Exhibit_A_-_ADES_Suspension_and_Expulsion_Prevention_Policy.pdf

CCA 1-01-01 Suspension and Expulsion Prevention Last Updated: 10/1/2021

ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Program Name: Child Care Administration Policy Number: CCA 1-01-01 Suspension and Expulsion Prevention Effective Date: October 1, 2021 Chapter: 1. Child Care Administration Section: 01. Child Care and Development Block Grant Subsection: 01. Suspension and Expulsion Prevention

CCA 1-01-01

Suspension and Expulsion Prevention

I. POLICY STATEMENT

The Arizona Department of Economic Security (the Department) is committed to supporting child care providers and caregivers to find the resources and support that are essential to ensuring access to quality child care for all children. Federal rule, under the Child Care and Development Fund (CCDF) requires States to provide information about age-appropriate social-emotional behavioral health policies for children from birth to school-age, and policies to prevent suspension, expulsion, and denial of services due to behavior of children birth to age 5 in child care and other early childhood programs.

Research demonstrates that suspensions and expulsions of children in child care settings are detrimental for children, families, and child care providers, and has a disproportionate impact along both gender and racial lines.1 Suspension and expulsion practices have been found to be ineffective in addressing the behaviors that adult caregivers may find challenging, are counterproductive to the goal of preparing children to succeed in school and life, and can influence a number of adverse outcomes across development, health and education.

To support positive social-emotional development, it is best to teach prosocial skills and help children feel connected and safe in their child care environment. Strategies to prevent challenging behaviors are essential skills for all caregivers. Child care providers and parents need sufficient knowledge, skills, and support to ensure children experience a high-quality early childhood program that utilizes developmentally appropriate practices to help each child grow and develop.2

The Department requires providers to utilize all supports to prevent suspension and expulsion of children from child care settings. The Department provides assistance through education, training and support mechanisms for parents and child care providers related to any issues that may lead to the suspension and/or expulsion of children in care.

The Department, when deemed the child care provider is non-compliant with this policy, shall issue the provider a Corrective Action Plan mandating the provider to complete an approved training or identify other actions as appropriate to the situation through a Corrective Action Plan

(CAP).

1 U.S Department of Education Office for Civil Rights (2016). A First Look: Key Data Highlights on Equity and Opportunity Gaps in Our Nation’s Public Schools. LINK.

2 U.S. Department of Health and Human Services. Administration for Children and Families. Expulsion and Suspension Policy Statement LINK; and Reducing Suspension and Expulsion Practices LINK.

Effective date: 10/1/2021 Page 1 of 10 https://www2.ed.gov/about/offices/list/ocr/docs/2013-14-first-look.pdf https://www.acf.hhs.gov/occ/resource/im-2016-03 https://www.acf.hhs.gov/ecd/child-health-development/reducing-suspension-and-expulsion-practices

II. AUTHORITY

42 U.S.C. 9858c Application and plan 42 U.S.C. 9858e Activities to improve the quality of child care

45 CFR 98.16 Plan provisions 45 CFR 98.33 Consumer and provider education 45 CFR 98.44 Training and professional development 45 CFR 98.53 Activities to improve the quality of child care

III. APPLICABILITY

This policy applies to the following groups or individuals:

DES Contracted Child Care Providers DES Eligible Clients and Families (with consent form signed) Non-DES parents and Families (with consent form signed) Child Care Administration

IV. DEFINITIONS

About Me Questionnaire: The Department-approved form (CCA-1200A), provided to parents at their local ADES Child Care office when they apply and are determined eligible for Child Care assistance. The form is completed by a parent for each individual child and used by the provider for purposes of understanding more about the child to assist the provider in supporting the child’s growth and development, and create a safe, stable and healthy environment for all children. At a minimum, the About Me Questionnaire shall be resubmitted annually.

Action Plan: A plan created by the child care provider and AZ STEPS Resource Consultant that identifies the child’s challenging behaviors, resources offered to the provider, and strategies the provider has agreed to take to avoid expulsion, meet the child’s needs, promote positive behavior, and decrease the identified challenging behaviors. The plan shall include a timeframe in which the strategies agreed upon will be implemented.

Arizona Suspension and Expulsion Support Request: A form completed by a provider, teacher, parent, or DCS caseworker when additional resources are deemed necessary to support the child’s continued enrollment in the child care setting. Forms are accessed through the State’s

CCR&R.

AzEIP: Arizona Early Intervention Program

AZ STEPS: Arizona Statewide Training and Technical Assistance for Expulsion Prevention.

Business Day: Monday through Friday, excluding holidays observed by the State of Arizona.

CAP or Corrective Action Plan: The document describing the steps a child care provider will take to remedy non-compliance with terms and conditions of this Policy, including completion of training assigned by the Department, or other actions identified as appropriate to the situation through a CAP.

CCA: DES Child Care Administration.

Effective date: 10/1/2021 Page 2 of 10 https://uscode.house.gov/view.xhtml?req=(title:42%20section:9858c%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section9858c)&f=treesort&edition=prelim&num=0&jumpTo=true https://uscode.house.gov/view.xhtml?req=(title:42%20section:9858c%20edition:prelim)%20OR%20(granuleid:USC-prelim-title42-section9858c)&f=treesort&edition=prelim&num=0&jumpTo=true

CCDF: Child Care and Development Fund, a federal program that helps low-income families obtain child care so that they may work, attend training, or continue their education. The purpose of CCDF is to increase the quality, availability, and affordability of child care.

CCR&R: Child Care Resource and Referral is a service the Department administers under A.R.S. §41-1967 and 6 A.A.C. 5 Article 50. This service provides assistance with resources and referrals to child care settings, and is provided to parents, child care providers, and the community free of charge.

Child Care Providers: The DES contracted child care providers including DHS licensed child care centers, DHS certified child care group homes, and DES certified family child care home providers.

DCS: Department of Child Safety

DDD: Division of Developmental Disabilities

DES or the Department: The Arizona Department of Economic Security.

DES Contracted: The DHS licensed child care centers and DHS certified child care group homes that hold a signed Child Care Provider Registration Agreement with CCA, and DES certified family child care providers.

DHS: The Arizona Department of Health Services

Expulsion: The dismissal of a child from the program permanently due to behaviors that have been identified by the child care provider as challenging behaviors. Expulsion typically takes place against the wishes of the child’s parent.

Expulsion Prevention Resources: Materials intended to educate or refer a family to potential supportive services not provided by the Expulsion Prevention Resource and Support Specialist.

Expulsion Prevention Resource Consultant: A DES contracted employee with expertise in early childhood mental health who provides expulsion prevention resources and support services and is assigned to assist child care providers and parents whose child is facing a possible suspension and/or expulsion. A DES contracted Resource Consultant has a minimum two year degree in Early Childhood Education or closely related field, and one year of experience in an early childhood setting.

Notification of Child Care Expulsion: A form completed by a provider, teacher, parent, or DCS caseworker two business days after a child has been disenrolled from a child care program.

Other Professionals: Professionals with expertise in child development, mental health/behavioral health, and the inclusion of children with special needs including:

1. Inclusion Specialist: An individual with a bachelor’s degree or higher in child development, early childhood special education or a related field who has specialized knowledge of the current principles and strategies from inclusive practices that promote giving all children the opportunity to access and participate in general education classrooms.

Effective date: 10/1/2021 Page 3 of 10 https://www.azccrr.com/

2. Mental Health/Behavioral Health Professional: A professional that is trained in providing mental/behavioral health services. Some services could include: consultation, individual therapy or other therapeutic services.

3. Other State Agency professionals who may interact with the family through services, including: the AzEIP, DDD, and the DCS.

Parent: Parent is defined in the DES Provider Registration Agreement for DES contracted providers as: the natural or adoptive parent of a child or a person responsible for the care, custody, and control of a child.

Serious Injury: Serious injury is defined in the DES Provider Registration Agreement for DES contracted providers as: a serious injury or accident resulting in medical treatment (outside the facility), hospitalization, or death of a child.

Service Consent Form: A form used only by the AZ STEPS Resource Consultant for purposes of obtaining consent from all parents receiving AZ STEPS supportive resources, to allow the Resource Consultant to observe the classroom, and to work with the child directly, if appropriate.

If a parent initiates the Arizona Suspension and Expulsion Service Request, this form does not need to be completed. If a parent declines services, the Resource Consultant will provide general support to the provider, and not child specific services. The provider must still follow their responsibilities in this policy whether a parent accepts or declines services from AZ STEPS. A Service Consent form does not need to be completed for children under the care of the Arizona Department of Child Safety.

Soft expulsion: An exclusionary practice whereby the parents are encouraged to voluntarily withdraw their child from the child care setting. Soft expulsion is a form of expulsion.

Suspension: A disciplinary practice that is defined in two ways:

1. In-program Suspension: A disciplinary practice that involves removing or excluding a child from a classroom or from activities that include other children, while the child physically remains in the child care setting.

2. Out-of-program Suspension: A disciplinary practice that involves removing a child from the program or placing restrictions on the time a child may attend the program.

Warm-Hand Off: The current child care provider will allow the parent a set amount of time to find a more appropriate child care provider. During this time, the child would remain in the care of the current provider and the provider would be speaking positively to the child about their upcoming transition to a new child care setting. At home, the parents would also be taking time to remind their child that they will be transitioning to a new child care setting.

V. STANDARDS

A. Preventing Suspension or Expulsion: Provider Responsibilities The Provider shall:

1. Ensure all staff successfully complete AZ STEPS Training Foundations I within 90 days of hire date, available on the Arizona Early Childhood Workforce Registry.

Effective date: 10/1/2021 Page 4 of 10 http://azregistry.org

a. Utilize additional training support provided including:

i. Submit a Technical Assistance request upon completion of

Foundations I training to support the transfer of learning.

ii. Register for and attend training provided through the Expulsion

Prevention training series, available on the Arizona Early Childhood Workforce Registry.

2. Include language in the provider’s internal policy and procedures for preventing suspensions and expulsions that informs the parent of the provider’s suspension and expulsion prevention policy and procedures during the child care enrollment process. Child care administrators and staff are required to understand and adhere to the policy and procedures. Consider utilizing the Sample Child Care Provider Expulsion Prevention Policy CCA-1277A provided by the Department to support the creation of an internal policy and procedure.

3. Obtain a completed About Me Questionnaire CCA-1200A or a profile used by the provider that captures the same content, signed by each parent

a. If the parent declines to complete the questionnaire, explain the importance of collecting this information to best support the child while in care, but keep the declined document in the child’s file.

b. Help the family with completing this questionnaire collaboratively, if needed.

c. Include the About Me Questionnaire in the child’s file on or before the first day of attendance.

d. Review the form for completeness and share the form with the child’s primary teacher. Notify the parent of any questions regarding information on the form.

e. Utilize information contained within the About Me Questionnaire to meet the needs of each individual child.

f. Obtain a resubmitted About Me Questionnaire, at a minimum, annually. The Provider is encouraged to update the form after any change in the child’s home and school life, to best support the changing developmental needs of the child.

4. Provide parent, upon enrollment, with an AZ STEPS Preschool Suspension and Expulsion Prevention Support for Families Flyer CCA-1275A.

5. Submit an Arizona Suspension and Expulsion Support Request form through azccrr.com at the first sign of challenging behaviors to promote early intervention.

6. Notify the parent of the child’s challenging behaviors in the classroom. Consider notifying the parent in written documentation.

7. Collaborate with the parent to identify and address any physical, cognitive, speech, social/emotional, or behavioral health needs that may arise in the child care setting. Services and supports may be available through AZ STEPS or the Department, the AzEIP, DDD, First Things First’s Quality Initiatives (Smart Support and Inclusion), and the DCS, where applicable.

Effective date: 10/1/2021 Page 5 of 10 http://azregistry.org http://azccrr.com

8. Identify opportunities to promote the child’s social, emotional, and behavioral development upon first display of challenging behaviors:

a. Review the About Me Questionnaire in the child’s file to see whether there are any steps or approaches advised by the parent to resolve the challenging behaviors.

b. Meet with the parent to discuss the child’s challenging behaviors and determine ways to meet the child’s needs, promote positive behavior, and decrease the identified challenging behaviors.

9. Complete an Arizona Suspension and Expulsion Support Request form to initiate additional resources from a Resource Consultant. This form can be completed through the State’s CCR&R by either:

a. Calling 1-800-308-9000 Option 2; or

b. Visiting azccrr.com and submit a request form available on the CCR&R homepage.

10. Collaborate and maintain frequent and open communication with the parent, the Resource Consultant, the Department and other professionals with expertise in child development, mental health/behavioral health, and the inclusion of children with special needs, including the AzEIP, DDD, and the DCS. Discuss any social/ emotional, developmental or behavioral health needs, as well as safety issues as they arise, for purposes of preventing a suspension or expulsion.

11. Participate in a collaboration meeting and develop an Action Plan, if deemed necessary by the AZ STEPS Resource Consultant.

12. Continue collaboration with the Resource Consultant and/or other professionals with expertise in child development, mental/behavioral health, and/or the inclusion of children with special needs to access supportive services such as:

phone consultation, mental/behavioral health consultation, technical assistance, linkage to other appropriate services (referrals), professional development opportunities (trainings), in-person site visits/observation to support the provider and parent, and any other services or support deemed necessary by the Resource Consultant to maintain the child’s continuous enrollment with the current child care setting. On an as needed basis:

a. Maintain communication with the parent and Resource Consultant regarding how implementation of the agreed upon strategies in the Action Plan are impacting the child’s behavior and functioning in the child care setting. Identify and communicate positive outcomes, any roadblocks, and collaborate to problem solve how to move forward.

b. Communicate with the child’s parent any changes regarding agreed upon strategies in the Action Plan, update the Action Plan.

c. Schedule a follow up collaboration meeting to discuss progress and to determine any other changes in order to maintain the child’s enrollment at the current child care setting.

B. Preventing Suspension or Expulsion: AZ STEPS Responsibilities The AZ STEPS Resource Consultant shall:

Effective date: 10/1/2021 Page 6 of 10

1. Contact the provider within two business days upon receipt of an Arizona Suspension and Expulsion Support Request form to gather any additional information needed to identify the behavioral challenges, determine interventions that will be most effective and appropriate to support the provider and maintain the child in the current child care setting, and educate the provider on this Policy.

2. Ask the child care provider if they have communicated current challenging behaviors and concerns with the parent.

3. Verify the child’s primary teacher has taken and completed Foundations I training. If the teacher has not taken the training, communicate to the child care provider that the training must be completed, and offer support to register for and complete the training.

4. Ask if the child’s primary teacher submitted a request for Technical Assistance for additional support.

5. Offer available and applicable resources and support to the provider such as phone consultation, assistance with linkage to other appropriate services (referrals), educating the provider about professional development opportunities (trainings) and technical assistance, in-person observation/site visits to support the provider and parent, and other services deemed necessary and appropriate by the Resource Consultant to support the continual enrollment of the child in the current child care setting, including additional training or supports focused on staff wellness.

6. Contact the parent to explain the AZ STEPS program and provide a Service Consent Form CCA-1271A.

a. If the parent consents to services in the form CCA-1271A, the Resource

Consultant will obtain a copy of the form, complete the intake process, and offer resources and support.

b. If the parent declines services in the form CCA-1271A, the Resource Consultant will obtain a copy of the form and no longer provide services to the family. However, the Resource Consultant will continue to support the child care provider and teacher.

7. Collaborate with the provider to schedule a meeting with the child’s teacher to complete the teacher section of the intake.

8. Consider whether a collaboration meeting is necessary, and if so, collaborate with the provider to schedule the meeting and develop an Action Plan. It is recommended this meeting take place in person; however, it can be over the phone or a virtual platform if needed.

9. Maintain open communication with DES Contracted child care providers, parent, CCA Contracts Unit, CCA Program Development Unit, Eligibility Specialists and Certification Specialists, as well as other professionals with expertise in child development, mental/behavioral health, and/or the inclusion of children with special needs. This may include professionals from the AzEIP, DDD, and the DCS, where applicable.

Effective date: 10/1/2021 Page 7 of 10

10. Continue to provide regular support to the provider and/or parent as needed until the risk of suspension and/or expulsion has been eliminated.

11. Assist the provider, if needed, in scheduling a follow up collaboration meeting to discuss progress and to determine any other changes in order to maintain the child’s enrollment at the current child care setting.

C. Notification of Expulsion

1. The Provider shall:

a. Notify the parent in writing, at least five business days prior to the child’s disenrollment after all resources and support mechanisms in Sections A and B, and listed in the Action Plan have been implemented and the provider’s decision is to expel the child. Maintain a copy of the written notice of expulsion in the child’s file which shall be made available to review, upon request from the Department or AZ STEPS. The provider may provide CCR&R information on the written notice to support the parent with finding alternative child care.

b. Complete a Notification of Child Care Expulsion to provide notice to DES and AZ STEPS within two business days after notifying the parent. This form can be completed through the State’s CCR&R by either:

i. Calling 1-800-308-9000 Option 2; or

ii. Visiting azccrr.com via CCR&R.

2. The Resource Consultant shall:

a. Contact the parent by phone within two business days of being notified about the impending expulsion to discuss the last date child care services will be provided and the need to select a new quality provider.

b. Coordinate with the parent to find a new provider and transition the child after the Resource Consultant has received notification of expulsion from the provider.

c. Advocate for a warm-hand off to a new child care provider. Assist the provider in maintaining the child in their care temporarily by providing support services with little to no interruption in services.

d. Refer the parent to the CCR&R to locate a new child care provider and other appropriate services.

e. Advise the parent to contact the assigned CCA Eligibility Specialist.

D. Unusual Circumstances: Immediate Causes for Suspension or Expulsion

1. Suspending or expelling the child without waiting the otherwise required five business day period, or before alternate child care arrangements are secured, may only occur in the following unusual circumstances:

a. An incident occurs that could cause a serious injury or death to the child, staff members, or other children in care.

b. The parent has failed to pay the required DES co-payments or additional fees.

2. The Provider shall:

Effective date: 10/1/2021 Page 8 of 10

a. Notify the parent in writing immediately of the cause for immediate suspension and/or expulsion.

b. Complete a Notification of Child Care Expulsion within two business days of suspending or expelling a child. This form can be completed through the State’s CCR&R by either:

i. Calling 1-800-308-9000, Option 2; or

ii. Visiting azccrr.com via CCR&R.

3. The Resource Consultant shall:

a. Contact the Child Care Provider upon receipt of the Notification of Child

Care Expulsion phone and/or email to offer support deemed necessary and gather feedback and data regarding alternative actions or steps that can be taken to result in more positive outcomes.

b. Contact the parent whose children have been expelled by phone and/or email to gather feedback and data regarding alternative actions or steps that can be taken to result in more positive outcomes.

c. This information will be used to improve the DES Suspension and Expulsion Prevention Policies and Procedures.

E. Corrective Action Plan:

When found non-compliant with this policy, the Department reserves the right to require the provider or facility owner to attend an approved training or identify other actions as appropriate to the situation through a CAP.

1. AZ STEPS Resource Consultant Shall:

a. Identify the provider responsibility in Section V(A) through (D) of this

Suspension and Expulsion Prevention Policy, in which the child care provider is non-compliant.

b. Complete the Non-Compliance for Expulsion Policy form to notify DES/CCA if compliance is not met on the final due date.

2. DES/CCA Shall:

a. Review the Non-Compliance for Expulsion Policy submitted by the AZ

STEPS Resource Consultant.

b. Review, verify and approve the Non-Compliance for Expulsion Policy form submitted by the AZ STEPS Resource Consultant and identify training or other actions as appropriate to the situation.

F. Other Circumstances:

A child will not be expelled if a child’s parent does any of the following:

a. Files a complaint regarding alleged violations of regulatory requirements;

b. Reports alleged child abuse or neglect at the child care site; or

c. Questions a child care provider regarding policies and procedures.

Effective date: 10/1/2021 Page 9 of 10

VI. RELATED INFORMATION

DCS Supports and Services: Children involved with the DCS have additional services and supports that may be initiated through their DCS Specialist. These services include various options for in-person support in the classroom to help work through challenging behaviors in addition to the support offered by the AZ STEPS program.

VII. FORMS INDEX

CCA-1277A Sample Child Care Provider Expulsion Prevention Policy CCA-1200A About Me Questionnaire CCA-1275A Preschool Suspension and Expulsion Prevention Support for Families CCA-1276A Action Plan CCA-1271A Service Consent Form

Effective date: 10/1/2021 Page 10 of 10

CCA-1277A FORENG (11-20) Page 1 of 2

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DEPARTMENT OF ECONOMIC SECURITY

Your Partner For A Stron9er Arizona

SAMPLE CHILD CARE PROVIDER EXPULSION PREVENTION POLICY

Purpose The purpose of this Sample Expulsion Prevention Policy is to help guide early childhood providers in developing the required internal policy and procedure for preventing suspension and expulsion in child care settings. An internal policy and procedure can help ensure the support of families and early childhood programs in preventing suspensions and expulsion in early childhood settings.

In order to receive federal funding, states are required to implement policies to prevent suspension, expulsion and denial of services due to behaviors of children in child care programs, and to provide information and support about age-appropriate social-emotional and positive behavior interventions and models.

Research demonstrates that preschool expulsions are linked to:

• Missed opportunities to learn, socialize with other children and interact with positive adult role models.

• Risk of developing ongoing behavioral problems and negative views about learning, school, teachers, and the world around them which can lead to greater challenges later in life.

• Unaddressed mental health needs that can result in challenging behaviors and other long term effects.

• Therefore, developing an internal policy and procedure to prevent suspension and expulsion that is shared with all early childhood staff and families helps support continual enrollment and positive social and emotional development in children.

Sample Expulsion Prevention Policy

We believe that all domains of learning are supported during play and through nourishing, positive, interactions with adults and peers. One of the fundamental responsibilities of our program is to further the social and emotional development of children in our care. The preschool age is a crucial time for children to learn how to regulate social and emotional skills, such as feelings, thoughts, attention, and behavior. Part of children’s social development is learning how to interact with their peers and other adults. We encourage interactions between children and their teachers to help them learn to form relationships.

We know that when children are provided opportunities and guidance to develop, learn, and practice self-control and other social and emotional skills, it gives them the foundation necessary for academic and life success. Developing social and emotional skills also requires communication between providers and caregivers in how to support the child in their learning process.

We support children’s development and work diligently to prevent expulsion through:

Our Environment

• Staff regularly observe the classroom environment and the children as they interact in it to ensure it promotes healthy social interactions (ex. activities are made available long enough for all children to participate)

• We develop schedules that meet the needs of children to ensure transitions throughout the day are smooth and to avoid long periods of wait time

• We are flexible in our schedule and follow the interests of the children’s cognitive, physical, and biological needs

• We provide children with materials and engage them in activities that are appropriate for their age and respectful to them as individuals

See page 2 for USDA/EOE/ADA disclosures

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DEPARTMENT OF ECONOMIC SECURITY

Your Partner For A Stron9er Arizona

CCA-1277A FORENG (11-20) Page 2 of 2

Our Teachers

• Teachers make an effort to communicate daily or weekly (in-person, phone, email, etc.) to parents on their child’s development, in particular to identify and address any social, emotional, behavioral, or health issues that may arise

• Encourage peer relationships by creating social opportunities and working with children to resolve conflict

• Assist children to put words to their emotions (ex. “Emily, I can tell you were mad when James took your block.”)

• Use positive methods of support and redirect the child’s behavior by providing alternative actions and behaviors that are acceptable

Our Families

• Communicate regularly with staff to ensure consistency in guidance between home and school

• Partners with us and allow us time to work with all children, including those needing higher levels of support

• Understand and acknowledge that we do not expel children as they are learning skills, and understand that we strive to serve individual needs while ensuring the safety of young children

• When applicable, partner with experts in social and emotional skill development to help give a child the best foundation for academic and life success

Our Children

• Develop confidence and self-efficacy

• Develop skills to help them regulate their behaviors and emotions

• Participate in play and activities to learn social and emotional skills

• Learn how to resolve conflict in a healthy manner (using appropriate words instead of physical harm)

Thank you for choosing to allow our staff to support your child’s development. We are committed to each child’s development and success, and we do not exclude or dismiss children from our program because of concerns with behavior. Behavior concerns tell us that children need more time, support and practice to develop their social and emotional skills. When serious concerns arise, we will partner with parents and professionals who specialize in supporting children’s social and emotional health. On rare occasions, we may work with families to seek the best care for their child if all parties agree that our program can no longer meet the needs of an individual child.

Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact 602-542- 4248; TTY/TDD Services: 7-1-1 • Disponible en español en línea o en la oficina local.

CCA-1200A FORFF (10-20) Page 1 of 2 ARIZONA DEPARTMENT OF ECONOMIC SECURITY Child Care Administration

ABOUT ME QUESTIONNAIRE

This confidential questionnaire is to help your child care provider support the growth and development of your child while creating a safe, stable and healthy environment for all children. By providing complete information about your child, you will be assisting us in creating a positive experience for your child while in child care. Confidentiality is a vital component in the child care setting. Therefore, this questionnaire is only allowed to be shared with the child care director and/or owner, and the child’s primary teacher, unless pre-approved by the parent/guardian.

Instructions: This questionnaire is to be completed by a parent/guardian and must be on file at the child care facility on or before a child’s first day of attendance. Additionally, this questionnaire should be updated when there are significant changes in the child’s care and/or annually. A copy should be shared with the child’s teacher to support the care of your child. If additional space is needed, attach a separate sheet of paper.

Child’s Name: Date of Birth:

Parent/Guardian completing this form:

What is your preferred method of communication? (Email/Phone/Text)

Provider/Center Name:

Has your child attended child care in the past? Yes No

If yes, what type of setting(s) was your child in? (Family child care, group care, etc.)

What did you like most about your child’s previous child care setting?

What did you like the least?

What is important to you about your child’s care?

Who is important to your child?

Does your child prefer to play alone or with other children? Alone Other Children

Does your child have a favorite toy or comfort object? Yes No

If yes, what?

What is your child’s current sleep schedule?

Does your child fall asleep easily? Yes No

What is his/her mood upon awakening?

What does your child like?

What does your child dislike?

Special things you say or do to comfort your child are:

See page 2 for EOE/ADA disclosures

CCA-1200A FORFF (10-20) Page 2 of 2

How do you know when your child is:

Happy:

Sad:

Mad:

Tired:

Other:

How does your child react when:

Something unexpected happens:

Something happens he/she doesn’t like:

He/She is scared:

Other:

Does your child have any health issues? Yes No If yes, please explain:

Has anything happened recently in your child’s life that might have an effect on him/her? Yes No Events at home often influence a child’s behavior, for example: changes in the family, such as a new sibling, separation or divorce, or moving to a new home. Knowing about these transitional times will allow us to provide special attention, understanding, and care that your child needs.

If yes, please explain:

Is there anything else you would like to share about your child that you feel would help us create a positive environment and relationship with your child?

Is your child in Foster Care? Yes No If yes, please list the Case Manager’s Name and Contact Information:

(Initial) Parent/Guardian declines to complete this Questionnaire.

Parent/Guardian Signature: Date:

Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact 602-542-4248; TTY/TDD Services: 7-1-1 • Disponible en español en línea o en la oficina local

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DEPARTMENT OF ECONOMIC SECURITY

Your Partner fur A Stron9er Arizona

PRESCHOOL SUSPENSION & EXPULSION

PREVENTION SUPPORT FOR FAMILIES

(For children ages birth through 12 years old)

HAVE YOU BEEN ASKED TO…

◦ Pick up your child early from child care due to challenging behaviors?

◦ Not return to the child care site for several days?

◦ Reduce the number of hours your child attends child care?

These are all examples of child care expulsion.

DID YOU KNOW?

◦ The primary goal of early education is to launch children on their educational journeys so they can succeed in elementary school and beyond

◦ Preschool-age children are expelled at three times the rate of children in kindergarten through 12th grade. This practice deprives young children of the benefits of early childhood education and may leave unaddressed mental health issues that can result in challenging behaviors and other long term effects

◦ An early childhood mental health consultation can reduce behaviors that may lead to expulsions

WHY IS EXPULSION A CONCERN?

Research shows that preschool expulsions are linked to:

◦ Missed opportunities to learn, socialize with other children and interact with positive adult role models

◦ A risk of developing ongoing behavioral problems and negative views about learning, school, teachers, and the world around them, which can lead to greater challenges later in life

High expulsion rates are also an indicator that parents and caregivers need support in providing positive social and emotional opportunities for children to lay the foundation for all learning, future relationships and school readiness.

WHAT’S NEW?

Arizona Department of Economic Security (DES) Expulsion Prevention Services are now offered through AZ STEPS!

Families working with AZ STEPS can receive suspension and expulsion support and resources from a DES Contracted Resource Consultant by completing an Arizona Suspension and Expulsion Support Request Form.

WHAT IS AZ STEPS?

Arizona Statewide Training and Technical Assistance for Expulsion Prevention

WHY AZ STEPS?

AZ STEPS provides resources, support and training to help child care providers prevent suspensions and expulsion while strengthening their ability to support all children! AZ STEPS helps parents and teachers understand children's behaviors and how teaching social-emotional skills can help prepare them for social and academic success.

HOW CAN AZ STEPS HELP? AZ STEPS OFFERS:

◦ Online training that covers behavior, trauma, and social-emotional development for families and caregivers

◦ Resources and support to help prevent expulsion from happening in the first place by working with parents and childcare providers to promote a child’s success

◦ Mental Health consultations for families, teachers, and administrators to help meet the needs of the child

HOW TO ACCESS SUPPORT?

If you notice your child exhibiting challenging behaviors, or you believe your child is at risk for suspension or expulsion, submit an Arizona Suspension and Expulsion Prevention Support Request through Arizona Child Care Resource and Referral (CCR&R) by visiting azccrr.com or by calling 1-800-308-9000 (option 2), Monday- Friday 8 am-6 pm and Saturday 8 am-12 pm.

If you are interested in training or additional support for your family, please contact Jennifer Atkari-Benavides at

(602) 633-8730 or JAtkari@swhd.org.

Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact 602-542-4248; TTY/TDD Services: 7-1-1 • Disponible en español en línea o en la oficina local. CCA-1275A FLYENG (10-20) http://visiting azccrr.com mailto:JAtkari%40swhd.org?subject=

CCA-1276A FORFF (6-21) ARIZONA DEPARTMENT OF ECONOMIC SECURITY

Child Care Administration

ACTION PLAN

Child Care Provider Name:

The Action Plan can be completed in a meeting with the AZ STEPS Resource Consultant, child’s parent, primary teacher, director and/or owner, if deemed necessary by the Resource Consultant. The Action Plan may be edited during consultation and collaboration with the Resource Consultant.

Name of Child: Date:

Classroom: Age: Date of Birth:

Action Plan meeting participants:

Challenging behavior(s) identified:

Strategies to decrease challenging behaviors:

Time Frame and key milestones for implementation of strategies:

Date of next meeting (if needed):

SIGNATURES

Parent/Guardian: Date:

Center Director/Owner: Date:

Teacher: Date:

FOLLOW-UP

Results of Strategies:

Date of next meeting (if needed):

Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact

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CCA-1271A FORFF (10-21) AZ STEPS

Small Steps…Big Impact!

Arizona Statewide Training and Technical Assistance for Expulsion Prevention System Supported by

•,•! southwest

• human development Creating a Positive Future .for Young Children

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DEPARTMENT OF ECONOMIC SECURITY

Your Partner fur A Stronger Arizona

SERVICE CONSENT FORM

AZ STEPS has received an Arizona Suspension and Expulsion Prevention Support Request or Notification of Expulsion regarding your child. Please review, sign and return to the AZ STEPS Resource Consultant within two

(2) business days to ensure timely service delivery and collaboration.

X I have been educated by an AZ STEPS Resource Consultant or Child Care Provider on the AZ STEPS program and all services offered to families and child care providers before I was provided the Service Consent Form.

X I understand a Resource Consultant may be observing and interacting with my child in the child care setting. I also understand that the Resource Consultant and child care provider may exchange information about my child in their efforts to understand and address my child’s needs and to enhance the overall quality of the child care program.

X I understand that anything discussed between the Resource Consultant and the provider, my child, or myself is confidential, and protected by law. State and Federal laws indicate the following exceptions to the confidentiality policy: suspected child abuse and neglect, harm to self, or imminent harm to others.

X I understand that I may revoke the right to participate in the AZ STEPS Program at any time. I will submit a written request to AZ STEPS that will include my signature. The revocation does not include any information that has been shared between the time that I gave permission to share information and the time it was cancelled.

I understand that the Service Consent Form expires one year from the date it is signed, unless otherwise indicated by myself.

I Consent to Services

I Decline Services

Name of Child Child’s Date of Birth Parent Phone Number

Name and Address of Child Care Site

Parent/Guardian Name (please print) Parent/Guardian Signature Date

Name of Resource Consultant Phone Number

Funding provided by the Arizona Department of Economic Security Child Care Administration through the Federal Child Care and Development Block Grant (CCDBG).

Equal Opportunity Employer / Program • Auxiliary aids and services are available upon request to individuals with disabilities • To request this document in alternative format or for further information about this policy, contact

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