EDUCATION FOR HOMELESS CHILDREN AND YOUTH



Homeless Coordinator or Contact Person _________________________________________________________

Title _______________________________________________ Phone # ( ) _________________________

EDUCATION FOR HOMELESS CHILDREN AND YOUTH

PROGRAM DATA COLLECTION FORM

I. Estimated Number Of Homeless Children And Youth

(a) Provide the estimated number of homeless children and youth in your school district according to school level.

|School Level [1] |Number of Homeless Children/Youth |Number of Homeless Children/Youth |Number of Homeless Children/Youth |

| | |Enrolled in Public School Programs |Regularly Attending School |

|Pre-K | | | |

|(birth-5 yrs.) | | | |

|K-5 | | | |

|6-8 | | | |

|9-12 | | | |

|Total | | | |

b) How does the local educational agency (LEA) define “regularly attending school”?

c) If there is a large discrepancy between the estimated number of preschoolers and

the numbers enrolled, explain this discrepancy.

II. Primary Night Time Residence Of Homeless Children And Youth

Of the total number of homeless children and youth, including preschoolers, listed in I (a), provide the estimated number who has the following as their primary night time residence. In instances where there was more than one location, choose the location of most frequency (do not duplicate estimates).

| | |

|Primary Night Time Residence |Estimated Number of Homeless Children/Youth |

|Shelters | |

|Doubled-up | |

|Unsheltered (e.g., campgrounds, cars, parks, etc.) | |

|Other (specify) | |

|Unknown | |

III. Barriers To School Attendance And Enrollment

Of Homeless Children And Youth

(a) From the list below, rank in order the most frequently identified barriers to school enrollment or attendance. Number one (1) indicates the “most frequently” identified barrier and number nine (9), the “least frequently” identified barrier. Use each number only once. Use “N/A” to indicate that the item is not a barrier.

|Attendance and Enrollment Barriers |Numerical Ranking |

| |1-9 |

|Residency requirements | |

|Availability of school records | |

|Birth certificates | |

|Legal guardianship requirements | |

|Transportation | |

|Lack of available preschool programs | |

|Immunization requirements | |

|Physical examination records | |

|Other (specify) | |

(b) Describe briefly the district-wide policies, local programs, or other steps that have been or are being taken to eliminate attendance and enrollment barriers.

IV. Unique Needs Of Homeless Children And Youth

a) Place a check mark (() in the appropriate box to indicate the extent to which the following educational and school-related activities are needed to ensure the individual success of homeless children and youth.

b) Additionally, place a (() to identify services currently addressed through state-developed programs. On a scale of 1-10 with “10” indicating “the need has been totally met”, indicate the extent to which the need is being met by implemented programs.

(Note: It is possible to have an activity listed as a need, even if it is currently being addressed.)

|Educational and School-Related Activities|A Major Need |A Minor Need |Not An Identified Need |Addressed by State |Extent to which |

| | | | |Program |identified need was |

| | | | | |addressed by State |

| | | | | |Program |

| | | | | | |

| |( () | |( () |( () |Ranking Scale of 1 to 10 |

| | |( () | | | |

|Tutoring/remedial | | | | | |

|Special education | | | | | |

|English as Second Language | | | | | |

|Counseling | | | | | |

|Transportation | | | | | |

|Free lunch/breakfast | | | | | |

|Medical services | | | | | |

|School supplies | | | | | |

|Preschool programs | | | | | |

|Staff development on homeless issues | | | | | |

|Parent training/involvement | | | | | |

|Agency coordination | | | | | |

|Policy revision to facilitate enrollment | | | | | |

|Case management | | | | | |

|Enrollment | | | | | |

|Records transfer | | | | | |

|Other (please specify) | | | | | |

c) Indicate by check marks (() which, if any, of the following programs the homeless children and youth, including preschoolers, have difficulty accessing.

|Federal Programs |(() |Describe briefly why there is a problem gaining access (e.g., program capacity, program |

| | |availability, specific Federal requirements, etc.) |

|Title I | | |

| | | |

|Head Start | | |

| | | |

|Even Start | | |

| | | |

|Special Education | | |

| | | |

|Adult & Vocational Education | | |

| | | |

|Safe & Drug Free Schools | | |

| | | |

|Other Federal Programs (specify) | | |

| | | |

| | | |

| | | |

|________________________ | | |

|State Programs (specify) | | |

| | | |

| | | |

| | | |

| | | |

(d) Describe briefly the policies, local programs, or other steps that have been or are being taken to address any problems identified above. In addition, please list the greatest challenges and/or barriers facing the above mentioned programs.

V. Coordinated Activities With Other Agencies

Describe briefly the coordinated efforts between the local educational agency (LEA) and other local agencies that serve homeless children and youth, including preschoolers, and their families. What results have these coordinated efforts yielded?

VI. Methodology

(a) Place a check mark (() to indicate which of the following data collection methods were used to estimate the number of homeless children and youth, including preschoolers, identified in this report.

METHODS:

Sample

Point in time study [2]

Annualized study[3]

Other (specify)

b) If the estimates and percentages in this data collection form differ greatly from past years, provide possible explanation of this variance.

Submitted by: ______________________________________ Date: __________________

Submit form on or before June 30, 2000 to Susan Underwood, Homeless Coordinator; Arkansas Dept of Education; #4 Capitol Mall Room #302-B; Little Rock, AR 72201.

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[1] Although school level configurations may differ among local educational agencies, it is understood that the data provided is an estimate. Thus, in order to compile the data, it is requested that the estimated numbers be extrapolated and reported in the school level configuration provided on the form.

[2] A “point in time study” is an estimated count of all the people who are homeless on a given day or during a given week. For example, a count taken on a Saturday night at a random shelter of all inhabitants.

[3] An “annualized study” is an estimated count of people who are homeless over a given period of time. For example, a count taken the first two weeks, spanning from September to October, and then a count taken the last two weeks, spanning from February to March, of the same year.

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