EOT&TA Procedural Safeguards Training 2013-2014
Training Location: EUP
Procedural Safeguards
Post-Training Questionnaire
First, Middle, & Last Name INITIALS ______
Today's Date: 9/12/13
1.Please indicate your agency affiliation:
Child Care ProviderEarly Head Start
Dept of Human ServicesHead Start
Higher EducationSocial Services
Education / ISDPublic Health
Mental HealthParent
Other, please specify: ______
2. Please indicate your primary position within Early On:
Service ProviderEarly On Coordinator
Service CoordinatorMulti-disciplinary Evaluation Team Member
Interim Service CoordinatorNot currently involved (skip question 3)
AdministratorParent
LICC Member representing: ______
Other, please specify: ______
3. How long have you been associated with Early On? ______Years, and ______Months
4. How would you rate your current level of understanding in the following areas?
Please CHECK one response for each statement. / Advanced Understanding(I have confidence that my understanding of this topic is thorough.) / Moderate Understanding
(I have a
good understanding
of this topic.) / Beginning Understanding
(I have some understanding of this topic, but know there is much I don’t know yet.) / No/Minimal Understanding
(I have very little understanding of this topic at this time.)
a. Procedural safeguards as related to record keeping. / / / /
b. Procedural safeguards as related to confidentiality. / / / /
c. Procedural safeguards as related to the consent process. / / / /
d. Procedural safeguards as related to dispute resolution. / / / /
e. The origin of procedural safeguards. / / / /
f. Using procedural safeguards to advise families of their rights. / / / /
g. Timelines associated with the implementation of procedural safeguards. / / / /
h. Completing forms associated with procedural safeguards. / / / /
i. The legal requirements for procedural safeguards in IDEA Part C. / / / /
j. Procedural safeguards as related to notice/native language. / / / /
These next few questions are intended to ascertain your knowledge about procedural safeguards. Given that this may be new material for you, you may not be able to answer all these questions. So, an answer of "Don't know" is perfectly acceptable. (Pen or pencil is okay).
True False Don’t Know
5. Written parental consent is required for not only the
implementation of the initial IFSP, but also for the
implementation of any annual IFSP.
6. If a parent disagrees with any matter under Part C, they must
first request mediation.
7. Early On must inform parents in writing if their child is eligible
Or not for Early On.
8. The family’s consent for Authorization to Share can be
revoked at any time.
9. Before Early Onproposes to change the frequency of an existing
Early On service, the parent must be notified in writing what the
change is and why it is being proposed.
10. Early On must notify the parent of a referral for Part C services
within 10 calendar days of receiving the referral.
11. The Early On record for a child not eligible for Special Education
must be maintained for a minimum of 5 years after the child exits exits Early On.
12. A foster care worker can sign an IFSP as a surrogate parent.
13. A parent requests to access their child’s record. A service area
has 15 calendar days in order to comply with this request.
Thank You
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