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 the ELPM Directory.
- Family Engagement
- ERSEA
- Health Nutrition Enrollment
- Education & Disabilities
- Health & Developmental Screenings
- Playgroups
- Pregnancy & Postpartum
- Immunizations
- Child Health Plans
- Well-Child & Dental Exams
- Mental Health
- Transitions
- ChildPlus
Family Engagement
Family Engagement
Procedures
EHS Home-Based Family Engagement Procedure
EHS Home-Based Services Checklist
Orientation to Early Learning Policies: English || Spanish
Forms
ERSEA
ERSEA
ERSEA Procedure
Recruitment
Recruitment Flyer: English and Spanish
Applications
Eligibility and Selection
- 2022-2023: Child || Pregnant Families
Eligibility Verification Form: 2022-2023
Health Nutrition Enrollment
Health Nutrition Enrollment
Procedures
Declining Early Learning Health Services Procedure
Authorization to Release Confidential Health Information Procedure
Health Nutrition Enrollment Tool - Flowchart || Table
Forms
Emergency Treatment and Consent Form
Declining Early Learning Health Services Form
Authorization to Release and Exchange Confidential Health Information Form
Education & Disabilities
Health & Developmental Screenings
Health and Developmental Screenings
Procedures
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
Forms
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
Procedures
Attendance and Meal Count Procedure
Potential Choking Foods Procedure
Menu and Special Diet List Upload Instructions
Foods from Outside the Early Learning Program
No Food Brought From Home Notice - various languages
Dietary Accommodations and Food Allergy/Intolerance/Preferences Flowchart
Food Allergies, Intolerance, Special Dietary Needs Procedure
USDA CACFP Enrollment and Reimbursement Procedure
CACFP Child Meal Pattern (OSPI)
CACFP Infant Meal Pattern (OSPI)
Building for the Future - English || Spanish
Child Supplemental Food Plan Procedure
Forms
Group Socialization Cycle Menu
CACFP Enrollment Form Template Creator
Parent/Guardian Request for Milk Substitute
Electronic Attendance
ChildPlus Attendance App Guide
ChildPlus Electronic Attendance Guide
Electronic Attendance Training Support Tool
Food Safety
Communicable Diseases and 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
Pregnancy & Postpartum
Pregnancy and Postpartum
See ERSEA Procedure and EHS Home-Based Family Engagement Procedure for more information.
Procedures
Services to Pregnant/Postpartum Families Procedure
Pregnancy and Postpartum Depression Screening Procedure
Forms
Pregnancy and Postpartum Depression Screening - English || Spanish
Immunizations
Immunizations
Procedures
Immunization Requirements Procedure
Forms
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
Procedures
Forms
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
Mental Health
Transitions
ChildPlus
ChildPlus/Recordkeeping
Procedures
EHS Home-Based Guidance for ChildPlus Records Retention 2022-2023
EHS Home-Based Electronic Family File Setup
Entering EHS Home-Based Home Visit Attendance in ChildPlus
IFSP and IEP Data Entry in ChildPlus Guidance
Adding Family Goal Event in ChildPlus Guidance
Printable How-To's
ChildPlus Document Upload Instructions
Early Head Start Health Data Attach/Enter Guide
How to Enter Health Events in ChildPlus
How to View and Add Health Information Notes
Video Tutorials
45-Day Health and Developmental Screening Results Form
How to Add Child Health Plan Event in ChildPlus
How to Add Health History Event in ChildPlus