(a) Family Goal Setting - Person County School District ...



Earl Bradsher Preschool 2019-2020Family & CommunityEngagement404 South Morgan Street ? Roxboro ? North Carolina ? 27573336.599-7585 ? 336.599.3484 faxSection 1: Family and Community Partnership Goals The Earl Bradsher Preschool program supports parents as they identify and meet their goals and nurture the development of their children. Earl Bradsher Preschool will collaborate with partners in the community in order to make available the utmost level of services to children and families and to foster the development of an assortment of family centered services to be able to advocate for a community that shares responsibility for the healthy development of children and families of all cultures and ethnicities.Section 2: Family and Community Partnership ObjectivesEarl Bradsher Preschool will engage in a process of collaborative partnership building with parents to establish mutual trust and to identify family strengths, goals, and necessary services and/or other supports. The Earl Bradsher Preschool staff will be of assistance and support families accomplishing goals of existing plans that are established with other agencies. Home visits, office visits, conferences, etc. will be conducted with Head Start families to assess their strengths and needs. Head Start staff will work collaboratively with participating families to identify and continually access, directly or through referrals, community services and resources that are responsive to each family’s interests and goals. Parents will be provided with an opportunity to participate in the Head Start program as participants in the classrooms, educational activities, and other program activities as volunteers and/or observers, and with direct participation in decision making in the program’s planning and operations. Parents will be supported and encouraged to become involved in community advocacy in order to influence the character and goals of community services. Head Start staff will provide parents with opportunities to collaboratively work together with other community members, on activities they have helped to develop and in which they have expressed an interest. Effective procedures established will provide families with comprehensive information about community and neighborhood groups, area residents, and other community resources which enable the family to meet their needs. Earl Bradsher Preschool will take an active role in building collaborative community partnerships in order to improve the delivery of community services to children and families. Interagency agreements will be established with local agencies in order to enable the effective participation of children with disabilities.A Health Services Advisory Committee, which will include Head Start families, professionals, and volunteers from the community will be established and maintained to address program service issues and to help agencies respond to community needs. Other advisory committees will be established as necessary.Procedures to support successful transitions for enrolled children and their families will be established and maintained. Head Start staff will assist parents in becoming their children’s advocate as they transition into Head Start from the home or other child care settings, and from Head Start to kindergarten or another child care setting.Section 3: Procedures Family Partnerships(a) Family Goal SettingA Family Assessment is completed by the Family Service Workers on each family accepted into the program upon enrollment (see Appendix A). These forms are used to determine the strengths, the needs and interests of each family. Information obtained from these assessments includes family strengths, members of the household, education, job/ employment training, health/safety, basic needs, literacy, child care, areas of support, and transportation. The Family Service Workers collaborate with families to provide them with the opportunities to build upon their Family Assessment and to develop an Individualized Family Partnership Agreement (see Appendix B). These agreements include timelines and strategies for achieving family goals. If families have an existing agreement with another agency, Head Start staff assists those families in building upon their existing agreement. The Family Service Workers contact families to schedule home visits to complete Family Assessments and Individualized Family Partnership Agreements. Once the Family Assessments are completed, the Family Service Workers compile the Family Assessments to identify the needs and interests of the families. Head Start parents are provided with an array of opportunities to network with one another. Spaces are accessible for parents to conduct meetings, to interact with other parents, and to collect parent resources (books, videos, brochures, parent magazines, etc). Parent trainings are conducted at Parent Committee meetings at the Earl Bradsher Preschool Center or off-site, as appropriate. Learning Connections, a parent/teacher resource library at Earl Bradsher Preschool Center, is available to parents. Learning Connections serves as a resource for Head Start families. Bilingual information, materials, and books are available. (b) Accessing Community Services and Resources The Family Service Workers contact community agencies in June to gather information regarding their services. Data is compiled and updated on these agencies and information is distributed to parents in the form of a Community Resource booklet during home visits in the fall. Information is shared throughout the year, as needed or requested by families. The Family Service Workers maintain documentation of regular family contacts, Family Assessments, Individualized Family Partnership Agreements, home visits, phone calls, etc., to assess the family’s need for crisis intervention, counseling, and community services on an ongoing basis. Families indicating a need for counseling are referred to the Mental Health Coordinator. The Mental Health Coordinator refers families to an appropriate agency for services, such as Freedom House, Child and Family Therapist, or the Smart Start nurse. (See Early Childhood Development and Health Services plan for more information). Families signifying a need for crisis intervention are assessed by the Family Service Workers to determine the severity of the crisis. The Family Service Workers assist families with locating the appropriate community resources to address their needs. Such agencies may include the Person County Department of Social Services, Christian Help Center, Food Pantry, Freedom House, Safe Haven, Legal Aid, and Piedmont Community College. Families indicating needs to teaching staff or other Head Start staff members are referred to the appropriate agency (see Appendix C). The Family Service Workers refer families to the appropriate agencies primarily by referral letters; however, phone calls and direct contact are also used (see Appendix D). The family is notified that a referral has been made by letter indicating what agency to contact for the needed services. The family also receives a copy of the referral letter that is sent to the agency. The agency completes the bottom portion of the referral letter indicating the services provided to the family or indicating that the family made no contact with the agency. The agency is then expected to return the referral letter to the Head Start staff member making the referral. The Family Service Workers follow-up with families to determine the quality of services they received through the referral and whether the services met the families’ needs. (d) Parental Involvement GeneralFamily Service Workers compile information from the Parent Interest Surveys, completed the first week of school in August, to determine the parent training interests, educational background, and information needs (see Appendix E). The Family Services collaborates with the other coordinators and director to develop an annual training calendar and distributes it to parents in August. Workshops for parents are scheduled to encourage parents to participate in educational programs and to provide training for parents, which enhance their parental skills, self-confidence, and independence in creating a learning environment for their children. Training is provided in such areas as child growth and development, educational activities for children in the home, child abuse and neglect, preventative health and safety, mental health, nutrition, budgeting, dental health, hand washing, behavior management, transitions, etc. Families are welcomed and encouraged to participate in the classrooms at any time and in other program activities as approved volunteers, observers, or as paid employees. Parents are encouraged to volunteer as much and as often as they can. A Volunteer Application Release form, and a TB test, is required for regular volunteers. Volunteering is not used as a requirement for children to participate in the program. (e) Parent Involvement in Child Development and EducationFamilies are oriented to the goals of the education component during parent orientation held at the beginning of the school year. Families are encouraged to assist in the development and planning of the education program and curriculum in several ways. First, families are asked for input during the home visit. They are asked about ideas for studies/projects, activities their child likes to do, and what they would like their child to learn. Furthermore, teaching staff and the Education Coordinator send home “At-Home Education Activities” for families to do with children. Families are then asked to complete an evaluation form so that the activity can be changed as necessary. Finally, lesson plans are posted at all times in the classrooms. Families are always encouraged to share suggestions and comments with staff. Families are also asked to conduct specific activities in the classroom and on field trips with children. Staff encourages families to share information regarding the various cultures that are served. For example, particularly during holiday seasons, parents are asked to share information regarding how their family celebrates (if they celebrate). Families of children who have special needs are encouraged to volunteer and share information about their child, as all parents are. Families work with their children in cooperation with the staff by participating in areas such as in classroom activities, in training to enhance their parenting skills and knowledge of child development, having input on the lesson plan, suggesting field trips, serving on Policy Council, Parent Committee, Health Services Advisory Committee, and in preparing children for the full Head Start experience. Piedmont Community College offers an Adult Basic Skills program which offers adults, ages 18 and older, the opportunity to learn or improve their ability to read, write, speak English, compute math, problem solve, master everyday living skills, and complete their high school education. Participants may choose from the Adult Basic Education (ABE), High School Equivalency (HSE) or English as a Second Language (ESL) programs. The Earl Bradsher Preschool program is also involved in promoting literacy through its involvement in Reading is Fundamental (RIF). The Roxboro Kiwanis Club in Person County donates funds to the Head Start program to sponsor RIF. The RIF committee includes Head Start staff, parents, and representatives from community agencies. The RIF committee plans RIF book distributions which are held three times per year. Each book distribution has its own individual theme and books are selected to coincide with the theme. Every child in the Head Start program has an opportunity to select a book of his/her own to take home. The books are available in both English and Spanish. The Program offers a Step Parenting Curriculum to Head Start parents. Classes are held once a week for seven weeks. Family Services present topics pertaining to child development and growth. Parents are presented a workbook to use as a guideline throughout the course to complete worksheets and activities. The Person County partners for Children funds Parents as Teachers (PAT) a free early learning program for parents of children birth age to age five. PAT is a six week program involving positive interaction between parent and child. A family literacy bulletin board is displayed that focuses on the current month’s parenting topics. This enables parents who are not able to attend the parent meetings to gather information on topics discussed at the parent meetings. In addition, a monthly event calendar is sent home to families. This calendar list educational activities and functions held at Earl Bradsher each month for parents and students to attend. Materials in Spanish are also included.Parents are encouraged to obtain and use a public library card for themselves and their children. Forms for library cards are available at the Person County Public Library. Parent activities, such as a field trip to the library or make-it and take-it day at Learning Connections or a parent meeting, enhance knowledge of available community resources.Teaching staff participates in parent/teacher conferences at least twice per year in addition to the required two home visits. Afternoon and evening conferences are held in the classrooms, in the fall and spring of each year. We strive to have 100% participation. Information regarding these conferences is documented on a form and filed for each child whose family participates. The original conference form is placed in the child’s classroom file. A copy of these forms is sent to the Education Coordinator for review and feedback. Relevant information is shared with various coordinators. Conferences include discussions of the child’s social, emotional, cognitive, and physical development during the year as documented using Teaching Strategies Gold. Conference information is also entered into the Child Plus data management system. Progress in meeting child outcomes is discussed as well. Both families and teachers are encouraged to communicate regularly concerning these issues. (f) Parent Involvement in Health, Nutrition, and Mental Health EducationFamilies and staff receive training in health related fields. Appropriate health topics are decided upon by meeting Head Start requirements and by considering requests from staff and parents. Workshops include topics such as first aid, CPR, dental hygiene, mental health, nutrition, child development, etc. The Health Coordinator organizes materials and contacts consultants as needed.The Health Coordinator provides parents with information about workshops concerning community health resources and what services they offer. As part of their home visit, parents are provided with a Community Resource Booklet containing numbers and addresses of medical and dental professionals they may contact for services. Parents are encouraged to become involved in the health care of their children. Parents accompany their children to receive health and dental services, which include immunizations, medical and dental examinations, and screenings. The Health Coordinator sends notes to parents prior to appointments to make the parents aware of times, dates, and places of appointments. When a child leaves the Head Start program, the Health Coordinator contacts the proper resource agency to provide ongoing follow-up care if needed. This optimistically should be of some reassurance of ongoing health care for the Head Start child and family after leaving the program. Training is provided for families in such areas as child growth and development, child abuse and neglect, preventative health and safety, mental health, nutrition, budgeting, dental health, hand-washing, children with special needs, behavior management, first aid, CPR, etc. Families are educated and supported in their role of promoting good nutrition habits for their children and families. A nutritional education program is provided for staff, families, and children to increase knowledge, understanding, and enhancement skills. The Person County Schools Child Nutrition Director may conduct workshops for Head Start families and staff on topics to enhance skills in the areas of selecting and preparing nutritional foods and budgeting. If the director is unavailable, other resources are used such as the WIC office staff, Person County Cooperative Extension staff, Person Memorial Hospital Registered Dietitian, or Person Memorial Hospital Business Health Services Coordinator. Finally, teaching staff plans nutritional activities for the classroom that includes multicultural experiences that are documented on their lesson plans. The Child Nutrition Director is available as a resource for staff. Teaching staff conducts home visits or conferences to discuss nutritional needs of particular children when needed. This information is then shared with the Health Coordinator. The Child Nutrition Director provides monthly menus. The Mental Health Coordinator obtains a mental health professional to train Head Start staff and families on observing, assessing, and on the availability of and procedures for usage of local mental health resources. The Mental Health Coordinator provides information to Head Start staff and families in order to help them achieve greater understanding of the mental health program. Head Start staff and families are trained on prevention and early identification of problems that interfere with the child’s development. Topics of interest to the Head Start family such as appropriate child behavior, as well as social, emotional, cognitive, physical, and developmental issues are discussed at parent meetings. The mental health training covers mental health wellness in order to provide positive methods of guidance for both the staff and families. This supports families who may need mental health interventions. The Mental Health Coordinator coordinates meetings with other Head Start staff and families in order to discuss individual children and formulate plans of action. Families are involved in the planning and implementation of their children’s individual mental health needs. (g) Parent Involvement in Community AdvocacyEarl Bradsher Preschool encourages all families and staff to be involved in affecting the quality of the community. The Family Service Workers contact community agencies to gather information regarding their services. Data from these agencies concerning services provided is compiled by the Family Service Workers and distributed to families in the form of a Community Resource Booklet. Also, information is shared throughout the year as needed or requested by families. The parent activity fund in the yearly budget provides parents with funds to plan and participate in educational activities they have helped to develop. An example is a family day planned by the parents as a day to interact with the children and staff and also to have educational activities in which parents can participate. The Policy Council approves all activities planned. (h) Parent Involvement in Transition ActivitiesTransition activities for Head Start parents start in May during Final Paperwork Days. Parents are asked to complete a questionnaire about their incoming child’s likes, dislikes, comforts, and needs. This sheet is used by teaching staff to provide an easier transition for each individual child coming into the program. Pictures may be taken of the parents on visits to the home, in the classroom, or submitted by families to place in each child’s classroom to provide them with some comfort of seeing their parent’s picture upon arrival at Head Start. Some teachers place the parental pictures in each child’s cubby, which serves as a way for each child to know where his/her individual cubby is located. Head Start families and children have the opportunity to and are encouraged to visit the classrooms before school begins. This provides a time for the child and family to become familiar with the classroom and for the family and teaching staff to interact. Staff works to prepare families to become their child’s advocate by providing opportunities for parent training at parent meetings or special meetings, in areas of child advocacy, parents’ rights and responsibilities, and school involvement. Parents have the opportunity to attend transition workshops offered by Head Start as well as Kindergarten Orientation, Open House at the assigned elementary school or other placement where their children will be attending as they exit Earl Bradsher Preschool . Transition workshops include topics such as school policies, importance of parent involvement, effective communications, and advocacy for their children. The Head Start staff works together with other agencies, which may have served Head Start children and families, to strengthen the link between home and Head Start and between Head Start and the public schools. During the transition process, the Earl Bradsher Preschool program keeps the child and family’s needs a priority, whether they are transitioning into or out of Head Start. Head Start parents are encouraged to participate in decisions related to their children’s education. Parents of children who have an Individual Education Plan (IEP) are encouraged to attend an annual meeting to review the plan, which is conducted by the Preschool Disabilities Coordinator. Other members of the exceptional services team who have worked with the child to obtain the present level of development also attend such as the speech therapist and the classroom teacher. Parents are also encouraged to participate in other decisions concerning their children such as summer activities, best placement for the next school year, resource help, or phasing out of the program if appropriate. (i) Parent Involvement in Home VisitsTeaching staff meet with families on a regular basis for discussion and assessment of children’s progress and needs through a minimum of two home visits per year. Home visits are completed for each child at the beginning of each school year and again before the end of the school year. These visits are scheduled at times that are convenient for both parents and staff. Information regarding home visits is documented on a form and filed in each individual child’s classroom file. Copies are sent to the Education Coordinator for review and feedback. Information is entered into the Child Plus data management system.Home visits are not used as a requirement for children to participate in the program, however, parents are encouraged to permit the home visit and the advantages of doing so are explained. Home visits may be conducted outside of the home if requested by parents or if visiting the home may pose a safety issue for staff. These visits include discussion of the child’s social, emotional, cognitive, nutritional, and physical development during the year as documented using the Teaching Strategies Gold. Progress in meeting child outcomes is discussed as well. Both parents and teachers are encouraged to communicate regularly on these issues.Other staff members make home visits as needed for issues such as crisis intervention, health or mental health related needs, attendance issues, assessing needs of the family, etc. In addition to the home visits and conferences, staff and families communicate by various memos, letters, telephone calls, newsletters, and by word of mouth. All communication is documented. Section 4: Community Partnerships(a ) PartnershipsThe Earl Bradsher Preschool staff represents the best interest of Head Start families to the community and to community agencies by participating on committees and boards, and being involved with organizations that may benefit Head Start families and the program. Representatives from community agencies and organizations are also asked to participate in the Head Start program along with the staff and parents. By collaborating with other agencies and having them as part of the Head Start program, Earl Bradsher Preschool is able to identify inadequacies of existing community services, is able to advocate for the needs of Head Start families, and is also able to provide suggestions and strategies for improvement of services.Parents, agencies, and organization representatives who participate on committees are able to better understand the program as a whole. Parents and others are able to participate in the preparation of service plans, budget, and goals of the program. Training and support are provided to the parents and community representatives by the Head Start staff and appropriate consultants. The Head Start staff assists families by establishing collaborative relationships with community agencies on an ongoing basis to promote the access of community services to Head Start children and families and to ensure that Earl Bradsher Preschool responds to the community’s needs. Earl Bradsher Preschool collaborates with many community agencies, such as the Partnership for Children, the Person County Department of Social Services, the Person County Health Department, Early Intervention and Family Services, Child Care Resource & Referral, the Public Library, Piedmont Community College, Person County Schools, Cooperative Extension, and other groups that develop programs and activities to promote a stronger community.Recruitment of Head Start parent volunteers begins during preschool registration in the spring and continues throughout the school year. As stated above, parents along with representatives from local community agencies are recruited to volunteer on committees. Volunteer recruitment also includes the continuation of utilizing volunteers from the following sources:Person High SchoolRoxboro Community SchoolRoxboro Kiwanis ClubApproved volunteers are used to the fullest extent to include, but not limited to, the areas of volunteering in the classroom, on field trips, and assisting staff with projects such as copying papers and making games, assisting the custodian at the center, serving on Policy Council and other committees, assisting during preschool registration, assisting during special events and activities, etc.Members of the Roxboro Kiwanis Club, which donates money to fund Earl Bradsher Preschool ’s Reading is Fundamental (RIF) program, are recruited to read to the children at RIF book distributions and volunteer any other way possible. Approved volunteers become available throughout the school year at different times. Volunteer training is held on an individual basis. Policy Council members are elected in September and ongoing training occurs. Other volunteers, such as human services interns and early childhood students from PCC are trained when they become available (for more information on volunteer training, please see the Program Design and Management plan). A Volunteer Application Release form, TB test, and health questionnaire are required for regular volunteers. A copy of the results of the skin test is obtained by Family Services and kept on file by the Health Coordinator. Approved volunteers are asked to sign in and out on a volunteer sheet indicating the time of arrival, departure, and services provided. Family Services calculates volunteer hours by a dollar amount, enters the information on a inkind report, and turns the report in to the director and fiscal office by the 5th day of each month (unless the 5th is on the weekend) to use as in-kind. Earl Bradsher Preschool encourages all families and staff to be involved in affecting the character of the community. Earl Bradsher Preschool staff are permitted to participate as members of committees and boards of local agencies with prior approval of the director. Earl Bradsher Preschool continues to work on establishing ongoing collaborative relationships with community organizations to include the following where appropriate, but not to exclude additional means:Invitations to serve on Head Start committees.Acceptance to serve on community agency committees.Sending referrals to community agency committees.Establishing working written agreementsDispersing information among staff/parents from community agencies. Person County Schools staff and the Preschool Disabilities Coordinator and Education Coordinator, works with Head Start to ensure that the disabilities needs of children are met. A written agreement between Head Start and Person County Schools is on file. (b) Advisory CommitteesThe Health Coordinator organizes the Health Services Advisory Committee to include a local medical and dental consultant, a Health Department representative, a nutritionist, a mental health consultant, Head Start parent(s), local doctors, an optometrist, the Person County Schools Exceptional Children’s Director, the Preschool Disabilities Coordinator, Smart Start Community Services Team, a Person County Cooperative Extension staff member, the Head Start Director and Coordinators, and other necessary representatives.The Health Services Advisory Committee is involved in offering suggestions for the Head Start health, nutrition, and mental health service plans and procedures that include short and long term exclusions. This committee is also presented with the needs and concerns affecting Head Start children such as the water supply, the lack of fluoridated water in ? of the county, nutrition related problems, prevalent health conditions in the community such as hunger, diabetes, hypertension, baby-bottle tooth decay, lead poisoning, etc. This committee meets biannually and additional meetings are scheduled as necessary. (c) Transition ServicesChildren who are exiting the Head Start program to attend kindergarten have the opportunity to attend orientations at the schools where they will be enrolled in the fall. This occurs in the spring of the year prior to the children entering kindergarten. In instances where the child’s best placement is another program, such as a preschool exceptional children’s classroom, special arrangements are made for the child and parent or guardian to meet the teacher and visit the classroom site prior to school attendance.In February, elementary school secretaries have the ability to look in PowerSchool to see the placement of Head Start children who will attend that particular school for kindergarten. Written invitations/reminders to spring orientations are sent to incoming kindergarteners and their families. A notice of orientation times and locations in the school, on the Earl Bradsher Preschool Facebook page and the Earl Bradsher Preschool webpage. January, February, and March families are given three opportunities to complete the online Kindergarten Registration process at Earl Bradsher Preschool. These rallies give parents morning and afternoon hours to complete Kindergarten registration online, with assistance from Head Start staff. At that time, Head Start staff collects from families their proof of residency. Reminders are sent home with families who do not attend registration events to reiterate the importance of Kindergarten registration. Every effort will be made by the Head Start staff to assist families in the registration process. In June, the elementary school principals coordinate a date to receive the cumulative record for each child exiting the Head Start program to the school where he or she will be attending in the fall. This record includes the child’s birth certificate, immunization record, and progress report. Profile cards are sent separately. Family Services and the Education Coordinator track children who are exiting Head Start for four years after leaving the program. The child’s kindergarten or other program teacher completes a survey that includes attendance, classroom participation, parent involvement, class work, social/emotional development, physical development, and special services if applicable. Teachers in first through third grades are also sent a similar survey to complete on former Head Start students as well. In the fall a transition survey is sent to all kindergarten teachers in reference to Head Start students. In the spring, the Education Coordinator and Family Service Team endeavors to visit each child who has transitioned to kindergarten in his or her new setting. Follow up is done mid-year.Transition activities are also carried out through parent workshops, staff training, home visits (if needed), handouts, kindergarten orientation, a summer activities countdown calendar, written and verbal communication with the parents, staff, and schools which the children will be transitioning into, follow-up visits to the exceptional children’s classrooms, kindergarten classes, or other programs where Head Start children have transitioned. Arrangements, if eligible for extended school year services and desired by the parent, may be made for the children to continue speech and language services. In addition, Learning Connections, a resource center, is open for families, except for July and August, who wish to make use of its materials. Transition activities for children coming into Head Start will be handled as previously mentioned in this plan and on an individual basis as requested by Head Start teachers and families. Teachers are available for consultation in the fall, along with the Education Coordinator, to answer any questions the kindergarten teacher or school counselor may have or to meet with the teacher, parents, and other staff to ensure a smooth transition. In the fall, Head Start staff may have the opportunity to observe kindergarten classes in session if requested. This allows teachers to see the kindergarten curriculum and better prepare Head Start students for the kindergarten experience.? Kindergarten teachers are extended an invitation to visit?Head Start classes if arrangements at their elementary schools can be made. The kindergarten staff, the preschool staff may meet to discuss transition and to assure kindergarten staff of the availability of records and the Head Start staff to help ease the transition into kindergarten. School staff is made aware of Head Start records that are not included in the cumulative folders that are sent to the schools. All relevant information not contained in the cumulative folder is released to the staff at the child’s next placement upon request. Revised 05/2019Appendix A-5985212794002896166109220Appendix B-5708643327403049905233680Appendix CEarl Bradsher PreschoolCommunity Agency Referral Date: _______________Child’s Name: __________________________________________________Date of Birth: ______________ Sex: □Male □Female _______ Race: ________Address: _______________________________________________________________Parent(s) Name: ________________________________________________Does child live with parent(s)? □ Yes □NoIf no, child lives with: ____________________ Relation: ____________________Reasons for Referral: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Check need(s) and describe in comments section below:_____Abuse/Neglect_____High Risk (Mental Illness/Disabled Adult)_____Serious Child Health Problem_____Family Crisis (Terminal Illness, Death)_____Social Needs/Problems_____Child Needs Health and/or Nutrition Care_____Other______________________________________________________________Additional Comments: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ____________________________________________________ Referring Person AgencyTitlePlease return this form to Treco Lea-Jeffers.404 South Morgan St.Roxboro, NC 27574jefferst@person.k12.nc.us336.599-3484 FaxAppendix DEarl Bradsher Preschool Referral/Follow-up FormDate: ______________________To: From: Earl Bradsher Preschool 404 South Morgan Street Roxboro, NC 27573 (Return Form to Above Address) Parent/Child Referred: __________________________________________Reason for Referral and Relevant Information: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature: __________________________ Title: _____________________________________________________________________________________________________Follow-up Services Provided by Agency: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature: _______________________________Date: ________________________Appendix E8300544450 ................
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