short-term period when keeping the child in care poses a significant risk to the health or safety of the child or anyone in contact with the child. Children with short-term contagious illness will be temporarily excluded from class and may only return when they have documented treatment from their physician. When a child is suspected of having a possible communicable disease, the child is taken to the designated person to determine as to whether the child needs to be seen by a physician and can return with a doctor s release. Individual emergency plan per classroom. Temporarily excluding a child from program participation protects the health of the affected child as well as other children and staff. School Nurses/Nurse Consultants Parents Health/ERSEA Community Partner Executive Director Incident Report Doctor s Excuse Child s File Individual emergency plan per classroom. 26

27 Child Health and Safety (b)(2) Grantee and delegate agencies must not deny program admission to any child, nor exclude any enrolled child from program participation for a long-term period, solely on the basis of his or her health care needs or medication requirements unless keeping the child in care poses a significant risk to the health or safety of the child or anyone in contact with the child and the risk cannot be eliminated or reduced to an acceptable level through reasonable modifications in the grantee or delegate agency s policies, practices or procedures or by providing appropriate auxiliary aids which would enable the child to participate without fundamentally altering the nature of the program. Parents and staff will be given a parent handbook including an exclusion policy and procedure explaining cases where a child would be temporarily excluded from program. At the time of intake parents are asked by the FACS about any special needs that might impact the care of their child. Children diagnosed with a contagious illness, by a medical professional, will be temporarily excluded from program and may only return when they have documented clearance by a medical professional. When a child is suspected of a communicable illness/condition while in class, the teacher will contact PSM. PSM will assess the situation and give directives to Teaching Staff and contact Health/ERSEA, who may need to contact the Health Dept. and/or medical professional and give directives to the teaching staff. No children will be denied placement into the Head Start program provided the program can reasonably accommodate them; all eligible children are afforded an equal opportunity to be included in the Head Start program. All Staff LEA/First Steps Consultants August - July Annually Application Priority Ranking List Enrollment ChildPlus Personnel Records 27

28 Child Health and Safety (b)(3) Grantee and delegate agencies must request that parents inform them of any health or safety needs of the child that the program may be required to address. Programs must share information, as necessary, with appropriate staff regarding accommodations needed to accordance with the program s confidentiality policy. Parents and staff will be given a parent handbook including an exclusion policy and procedure explaining cases where a child would be temporarily excluded from program. At the time of intake parents are asked by the FACS about any special needs that might impact the care of their child. Children diagnosed with a contagious illness, by a medical professional, will be temporarily excluded from program and may only return when they have documented clearance by a medical professional. When a child is suspected of a communicable illness/condition while in class, the teacher will contact PSM. PSM will assess the situation and give directives to Teaching Staff and contact Health/ERSEA, who may need to contact the Health Dept. and/or medical professional and give directives to the teaching staff. Parents are reassured that disclosing health needs information is voluntary and that all information they provide is kept confidential. Executive Director Health/ERSEA HR All Grantee and Management Staff August July Personnel File Application 28

29 Child Health and Safety (c) Medication administration. Grantee and delegate agencies must establish and maintain written procedures regarding the administration, handling, and storage of medication for every child. Grantee and delegate agencies may modify these procedures as necessary to satisfy State or tribal laws, but only where such laws are consistent with Federal laws. The procedures must include: Written policies and procedures regarding the administration, handling, and storage of medication are in place and staff receives training. Periodic checks of expiration dates. Notice parents two weeks prior to expiration. If the child refuses to take the medication, or has any other problems related to medication administration, the parents must be notified immediately. Proper storage of medication and its administration safeguard the health of children, staff and families. Health/ERSEA Consultants Local School Districts Nurses August July Classroom Checklist Child s File ChildPlus Medication Form Healthcare Plans Personnel Files (c)(1) Labeling and storing, under lock and key, and refrigerating, if necessary, all medications, including those required for staff and volunteers. All medication will be kept in the original container and properly labeled by the pharmacist. The label information must include the child s name, frequency and dosage, name of the drug, duration, method, expiration date, storage instructions, date filled, and name of the prescribing physician. All medication will be kept under lock and key at all times. Medication that requires refrigeration will be kept in a locked box in the site refrigerator. Children s safety is ensured. Data Team Health/ERSEA Consultant August July Medication Form Healthcare Plans Personnel Files Local School Districts Nurses 29

30 Child Health and Safety (c)(2) Designating a trained staff member or school nurse to administer, handle, and store child medications. The Health/ERSEA, Program Service, and local school districts nurses and nurse consultant will ensure that appropriate staff members can demonstrate proper techniques for administrating medication, including the use of any equipment needed to give the medication by providing the proper Consultant for training. Child medications are handled by designated staff, which is trained in accordance with state law. Health/ERSEA Local School Districts Nurses Consultant August July Medication Form Healthcare Plans Personnel Files Training sign-in sheets (c)(3) Obtaining physicians instructions and written parent or guardian authorizations for all medications administered by staff. A permission for medication form must have written instructions from physician from the parent before medication can be given. Over the counter medication require both parent and physician signatures. The Nurse Consultant will give a copy of the signed permission form to the school nurse and Health/ERSEA. A physician provides instruction for the dosage, frequency, and method to be given as well as the duration of administration. All documentation of authorization will be kept in child s file. Transportation Health/ERSEA Local School Districts Nurses Consultant August July Medication Form Healthcare Plans Personnel Files Child s Physician Transportation 30

31 Child Health and Safety (c)(4) Maintaining an individual record of all medications dispensed, and reviewing the record regularly with the child s parents. The school nurse or designee will transfer information from the prescription bottle to their school s flow sheet. The Nurse Consultant will periodically review the school s nursing flow sheet and ensure the school nurse has had discussions with the parent. Information pertaining to the dispensation of medication is well-documented, so that administration is accurate and accomplished its intended purpose. Health/ERSEA Local School Districts Nurses/or designee Consultant August July Medication Form Healthcare Plans Personnel Files (c)(5) Recording changes in a child s behavior that have implications or drug dosage or type, and assisting parents in communicating with their physician regarding the effect of the medication on the child. If a child refuses to take the medication, has an adverse reaction, or has any problems related to medication administration, the parents must be notified immediately. If physical or behavioral changes are noted after medication is given, they are recorded and immediately brought to the attention of the parents and the school nurse. The parent in turn contacts the child s physician who determines if medication changes should be made. Any changes that may be a result of the child s medication will be properly documented and acted upon by all involved staff. Transportation Health/ERSEA Local School Districts Nurses Consultants August July Medication Form Healthcare Plans Personnel Files 31

32 Child Health and Safety (c)(6) Ensuring that appropriate staff members can demonstrate proper techniques for administering, handling and storing medications, including the use of any necessary equipment to administer medications. Written policies and procedures regarding the administration, handling and storage of medication are in place and staff has received training. Staff reads the label and prescription directions prior to giving medication. Trained staff knowledge or proper techniques for handling medication safeguards the health of all children in program. Health/ERSEA Local School Districts Nurses August July Medication Form Healthcare Plans Personnel Files Age appropriate administration techniques are used to gain the child s cooperation (d)(1) and (2) (1) Ensure that staff and volunteers can demonstrate safety practices (2) Foster safety awareness among children and parents by incorporating it into child and parent activities. Staff/School Nurse will document that medication was administered on proper form supplied by the health staff or school nurse. Medical and dental emergency procedures will be outlined and posted in each classroom. Teaching team are trained and certified in CPR, First Aid, and Universal Precautions. Families, staff, and children are made aware of and trained on injury prevention and safety practices so that the safety of all is ensured. Consultant FACS Consultants HR Sign in Sheets Personnel Files Classroom Checklist Child s File Books and posters about safety will be in every classroom. Safety Sam Early Head Start/Head Start staff will give safety presentations to children in classroom and bus safety information sent home to parents. 32

33 Child Health and Safety (e)(1)(i) Staff, volunteers, and children must wash their hands with soap and running water at least at the following times (i) after diapering or toilet use. A policy and procedure on hand washing is implemented. Instruction on hand washing is provided by teaching team to children. Staff and children shall wash their hands whenever they come in contact with bodily fluids and the following times: before food preparation, handling, or serving (including setting the table, after toileting, changing diapers, or assisting a child with toilet use, before and after eating meals or snacks, after handling pets or other animals, before and after using disposable gloves, after coughing or sneezing, after inspecting for lice, before and after giving medications, before and after giving first aid or universal precautions kits, and after playing outside (applies to (e)(1)(i-iv)). Clear, simple hand washing procedures will be posted in all classrooms. Effective implementation of hygiene, sanitation, and disinfection procedures reduces health risks to children and staff by limiting the spread of infectious germs. All staff and volunteers Daily Classroom Observation CACFP Monitoring Classroom Checklist CAT Staff Training Sign in Sheets 33

34 Child Health and Safety (e)(1)(ii) Before food preparation, handling, consumption, or any other food-related activity (i.e. setting the table). Effective implementation of hygiene, sanitation, and disinfection procedures reduces health risks to children and staff by limiting the spread of infectious germs will be monitored. All Staff Daily Classroom Monitoring CACFP Monitoring CAT (e)(1)(iii) Whenever hands are contaminated with blood or other bodily fluids. Effective implementation of hygiene, sanitation, and disinfection procedures reduces health risks to children and staff by limiting the spread of infectious germs will be monitored. All Staff Staff Orientation Daily Classroom Monitoring CACFP Monitoring CAT (e)(1)(iv) After handling pets or other animals. Effective implementation of hygiene, sanitation, and disinfection procedures reduces health risks to children and staff by limiting the spread of infectious germs will be monitored. All Staff Staff Orientation Daily Classroom Monitoring CACFP Monitoring CAT Staff Orientation 34

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