USA ELOF Part 1302 Subpart D – Health Program Services

We’ve read through the compliance information for the United States Head Start Program (ELOF) and have used this information to provide practical steps you can take to run an excellent service. We also provide an example weekly schedule for improvement and reflective questions to guide ongoing improvements.

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Practical Steps Towards An Excellent ELOF

To meet the standards for 1302 Subpart D—Health Program Services for 3-5 year old ELOF children in the USA, here’s an exhaustive list of practical steps based on the provided information:

1302.40 Purpose:

  1. Ensure the provision of high-quality health, oral health, mental health, and nutrition services that are developmentally, culturally, and linguistically appropriate.
  2. Support each child’s growth and school readiness.
  3. Establish and maintain a Health Services Advisory Committee that includes Head Start parents, professionals, and community volunteers.

1302.41 Collaboration and communication with parents:

  1. Collaborate with parents in a linguistically and culturally appropriate manner.
  2. Communicate with parents about their child’s health needs and development concerns promptly.
  3. Obtain advance authorization from parents for all health and developmental procedures.
  4. Maintain documentation if parents refuse to give authorization for health services.
  5. Share policies with parents regarding health emergencies that require rapid staff response or immediate medical attention.

1302.42 Child health status and care:

  1. Consult with parents within 30 days of the child’s first attendance to determine if the child has an ongoing source of continuous, accessible health care and health insurance coverage.
  2. Assist families in accessing a source of care and health insurance if the child lacks them.
  3. Within 90 days of the child’s first attendance, obtain determinations from health care and oral health care professionals regarding the child’s health status.
  4. Assist parents in bringing the child up-to-date on health requirements.
  5. Obtain or perform evidence-based vision and hearing screenings within 45 days of the child’s first attendance.
  6. Identify each child’s nutritional health needs, considering health information, family and staff concerns, and community nutrition issues.

1302.43 Oral health practices:

  1. Ensure all children with teeth brush their teeth with fluoride toothpaste once daily, with assistance from staff or volunteers.

1302.44 Child nutrition:

  1. Design and implement nutrition services that are culturally and developmentally appropriate.
  2. Ensure children receive meals and snacks that meet their daily nutritional needs based on program hours.
  3. Adhere to USDA requirements for meals and snacks.
  4. Promote breastfeeding and provide facilities for breast milk storage.
  5. Make safe drinking water available to children during the program day.
  6. Use USDA Food, Nutrition, and Consumer Services child nutrition programs as the primary source of payment for meal services.

1302.45 Child mental health and social and emotional well-being:

  1. Provide supports for effective classroom management, positive learning environments, and strategies for children with challenging behaviors.
  2. Secure mental health consultation services.
  3. Obtain parental consent for mental health consultation services at enrollment.
  4. Build community partnerships for additional mental health resources and services.

1302.46 Family support services for health, nutrition, and mental health:

  1. Collaborate with parents to promote children’s health and well-being by providing medical, oral, nutrition, and mental health education.
  2. Provide opportunities for parents to learn about various health topics, including preventive care, nutrition, mental health, and safety.
  3. Assist parents in navigating health systems and understanding health insurance.

1302.47 Safety practices:

  1. Establish, train, implement, and enforce a system of health and safety practices.
  2. Ensure all facilities meet licensing requirements and are safe for children.
  3. Ensure equipment and materials meet safety standards.
  4. Conduct background checks on all staff.
  5. Provide safety training to all staff.
  6. Implement hygiene practices, including toileting, hand washing, and safe food preparation.
  7. Establish administrative safety procedures for emergencies, fire prevention, medication handling, and child-specific health care needs.
  8. Develop a disaster preparedness plan.
  9. Implement an evidence-based COVID-19 mitigation policy in consultation with the Health Services Advisory Committee (HSAC).
  10. Report any safety incidents as required.

By following these practical steps, your service can ensure that it meets the standards set out in 1302 Subpart D—Health Program Services for 3-5 year old ELOF children in the USA.

An Example Monthly Schedule

Ready to implement these practical steps in your service? Using the constraints of 4 hours per week to work on improvements, we’ve created an example schedule below.

Given that an educator has 4 hours per week (which totals to 16 hours a month) to work on improving their Health Program Services, here’s an example monthly schedule prioritizing the most crucial aspects of the 1302 Subpart D—Health Program Services:

Week 1: Understanding and Assessment (4 hours)

  1. Hour 1: Review and familiarize with the 1302 Subpart D—Health Program Services standards.
  2. Hour 2: Assess the current state of the Health Program Services in place. Identify strengths and areas of improvement.
  3. Hour 3: Engage with parents and staff to gather feedback on current health services and areas they feel need improvement.
  4. Hour 4: Document findings and prioritize areas that need immediate attention.

Week 2: Collaboration and Communication (4 hours)

  1. Hour 1: Develop a plan to enhance collaboration and communication with parents. This could include creating templates for health updates, authorization forms, and emergency protocols.
  2. Hour 2: Set up a system for obtaining advance authorizations from parents for health and developmental procedures.
  3. Hour 3: Draft a clear and concise policy for health emergencies that require rapid response.
  4. Hour 4: Plan a parent workshop or information session to discuss child health needs, nutrition, and developmental concerns.

Week 3: Child Health Status and Care (4 hours)

  1. Hour 1: Review the current health status documentation process. Ensure that within the stipulated timeframes, health checks and screenings are being conducted.
  2. Hour 2: Establish or refine the system for vision and hearing screenings.
  3. Hour 3: Develop or enhance the program’s nutritional health assessment, ensuring that it considers health records, family concerns, and community nutrition issues.
  4. Hour 4: Plan strategies to assist parents in accessing continuous, accessible health care and health insurance for their children.

Week 4: Safety Practices and Mental Health (4 hours)

  1. Hour 1: Review and refine the program’s safety practices, ensuring facilities and equipment meet safety standards.
  2. Hour 2: Develop or enhance the program’s hygiene practices, focusing on hand washing, toileting, and safe food preparation.
  3. Hour 3: Begin establishing a relationship with a mental health consultant or service, ensuring they can assist in identifying and supporting children with mental health and social and emotional concerns.
  4. Hour 4: Draft or refine the program’s disaster preparedness plan, ensuring it covers both natural and man-made disasters.

This schedule provides a structured approach to improving Health Program Services, starting with understanding the current state, enhancing communication, focusing on child health, and ensuring safety and mental well-being. Adjustments can be made based on the specific needs and priorities of the program.

Reflective Questions

Reflective questions can help educators and administrators critically think about their Health Program Services, identify areas of strength, and recognize opportunities for improvement. Here’s an exhaustive list of reflective questions tailored to Health Program Services:

Understanding and Assessment:

  1. What are the core objectives of our Health Program Services?
  2. How familiar am I and my team with the standards set out in 1302 Subpart D—Health Program Services?
  3. What feedback have we received from parents, staff, and children about our current health services?
  4. How do we currently measure the success and effectiveness of our Health Program Services?

Collaboration and Communication:

  1. How effective is our current communication with parents regarding their child’s health needs and developmental concerns?
  2. Are there barriers to communication that we need to address?
  3. How often do we collaborate with external health professionals, and how can this collaboration be enhanced?
  4. Are there any cultural or linguistic challenges we face in our communication, and how can we overcome them?

Child Health Status and Care:

  1. How comprehensive and up-to-date are our health records for each child?
  2. Are we conducting regular health screenings, such as vision and hearing tests, in a timely manner?
  3. How do we address and support children with special dietary and nutritional needs?
  4. Are there any gaps in our current health status assessment and care procedures?

Safety Practices:

  1. How often do we review and update our safety protocols?
  2. Are our facilities and equipment meeting the latest safety standards?
  3. How prepared are we for emergencies, both medical and environmental?
  4. How confident are our staff in handling health emergencies, and are there training opportunities we should consider?

Mental Health and Social and Emotional Well-being:

  1. How do we currently address the mental health needs of our children?
  2. Are our staff equipped with the tools and knowledge to recognize signs of mental health or social and emotional challenges?
  3. How do we promote a positive learning environment that supports children’s mental well-being?
  4. Are there local mental health resources or professionals we can collaborate with to enhance our services?


  1. How do we ensure that our meals and snacks meet the nutritional needs of our children?
  2. Are we promoting healthy eating habits and educating both children and parents about nutrition?
  3. How do we accommodate children with special dietary needs or allergies?

Continuous Improvement:

  1. What feedback mechanisms do we have in place to continuously gather insights about our Health Program Services?
  2. How do we stay updated with the latest research, guidelines, and best practices in child health?
  3. Are there community or external resources we haven’t tapped into that could benefit our program?
  4. How do we ensure that our Health Program Services are culturally and linguistically appropriate for all our children and families?

Overall Reflection:

  1. What are the top three strengths of our Health Program Services?
  2. What are the top three areas of improvement for our Health Program Services?
  3. How do we envision our Health Program Services evolving in the next year?
  4. Are there any immediate changes or interventions we need to implement based on our reflections?

Using these reflective questions, educators and administrators can gain a deeper understanding of their Health Program Services, celebrate their successes, and strategize for continuous improvement.



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