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pdfU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
ADMINISTRATION FOR CHILDREN AND FAMILIES/ HEAD START BUREAU
OMB NO. 0980-0017
EXPIRES: 04/30/2008
HEAD START PROGRAM INFORMATION REPORT 2008–2009
REPORTING REQUIREMENTS
The annual Head Start Program Information Report (PIR) must be completed by all programs funded by the Federal
government to operate Head Start and Early Head Start programs. A separate PIR must be completed for each grant
holder and each delegate agency. Separate reports must also be completed for Head Start and Early Head Start
Programs. Programs operating a "combined" Head Start/Early Head Start are required to submit two reports.
DEADLINE: The 2009 PIR is due to Xtria no later than August 31, 2009.
Programs operating part-year options only are encouraged to submit their reports prior to this deadline.
NOW AS EASY AS 1- 2 - 3 …
1- COMPLETE YOUR PIR ON THE WEB
All programs are required to submit their PIR data electronically using the web-based PIR Reporting
system at https://www.pirweb.net. The web-based PIR system makes the reporting process faster and
more convenient, and gives program staff a password-protected means to submit the data. The online
reporting system includes all error checks and provides program level reports based on your 2009 data.
Alternative reporting using desktop PIR software will only be allowed in exceptional circumstances for
those programs that have no access to the Internet. Contact Xtria at (866) 517-1247 if you require
assistance with reporting.
2 - GUIDANCE AND REFERENCE MATERIALS
This copy of the 2009 report is provided solely as a reference as you prepare your program’s data for
submission. Additional guidance is provided in the 2009 PIR Users Guide which provides item-by-item
definitions of terms and instruction on completing report items. The Users Guide and other reference
materials are available for download at https://www.pirweb.net.
3 - COMPLETE ALL REQUIRED INFORMATION
Complete all questions in the PIR, unless otherwise indicated in the instructions for the item. Certain
items should be completed by “EHS” Programs only," “EHS and Migrant Programs only” and "Preschool
Head Start programs only."
o
Attention Migrant Programs: The term “migrant programs” includes only grants and
delegates funded by the Migrant and Seasonal Program Branch. When completing items for
“EHS and Migrant Programs only” report on children ages 0 through 2; when completing
items for “Preschool” age children, report on children age 3 and older. Look for this symbol
Migrant Programs for reminders of where special reporting rules apply.
Enter any comments regarding your responses to PIR items in the designated “Comments” box for the item or in
the “General Comments” section of the report. Every PIR submitted must be approved by a representative of
your agency. Enter the name of the approving official in the designated fields in the General Information section
of the report. Note: Programs are no longer required to fax or mail the signature page.
The Paperwork Reduction Act of 1995 (Public Law 104-13) Public reporting burden for this collection of information is estimated to average 4 hours
per response, including the time for reviewing instructions, gathering and maintaining the data needed and reviewing collection information. The
project description is approved under the Office of Management and Budget (OMB) control number 0980-0017 which expires April 30, 2008. An
agency may not collect or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB
control number.
CONTENT
General Program Information…………………………………….
3
Section A: Enrollment & Program Options………………..
Enrollment Year
Funded Enrollment
Actual Enrollment
Classes, Groups & Centers
Child Care
5
Section B: Program Staff & Qualifications……………………
Total Staff
Volunteers
Management Staff
Child Development Staff
Family & Community Partnerships Staff
13
Section C: Child & Family Services………………………..…
Health Services
Disabilities Services
Education
Family & Community Partnerships
19
Special Item: Program Equipment…………………………..
Transportation
Federal Interest in Head Start Facilities
30
___________________________________________________________________________________________________________
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General Program Information
2. DELEGATE NUMBER1
1. GRANT NUMBER
________
3. THE PROGRAM DESCRIBED IN THIS REPORT
___
IS A/AN:
("X" ONLY ONE): a) Head Start __ b) Early Head Start __ c) Migrant __
4. NAME OF PROGRAM:
5. ADDRESS LINE 1 :
6. ADDRESS LINE 2 :
7. CITY :
8. STATE :
10. PROGRAM'S PHONE NUMBER :
9. ZIP : _ _ _ _ _ - _ _ _ _
11. FAX
NUMBER
:
12. HEAD START DIRECTOR OR EARLY HEAD START DIRECTOR
a. Mr./Ms./Dr./etc.
b. First Name
c. Middle Initial
13. DIRECTOR'S E-MAIL :
d. Last Name
e. Sr./Jr./etc.
14. AGENCY’S E-MAIL :
15. AGENCY’S WEB SITE ADDRESS (IF APPLICABLE) :
16. NAME AND TITLE OF APPROVING OFFICIAL: Enter the name of the Agency Director, Executive Director or other individual
responsible for certifying that this form is the agency's authorized response. PLEASE PRINT.
a. Mr./Ms./Dr./etc.
b. First Name
c. Middle Initial
d. Last Name
e. Sr./Jr./etc.
_________________________________________________________________________________________________________
_
f. Title
AGENCY DESCRIBED IN THIS REPORT.
X only one
17. SELECT THE ONE PHRASE THAT BEST DESCRIBES YOUR AGENCY:
a.
GRANT THAT DIRECTLY OPERATES PROGRAM(S) AND HAS NO DELEGATES.
Includes grants that both directly operate programs and maintain central office staff.
Complete all sections of this report.
b. GRANT THAT DIRECTLY OPERATES PROGRAMS AND DELEGATES SERVICE DELIVERY.
Do not include data from delegates. Complete all sections of this report.
c. GRANT THAT MAINTAINS CENTRAL OFFICE STAFF ONLY AND OPERATES NO PROGRAM(S) DIRECTLY.
Complete "Program Information" (Items 1-20) Only.
d. DELEGATE AGENCY. Complete all sections of this report.
e.
GRANT THAT DELEGATES ALL OF ITS PROGRAMS; IT OPERATES NO PROGRAMS DIRECTLY AND MAINTAINS
NO CENTRAL OFFICE STAFF. Complete "Program Information" (Items 1-20) Only.
1
Use the Delegate ID field to identify Early Head Start programs in combined HS/EHS grants; combined EHS programs have a “CH” or “CI” in their
grant number. The combined EHS must report a Delegate ID Number of 200-299, by adding 200 to its current Delegate ID number (e.g., an EHS grant
would convert its "000" Delegate ID to "200," an EHS delegate “002” would report its Delegate ID as “202”).
___________________________________________________________________________________________________________
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GRANT HOLDERS ONLY
# of delegates
18. FOR GRANT HOLDERS ONLY, NUMBER OF DELEGATE AGENCIES.
(If the answer is zero, enter 0. If you selected 17.a or 17.d above, this answer must be 0.)
TYPE OF AGENCY.
X only one
19. SELECT THE ONE PHRASE THAT BEST DESCRIBES YOUR AGENCY:
a.
COMMUNITY ACTION AGENCY (CAA)
b. SCHOOL SYSTEM
c.
PRIVATE/ PUBLIC NON-PROFIT (Non-CAA) (e.g., church or non-profit hospital)
d.
PRIVATE/ PUBLIC FOR-PROFIT (e.g., for-profit hospital)
e.
GOVERNMENT AGENCY (Non-CAA)
f.
TRIBAL GOVERNMENT OR CONSORTIUM (American Indian/ Alaska Native)
AGENCY AFFILIATION.
X only one
20. SELECT THE ONE PHRASE THAT BEST DESCRIBES YOUR AGENCY:
a.
A SECULAR OR NON-RELIGIOUS AGENCY.
b.
A RELIGIOUSLY AFFILIATED AGENCY INSPIRED BY RELIGION, PROVIDING ESSENTIALLY SECULAR
SERVICES.
c.
A RELIGIOUS ORGANIZATION WITH PRONOUNCED RELIGIOUS CHARACTERISTICS OR A HOUSE OF
WORSHIP, PROVIDING ESSENTIALLY SECULAR SERVICES.
___________________________________________________________________________________________________________
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A. Enrollment & Program Options
ENROLLMENT YEAR.
Information provided in this report is based on families and children served during the 2008-2009 Enrollment Year.
Enrollment Year is defined as "the period of time, not to exceed twelve months, during which a Head Start program provides
center or home-based services to a group of children and their families."
Programs with full-year options should define the enrollment year based on the significant turnover that tends to occur in
conjunction with the beginning of the school year. Therefore, please define an enrollment year as a twelve-month period that
must begin between August 1 and September 15.
Programs with part-year options should use the first and last dates on which classes and/or home visits begin and end to
specify their Enrollment Year.
Migrant Programs Note the following supplemental rules:
Migrant programs may report both start and end dates either in the same calendar year or in different years, not to exceed a
12 month period.
Example 1: Enrollment Start date 4/25/08
Enrollment End date: 10/28/08
Example 2: Enrollment Start date 6/13/09
Enrollment End date: 8/26/09
Example 3: Enrollment Start date 8/22/08
Enrollment End date 5/19/09
Operating Period is the entire period in which the program operates, including the program's enrollment year and any days or
months when enrollees do not attend the program (for example, holidays and summer months).
This report should NOT include children and families enrolled for the first time who will begin in the next enrollment year.
1. YOUR ENROLLMENT YEAR: a. START DATE (MM/DD/YYYY)
b. END DATE (MM/DD/YYYY)
FUNDED ENROLLMENT BY PROGRAM OPTION.
Funded Enrollment is the total number of enrollees (children and pregnant women) your program was funded to serve
for the 2008-2009 enrollment year, regardless of funding source. Report the total number of enrollees funded to
participate in the Head Start program, including those paid for by non-ACF funds (e.g., state or other non-Federal funds).
Unless otherwise directed, enrollees include children and pregnant women.
NOTE: Programs that receive non-ACF funds as a supplement (i.e., to extend the hours of service for children/pregnant women)
should count those slots as ACF Funded. Only when services to enrollees are fully supported by non-ACF funds should they report
those participants as non-ACF Funded.
FUNDED ENROLLMENT.
Must be numeric
2. ACF FUNDED HEAD START OR EARLY HEAD START ENROLLMENT.
The number of children (and pregnant women for EHS programs) that you have been funded by ACF to serve, as
stated on the most recent Financial Assistance Award.
3.
NON-ACF FUNDED HEAD START OR EARLY HEAD START ENROLLMENT.
The number of enrollees funded by a source other than ACF who receive comprehensive services in compliance
with Head Start Program Performance Standards (e.g., slots funded by the state or local school district).
4.
TOTAL FUNDED HEAD START OR EARLY HEAD START ENROLLMENT FROM ALL SOURCES (A.2 through A.3 above).
___________________________________________________________________________________________________________
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Definition of terms used in the Funded Enrollment by Program Option table.
Average Annual Days refers to the number of days that the program served children during the enrollment year. Do NOT average
in days attended for pregnant women. Explain in "Comments" if necessary.
Home Visits refers to the visits made by home visitors in a home-based option for the purpose of assisting parents in fostering the
growth and development of their child. These visits may also be made to pregnant women in EHS programs.
Child Care Partners are arrangements with child care centers or family child care homes to provide services to Head Start
enrolled children. Services provided by the child care partners meet the Head Start Performance Standards. Examples include
partnering child care centers or family child care homes where Head Start children receive the full package of Head Start services
as well as child care. PIR questions regarding child care partnerships apply only to those providers with whom the Head Start or
Early Head Start program has made such an arrangement.
To Determine Average Annual Days:
Multiply the number of days per week your program operated by the number of weeks in your enrollment year. If the program includes more
than one center and each operates for a different number of days, determine the average number of days across centers (rounded to the nearest
whole number). For example, if one center operates 4 days a week and one operates 5 days a week, both for 32 weeks, the average number of
days equals (4 X 32) = 128; (5 X 32) = 160; (128 + 160)/2 = 144.
Full-day and Part-day Enrollment is based on the number of hours per day children spend in the Head Start center, even if nonACF funds contribute to the hours (e.g., Head Start and State Pre-K funds allow a program to operate full-day).
Early Head Start programs should include pregnant women where applicable in Column 1; do not include pregnant women in
Column 2.
Type of Program
5.
(1)
Funded Enrollment
(2)
Average Annual Days
(Children Only)
CENTER BASED PROGRAM - 5 DAYS PER WEEK
a. Full day enrollment (more than 6 hours per day).
b. Part day enrollment (6 hours or less per day).
(i.) Of those children reported in 5.b, the number enrolled in
DOUBLE SESSIONS.
6.
CENTER BASED PROGRAM - 4 DAYS PER WEEK
a. Full day enrollment (more than 6 hours per day).
b. Part day enrollment (6 hours or less per day).
(i.) Of those children reported in 6.b, the number enrolled in
DOUBLE SESSIONS.
7.
HOME-BASED PROGRAM – A program providing services primarily in
the child's home.
8.
COMBINATION PROGRAM – A program providing service in both a
center setting and in a home setting. (Refer to regulations on program
option, 45 CFR Part 1306.)
a.) The number of double session enrollments.
9.
FAMILY CHILD CARE -- Head Start or Early Head Start services
provided in a Family Child Care home.
10. LOCALLY DESIGNED OPTIONS. Include only options that have been
formally approved by ACF Headquarters to meet the particular needs
of children and families in their communities.
11. TOTAL. The total of Column 1 A.5-A.10, excluding double session
enrollments [A.5.b(i) and A.6.b(i)], must equal the TOTAL FUNDED
ENROLLMENT (A.4).
a) Total number of pregnant women reported in funded enrollment.
___________________________________________________________________________________________________________
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# of children
12. OF THOSE CHILDREN SERVED IN A CENTER-BASED PROGRAM, the number who received Head Start or
Early Head Start services at a child care center partner.1 (Include only those children served through a
partner organization; not those in your own program’s extended day or wrap-around care)
# of children
13. THE TOTAL NUMBER OF CHILDREN WHO WERE ENROLLED IN HEAD START OR EARLY HEAD START
1
PROGRAM OPTIONS THAT PROVIDED SERVICE FOR 8 OR MORE HOURS PER DAY.
1
Items A.12 and A.13 are based on the actual number of children who received the services, not on funded enrollment.
ACTUAL ENROLLMENT.
Actual Enrollment includes all children and, for Early Head Start programs only, all pregnant women who:
Have been enrolled in your program for any length of time provided they have attended at least one class or, for
programs with home-based options, received at least one home visit
Have dropped out or enrolled late, but have attended at least one class or, for programs with home-based options,
received at least one home visit
Participated in Head Start or Early Head Start programs and received the full range of Head Start services, regardless
of the funding source (ACF or non-ACF)
# of children/women
14. TOTAL ACTUAL ENROLLMENT.
Include preschool children, infants, toddlers and pregnant women in EHS programs.
# of children ONLY
15. TOTAL ACTUAL ENROLLMENT OF CHILDREN.
Include children in preschool programs, and infants and toddlers in EHS and Migrant programs only.
ACTUAL ENROLLMENT OF CHILDREN BY AGE.
16. Use the age of the child as of the date used by the local school system in determining eligibility for public school1.
a. Under 1 year
d. 3 years old
b. 1 year old
e. 4 years old
c. 2 years old
f. 5 years and older
1
Note: Children who are age-eligible to attend kindergarten next year are considered four year olds for PIR purposes, even if they
have already turned five at the time of the report.
ACTUAL ENROLLMENT OF PREGNANT WOMEN.
EHS PROGRAMS ONLY
# of women
17. Total actual enrollment of pregnant women.
18. Of pregnant women enrolled, the number who were under 18 years of age.
___________________________________________________________________________________________________________
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ACTUAL ENROLLMENT BY TYPE OF ELIGIBILITY.
Report each enrollee only once by primary category of eligibility.
The sum of Items A.19(a-d) must equal Item A.14 Total Actual Enrollment.
# of children/
pregnant women
19. Of the Total Actual Enrollment (A.14):
a. The number of children (and pregnant women in EHS programs) who were enrolled based on
receipt of public assistance (i.e., TANF or SSI).
b. The number of children (and pregnant women in EHS programs) who were enrolled based on
income eligibility (below 100% of the federal poverty line).
c. The number of children (and pregnant women in EHS programs) who were enrolled although their
families were over-income (above 100% of the federal poverty line) and were not eligible for
public assistance.
d. The number of children who were enrolled due to status as a foster child.
Eligibility Comments:
Comments are required if the number of over-income enrollees exceeds 10%.
PRIOR ENROLLMENT.
# of children
20. OF THE TOTAL ACTUAL ENROLLMENT OF CHILDREN (A.15),
a. The number of children who were enrolled in Head Start and/or Early Head Start for the second year.
Children should be counted here only if in their first year of Head Start or Early Head Start they were
enrolled for at least half of the time that classes were in session.
b. The number of children who were enrolled in Head Start and/or Early Head Start for three years or
more.
___________________________________________________________________________________________________________
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ACTUAL ENROLLMENT BY ETHNICITY & BY RACE.
Please read the instructions for reporting of ethnicity and race carefully.
Ethnicity and race category is determined according to the ethnicity or race that the family chooses.
Both ethnicity and race must be reported for all children (and pregnant women in Early Head Start programs).
1. First, report the total number of enrollees whose ethnicity is Hispanic or Latino in A.21.a (i) below and the total
number whose ethnicity is non-Hispanic in A.21.a (ii).
HISPANIC OR LATINO ORIGIN is defined as a person of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of their race.
2. 2.
Second, specify the race of all enrollees in A.21.b, regardless of their ethnicity.
For example, a Black Cuban child will be counted in the Ethnicity category as “Hispanic or Latino” and
counted in the Race category as “Black or African American.”
Example: A Head Start program whose actual enrollment of 20
children included 2 Black Hispanic, 4 White Hispanic and 14 Black
Non-Hispanic children should report the following:
A.21.a Ethnicity
(i) Hispanic or Latino
(ii) Non-Hispanic/Non-Latino
6
14
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
(viii)
0
0
16
0
4
0
0
0
A.21.b Race
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian/Pacific Islander
White
Biracial or Multiracial
Other
Unspecified
___________________________________________________________________________________________________________
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# of children/pregnant women
21. OF THE TOTAL ACTUAL ENROLLMENT (A.14), the number of enrollees in the following categories of
Ethnicity and Race:
a. ETHNICITY
The sum of A.21.a (i) and A.21.a (ii) must equal Total Actual Enrollment, A.14.
i)
ii)
b.
HISPANIC OR LATINO ORIGIN
NON-HISPANIC/NON-LATINO ORIGIN
RACE
The sum of A.21.b (i) through A.21.b (viii) must equal TOTAL ACTUAL ENROLLMENT, A.14.
i)
AMERICAN INDIAN OR ALASKA NATIVE. A person having origins in any of the
original peoples of North and South America or Central America, and who
maintains tribal affiliation or community attachment.
ii)
ASIAN. A person having origins in any of the original peoples of the Far East,
Southeast Asia, or the Indian subcontinent.
iii)
BLACK OR AFRICAN AMERICAN. A person having origins in any of the Black
racial groups of Africa.
iv)
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER. A person having origins in
any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
v)
WHITE. A person having origins in any of the original peoples of Europe, the
Middle East, or North Africa.
vi)
BIRACIAL/MULTI-RACIAL. A person of 2 or more races.
vii)
OTHER. A person reporting a race other than those listed. (Specify in
“Comments).
viii)
UNSPECIFIED. A person whose race is unknown or whose parents declined to
identify their race.
Race Comments:
Comments are required if any other races are reported in question A.21.b(vii)
ACTUAL ENROLLMENT BY PRIMARY LANGUAGE OF FAMILY AT HOME.
22 OF THE TOTAL ACTUAL ENROLLMENT (A.14), the number of enrollees using the following languages as their primary language at
home:
a. ENGLISH
g. NATIVE NORTH AMERICAN/ALASKA NATIVE
LANGUAGES
b. SPANISH
h. PACIFIC ISLAND LANGUAGES
(e.g., Palauan, Fijian)
c. NATIVE CENTRAL AMERICAN, SOUTH
i. EUROPEAN & SLAVIC LANGUAGES
AMERICAN & MEXICAN LANGUAGES
(e.g., German, French, Italian, Croatian,
Yiddish, Portuguese. Russian)
(e.g., Mixteco, Quichean)
d. CARIBBEAN LANGUAGES
j. AFRICAN LANGUAGES
(e.g., Haitian-Creole, Patois)
(e.g., Swahili, Wolof)
e. MIDDLE EASTERN & SOUTH ASIAN
k. OTHER (SPECIFY IN “COMMENTS”)
(e.g., American Sign Language)
LANGUAGES
(e.g., Arabic, Hebrew, Hindi, Urdu, Bengali)
f. EAST ASIAN LANGUAGES
l. UNSPECIFIED
(e.g., Chinese, Vietnamese, Tagalog)
(language is not known or parents declined
identifying the home language)
The sum of A.22.a through A.22.l must equal TOTAL ACTUAL ENROLLMENT, A.14.
Language Comments:
Comments are required if any other languages are reported in question A.22.k.
___________________________________________________________________________________________________________
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TURNOVER IN ENROLLMENT1.
Must be numeric
23. TOTAL NUMBER OF ENROLLEES WHO DROPPED OUT ANY TIME AFTER CLASSES OR HOME VISITS
BEGAN AND DID NOT RE-ENROLL.
a. Of the children/pregnant women who dropped out, the number replaced during the
enrollment year.
b. THE NUMBER OF CHILDREN WHO WERE IN CLASS LESS THAN 45 DAYS. Count from the date the child
began classes or, for home-based programs, the date home visits began. If the program operated
for less than 45 days, do not count children here who completed the program; enter 0.
c. THE NUMBER OF CHILDREN WHO RECEIVED SERVICES FROM HEAD START OR EARLY HEAD START
BUT LEFT THE PROGRAM BEFORE CLASSES BEGAN OR, FOR HOME-BASED PROGRAMS, BEFORE
RECEIVING A HOME VISIT. (These children should not be included in your Actual Enrollment
totals).
1
EHS programs should include pregnant women.
CLASSES AND GROUPS.
A Class is a group of children that functions as a single unit, including preschool, infants/toddlers, and mixed-age groupings.
Classes that share space should be counted as separate classes if they function as separate units for more than 50 percent of
the time. Count double sessions as separate classes and include them.
Double Session Classes are defined as two groups of children per day with ONE teacher. Count each session as a separate
class. For example, if a program had 5 classes that operated mornings and 5 that operated afternoons with the same 5
teachers, this would count as 10 classes.
Classrooms and Centers refer to actual physical space.
Classes Operated in a Child Care Center Partnership are Head Start/Early Head Start classes located in a partnering child care
center. Partner-operated classes are in addition to classes operated directly by Head Start or Early Head (not a subset of A.24).
24. TOTAL NUMBER OF CLASSES OPERATED DIRECTLY BY HEAD START OR EARLY HEAD START.
a.
OF THE TOTAL CLASSES, the number of double session classes operated. This must be evenly divisible by 2.
b.
Of the total classes operated by the Head Start/Early Head Start program, the number of classes in which at
least one teacher (excluding assistant teachers) has an Associate, Baccalaureate, or advanced degree in Early
Childhood Education or a degree in a related field.
25. TOTAL NUMBER OF CLASSES IN WHICH HEAD START OR EARLY HEAD START CHILDREN ARE SERVED THROUGH A
CHILD CARE CENTER PARTNERSHIP.
a. OF THE TOTAL CLASSES, the number of double session classes operated. This must be evenly divisible by 2.
b. Of the total Head Start/Early Head Start classes operated by a child care center partner, the number of classes
in which at least one teacher (excluding assistant teachers) has an Associate, Baccalaureate, or advanced
degree in Early Childhood Education or a degree in a related field.
26. TOTAL NUMBER OF FAMILY CHILD CARE HOMES THAT SERVE HEAD START OR EARLY HEAD START CHILDREN
(include only family child care homes staffed by HS/EHS employees and/or contracted teachers).
27. TOTAL NUMBER OF HOME-BASED SOCIALIZATION GROUPS OPERATED (for home-based children only).
Report the number of groups only, not the number of time the groups were held.
CENTERS.
# of centers
28. TOTAL NUMBER OF HEAD START OR EARLY HEAD START CENTERS (do not include family child care homes or
centers operated by child care partners).
___________________________________________________________________________________________________________
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CHILD CARE.
# of children
At
enrollment
29. THE NUMBER OF HEAD START OR EARLY HEAD START CHILDREN FOR WHOM FULL-YEAR AND/OR FULL-DAY
CHILD CARE IS NEEDED (EXTENDED OPERATIONS TO MEET THE NEEDS OF PARENTS WHO ARE WORKING OR IN JOB
TRAINING.) Include children whose families may already have found child care.
a. OF THE CHILDREN IN A.29, the number of children who received full-year/full-day services through Head Start
or Early Head Start (either directly or through a child care partner).
b. OF THE CHILDREN IN A.29, the number whose primary source of child care during that part of the day when the
child was not in Head Start or Early Head Start was one of the following: 1
(Count each child only once under their primary source of child care)
i. Received care at a family child care home1
ii. Received care at a child care center or classroom1
iii. Received care at home or at another home with a relative or unrelated adult
iv. Received care through a public school pre-Kindergarten program
v. Other (specify in "Comments")
1
Note: These child care arrangements are not affiliated with the Head Start or Early Head Start program or its partners.
Child Care Comments:
Comments are required if any other types of child care are reported in question A.29.b(v)
# of children
30. THE NUMBER OF HEAD START OR EARLY HEAD START-ENROLLED CHILDREN WHO RECEIVED A CHILD CARE
SUBSIDY (VOUCHER OR CONTRACTED SLOT), WHETHER THE CARE WAS PROVIDED THROUGH HEAD START OR
ANOTHER PROVIDER.
___________________________________________________________________________________________________________
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B. Program Staff & Qualifications
This section of the PIR should be used to describe all staff involved in your Head Start or Early Head Start program.
Head Start and Early Head Start programs must report separately. Grant holders and delegate agencies must also report staff
separately.
Staff includes all administrative, management, child development, content area, and support staff (such as custodians),
regardless of the funding source for their salaries.
Include contracted providers in Column 2. Contracted staff includes individuals who are not Head Start/Early Head Start
employees that the program has contracted with to provide an ongoing service. Contracted providers may include:
Disabilities Specialists and Mental Health professionals
Child care providers
Bus drivers
Family child care teachers/ providers
Include collaboration partners. Total staff should include the staff of any partner organizations that provide Head Start or
Early Head Start services as part of a partnership arrangement with your program. For collaboration partners report only staff
members who provide direct services.
Do not include consultants (individuals providing short-term services to the program), volunteers, student interns, or trainees.
Substitutes should not be counted unless they replaced a staff member for an extended period of time (e.g., due to turnover,
maternity or other extended leave).
TOTAL STAFF.
(1)
(2)
Head
Start/Early
Head Start
Staff
Contracted
Staff
1. TOTAL STAFF.
Number of all staff members, regardless of the funding source for their salary or
number of hours worked. Refer to the definition of staff, above, for additional
guidance.
a.
OF THE TOTAL STAFF, the number who are current or former Head Start parents.1
b.
OF THE TOTAL STAFF, the number who left during the year (include those who left
during the enrollment year and any non-operating summer months before the
enrollment year began). 1
i. OF THE STAFF WHO LEFT DURING THE YEAR, the number who were replaced during
the year
1
If known, report for contracted staff.
VOLUNTEER INFORMATION.
# of volunteers
2. THE TOTAL NUMBER OF PERSONS PROVIDING ANY VOLUNTEER SERVICES TO YOUR PROGRAM THIS
ENROLLMENT YEAR. Include both classroom and non-classroom volunteers. Count each volunteer
only once, regardless of the number of times volunteered.
a.
OF THE VOLUNTEERS, the number who are current or former Head Start parents.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
EDUCATION, EXPERIENCE & SALARY OF MANAGEMENT STAFF.
Complete the table below for executive staff and the individual staff persons with lead responsibility for each content area. Do not
use averages.
Enter the highest level of education completed by the staff member who holds the position. Report the education level for each
position using the following codes:
Level of Education Codes:
1 for GED or high school graduate
2 for Associate degree or at least two years of college completed
3 for Baccalaureate degree
4 for Graduate degree
Position
(1)
Level of
Education
(Enter code
1-4)
(2)
Number of
Years
in Position
(3)
Annual Salary1
(Regardless of
funding source)
(4)
Percentage of
Salary Funded by
Head Start2
3.a. Executive Director
3.b. HS, EHS or MHS Program Director
4. Child Development & Education Manager
5. Health Services Manager
6. Family & Community Partnerships Manager
Salary Comments:
Enter any comments here regarding high salary levels for any of the management salaries reported above (B.3 thru B.6)
1
Report the staff member’s full annual salary for this position, even if part (or all) of the salary is funded by a non-ACF source or if
the position is split between programs. Specify the actual salary per year. Do not annualize this figure if the staff member works less
than 12 months of the year.
2
Report the percentage of the staff member’s salary that is paid by Federal Head Start funds or program income. Enter the percentage
(%) do not enter the dollar amount. For example, the Program Director’s annual salary is $75,000. One-third of their salary is paid
for by the local school district and two-thirds is paid by Head Start. Report the full salary of “$75,000” in Column 3 and “66%” in
Column 4.
DISABILITY SERVICES MANAGER.
# of hours per week
7. ON AVERAGE, HOW MANY HOURS PER WEEK DOES THE DISABILITY SERVICES MANAGER SPEND
COORDINATING DISABILITIES SERVICES? If more than one person has lead responsibility for this role,
provide the combined number of hours per week devoted, on average, to coordinating disabilities
services.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
QUALIFICATIONS OF CHILD DEVELOPMENT STAFF.
Early Childhood Education Degree is an Associate, Baccalaureate or advanced degree in Early Childhood Education.
Related Degree is an Associate, Baccalaureate or advanced degree with a program of study that included six or more
courses in Early Childhood Education and/or Child Development.
Include all child development staff, both part-time and full-time, regardless of the funding source for their salaries.
Include contracted child development staff and the child development staff of partnering agencies that provide direct
services to Head Start and Early Head Start children.
Teachers Report all lead teachers and co-lead teachers in Column 1.
Assistant Teachers and Teacher Aides should be reported in Column 2.
Home-based Visitors. Report child development staff only in Column 3. (Do not include Family & Community Partnerships
staff who conduct home visits in this item; FCP staff are reported in Item B.22).
(1)
(2)
(3)
(4)
(5)
Teachers
8.
TOTAL NUMBER OF CHILD DEVELOPMENT STAFF
BY CATEGORY.
9.
OF THE CHILD DEVELOPMENT STAFF, (ITEM B.8)
the number with a degree or credential in the
following areas. Count each person only once by
the highest degree or credential held.
a.
b.
Assistant
Teachers
Home –
Based
Visitors
Family Child
Care Teachers /
Providers
Child
Development
Supervisors
(6)
HomeBased
Supervisors
An Associate degree in Early Childhood
Education or a related field.
i) Of child development staff with an
Associate degree, the number enrolled in a
Baccalaureate degree program in Early
Childhood Education or a related field.
A Baccalaureate degree in Early Childhood
Education or a related field.
c.
A Graduate degree in Early Childhood
Education or a related field.
d.
A Child Development Associate (CDA)
credential or state-awarded preschool,
infant/toddler, family child care or home-based
certification, credential, or licensure that meets
or exceeds CDA requirements.
10. OF THE CHILD DEVELOPMENT STAFF, (ITEM B.8)
the number who do not have degree:
a.
The number with a CDA or equivalent
credential, enrolled in an Early Childhood
Education or related degree program.
b.
The number without a CDA or equivalent
credential enrolled in an Early Childhood
Education or related degree program.
c. The number without a CDA or equivalent
credential enrolled in any type of CDA
training for preschool, infant/toddler or family
child care certification, or home-based
credential at the close of the operating period.
___________________________________________________________________________________________________________
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(1)
(2)
(3)
(4)
(5)
Teachers
Assistant
Teachers
Home –
Based
Visitors
Family Child
Care Teachers /
Providers
Child
Development
Supervisors
(6)
HomeBased
Supervisors
11. OF THE TOTAL CHILD DEVELOPMENT STAFF (ITEM
B.8), the number who are the staff of a child care
center partnering with Head Start or Early Head
Start.
Avg. Annual Salary 1
12. AVERAGE (ANNUAL) TEACHER SALARY BY LEVEL OF EDUCATION.
a.
An Associate degree in Early Childhood Education or related degree.
b.
A Baccalaureate degree in Early Childhood Education or related degree.
c.
A Graduate degree in Early Childhood Education or related degree.
d.
A Child Development Associate (CDA) credential or state-awarded preschool, infant/toddler,
family child care or home-based certification, credential, or licensure that meets or exceeds CDA
requirements.
1
Average annual salary: Report the average annual salary for teachers with each listed degree or credential type, even if part (or all) of their salaries
are funded by a non-ACF source. Report the actual average salaries for the teachers as reported in B.9(a-d) Column #1, not the pay scale for teachers
with this degree or credential.
AVERAGE SALARY OF DIRECT CHILD DEVELOPMENT STAFF
Avg. Annual Salary 1 Avg. Hourly Rate 2
13. Average Salary – Teachers (include all teachers as reported in B.8(1))
14. Average Salary – Assistant Teachers (include all as reported in B.8(2))
15. Average Salary – Home-based Visitors (include all as reported in B.8(3))
1
Average annual salary: Report the average annual salary for all staff in each position, even if part (or all) of the salary is funded by a non-ACF
source or if the position is split between programs. Calculate the average using actual salary per year -- Do not annualize this figure if staff members
work less than 12 months of the year.
2
Average hourly rate: Report the average annual salary as an hourly dollar amount. (For example, Average Annual of Salary of $30,000 in a 36
week (40hr/week) program equals an Average Hourly Rate of $20.83).
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
ETHNICITY & RACE OF CHILD DEVELOPMENT STAFF.
This item refers only to non-supervisory child development staff, which includes teachers, assistant teachers, home-based visitors,
and family child care teachers. Do NOT include supervisory staff (Child Development Supervisors or Home-Based Supervisors).
Please read the instructions for reporting of ethnicity and race carefully.
Both ethnicity and race must be reported for all non-supervisory child development staff.
1) First, report the total number of non-supervisory child development staff whose ethnicity is Hispanic or Latino in B.16.a (i)
below and the total number whose ethnicity is non-Hispanic in B.16.a (ii).
2) Second, specify the race of all non-supervisory child development staff in B.16.b, regardless of their ethnicity.
# of staff
16. OF THE CHILD DEVELOPMENT STAFF REPORTED IN ITEM B.8(1) - B.8(4), the number of staff in the following
categories of Ethnicity and Race:
a. ETHNICITY
i)
ii)
HISPANIC OR LATINO ORIGIN
NON-HISPANIC/NON-LATINO ORIGIN
b. RACE
i)
AMERICAN INDIAN OR ALASKA NATIVE. A person having origins in any of the original
peoples of North and South America or Central America, and who maintains tribal affiliation
or community attachment.
ii)
ASIAN. A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian subcontinent.
iii)
BLACK OR AFRICAN AMERICAN. A person having origins in any of the Black racial groups of
Africa.
iv)
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER. A person having origins in any of the
original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
v)
WHITE. A person having origins in any of the original peoples of Europe, the Middle
East, or North Africa.
vi)
BIRACIAL/MULTI-RACIAL. A person reporting 2 or more races.
vii) OTHER. A person reporting an ethnicity/race other than those listed. (specify in
“Comments).
viii) UNSPECIFIED. A person whose ethnicity is unknown or who has declined to identify
their ethnicity.
Race Comments:
Comments are required if any other races are reported in question B.16.b(vii)
LANGUAGE OF CHILD DEVELOPMENT STAFF.
This item refers only to non-supervisory child development staff, which includes teachers, assistant teachers, home-based visitors,
and family child care teachers. Do NOT include supervisory staff (Child Development Supervisors or Home-Based Supervisors).
# of staff
17. OF THE CHILD DEVELOPMENT STAFF REPORTED IN ITEM B.8(1) - B.8(4), the number who are proficient in a
language other than English.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
TEACHER TURNOVER.
This item applies to teachers only. Do not include assistant teachers, home-based visitors and family child care teachers.
# of teachers
18. THE NUMBER OF TEACHERS WHO LEFT YOUR PROGRAM DURING THE YEAR (including those who left
during the enrollment year and any non-operating summer months before the enrollment year).
19. OF THE TEACHERS WHO LEFT THE PROGRAM, the number who left for the following reasons:
a.
Higher compensation/benefits package in the same field (e.g., teacher left to school system)
b.
Change in job field
c.
Other (specify in "Comments")
20. NUMBER OF TEACHER VACANCIES IN YOUR PROGRAM THAT REMAINED UNFILLED FOR A PERIOD OF
3 MONTHS OR LONGER.
21. NUMBER OF TEACHERS HIRED DURING THE YEAR DUE TO TURNOVER. Do not count staff added due to
expansion.
Teachers Leaving the Program Comments:
Comments are required if other reasons for teachers leaving the program are reported in question B.19.c
QUALIFICATIONS OF FAMILY & COMMUNITY PARTNERSHIPS AND SUPERVISORY STAFF
Related Degree is an Associate, Baccalaureate or graduate degree with a major in such fields as Social Work, Sociology,
Psychology, Family Studies, Counseling, Family Development, Family Systems Theory, or Human Resources
Development.
Include all Family Service staff, both part-time and full-time, regardless of the funding source for their salary.
Include Family Service staff shared by Head Start and Early Head Start programs on the PIR of the program in which the majority
of their time is spent. (Explain in the general “Comments” section).
(1)
(2)
Family Workers
22.
Family & Community
Partnerships
Supervisors
a. Total number of Family & Community Partnerships staff.
b. Number of case managers and other staff members who work directly
with families (i.e., staff with a family caseload).
23. OF THE FAMILY & COMMUNITY PARTNERSHIPS STAFF, the number with
the following education: (Count each staff member only once by the
highest level of education completed).
a. GED or High School Diploma.
b. A related Associate degree.
c.
A related Baccalaureate degree.
d.
A related Graduate degree.
24. OF THE FAMILY & COMMUNITY PARTNERSHIPS STAFF WHO DO NOT HAVE A
DEGREE (B.23.a), the number in training leading to a related degree or credential.
FAMILY WORKER EXPERIENCE.
(a) < 1 year
(b) 1 to 5 years
(c) 6 to 10 years
(d) > 10 years
25. REPORT THE NUMBER OF FAMILY WORKERS
WITH THE FOLLOWING YEARS OF
EXPERIENCE IN THIS POSITION:
___________________________________________________________________________________________________________
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C. Child & Family Services
Selected items in this section require data to be reported at two points in time during the operating period – at the time of
enrollment and at the end of the enrollment year.
Report on ALL children enrolled during the course of the enrollment year in both columns, including drop-outs and late
enrollees.
At Enrollment refers to the status of the individual enrollee at the time of enrollment (i.e., include the status of children who
enrolled mid-year).
At End of Enrollment refers to the status of each enrollee at the end of his or her enrollment in the program (i.e., include the status
of enrollees who dropped mid-year).
HEALTH SERVICES
Health information should be obtained from the medical, dental, and immunization records of all children served for any length
of time during this operating period.
Medicaid enrolled means that the child has been officially certified as eligible for Medicaid paid services. It does not include
children who are thought to be eligible but have not been officially certified. Include children enrolled in Medicaid for any
length of time during this operating period.
SCHIP enrolled means that the child has been officially certified as eligible to receive services covered by the State Children's
Health Insurance Program, a federal-state partnership administered by the state under broad federal guidelines. The program
may be known as "SCHIP" or function under a different name. Include children enrolled in SCHIP for any length of time.
Refer to the Center for Medicare & Medicaid Services (CMS) http://www.cms.hhs.gov/Medicaid/StatePlans/map.asp to
determine the name of the program in your state.
Several items request information on child health status “within the operating period or within the last 12 months.” Note when
responding to these items that the intent is to determine the number of children who were up-to-date on their exams through the end of
the enrollment year; not at the time when the PIR is being completed, which is likely to be after the enrollment year has ended.
Example: A child whose physical exam was complete as of 8/1 in a program whose enrollment year is September 1 to May 15
would be up-to-date throughout the enrollment year; regardless of when the PIR report is being completed.
If applicable, use the "Comments" section to explain why children are not receiving medical, dental, or immunization services.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
HEALTH INSURANCE.
Please note:
In each column, the sum of C.1. and C.3. must equal the total number of children served (A.15).
In each column, the sum of C.2 (a-f) must equal the NUMBER OF CHILDREN WITH HEALTH INSURANCE
(C.1).
# of children
(1)
(2)
At
At end of
enrollment
enrollment year
1. NUMBER OF ALL CHILDREN WITH HEALTH INSURANCE. This cannot be greater than TOTAL
ACTUAL ENROLLMENT OF CHILDREN (A.15).
2. OF THE CHILDREN WITH HEALTH INSURANCE, the number of children whose primary
health insurance fits into the following categories: (If answer is zero, enter 0)
a. The number enrolled in Medicaid/EPSDT
3.
b.
The number enrolled in the State Child Health Insurance Program (SCHIP) if the State
operates a separate program
c.
The number enrolled in a combined SCHIP/Medicaid Program if the State operates a
Medicaid expansion
d.
The number enrolled in state-only funded insurance (for example, medically indigent
insurance)
e.
The number with private health insurance (for example, parent's insurance)
f.
The number with other health insurance not listed (for example, Tri-Care Military
Health/CHAMPUS, Indian Health Service, Migrant Health Service). Specify in
"Comments".
NUMBER OF CHILDREN WITH NO HEALTH INSURANCE
Other Insurance Types Comments:
Comments are required if other types of insurance were reported in question C.2.f. (Columns 1 and 2)
HEALTH INSURANCE OF PREGNANT WOMEN.
EHS PROGRAMS ONLY
The sum of C.4 and C.5 in each column must equal TOTAL ACTUAL ENROLLMENT OF PREGNANT WOMEN
(A.17).
(1)
At
enrollment
# of women
(2)
At end of
enrollment year
4. NUMBER OF PREGNANT WOMEN WITH AT LEAST ONE TYPE OF HEALTH INSURANCE.
5.
NUMBER OF PREGNANT WOMEN WITH NO HEALTH INSURANCE.
___________________________________________________________________________________________________________
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Medical Home is an ongoing source of routine, preventive and acute health care. Examples include family doctors, health clinics,
health maintenance organizations.
MEDICAL HOME.
# of children
(1)
(2)
At enrollment
At end of
enrollment
year
6.
NUMBER OF CHILDREN WITH AN ONGOING SOURCE OF CONTINUOUS AND ACCESSIBLE
ROUTINE, PREVENTIVE AND ACUTE MEDICAL CARE.
7.
NUMBER OF CHILDREN RECEIVING MEDICAL SERVICES THROUGH THE INDIAN HEALTH
SERVICE.
8. NUMBER OF CHILDREN RECEIVING MEDICAL SERVICES THROUGH A MIGRANT
COMMUNITY HEALTH CENTER.
MEDICAL SERVICES.
9.
# of children
NUMBER OF ALL CHILDREN WHO ARE UP-TO-DATE ON A SCHEDULE OF AGE-APPROPRIATE PREVENTIVE AND
PRIMARY HEALTH CARE, INCLUDING ALL APPROPRIATE TESTS AND PHYSICAL EXAMINATIONS, DURING THE
CURRENT OPERATING PERIOD OR WITHIN THE LAST 12 MONTHS. Include dropouts, re-enrolled children and
late enrollees if they have completed all required tests. Do not include children who are missing any of the
required tests. This cannot be greater than TOTAL ACTUAL ENROLLMENT OF CHILDREN (A.15).
a. OF THE CHILDREN REPORTED IN C.9, the number of children diagnosed within the current operating
period or within the last 12 months as needing medical treatment. Medical treatment is defined as any
service that is required to improve the physical condition of the child, including all forms of medical
follow-up.
b. OF THE CHILDREN DIAGNOSED within the current operating period or within the last 12 months, the
number of children who have received or are receiving medical treatment.
10. NUMBER OF CHILDREN WHO RECEIVED MEDICAL TREATMENT FOR THE FOLLOWING CONDITIONS:
# of children
a.
Anemia
e. Vision Problems
b.
Asthma
f. High Lead Levels
c.
Hearing Difficulties
g. Diabetes
d.
Overweight
IMMUNIZATION SERVICES.
Please note: In each column, the sum of C.11 and C.12 cannot be greater than the TOTAL ACTUAL
ENROLLMENT OF CHILDREN (A.15).
# of children
(1)
(2)
At
At end of
enrollment
enrollment
year
11. NUMBER OF CHILDREN WHO HAVE BEEN DETERMINED BY A HEALTH CARE PROFESSIONAL
TO BE UP-TO-DATE ON ALL IMMUNIZATIONS APPROPRIATE FOR THEIR AGE.
12. NUMBER OF CHILDREN WHO HAVE BEEN DETERMINED BY A HEALTH CARE PROFESSIONAL
TO HAVE RECEIVED ALL IMMUNIZATIONS POSSIBLE AT THIS TIME BUT WHO HAVE NOT
RECEIVED ALL IMMUNIZATIONS APPROPRIATE FOR THEIR AGE.
___________________________________________________________________________________________________________
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PROGRAM SERVICES FOR PREGNANT WOMEN.
EHS PROGRAMS ONLY
# of women
13. INDICATE THE NUMBER OF PREGNANT WOMEN WHO RECEIVED THE FOLLOWING WHILE ENROLLED IN
THE EHS PROGRAM:
a. Prenatal and postpartum health care.
b.
Mental health interventions and follow-up including substance abuse prevention and treatment.
c.
Prenatal education on fetal development.
d.
Information on the benefits of breastfeeding.
PRENATAL HEALTH.
EHS PROGRAMS ONLY
# of women
14. IN WHICH TRIMESTER OF PREGNANCY DID THE PREGNANT WOMEN SERVED ENROLL?
a. 1st trimester (0-3 months)
b. 2nd trimester (3-6 months)
c. 3rd trimester (6-9 months)
15. OF THE TOTAL NUMBER OF PREGNANT WOMEN SERVED (A.17), the number whose pregnancies were
identified as medically "high risk" by a physician or health care provider.
The sum of C.14.a through C.14.c must equal the TOTAL NUMBER OF PREGNANT WOMEN ENROLLED (A.17).
___________________________________________________________________________________________________________
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Dental Home is an ongoing source of routine, preventive, and acute dental care under the supervision of a dentist.
Examples include family dentists and dental clinics.
DENTAL HOME.
# of children
(1)
(2)
At
At end of
enrollment
enrollment
year
16. NUMBER OF CHILDREN WITH AN ONGOING SOURCE OF CONTINUOUS AND ACCESSIBLE
ROUTINE, PREVENTIVE AND ACUTE DENTAL CARE.
PRESCHOOL PROGRAMS ONLY1 # of children
DENTAL SERVICES.
17. NUMBER OF ALL CHILDREN, INCLUDING THOSE ENROLLED IN MEDICAID OR SCHIP, WHO HAVE
COMPLETED A PROFESSIONAL DENTAL EXAMINATION DURING THE CURRENT OPERATING PERIOD OR
WITHIN THE LAST 12 MONTHS (e.g., children examined during the summer months prior to the start
of the
class session). Include dropouts, re-enrollees, and late enrollees if they have completed a professional
dental examination. (This cannot be greater than TOTAL ACTUAL ENROLLMENT OF CHILDREN (A.15)).
a. OF THE CHILDREN EXAMINED (C.17), the number of children who received preventive care.
Preventive care includes fluoride application, cleaning, sealant application, etc.
b. OF THE CHILDREN EXAMINED (C.17), the number of children diagnosed within the current operating
period or within the last 12 months as needing treatment. Treatment includes restoration, pulp therapy,
or extraction. It does NOT include fluoride application or cleaning.
c. OF THE CHILDREN DIAGNOSED within the current operating period or within the last 12 months (C.17.b),
the number of children who have received or are receiving treatment. Treatment does NOT include
fluoride application or cleaning.
(i.) If C.17.c is less than 90% of children diagnosed as needing treatment (C.17.b), please specify the primary reason
below.
Check one primary reason: (specify any additional reasons in the general “Comments” section.
a.
Health insurance for children doesn’t cover dental treatment
b.
No dental care available in local area
c.
Medicaid not accepted by dentist
d.
Dentist does not treat 3 – 5 year old children
e.
Parents did not keep/make appointment
f.
Child dropped out before appointment date
g.
Appointment is scheduled for future date
h.
Other (please specify) ______________________________
1
Migrant Programs should report on children age 3 and older only when completing this item.
PREVENTIVE DENTAL SERVICES.
EHS AND MIGRANT PROGRAMS ONLY1
# of children
18. NUMBER OF CHILDREN WHO RECEIVED ORAL HEALTH SCREENINGS AS PART OF THE SERIES OF WELL-BABY
EXAMINATIONS (MANDATED BY MEDICAID/EPSDT).
19. NUMBER OF CHILDREN WHO RECEIVED A PROFESSIONAL ORAL EXAMINATION(S) DURING THE OPERATING
PERIOD OR WITHIN THE LAST 12 MONTHS.
1
Migrant Programs should report on children age 0 through 2 only when completing this item.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
DENTAL SERVICES FOR PREGNANT WOMEN.
EHS PROGRAMS ONLY
# of women
20. OF THE NUMBER OF PREGNANT WOMEN SERVED IN YOUR EHS PROGRAM (A.17), the number who received
a dental examination(s) and/or treatment within the last 12 months.
MENTAL HEALTH SERVICES
MENTAL HEALTH PROFESSIONAL.
# of hours
21. AVERAGE TOTAL HOURS PER OPERATING MONTH A MENTAL HEALTH PROFESSIONAL(S) SPENDS ON-SITE.
Report the number of hours spent (e.g., with children, parents and families, within or outside of the
classroom, and in training or consultation with the Head Start staff.)
MENTAL HEALTH SERVICES.
# of children
22. INDICATE THE NUMBER OF ENROLLED CHILDREN WHO WERE SERVED BY THE MENTAL HEALTH (MH)
1
PROFESSIONAL(S) IN THE FOLLOWING WAYS DURING THE OPERATING PERIOD :
a. Number of children for whom the MH professional consulted with program staff about the child’s
behavior/mental health.
(i) OF THE CHILDREN IN C.22.a, the number for whom the MH professional provided three or more
consultations with program staff during the operating period.
b. Number of children for whom the MH professional consulted with the parent(s)/guardian(s) about their
child’s behavior/mental health.
(i) OF THE CHILDREN IN C.22.b, the number for whom the MH professional provided three or more
consultations with the parent(s)/guardian(s) during the operating period.
c. Number of children for whom the MH professional provided an individual mental health assessment.
d. Number of children for whom the MH professional facilitated a referral for mental health services.
1
Do not include routine communication with staff or parents or routine child screenings and assessments in the counts above.
MENTAL HEALTH REFERRALS.
# of children
23. NUMBER OF CHILDREN WHO WERE REFERRED FOR MENTAL HEALTH SERVICES OUTSIDE OF THE HEAD START
PROGRAM DURING THE OPERATING PERIOD.
a.
OF THE CHILDREN REFERRED, the number who received mental health services during the operating
period.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
DISABILITIES SERVICES
LOCAL EDUCATION AGENCY (LEA).
Must be numeric
24. THE NUMBER OF LEAs (or Part C agencies for those programs serving infants and toddlers) IN YOUR HEAD
START OR EARLY HEAD START SERVICE AREA.
25. THE NUMBER OF LEAs (or Part C agencies for those programs serving infants and toddlers) THAT YOUR
PROGRAM HAS A FORMAL AGREEMENT WITH TO COORDINATE SERVICES FOR CHILDREN WITH DISABILITIES.
DISABILITY DETERMINATION.
# of children
26. THE NUMBER OF CHILDREN ENROLLED IN YOUR PROGRAM WHO WERE DETERMINED BY A MULTI-DISCIPLINARY
team to have a disability(ies) during the following time periods:
a. Prior to enrollment into Head Start or Early Head Start program for this enrollment year.
b. Between the time of enrollment and the end of the enrollment year.
27. TOTAL CHILDREN DETERMINED TO HAVE A DISABILITY(IES). Sum of C.26.a and C.26.b.
a.
OF THE TOTAL CHILDREN DETERMINED TO HAVE A DISABILITY, the number of children with an
Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP).
b.
OF THE TOTAL CHILDREN REPORTED IN C.27.A, the number determined eligible by the LEA or Part C
Agency to receive special education and related services or Part C services under the Individualized
Education Program (IEP) or Individualized Family Service Plan (IFSP).
28. THE NUMBER OF CHILDREN DETERMINED TO HAVE A DISABILITY WHO HAVE NOT RECEIVED SPECIAL EDUCATION
AND RELATED SERVICES.
PRIMARY DISABILITIES.
PRESCHOOL PROGRAMS ONLY1
(1)
29. DIAGNOSED DISABILITY
NUMBER OF CHILDREN
DETERMINED TO HAVE THIS
DISABILITY2
(2)
NUMBER OF CHILDREN
RECEIVING SPECIAL SERVICES
a. Health impairment
b. Emotional/behavioral disorder
c. Speech or language impairments
d. Mental retardation
e. Hearing impairment (including deafness)
f. Orthopedic impairment
g. Visual impairment (including blindness)
h. Learning disabilities
i. Autism
j. Traumatic brain injury
k. Non-categorical/developmental delay
l. Multiple disabilities (including deaf-blind)
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
Migrant Programs should report on children age 3 and older only when completing this item.
Report the number of children enrolled during this enrollment year whose primary or most significant disability was determined
by a multidisciplinary team to be one of the above. Report each child only once, by primary disability.
1
2
EHS AND MIGRANT PROGRAMS ONLY1
PART C OF IDEA.
# of children
(1)
(2)
Eligible
Receiving
for
services
services
30. THE NUMBER OF CHILDREN RECEIVING SERVICES UNDER PART C OF THE INDIVIDUALS WITH
DISABILITIES EDUCATION ACT (IDEA).
1
Migrant Programs should report on children age 0 through 2 only when completing this item.
EDUCATION
PRESCHOOL PROGRAMS ONLY1
TRANSITION ACTIVITIES.
31. THE NUMBER OF LOCAL SCHOOL DISTRICTS IN YOUR HEAD START SERVICE AREA.
a. OF THE NUMBER OF LOCAL SCHOOL DISTRICTS, the number with whom you have a formal agreement to
coordinate transition services for children and families.
32. OF THE NUMBER OF CHILDREN ENROLLED IN HEAD START AT THE END OF THE CURRENT ENROLLMENT
YEAR, the number that you project to be entering Kindergarten in the following school year.
1
Migrant Programs should report on children age 3 through 5 only when completing this item.
EHS AND MIGRANT PROGRAMS ONLY1
EARLY HEAD START TRANSITION.
# of children
33. THE NUMBER OF CHILDREN LEAVING EARLY HEAD START AND ENTERING:
a. Head Start program
b. Other early childhood program
1
Migrant Programs should report only on children age 0 through 2 who are leaving their program to go to another agency.
CURRICULUM, SCREENING, AND ASSESSMENT .
# of children
34. THE NUMBER OF ALL CHILDREN WHO COMPLETED ROUTINE SCREENINGS FOR DEVELOPMENTAL, SENSORY,
AND BEHAVIORAL CONCERNS DURING THE OPERATING PERIOD. Report on all children, including those
who dropped out of the program within 45 days.
a.
OF THE CHILDREN SCREENED, the number identified as needing follow-up assessment or
formal evaluation (e.g., to determine if a child has a disability).
35. WHAT CURRICULUM MODEL DOES YOUR PROGRAM USE AS ITS PRIMARY FOUNDATION? (Enter one/primary1 model only)
a. For center-based services: ___________________________________________________________________
b. For home-based services (if different): _________________________________________________________
36. WHAT INSTRUMENT DOES YOUR PROGRAM USE FOR DEVELOPMENTAL SCREENING? (Enter one/primary1 instrument only)
________________________________________________________________________________________
37. WHAT APPROACH OR TOOL DOES YOUR PROGRAM USE FOR ONGOING CHILD ASSESSMENT? (Enter one/primary1 tool only)
___________________________________________________________________________________________
a. Is this tool locally designed?
Yes ___________
No _____________
(X only one)
1
Additional models or instruments can be noted in the “General Comments” section.
___________________________________________________________________________________________________________
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FAMILY & COMMUNITY
PARTNERSHIPS
The following questions refer to the families of children enrolled in Head Start and Early Head Start.
Parents include the biological or non-biological person(s) identified as the primary caregiver(s). Include, for example,
custodial grandparents, stepparents, guardians, and foster parents.
NUMBER OF FAMILIES.
# of families
38. TOTAL NUMBER OF HEAD START OR EARLY HEAD START FAMILIES.
Count families, not children. Families with more than one child enrolled should be counted only once.
Count dual-custody families as two families.
39. OF THE TOTAL NUMBER OF FAMILIES, the number of two-parent families.
40. OF THE TOTAL NUMBER OF FAMILIES, the number of single-parent families.
The sum of C.39 and C.40 must equal the TOTAL NUMBER OF FAMILIES (C.38).
41. EMPLOYMENT
Count each family only once in the appropriate category.
At time of enrollment
a. OF THE NUMBER OF TWO-PARENT FAMILIES (C.39), the number of families in which:
i) Both parents/guardians are employed
ii) One parent/guardian is employed
iii) Both parents/guardians are not working (unemployed, retired, disabled)
b. OF THE NUMBER OF SINGLE-PARENT FAMILIES (C.40), the number of families in which:
i) The parent/guardian is employed
ii) The parent/guardian is not working (unemployed, retired, disabled)
The sum of C.41.a (i – iii) must equal C.39 (total Two-parent families); C.41.b (i – ii) must equal C.40 (total Single-parent families).
The sum of C.41.a through C.41.b must equal the TOTAL NUMBER OF FAMILIES (C.38).
42. JOB TRAINING/SCHOOL
Count each family only once in the appropriate category.
At time of enrollment
a. OF THE
NUMBER OF TWO-PARENT FAMILIES (C.39), the
number of families in which:
i) Both parents/guardians are in job training or school
ii) One parent/guardian is in job training or school
iii) Neither parent/guardian is in job training or school
b. OF THE
NUMBER OF SINGLE-PARENT FAMILIES (C.40), the
number of families in which:
i) The parent/guardian is in job training or school
ii) The parent/guardian is not in job training or school
The sum of C.42.a (i – iii) must equal C.39 (total Two-parent families); C.42.b (i – ii) must equal C.40 (total Single-parent families).
The sum of 42.a through 42.b must equal the TOTAL NUMBER OF FAMILIES (C.38).
___________________________________________________________________________________________________________
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EDUCATION.
# of families
43. OF THE TOTAL NUMBER OF FAMILIES (C.38), THE HIGHEST LEVEL OF EDUCATION OBTAINED BY THE CHILD’S
PARENT(S)/GUARDIAN(S). Count each family only once. For example, if one parent completed high school
and one has an Associate degree, count this family once under "Associate Degree,” C.43.c.
a. Less than high school graduate
b. High school graduate or GED
c. Some college, vocational school, or an Associate degree
d. Bachelor’s or advanced degree
FEDERAL OR OTHER ASSISTANCE.
# of families
44. TOTAL NUMBER OF FAMILIES RECEIVING ANY CASH BENEFITS OR OTHER SERVICES UNDER THE FEDERAL
TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) PROGRAM.
45. TOTAL FAMILIES RECEIVING SUPPLEMENTAL SECURITY INCOME (SSI).
FAMILY PARTNERSHIP PROCESS.
# of families
46. OF THE TOTAL NUMBER OF FAMILIES (C.38), the number participating in a family goal setting process which
results in an individualized family partnership agreement.
FAMILY SERVICES.
47. Report the number of families who received the following services during the operating period:
(Families may be counted in more than one category if more than one type of service was received)
SERVICE TYPE
NUMBER OF FAMILIES THAT
RECEIVED SERVICES THROUGH
HEAD START/EARLY HEAD
START OR THROUGH REFERRALS
a. Emergency/crisis intervention (meeting immediate needs for food, clothing, or shelter)
b. Housing assistance (subsidies, utilities, repairs, etc.)
c. Transportation assistance (subsidizing public transportation, driving parents to Policy Council
meetings)
d. Mental health services
e. English as a Second Language (ESL) training
f. Adult education (GED programs, college selection)
g. Job training
h. Substance abuse prevention or treatment
i. Child abuse and neglect services
j. Domestic violence services
k. Child support assistance
l. Health education (including prenatal education)
m. Assistance to families of incarcerated individuals
n. Parenting education
o. Marriage education services
p. Number of families that received at least one of the services listed above.
___________________________________________________________________________________________________________
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WIC PARTICIPATION.
# of families
48. TOTAL NUMBER OF FAMILIES RECEIVING SERVICES UNDER THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM
FOR WOMEN, INFANTS, AND CHILDREN (WIC).
FATHER INVOLVEMENT.
49. DOES YOUR PROGRAM HAVE ORGANIZED AND REGULARLY SCHEDULED ACTIVITIES DESIGNED TO INVOLVE FATHERS/FATHER
Yes ___________
No _____________
(X only one)
FIGURES IN HEAD START OR EARLY HEAD START?
# of children
50. THE NUMBER OF ENROLLED CHILDREN WHOSE FATHERS/FATHER FIGURES PARTICIPATED IN THESE ACTIVITIES.
SERVICES TO HOMELESS FAMILIES.
"Homeless" includes, for example, families living temporarily in shelters, hotels, or vehicles; or moving frequently between the
homes of relatives and friends.
51. THE TOTAL NUMBER OF HOMELESS FAMILIES SERVED DURING THE ENROLLMENT YEAR.
52. THE TOTAL NUMBER OF HOMELESS CHILDREN SERVED DURING THE ENROLLMENT YEAR.
53. THE TOTAL NUMBER OF HOMELESS FAMILIES WHO ACQUIRED HOUSING DURING THE ENROLLMENT YEAR.
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
SPECIAL ITEMS:
TRANSPORTATION.
54. ENTER BELOW THE NUMBER OF BUSES, IF ANY, THAT WERE PURCHASED BY YOUR PROGRAM DURING THE OPERATING PERIOD.
Include only buses purchased with ACF grant funds that will be used to support the operation of your Head Start or Early Head
Start program. Indicate, by month, the number of buses purchased. Use the month in which you signed the agreement to purchase
the bus rather than the month in which the bus was actually delivered.
Month
Number of Buses Purchased
Month
a. AUGUST 2008
f. JANUARY 2009
b. SEPTEMBER
g. FEBRUARY
c. OCTOBER
h. MARCH
d. NOVEMBER
i. APRIL
e. DECEMBER
j. MAY
Number of Buses Purchased
k. JUNE
l. JULY
55. DO YOU LEASE ANY OF THE BUSES USED BY YOUR PROGRAM?
a. If yes, how many?
Yes ___________
No _____________
(X only one)
___________
56. DO YOU CONTRACT WITH A TRANSPORTATION PROVIDER TO TRANSPORT SOME OR ALL OF YOUR ENROLLED CHILDREN?
Yes ___________
No _____________
(X only one)
FEDERAL INTEREST IN HEAD START FACILITIES.
57. PLEASE CONFIRM THAT AN APPROPRIATE FEDERAL INTEREST HAS BEEN ESTABLISHED BY LISTING BELOW EVERY FACILITY WHICH
HAS BEEN PURCHASED, CONSTRUCTED, OR RECEIVED MAJOR RENOVATIONS USING HEAD START FUNDS DURING THE 2008-2009
OPERATING PERIOD.
Report the addresses of program centers that were purchased, constructed or received major renovations using Head Start funds
during the 2008-2009 operating period.
Then, indicate in the corresponding check box whether the Federal Interest has been formally established.
Refer to 45 CFR Part 1309 of the Head Start Performance Standards for additional guidance on Federal Interest and facilities.
a. CENTER 1
1. ADDRESS LINE 1 :
2. ADDRESS LINE 2 :
3. CITY :
PLEASE CHECK:
4. STATE:
5. ZIP : _ _ _ _ _ - _ _ _ _
FEDERAL INTEREST HAS BEEN ESTABLISHED
b. CENTER 2
1. ADDRESS LINE 1 :
2. ADDRESS LINE 2 :
3. CITY :
PLEASE CHECK:
4. STATE:
5. ZIP : _ _ _ _ _ - _ _ _ _
FEDERAL INTEREST HAS BEEN ESTABLISHED
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
c. CENTER 3
1. ADDRESS LINE 1 :
2. ADDRESS LINE 2 :
3. CITY :
PLEASE CHECK:
4. STATE:
5. ZIP : _ _ _ _ _ - _ _ _ _
FEDERAL INTEREST HAS BEEN ESTABLISHED
(Space will automatically expand for additional centers in the Web application).
THANK YOU FOR SUBMITTING YOUR 2008-2009 HEAD START PIR
___________________________________________________________________________________________________________
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PIR 2009 (Version 12.0) – 6/20/2008
| File Type | application/pdf |
| File Title | Microsoft Word - PIR2008-Form-Draft-OMB_Revised_6-20-08NoComments.doc |
| Author | dstark |
| File Modified | 2008-06-20 |
| File Created | 2008-06-20 |