If You Replied No to Question 3, You Do Not Have to Complete This Application, the Program
/ DEPARTMENT OF EARLY EDUCATION & CARE
FY08 UNIVERSAL PRE-KINDERGARTEN (UPK)RFR
Welcome to the FY08 Universal Pre-Kindergarten (UPK)Classroom Quality Grant RFR Questionnaire
Public Schools (including Charter Schools)
PROGRAM CONTACT INFORMATION
School Name / ______
School Organization Code / ______
Program Name / ______
School Address / ______
Program Phone Number: / ______Please enter phone number
Contact Name Please enter contact person / ______Title______
Email / ______
Note: Accreditation by NAEYC or NEASC is required for center based or school programs to be eligible for this grant.
1. As of 10/01/07, is the programcurrently accredited by the National Association for the Education of Young Children (NAEYC)?Please answer question #1
YES / NO / IN PROCESS OF REACCREDITATION
1a. If yes, Enter NAEYC accreditation number:
NAEYC accreditation expiration date: (mm/yyyy)Please enter NAEYC Accreditation Number
1b. If no, as of 10/1/07, is the program currently accredited by the New England Association of Schools and Colleges (NEASC)?
YES / NO / IN PROCESS OF REACCREDITATION
If yes or "in process" to 1a:
NEASC accreditation expiration date: (mm/yyyy)
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2. Does the program orprovider currently use the Guidelines for Preschool Learning Experiences to plan the curriculum and Early ChildhoodProgram Standards for Three and Four Year olds(not applicable to family child care) to plan the curriculum andactivities for preschool children?Please answer question #2Yes / No
3. Does the program or provider use one of the four EEC approved assessment instruments (Work Sampling,Creative Curriculum Developmental Continuum, High Scope Child Observation Record (COR), or Ages and Stages)to assess preschool children in the program?
Yes / No
If you replied “No” to question 3, you do not have to complete this application, the program is noteligible to receive a Universal Pre-Kindergarten (UPK) Pilot Program Classroom Quality Grant. The program may however, be eligible to receive a UPK Assessment Planning Grant to support implementation of on-going child assessments. This RFR will be posted on the EEC website and on Comm-PASS in the next few weeks. We hope you will consider applying for this grant opportunity.
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4. If yes, which one of the four EEC approved assessment instruments is usedto assess preschool children in the program?_____ Work Sampling
_____ Creative Curriculum Developmental Continuum
_____ High Scope Child Observation Record(COR)
_____ Ages and Stages
5. When did the program start using this assessment tool?Month ______Year______
Please reply with information regarding the entire program at this site as of October 1, 2007. Please note that if your agency has more than one eligible site, you will need to submit a separate questionnaire for each program site.
6. Number of preschoolchildren(2.9 years until Kindergarten eligible) enrolled at this site?______
7. Number of preschool children (2.9 years until Kindergarten eligible) at this site whose enrollment is funded through EEC Financial Assistance (Vouchers, Contracts, or CPC funding), Head Start, or the local Public School, or private scholarship?Please only count each child once (by primary funding source). If the number served is zero, please enter a 0 (and the program must be willing to serve EEC-subsidized children in FY08 to remain eligible).______
7a. Does theprogram fund children through private scholarships?
Yes / No
If Yes to 7a., specify the source(s) (Check all that apply)
United Way
Faith based organization
Your Agency
Other organization, please specify______
Is the criteria for private funding/subsidy eligibility based on income?
Yes / No
If Yes, Please indicate gross monthly income for a family of three, to be eligible for private funding
_____ Less than $1,799
_____ Between $1,800 and $2,990
_____ Between $2,990 and $5,083
_____ Greater than $5,083
Classroom Eligibility Information
Grants will be made to programs on a per classroom basis
8. As of October 1, 2007, What is thetotal number of preschool classes in the program site?Please answer question #7______
9. For how many preschool classrooms is the program requesting UPK classroom quality funding?Please answer question #8______
NOTE:For each of the preschool classes for which the program is requesting UPK funding, please complete question 10.
For example, if your response to question9 is eight classes, you should respond to question 10 eight times to provide information about each class.
10. Complete the following informationfor each of the preschoolclassroomsfor which the program is requestingUPK funding:
Classroom Name: / ______
Teacher's Name: / ______Teacher Name is required
EEC certification or DOE license number: / ______
Highest Degree obtained: / __ HS Diploma / GED
__ CDA
__ AA
__ BA/BS
__ Masters
__ Doctorate
__ No DegreePlease select the highest degree obtained
Second Teacher's Name (if applicable) / ______
Second Teacher's EEC certification or DOE license number: / ______
Second Teacher's highest degree obtained: / __ HS Diploma / GED
__ CDA
__ AA
__ BA/BS
__ Masters
__ Doctorate
__ No Degree
Number of hours per day thatclassroom operates: / ______1hour
______1.5 hours
______2 hours
______2.5 hours
______3 hours
______3.5 hours
______4 hours
______4.5 hours
______5 hours
______5.5 hours
______6 hours
______6.5 hours
______7 hours
______7.5 hours
______8 hours
______8.5 hours
______9 hours
______9.5 hours
______10 hours
______More than 10 hours
Please select one
Number of days per week thatclassroom operates: / ______daysPlease select one
Number of weeks per year thatclassroom operates: / ______weeks (1-52)Please select one
Please list the number of preschool children in this classroom by funding source. If children are funded by more than one source, please list them only once, counting the primary funding source. Please enter 0 if zero is the correct response or your response will not be considered complete.
Total number of preschool children in classroom / Total number of preschool children in theclassroom receiving EEC financial assistance (voucher, contract, or CPC), Head Start, or Public School Funding / Number of preschool children in theclassroom receiving subsidy/financial assistance: / Number of Children in theclassroom with IEPs
______Please enter number of children. / ______Please enter number of children. / Head Start:____Enter number of Head Start children.
Public School:____Enter number of Public School children.
CPC:____Enter number of CPC children.
Voucher:____Enter number of Voucher children.
Contract:____Enter number of contract children.
Private scholarship children:____ / ______Enter number of IEP
Mail this completed questionnaire to:
Department of Early Education and Care
Attention: Amy Checkoway
51 Sleeper Street, 4th floor
Boston, MA 02210