Voluntary Prekindergarten Provider Monitoring Tool

Transcription

1 Voluntary Prekindergarten Provider Monitoring Tool Program Assurance Specialist Information Specialist Name: Time in: Time out: Specialist #: Fax #: Specialist Date: Program Year: School Year Summer Program Name: Site Contact Information Phone Number: Fax Number: Provider ID: Program Address: City: Zip Code: Address: Hours of Operation: Attendance Month in Review: Owner/Operator: Director: Site Data Provider Type: Licensed Child Care Center Licensed Exempt Licensed FCCH Large FCCH Agreement Type: SR VPK Provider maintains applicable insurance: Liability Insurance Expiration Date: Workers Compensation Expiration Date: N/A Reemployment Compensation: N/A Provider on Probation: Improvement Plan Selected: Gold Seal Expiration: N/A Accreditation Expiration: N/A Provider License: Capacity: License Expiration Date:

2 Director on site: Director on VPK application: Director Credentials If no, name of director: If no, provider completed new VPK 10 Director Credential Expiration Date: VPK Endorsement: VPK Exempt: Curriculum being used: Edition: If a VPK POP must use approved VPK curriculum Curriculum Copy of selected curriculum: Attendance Reporting Sign in/out sheets & enrollment/attendance certification completed accurately (month in review) Sign in/out sheets for the current month accurately reflect children present Student Attendance and Parental Choice Certificate appears to be in compliance Short Form Long Form Child Certificate of Eligibility completed Files compliant with VPK Provider Contract record maintenance requirements Instructor/Substitute Name as on VPK-11A: Classroom Observations Secondary/Substitute Name as on VPK-11A: Classroom/instructor credentials validated:

3 Classroom Observations Instructor/Substitute Name as on VPK-11A: Secondary/Substitute Name as on VPK-11A: (Classroom/instructor credentials validated: Instructor/Substitute Name as on VPK-11A: Classroom Observations Secondary/Substitute Name as on VPK-11A: (Classroom/instructor credentials validated: Instructor/Substitute Name as on VPK-11A: Classroom Observations Secondary/Substitute Name as on VPK-11A: Classroom/instructor credentials validated:

4 Assessment Implementation Criteria Met Not Met N/A Evidence Provider has implementated the pre- and/or postassessment as required. Pre-assessment date administered: Post-assessment date administered: Providers on Probation (ONLY) Criteria Met Not Met N/A Evidence Provider demonstrates compliance with the improvement plan submitted to the Department of Education (Complete Curriculum Improvement Plan Form OR Staff Development Form based on the providers selected improvement plan)

5 Was TA provided while onsite during monitoring? Technical Assistance Yes No What was the nature of the TA provided? Additional Comments Follow up Needed Please submit any follow up documentation on the portal in the folder marked Monitoring. OUTCOME In Compliance Not In Compliance Follow Up Required Due Date: Corrective Action Required Technical Assistance Required X Provider Signature: X Program Assurance Specialist Signature: Date: Date:

6 OVERALL COMPLIANCE OBSERVATIONS