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1l.9WV STATE TRAINING AND REGISTRYSYSTEMCERTIFICATE OF TRAINING ATTENDANCE, "\1PRESENTED TOI.' ',/1__I -, ,,,\. i ~I 1 ;,__ ~'. ~ '...~'i ,\\ ,I"o.i'I~\'\\u ~h\\d Lo~..e;'\\-O~\Oe..., --J ,WV STARS TRAINING PARTICIPANT\"._" ,"WV STARS TRAJNER'S SIGNATUREt ~ """'--' ,- ..-.. 'Core Knowledge Content AreaClockHoursProfessionalism 1.55747 Reach for the STARS· ~o.lY);\'-\ C,n\\d tel,-" \:."'/"I"!>\l\>\"nTCL\ I
_.-~ ~- -SCORE SHEET-EXPANDED VERSIONFamily Child Care Environment Rating Scale-Revised EditionThelma Harms, Debby Cryer, and Richard M. CliffordlLaObserver:_ Observer Code:Home:Facility Code: _Provider(s):_ Provider Code:__Number ofproviders present:__Number ofchildren enrolled:__Highest number ofchildren ramily child care home allows at one time:__Highest number ofchildren present during observation:__Time observation began: _ _ _ _ 0 AM 0 PMTime observation ended: __ .__ 0 AM 0 PMTime interview began: __ , _ _ 0 AM 0 PMTime interview ended: ---_._--- oAM 0 PMDate of Observation: __ / __ / __III m d d y yNumber ofchildren with identified disabilities:__Check type(s) ofdisability: 0 physical/sensoty 0 cognitive/languageo social/emotional D.other: _Birthdates ofchildren enrolled: youngest__ / __ / __mill dd yyoldest / /Number enrolled in each age group:Infants (birth through II mos.)Toddlers (12 mos. through 29 mos.)Preschool/K (30 mos. through 5 yrs.)School-agers (6 yrs. through 12 yrs.)m m d d y ySPACE AND FURNISHINGS1. Indoor space used forI 1 2 3 456 7 I 7.3. Accessibility: a) Doonvays ;>: 32" wide? (y / n)child care b) Easy to use handles on doors (y / n)Y N Y N Y N NA Y N c) Thresholds appropriate height/beveled if > 'I,' (y I n)l.lOO 3.10 0 5.100 7.1001.20 0 3.200 5.200 7.20 01.300 3JOO 5.3000 7.3 0 01.4 0 0 3.4 0 02. Furniture for routine I 1 234 5 6 7 I5.3. Examples of provisions that promote self-help used (at least 2 observed):care, play, and learning 1)2)Y N Y N Y N Y N NAl.lOO 3.10 0 5.100 7.1 0 0 0 5.5,7.3. Use of adult seating by provider observed (at least 1 example)? (y / n)1.200 3.2 0 0 5.2 0 0 7.2001.300 3JOO 5.300 7.3 0 05.4005500Copyright © 2007 by Harms, Cryer & Clifford Score Sheet p. 1
Page 1 and 2: Tier II ReimbursementRequirementsVa
Page 3 and 4: Hours of Operation: The family chil
Page 5 and 6: Health Policies: The FCC Home attem
Page 7 and 8: 1Insurance CompanyLetterheadXYZ Ins
Page 9 and 10: I Attachment CIEMERGENCY KITS AND S
Page 11 and 12: Attachment EI3Procedures For Conduc
Page 13 and 14: Attachment A IEMERGENCY NUMBERSDire
Page 15 and 16: 5Indoor and Outdoor materials atSal
Page 17 and 18: PRE-SCHOOL LESSON PLANL9Group Time(
Page 19 and 20: 8Learning Centers at Sally's Family
Page 21 and 22: \0Sally's Family Child Care Home:Da
Page 23 and 24: Child's Name::SDDD ])oeDaily Report
Page 26 and 27: \4State Training and Registry Syste
Page 30 and 31: \\January 30, 2009To Whom It May Co

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