Application for the Leadership Peer Learning Community

Application for the Leadership Peer Learning Community:

Implementing Supportive Child Enrollment, Transition and Referral Systems:

A Proactive Approach to Keeping Children in Care

Date: ______

Program Name: ______ Program ID number: ______

Address: ______City & Zip Code: ______

Phone: ______ Fax:______

Email: ______

Director/Primary Contact:______

Signature: ______

PLEASE ATTACH LIST OF STAFF FROM YOUR PQR: PROFESSIONAL QUALITY REGISTRY

Licensed Capacity: ______Current Enrollment: ______Number of EEC Subsidized Slots: ______

Number of:

Infant Classrooms: ______Infant/Toddler Classrooms: ______Toddler Classrooms: ______

Toddler/Preschool Classrooms: ______Preschool/Pre-K Classrooms: ______OST Groups: ______

Is your program a: ___ 10 month program or ___ 12 month program

Which of the following best describes your center:(Please check all that apply)

___For Profit Program___ Non-Profit Program ___ Head Start Agency ___ Public School

___PEG Grantee___UPK Grantee ___ 391 Grantee Other______

Are you aware of the Quality Rating and Improvement System? ___Yes ___ No

What QRIS level is your program self-assessed at? ______

What QRIS level is your program verified at? ______

Have not applied ______

Are you currently receiving coaching & mentoring services? ___ Yes ___ No

If Yes, who is providing these services? ______

This PLC has a requirement to meet with a coach between each session.

What would be the best time of day to meet? ______

Description:

During four face to face, two hour PLC sessions, participants will examine the relationship between EEC regulations and policies, best practice, and their own current systems and protocols that support the program, children, and families. The PLC will guide participants in identifying the regulations and policies that pertain to Intake, Enrollment, Working with Parents, Classroom Observations, Referrals, Action Plans, and Termination. As participants analyze their own program policies and practices that uphold these regulations they will develop and/or improve protocols and procedures that best work for their programs to support an individual child’s needs and the needs of the family, from enrollment and beyond.

Requirements:

• Attendance at all four sessions of all appropriate program staff including but not limited to: director, intake coordinator, or any staff that assist families through the enrollment process.
• Participate in coaching between PLC sessions
• Willingness to share and discuss policies and procedures as they relate to: intake, enrollment, child guidance and referral.

Questions:

1) Please describe your ideal intake procedure?

2)Which staff assist families throughout the intake process? Who will be attending this PLC?

3)Please tell us something you would like us to know about your program?

Please submit completed application to: Liz Charland-Tait, , fax 877-635-0920 or mail to 35 Mt. Carmel Avenue, Chicopee, MA 01013

Applications should be received bySeptember 29, 2017.

For EPS Coach Use

Reviewed by: ______

Date: ______