Early Head Start Home-Based
This section contains documents used by or specific to Early Head Start Home-Based. Explore other Early Learning Program Manual (ELPM) pages for additional documents and resources. Or see ELPM Directory and Updates.
- Family Engagement
- ERSEA
- Health Nutrition Enrollment
- Education & Disabilities
- Health & Developmental Screenings
- Playgroups
- Pregnancy & Postpartum
- Immunizations
- Child Health Plans
- Well-Child & Dental Exams
- Communicable Diseases
- Mental Health
- Transitions
Family Engagement
Family Engagement
EHS Home-Based Family Engagement Procedure
EHS Home-Based Family Connections: English || Spanish
ERSEA
Recruitment
Applications
Eligibility and Selection
- 2021-2022: Child || Expectant Mother
Eligibility Verification Form: 2021-2022
Health Nutrition Enrollment
Health Nutrition Enrollment
Emergency Treatment and Consent Form
Declining Early Learning Health Services Procedure
Declining Early Learning Health Services Form
Authorization to Release Confidential Health Information Procedure
Authorization to Release and Exchange Confidential Health Information Form
Health Nutrition Enrollment Tool - Flowchart || Table
Dietary Accommodations and Food Preferences Flowchart
Food Allergies, Intolerance, Special Dietary Needs Procedure
Education & Disabilities
Health & Developmental Screenings
Health and Developmental Screenings
Required 45-Day Developmental Screenings Procedure
Required 45-Day Screenings: Guidance on Children with Current IEPs or IFSPs
Vision & Hearing Screenings Procedure
Growth Assessment Procedure 0-3 Years
EHS Health and Developmental Screening Results Form
Hearing Screening Referral Letter
18 Vision Development Milestones from Birth to Baby's First Birthday (from National Center for Children's Vision and Eye Health at Prevent Blindness)
Diagnostic Follow Up Form (from Infant Hearing)
Playgroups
Playgroups
- Playgroup Activities
- Incidents and Reporting
- Active Supervision
- Health Practices
- Illness and Injury
- USDA
- Food Safety
Playgroup Activities
Incidents and Reporting
Active Supervision
Health Practices
Illness and Injury
USDA
Food Safety
Pregnancy & Postpartum
Immunizations
Immunizations
The links below are from the Washington State Department of Health (visit their webpage for more resources):
Authorization to Release Immunization Records: English || Spanish
Certificate of Immunization Status (CIS): English || Spanish || Chinese || Korean || Somali || Russian || Tagalog || Ukrainian || Vietnamese
Certificate of Exemption (COE): English || Spanish || Simplified Chinese || Korean || Somali || Russian || Tagalog || Ukrainian || Vietnamese
Child Health Plans
Child Health Plans
Child Health Plan and Provider Orders - Dietary Accommodations/Food Allergies/Intolerances
Child Health Plan and Provider Orders - Non-Food Allergies
Child Health Plan and Provider Orders - Other Health Conditions
Child Health Plan and Provider Orders - Reflux (Infants/Toddlers)
Child Health Plan and Provider Orders - Respiratory Disorder
Well-Child & Dental Exams
Communicable Diseases
Exposure Notices
- Bacterial Meningitis
- Chicken Pox
- Cold Sores
- Conjunctivitis/Pink Eye
- Cytomegalovirus
- Diarrheal Illness/Stomach Flu
- Fifth Disease
- Hand Foot and Mouth Disease
- Head Lice
- Impetigo
- Influenza
- Molluscum Contagiosum
- Mononucleosis
- MRSA
- Pinworms
- Reyes Syndrome
- Ringworm
- Scabies
- Scarlet Fever
- Strep Throat
- Whooping Cough
Bacterial Meningitis
Chicken Pox
Cold Sores
Conjunctivitis/Pink Eye
Cytomegalovirus
Diarrheal Illness/Stomach Flu
Fifth Disease
Hand Foot and Mouth Disease
Head Lice
Impetigo
Influenza
Molluscum Contagiosum
Mononucleosis
MRSA
Pinworms
Reyes Syndrome
Ringworm
Scabies
Scarlet Fever
Strep Throat
Whooping Cough
Mental Health
Transitions
Transitions
For all other transition information, see the EHS Home-Based Family Engagement Procedure.