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1304 Operations - Module Two

This Head Start Standards Training Module includes 1304.20 - 1304.21
Pages 122 - 124

Successful completion of this Programmed Learning Packet will provide you with 30 minutes of training.

45 CFR Ch. XIII (10–1–05 Edition)

§ 1304.20

		age appropriate preventive and primary health care which includes med-cal, dental and mental health. Such a schedule must incorporate the requirements for a schedule of well child care utilized by the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program of the Medicaid agency of the State in which they operate, and the latest immunization recommendations issued by the Centers for Disease Control and Prevention, as well as any additional recommendations from the local Health Services Advisory Committee that are based on prevalent community health problems:
		(A)	For children who are not up-to-date on an age-appropriate schedule of well child care, grantee and delegate agencies must assist parents in making the necessary arrangements to bring the child up-to-date;
		(B)	For children who are up-to-date on an age-appropriate schedule of well child care, grantee and delegate agencies must ensure that they continue to follow the recommended schedule of well child care; and
		(C)	Grantee and delegate agencies must establish procedures to track the provision of health care services.
	(iii)	Obtain or arrange further diagnostic testing, examination, and treatment by an appropriate licensed or certified professional for each child with an observable, known or suspected health or developmental problem; and
	(iv)	Develop and implement a follow- up plan for any condition identified in 45 CFR 1304.20(a)(1)(ii) and (iii) so that any needed treatment has begun.
(2)	Grantee and delegate agencies operating programs of shorter durations (90 days or less) must complete the above processes and those in 45 CFR 1304.20(b)(1) within 30 calendar days from the child’s entry into the program.

"Grantee and delegate agencies must establish procedures to track the provision of health care services."

(b) Screening for developmental, sensory, and behavioral concerns.

(1)

In collaboration with each child’s parent, and within 45 calendar days of the child’s entry into the program, grantee and delegate agencies must perform or obtain linguistically and age appropriate screening procedures to identify concerns regarding a child’s developmental, sensory (visual and auditory), behavioral, motor, language, social,

	cognitive, perceptual, and emotional skills (see 45 CFR 1308.6(b)(3) for additional information). To the greatest extent possible, these screening procedures must be sensitive to the child’s cultural background.
(2)	Grantee and delegate agencies must obtain direct guidance from a mental health or child development professional on how to use the findings to address identified needs.
(3)	Grantee and delegate agencies must utilize multiple sources of information on all aspects of each child’s development and behavior, including input from family members, teachers, and other relevant staff who are familiar with the child’s typical behavior.

"Grantee and delegate agencies must utilize multiple sources of information on all aspects of each child’s development and behavior, including input from family members, teachers, and other relevant staff who are familiar with the child’s typical behavior."

(1)	Grantee and delegate agencies must establish a system of ongoing communication with the parents of children with identified health needs to facilitate the implementation of the follow- up plan.
(2)	Grantee and delegate agencies must provide assistance to the parents, as needed, to enable them to learn how to obtain any prescribed medications, aids or equipment for medical and dental conditions.
(3)	Dental follow-up and treatment must include:
	(i)	Fluoride supplements and topical fluoride treatments as recommended by dental professionals in communities where a lack of adequate fluoride levels has been determined or for every child with moderate to severe tooth decay; and
	(ii)	Other necessary preventive measures and further dental treatment as recommended by the dental professional.
(4)	Grantee and delegate agencies must assist with the provision of related services addressing health concerns in accordance with the Individualized Education Program (IEP) and the Individualized Family Service Plan (IFSP).
(5)	Early Head Start and Head Start funds may be used for professional medical and dental services when no other source of funding is available. When Early Head Start or Head Start funds are used for such services, grantee and delegate agencies must have written documentation of their efforts

122

Test Questions:

Select the response that is the most correct.

Office of Human Development Services, HHS

§ 1304.20

to access other available sources of funding.

(d)

Ongoing care. In addition to assuring children’s participation in a schedule of well child care, as described in § 1304.20(a) of this part, grantee and delegate agencies must implement ongoing procedures by which Early Head Start and Head Start staff can identify any new or recurring medical, dental, or developmental concerns so that they may quickly make appropriate referrals. These procedures must include: periodic observations and recordings, as appropriate, of individual children’s developmental progress, changes in physical appearance (e.g., signs of injury or illness) and emotional and behavioral patterns. In addition, these procedures must include observations from parents and staff.

"These procedures must include: periodic observations and recordings, as appropriate, of individual children’s developmental progress, changes in physical appearance ... and emotional and behavioral patterns."

(e) Involving parents. In conducting the process, as described in §§ 1304.20 (a), (b), and (c), and in making all possible efforts to ensure that each child is enrolled in and receiving appropriate health care services, grantee and delegate agencies must:

(1)
Consult with parents immediately when child health or developmental problems are suspected or identified;

(2)
Familiarize parents with the use of and rationale for all health and developmental procedures administered through the program or by contract or agreement, and obtain advance parent or guardian authorization for such procedures. Grantee and delegate agencies also must ensure that the results of diagnostic and treatment procedures and ongoing care are shared with and understood by the parents;

(3)
Talk with parents about how to familiarize their children in a developmentally appropriate way and in advance about all of the procedures they will receive while enrolled in the program;

(4)
Assist parents in accordance with 45 CFR 1304.40(f)(2) (i) and (ii) to enroll and participate in a system of ongoing family health care and encourage parents to be active partners in their children’s health care process; and

(5)
If a parent or other legally responsible adult refuses to give authorization for health services, grantee and delegate agencies must maintain written documentation of the refusal.

(f) Individualization of the program.

(1)	Grantee and delegate agencies must use the information from the screening for developmental, sensory, and behavioral concerns, the ongoing observations, medical and dental evaluations and treatments, and insights from the child’s parents to help staff and parents determine how the program can best respond to each child’s individual characteristics, strengths and needs.
(2)	To support individualization for children with disabilities in their programs, grantee and delegate agencies must assure that:
	(i)	Services for infants and toddlers with disabilities and their families support the attainment of the expected outcomes contained in the Individualized Family Service Plan (IFSP) for children identified under the infants and toddlers with disabilities program (Part H) of the Individuals with Disabilities Education Act, as implemented by their State or Tribal government;
	(ii)	Enrolled families with infants and toddlers suspected of having a disability are promptly referred to the local early intervention agency designated by the State Part H plan to coordinate any needed evaluations, determine eligibility for Part H services, and coordinate the development of an IFSP for children determined to be eligible under the guidelines of that State’s program. Grantee and delegate agencies must support parent participation in the evaluation and IFSP development process for infants and toddlers enrolled in their program;
	(iii)	They participate in and support efforts for a smooth and effective transition for children who, at age three, will need to be considered for services for preschool age children with disabilities; and
	(iv)	They participate in the development and implementation of the Individualized Education Program (IEP)

"... for children with disabilities in their programs, grantee and delegate agencies must assure that they participate in and support efforts for a smooth and effective transition for children who, at age three, will need to be considered for services for preschool age children with disabilities ..."

123

Test Questions:

Select the correct "True" or "False" option.

4.	Within the first 45 days only, grantee and delegate agencies must implement ongoing procedures by which Early Head Start and Head Start staff can identify any new or recurring medical, dental, or developmental concerns so that they may quickly make appropriate referrals. (1304.20)
		True
		False
5.	Encourage parents to be active partners in their children’s health care process. (1304.20)
		True
		False
6.	Enrolled families with infants and toddlers suspected of having a disability are promptly referred to the local early intervention agency. (1304.20)
		True
		False

45 CFR Ch. XIII (10–1–05 Edition)

§ 1304.21

for preschool age children with disabilities, consistent with the requirements of 45 CFR 1308.19.

(The information and collection requirements are approved by the Office of Management and Budget (OMB) under OMB Control Number 0970–0148 for paragraphs (a), (c) and (d).)

[61 FR 57210, Nov. 5, 1996, as amended at 63 FR 2313, Jan. 15, 1998]

§ 1304.21 Education and early childhood development.

(a) Child development and education approach for all children.

(1)	In order to help children gain the skills and confidence necessary to be prepared to succeed in their present environment and with later responsibilities in school and life, grantee and delegate agencies’ approach to child development and education must:
	(i)	Be developmentally and linguistically appropriate, recognizing that children have individual rates of development as well as individual interests, temperaments, languages, cultural backgrounds, and learning styles;
	(ii)	Be inclusive of children with disabilities, consistent with their Individualized Family Service Plan (IFSP) or Individualized Education Program (IEP) (see 45 CFR 1308.19);
	(iii)	Provide an environment of acceptance that supports and respects gender, culture, language, ethnicity and family composition;
	(iv)	Provide a balanced daily program of child-initiated and adult-directed activities, including individual and small group activities; and
	(v)	Allow and enable children to independently use toilet facilities when it is developmentally appropriate and when efforts to encourage toilet training are supported by the parents.
(2)	Parents must be:
	(i)	Invited to become integrally involved in the development of the program’s curriculum and approach to child development and education;
	(ii)	Provided opportunities to increase their child observation skills and to share assessments with staff that will help plan the learning experiences; and
	(iii)	Encouraged to participate in staff-parent conferences and home visits to discuss their child’s development

"Parents must be Invited to become integrally involved in the development of the program’s curriculum and approach to child development and education; ..."

		and education (see 45 CFR 1304.40(e)(4) and 45 CFR 1304.40(i)(2)).
(3)	Grantee and delegate agencies must support social and emotional development by:
	(i)	Encouraging development which enhances each child’s strengths by:
		(A)	Building trust;
		(B)	Fostering independence;
		(C)	Encouraging self-control by setting clear, consistent limits, and having realistic expectations;
		(D)	Encouraging respect for the feelings and rights of others; and
		(E)	Supporting and respecting the home language, culture, and family composition of each child in ways that support the child’s health and well- being; and
	(ii)	Planning for routines and transitions so that they occur in a timely, predictable and unrushed manner according to each child’s needs.
(4)	Grantee and delegate agencies must provide for the development of each child’s cognitive and language skills by:
	(i)	Supporting each child’s learning, using various strategies including experimentation, inquiry, observation, play and exploration;
	(ii)	Ensuring opportunities for creative self-expression through activities such as art, music, movement, and dialogue;
	(iii)	Promoting interaction and language use among children and between children and adults; and
	(iv)	Supporting emerging literacy and numeracy development through materials and activities according to the developmental level of each child.
(5)	In center-based settings, grantee and delegate agencies must promote each child’s physical development by:
	(i)	Providing sufficient time, indoor and outdoor space, equipment, materials and adult guidance for active play and movement that support the development of gross motor skills;
	(ii)	Providing appropriate time, space, equipment, materials and adult guidance for the development of fine motor skills according to each child’s developmental level; and
	(iii)	Providing an appropriate environment and adult guidance for the participation of children with special needs.

"Grantee and delegate agencies must support social and emotional development by Supporting and respecting the home language, culture, and family composition ..."

124

Test Questions:

Select the correct "True" or "False" option.

7.	Provide a balanced daily program of child-initiated and adult-directed activities. (1304.21)
		True
		False
8.	Grantee and delegate agencies must support social and emotional development by fostering dependence. (1304.21)
		True
		False
9.	Grantee and delegate agencies must provide for the development of each child’s cognitive and language skills by promoting interaction and language use among children and between children and adults. (1304.21)
		True
		False

After completing this instrument, provide your Staff ID number, click you work "content area" and "job location". Forward to the Training Department. Your name is verification that you have read and understood the content of this module and have completed this learning program in good faith, and are willing to practice the principles outlined.

First Name , Last Name HSGD Staff ID#

Your Content Area Job Location

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1.	For children who are not up-to-date on an age-appropriate schedule of well child care, grantee and delegate agencies (1304.20)
		a.	must encourage the parents to get the child up-to-date before the 45th day after entry into Head Start.
		b.	must assist parents in making the necessary arrangements to bring the child up-to-date.
		c.	will take of this for the parents.
		d.	must adjust their recruitment methods to avoid this type of occurrence.
2.	The developmental and behavioral screening (1304.20)
		a.	must be done within 45 calendar days and be culturally sensitive to the child.
		b.	must be done within 30 calendar days and be culturally sensitive to the child.
		c.	is only necessary for children who grantee and delegate suspect have developmental lags.
		d.	must be done prior to entry into the program.
3.	Early Head Start and Head Start funds (1304.20)
		a.	for medical and dental services must be reimbursed by the parents with 45 days of services.
		b.	are the only funds to be used for professional and dental services.
		c.	must not be used for professional medical and dental services.
		d.	may be used for professional medical and dental services.