3. Child File Review Questionnaire

Child File Review

Greetings! This questionnaire will ask general information about the QSLA site going through the assessment process & Desired Results Developmental Profile (DRDP) protocols. In addition to answering these questions related to the DRDP, you will need to upload a copy of a Completed CD 4001B Desired Results Developmental Profile Survey form to be reviewed by QSLA, along with proof that the previously selected children have or will have a DRDP on file. This questionnaire also has questions about the Ages and Stages Questionnaire (ASQ) and the Ages and Stages Questionnaire - Social Emotional (ASQ-SE) will be asked. If you need additional support or clarification, please contact QSLA at lopez_nancyx@lacoe.edu
Name*

First NameLast Name
Email*
example@example.com
Site Name*
Donald Duck Preschool
When are children enrolled in the site? (Choose all that apply.)*

On-Going Basis (year round) - Children may stay in the program for multiple years and are NOT re-enrolled every year.Traditional School Year - Children are enrolled or re-enrolled at the beginning of each school year.
Element 1: Child Observation
Does the site use the Desired Results Developmental Profile 2015 (DRDP)? (Choose one that applies)*

YesNo
If the site does NOT use DRDP, do you use a different Child Observation tool? *
Ex. High/Scope Child Observation Record (COR), NIEER Early Learning Scale, The Ounce Scale, Learning Accomplishment Profile 3rd Edition (Preschool), Work Sampling, Developmental Guidelines - Preschool 3 or 4
Please upload a BLANK copy of the Child Observation tool used.*

Cancelof
How often does the site use the Desired Results Developmental Profile (DRDP) 2015? (Choose one that applies)*
The Fall/Winter DRDP is expected to be completed by 12-31. The Spring DRDP is expected to by completed by 05-31*.
How to show proof of the CD 4001B - Desired Results Developmental Profile Summary of Findings for the Classroom

All versions of the DRDP Summary of Findings are accepted, even if you have created your own. Can be completed at the Site level (upload 1 completed) or Classroom level (upload completed for each classroom at the site).
Upload a copy of a COMPLETED Desired Results Developmental Profile Summary (CD 4001B) form to be reviewed by QSLA.*

Cancelof
How does the site use the DRDP results? (Choose all that apply)*

As a tool to screen childrenTo guide communication with parents regarding goals for childrenTo inform curriculum and design activities and lesson plansTo inform teachers of individual children’s learning needsTo gather data for accreditation reportsTo gather data regarding children’s readiness for kindergartenTo complete Head Start School Readiness GoalsTo complete the CD 4001B Desired Results Developmental Profile Summary of Findings to the classroomOther
Do all classrooms enter DRDP data into DRDP Online? (Choose one that applies)*

YesNo
If no, explain why all classrooms do not use DRDP online.*
DRDP Proof of Completion - Child Progress Report

The QCC Rating Matrix requires that QSLA review proof that all children at a site are assessed using the DRDP, twice a year, and that the scores are used to inform classroom activities. Review the information below to learn about how to submit appropriate documentation.
How to Video: Create a Child Progress Report to show proof of DRDP usage
Upload the FIRST PAGE of the MOST RECENT Child Progress Report from DRDP Online - make sure the report includes the (2) children randomly selected by QSLA per classroom. Remove the child's name and write in their initials. If the site has not yet completed the DRDP data entry into DRDP Online or the QSLA Assessment is occurring before deadlines to complete DRDPs for children, upload a picture or PDF of the site's policy for completing the DRDP. *

If you do not use DRDP Online, submit a Learning Genie, ChildPlus, Child Folio, or manually completed hardcopy of the DRDP that shows the (2) children previously selected by QSLA.
Cancelof
Element 2: Developmental and Health Screenings
Does the site require a Physicians Report/Health Screening Form [Licensing Form 701] for all children at the site? See image above for an example of the LIC 701 form.*

YesNo
How often are caregivers asked to submit a Physician Report? (Choose ALL that apply)*

When the child ENROLLS in the program year (At entry)Every year the child is in the programOther
Does the site complete a Vision screening yearly for all children at the site?*

YesNo
Who administers the vision screening? *
What was the date of the vision screening?*

MonthDayYear
Does the site complete a Hearing screening yearly for all children at the site?*

YesNo
Who administers the hearing screening? *
What was the date of the hearing screening?*

MonthDayYear
Does the site use the Ages and Stages Questionnaire (ASQ)? (Choose one that applies)*

YesNo
If the site uses a screening tool other than the ASQ, what is the name of the tool? *
When does the site complete the ASQ? (Choose one that applies)*
How are ASQ results used? (Choose ALL that apply)*

Rescreen children based on scoreComplete the ASQ-SE based on scoreRefer children based on scoreOnly used to screen the children, no follow-up is completed after a child is screened with the tool
Explain the site's Referral procedure when children need to be referred.*
Only write N/A if the site does NOT have a process for completing referrals.
Explain the site's Rescreen procedure when children need to be rescreened.*
Only write N/A if the site does NOT have a process for rescreening children based on scores achieved.
How does the site incorporate families and/or caregivers into the ASQ assessment process? (Choose all that apply)*

Parents/caregivers work with the teaching staff to provide answers to the ASQ questionsASQ scores are shared with parents/caregivers during parent conferencesASQ's are completed with parents/caregivers during home visits
Of the children randomly selected for the Child File Review, were any ASQ's missing or incomplete:*

Yes, one or more children had missing or incomplete ASQ's in their fileNo, all children had completed ASQ's in their file
Does the site use the Ages and Stages Questionnaire - Social Emotional (ASQ-SE)? (Choose one that applies)*

YesNo
How does the site use the results from the ASQ-SE? (Choose all that apply)*

Only used to screen the childrenRescreen children based on scoreRefer children based on scoreProvide activities to support individualized needsShare results with the child's primary healthcare providerIndividualize lessons based on child resultsProvide information about available parenting classes or support groups
Of the children randomly selected for the Child File Review, were any ASQ-SE's missing or incomplete:*

Yes, one or more children had missing or incomplete ASQ's in their fileNo, all children had completed ASQ's in their fileNo ASQ-SE was needed because no children selected fell in the gray or black area for the Personal-Social Domain
Thank you for completing the QSLA Child File Review Questionnaire. You will be contacted by LACOE once your answers and documents have been reviewed.
Should be Empty:

Child File Review

Element 1: Child Observation

How to show proof of the CD 4001B - Desired Results Developmental Profile Summary of Findings for the Classroom

DRDP Proof of Completion - Child Progress Report

Element 2: Developmental and Health Screenings

Thank you for completing the QSLA Child File Review Questionnaire. You will be contacted by LACOE once your answers and documents have been reviewed.