d.c. note - eric · d.c. report no ocd-n-30-364-4 pub date jul 75 note /op.; ocd-hs head...

DOCUMENT RESUME

ED 122 936 PS 008 565

TITLE Head Start Program Performance Standards.INSTITUTION Office of Child Development (DHEW), Washington,

D.C.REPORT NO OCD-N-30-364-4PUB DATE Jul 75NOTE /Op.; OCD-HS Head Start'Policy Manual; Appendix .may

be marginally legibile due to quality_ogoriginal

EDRS PRICE MF-$0.83 HC-$3,50 Pius Postage =

DESCRIPTORS Dental Health; Educational Objectivep; FacilityRequirements; Health Services; Medical\Services;Mental Health Programe; Nutrition; *Objectives;Parent Education; Parent Participation; -Parent 'School,Relationship; *Performance Criteria; *PerformanceSpecifications; *Preschool Educa on; *PreschdolPrograms; School Community Relatio hip; soial

1 ServicesIDENTIFIERS I *Project Head Start

'ABSTRACTThis manual presents the Project Heady Start program

goals and performance.standards in the areas of education, health and'nutrition services, social services, and parent,involvement4 A-shortdiscussion of general Head Start goals, performance-standard'development, implementation, and enforcenent is included. Eachperformance standard is accompanied by guidance material whichprovides further information about the purpose of,the.standard aidthe methods and procedures for i4lementation._Apfenarais proWidestatements of policy concerning the develatiiiit and implementation ofprogram design variations for local\ Head Start programs as well aspolicy for the involvement of parents of Head Start children.(BRT) \

***********4********************************************************Documents acquired by ERIC include many informal Unpublished

*' materials not available from other sources. ERIC makeskevery effort ***to obtain the best copy available. Nevertheless, items of marginal ** reproducihility are often encountered and this affects the quality ** of the microfiche and hardcopy reproductions ERIC makes available qc'

* via the ERIC Document Reproduction Service (EDRS). EDRS is not* responsible for the quality of the ,;original document. Reproductions ** supplied by EBBS are the best that Ican be made from the original. *******************************************************************4****

J

teNCrC\I MANUALCN.1 PART1-1

Lit

CHAPTER

S DEPARTMENT OP HEALTH.EDUCATION SWELPARENATIONAL uNSTITUT E OF

EDUCATIONTHIS DOCUMENT HAS BEEN REPRODUCE° EXACTLY AS RECEIVED PROMTHE PERSON DR ORGANIZATION ORIGINATINE IT POINTS OP VIEW OR OPINIONSSTAIEO DO NOT NECESSARILY REPRESENT OFFICIAL NATIONAL INSTITUTE OFEDUCATION POSITION OR POLICY

OCD-HS HEAD START POLICY MANUAL

OCD Notice N -30 -364 -4

HEAD START

PROGRAM PERFORMANCE STANDARDS

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE-

Office of Human DevelopmentOffice of Child Development

JULY 19754

GPO-210-971 P.O. 50570 Print Order 1454 Mod. 8678

2

IN 75.07 OCD Notice N-30464-4-00

CHAPTER N-30-364-4 6OFFICE OF CHILD DEVELOPMENT NOTICE

PROGRAM PERFORMANCE STANDARDS

SUBPART A GENERAL

Section1304.1-1 Purpose and application. .

1304.1-2 Definitions.1304.1-3 Head Start program goats.1304.1-4 Performance standards plan development.1304.1-5 Performance standards implementation and enforcement.

SUBPART 8EDUCATION SERVICES. OBJECTIVES AND PERFORMANCE STANDARDS

1304.2 -1 Education services objectives.1304.2-2. Education services plan content: operations: ,

1304.2-3 Education services plan content: facilities.

SUBPART .CHEALTH SERVICES OBJECTIVES AND PERFORMANCE STANDARDS

= 1304.3 -1 Health tervioesgeneral objectives.-1304.372' -- Health Services Advisory Committee.1304.3 -3 Medical and dental history, screening, and examination.1304.3-4 Medical and -dental treatment.1304.3-5 Medical and dental records.1304.3-6 Health education.1304A-7 Mental heelth.objectives..1304.3-8 Mental health services.1304.3-9 NUtrition objectives.1304.3-10 Nutrition services.

SUBPART DSOCIAL SERVICES OBJECTIVES AND PERFORMANCE STANDARDS

1304.4-1 Social services objectives..1304.4-2 Social services plan content.

SUBPART E--PARENT INVOLVEMENT OBJECTIVES AND PERFORMANCE STANDARDS

1304.5-1 Parent involvement objectives.1304.52 Parent involvement plan content: parent participation policy. .

1304.5-3 Parent involvement plan content: enhancing development of parenting skills.1304.5-4 Parent. involvement plan content: communications among program management, pro-

gram staff, and parents.1304.5-5 Parent involvement plan content: parents, area residents, and the program.

Subpirt AGeneralSec. 1304.1-1 PURPOSE AND APPLICATION

I

This part sets out the goals of the Head Start program as they miiiibe'achieved by the combinedattainment of the objectives of the basic components of the program, with emphasis on the pro-.gram performance standards necessary and required to attain those objectives. With the requireddevelopment of plans covering the implementation of thee performance standards, grantees anddelegate agencies will have firm baies for operations most likely to lead to demonstrable bene-fits to children and their families. While compliance with the performance standards is requiredas a condition of Federal Head Start funding, it is expected that the standards will be' largelyself- enforcing. This part applies to all Head Start grantees and delegate agencies.

Sec. 1304.1-2 DEFINITIONS

As. used in this part: ;-

(a). The term "OCD" means-the Office of Child 'Development, Office of Human Development, in thekU.S. Department of Health, Education, and Welfare, and includes appropriate re nal office staff.

(b) The term "responsible HEW official" means the official who is authorized to ke the grantofassistance in question, or his detignee. . .

(c) The term "Director" means the Director of-the Officef Child Development.(d) The teem "grantee" means the public or priVate nonprofit agency which has een granted as-sistance by OCD to carry on a Head Start program. 1(e) The term "delegate agency" means a public or private nonprofit organizati 9 or agency towhich a grantee has delegated the carrying on of all or part of its Head. Start program.(f) The term "goal" means the ultimate purpose or interest toward which. total Head Starkprogram --/efforts are directed."(g) The term "objective" means the ultimate purpose or interest toward which Head Start pro-gram 'component efforts are directed.'(h) The term "program performance standards" or "performance standards" means the HeadStart program functions, activities and facilities required' and necessary to meet the objectivesand goals-of the Head Start program as they relate directly to children and their families.(!) The term "handicapped children" means menta119\ retarded, hard of hearing, deaf, speech im-paired, visually handicapped, seriously emotionally disturbed, crippled, or other health impairedchildren who by reason thereof require special education and related services.

Sec. 1304.1-3 HEAD START PROGRAM GOALS

(a) The Head S6lit:17rogram is based on the premise that all children share certain needs, andthat children of \low income families, in - particular, can benefit from a comprehensive devel-opmental program 'to meet those needs. The .Head Start program approach is based on the phi-losophy Mat: . . - .

(1) A child can benefit most from a comprehensive, interdisciplinary program to foster devel-opment and remedy problems as expressed in a broad range of services; and that .

(2) The child's entire family, as well as the community must be involved. The program shouldmaximize the strengths and Unique experiences of each child.,The family, which is perceivedas the principal influence on the child's development, must be .a direct participant in the pro-gram. Local communities are allowed latitude in developing creative program designs so longas the basic goals, objectives and standards of a comprehensive program are adhered to.(b) The overall goal of the Head Start program is to bring abbut a greater degree of social com-petence in children of low income families. By social competence is meant the child's everydayeffectiveness in dealing with both present environment and later responsibilities in school andlife. Social competence takes into account ,the interrelatedness, of cognitive and intellectual de-velopment, physical and mental health, nutritional needs, and "other factors that enable- a devel-opmental approach to helping children achieve social competence. To the accomplishment of .this goal, Head Start objectives and performance standards provide for: .

(1) The improvement of the child's health and physical abilities, including appropriate stepsto correct present physical and mental problems and to enhance every child's access to an ade-quate diet. The -improvement of the family's attitude toward .future health care and physicalabilities.

4

-4f1

(2) The .encouragement of 'self- confidence, spontaneity, curiosity, and self-di edipline which willassist in the development of the child's social and emotional health:

(3) The 'enhancement of the child's mental processes and skills with parllnig attention toconceptual and communications skills.

(a) The establishment of patterns and expectations of success for the child, which will createa climate of confidence for present and future learning efforts and overall development.

(5) An increase in the ability, of the child and the family to relate to each other and to others.16) The enhancement of the sense of dignity and self-worth within the child and his farhily.

Sec. 1304.1-4 PERFORMANCE. STANDARDS PLAN DEVELOPMENT

Each grantee and delegate agency shall develop a plan for implementing the performance stand-arils prescribed in Subparts 13, C, 0, ardE of this part for use in the operation of its HeadStart prograin. (hereinafter called "plan" or "performance standards plan"). The plan shall pro-vide that the Head .Start -progamcovered -thereby shall meet or exceed the performance stand-ards. The plan shall be in writing and shall be developed by the appropriate professional HeadStart staff of the grantee or delegate agency with cooperation from other Head Start gtaff, withtechnical assistance and advice as needed from personnel of the Regional Office and profes-sional consultants, and with the advice and concurrence.of the policy council or policy committee.The plan must be reviewed by grantee or delegate agency staff and the policy council. or policycommittee at least annually and. revised and updated as may be necessary..

Sec. 1304.1 -5 PERFORMANCE STANDARDS IMPLEMENTATION AND ENFORCEMENT

(a) Grantees and delegate agencies must be in compliance with or exceed the performance stand-ards prescribed in Subparts B, C, D, and E of this part at the commencement of the grantee'sprogram year next following July 1, 1975, effective date of the regulations -in. this part, or 6months after that date,'wh ichever is later, and thereafter, unless the period for full compliance isextended in accordance with paragraph (f) of this section.(b) If the responsible HEW official as a result of information obtained from program self-evalua-tion, pre-review, or routine monitoring, is aware or has reason to believe- ..that a .Head Start pro-gram, with respect to performance standards other tanterse for which the time for compliancehas been extended in accordance with paragraph (f) of this section, is not in compliance withperformance standards, he .shall notify the'grantee promptly in writing of the deficiencies andinform the grantee that it, or if the deficiencies are in a Head Start program operated by a dele-gate agency, the delegate agency has a period stated in the notice not to exceed 90 days to comeinto compliance. If the notice is with respect -to a delegate agency, the grantee "shall imme-diately notify the delegate agency and inform it of the time within which the deficiencies mustbe corrected.- Upon receiving the notice the grantee or delegate agency shall immediately ana-lyze its operations to determine haw it might best comply with the performance standards. Inthis process it shall review, among other things, Its utilization of all avairable local resources,and whether it is receiving the benefits of. State and other Federal programs for which it iseligible and which are available. It shall review and realign where feasible, program priorities,operations, and' financial and manpower -allocations. It shall also consider the possibility ofchoosing an alternate program option for the delivery of Head Start services in accordancewith OCD Notice -30-334-1, Program Options for Project Head Start, attached hereto as Appen-dix A, whiCh the grantee, with OCD concurrence, determines that it would be able to operate asa quality program in compliance with performance standards.(c). The grantee or delegate agency shall report in writing in detail its efforts to meet the per-formance standards within the time given in the notice to the responsible HEW official. A dele-gate agency shall report through the grantee. If the reporting agency, grantee 'or delegateagency determines that it is unable to comply with the performance standards, the responsible

'HEW official shall be notified promptly in writing by the grantee, which notice shall contain a'detcription of the deficiencies not able to be corrected and the reasons therefor. If Insufficientfunding is included as a principal reason for inability to comply with performance standards, thenotice shall specify the exact amount, and basis for the funding deficit and efforts made toobtain- funding from other sources.(d) The responsible HEW official on the basis of the reports submitted pursuant to paragraph(c) Of this section, will undertaketo assist grantees, and delegate agencies through their grantees,

2

5

7

-to Comply with the performance standards, including by furnishing or by recommending technicalassistance.(e) If the grantee ordelegate agency has not complied with the performance standards, otherthan those for which the time toe compliance has been extended in accordance with paragraph(f) of this .section,' within the period stated in the notice issued under paragraph (b) of this sec-tion, the grantee shall be notified promptly by the 'responsible HEW official of the commence-ment of suspension or termination proceedings or of the intention to deny refunding as may beappropriate, under Part 1303 (appeals procedures) of this chapter.(f) The time within which a grantee or delegate agency shall be required to correct, deficien-cies in implementatio of the performance standards may be extended by the responsible HEWofficial to a maximum of one year, only with respect to the followihg deficiencies:

(1) The space- per child provided by the Head Start program does not comply with the Education Services performance standard but there is no risk to the health or safety of the children;

(2) The Head Start program is Unable to provide Medical or Dental Treatment Senrice-,sas re-quired by Health -Services Performance Standards because funding, is insufficient and the7iFereno community or other resources available; .

(3) The services of a. mental health professional are not available or accessible to the programis. required by the Health Se'rvices' Performance Standards; or

(4) The deficientrVice is not able to be corrected within the 90 days notice period, notwith-standingfull effort at compliance, because of lack of funds and outside community resources,but it is reasonable to expect that services will be brought into compliance within theextendedperiod, and the overall high quality of the Head Start progiam 'otherwise, will be maintainedduring the extension.

INTRODUCTION

The Performance Standards-presented in the following pages are accompanied by guidancematerial which elaborates upon their intent and provides methods and procedures for imple-menting them. The .standard found in the left "hand column, and appropriate guidancematerial in the right hand column. The standards in.,the left hand coumn constitute Head Start'policy with which-all grantees and delegate agencies are required to conform. They are takenverbatim from the Federal Register dated June 30, 1975, Volume 40, Number 126, Part II, thatcontains the,Head Start .Program Performance Standards for operation of Head Start programsby grantees and delegate' agencies. The guidance in the right hand column is provided for the

.Lfissistance of Head Start programs in interpreting and implementing the standards and is. not- in itself mandatory.

63

EDUCATION ,

PERFORMANCE STANDARDS

Subpart BEducation Services Objectives andPerformance Standards

1 1304.2-1 Education services objectives.

The objectives of the Education Service com-ponent of the Head Start program are to:

(a) Provide children with a learning environ-ment and the varied experiences which willhelp theM deVelop socially, intellectually, physlIcally, and emotionally in a manner appropriateto their 'age and stage of development towardthe overall goal of social competence.

(b) Integrate 'the educational aspects of thevarious Head Start components in the dailyprogram of activities.

(c) Involve parents in educatiohal activitiesof the program to enhance their role as theprincipal influence on the child's education anddevelopment.

(d) Assist parents to increase knowledge,understanding, skills,. and experience in childgrowth and developinent.

. (e) Monti and reinforce experiences which'occur in the home that parents can utilize aseducational activities for their children.

. 1304.2-2 Education 'services plan content:. operations.

(a) The education services component theperformance standards planshall provide stra-tegies for achieving the education objectives.In so doing it shall provide for program activ-ities that include an organized series of wiped-

-- once* designed to meet the individual differ-ences and needs of participating children, thespecial needs of heifdidipped abildria, theneeds of specific educational, priOrities of thelocal .. population and the Community. Programactivities must be carried out in a manner toavoid sox role stereotyping.In addition, the plan shall provide methods forassisting parents in understanding and usingalternative ways to foster learning and develop-ment of their children. .

GUIDANCE

(a) The education plan should be preparedby the educational staff- with cooperation fromother Head Start staff,.parents and policy groupmembers. Professional consultants may becalled upon-as needed.

Before the education plan.is written, parents,staff and policy group members should meetto discuss the education service objectives andperformance standards. The staff has the re-sponsibility to inform parents and policy group.members about alternative strategies for achlev-.

_ ing the education objectives. The staff shouldrecommend' those strategies (curriculum ap-proaches, teaching methods, classrodm activi-ties, etc.) most appropr to to the Individualneeds of the population s rved and based on

4

7 N

EDUCATION

PERFORMANCE STANDARDS GUIDANCE

performance standard :requirements. With theconcurrence of the parents and policy groupmembers, the educational staff will then writethe plan. The education plan, must be specifi-cally designed to meet children's heeds asdetermined through assessment procedures.

The education plan must specify strategies.for implementing each of the education serv-ices objectives of the Head Start program. .

The education plan should indicate:

'How the education program will providechildren with a learning environment andvaried experiences appropriate to their'age and stage of development which willhelp them develop:

sociallyintellectuallysphysically '%

emotionally'

How the education program will integratethe educational aspects of the variousHead Start components in the dairy pro-gram of activities.

How the education program will involve.parents in educational activities to enhance their role as the-principal influe'iceon the child's education and development.

/How the education program will assistparents to increase knowledge, under-standing, skills, and experience in child .growth and development:'

.

How the education program will identifyand reinforce experiences which occur inthe.hewne that parents can utilize as edu-cational activities for their children.

The plan- should be accompanied by briefdescriptive' information -regarding:

'Geographical settingPhysical setting (available facilities)Population to be served (ethnicity, 'face,language,- age, prevelance of handlcap-ping conditions, health factors, family sit-uatio9s)Education staff (staffing patterns, experi-

8 ence, training)

1

5 , i

EDUCATION


(b) The education services component of theplan shall provide for:

(1) A supportive sociaf and emotionaf cli-mate which:

(i) Enhancei children's understanding ofthemselves as individuals, and in relation toothers, by providing for Individual, small group,and large group activities;

(ii) Gives children Many opportunities forsuccess through program activities;

6

GVIDAliCE

Volunteers,,, Community, resources

Program philosophy/curriculum approachAssessment procedures (individual child,total prbgram)

Refer to DHEW Publications:

project Head Start Program Series Book-lets:

# 4, Daily Program I (OHD) 73-1016#11, Daily Program Ill .(OHD) 73-1023#13, Speech, Language, and HearingProgram .(OCD) 75-1025

Caring for Children Series:#1. The Ways Children Learn (OHD) 75-1026 .

#2, More than a _Teacher (OHD) 75-1027#3, Preparing for Change (OHD) 75-1028#4, Away from Bedlam (OHD) 75-1029#5, The Vulnerable Child (OHD) 75-1030

Child Development Day Care Series:#3, Serving Preschool Children (OHD)' .

74-1057#8, Serving Children with' Special Needs(OCD) 73-1063 - '' (

(1) The following suggestions may be usefulbeginning4steps:.

(i) .Encourage awareness of self through theuse of fall-length mirrors, photos and drawingsof child and family, tape recordings of voices,etc;

Use child's name 'on his work and belong-ings.Arrange activity settings to invite groupparticipation (block 'and doll .corners, dra-

Matic play).Include active and quiet periods, child-initiated and adult-initiated activities, anduse of_ special areas for quiet and individualplay or rest.

(ii) Here are some examples:

Make sure that activities are suited to thedevelopmental level of each child;Allow the child to do as much for himselfas he can;Help the child learn "self-help" skills (pour-ing milk, putting on coat);

PERFORMANCE STANDARDS<

EDUCATION

(iii) Provides an environment of acceptance_which helps each _child build ethnic pride, de-velop a positive self:concept, enhance his indi-vidual strengths,-Wd develop facility in socialrelationships.

i-k

(2) Development of intellectual skills 'by:

(I) Encouraging children to solve problems,initiate activities, explore, experiment, question,and gain mastery through learning by doing;

GUIDANCE

Recognize and praise honest effort and notjust resultsySupport efforts and intervene when helpfulto the child; .

Help' the child accept failure' without de-feat ("I will help you try agaln.")1; t

Help the child learn to wait ("You will havea turn in five -minutes."); .Break tasks down into manageable partsso that children can see hoW much prog-ress they are making.

- (iii) This can be accomplished by adult be-havior such as:

showing respect for each child;listening arid- responding to children;showing affection. and personal regard(greeting by name, one-tb-one contact);giving attention to what the child considersimportant (looking at a block structure,lecating'a loit mitten);expressing appreciation, recognizing. effortand accomplishments of each child, follow-ing through on promises;.respecting and protecting individual rightsand personal belongings (a "cubby" or boxfor storage, name printed on work in large,clear letters);acknowledging and accepting unique qual-ities of each child;avoiding situations which stereotype sexroles or racial/ethnic backgrounds;proViding ample opportunity for each childto experience, success, to earn praise, todevelop an "I.,can," "Let me try," attitude;accepting each child's language, whetherit be standard English, a dialect or aforeignlanguage; fostering the child's comfort in,using the primary language;proiriding opportunities to talk about teelings.,. to share responsibilities, to' sharehumor.

(2) Intellectual skills can be enhanced by pro-viding a learning climate in which staff guidechildren to -foster cognitiv9 functioning (i.e., un-derstanding, reasoning, conceptualizing, ,etc.).

(i) Provide materials and time appropriate tothe child's age and level of development in theareas of:

7

1 0

EDUCATION


IN

,..--

(II) Promoting language understanding anduse in an atmosphere that encourages easycommunication among children and betweenchildren and adults;

(ill) Working toward recognition I the sym-bolsbols for letters and numbers according to theindividual developmental level of the children;

- -

`

(iv). Encouraging children to organize theirexperiences and understand concepts; and

(v) Providing-a balance program of staff di-rected and child initiated activities.

i ,

1%

,

(3) Promotion of physical growth by

(i) Providing adpquate indoor and outdoorspace, materials, equipment, and time for chil-dren to use large and small muscles to increasetheir physical skills; and

i

GUIDANCE

science; concepts of size, shape, texture,weight, color, etc.;dramatic play;art;music;numerical concepts; spatial, locational andother relationships. -

(ii) Some examples are:

Give children ample time to talk to eachother and ask questions in the language oftheir choice;

. _ . .

Encourage free discustion and conversa-tion between children and adults;Provide games, songs, stories, poemswhich offer new and interesting vocabulary;Encourage children to tell and listen tostories:

(iii) ,Make use of information that is relevantto the child's interests, such as his name,.tele-phone 'number, address and age. Make ampleuse of written language within the context ofthe child's understanding, for example, experi-,ehce stories, labels, signs.

(iv,) The sequence , of classroom activitiesshould progrest fr m simple to more complex

_,tasks, and from co crete to abstract concepts.Activities can be o ganized around concepts tobe learned.

(v) Although each day's activities should beplanned by the staff, the schedule should allowample time for both spontaneous activity bychildren and blocks of time for teacher-directedactivities.

(i) This can be accomplished through regularperiods for physical activity (both Indoor andout). Physical activities should include.mgerialsand experiences designed to develop:

large muscles (wheel toys, climbing appa-ratus,, blocks);small muscles (scissors, clay, puzzles,small blocks);eye-hand coordination (puzzles, balls,

\ lotto);\ body awareness;\ rhythm and movement (dancing, musical\ instruments)..

8 ti .\

11 \_. .

EDUCATION


Providing appropriate guidance whilechildren .are using equipment and materials inOrder to promote children's physical growth.

(c) The-education services component of theplan shall provide-for a program which is indi-vidualized to meet the special needs of childrenfrom various 'populations by:

(1) Having a curriculum which is relevantand reflective of the needs of the populationserved (bilingual/bicultural, multicultural, rural,urban, reservation, migrant, etc.).

(2) Having staff and program resources re-flective of the racial and ethnic population ofthe children in the program.

(i) Including persons who weak the primarylanguage of the children and we knowledge-able about their heritage; and, at a minimumsirhen a majority of the children. speak a lan-guage other than English, at least one teacheror aide interacting regularly with fhe childrenmust speak their language; and

(ii) Where only a few children, or a singlechild, speak a language different from the rest,one adult in the center should be available tocommunicate in the native language.

(3) Including parents in curriculum develop-ment and having them serve as resource per-sons (e.g., for bilingual/bicultural activities).

9

UIDANCE

ii) Staff sh uld be actively involved with chil-dren during eriods of physical activity. Duringsuch activitie , staff should take opportunities toincrease their contact with individual children.To ensure sa ety, activities should be &ie-Q.istsily supervised.

12

(1) This can De accomplished by includini ineach classroom materials and activities whichreflect the cultural background of the children.Examples of materials include:

books;records;posters, maps, charts;dolls, clothing.

Activities may include:

celebration of cultural events and holidays;serving foods related to other culturris;'stories, music, and games representative ofChildren's background;

inviting persons who speak the child'snative language to assist with activities.

(I) This adult may be:

a teacher or aideother member of the center staffa parent or family membera volunteer who speaks the child's lan-guage

(ii) In some cases where h single child is af-fected it may notNbe possible for the center toprovi e an adult speaking the child's languageon a r War basis.

(3) Parents can be valuable., resources inplanning activities which reflect the children'sheritage. 'Teachers may request suggestionsfrom parents on ways to integrate cultural activ-ities into the program. For example, parentsmay wish to:

plan tioliday celebrations;prepare foods unique to various cultures;

e

EDUCATION


(d) The education services component of theplan shall provide procedures' for on-going Ob-servation, recording and evaluation of eachchild's growth and development for the purposeof planning activities to- suit - individual needa.

shall provide, also, for integrating the educa-tional! aspects. of other Head Start componentsInto the daily education services program.

GUIDANCE

recommend books, records, or other mate-rials for the classroom: Iact as classroom volunteers;

lb. suggest games, songs art projectswhich reflect cultural c stoms.

(d) The education plan should specify how--Head Start staff will assess tlie Individual devel-opmental/instructional needs of children,. Someways this may be accomplished include:

discussions with paredts during recruit-ment, enrollment, 'home* visits, parent-staffconferences and meetings;review of child's Medical acrd develop-mental records;conferences with medical -or psychologicalconsultants where indicated;teacher observations -documenting devel-opmental progress used as guidance inplarMing for and/or modifying individualchildren's activities;use of Specific -assessment Instruments orscales.

Planning should take into accoun the age.gedups and abilities of the children. For exam-ple, activities will differ for. three and five yearolds. Children with handicaps, Ilke all children,shluld have spectlio goals set Jot them accord-ing to their ability.' ''

The plan 'should alga include, the following:

long-range ',plans based- on evaluation ofeach child's current needs, .interests andabilities;specific 'activities and responsibilities of

-staff memberl;consistent methods for observing and re-cording the Progress of each child;

I, procedures to be used for reviewing eachchild's progress and modifying the programwhen Indicated.

Activities,to integrate educational aspects ofother components into the daily education pro-gram could Include:

Health Education built into the schedulethroogh:

timlec-to talk about physical and dentalexaminations in order to increase under-

, standing and reduce fears;I o


.N,

. .

e.

EDUCATION

- GUIDANCE

books" and pictures about doctors" anddentreti;

.

,,

materials for dramatic play (stethostope,.

nurse's uniform, flashlight);rotA,playing before and after visits todoctors, . dentists, hospitals, clinics, etc.

Nutrition Edgication as part of the daily? .

schedule:7taatliestance in meal preparition, setting .

.-learning experiences through food prep- aratidn (adding liquids tO'Solide, season-ing, freezing, Melting,' heating, cooling. /cooking simple foods) , '

books, pictures, films, trips related to thesource of foods, (farm, garden, ware- /house, market, grocery store).

Refer to Prqject Head Start Program SeriesBooklets:

#2, Health Services (060) 73-1007/ #2A, -Dental Services (OCD) 73-1008

*3, Nutrition (OCD) 72-47=3E, Leader's Discussion Guide I6r Nutri-tion Film

-----*--:-Nutrition-Ectli-ativtrItic5TO17rghli-dren (OH D) 75-1015

(e) The' plan shall provide methods for en-hancing the knowledge and understanding ofboth staff and parents ,of the educational anddevelopmental needs and activities of childrenin the program. These shall include:

,1'

."

I/

1411

(e) The plan should indicate some of theways parents and staff will work together tounderstand each child and provide for his learn-ing experiences. The plan should include .de-tails of ways the hbme and center will attemptto supplement each.other in providing positiveexperiences for the child.

There should b6 an early orientation to theEducatOn Services Objectives. 'Special empha-sis should be given to the significance of thematerials, equipment and experiences providedin a 'Head Start Child Development program.Interpreters ahould,be available to facilitate fullparticipation of non-English speaking. parents.

Procedures should be established to facilitatemmemum communication between staff andparents, for example:

newslettersparent/teacher conferencesgroup meetingsphone callshome visitsposters, bulletin boards, radio/TVnouncements.

an-

EDUCATION


(1) Parent participation in planning the edu-.cation program, and in center, classroom andhome program 'activities;

(2) Parent training in activities that can beused in the home to reinforce the learning anddevelopment Of their children in the center;

(3) Parent training in the observation ofgrowth and development- of their children inthe home environment and identification of andhandling special developmental needs;

(4) Participation in staff and staff-parent con-ferences and the making of periodic home visits-(no less than WO by members of the educationstaff;

(5) Staff and parent training, under a pro-gram jointly developed with all components ofthe Head Start. program, in child developmentand behavioral developmental problems of pre-school children; and

GUIDANCE

(1) Meeting with staff to provide for the over-all written education-plan (see item 1304.2 -2(a)for further guidance).

(2) /Some examples are:

drientation and training sessionsdesigning activities for children at homeparticipating in classroom/center activities.

(3) Provide parents with' films, workshops,publioations;- specialists, professionals, etc,_inchild growth and development. Arrange forfilms, publications and specialists to providetraining.

Refer to DHEW Publications:

Caring for Children Series #10, Language. is for Communication (OH D) 75-1035 *:

Children's Bureau Publication. -#30, Your_Child from 'I to 6 (OH D) 76-26 .

(4) 'Areas of mutual concern to be discyssedcould include: .

chi Id=s developmental progress;child rearing issues;discussion- of possible home activities toexpand the HeaclStart experience;discussion of health problems or handicap-ping conditions of the Head Start child.

Although only two, home visits are required,we suggest that consideration be given to visit-ing each child's.home at the beginning, middleand end 'of the yearl'Arringements for suchvisits should respect parent's wishes, and con-vience and should be coordinated with the visitsof other Component staff. At least one of thesevisits should be devoted to discussion withparents around areas of mutual interest and'concern in order to identify home activities andother ways to expand the Head Start experi-ence.,

(5)' An orientation and training programshould be planned in cooperation with Othercomponent staff members and parents. Thetraining program should provide for periodicformal and informal. sessions. The content, or-ganization, staffing and *scheduling will dependbri the individual-program needs as determinedin the planning stage. Training should focuson the normal child as well ias the, child with

12

15

EDUCATION

PERFORMANCE''STANDARDS

,

(6) Staff training In Identification of andhandling children with special needs and work-ing with the parents of such children, and incoordinating relevant referral resources.

---

§ 1304.2-3 Education services plan content:_

-facilities.

(a) The education:services .component of theplan shall provide for a physical environment,conducive to learning and reflective of the dif-ferent stages of development of the children.Nome-base projects must. make affirmative ef-forts to achieve this environment. Far center-based programs, space shall be organized intofunctional areas recognized by . the children,and space, light, 'ventilation, heat, and otherphysical arrangements must be consistent withthe health, safety and developmental needs- ofthe children. To comply with this-standard:

-,

(1) There shall be a safe and effective heat-ing system;

(2) No highly flammable furnishings or dec-orations shall bevsed.

c

(3) Flammable and other dangerout mate-rials and potential poisons, shall be stored inlocked cabinets or storage facilities accessibleonly to authorized persons;

(4) Emergency_lighting shall be available incase of power failure;

- r

(5) Approved, workingshall be readily available;

(..

fire extinguishers

GUIDANCE

special needs. Emphasis should be on mental,physical, social, and emotional growth anddevelopment. `,

There should be identification of opportunitiesfor training or continuing education to con-tribute to staff competence. In some locations,CDA training can be an appropriate means forachieving this; many Head Start staff mem-bers are receiving CDR training throirgh theHead Start Supplementary' Training program.(Refer to DHEW Publication: The CDA Program:The Child Development AssociateA Guide forTraining (OHD) 75-1065)

(6) Training should also familiarize staff andparents with appropriate referral resources inthe community. (Refer to 1304.3-3(b)(10))

(a) Indoor and outdoor space should be suffi-cient and appropriate for necessary programactivities and for support fun ctions.(offices, foodpreparation, custodial services) if they are con-ducted on the premises. in addition,. rest/napfacilities and space -for isolation of sick childrenshould be available.

Refer to DHEW Publications:. ,

#4, Daily Program 1(OHD) 7,3-1016Caring for Children Series *6 A Setting for;Growth (OHD) 75-1031Space for Learning (OCb) 72-51

(1) Radiators, stoves, hot water pipes, port-able.heating units, and similar potential hazardsare adequately screened or insulated to preventburns.

(2) Flammable materials can be fireproofedwith commercial preparations. :

I

(3) Cleaning supplies and [Potentially dan-gerous materials should be stored separatelyfrom food and out of reach olichildren. *.

.. ,

(4) High powered, flashlights may be used.Candles are -fire hazards. if

(5) Adults In, the progra to should be able.tolocate and properly operat firi extinguishers.

'13

165

r

.. EDUCATION


(6) Indoor and outdoor premises shall bekept clean and free, on a daily basis, of unde-sirable and hazardous material and conditions;

(7) Outdoor play areas shall 'be made so asto prevent children from leaving the premisesand getting into unsafe and unsupervised areas;

(8) Paint coatings on premises usedfor careof children shall be determined to assure theabsence of a hazardous quantity of lead;

(9) Rooms shall be well lighted;

(10) A sotirce of water approved by the ap- ,propriate local 'authority shall be available inthe facility; adequate. toilets and handwaih-ing facilities shall be available and easilyreached by children; .

(11)t All sewage and liquid Waste shall be dis-posed of 'through a sewer system approved byan appropriate responsible authority, and gar-bage and trash shallbe stored in a safe ,andsanitary manner until collected;

(12) There shall be. at least 35 square feet ofIndoor space per child available for the care ofchildren (i.e., exclusive of bathrooms; halls,kitchen, and storage places). There shall be atleast 75 square feet per child outdoors; and

GUIDANCE

(6) If evidence of rodents or vermin is found,the local healthor sanitation department mayprovide assistance or referral for extermination.At regular intervals programs should check forand correct splintered surfaces, extremelysharpor protruding corners or edges, loose or brokenparts. All clear glass doors should be dearlymarked with opaque tape to avoid accidents.

i .\. (7) Where outdoor apace borders on unsafeareas (traffic, streets, ponds, swimming areas)adults should always be positioned to supervisethe children. If possible such areas should beenclosed.

(8) Old. buildings may be dangerous; be sureto check for lead contamination.

The local public health department can. becontacted to provide information on lead poi-soning and to deteqi hazardous quantities oflead in the facility.

." (9), Fixtures whici have a low glare surfaceto sufficiently diffuse' and reflect light may beuseful. Use bulbs with sufficient wattage, Checkand replace burned-out bulbs regularly.

(10) Verify State and local licensing reqiiiire-ments in these areas. Stepstools or low plat-forms may be useful where toilets or handwash-ing facilities are too high.

;(11) Disposal problems can be referred to the

local sanitation and public work department.Keep all waste materials' away from children'sactivity areas and from areas used for storage'and for preparation of food. -'

.. (12) Where minimum space is not available,various alternatives can .be considered. For ex-ample, a variation in program design (See OCDNotice N.:30-334-1 on Program Options for Proj-

-. ect Head Start)', stagger the program day, theprogram week, outdoor play periods. In this

. manner, all children will not be present at .thesame time. bin sonic. cases, outdoor space re-quirements may be -met- by arraeging for dailyuse of an adjoining or nearby school yard, park,playground, vacant lot, or other space. Be surethat these areas,are easily accessible and fulfill, .the necessary safety requirements.

In Some cases, imay be necessary to locatemore -suitable facilities.

14'17

...

,

EDUCATION


(13) Adequate provisions shall be made forhandicapped children to ensure their safety and

' comfort.

Evidence that the center meets or exceedsState or lobed fidensing requirements for sim-ilar kinds of facilities for fire, health, and safetyshall be accepted as prima facie compliancewith the fire, health and safety requirements ofthii section.

(b) The planshall provide for appropriateand sufficient furniture, equipment and ma-terials to meet the needs of the program, andfor their arrangement in such a way as to tacit-ita e learning,' assure a balanced program ofspo taneous and structured activities, and en-courage-self-rellanci in the children. The equip-ment and materials shall be:

. d

1 .

(1) onsistent with thi specific educationalobject' ex of the local program;

., .

(2) Consistent with the cultural and ethnicbackground otthe children;

, .

et

(3) Geared to fhe age, ability, and develop-mental needs of the children;

. .

(4) Safe, _durable, and kept in good condi-, lion; .

(5) Stored in a safe and orderly fashion whennot in use;

0 :

(6) Accessible., attractive, and inviting to thechildren; and

t7 :.

(7) Designed to provide a variety of learningexperiences and to encourage,experimentationand exploration.

icp

GUIDANCE

(13).-Ramps, railings, and special materialsand equipment' may be needed in order to allowsuch children maximum possible mobility.'Corn-

. munity resources may be used to acquireneeded special materials and services.

Confirm compliance with local *licensing re-quirements. Where no licensing is required, thegrantee and Policy Council should request ad-vice from local fire and health departments indetermining safety standards.

(b) Refer to OHEW Publications:

Project Head Start Program Series Book-lets:

# 4, Daily Program (OHD) 73-1016# 9, Equipment and Supplies#11, Daily Program Ill (OHD) 73-1023

Caring for Children Series:# 6, IA Setting for Growth (OHD) 75-1031

Spate for Learning (0CD) 72-51 ..

(1) Make use of the written plan when select-ing materials and eqiiipment. -

L. 4

(2) Many books, pictures, records, and othermaterials reflect ethnib and culturl heritageand' background.

(3) For instance, chairs and tables are childsize; toys, books, and other materials and equip-ment are interesting and challenging to thechildren. ..

. .

(4) Contact U. S. Consumer Product SafetyCommission, Wadhington; D. C: 20207 for infor-matiOn; Repair broken equipment and materialspromptly:

..

(5) (6) Securely -.fastened, Well =organizedclosets and cabinets are needed for many sup-plies which should. be stored out of reach andsight of smait children. Classroom materials andequipment, stored on low shelves and/or inopen bins should be located near the areawherekthey are to be used and arranged in or-derly convenient fashion so that children maybe responsible for their use and return to stor-age.

(7) Materials that can be used in a numberof ways rather than single-purpose items aregenerally more useful.

15

18It

HEALTH


Subpart CHealth Services Objectivesand Performance Standards

§ 1304,3-1 Health services general objectives.The general objectives of the health services

component of the Head Start program are to:(a) Provide a comprehens0fe health services

program which includes a broad range of medi-cal, dental, mental health and nutrition servicesto. preschool children, including handicappedchildren, to assist the physical, emo-tional, cognitive and sociiil development-towardthe overall goal of social 'competence.

(b) Promote preventive health services andearly. intervention.

(c) Provide the child's f aritily with the.neces-.

sary skills and insight and otherwise attempt totink the family to an ongoing health care systemto ensure that the child continues to receivecomprehensive health care even after leaSing

. the Head Start program.

§ 1304.3-2 Health. Services Advisory Commit-tee.

The plan shall provide .1Or the creatien*.iHealth Services Advisory Committee whose pur-pose shall be advising in the planning, opera-tion and evaluation of the health services pro-gram and which shall consist of Head_ Startparents and health services providers in . thecommunity and other specialists in the varioushealth disciplines. (Existing committees may bemodified or combined to. carry out this- func-tion.)

GUIDANCE

(a}, (b), & (c) These are the aims toward whichthe program efforts should be directed.

In order to achieve the comprehenSivprofes-

sionallythe health program must by planned by profes-sionally competent, people. Planning must takeplace early and must involve a wide cross-section of the professional health 'talent avail-.able in the community. Examples of people'whocould be involved in planning the health pro-gram of the Head Start Center include:

a. Pediatricians and pediatric societies.b. General practitioners and the Academy of

General Practice.Other physicians arid the county and Statemedical societies.

d. Local, regional, and State health offices.e. Child and general ptychiatrists and their

associations. -,

f. Hospital administrPtors and theiassocia4lions.Dentists and dental associations.Public health nurses, school nurses, andnursing organizations.Nutritionists and their associations.ptornetrists and their associations.sychologits and their associations.

r.


HEALTH

G.

§ 1304.3-3 Medical and dental history, screen-ing, and examinations.

(a) The health services component of the per-formance standards plan shall prOVine that foreach child enrollectin the bead Start programa complete medical, dental and developmentalhistory will be obtained and recorded, a thor-ough health screening will be given, and medi-cal and dental examinations will be performed.The.plin will provide-also for advan6e parent or

*guardian authorization for all health services,under this subpart.

, 1.

20

GUIDANCE *.

I. Medical technologists and their associa-

m. Speech and hearing personnel and theirassociations.

The plan should indicate the number ofparents, and specifid health professionals onthe health advisory committee; goals and objec-tives; and projected number of meetings.

Involving parents, health profestionals andtheir organizations in planning will ensure thatthe health program is tailored to the needs ofthe children, and that it utilizes fully the re-sources available in the community without d,u-plicating already existing services. The healthprofessionals should be aware of commonhealth practices in their community. The healthadvisory committee should develop guidelinesto. deal with.health practices that may be poten-tially harmful to a child. Organizations and indi-vidualS who are involved in the early planningof a program are likely to cooperate fully in theimplementation of the prOgrarrr.

(a) As much pertinent health information aspossible should be accumulated- and recordedfor each ,child. This should be performed assoon nioafter the child is enrolled as is feasible.There are three main sources fOr such infor-mation: records of past medical care, teachers'observations, and interviews with -parents orguardians.

Every effort should be made to obtain recordsor summaries of the significant medical care.an immunizations. that each child has receivedin the past. This information may be availablefrom hospital clinics, private physicians, orhealth department-sponsored well-child clinics.In special ,cases, it may .be desirable to obtainthe mother's and infant's delivery and birth his-tory from the hospital where the child was born,especially if. the child now shows evidence ofneurologic impairment. Written records of im-portant health events are important supplementsto the mother's recollection of such events. "8yacquiring such records before the physicianperforms his complete health evaluation, a greatdeal of repetition, liasted time, and unnecessaryconcern may be avoid d:

An example of th t type of information re-. quired is contained in CAP-HS Form 30.

17

HEALTH


. (b) Health screenings shall include:

r (1) Growth assessment (head circumference

The teacher is in an onusually good positionto notice those children who may have healthproblems. The teacher observes the children fdr15 to, 30 hours a week, whereas the physiciancan onlY observe the child for 20 minutes to anhour. Poor codrdlnation, hyperactivity, unintel-ligible' speech, excessive tiredness, or h-drilival from othEA, may be noted 'muc rereadily by a teacher than -by either the t,who usually has little basis for compari or. _

the physician, who has a limited.time of ,er-vation. The teacher may observe dental prob.ferns when children eat. Some formal provisionshould be made to be sure that teachers' ob-'servations of the children's health and behaviorare available to the physician at the time of hismedical evaluation.

An example-of the type of form and informa-tion the teacher.should record is contained inCAP-HS Form 3Q, mentioned above. "

An example of a consent form is also con-tained within CAP-HS Form 30.

(b) Screening tests should be carried out forall of the Head Start children. These are testssome of which. may be performed by non-professional workers. They do not represent a corn-.plete evaluation, but they identify a grOup ofchildren who require more complete profes-sional evaluation. Screenings 'should be com-pleted within 90 days afterchild is enrolled orentered into -the 'program.

It is important that the results of the screeningas well as the complete medical and develop-Mental history' are available to the' physician atthe time of medical examination. The purposeof this is to identify children with needs and toalert the physician to problems requiring a morecomplete professional evaluation.

(1) Head, circumference measurement :is notup to two years old) height, weight, and age.' '.necessary after the child reaches two years of

age. (A Health professional should, teach this-procedure to para-professionals.)

The results of careful height 'and weightmeasurements for each .child should be re-corded.

A beam balance scale should be used forweights since ordinary bathroom Scales may beinaccurate.

18

21

*

PERFORMANC TANDARDS

.., ..

(2) Vision testing.

.

HEALTH

V

. 19

2.2.

GUIDANCE

Heights should be measured with the childstanding straight with his back to a wall onwhich is mounted a paper, wooden, or metal.measure. -A_ -_strapht-edged device -rested on the_child's head 's held at right angle to themeasure.. -

In interpreti g height and weight measure-ments, one mu t remernb r -that -'many normal, ---well-nourished hiliiren ar small tor their age.in evaluating poor nutrition and poor growth,the rate of growth of a child between two meas-urements separated, in time is more imT:icirtafirthan a single measurement. For this purpose,and whenevgr available, weights and measure-ments which` were 'obtained in previous 'healthexaminations, should be recorded on a graphicrecording sheet. The small child who Is grow-ing at a normal rate is likely to be well-nourished' and free from serious disease.'Evena much larger child who is growing, at an un-, % I

usually slow rate may have some significant ad-verse condition affecting his health.

;f(2) 'The most appropriate Visual' 'Screening ?test to be applied in any community can usuallybeat. be ,determined by the health services di-I,rector in consultation with the group of health,practitioners -- ophthalmologists and optomretristswho will be responsible for the ,coin-plete evaluation and treatment of goose childrenselected for the screening tests. These special-ists can determine the type of tests and the.criteria for passing or 'tailing which they feelare most appropriate.- Health departments andschool health programs often have well- estab-lished visual screening programs- which can beapplied readily to -Hea Start children.

When there is no established screening pro-gram and consultation from eye specialists isnot -available, ta community, the National So-ciety for the' Preverdon bf Blindness** or its 'State or local chapters, or the Volunteers forVision may assist in setting up a screening pro!.gram. H

le'none of these 'resources is available, the ..following vision screening method may be used,which will generally identifrmOst of the children .,who ace inneed of further eye care. The testmay be performed by nurses, by heilith aides, or 1

volunteers trained in the method...

. 0

*Address: 79 Madison Avenue, New York NewYork 10016,

_I

1

i

.111.1.

...11..


HEALTH

GUIDANCE rz ------A Snel len E illiterate visual testing chart (ob-

tainable from any hospital supply company orfrom the National Society for the Prevention ofBlindness) should be placed on a bare wall with-out windows. There should be no bright light or

, glare within the child's field of vision. The childshould be seated comfortably with his head 20feet away from the chart. A goose-neck lampwith a metal shade and a 75 watt bulb placed5 feet from the chart will'provide adequatestandard illumination. .

Children should be instructed In the HeadStart classroom, or in small groups before test-ing, in "how to- play the E game." The child istold-to indicate with his ownfingeis the direc-

- tion in which the "fingers" of the E point. Afterhe has learned to do this, each child is tested

individually, a black "pirate's patch'1 may be amore acceptable way of covering one eye thansimply holding a card in. front of that eye. Toavoid possible transfer of infection, a separatepatch or card should be used for each child.The card or patch should not put any pressureon the eye,- and the child should keep the cov- :ered eyeoen. First, the child's vision with. botheyes is-tested. Then, with his left eye covered,the child is asked to indicate which directionthe E is pointing as the examiner uses a pencilor pointer to indicate specific symbols on the

Ichart. An examiner may point first to the firstE on the 20/60 line. If this is passed. success-fully, go on to the first two symbols on the 20/40,line..II these are passed successfully, go on tothe-first three symbols on the 20/.30 line, and r7

if these are, passed' successfully, go on to the_ 20/20 line. Whenever a child fails to identify

the position correctly, the tester should. continueacross the same line on the E chart. A line isconsidered "pasted" if more than one half of-the figures on the line are correctly identified.

The same procedure is repeated with the righteye.covered. A child fails the test if, with eithereye, he is unable toidentify more than half ofthe symbols on the 20/40 line or if there is morethan a two line difference in vision between one.eye and the other, even if the worse eye is20/40 or better-.

A child who is unable to learn to "play the Egame" should be reported as "non-testable"may be ,given further instruction in the "Egame,!!- either in the classroom or by his par-ents at home, and retested at a later date.

2320

.4 I.


(3)-Hearing testing.

t:v

,7'

c

.,

HEALTH

GUIDANCE .

Children sire dy wearing glasses should betested while wearing their glasses'. If they pissthe test while wearing their glasses, there is noneed for further testing. / -

Children failing the test whp appear acutelyill or particularly .fatigued should be retestedbefore they are 'referred,. to an eye specialist:Other children who fail the screening test shouldbe referred to an eye specialist for further eval-uation. The results of the screening test shouldbe recorded. on the child's health form andshould be brought to the attention of the physi-cian-at the time of the health evaluation. At thistime, the -physician should eiamine the opticfundi with an ophthalmoscope and shoigd noteany deviation in extra-ocular movements.

(3) Children will be better prepared for test-ing if the procedure is demonstrated in. theclassroom, where the whole class can be made 4...

familiar with the sounds and taught to make thedesired responses.

Children who cannot learn to respond to thetest properly, or. who give grossly inconsistentresponses to sounds of any intensity, should bedesignated as "non-testable." A child is gen-erally considered to "have failed the screeningtest if he fails to respond at the recommendedlevel at any frequency in either ear. The fre-quencies generally used in a limited hearingscreening test are 1000, 2000, and 4000 Hz.

A' large proportion of children who fail:a hear- ,

ing screening test has only temporary hearingimpairment associated with upper respiratoryconditions. Such, children should be retested-after,a few weeks before they are referred 'forspecialist medibal or audiology care. For this'reason, it is important to institute the hearingscreening program as early as possible in theHead Start program or even before the Head

/ Start .officials may encourage school personnelStart classrooms begin to meet formally. Head

to include hearing screening tests at part of theroutine pre-school interview )vhich many schoolsystems conduct in spring before students willenter school.

Results of the preliminary .hearing screeningtest shoiild be recorded on the health.form andbe available to the physician at the time of hiscomplete health. evaluation. . -._

The person performing a hearing screeningtest must have special training in the use of theequipment and in the interpretation of the vari-

2 4.ous responses which children may make to the

. . .

ck.;-

21


1

(4) Hemogtobin or hematocrit determination. (4) An accurate test of hemoglobin concen-tration is the best screening test for anemia.However, accurate tests require trained techni-cians and equipment that is moderately expen-sive. .

The microhematocrit :test is somewhat lespprecise as an indicator a anemia. However, thelaboratory determination itself is,so simple andaccurate that this test could often be morepractical than a hemoglobin test. Most commu-pity- hospitals -will have equipment to perform.this_test-a will many health department clinics.---- in using either of these tests, blood samplesmay be obtained at the Head Start center or atanother convenient place by a technician or, nurse. The blood samples can then be trans-ported and tested in a central location.

Children with anemia and similar medicalnutrition problems need specific diagnoses andfollow-up. A child with a hemoglobin of lessthan 11 or hematocrit of less than 34 is consid-

i ered to,be anemic. This is consistent with thestandards of Public Health Service, Maternaland Child_ Health and with-CDC National Nutri-tion Status Survey as well as EPSDT guidancematerial .-t

(5) Tuberculin testing where indicated. (5) Tuberculin testing has the dual value ofidentifying childrerh who may have tuberculosis,and of finding active cases of tuberculosiswithin the families or other intimate ofsuch 'children. Most Head Start programs will

HEALTH

GUIDANCE

test. Most school health programs and healthdepartments have- both testing equipment andpersonnel trained in its use. If equipment andpersonnel are not available locally, help may beobtained from: (1) An audiologist in a neighbor-ing community, (2) the regional or State healthor education department, (3) the State speechand heating associations, (4) the AmericanSpeech and Hearing Association.*, (5) NationalAssociation of Hearing and Speech Agencies.*It will usually be more economical for a HeadStart program in a smeller community to obtainservices from a trained technician in a nearbylarger community than to purchase its ownequipMent and train its own personnel.

*Address: 9030 old Georgetown Road, Wash--. ington, D. C. 20014.

**Address: 814 Thayer Ave:, Silver Spring, Md.20910.

22

25

1 ;


HEALTH

2 t)23

L.,..\GUIDANCE

-be able to obtain both test materials and per-sonnel trained in their use through their school .health program, the focal health department, orthe local, county, or State tuberculosis associa-tion. Initial tuberculin testing Is usually dons atapproximately one year of age.

Routine periodic ,tuberculosis testing is partof screening only If (1) the child has had con-tact with a known case of tuberculosis or. Is amember of a family with a history of tuberculo-sis, (2) the child is living in a neighborhood orcommunity in which the prevalence of tuber-culin sensitivity in the school-age children is ,

known_ to exceed 1%, or (3) the child presents.symptoms consistent with tuberculosis; ..

A Head Start program conducting its owntuberculosis testing program will usually Find thetuberculin tine test to be the most economicaland convenient. Materials for this test are avail-able '.. through many.. health departments andthrough any pharmacy. Complete instructionsfor, administering and reading this test are.packed With the test materials.- The test shouldbe scheduled at such a time that the children-will be in a class three days later to have Thetest read. Any swelling or induration surround-ing_any..pf_t_heloutncedle_puncturessbould_be.considered a positiVeeaction.

Children who react positively to the tuberculintine test should have *a Mantoux intiabuteneottstest' performed using either Intermediatestrength, PPD 0.1 mil., or OT 1/11300 0.1 ml: TheMantoux test must be performed by a physicianor a specially trained nurse or technician: Itshould be read on the second or.third day.

Since children who are known to have beenexposed to an acVve case of pulmonary 'tuber-culosis may have large, uncomfortable reac-tions to the standard screening test, theybe referred to a physician for testing with amore dilute perparation of PPD or OT. Certainviral infections (such as measles, influenza,mumps); some viral vaccines (such as measlesand Influenza) adminIstratiorhot corticosteroldS,and extreme malnutrition (MI; all depress 'orsuppress the tuberculin reaction for as tang asfour to six weeks. Children with a history ofsuch conditions should be retested at laterdate.

The results of the test should be recordedand available to the physician at the lime of hisexamination. -

(6) A simple and inexpensive screening testthat may detect some Winery tract abnormal-

HEALTH


(6) Urinalysis.

(7) Based on community health problems,other selected screenings where appropriate,e.g., sickle cell anemia, lead poisoning, and in-testinalparasites. A.

(8) Assessment of current immunization sta-tus.

-(9) During the course of health screening,. procedures must. be in effect for identifyingspeech probleiiis, determining theWcause, andprovidipg services.'

- GUIDANCE

Hies' is theuse of a test paper which detects-albumin, sugar, blood, .and determines -the pHof the urine. Urin4 can be obtained at the centeror In the home using clew p glass Bottles orpaper cups. The test papa; is dipped' in theurine -and color changas on 'the paper are inter-preted according to .a chart encloseld on thetest. papers. 'Children who$e test shows 'thepresence of sugar, blood, rriore than 1+ albu-Min, or'pH of more than 7.0 should hae* a com-plete urinalysis. Most child 6n with abnormalscreening urine tests will b found' Hormel oncareful retesting. -

.. Quantitative urine culture; ; tb 'discover bac-teriuria is an importarit screening test for urinarytract abnormality. Unfortunately; this test is rela-tively expensive, and only a fem.! Head Start com-munities will have the necessary bacteriologiclaboratory facilities, to perforrh the test econom-ically and well. Diagnostic laboratory kits arenow available for urine cUltures whidh do notrequire bacteriological laboatory faOities In'those communities where and accu-rate testing is possible, this test[ should be con-sidered for all grrls. Boys %491-so ave" enuresis(bedwetting) or other sym toms should betested; asymptomatic 'boys do not require.testing. ,

(7) The local board of health, the pediatric'consultant, and the health aprovide information to ascertcell anemia, lead poisoning,sites are community health psuch as head lice can bemanner.

(8) Staff ,should-check meconsult with parents on childzation status regarding diptetanus, measles, polio, Germumps.

(9) Many children talk vmedical' examination, and thpoor position to judge thespeech.

Etfibierit screening of verybe done quickly and informadien talk about stimulus piwords containing a variety

24

-2 7

visory committeein whether sickle

nd intestinal pare-obiems. Problemsealt -with in this

Ica! records ands current immunitheria, pertussis,an Measle, .and

'ry little 'during aphysician is in a

dequac of their

oung children canly by haifing chil-tures, repeat keyf speech. sounds,

i

I

Cl

HEALTH


,

v

,.4'10) Identification of the special. needshandicapped children,

and relate oral information Spontaneously. ingeneral, remedial speech services should beprovided only where conditions exist which sug-gest that without attention, a handicappingdis-order will continue into late childhood.

The teachers in the Head Start center shouldmake note of any childreh' in their class whosespeech is substantially different from that ofthe average Head Start child. -These observa-tions should be available to the physician at thetime of his examination. He can then make spe-cial evaluations of the ears, palate, and lary'nx,and may be able to give advice as to 'whether .the speech pattern is normally immature or ispathological ter the child. Whenever speechand hearing profeiiionals are available to theHead Start program, they should work in coop-eration . with the physician and leacher in de-tecting, examining and evaluating speech ab-normalities.

Every language community or geographicarea has certain differences from so-calledstandard speech in pronunciation, vocabulary,and grammar. It should be recognized that asizeable number of pre-schoolers have unclearspeech due to immature articulation patternsabd will mature and develop normally if theyreceive the efece'ssary developmental services.Therefore, a child who may speak a languageother .than English or ethnic colloquialismsshould not be r

The health avelop this procedspeech and hearinga schedule for check'

garded as speech- mpaired.visory committee should de-

e including the utilization ofofiiissionals and pUdining

suspect' speech ab-normalities.

Services include speech and language de-velopment, clinical services, and parent coun-seling services.

of (10) Special needs of handicapped children° 'can be identified from. the screening and physil

cal examination results, parent interviews, and 'teachers' and mental health professionals' ob-servatIons. , . -

Jhe plan to provide for these special needs "could include modification of the physicalfacility, modification of the curriculum, develop-ment of new or different feeding skills, and. .

continuation of special medical care. :You will find the -paniphlet ogesponding to

Individual Needs in Head Start" helpful in work-ing with the children and the identifjcation of

. resources. .

25 .

2fr

HEALTH

PERFORMANCE -STANDARDS .

(c) Medical examinations for children shallinclude:

(1). Examination of all systems or regionswhich are made suspect by the history orscreening.test.

(2) Search for certain defects ,in specific re-:gions common or important in this age group,i.e., skin, eye, ear, nose, throat, heart, lungs,and groin (ingainal) area. .

.(d) The plan shall provide, also, in accord-.,ance with local and State health regulations

that employed program staff have initial healthexaminations, periodic check-ups, and arefound to be free from communicable disease;and that volunteer staff be screened for tuber-culosis.

§ 1304.3-4 Medical and dental, treatment.(a) The plan shall provide for treatment and

follow-up 'services which include:

4 ,

...

GUIDANCE

A number of 'children may-be receiving a`predetermined set of screening servlose-thro hpublic health clinics, neighborhood health cen-ters, or Title XIX Medicaid Early and PeriodicScreening, Diagnosis and Treatment, etc. It-thiSset of screening services does. not include allof those screenings herein required in the Per, -

fbrmance Standards, Head Start must' see thatthese screenings are provided.

r

1Pr

al.

(d) Staff and volunteers with reipiratarOnfec-flans, skin infections, or other types" of com-municable diseases should not have contact.

.

with the children. . .

Depending on conditions in the community,tubercUlin testing, miniature chest X -rays orfull-size chest.films may be the most economicalforms of screening. .

Tuberculin screening is not necessary irk the_occasional- volunteer.

(a) The purpose of all examinations andscreening tests is to identify children in need of,treatment. Examinations which do not lead toneeded remedial or rehabilitative treatmentrepresents a waste of time and money.

A person on the staff should assume respon-sibility for assuring that all health defects dis-covered actually redoive, competent and con-tinuing care until they are remedied or until apattern of continuing care for them has 'beenwell estaOliihed. This should include:

Aid for the parent to find the necessary serv-ices and to find funds to pay for the services.

Assistance so that the .parent and childactually have transportation to the physician Orclinic, and.that other children in the family canbe cared for during the visit. Community re-sources should be used for these services.

Careful-and repeated review of health recordsto assure that recommended treatment is aCt-

.26

294,

1

HEALTH


(1) Obtain 114g or arranging for treatment ofall health'problems detected. (Where funding isprovided by ndn-Head Start funding sourcesthere must be written documentation that such,funds ate used to` the maximum feasible extent.-Head Start funds may be used only when noother source of funding is available),

tee

GUIDANCE

ually taking place and-Must-plan to do whateveris necessary to ensure treatment and follow-up.

(1) The program should coordinate and sup-plement existing resources for health care ofchildren; it should not duplicate them. Whenexisting service programs do not meet thestandards _because of inaccessibility, unaccept-ability, or poor professional quality, funds maybe used. to suppleMent the existing services andbring theni.to,standard. Only if existing servicescannot. be modified should .new services,. bearranged or purchased:

Every community will have available many of the resources listedin the following table. The, program may contract with existingagencies to 'provide some or all of the health services.

1. Private Practitioners ofMedicine, Dentistry, Optometry,Psychologyindividual or group.

1. May provide all types of 'health services (consultation andplanning, administrative, exam-inations and screening tests,

' treatment, immunization, healtheducation, and continuing healthsupervision) on a volunteer, con-tract, or fee-for-service basis.

2. Health . Departmentscity, 2. May provide all typ' ofhealth services. Some may befree for all or some Head Start'Children as part of existing pro-grams; some may be contractedfor. May provide funds to pur-chase services from other swops.

county, regional, or State. .

3. School Health Programs. 3. -Same possibilities. as HealthDepartment.

4. Clinicsrun by hospitals. 4. May provide alt types ofmedical schools, or other age health, services, usually on con-cies. * tract or fee-for-service, but some

services 'May be free rot all or';'someHead Start children.

5. May provide complete range'of services to children of ritens-'bers of group. ,

8. Armed Forces Medical Seri,- 6. May provide medical pre;ices. ventive,* diagnostic,. and treat-

ment services to children Qf

Armed Forces personnel. Dentalservices available only at rh-mote posts.

7. Neighborhood Health Cen- 7. May provide comprehensivetern. health seryices at no cost; to

Head Start for childrea living ingeographically defined neighbor-hoods served by centers.

5, Prepaid. Medical Groups.

8. Comprehensive Child HealthCenters (Example: Children and'Youth Programs).

27

3 0

8. May provide Comprehmisivehealth services at no cost toHead Start children who ate inthe defined population servedby the center.

7X

411$1"


'HEALTH

GUIDANCE'9. Dental Service Corporations.

10. Special Voluntary Agenciesand Public Agencies.

11. State Crippled Children'sPrograms.

12. Local and State Welfare orPublic Assistance Programs.

13. Insurance and' PrePaymentPlans.

14. MediCal Assistance underTitle XIX "Medicaid Early andPeriodic* Screening, Diagnosisand, Treatment (EPSDT)."

. ,9. 'May provide planning andadministration of dental servicesFor Head Start children on a. con.tract fee. .

ID. Miy provide funds or serv-ices for screening or treatmentand rehabilitation of certainhealth problems. Each is usuillyconcerned with a single categoryof illness.

11. May provide .funds for Cerv-ices for screening or treatmentand rehabilitation of certainhealth problems. Limited to cer-tain categories of illness whichvary from State to 'State andwithin Mies.

12. May provide funds for anyor all health services for childrenwhose families receive or areeligible for public assistance.'Eligibility and type of servicepaid for vary by State and local.ity.

.13. Provide payment for certainkinds of health services forchildren of families covered bypolicies.

14. The majority of Head., Startchildren are eligible for MedicaidEPSDT. This, provides preventivehealth services for eligible Med-icaid children through screening,diagnosing and treating childrenwith health problems. Exact serv-ices provided and paid for andrules for eligibility vary -,friimState to State. At this time,Arizona does not participate in-Title XIX. (See Transmittal Notice73.14 for further info'rmation.)

SOME PECIAL HEALTH AGENCIES WHICH MAY HELP WITH HEADSTART HEALTH SERVICES

Catholic, Protestant! Jewish Welfare Associations.

Family Service Associations.

Lions Club.

Other fraternal organizations,Civii Clubs, Women% Clubs, andParent-Teachers AssociatiOns.

Associations for the blind or forprevention of blindness.

Associations for retarded chi'dren, cerebral palsy, Crippledchildren and for children with

.special diseases.

28.

3 1 .

!Abney for services, social serv-ices.

Psychological, psychiatric andsocial services.

Eyeglasses for needy children.-

Money or volunteer help forspecial projects.

Vision screening, special servicesfor visionimpaired children...

Special services for retarded andhandicipped children.

HEALTH

PERFORMANCE STANDARDS-

(2) Completion of all recommended' immuni-zationsdiphtheria, pertussis, tetanus (DPT),polio, measles, German measles. Mumps -immu-nization shall be provided where appropriate.

(3) Obtiining or arranging for basic dentalcare services as follows:

(i) Dental examination.

GUIDANCE

Tuberculosis Associations. Tubercutin testing and follow-up.

Mental Health Associations. Psychological and social services..mental health consultations.

Resources need not be utilized solely because they are free. TheUtilization of community resources should be consistent with theHead Start goal of enhancing the sense of. dignity and self-worthWithin the child and his/her family.

Ideally, each child should be examined by a priVate physician orby health facility staff who will institute corrective treatment for alldefects, discovered and who will also provide continuing health supervision for The child during the time that he/she is in Head Start andover the years to follow. One of the central goals of the Head Startprogram is to introduce a child and his parents to a physician orhealth facility that will be: able to meet all of his health needs overan extended period of tin*.

Immunization instructions:(a) "complete" immunization is defined as

follows:

(i) DPTat least three doses of DPT (Diph-theria, pertussis, tetanus) vaccine, the mostrecent within the past two years.

. (ii) Polioat least -.two. doses of trivalentoral vaccine' or three doses of monovalent oralvaccine plus one doSe of trivalent vaccine..

(iii) RubeolaMeasles-'one dose' of liveMeasles _vaccine. Naturally occurring measlesprovides complete immunity.

(iv) RubellaGerman MSaslesone dose of,live Rubella vaccine or Serologically docu-m'ented immunity.

(v) Mumpswhere mumpi vaccine is part ofa combined vaccine- it is appropriate for use inthe immunization program. Naturally occurringmumps provides complete immunity.

The 'American Academy of Pediatricsschedule is an, appropriate guide for immunisa-tions.

(3) A staff' member or dental hygienist mayscreen the child through checking the teethfor obvious holes or cavities, bleeding aroundthe gUrns, and pus drainage.

Priorities for dental treatment are ordinarily:..(11) Children with painful teeth;

(2) Obvious cavities, bleeding gums, and pus*drainage;

(3) Routine care for all' children.

(i) The dental examination is' an oral exami-nation including diagnostic radiographs. Nec-essary treatment follows the examination. Ex-aminations without treatment are of no value tothe children or to the Community.

29

32

.


01) Servicia required foi the relief of pain orinfection.

(ill). Restoration of decayed primary and per-manent teeth.*

(iv) Pulp therapy for primary and permanentteeth a necessary.

(v) Extraction* of non-restorable teeth.

(vi) Dental prophylaxis and instructionself-care oral hygiene procedures.

HWALTH

GUIDANCE

in (vi) Self-care oral hygiene, Should be em-phasized daily in the classroom teaching andafter meals.

-Cleaning of teeth (Dental Prophylaxis) andself-care oral hygiene (brushing,liossing, wish-ing) instructions may also be conducted simul-taneously with the examination or may be con-ducted at the time of dental treatment.

(vii) The loCal health . department; Depart-ment of Water and Sanitation, local dentalhealth association, or USPHS Dental Consultantshould be contacted to determine the adequacy

fluoride levels.

(b) A plan should be developed with the par-ents to-provide for emergency medical care fortheir child. Written policy should deal withissues such as parental permission and consentforms to secure emergency care, transportationand available physicians, clinics and hospitals.A community physician, clinic or nurse shciuldbe available for telephone consultation at alltimes.

At least one member of the fUll-tfme staff.should be knowledgeable or beCoMe Trained infirst aid.

(vii) Application of topical fluoride in com-munities' which lack adequate fluoride levels inthe public water supply.

.(b)c There must be a plan of action for medi.-cal emergencies.

§(1304.3-5 Medical and dental records.

The plan shall provide for: (a) the establish-ment and maintenance of individual health rec-ords which contain the child's medical and de-velopmental history, screening results, medicaland . dental examination data, and evaluation ofthis material, and up-to-date information abouttreatment and follow-up; (b) forwarding, withparent consent; the reconli to either the schoolor health delivery System or both when the childleaves' the program; and (c) giving parents asummary of the record which includes informa-tion on immunization and follow-up treatment;and Id) utilization of the Health Program 'As-sessment Report (HPAR); and le) assurancethat in all cases parents will be told the natureof the data to be collected- and the uses to

The health records 'should be used for: (1).identifying needed preventive and correctivecare, (2) arranging for such care, and (3) pro-viding - an educational program suited to theindividual child.

To aid the individual child, the record mustcompletely, but concisely, summarize

screen-ingfindings as determined from the history, screen-ing tests, and medical- evaluation; and mustrecord all preventive measures in a way thatclearly showS which recommended preventivemeasures-have not yet taken place.

Whenever a child is referred for consultation:or. treatment, all of the information in the healthrecord should be made available to the con -suiting or treating rofessional. If this is notdone, the consultant must either 'obtain and

30 '

33

HEALTH

- PERFORMANCE STANDARDS GUIDANCE

.which the data will be put, and that the uses record his own information, an unnecessary -

%Alin restricted to the stated purposes. -waste of time and effort, -or proceed withoutsuch information, with possible ifl effects forthe child.'

To aid -physicians and health workers in pro-viding needed health care, the record must pro-vide a stfficient background of social, medical,and educational information of a general natureso that each health professional dealing with thechild; need .not accumulate his own record andhistory. r

To serve the educational needs of the child,health findinmust be translated into class-

-- ,room recommeadaa'ns. This- process should&gin at the time the original health diagnosesare made. It must then be,elaborated both byfurther written recommendations and by con--terences between physicians, teachers, nurses,and other health personnel.

Records should indiCate the progress incompleting treatment for alconditions in needof follow-up as a result of screenings and Medi-cal examinations.

In prder to be 'useful to health- workers and _-individual children, the health records mustcontain a large amount of information of a Gen;fidential nature. The privacy and confidence -ofthis- information ' must be respected. Therecords should be kept in a place that is nitaccessible to unauthorized persons. Such infor-

i mation should not be available routinely toteachers, administrators,, or other nonmedicalpersonnel. Those portions of the health informa-tion which are pertinent and useful to teachersand to administrative personnel should beshared with theft, through reports and throughconferences whiqh translate the confidentialhealth information into useful eduCational andadministrative, recommendations. Health (info(-mation must not be released to insurapcedbm;.,,panies or other inquiring agencies wit'hout writ-

' tentonsent of child's parents or guardian.Staff should review all health records with he:h

pare*. The summary should be given to pat-ents so they have a written'account of their curt;rent health status annually. In addition, a child'shealth record should be transferred tohis /herschool in order to ensure continuity Of healthservices.

in order to complete the HPAR, the programmust have complete up-to-date records. Thisinstrument is used- to assist the programs inself-assessment in the areas of planning; man-egement, and delivery of health services..

31

34

HEALTH

PERFORMANCE STANDARDS.

1 1304.3-6 Health education.

(a) The plan *half' provide for an organizedhealth education program for program staff,parents and children which ensures that:

.

(1) Parents are provided with informationabout all available health resources;

A

(2) Parents are encouraged to become. in-volved in the health care procifs relating totheir child. One or both parents should be en-

. couraged to accompany their child to medicaland dental exams and appointments;

. _

(3) Staff are taught and parents are provided-,. the opportunity to learn the principles, of .pre-

ventive health, emergency first-aid measures,and*safety practices; .

C,

r

(4) Health education is integrated into on-going classroom and other program activities.

(5) The children are familiarized with allhealth services they will receive prior to thedelivery of chose services.

r

GUIDANCEo

I.(a) Health personnel should devote a sub-

stantial amount of time in helping the HeadStart staff and parents understand the implica-tions of health findings .for individual children,and for the program. in gpneral. Regularlyscheduled consultations between the physicianand the teachers are suggested for this purpose.

(1) A local health resource booklet or pam- .phlet should be prepared for distribution to par- ,-

ents. The information ought to be categorizedby services. ,

(2) Parents can learn about health eke con-tinuing process and not just as a physical ex-amination if they accompany the child to the.examination.

(3) Procedures should outline measures to betaken in a medical emergency at the center andthe home. Preventive health topics can includeprenatal and postnatal health, immunizations;sanitation, accident preiention,.hazards of toxiclead paint, and first aid for cuts, bruises, In-sect bites, burns, and other specific communityhealth -problems. . .

Staff should be aware of common health- prac-tices in their community.

..(4) The most important health edycation ac-tivity of a program is the example it sets byproViding each child with pleasant, dignified,individuallied care within the health program.Paients learn from the emphasis placed% oncareful examinations, immunizations, dentalcare, and other health measures that suchhealth activities are important for their children.

Parents' participation in classroom-activitiesand in the health care process related to thechild (screening, examinations) can be an effec-tive method of health educaticirijor the entirefamily. .

. C

Teaches should integrate health into the cur-riculum and daily activities of the children.

- (5) Health education can build on She healthservices program in -another way. Each screen,-ing test, immunization, and examination can bediscu(ied jo the classroom. Thiswill serve bothto prepare the children for an unusual experi-

32

/35 4

.

.


4

. 1304.3-7 Mental health objectives.l..

The *objectives of the mental health part ofthe health services component ofthe Head Startprogram are to: s.

(a) Aisle all children participating in the'program in emotional, cognitive and social de-VelOpment toward the overall goal of Socialcompetence in coordination with the ethicationprogram and other related component activi-ties;

(b) Provide- handicapped children and chil-dren with special needs with the necessarymental health Services whiCh will ensure thatthe child and family achieve the full benefits ofparticipation In the program;

(c) Provide staff and parents with an under;standing of child groWth and development, anappreciation of individual differences, and theneed' for a supportive environment;

HEALTH

V

(d) Provide for prevention, early identifica-tion and early intervention in problems that in-terfere with a child's development; = .

(e) Develop a positive attitude toward mentalhealth: services and a.recognition of the contri-bution of pttchblogy, medicine, social services;

4 education and other disciplines to the mentalhealth program; and

(f) Mobilize community resources to serve ,children with preiblems that prevent them fromcoping with their environment.

§ 1304.3-8 Mental health services.i(a) The mental health part of the plan shall

provide that a mental 'health professional, shallbe available, at least on a consultation basis, to

\the Head -Start program and to the children.The mental health professional shall:

. ..

33

36

GUIDANCE

ence and to give them anew knowledge abOuthow each*of these measures can contribute totheir health. Children love to act out the experi-ences they have had with.the doctOr or nurse..

.. .

These : are the outcomes toward which theprogram efforts should be directed.

. i r

/

(a): A mental health professional is a, childpsychiatrist, a licensed psychologist, or a psy-chiatric nurse or psychiatric social worker. Boththe psychiatric nurse and psychiatric socialworker should have experience in working withyoung children. A mental health aide may bea Member of the mental health team providedthe aide is'under.tha supervision of one of theabove professionals. . .

A mental health professional may be securedfrom a mental health center in the geographicalareas, the school system; a university, or other

......1,

HEALTH


appropriate vendors capable of providing com-prehensive mental health services.

(1) Assist in planning mental health program. (1). .

The mental health professional shouldactivities; with the Head Start Director, the coordina-

tortor responsible for mental health services, and .

representative parents to assist in d.eveloping a

(2) Train Head Start staff;

plan for delivery, of menial health services,The planning should focus on the setting of

priorities according to program needs and avail-.- ability of trained personnel and resources.

-Mental health program activities include:pre-service and in-service training of teachersand aides;consultation , with teachers and teachers'aides; ,work with parents;screening, evaluation,' and recommendationsfor intervention for children with special

.needsThe mental health professional should meet

annually with appropriate staff and parents toassist in evaltiation of objectives of the planand to assist in revision of objectives for thefollowing year.

(2) Be involved in the assessment of mentalhealth training needs, in designing the Mentalhealth training program, in the selection /oftrainers, and evaluatiqg staff members' prog-ress.

Provide information which will help staff mem-bers better understand normal development aswell as the more_common behaVior problemsseen in children. .

Training should include observation tech-niques and methods in meeting the assessedneeds of the child.

(3) PeriodiCally`observe children and consult (3) The mental health .professional can pro -with teachers and other staff; vide practical advice and help to the teaching

staff by observing the children in theirsurroundings at least semi-annually.

Teachers can share their information, ideas,and suggestions about the children., .

(4) Advise and assist .in developmental (4) Advise and assist staff in devising a proc-screening and assessment; ess for screening children with atypical behav-

ior, and in evaluating children needing furtherN assessment. In addition, the mental health pro-

fessional will train or assist in obtaining trainingfor teachers in use of behavior checklists andother screening instruments:

Classroom observation and screening should

34

37 ,

4,:

.PERFORMANCE STANDARDS

HEALTH .

(5) Ass lit in providing special help for chit.'dren with atypical behavior or development, In-cluding-speech;

.4.

(6) Advisee iifthe utilization of other commu--nity resources and referrals;

..

(7) Orient parent's and work. with them toachieve the objectives of the mental health pro-gram; and

0

(8) Take appropriate steps in conjunctionwith health and education services to refer chil-dren for diagnostic examination to confirm thattheir emotional or behavior problems do nothavi a physical basis.

GUIDANCE

be initiated within the early- weeks of classattendance and then-continued on a periodicbasisas considered necessary by staff and/ormental health professio

included in screen, evaluation are:

Physical coordin d development;intellectual devel ment;

s

Sensory develop =nt with special emphasison sensory discri tiOn;Emotional develo ment;

. Social developme t.

(5) Advise and 'as st in provision of specialservices for children ith atypical behavior ordevelopment, includin language and speech:

Through staff conferences, practical recom-mendations may be generated when workingwith the child with special needs. For example, \ ;the use of games aimed at increasing the child's ' 1verbal expression, how"the staff may work withthe overly shy or overly aggressive child, andhow to curb impulsive behavior. f -

I. -

(6) The mental health professional shouldhave a working*knowledge of mental hedlth re-sources in the community in order to assist indevelopment of a file of community resources,including referral procedures and documenta-tion cif their use Examples of such resourceagencies include- child guidance clinics, com-munity mental health centers, psycho-educa-tional clinics, and State or county- childrenservices. _ .

(7) Orient parents 'and work with them- toachieve the objectives of the-mental health pro-graM, including advising parents on how to se-cure assistance-on individual problems, assist-ing center staff lii developing an ongoing edu-cation in mentalhealth for parents, and evaluat-ing the effectiveness of the parent mental healtheducation program.

The mental health professional should help. parents to recognise a variety of ways in which

they can further their children's intellectual,emotional, and social development at home.This may be accomplished through individualor group meetings.

(8) When a child is referred for emotional orbehavioral problems, a physical examinationshould be included in the assessment in orderto' rule out a physical cause for the mental,health problem which Can be treated.

35 s-

a8

HEALTH ,07


(b) The plan shall also provide

(1) attention to pea rtinent medical and familyhistory of each child so that mental healthservices can be made readily available whenneeded; .,

(2) use of-existing community mental -healthresources;

GUIDANCE

' (1) The assessment of -each child's medicalrecords, family history ano -ne visits by ap.:propriate coordinators and teachers, for infor-mation, will indicate if the child or his familymay need additional assistance from the mentalhealth. program. A plan for follow-through willbe written for each child whose mediOal and/orfamily history and/or home visit suggests a po-tential for emotional or behavioral problems.The plan should include objectiveslo be evalu-ated monthly.

(2) Procedures for utilizing existing commu-nitymental health resources including specifiedcontact person's. These procedures should bedeveloped in conjunption with the mental healthprofessional for identifying and contacting re-sources.

(3) coordination with the education services (3) The mental 'health professional and thecomponent to provide a program keyed to indi- educational coordinator sho-uld work .closelyvidual developmental levels; - with each - teacher and the parents in jdqsigning

an education program for each child based onhis developmental level and in training teachersto be able -to do such program planning-

Conferences should be held periodically with .

the staff to discuss particular children who have- been identified as needing special help. The

mental health professional should share ideas.and suggestions with staff on helping the child-'benefit from the program.

.(4) confidentiality or recOrds;.I (4) Only authorized persons shouid be per-

mitted to see the records. Parents and staffshould jointly decide if such records are for-warded to the school system. .

(5) regular group meetings of parents andprogram staff;

(6) parental consent for special mental healthservices;

(5) Periodic.group meetings at least quarterly,!between parents andstaff can be used foricitritifying and discussing child development,disCipline, childhood fears, complex familyproblems, and other parental and staff con-cerns. A mental health professional should bepresent at, theseeessions periodically.

- (6) There must be a written consent fromthe parent for special mental health service.'A standard "informed consent" form should beused-and should include the following: the nameof the child, the name of the service provider,a description of the-services to be provided, andthe date the form was signed.

36'

33

4

HEALTH

--\ . ; PERFORMANCE STANDARDS

(1) opportunity for parents to obtain individ-ual assistance; and,

(8) active involvement of parePnts in planningand implernenting the individual mental healthneeds of their children.

14

tr

A.

t

e

GUIDANCE

(7) Opportunities should be provided for par-ents to discuss Individual problems of the childor the fall* with the mental health profes-sional. This can be done on an appointmentbasis.

(8) There should be a parent orientation meet..ing to explain the ,mental health program andthe available services. Ideally, the mental healthprofessional should conduct this meeting. Par-

-ents should ,be Involved in developing and eval-uating the mental health program.

37

4 0

nt.

,NUTRITION.


1304.3-9 Nutrition objectives.

The objectives of the nutrition part of thehealth services component of the Head Startprogram are to:

(a) bleb) provide food which will help -meetthe daily nutritional needs in the child's

..*.kome or in. another clean and pleasant environ-ment, recognizing individual differences. andCultural patterns, and thereby promote soundphysical; social, and emotional growth and de-velopment.

.

(b) Provide an environment for nutritionalservices which will support and promote theuse of the feeding situation as an oppOrbinityfor learning;

.(c) Help child and family to understand

the relationship of nutrition to health, factorswhich influence food practiced, variety of waysto provide for nutritional needs and to applythis knowledge in the development of sound ,

food habits even after leaving the Head Startprogram;

(d) Demonstrate the interrelationships of nu-Union to other activities of tbe Heed Start pro-gram and its contribution to the overall. childdevelopment goali; and .

(e) Involve all staff, paienti and other com-munity agencies as appropriate in meeting theMid!, nutritional needs so that nutritional careprovided by Head Start complements and sup-plements that of the home and community.

1 1304.3-10 Nutrition services.

(a) The nutrition services part of the healthservices component of the performance stand-ards plan must identify the nutritional needsand problems of the children in the Head Startprogram and their families. in so doing account.must be taken-of:

.0*

38

4

GUIDANCE

(a) The intended purpose I of the writtenPlan is to develop a systbm to:

identify the- problem areas and needs thatmust be addressed related to nitration;

meet total needs including providing theoverall high quality 'feeding and nutrition edu-cation program expected for children,-and

bring parents and thaff.to al level of under-standing and involvement in the area of nutri-tion to enable them to meet their; various appro-priate responsibilities.

41

NUTRITION .


4

. ,.

(1) The nutrition assessment data (height,weight, hemogtobin/hematocrit) obtained foreach child; . -:

,

(2) Informahbn about family eating habitsand special dietary' needs and feeding prob-lems, especially of handicapped children; and,

)

GUIDANCE

It should be designed for the'agency to use to ,

develbp and provide a high quality nutrition-component and-does not have to be elaborate.

Appendix G, "Nutrition Component ProgramPlanning" and Appendix H, "T/TA Plan of Ac-ticn-for the.Nutrition Component," of the OCDHandbook for Local Head Start Nutrition Spe--cialists can provide additional guidance to theprofessional' staff iresponsible for developingthe written. plan.

The Handbook is available through-the OCDRegional Offices.-

.

(1) These data should b available from the.child's current healtht eval ation record or hismedical history record. eight' and weightmeasurements should be lotted on growthcharts at tha.beginning, mid le and end of theschool year. Other pertinen Information canbe obtained from the medic I and deptal rec-

.ords. .

Underheight/underweight children\ may needadditional food provided at the center alongwith follow-up at home. .

Overweight children need follow-up to iden-tify the specific factors involved* in the weightproblem and realistic interventions consistentwith good child growth. and- deVelopment prac-ticestices both at the center and at home.

Children' with anemia and similar medical nu-trition problems need specific diagnoses andfollow-up. A child with a hemoglobin of lessthan 11 othematocrit of less than 34 IS consid-ered to be anemic. This is consistent With the .standards of Public Health Service, Maternaland Child Health and with CDC Natibnal Nutri-tion Statut Survey as,well as EPSDT guidancematerial.

Children with unresolved nutrition-relatedneeds should be referred to appropriate agen-cies who have continuing contact with. thechild for follow -up after the child leaves HeadStart.

(2) This information should be obtained bytalking with parents early in the year. The inter-viewer -should receive orientation and .trainingon how to conduct such interviews. Examplesof the type of informatiOn to be solicited -arecontained in Screening Children for NutritionalStatus: Suggestions for Child Health Programs.1971. -DHEW HSM 72-5603. Available from Ma-temal & Child Health, Health Services Admin.,Public Health Service, 5600 Fisher's Lane,

39

4 7

(

.NUTRITION

/ PERFORMANCE STANDARDS

(3) Information about major communityproblems.

:1:::

(b) The plan, designed to assist in meetingthe daily nutritional needs of the children, shallprovide that:

.(1) Every child in a part-day program will re-

ceive a quantity of food in meals (preferablyhot) and snacks which provides at least 1/3 ofdaily nutritional needs with consideration formeeting any special needs of children, includ-ing the child with a handicapping condition;

.

.

.GUIDANCE

Rockville, Maryland 20852. The information willbe used to assure that the many good aspectsof the family eating patterns are reinforced

. through food served in the center; that specialdietary needs are met at the center; and thatthis inf6rmation will be considered in develop-ing a nutrition plan with families.

... . .

(3) Information about major community *nu-trition. related problems may be obtained fromthe demographic characteristics of the target.group such as family income, edu'cational level,racial and ethnic composition, religion,' andfrom the quality of the local food end water

. supply such as availability of enriched foodstaples, fluoridated water, etc. See Nutrition

--Assessment in Health Programs. Am. J. PublicHealth, vol. 63, November 1923, Supplement.

. .Available from American Public Health Associ-ation, 1615-18th St., N.W., Washington, D.O.20036 ($4.00) for a -discussion of this subject.The State and local health depattment nutri-tionists. are helphil in obtaining such informa-tion. The information should be used for.devel-opin'g the applied aspects of the nutritionprogram by determining the need for incomesupplementation, fluoridation of water, 'in-creased use. of iodized salt, control of sale ofuncertified raw milk, more effective method ofdistribution and utilization of food stamps, asystem for making food available, i.e. transpor-tation, food outlets, coops, etc.

.-+...1 .

(b) The' child's total daily nutritional needs.should be supplied by- the food served in thehome, complemented by the food served at thecenter.

(1) The Recommended Dietary Allowahces ofthe National Research Council, National Acadr'emy of Sciences are used as the basis forestablishing the nutritional needs of the child.Foods in the pattern shown under. (b)(4) meetthese heeds. Calculations of nutrients in food:served can be compared to'the RecommendedDietary Allowances as: a cross-check in assur-ing that one-third of the nutrient needs are metif there is any question of the .adequacy of theMeals. .

To meet ih of the daily nutritional needs,use the lunch or supper pattern plus a breakfastor Snack pattern. If the morning breakfast is-used as the main meal rather than lunch orsupper, it must be -very substantial and include

40

43

ek

NUTRITION

PERFORMANCE STANDARDS .GUIDANCE

a protein-rich food in additiqn to milk to helpmeet 1/3 the daily nutrient ,needs. In addition,the snack served must also be Carefullyplanned to add fruit or v getable and Probablymilk in order to meet the remaining nutrientneeds.

Use of menu cyc es (3 weeks or longer), arehelpful iii form)l tang balanced and variedMenus and in pl nning purchasing orders andwork schedule . Include hot and cold foodsand variety irycolors, flavors and textures. Sea-sonal foods/and USDA donated commoditiesshould< be." fully utiliied to keep .fOod costsdown. Check children's acceptance of fooditems on menu periodically and make changesaccordingly. .

Menus should be dated, labeled. accuratelyand posted in :the food preparation- area as wellas in the dining area. All tubititutions must beindicated on the posted menus and menu at

-;food preparation site.Choose foods for meals and snaoks,that con-

, tribute not only to the child's nutrient needs but'also to good dental health and support thedental education program. Do not serve overlysweet. and sticky foods especially those highin refined sugars.

The nutrient needs of handicapped childrenare the' same as for other children. However,due to difficulties in chewing or swallowing orlack at feeding skills the texture and consistyency of the foods may need to be modified. Inother conditions which require modification ofthe menu sucfi, as in food allergies, digestive ormetabolic disturbances, etc., thiS informationshould be part of the child's health record, anda physician's prescription must be kepi on fileat' the ',center and at the food preparation siteand updated periodically. A qualified nutrition-ist should help plan for meeting these needs.

General use of special dietary foods such asvitamin fortified modified milk products eitheras snacks or as meal supplements are notallowed. They are not in keeping with HeadStart nutrition program goals Of (1) providingneed$d .nutrients through well planned meals,(2) providing a variety of food and eating ex0eri-.ences, and (3) 'providing opporturiitiel for chil-dren to participate in menu planning' andwherever (possible in simple food preparationand seleCtion, (4) reinforcing cultural and ethnicpractices found in the children's nbes.

41

44

NUTRITION


(2) Every child in a full-day program will re-ceive snack(s), lunch, and other meals as ap-propriate which will provide 1/2 to 2/3 of dailynutritional needs -depending on the length ofthe program;

(3) All, children in morning programs whohave not received breakfast at the time theyarrive at the Head Start program will be serveda nourishing breakfast;

(4) The kinds of food served conform to mini-mum standards for meal patterrs;

GUIDANCE

(2)*1-1 To meet 2/3 the child's nutrient needswill necessitate the use of the lunch' or simperpattern plus breakfast and a snack or plus twowell planned snacks, one of 'which containsmilk. Even so calorie intake using the sug-gested quantities is generally inadequate, so itis critical to have seconds available and use-butter or margarine as appropriate.

(3) Since it is virtually impossible for smallchildren to meet their nutrient needs withouthaving 3 meals a day,- breakfast is required tobe available, at the .center for children whohave not had it at home. Breakfast should beserved immediately upon arrival of the, child'atthe 'center. If only a small number of, the Chil-dren arrive -Without breakfast, concentrate onsupplementing the snack with Simple additional"foods to meet the breakfast pattern and servethe snack early. All children should then haveaccess to this. If a majority of the children come

,..without breakfast, it may be simpler to servebreakfast to all children. 4:-

The use of the grain/fruit product or fortifiedcake roll made. to meet 'specifications as a re-placement for the bread and/or cereal -andfruit components of the breakfast pattern is notconsistent with Head Start philosophy and thUsis not acceptable. They neither satisfy the needfor meeting 'cultural food preferences nor the.need for using the feeding 'program to teachsound food habits and attitudes by introducingthe child and family ,to a wide variety of nutri-tious foods available in the market. In additionto this cake rol pastries, doughnuts, sugar-coated cereals, etc., because of their sweetand sticky nature are not supportive of HeadStart dental health education and are not rec-ommended.

(4) Meal Patterns

Programs on SFSP 'reimbursement shouldalso check USDA requirements for meal pat-terns.

Breakfast- -Nice or Fruit

Cereal

Milk (part used

for cereal)

Stitter or Margarine.

as needed.

42

46

OA

Juice or Fruit .

Froteinrich food

Bread, enriched or

whole grain

Milk

NUTRITION


Snackone or more of the following:

Milk, fruit, vegetable, juice or Proteinrich food

Lunch or Supper...N.M. . 4.1i11.1.

Protein ridi foodmain dishVegetal* and/or fruit (at least 2 kinds)Bread, enriched or whole grainButter a fortified margarine as neededMilk

Snacks should be planned to supplementnutrient needs not met in the meals. (USDA-SFSP requires a bread-stuff plus milk, fruit orjuice.) :

Menus developed from the pattern can in-clude cultural foods. For example,' at lunch themeat or meat substitute, vegetable ang. breadcould be made into an enchilada, taco or bur-rito using the meat or cheese or bean, tomatoesor tomato sauce and onion and 'an enriched -,corn or 'flour tortilla. -

Protein -rich foods are meat, poultry, fish,eggs, cheese, peanut,. butter, dried peas andbeans. .

Fruit drinks and beverage's made ,from fruit-flavored powders or syrups are not acceptable.They do not contain mart of the 'vitamins Indminerals found in natural juices.

Bread includes tortillas, cornbread, rolls,muffins, bagel, fried bread, flat bread, etc.,made of whole grain or enriched flour. The useof whole grain bread and cereals is preferred.

"Milk" can be any type of fluid milk that, meets State and local standards. The use of

chocolate flavored milk is discouraged. Be-cause it is sweet, it may satisfy the child's hun-ger before the child. has eaten enough' food tomeet other nutrient needs. In addition; it is .

dentalenial practice.... : .

Raw vegetables contain larger amounts ofvitamin C than cooked vegetables. Include bothraw and cooked fruits and vegetables in themenu.

A go'od to excellent source of vitamin C.should be served daily. Fruits. and vegetablesthat are good to excellent sources. of vitamin Cin the quantities consumed are-listed below:

. -

Excellent: Orange, orange PAM. grapefruit,grapefruit juice, broccoli, collards, cantaloupe,raw tomateand raw strawberries. ..

Very Good: Mustard, beet and turnip. greens,kale, cauliflower, chard, tangerine, and tomato

4 6juice.

43

NUTRITION


(5) The quantities of food served conform torecommended' amounts indicated in OCD HeadStart guidance materials; and,

(6) Meal and snack periods are scheduledappropriately to meet children's needs and areposted along with menus; e.g., breakftst mustbe-served at least 2112 hours before lunch, andsnicks must be served at least 11/2 hours beforekinch or supper.

1GUIDANCE .

Good: Spinach, .raw green pepper, dandeliongreens, raw cabbage.

A dark yellow or leafy green .vegetableshould be served every other day to providevitamin A. Fruits and vegetables that are goodto excellent sources of vitamin /Line:

SWeet :potatoes, carrots,. pumpkin, broccoli;winter squash,. apricots, peaches, tomatoes,cantaloupe, dark green leafy vegetables: 'beerand turnip greens,epinach, kale, collard, etc.

(5) Since children's appetites vary, average_serving site for specific age groups are sug-gested below:

AGES

4.6

Milk c.' %.1 c. 1/21 c.Bread 1/2 st.* 1.11/2 s,

Cereal . 1/2 c. 1/3 0. 1/2

VegetableVit. A Source 2 T. 4 T.Other 2 T. 3 T. 4 T.

FruitC Source y. c. thth c. 1/2 c.:Other 2 T. 3 T. 4 T.

Meat, leancooked withoutbone yz oz.' I-11/2 oz. I1/2.2

EnDried Peas

or Beans, cooked 1 T. 2.3 T.

- :.1-)

341 ,r

Peanut Butter I T. 2.3 T. 3-41,Cheese, cheddar 1/2 oz. tIi/i oz. 11/24 oz;Cottage cheese I T. 2-3 T. 3.4 T.Butter or Margarine 1/2 V*. It. 1 t.

Remember that both these amounts) and the amounts mandated* the USDA-SFSP are minimums and are guides. Some children

USIImay need more than these amounts. Check the -A' guides'for theirmandated amounts.

'NOTE c. cupsl. . sliceT. - Tablespoon

oz, = ouncet. teaspoon

(6) Quiet time should be scheduled beforethe meal so the children come to the 'table re-laxed and ready to eat. Regularity in times, ofserving meals and snacks and the following ofa daily routine help young children to establishgood habits. ,Proper spacing of meals allowstime for the child lo be hungry enough tO eat.Time should be .pUowed after meals for activi-

-ties such .as--toothbrushing, handwaShing; etc.

44

47

NUTRITION


(c) The plan shall undertake to ensure thatthe :nutrition services contribute to the develop-ment and socialization of the children by pro-viding that:

.e

(1) A variety of foods which broaden thechild's food experience in addition to thoie thatconsider cultural and ethnic preferences isserved;

GUIDANCE

This is especially important when the Meal isserved just before the children gO home.

. -

(c) The feeding situation .should promote thephysical, Social and_eiriotional development ofchildren. 'This, needs to take place in a ouiet;well-lighted and ventilated area.

Meal elated activities pro%;ide opportunitiaifor decision making, learning to take resporfsi-bility, sharing, communicating with others,Muscle.. control and eye-hard 'coordination.Family style foodservice supports theseefforts.

Food-related activities should be plannedfrom the very simple to more difficult, all withinthe child's range of abilities. Usually food prep-aration activities are coordinated with andmay be carried out in the kitchens. If food isnot prepared on-site, special efforts will need to .

be made to assure that opportunities are avail-able for food preparation activities in the class-

- room. These will need to be clodely coordinatedwith the planned menus.

(1) Start with farriiliar foods which make achild feel comfortable' and promote good self-concept. Introduce new foods gradually. Offer asmall amount of one new food along with ameal of familiar foods. Children should be pre-pared for the new fciod, through classroomactivities such -as reading stories about thefood, shopping for the food and helping in itspreparation, growing the food or seeing it groWon a farm, etc. Snack time can be used to-intro-,duce a new food.

. .

Explore various ways one food item is servedin different cultures. For example, the manydifferent types of breads used: tortillas, bis-

. cuits, pita (flat bread), bagels, soda bread, etc.Explore the many ways one food can be pre-

pared. For example: hard and soft cooked egg,fried, poached, coddled, egg salad, deviled,meringue, egg nog, etc.

(2) Food is not used as punishment or re- (2) If a child refuses a food, offer it again atward, and that Children ire .encouraged.but not some future time, don't keep pestering theforced to eat or taste; child. Forcing children to eat or using 'desserts

or other food as reward or punishment maycreate problem eaters and unpleasant or unde-sirable associations with the food. Rememberthat all foods offered' should contribute to thechild's ,needs, including the dessert.. "Cleanplate" clubs, stars and. other -gimmicka to en-courage children to eat are not appropriate.

45

48

NUTRITION


(3) The size and number of servings of foodreflect .Cpnsideration. of individual children'sneeds;

4,7--,b

(4) Sufficient time is allowed for children toeat;

.(5) Chairs, tables, and `suing utensils aresuitable for the size and developmental levelof the children with special consideration formeeting the needs of children with handicap-ping conditions;

GUIDANCE

"(3) .Appetites vary among Children and in thesame. child from day to day. Start with smallportions allowing. for additional portions asdedired. Permitting children to serve - them-selves gives them latitude to 'make decisions onthe quantity they want- and prevents waste.Family style food service Is preferred.

Use of pre-packaged (e.g. preplated TV type)meals is unacceptable. They allow no opportu-nity for individualizatidn of serving size, andusually allow little variety, especially in culturalfoodd.

Serve food in a .form that is easy for thevoting child to manage. Bite-size pieces andfinger food are well-liked and suitable for smallhands. Meat cut in biteasize plebes, bread, andraw vegetables cut in strips and fruit in sectionsare easy for children to handle.

(4) Serve children as soon as they come tothe table. Slow eaters should be allowed suffi-

° cient time to finish their food (about 30 *min-utes)..lf ,children become restless before ,themeal period is over allow them to get up andmove around, i.e., the children can take theirplate to a cleaning area away from the .tablewhen finished. A leisurely meal time pace

- should be encouraged.Some handicapped children may be eating

at a different developmental level than the otherchildren. For example, if the 3-year-old child iseating with skills of a 2-year-old, start wherethe child is and.plan with a nutritionist or othertherapist for helping the child reach an ade:quate level of self-feeding skill.

See booklets: Feeding the HandicappedChild, Mary Ann Harvey, EditOr. Available from:University of Tennessee, Child DevelOpmentCenter, Department of Nutrition, 711 JeffersonAvenue, Memphis, Tennessee 38105 Cost: $3.50;and Feeding the Child with a Handicap,- Publi-;cation No. (HSM) 73-5609 for suggestions onfeeding techniques for handicapped childrenand types of feeding utensils available. Avail-able from Supt. of Documents, GovernmentPrinting Office, Washington, D.C..20402 Cost:$.60.

(5) Heavy duty plastic .dishes and .stainlesssteel flatware are practical for use with small

Small flat - bottom plastic glassed orcuss- (4 oz.) are easy to hold and help avoidspills. Small pitchers can be handled by chi!»dten. fir Forks should have broad shortrfandles and short blunt tines. Spoons should

46

49

PERFORMANCE 'STANDARDS

v.

(6) Children and staff, including volunteers,eat together sharing the same menu and asocializing experience in a relaxed atmosphere;and

(7) Opportunity is provided for the involve-ment of children in activities related to mealservice. (For example: family style service)

(d) The plan shall set forth an organized nu-trition education program for staff, parents andchildren. This program shall assure that

(1) Meal periods and food are planned to beused as an integral part of the total educationprogram;

GUIDANCE

have shallow bowls: -Children need experienceusing knives. These should have rounded tipsand short handles.

If paper plates must be used they should beof sturdy weight so that fhey do not slide aroundnd sejuice does not soak through the surface.d make eating difficult. Paper or styrofoam-

tu biers are not suitable. The children squeeze'the aperwith obvious 'results of spillage andbite rough the styrofoam. Disposable plasticflatwa is unacceptable. it is a safety hazardand it i not conducive to development of eatingskills. M st local sanitary todesshould\ permitstainleis atware to be washed in_ hot' soapywater, tins and boiled or sanitized by an ap-proved"blea or other chemical method.

Use washa le tabletbps, covers or mats foreasy cleaning f spills. *.

(6) Small grow s of 5-7 persOns are condu-cive to conversa ion and interaction. Interest-ing and pleasant table conversation centeredabout children's total experiences (not limitedto- food and nutrition) should be encouraged.Discourage talk about personal dislike of food.Teachers and other adults should set a goodexample by their attitude toward acceptance offood served. If the teacher must be on a specialdiet and .cannot eat-the same foods as the chit.;dren, this should be explained to them. Good'food habits are "caught rather than taught."The cost of food for teachers, 4folunteers andparents as guests should be budgeted. (USDASpecial Food Service Program for Children doesnot reimburse .food costs for adults.)

47

5o,,

(7) Activities related to meal service includeshopping for food, food preparation, setting thetable, serving the food to others or self clean-ing up, helping the cook, making place matsand table centerpieces, etc. Children should beallowed to help with all of these activities... . .

'(d) An organized program is based on identi-fied needs and consists of planned activities*to meet theS4 needs.' Nutrition education helpsstaff, children and parents increase knowledge,understanding and skills to achieve good nutri-tion.

(1) Meal periods are part of the flow of theday's activities. Foods' serve as objects of ob=*"servation and conversation for conceptual, sen-sory, and vocabulary development of children.

1%.

.N UTRITI ON ,


(2) Children participate in learning activitiesplanned to effect the selection and enjoymentof a wide Nariety of nutritious foods;

(3) Families receive education in the selec-tion and preparation of foods to meet familyneeds, guidance' in home and money manage-- ment and help in consumer education so thatthey can fulfill their major role and responsi-bility for the nutritional health of the family;

(4) All staff, including administrative, receiveeducation in principles of nutrition and theirapplication lo child development, and family

_health, and ways lo create a good physical, so-cial and emptional environment which 'supportsand promotes development of sound food hab-its and their role in helping the child and familyto achieve adequate nutrition.

(e) The plan shall make special pro ision forthe involvement of parents and ap ropriatecommunity agencies in planning, implementing,and evaluating the nutrition services. It shallprovide that:

t

GUIDANCE

Food related activities can be used,as a meansfor.teaching language arts, color, texture, e`h-metic, science, social skills and hygienic prac-tices;. hoWever, the primary purpose of theseactivities is to establish tong term sound foodhabits,_and attitudes, and the food should beeaten.

There also maybe a special nutrition focus inthe education program with carry over into theMenu and meal time activities. For example, ifa trip is planned to an orchard, related emphasisshould be piked on the fruit in theMenus, mealtime conversation, and classroom food. prepara-tion. experiences.

(2) Examples of learning activities' are fieldtrips, tasting parties: food preparation, plantingand. growing food, reading stories about food;role playing- as parents,' grocer, making scrapbooks and exhibits; feeding classroom .pets,planning menus to share with parents, etc.

(3) Staff should talk with pirents to identifynutrition information and food needs and de-velop the plan_ in response- to their specificneeds. "Education" may mean organizing foodcoops, group. gardens, transportation systemsand other activities that contribute to meetingthe needs. Parents have much to offer' each

-other.Many ways can be used for parent involve-

ment in education such as formal and informalpresentations, individual counseling by nutri-tionist,,nurse and other staff, attendance at localadult education programs and cook training.sessions. Also, parents can participate in menuplanning committees and staff can distributepamphlets, newsletters and employ audio-visualaids.

(4) This education must be ap ropriate to thespecific nutrition-related respon bilitics of eachstaff member. For example, nutrition educationlot the classroom staff should have a differentfocus from that of the food service staff or thatof the director. The staff training prograrri shouldbe coordinated and Integrated with 'the totalstaff training and orientation program.

(e) Parents should be encouraged to partici-pate in nutrition program activities suchas plan-ning menus and working in 'classroom nutrition

lactivities, to serve as volunteers or in jobs infood service and in on-going monitoring of thenutrition component.

48

5.I.


f

NIP

NUTRITION

(i) The Policy Council or Committee and the'Health Services Advisory Committee have op-portunity to review and comment on the nutri-tion services;

(2) The nutritional status of the children _Willbe discussed with their parents;

(3) Informfftion about menus and nutritionactivities will be shared regularly with parents;

GUIDANCE

. Parents or 'members of the community whomeet the following requirements should be en-couraged to apply for food service positions:

know how to prepare good foodare willing to try out new foods

. meet health standardshwie good attitudes toward 'food'like being and working with and around chil-drenare eager and flexible to learn the necessarycompetencies to carry out -the functions re-quired.

Appropriate agencies can provide profes4sional input and are resources for trainingteachers, staff and food service. personnel aswell as meeting needs of parents. It is importantthat these agencies understand 'the Head Start,,philosophy. Some agencies may be resourcesfor additional fUnding.for equipment, food, etc.Examples are local health departments, schools,_colleges, hospitals, countY extension service,professional and trade organizations (The Amer-ican Dietetic Association, Dairy Council, HomeEconomics Association, att.)

(1) The health advisory committee and policycouncil should review the nutrition programplan and advise on specific needs of the pro--gram with special reference to addressing iden-tified community nutrition needs.-

(2) Any problem related to nutritional statusas identified in (a)(1) and (2) and by teachers'observations of feeding skills and habits shouldbe discussed with parents. A plan to solve theproblems should be developed with the parents.Opportunity should be taken to reinforce thepositive food habits and good growth pattern ofthe child.

(3) Information can be shared by sendingmenus to the home, periodic group 'meetings,parent-staff discussions, home visits, and-pe-riodic newsletters.' Frequency of these activitieswill vary from agency to agency.

(4) Parents are informed of the benefits of (4) Food assistance ,programs include foodfood assistance programs; and stamps, free or reduced price school breakfast,

lunch, and food programs for high risk cate-garia (pregnant mothers, infants, children, theelderly). Contact USDA Food & Nutrition SON-

49

52

II) NUTRITION

PERFORMANCE 'STANDARDS

(5) Community agencies are enlisted to as-sist eligible families participate in food assist-ance programs.

(f) The plan shall provide for compliancewith applicable local, State and Federal sanita-tion laws and regulations for food service op-erations including standards for storage, prepa-ration and service of food, and health of foodhandlers, and for posting of evidence of suchcompliance. The plan shall provide, also, thatvendors and caterers supplying food and bev-erages comply with similar applicable laws andregulations.

c..

GUIDANCE iice for materials and iritormation on these pro-grams.__Food & Nutrition Service

-- U.S. Dept. of Agriculture500 12th Street, S.W.Washington, I.C. 20250

(5) It is important to assure that families havefood. This may involve utilization of emergencyfood banks, providing transportation to buy foodstamps or food, etc.; but it should be remem-bered that long term goal is to help familiesbecome independent. Work with The social servzice component on this. .

(f) These are established to protect the healthand safety of children being fed.

All food service personnel shoUld possess, aHealth Card or Statement of Health from thelocal Health Department or physician.

Some State,a do not send inspectors to checkHead Start failities for compliance with localand State standards. In such a situation, desig-nated program,personnelwith knowledge ofapplicable sanitation laws and regulations orsanitation standards that assure provision of asafe food service should check annually forcompliance with these regulations and be re-sponsible for the correction of existing viola-tions. Written evidence of this must be available:

Stalf-insOection. reports should be 'completedquafterly to assure maintenance of standards. ...

The following areas should be addressed:

Cleanliness- and safety of food before, duringand after preparation including maintenanceof correct temperature

Cleanliness and maintenance' of food prepara-tion, service, storage and delivery areas andequipment

Insect-and rodent controlGarbage disposal methodsDishwashing procedures and equipmentFood handling practicesHealth of food service personnelWater supply

50

53

f

Local or State` sanitarlans in health agenciescan be most helpful in providing Ideas on ways,to meet sanitation standards.

Evidence must be available that food caterershave met codes. Vehicles used for transportingand holding food must' be Insulated so foodmeets temperature standards and transportationequipment must be able to be sanitized,

)

1

NUTRITION

PEAFORMANCE STANDARDS

(g) The plan shall provide for direction of the.nutetipn 'services by a_ qualified full-time staffnutritionist or for periodic and regularly sched-uled supervision by a qualified nutritionist ordietitian as defined in the Head Start Guidancematerial: Also, the. phirrshall ,piovide that allnutrition services staff will receive preserviceand in-service training as necessary to demon-strate and maintain proficiency in menu plan-ning, .food purchasing, food .preparation andstorage, and sanitation and personal hygiene.

. 1.

GUIDANCE

(g) The services that a nutritionist is expectedto provide in developing, implementing and su-pervising a high quality feeding and nutritionprogram require a person with at least the mini-mal amount of nutrition training and experienceas follows:

A qualified nutritionist can be dne who ()meets the educational and training require-ments for membership in the American DieteticAssOciation plus one year of expedence,in com-munity nutrition including services to children0.z6 or (2) has a beccalaureate degree with amajor in foods and nutrition, dietetics or equiva-lent hours of food and nutrition course workplus two years of experience in commtlaty nu-trition including services' to children 0-6. Re-quired experience could have been concurrentwith or a part of training.

It is important thal the same nutritionist beused to establish consistency and continuity inthe services. The amount and frequency of su-pervision needed will depend on the size of theprogram and the help it needs in coming intocompliance with the performance standards.A minimum of 8 ht urs of services per monthpot center is suggested. Field experience*Indi-Yates that grantees with on-site food prepara-tion facilities can effectively use the servicesof one full time nutritionist for every 10 sites..Grantees providing food from a centralized foodpreparation facility. Including catered or con-tract services, can use one full lime nutritionistfor every 10-15 centers served. Nutritionists ..even though meeting the qualifications outlinedabove must be oriented in Head Start Perform-once Standards. Every nutritionist should beprovided with the Handbook for Local .HeadStart Nutrition Specialists obtained from Officeof Child Development Regional Offices.

The nutritionist provides the following typesof services: ,

(1) Assesses the nutritional status and specialneeds'ol children and their families from inkir-motion provided by the family and.'from thehealth records, discussions with nurse, physi-cian, dentist, and from knowledge of communitynutrition problems; helps parents and staff inlormulatinq'plans for the nutrition program fromthis information.

(2) Provides necessary counseling for par-ents.

(3)' Plans the nutrition education program with

61

'54

of :

e,


NUTRITION

GUIDANCE

staff, parents and children. Participates in stafftraining.

(4) Observes per,formance of food service per-sonnel and provides' for a training program thatwill improve or 'develop competencies to insureproficiency. .

(5) Helps teaching staff plan arid' providenutrition-related learning exparences in class-room.

(6) Utilizes community resources in carryingout the total nutrition program.

(7) Participates in menu 0Anning and review. , and takes other steps to assure a high quality

feeding ,program.. .

(8) Provides the food service unit with direc-tion in food budgeting, purchasing, storage,preparation, service, and setting up of efficientrecord systems. .

(9) Assists in interpreting and Meetinghealth, sanitation, and safety standards related

a to nutrition. ;

(10) Interprets Head Start nutrition servicephilosophy to peers in .other agencies and en-lists skills of such personnel. .

(11) Assists in preparation of job descrip-tions and schedpIes in faod preparation. facilityto assure an efficient food serviceoperation.

(12) Assist's in preparation of the bpdget andany written plans for the nutrition comporfent.

(13) Participates in the self-assessinent pra-.cess.

The nutritionist should work at the grantee ordelegate agency level so that she can' coordi-nate all nutrition efforts across the board. Shecan function in several modesusing locel re-sources in each program. independenfly,,settingup a cluster of model- centers at which -trainingof personnel can be conducted, scheduling herown time to make a monthly visit; to each,on -site facility (or however frequently this is'feasible depending on the need in centers)

Training for ,food service staff must; focus onknowledge, skills and attittid'es, needed to dothe job as well as career deireiopment plans forthose interested. The training program can bedesigned to meet thequalifications for a dietarytechnician or assistant as defined by the Amer-ican Dietetic AssociatiOn and provide opportu-

52

55

A

i--- -.....

NUTRITION


/ 1

..

(h) The plan shall provide for the establish-ment and maintenance of records covering thenutrition :services budget, expenditures for food,menus utilized, numbers and types of mealsserved daily with separate recordings for chil-dren and adults, inspection reports made byhealth authorities, recipes and any other infor-mation deemed necessary -for efficient opera-tion. .

53

.56

GUIDANCE

nity for career ladders into hospital dietary,.departments and. other types of institutions.

Examples of duties which food service per- .sonnel may be expected to perform and there- -

fore need training are:. ,

Plan menus with staff and parents .

Procure and store food, supplies, equipment .Prepare or supervise the preparation s,andservice of nutritious meals and snacksArrange work schedules for. aides and vol-unteers .

Maintain established standards of sanitation,safety and food preparationPrepare budget data and- maintain cost con-trol system t

Identify equipment needsMaintain records pertaining to folod service -operation .

Develop and test recipes and productsCooperate and participate in nutrition educa- .

tion activities forchildren, parents and-staff'Prepare simple written reports

Adequate numbers of staff and time are re;quired to do.this. What constitutes an adequatenumber of food service personnel depends onthe size of the.food operation (the numbdi ofchildren being fed), the type of equipmentavailable, the level of compentency of the em-ployees, and the available auxiliary help suchas janitorial service and volunteers. One fulltime' cook on basis of past Head Start experi-ence is suggested for centers serving 30-40children supplemented by one full time aide forcenters serving up to 80 'children. For centers.serving 15-30 children; a minimum of 6 hoursper day' of cook's time is needed.

Sufficient paid time should be allotted to.foodservice personnel to attend staff meetings,training and for planning.

. _(h) The nutrition services budget includescosts of food, food service anti nutrition staff,equipment and nutrition education materialsand supplies for children and_ parent activitiesand staff training

Records should be kept on file foralninimumof 3 years and should -be available to. moni-tors, auditors and other agency personnel asneeded.

All food .program costs should ipe' recorded:quantity and cost of 'food, purchased or do-

NUTRITION,.


nated, labor including volunteers; expendituresfor equipment, utilities and transportation.

Programs under the Special Food ServiCeProgram must supply reports according to therequirements of the 'agency administering theprogram.

A daily count of meals served to children andadults is a requirement of USDA as a conditionfor reimbursement.

All menus should rdflect any changes made.Written inspection reports shourd be posted

and indicate any sanitation violations and dateof Compliance or expected compliance...

Suggested sources of recipes are:

USDAFNS-86Quantify Recipe's for ChildCare' Centers. USDA sends these recipes toprograms participating rn SFSP. See nutritionguidance (e)(4) for address.

Tested recipes are recommended to insureuniform quality, prevent waste and serve as aguide to.purchasing.

Oiher needed records include food andequipment inventories, personnel evaluationand training records,

4

54

JI

SOCIAL SERVICES


.Subpart D-Social Services Objectives and Per-formance Standards

§ 1304.4-1 Social services objectives.

The objectives of the social services compo-nent of the performance standards plan are to:

(a) Establish and maintain an outreach andrecruitment process which systematically in-sures enrollment of eligible children.

(b) Provide enrollment of eligible children re-gardless of race; sex, creed, color, nationalorigie,.or handicapping condition.

(c) Achieve parent participation in the center. and home program and related activities.

(d) Assist the family in its own efforts to im-prove the condition and quality of family life.

(e) Make parents aware of community serv-ices and resources and facilitate their use.

§ 1304.4-2 Social services plan content.

(a) The social services plan shall provideprocedures for:

(1) Recruitment - of children, taking into ac-count the demographic Make-up of the commu-nity and the needs of the children and families;

(2) Recruitment Of handicapped children;

(3) Providing or referral for appropriate coun-seling; 4

55

GUIDANCE

(a) nput into. the plan should be made bystaff nd parents.

recruitment process should systema-tica eek out children from the most disad-vantaged homes. Recruitment techniques -in-clude door to door contact, use of incomeeligibility lists, and use of recruitment staff whocan identify wlth'the community.

Special emphasis should be placed on re-cruiting and enrolling from and coordinatingwith other agencies which are serving onlysome of the children's needs.

(2) The following factors will be taken intoaccount:

Number of handicapped children in the tar-.get population, .including types of handicapsand their severity.Services provided by other community agen-cies.

(3) (4) Preferably, these services should beavailable directly from the local Head Start pro-gram. If unavailable directly, provision shduld

58

4

SOCIAL SERVICES


4) Emergency assistance.Or crisis interven-tion;

. .

(5) Furnishing information about availablecommunity services and how ,to use them;

. ,

(6) Follow:Op to assure delivery of neededassistance;

GUIDANCE.

be made for obtaining appropriate servicesfrom outside resources.

(5) The procedure should. ensure that allavailable community resource,are used tothe maximum extent possible.

(6) Agencies to whOm children or other fam-ily members were referred should be contactedto assure the services were satisfactorily pro-vided.

-(7) Establishing a role of advocacy and (7) Head Start staff should, in a prudent andpositive way, represent the best interests ofHead Start. families,to the community and othercommunity agencies, especially if the familyhas any problems in receiving benefits fromlocal resources:

q

(8) Social services staff should make regu-larly scheduled family contacts (preferablyhome visits) and should assess and re- assessfamily needs on a continuing basis. Theie con-tacts should be coordinated with other 'compo-nent staff.

(9) The procedure shOuld specify those seryices which' will be provided directly by the localHead Start program; i.e., counseling and thoseservices which willbe proVided by resourceagencies other than the local Head Start pro-gram. Head Start staff should make every effortto involve parents in identifying individual fam-ily needs and in planning ways to meet, those

e needs. Head Start staff should be providedtraining in how to identify families and children

, in need of social services.

spokesman for Head Start families;.

(8) Contacting of parent or guardian with re- -

spect to an enrolled child whose participationin the Head Start program is irregular or whohas been absent four consecutive 'days; and

(9) Identification of the social service needsof Head Start families and working with othercommunity agencies to develop programs tomeet those needs. 0 .

t

(b). The plan shall provide for close coopera-tion with existing community resources includ-ing: . .1.

(1) Helping Head Start parent groups workwith other neighborhood and community groupswith similar concerns; ---,---

''.(2) Communicating to other community agen-cies the needs of Head Start families,- and waysof meeting these needs;

_ (3) Helping to assure better coordination, co-operation and information sharing with commu-nity agencies;

56

(1) (2) Some form of official communicationcould be established through designated liaison .*to maintain contact with public service agen-cies. Letters of intent should be sought fromagencies cooperating with Head Start- wherepossible. Staffs should initiate the effort of find-ing out (inventorying) what services theseagencies currently do offer and have the poten-tial for offering in the ruture. .

(3) Ways of facilitating communication withother social service providers in the communityinclude- visiting those providers, inviting thoseproviders to visit the Head Start program, plac-ing providers, on a special Head Start mailing

59-

p

.1

SOCIAL SERVICES.


(4) CalPng attention to The inadequacies ofexisting community services, or to the need foradditional services, and assisting in improvingthe available services, or bringing in new. serv-ices; and :.

(5) Preparing and making available a com-munity resource list to Head Start staff and

families.

(c) The plan shall provide for the establish-ment, maintenance, and confidentiality of rec-ords of up-to-date; pertinent family data, includ- .

ing- completed enrollment, forms, referral andfollow -up reports, reports of coniaots with otheragencies, and reports of contacts with families.

57

GUIDAN CE

list to receive pertinent information,. beingplaced on the providers' mailing list to keepabreast of the providers' activities, and devel-oping a media 'relations program with localpress, radio stations, and TV stations.

(4) A Social Service Advisory Committeecomprised of Head Start,staff, staff from othercommunity agencies, and Head Start parentscould be formed to provide input concerningneeded social services and to act as an ad-vocacy groLip in obtaining these services. ,.

(5) In communities where another agencyprepares a community resource Hit, the HeadStart program might update the list 'and makeit more relevant for-Head Start purposes.

(c) Adequate records should be kept andreviewed periodically at the center level. Socialservice staff can coordinate with teaching staffon class attendance and follow-up: Parents andstaff should be involved Iri determining criteriafor confidentiality. .'

160

i

i

r

:PARENT INVOLVEMENT.


Subpart E-Parent Involvement Objectives and(Performance Standards

§ 1304.5-1 Parent involvement objectives.

. The objectives` of the parent involvementcomponent of the performance standards areto:

(a) Provide a planned prograrri of experi-ences and activities which support and enhancethe parental role as the principal influence intheir child's education and development.

(b) Provide a program that recognizes theparent as:

(1) Responsible guardians of their children'swell . being.

(2) Prime educators of their children.(3) Contributors to the Head Start- program

and to their communities.

(c) Provide the following kinds of opportuni-ties for parent participation:

(1) Direct involvement in decision making inthe program planning and operations.

(2) Participation in classroom and other pro-gram activities as paid employees, volunteersor observors.

1(3) Activities for parents Which they havehelped to develop.

(4) Working with their own children in co-operation with Head Start staff.

§ 1304.5-2 Parent involvement plan content:parent partiCipation.

(a) The basic parent participation policy ofthe Head Start program, with which all HeadStart programs must comply as a condition ofbeing granted financial assistance, is containedin Head Start Policy Manual, Instruction 1-31Section B2, The Parents (OCD Transmittal No-tice 70.2, dated August 10, 1970). This, 'policymanual instruction is set forth in Appendix Bto this part -

(b) The plan shall describe in detail the im-plementation of Head Start Policy Manual, In-struction I-31Section B2. The Parents (Ap-

58

GUIDANCE

(b) The written plan shaugl include a gen-eral statement of objectivis for the parentInvolvement component, a listing of specific

PARENT INVOLVEMENT


pendix B). The plan shall assure that participa-tion of Head Start parents is voluntary and shallnot be required as a' condition of the child'senrollment.

- ,

§ 1304.57.3 Parent involvement plan content:enhancing divelopment of parenting skills.

The plan shall provide methods and oppor-tunities for involving parents in:

(a) Experiences and activities which lead toenhancing the development of their skids, self-confidence, and sense of independence in fos-tering an environment in which their childrencan develop tolheir full 'potential.

1.

(b) Experiences in child growth and devel-opment which will strengthen their role as theprimary influence in their children's lives.

(c) Ways of providing educational and devel-opmental activities for children in the home andcommunity.

(d) Health, mental health, dental and nutri-tional education. .

62

GUIDANCE ,

goals, --and the appropriate methodology forachieving ,these goald. An example of a goalmight be Involving Parents in the EducationProgram and one technique of the methodologyfor achieving this.goal could be Recruiting Par-ents. tb Serve as Classroom' Volunteers. Em-phasis should be 'placed on :maintaining theHead Start philosophy in the home so that par-ents' lives are enriched and the objectives ofHead' Start Are continued. by the child and thechild's parents in the home or community.

(a) Parents should be encouraged to partici-pate in Head Start policy group and on com-munity boards of directors and -committees.Parents shouldpe given the opportunity andencouraged to cbnduct sessions for staff, chil-dren,'-and other parents in relevant activitiesfor. 'which they have special skills. Parentsshould be encouraged to participate as volun-teers in social service activities making con-tact With community social agencies and mak-ing home visits ass.well as volunteering in the

eciassroomi.

(b) Parents -could be provided with trainingin child sieveloprilent Concepts through suchmeans as films, brochures, discussion groups,

0 rap .sessions, courses, books and parent-childinteraction activities in home or center...

(b) Parents could be exposed to specific ac-. tivities which foster learning in children in the

home, e.g., the use of common household items-to teach the. names, of colors, as in "Bring methe blue towel," and in the community, e.g.,planning a trip to the store.

Detailed guidance on program activities thatcould be utilized by Head Start programs arecontained in the following:

(1) A Guide for Planning and OperatingHome-Based Child Development Programs.,

(2) HoMe Start Evaluation Executive Sum-, mary..

(3) 'Home Start and Other Programs for Par- .

ents and Children (Conference Report).

(d) Training. could be made available to par-ents, either in conjunction with staff training in

59

.

PARENT INVOLVEMENT


4".

. (e) Identification, and use, of family and com-munity resources to meet the basic life supportneeds of the family. \

(f) Identification of opportunities for continu-ing education which may lead towards self-enrichment and employment.

-, (g) Meeting with the Head Start teachers andother appropriate staff for discussion and as-sessment of their children's Individual needsand progress.

GUIDANCE .

these areas or as a unit by itself. ,.1'o facilitateparental attendance at training /sessions, 'par-ents should receive adequate notice and baby-sitting services should be provided.

(e) Parents should be provided 'or madeaware of available community resources, suchas adult classes in consumer education, finan;.*cial assistance programs, and family and ernployment counseling. This ought to be coordi-nated. with the social services component toavoid duplication of effort and to Strengthen.

, the family-centered approach of Head Start. -(f) Educational opportunities might include

basic adult education classes; continuing edU -.cation programs, vocational training or childdevelopment associate (CDA) training, and self -enrichment'- programs. Resources in 'the localcommunity and Hi- immediate environs whichoffer programs in thete and other educationalareas should be identified and arrangementsmade for the participation of Head Start 'par-ents. Where these resources-are inadequate ordo not exist in close physical proximity, 'Head .Start staff should seek assistance from thettatetraining and technical assistance resource orfrom the OCD Regional Office. Many Head Startstaff members are receiving training throughthe. Head Start Supplementary Training Pro-gram. -

.. ,

(g) Head Start staff should encourage pa-. rental interest in their child's development. Par-ents should be given the opportunity to meetwith teachers on a scheduled and ea-neededbasis throughout the year (e.g., three homevisits are recommended, although only two arerequired, at the beginning, middle, and end ofthe school year). .

At these meetings parents and teachersshould discuss the child's physical, social/emotional, and intellectual development andreview the child's progress. Such meetings canbe used to arrive at agreement regarding desir-able short-range goals and some discussion ofspecific- activities and experiences which maycontribute to the child's progress toward thesegoals., .

Home visits should be planned to enablestaff to acquire a fuller understanding of eachchild's abilities and experiences. Such visitsmay also be used to help parents conside" r thechild's current needs, interests and ability inorder to plan home activities and interactions

60

63.

PARENT INVOLVEMENT

PERFORMANCE' STANDARDS

1304.5 -4 Parent involvement plan content:. communications among program manage-

ment, program staff, and parents. .

(a) The plan shall provide for 'two -way com-munication between staff and parents carriedout on a regular basis throughout the programyear which provides information about the pro-gram and its services; program activities for

. the children; the policy groups; and resourceswithin the program and the community.

Communications must be designed andcarried out in a way which reaches parents andstaff effectively. _Policy. groups, staff and par-ents must participate in the planning. and, devel-opment of the communication system used.'

(b) The plan shall provide a system for theregular provision of information to members ofPolicy Groups. The purpose of such communi-cation is to enable the policy group to makeinformed decisions in a timely and effectivemanner, to share professional expert' se, andgenerally to be provided with staff support. At aminimum, information provided will include:

(1) Timetable for planning, development, andsubmission of proposals;

(2) Head Start policies, gu'delines,'and othercommunications from the Office_of Child Devel-opment.

(3) Financial reports and statement of fundsexpended in the Head Start account; and

(4). Work :plans, grant applications, and per-sonnel policies for Head =Marl.,

(c) The entire Head Start' staff shall share re-spontibility for providing assistance in the con-

_duct of the above activities. In addition, HealthServices, Education, and Social Services staffshall contribute their direct services to assistthe Parent involvement staff. if staff resourcesare not available, the necessary resources shallbe sought within the community.

1304.5-5 Parent involvement plan content:parents, area. Jesidents, and the program.

The'plan shall provide for:

(1) The establishment of effective proceduresby which parents and area residents concerned

GUIDANCE

which will contribute to the child's progress. Inaddition to regularly scheduled teacher con-ferences, parents should meet with other HeadStart-staff on an as-needed basis.

(a)Examples of specific communicationlech-niques include newsletters; home visits; trainingsessions; and policy group meetings. Thesetechniques should be programmed to occur ona regular and continuous basise.g., monthlynewsletter, and bimonthly group meetings.

(b) Examples of ways in which this informa-tion may be transmitted include Written hand-outs; written minutes of meetings; official cor-respondence; and oral presentations at policygroup meetings and training sessions. Policygroups should have the opportunity to commentwithin a reasonable time.

(1) (2) (3) Content of the program should in-clude:

61

64

4 PARENT INVOLVEMENT


will be enabled to influence the Character bf \programs affecting their interests,

(2) Their regular paiticipation in the imple-mentation of such programs and,

(3) Technical and other support needed toenable parents and area residents to secure ontheir own behalf available assistance from pub-lic and private sources.

,,

I'

.

G:5

62

GUIDANCE

Training in all program components, in a-way which allows parents to understandthe Head. Start program as an interrelatedwhole and to facilitate parent participationin the- preparation of the work plan andbudget.

Ways in which parents can assist staff insetting the goals of the local program andthe goals of other community institutionsconcerned with children and families, in-away which allows parents and staff to seethose goals as an interrelated system.

Training thit occurs in a planned and con-tinuous fashion, beginning with and con-tinuing through the grantee's funding cycle,with adequate provision for parental inputin the -design and evaluation of the pro-gram.

1

'PI

,

0

Menton APsocasar,,Orrioirs roe PaosecT

This' appendix sets forth policy governing--the- development end-.'implementation of

41. variations in program'dpir by local HeadStart-prwraine.

N-30-33E4-00 1PtirnoseThis ebauter seta forth the policy govern-

Mg the deltelopment end implementation ofvariations in program design by local HeadStart programs.

_N-30-33E4-19 SsopeThis policy applies to all Head Stert

grantees, and delegate agencies that operateor propose to operate a 'full year programwhich provides a set of services to the samechild or the same group of children for lessthan Mx hours a day. The policy will be ap-pliairto all spplieations submitted by suchgrantees or delegate 'agencies on or afterApril 1, 1973.

.N-30-334-11-20 PolicyA. CRIVERAL PROVISION

Beginning in the fourth quarter of Fr1973 (April 1073). Head Start programs willbe permitted and encouraged to considerseveral program 'dela in addition to thestandard' Head Start model and select theprogram option best suited to the needs ofthe children served and the capabilities andresources of the program staff. The programoptions that are to be available for localseliction are as follows: -

meet those needs must he's priority in suchan assessment.

4. Proposed options must be justified asconsistent with good developmental pree-1Meg.

5. All parents whose children participatein any option must be represented in theirparent-group organisations in accordancewith the revised parent involvement guide-lines of the Head Start Policy Manual ofAugust 10, 1970.

G. Program options Must receive the ap-proval of the Head Start Policy Council priorto submission to OCD. .

7. There twat be vi specific training plea'for staff and volunteers for any optionchosen. It should address itself to -there-quirement@ and goals of the specific programvariations being implemented.

8. The number of hours spent if the HeadStart center will Wiry depending on the op --Lion chosen. In all eases, the center &entitle%are to maximize opportunities for Meetingthe child's developmental needs.

9. The application must demonstrate theability to conduct the program option withinthe limits of the current funding level Wilmafunds are added to the program from othersources. However, some options may enableprograMs to serve more children within thesame funding level. Careful planning andanalysis will be necessary to determine thetotal cost associated with serving additional'Children.' In such planning, the followingareas should be considered:

The standard Head Start model:Variations in center attendance.Double sessions.Home-based models.Locally designed variations.

In principle, the Office of Child Develop:moot will support any option or design modelProvided a community con demonstrate inan acceptable proposal that It will result Ina quality child developmentprogramt at rea-sonable cast and meet Had Start gnitielines.Any program option proposed must demon-strate that it meets'esch of the followingconditions:

i. All -policies stated in the Head Stara*Manual for Bead Start components must

'lie adhered t4,- with the exception of thosepoints detailed in the descriptions of eachof the options under Special provisions. Thispolicy is not to be interpreted in any waywhich would lessen the. force 'of. the presentRead Start policy, which states that "Pro-grams in which enrollment does _not reflect.the racial or ethnic composition of disad-vantaged families in the area may not befunded . . (Head Start Manutd 51001-I,page 8).

2. The design and selection of program op-tions is to he based on an assessment of thechild development needs and resources of the

thecommunity as well as the nkeds of

he current enrollees and their families.3. 'I'hei adsigornent of children to programs

W to be determined by "aseeesling such fad-tom as age Or developmental level, familyanus Mon, handicaps, health or learningproblems, lend prevtoui schoOl experience,blecuSsion with all parents about specificneeds of their children and hew best to

.11

66

a. Additional medicaI-dental Costa;h. Increased coats due to separate sched-

uling and operating practices in thearea of pupil and staff transporta-tion;

e. Additional' staff for. home visits andMintier supportive activities:

d. Need for additional recruitmenteffort;

e. Increased insurance costs:f. Additions to pereht activity funds.

IL SPECIAL PROVISIONS

1. The Standard Head Start Modelcontinuation of She present five-der-per-

week, center -based classroom format will beoptional. Communities electing to continuethis format' are free to do so provided thatthey demonstrate through' a careful assess-ment of their heed* and capabilities thatcontinuing the present program Is in thebest interests of the individual children andfamilies served. If this assessment nucleatesthat the present format Is not adequatelymeeting local needS, the program is to con-.alder whether these needs cotqd be met moreeffectively by one or more of the otheroptions.

2. Variations in Center Attendancea. Head Start programs may elect to serve

some or all children on B Ieks than five-day-per-week basis. All children who' attendHead Start on- a partial basis meat receive

-the. same comprehensive developmentalservices as ohildren attending the 5-day ses-sion, except as otherwise indicated. Short-ened hours in the classroom may bemooted by a parent educition program oranother option which would 'assist parentsin developing their role as the first-and diostinfluential educators Of their own children.

In phinning for lees than a live-day-weekclassroom schedule, careful considerationmust be given to the underlying *aeons forthe attelidanee variations. Program planningmust specifically address the followingqhestions:

(1) What are the developmental needs ofthe child? Can MO be met as effectively ormore effectively by lea 'Shan a nve-dayschedule?

(2) What are.the needs and dealres'of the-family? Wodid adjustment factors dictite

3, consecutive-days attendance as opposed to,-say, an. every-othef-day schedule?

(2) Now does the curriculum plan At thesip and developmental needs of the children?

.., Does the plan take into account differingneeds of children of different ages, end vary-ing needs of the same child over time?

(4) What kind of staling pattern Is -re-quired to obtain the program objectives?

b.-111 all altuatlont where the children arein the center less than fiva dayi a week, theprogram must specify how they will receivecomprehensive services. The following exam-elle. are Illustrative of what this require..

(I) One-third to omiThaii of the child'sdaily nutritional need' must he met each dayhe attends the Center.. Parente must, gn re-quest, be provided with simple. economical'Weekly muftis and counseling on budgeting.food preparation and sanitation. as -yeti asOn bow to involve children id food-relatedactivities in the home.

(2) Prcefisions nir complete medical anddental services must be made for all childrenin accordance with Nead Start policiel.

(d-). Staff-family interaction. as central fothe Need Start concept,. must be includedIn any variation plan, Varied scheduling isto. provide staff with new and additional op-portunities for such Interaction.

0. Staff utililation should contribute no-ticeably to program quality by maximizingstaff talent, potential and expertise, Stafftraining goals must be identified and a train-ing plan devised which will facilitate the im- .plementation of the option. Such trainingshould enable the staff to incorporate cur-ricillum modification:I neoessary to accom-modate the shorter week and to allow for the

-developmental 4

year -olds,between three-

. Veer:olds end IId. Several attendance. variation' models are

possible In plan n g the delivery a. HeadnBMA services, At mimeo schedules must bedevised for the ildren In accoedance withtheir assessed needs. Proposals Inuit describethe methods by which children ere' assignedto their schedule.. The following examplesIndicate possible scheduling variations. Thelist i not meant to be exhaustive.

(I) The four - day -week schedule providefour days for center-based activities plus anadditional day for center staff' to performspecial activities, such as:.. In-service training for staff, parents and

volunteers.Special experiences for children.Home visits.Two days in small groups in homes with

parent training by the staff.(2) Split - session schedules: Two regularly

enrolled groups, each meeting two days perweek, with the fifth day set aside for suchthings as in-service training or working withemail groups of parents or children with ape-Mal needs.

3. Double SessionsHead Start programs are permitted to oper-

ate double sessions as an optiOn. In no caseshall the addition of other children resultin fewer services for children burrently inthe program. A program shall not be re-quired, nor shall. it be permitted, to conductdouble IMMO= solely as cat - saving device.'In addition to the policies which apply tofull-year, part-day prOgram, the followingconditions must be met when the doublesessions option is utilized: -

a. Provisions must be made for a one-hoUrbreak betheen doube-session classes when a-single teaching staff conduct* both halvesof a double session. In addition, at leastthirty minutes must be allotted prior toeach sessionwhether or. not a different

teiehing staff is usedto prepare- for thesession and set up the classrooni"environ-ment, as well as to give individual attentionto childien entering and leaving the center.In some instances where schools, serve ascenter sites, vafistione In scheduling double-sessions may have to be considered.

h. The scheduling of children to attendmorning or afternoon sessions must attemptto meet individual children's needs such asreceptivity necessity for naps, and otherfactors that might prevents, full programbenefit to some children.

c, Adequate' time for staff oolisultetion,planning (staff must plea for each sessiontp meet the needs of particular children en-rolled). in-service training and career de-velopment must be provided' during theworking schedule. In some bases, this canonly hi achieved by variation in centerattendance (e.g., a four - day -week I forchildren).

d. Staff teaching both halves of a doublesession are not to have the primary responsi-bility for home visite unlade some provisionis made for substitute staff, In such eases.epeeist provisions must be made for homevisits.

e. Provisions must be made for an increaseIn supportive personnel and services in rela-tion to the anticipated requirements of ad-ditional children and their families.

f. Provisions must be made for custodialservices between sessions, including thecleaning of indoor. and outdoor spaces.

g. Provisions must -be made to maintainhigh food quality for both melons. AUchildren should have an opportunity to joinin cooking and other food-related activities,preferably with the participation of thecook-manager.

4. Bone-Based ModelsBead Start grantees may elect to develop

and incorporate a home-based model intotheir current program. Such models wouldfocus on the parent as the primary factorin-the child's development and the home asthe central facility. These models may bedesigned along the lines of the Home Startdemonstration programs initiated in fifteencommunities in FT len or on a model de-veloped by the local community. The fol-lowing conditions must be met by thesegrantees in Implementing their programs;a. Comprehensive Services

The same kinds of services which are avail-able to children served In a center-basedNeed Start program will be available tochildren -served by a home-based program.As in center-based programs, the home-basedprogram must make every possible effort toidentify, coordinate, Integrate and utilizeexisting community resources and services(public, reduced -fee, or no-fee) in providingnutritional, health, social and psychologicalservices for Its children end their families.

(1) Nutrition.In home -based programs.whenever feasible children should receivethe same nutrition services as in center-based programs with priority emphasis onnutrition education aimed at helping par-ents learn to make the beet'use of existingfood resource's through food planning, buy-ing and cooking. If periodic, regular or in-cidental group seselohs for children are held,every effort should -be made to Prepare andserve a nutritious 'neck or meal. When foodis not available to a family, the home -basedprogram must make every effort to put thefamily in touch with whatever community-organization can help supply food. In addi-tion, parents should be informed of all avail-able family assistance programs and shouldbe encouraged to participate in them.

Nutrition education must recognize cul-tural variations in food preferences and sup-plement and build upon them preferences

rather than attempt to replete them. Thus._food items that are a regular part of a if:m-itre diet will be a major focal point of nu-tritton education,

(2) Health Every effort must be made toprovide health services through existing re-sautes*. Children in home-based, programsare to receive the 'same health serviceschildren in center -based Warms,

As with the standard Head Start program.home-based programs shall provide linkageswith existing health Cervices for the entirefamily unit on an ea-needed basis, flowerer,Bead Start funds may be used to providehealth services' only for the pre-school mem:hers of the family.

(3) Psychological and Social Services.Home -based programs shall provide neededservices through existing community re-sources or within the sponsoring Need Startprogram In accordance with existing- Head

' Start policies.b. Curriculum for Children

A major emphasis of the Avogram must beto help parents enhance the, total develop-ment -(including cognitive, language,' aso-cial, emotional and physical) of all theirchildren.

Whatever the educational program orphilosophy or a home-based piogrant, It musthave plan or system for developing "Indi-vidualized" or "personalized", education pro-grams for its children.

In addition, programs must provide ma-terial, supplies and equipment (such as tri-cycles, wagons, blocks, maelpulatiVe toysand books) to foster the children's develOp-*ment in their hornet as needed. Provision forsuch materials may be made through iending, cooperative or.purchase systems.

Group socielization experiences must beprovided on a periodic, basis for all childrenin home -based programs: The proposal mustspecify what kind of developmental aotivi-tiea will take place in the group setting.

Furthermore, the education components* well as all program components mustmeet the needs of the loads by taking Intoaccount appropriate local, ethnic, culthraland language characteristics.cr. Peren t Program

Home -based programs reflect the conceptthat the parent is the first and most in-fluential "educator" and 'enabler" of his orher own children. Thus, home-based pro-grams are to piece emphasis on developingand expanding the "parenting" role of BeadStart parents.

Nome-based progrinis must give both par-ents (or parent substitutes and other appro-priate. family members) an opportunity tolearn about such things as various ap-proaches to child rearing, ways to stimulateand (*therm their children's total develop-.

Anent, ways to turn everyday experiencesinto constructive learning experiences forchildren, and specific information abouthealth, nutrition and community resources.d, Evening and Weekend- Services

It is suggested that the program makeprovision for evening and Weekend servicesto Whines when needed.e. Career Development

Programs must prorde career develop-ment opportunities foe, staff, For example,training of staff should qualify for 'academiccredit or other appropriate oredentigis when-ever possible./. Service Delicate Slater % -

In their proposals, grantees must describe.their system for delivering health, nutrition*psychological and other services that arenot provided primarily by the in-homecaregiver,

g.SM5 SelectionPropseals must dêcrIbo tne

aysten for selecting taIT h.iceortt with theresponsibliitles..ILsaigned by the program tothe ltaL,metnber. Por, example,. the ataUvisiting homeS must be:

(1) FIueht in the Language used by thefsmiUestbeyserve;

(2) Responsive IfatenhIra:(3) tXnOWlCdgeable about human dl-

opmen. family dynamics, and needs.01cMldre

(4) -Knowledgeable about nfl programcomponents;

() Knowledgeabie about eommtmltyresources.

it, stal ,0000lopmentPrograms.ThUst submit a staff and volun-

tee, recrufiment plan end a training plan,Including con that of proposed pre- aDd in-service trttLning programs, tenoblng m4tbod,ducr1pttos ot training af! or eonaulttnts..na provisions for cOntinUed ScrVI.training. Tho cereer development plan htulltbe designed to.deveiop or increase craft mem-bers knowledge about;

(1) Approaches tO and techniques ofWorking with parents;,

(2) Other borne-hated or Rome Start-like progyains;

(3) All Read 8tart component dron5.I. VoJitnICers'

As in aU other Heed Start prograint. thehome-based programs flUit encourage Sandprovide opportunity tar the use of VOlun,teem.

Ltocafly Designed OptionsIn addition to the above models, local pro-

grains may eliet to design anti propose otherprogram options whirl, they And Weli'luitodto meet the'neo4c of individual Chtldro* andthe femlUee in their communitIes. Proposalsfor local piogrsmbpiiens must idhera tothe following guldelineal

a. They must be derived from an analystsof the present standard Read Start modeland must represent a more offectivO ap-proach to meetIng the needs Of eb1ldro inthe community.

b, They mtst be consistent with good do-Velopmefltfll practices.

c They must be consistent with ReadStart performance itnndard and must en-Bure that H eomponoptc of Reed Start areóitectivsly delivered, unless they are operated$s an adjunct to a program which deliversthe faD range of Read Start services, Or un'less they ropesent a special program thrustOr circumscribed eftort such as:

(1) Health Start-typo' program or otherservices such as elcicie cell or leadpaint screening.

(2) Bummer follow-On services orhandicapped high risk or other chit-dron with special needs.

Dtfrsn BThRT

POt.!cT Sttfl t.,Tltn ?MtT5

Thii appendix hta forth oi1c7ernh1the Involvement of parents of ad Starschildren . in the dcvelopment, ronduct.and overall program direction at the locallevtL"

p 1-30-2 7he Parents

A. UhTaOOUcTioK

Head a. believep that the gains madeby the chd,4m ffc1d 8ttrt tnust be unoó'Clood an4'bUUt vpis:?y the family and thecommunitojIebs* this goal, Read Startproildes £ or the In'ovement Of the child'sparent. anti other mOlnl?ers of the family 1lbs experiences be reosivee inthe child de-.veiopment ephter by gtv*n them many op-

RULES AND

portunitle4'$or a richer apeciation of theyoung chflds needs and bow o Satiety them.

!.fany ot,tbs .beneete of Read Start arerooted in 'cbange". Those cbaages must takeplace in the family Itaelt. in tbp community,and In the att(tudes Of people and institu-lions that 1iav an Impact on bLb

It Is clear that the success of Head Starritt bringing about substantial changes de-mands @10 fUllest involvement at the parents,parental-aubsittulea, and famUIw of chil-dren enrolled in Hi progreme- this trirol!.-ment begins when a Head lart programbegins and ahou1çi gain vigor and vitslity asplanning and actIvities go forward

Successful pdrantal nvotemen. entarInto every part of Read Stirt, Iitflu*ncsaother anti-poverty programs, helpS bringabout changes in institutlobo In the com-munity, anti works toWsrd uttering the sedletconditions that btvo formed the systems thatstlrroupht the Ceobomienfly diu#vantigcdehtkt and his tiuntly.

Project Head inrt must eoflt!nuø tO dis-cover new trays tr parentabo become deeplyInvioved in decision-making about the pro-gram end Ut the dovelopatont of aetivilleathat they deem helpful anti important inmeeting their partieular needs and coodi-tious. For some parents, participation zrlay

.begln on a simple level and move to morecomplex levels, For other parents the move.mont Will be Immediate. becauaof past ax-perlencet, into complex level. of sharing and.giving. Every 'Itead Start program iii obligatedto provide the channels through which auohparticipation 'md involvement can be pro-vided Zeroed enhiched,

Unless this happens, tho' genie of HeadStart will not e achieved and the programItself will remain & creative expertenco forthe preschool ehUd in a eetting.thnt la nOtreinforced by needed changed In social sys-tems Into which the child wilt move alterida Head Start expehioltea.

This sharing in decisions for the futureIs ouao( the primary aims of parent partici'pation and Involvement -*n Project BeadStart.

n. vHS ROUt or TireEvery Head Start Program Mut Have Ef-

fective Parent Partiolpaton. These are atleast four major kinds of' parent partlelpa-lion in local Heed Start programs.1. PARTICiPATION IN TEE PROCE$S OP

MAK.IUG DECISIONS ABOUT THE NATUREIsihD OPERATION OP TIlE PROORAbt

2. PARTICIPATION iN TUB CMSSROOIfAS PAID ZMPI.OTEES, 'VOEWTECItS OTtOBSERVERS

5, ACTIVITIES FOR THEWWOThETWiVEHEt.PED TO DEELOP.4 WOREING SVZTh Tknum CIflWREN TN

COOPERATION WITH TIlE STAFF OF TEECENTER. -

Each of thosols essential to ft.Road Start program both at thegraute. leveland the delegate agency level. Every livedSt*rt program must hirajdc&gaato a Ceod1DatOr Of Patent Activities to help bringabOut appropriate puedi partlolpatich. Thisstaff member iday boa. QIunteer In emdflercolwlltlflltloa.

I, Parent 1?uUeLpstlon In the PTOOtSS otMaking,Dectalong About lbs 1istur andOperatlo* of the Pzcgbeul

head St*it *'oUep qroupsa rc..-Tho torinai 'structure by

which pare*ts can partielpate iapoUoy mak-ing and operation OX the program 'UI maywith ta. Ioceicdministiativa aaructwe of theprogram.

Normally,, kowevbr, The Iritd Start polloygrohpa will consist; ad the following:

I. hired ssar* Center CoarnUttee Thincommittee must hi set up at'tba Center 1ovo)Whose centers' bay. several diasias, It I. tee'ommDded tltat there also be pazon. clamcmmititeft,

2, Heed SCott Policy Committee. Thip corn-mltt*e muss hO set up at the delegate agencylevel when the propam Is admhdatesed litwhole erie part by such agencies.

2. hIred Ztort PoUcy Council. Dals Councilmust be set up at lb. grantee level.

When 5, grantee has delegated tbi entireROad Start ptwgremto one Dalegst Agency,t Is not necessary to bare a Policy CouncilIn addlUon to a Deieg'mto Agency POlicy Cam.mitts.. Inate.4 on. policy group serves boththe Grantee Board said the Delegate Agency

b. CompoaIUhChaat A describes theeompeeitlola of beth of these groups.

Eapre.Jntalftes oi i1i Ceuu*iinily (Die.pets Apeeeij frvei): A reprsuaflhiitivo ofnolgbborhood cbmm'uuitiy groups (pubftoand pr*vnto and of beSt nelgbboiisood cent.raunity es profOsetolaSI organizations, 'whiols

a concern for Ghl*dren Of lotr Incomefamifles and can cozihibut. to the dead-opment of the program. ThO numbSr of Suchrepressntativu will vary dopt%ndIaS on the

ChcrlAOrganizatloni Composition

I. Réitd Start Center Committee ------- I. Parent. trbam children are enroiled in thateeifler

2. Head Start Policy Committee (dole- 2, at least 0% patents at Hc StArt ChlidiCngate agency). presently enrolled tat Uial delegate agency

program phis representatives of the ccm.,

3. Reed Start Policy Council (grantee) 3, At least SO parents of Head Start ebildienprcenttyeiirolI*d In that nteesprogratnplusrepresentativesof the

1,;--- '-' -----:-'---itUmber of organizations which should vp.

.

geflc1es (public and private) and majorproprtatoiy be represented. The Delegate community ohio or proteiwionat organize.Ag,euoy determines tbo compoeltion of Their lieu. which hero a concern tar children ofcommittee (within the above guIdelines) and low income fateUlee and can ,00attelbuto tomethod. to be used In selecting reproanita- the pregram.' The liumber Of SUdimttves of the community, Parents of fornt4r aeritativec wPU vary, depending on the mini-'Head start children may serve as repr5-' ber of organization, which should suppro-sentatlees of the commUnity oh delegate

'Ulprislely bsrepruented.Ttie applicant agency

agency policy groups. repr#eentativea of, determines The composulozr of the oouneUthe ccinnaunity zetcted by the agency must (wit hr lbs above guideline.) and the math-be approved by elected parent arsemnbera Of odSYto be uSed hi selecting zepreasnlvtivutho committee. Zn no csse, bowevir, akould of the community, PerSals of tormr Usedrepresentdttves of the co mum iay'exceed6Qt Start chiltiten may urea asof the tOtal ceminitte.. - -, of 'be COTruilUally on grantee agency policy

.flep,'enftlru 0/the Chiwairinify (Gras- groups. AU repiseontativee of the eótmnu*ittytee Agency level): A representative of major selected by IRO agency must be appeared by

68FIOSIAT. CEOISIES, VOL 40, No. 124MONDAY, IUNE 20, 1974

elected parenthionsbera of the committee. Inno case, however. eliould representatives ofthe community exceed Sr le of the totalcOmmitWe or council.Special Notes

I. 011 parents serving on policy groupsmust be elected by parents of Head Startchildren currently enrolled in the program.

I. It Is strongly recommended that the/eolneritinity Action agenty board have repre-sentStion from the Head Start Policy Councilto assure coordination of Head Start ne-

t.. Wales with other CAA programs. Converse-' ly. community action agency board repro-

seretatIon on the Polley Council Is alsorecommended.

3. It 1.3 important that the membership ofpolicy groups be rotated to assure a regularWins of new ideas into the program. Forthis ptirpose, terms of neMberehip must be

. limited to no more than three years.4. No staff member (nor members of their

families as donned In CAP Memo 2311) of theapplicant or delegate agencies shall serve onthe council or committee in a voting ca-pacity. Staff members may attend the meet-ings Of counella or committees in a con-sultative non-voting capacity upon requestof the 'saurian or costunittee.

O. Every corporate board operating a HeadStart program must have a Policy Commit-tee or Council as donned by HEW. The cor-potato body and the Policy Committee orCohneil must not be one and the same.

0. Polley groups for summer programs pre-sent a special problem because of the dif-ficulty of electing parent representatives inadvance. Therefore. the policy group for Onesummer program must remain in °See untilits successors have been elected and taken°See. The group from the former programshould meet frequently between the enneoftho program and tho eleetion of new mem-bers to assure some measure of prognimcontinuity. These meetings should be for 'thepurpose of (a) assuring appropriate followup of -the children (b) aiding the devol-cment of the upcoming summer HeadStart program, (o) writing of the applica-tion, (d) hiring of the director and °step-lisnment of criteria for hiring staff arid,when necessary (e) orientation of the newmembers. In short, the policy group frord.former program must not be dissolved untila new group is elected. Tha expertise of thosepatents who have previously served shouldbe used whenever possible. .'

O. Functions. Tee following paragrapinand charts describe the minimum functionsand degrees of responsibility for the verlons,

.polley groups Involved in administration oflocal Head Start programs. Local groups ntaynegotiate for additional /unctions and agreater share Of responsibility fJ all partiesagree. AU such agreemehts are subject tosuch limitations as may be caned for byHEW policy. Questions about this shouldbe referred to your HEW regional office.

(1) The Head Start Center Committeeshall terry out at least the following mini-mum responsibilities:

(a) Assists teacher. center director, andall other persons responsible for the de-velopment and operation of evory componentincluding curriculum in the Head Startprogram.

(b) Works Closely wail classroom teachersand all other Component Malt to carry outthe daily activities program.

(0 Plans. conducts, and participates idInformal as volt as 'found programs andactivities for center parents and staff.

(d) Participates in recruiting and screen-ing of Center employees within guidelineiestablished by HEW, the Grantee Conn-en and Board. and , Delegate Agency Com-mittee:and Board.

(3) The Head* Start policy Committee.Chart B ("Mines the major management

'-RULES AND REGULATIONSco

functions connected with local liencl Startprogram administered by delegate agenciesand the degree of responsibility assigned toeach participating group.

In addition to' those listed functions, thecommittee Shall:

(a) Serve as a link between public andprivate organizations, the grantee PolicyCouncil, the Delegate Agency Board of Di-rectors. and the community it serves,

(b) Have the qpportunity to initiate sug-gestions and ideas for program Improve-ments and to receive a report- on actiontaken by the administering agency with re-gard to its recommendations.

(c) Plan, coordinate and organize agency-wide activities 'for parents with the assist-ance of stiff.

(d) Assist in communicating with parentsand encouraging their participation in theprogram.

(e) Aid in recruiting volunteer servicesfrom parents, community residents and corn-murdty organizations, and assist in the mo-bilization of community resources to meetidentified needs.

(f) Administer the Parent Adivity4funds.(3). The !lead Start Policy Council. Chart

C outlines the major management functionsconnected with the Head Start program atthe grantee level, whether it be a communityaction or limited purpose agency, and thedegree of responsibility assigned to each par-ticipating group,

'In addition to those listed functions, theCouncil shall:

(a) Servo as a link between public Mid'private organizations, the Delegate AgencyPolley Committees, Neighborhood cdunells,the Grantee Hoard or Directors and the corn-

,rniiinity 11 serves.(b) Have the opportunity to initiate sug-

gestions and ideas for program improve-manta and to receive a report on action taken

by the administering agency with regard toits reconImendations

(c) Plan, coordinate and organize agency-wide act:Utica for parents with the assist-ance of staff,

(d) Approve the selection pf DelegateAgencies.

(o) Recruit volunteer services from par-ents, community residents and communityorganizations, and mobilizes community re-sources to meet identified needs.

(f) Distribute Parent Activity funds toPolicy Committees.

1,t may not be easy for Head Start direc-tors and professional stall to share respon-sibility when decisions must be made. Evenwhen they are committed to involving par-ents, the Head Start staff must take care toavoid dominating meetings by force of theirgreater training and experience in the proc-ess of decialonmaking. At these meetings,professionals may be tempted to do most oftho talking. They mint learn to ask parentsfor their ideas, and listen with attention,patience and understanding. Self-ebnildeneeand self - respect are powerful motivatingfortes. Activities which bring out these qual-ities In parenta can prove Invaluable in im-proving family .1Ife of young children fromlow income homes.

Members of Head Start Policy Groupswhose family income falls below trio "povertyline index" may receive, meeting allowancesor be reimbursed for tiavel, per diem, mealand baby sitting expenses Inclined becauseOf Policy Group meetings. The proceduresnecessary to secure.relinhursement fundsand their regulatiAls_ are detailed In CEOInstruction *OM-1.2.* Participation in the Classroom as Paid

Employees, Voinnteers or ObserversHead Start classes must be open to parents

at times reinonable and convenient to them.There are very few occasions when the pres-ence of a limited number of parents Would

69FEDERAL REGISTER, VOL, 40, No. 126MONDAY, JUNE 30, 1.975

preSent any problem in' operation of theprogram.

Having parents in "tire classroom has threeadvantages, It:

a. Gives the parents a better understand-ing of what theNcenter Is doing for, the chil-dren and the ki ds of home assistance theymay reqnire.,

b. Shows the child the depth of his parentsconcern.

c. Gives the st Ir an opportunity to know:.the parents bette` and to learin from them.

There are, of c urSe, many center antivi-tics outside the lassroom ..(e.g.. field trips,clinic visits; soeis occasions) in which thepresence of paren is equally desirable.4' Parents are one f the categories of_per-

sons who must receive preference for em-ployment as non- rofessionals, Participa-tion as volunteers ay also be 'possible formany parents. Ex crienee obtained as 'avolunteer may be helpful in qUalifying forrion-protessional employment. At a minimum

'parents should be encouraged to observeclasses several times. In order to permitfathers to observe 11-Wirlit-be.-4--good-iclek.,to have some parts of the program IA theevening or on weekends. . .

Head Start Centers are encouraged GS set .aside space within the Center -which can beused by parents for meetings and staffconferences.

e..i .- 43. Activities for Parents Which They Have

Helped To DevelopHead Start programs must develop a plan

for parent education programs which are responSive nedds expressed by the parentsthemselves. Other community agenciesshould be encouraged to assist in the plan-ning and implementation of these programs.

Parents may also wish to work together oncommunity problems of common concernsuch as health, housing, education and wel-fare and to sponsor activitlee and programsaround Interests expressed by the group.Policy Committees must anticipate suchneeds when developing program proposalsand include parent activity funds to eeverthe cost of parent sponsored activities.4. 'Working With Their Children in Their

Own Home in connection with the Stairof the CenterHEW requires that each grantee make

home Visits a part of its program when par-ents permit such visits, Teachers shouldvisit parents of summer children a minimumof, once; in full year programs there shouldbe at least tbree visits, Lt the parents haveconsented to such home visits. .(Educationstaff are now *required to make no less thantwo home visits during a given program yearin accordance with 1304.2-2(e) (ft.) In thoserare cases where a double shift has been ap-proved for teachers it may be necessary touse other types of personnel to make homevisits. Personnel, such as teacher aides. healthaides and social workers may also make hoinevisits with, of independently of, the teachingstair but coordinated through the parent pro-gram staff 'in order to eliminate uncoordi-nated* visits.

Head Start, staff should develop activitiesto be used at home by other family membersthat will reinforce and support the child'stotal Head Start experience.

Staff, parents and children will all benefitfrom 'home visits And activities. Granteesshall not require that parents permit.homevisits as a condition of the child's participa-tlon in Head Start. However, every effort musebe made to explain the advantages of visits toparents.

Definitions as used on charts B andGeneral Iterponstbillty.,The Individual

or group with legal and fiscal responsibility .guides 'and directs the carrying out of theflIbetiott described through the person orgroup given operating responsibility.

B. Operating Responsibinty.The individ-ual or group that is directly responsible forcarrying out or per-forma, the function, con-sistent with the gene guidance and direc-tion of the individual or group holding gen-eral responsibility.

O. Must. Approve or DisaPprove.The in-dividual or group (other than persons orgroups bolding general and operating responsibility, A and B above) must approve beforethe decision is finalized or action taken. The

Individual or group must also have, been con-sulted in theAecision Making process prior tothe point of seeking approval.

If they do not approveethe proposal cannotbe adopted, or the proposed action taken.until agreement is reached between the dis-agreeing groups or individuals.

D. Must be Consulted.The Individual orgroup must be called upon before any .de-Melon is made or approval le granted to give

. advice or information but not to make thedecision or grant approval.

E. May be Consulted. --The individual orgroup inhy be called upon for information,advice 07 recommendations by those Individ-uals or groups having general responsibilityor operating responsibility.

A +General responsibility..B.Gperating responsibility

+Humhf

approve or disapprovewust be ponsulted

E +Way be consulted

Chart B

Delegate *gluey

Function

las

Chart

Grantee igerley

I. Planning,(a) identify child development needs in the area to

be served (by C AA if not delegated).(b) Estahliith 'Ws of Head Start end

develop ways to meet shear wit in IIEWguldolinoa

(c) Determine- delegate agencies and arms in thecommunity hi which heed Start previouswill operate.

(d) Determine location of eentere or classes.(e) Develop plans to use all available community

resources in Heed alert.. (I) Establish criteria for selection of children-within

applicable laws and MEW guidelines., 1,

(g)- Develop plea for retain:nen' of children-1-II. General Administration:

(a) Determine the composition of the appropriatepolicy group and the method for setting it up

.! (within HEW guidelines).(b) Deterndne what services should be provided to

Head Start from the CAA* eentrei office and: the neighborhood centers.

(c) .Determine whet services should be provided toRead Start from delegate agency.

(d) Bstabilsh a method of heating and resolvingcommunity complaints about the HeadStartwegrare.

(e) I.Mreet.the CAA Heed StartStie in day-to-clay; Operations.

0) Direct the delegate agency Head Start stiff inday-to-day operations.

(g) Insure that standards for acquiring apace, equip-, meat. and supplies are met.

ill, Pereonnil etiminfitmtion:(a) Determinelleed Start rsonnel policies (tnclud-

I ing establishment of hpersonnel

and thing criteriaI for freed Start staff. career development piens,

and employee grievance procedure*.Grantg agencyDelegate wncy

(b) Eire and are Dead Start Director of granteeag enndcy.

(c) Hire e Ore Head Start staff of grantee agency(d) Hire and are Head Start Director of delegate

agency. -(e) Hire and Ore Head Start staff of delegate agency_

IV. Grant application process: .(a) Prepare request for funds and proposed work

L program.Prior to sending to ...........Prior to sending to HEW

(b) Itfakenutiorchanges in budget and work program-1 while INOMM Is in operation.

(c) Provide -information needed for ptetevlow toI policy council.

Id) Provide information needed for prereview toHEW.

V. Evaluation: Conduct eelf-evelustion ot agency's Ewarogrem.

A

A

......

AA

A

A

B.C

...

D

0DB

C B

C

C

B

A

A

C

A

D

A......

C

C

A

......E

A BA

C

......C

C

OA

A

A

0D

D

0C

B

DB

BB

AA

A

B

0

D

AA

D

C

A

A

B

B

D Ci A

A.A

AA.

D. D

0

B'A_

C

D

D B

OkA orligeneral term grantee".112S 1,00:rra-113665 Filed, 6.-2/48;11:45 am)