Attachment A - Governance Documents.pdf

City of Phoenix — Land Use and Livability Subcommittee (2020-05-20)

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Attachment A 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Head Start Birth to Five Program  
Governance Documents

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Head Start Birth to Five Program Shared Governance Overview 
 
Shared governance is achieved by coordinating the efforts of two distinct entities.  First, 
the City Council assigns a subcommittee for the governance role of the City of Phoenix 
Head Start Birth to Five program.  Second, the Policy Council provides a mechanism for 
parental and community involvement in the decision-making process. The  
Subcommittee and the Policy Council “share” authority with each other through a 
combination of unique and shared responsibilities: 
 
The roles and responsibilities of the Subcommittee include the following:  
 Legal and fiscal responsibilities  
 Approve shared decision-making procedures, including impasse policies 
 Approve all funding applications and amendments 
 Review program budget reports 
 Approve or disapprove key decisions about the program 
 Establish the internal control to safeguard federal funds 
 Provide direction and broad oversight 
 Ensure that effective organizational planning and evaluation occur 
 Determine new services and monitor ongoing program and services 
 Act as a liaison with the community 
 Interact with and communicate with the Policy Council and City of Phoenix 
Head Start Birth to Five staff 
 
The roles and responsibilities of the Policy Council include the following: 
 Approve or disapprove key decisions about the program 
 Approve the long and short term goals and objectives 
 Approve of the hiring and termination of Head Start personnel 
 Approve all funding applications and amendments 
 Review and approve personnel policies and procedures related to City of 
Phoenix Head Start Birth to Five staff 
 Approve written shared decision-making procedures and impasse policies 
 Act as a liaison with the community 
 Interact and communicate with the Subcommittee and City of Phoenix Head 
Start Birth to Five staff

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Head Start Birth to Five Program 
Policy Council Shared Governance Procedures 
 
The Human Services Department (HSD) shall afford Head Start parents every 
opportunity to participate in policymaking and other decisions concerning the Head Start 
Birth to Five program by providing staff support for a governing body comprised of 
parents and community representatives entitled the Policy Council.  The Policy Council 
shall advise and assist the Governing Board entitled the City Council Subcommittee 
(Subcommittee) and HSD in initiating, developing and sustaining policies, programs, 
and services to meet the needs of Head Start children and families.   
 
The Policy Council and Subcommittee shall work in partnership with key management 
staff to develop, review, and approve or disapprove the policies and procedures as 
outlined in “Article III: Functions” contained in the Policy Council Bylaws. 
 
The City of Phoenix, including the Subcommittee, and the Policy Council shall utilize the 
following shared decision-making procedures as outlined in the Head Start Program 
Performance Standards Part 1301 Program Governance.  
 
PLANNING: 
 
Planning procedures shall be reviewed and approved by the Policy Council and 
Subcommittee annually. 
 
Five-Year School Readiness/Program Goals and objectives shall be reviewed and 
approved by the Subcommittee and Policy Council, based on the Community Needs 
Assessment Report.  Goals will describe, in broad terms, how the program plans to 
address issues/needs of Head Start families which were chosen as priorities.  
Objectives describe measurable actions to be taken to attain the five-year goals. 
 
The selection of delegate agencies and their service areas shall be reviewed and 
approved by the Policy Council and the Subcommittee as needed. 
 
All funding applications, amendments, and any other financial obligations and support to 
the program shall be reviewed and accepted by the Policy Council and approved by the 
Subcommittee.  Monitoring and fiscal reports shall be shared with both policy groups to 
allow for consistent oversight of program operations and budgetary matters.

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In addition, Policy Council members shall be consulted and invited to participate in the 
annual Continuous Quality Improvement Process. The Quality Improvement Plan will be 
presented to the Policy Council with a description of the areas that require corrective 
action to comply with requirements fully. 
 
GENERAL: 
 
HSD staff and delegate agencies shall work jointly to follow the Bylaws in electing 
representatives to serve as Policy Council members. Grantee staff shall have ongoing 
communication with the delegate agency staff through meetings, site visits, telephone 
calls, email messages, representation, and attendance at Policy Council meetings. 
 
Procedures describing the roles and responsibilities of the Subcommittee shall be 
reviewed annually and presented to the Subcommittee and Policy Council when major 
changes are needed. 
 
Orientation is conducted with both the Policy Council and the Subcommittee to review 
their roles and responsibilities with regards to oversight and involvement within the 
program. 
 
Policy Council members will be encouraged to attend Subcommittee meetings when 
Head Start items are on the agenda, and there is a need for discussion and if action is 
required.  Results will be reported at the next Policy Council meeting. 
 
The Policy Council and Subcommittee shall annually review Shared Governance 
Bylaws, Impasse Procedures, Conflict of Interest Affidavit, and Code of Ethical Conduct 
to seek approval for changes or amendments as needed. 
 
Policy Council and the Subcommittee work to make sure internal controls are 
established and implemented to safeguard federal funds. 
 
Fiscal and programmatic reports shall be provided to the Policy Council and 
Subcommittee. 
 
The program has established and maintained Impasse Procedures in the event of a 
disagreement between the Policy Council and the City of Phoenix, including the 
Subcommittee. The procedures shall be implemented when a disagreement on any 
programmatic or fiscal matter impacting the delivery of services has occurred.

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Head Start Birth to Five Program  
Policy Council BYLAWS 
 
ARTICLE I: NAME 
The name of this organization shall be the Head Start Birth to Five Policy Council and 
shall be hereinafter referred to as the Policy Council. 
 
ARTICLE II: PURPOSE 
The purpose of the Policy Council is to create a body for shared governance through 
which Head Start Birth to Five parents can participate in policymaking decisions about 
the program. The Policy Council shall serve as a link to the Parent Committees, 
Grantee and Delegate Agency governing bodies, public and private organizations, and 
the communities they serve. The Policy Council shall advise and assist the Phoenix City 
Council Subcommittee and the Human Services Department (HSD) in initiating, 
developing and sustaining policies, programs, and services to meet the needs of 
children birth through age 5. 
 
ARTICLE III: FUNCTIONS 
The POLICY COUNCIL shall: 
1) Use ongoing monitoring results, data on school readiness, and other information to 
conduct its responsibilities.                                                                                                                  
2) Work in partnership with key management staff and the City Council or its designee 
to develop, review, and approve or disapprove the following: 
a) Procedures describing how the City Council Subcommittee and the Policy 
Council will implement shared decision-making. 
b) Procedures for program planning. 
c) The program’s philosophy and long and short-range program goals and 
objectives.

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d) The composition of the Policy Council and members (parents of enrolled children 
and community members) who are chosen. 
e) The annual Quality Improvement Plan of the grantee. 
f) The resolution of internal disputes, including impasse procedures between the 
Policy Council and the City Council Subcommittee. 
g) The hiring of Head Start Birth to Five employees must be approved by the Policy 
Council, with the exception of: 
i) Staff used through a temporary services agency. 
ii) Policy Council will be notified of City employees placed into Head Start Birth 
to Five by the Human Services or Human Resources Department of these 
placements. 
iii) On occasion, hiring key personnel prior to Policy Council approval may be 
necessary for positions that are very critical to the implementation of service 
delivery and or operations of the program.  Based upon staff input, the Deputy 
Human Services Director will determine if waiting for Policy Council approval 
will cause a major disruption of services to children and families.  If so, the 
Deputy Director will discuss this matter with the Policy Council Chair for 
concurrence and provide information to the Policy Council at the next 
regularly scheduled meeting. Key personnel includes the Early Head Start 
Family Advocate (Home Visitor). 
h) The termination of Head Start Birth to Five employees must be approved by the 
Policy Council with the exception of: 
i) Staff used through a temporary employment agency. 
ii) Employees on probation. 
iii) Employees hired in temporary grant-funded positions. 
iv) Employees removed as a result of City Personnel Policies regarding seniority 
rights. 
i) Activities to support the active involvement of parents in supporting program 
operations, including policies and procedures to ensure that the Head Start Birth 
to Five program is responsive to parent and community needs. 
 
3) Work in partnership with key management staff and the City Council or its designee 
to develop, review, and approve and submit to City Council the following: 
 
a) All funding applications and amendments to funding applications for Head Start 
Birth to Five and Child Care Partnerships, including Administrative services prior 
to the submission of such applications to the U.S. Department of Health and 
Human Services (DHHS). 
b) Budget planning for program expenditures, including policies for reimbursement 
and participation in policy council activities. 
c) The selection of delegate agencies and their service areas.

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d) Criteria for defining recruitment, selection, and enrollment priorities. 
e) The annual Quality Improvement Plan of the grantee. 
f) Program personnel policies, including standards of conduct for program staff, 
consultants and volunteers within the legal framework of the city’s merit system. 
g) The resolution of internal disputes, including impasse procedures between the 
Policy Council and the City Council Subcommittee. 
h) Bylaws for the operation of the Policy Council. 
i) Developing procedures for how members of the Policy Council of the Head Start 
agency will be elected. 
4) Guide Head Start Birth to Five staff in establishing a method of hearing and 
resolving community concerns about the Head Start Birth to Five program. 
5) Speak on behalf of and advocate for children enrolled in the Head Start Birth to Five 
program. 
6) Be consulted concerning actions in the following areas: 
a) Identification of child development needs in the area to be served. 
b) Assurance that standards for acquiring space, equipment and supplies are met. 
 
ARTICLE IV: COMPOSITION AND ELECTIONS  
1) The Policy Council shall be comprised of two types of representatives: parents of 
currently enrolled children and community representatives. 
2) Parent Members 
a) Each Delegate Agency shall have two representatives and two alternates on the 
Policy Council. Home-Based and Child Care Partners will each have one 
representative and one alternate on the Policy Council. 
b) Each of the program options: Delegate Agency, Home-Based, and Child Care 
Partners, shall notify parents of currently enrolled children of an election meeting 
of parent Policy Council members to be held no later than October 30 of each 
year. 
c) At the election meeting, Delegate Agency parents shall elect two parents as 
representatives and two as alternates per agency. Home-Based and Child Care 
Partner parents will each select a parent representative and a parent alternate to 
represent their programs. 
3) Community Members 
a) Each year, the parents shall elect a maximum of nine community members to 
the Policy Council. 
b) Members may be from the public or private sector, civic and professional 
organizations, the Human Services Commission, and others who are familiar

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with resources and services for low-income children and their families, including 
parents of formerly enrolled children. 
4) Vacancies occur when: 
a) A Policy Council member is removed for cause or absenteeism. 
b) A Policy Council member resigns. 
c) A Delegate Agency Policy Committee removes its representative. 
d) A Head Start Delegate Agency is not renewed or terminated. 
5) Alternates – An alternate shall serve in the capacity of the elected representative in 
their absence. 
6) Membership - Membership begins in November and ends in October the following 
year. Membership terms must be limited to no more than five one-year terms as 
required by Head Start Program Performance Standards. 
7) Reimbursement 
a) Head Start Birth to Five program will reimburse eligible income members for 
mileage and child care costs incurred due to participation in Policy Council 
meetings, Policy Council events, and for extended day child care for out-of-town 
travel. 
b) For reimbursement, the child care provider cannot be the member’s spouse or 
significant other living in their home. 
c) Reimbursement cannot be claimed for 1) children over 12 years of age, 2) for 
time children should be in school, or 3) for times children are generally in the 
care of others unless approved by the Policy Council. 
8) Quorum 
a) A majority of members of the Policy Council shall constitute a quorum for the 
transaction of any business meeting. 
b) For the months of June and July, a majority of Delegate Agencies, including the 
Early Head Start program, shall constitute a quorum.   
c) A meeting shall not be deemed regularly constituted unless the quorum 
requirements are met. 
9) Voting 
a) A vote of a majority of the Policy Council members when a quorum is present in 
person, or by phone, shall decide any matter. 
b) No proxy or absentee voting shall be permitted. 
10)  Regular Meetings 
a) Regular meetings shall be scheduled on the same day each month as 
designated by the Policy Council and the Deputy Human Services Director or 
designee.

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b) The meeting day and time can be changed upon approval of the Policy Council 
and Grantee staff. 
11) Special Meetings 
a) Shall be held within the City of Phoenix. 
b) May be called at the discretion of the Chairperson or upon request by two-thirds 
(2/3) of the members of the Policy Council. 
12) Executive Session – The Policy Council may meet in executive session for the 
purposes permitted by Open Meeting Law.  All discussions held in executive 
session shall be held confidential by members. 
13) Notices 
a) There shall be at least five (5) calendar days’ public notice for any regular 
meeting of the Policy Council and two (2) calendar days’ public notice for special 
meetings. 
b) Notice of all the meetings shall be given in accordance with the Arizona Open 
Meeting Law, and notice shall include for all Policy Council members the minutes 
of the previous meeting. 
c) Policy Council members shall make an effort to confirm their attendance prior to 
each meeting by calling the Education Division designated Secretary or 
designee. 
 
ARTICLE V: OFFICERS 
1) Powers and Duties of Policy Council Officers 
a) Chairperson – The Chairperson shall be a current or former Head Start parent 
within the last two years. The Chairperson shall be responsible for presiding over 
meetings, calling Special Committee meetings, officially representing the Policy 
Council at all functions, providing input on agenda items as needed, and 
performing such other duties as the Policy Council may direct. 
b) Vice-Chairperson – The Vice-Chairperson shall serve in the absence of the 
Chairperson. 
c) Treasurer – The Treasurer shall present budget reports to the Policy Council and 
provide input about Head Start budget issues and other fiscal matters as needed. 
2) The Education Division designated Secretary shall keep Policy Council meeting 
minutes, including the disposition of all motions of the Policy Council in accordance 
with the Arizona Open Meeting Law. The Secretary shall give Public Notice of Policy 
Council meetings, including time, place, and agenda. The Deputy Human Services 
Director or designee shall have charge of records of the Policy Council.

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ARTICLE VI: ELECTION OF POLICY COUNCIL OFFICERS 
1) Election – The election of Policy Council officers shall take place each year at the 
regularly scheduled November meeting.   
2) Term of Office - The term of office for all officers shall be from the time of one 
election to the next. No person may serve in the same capacity for more than two 
consecutive years. 
3) Vacancy - In the event of a vacancy between elections, the officer or chair shall be 
filled by a special election or at the next regularly scheduled meeting when at least 
five (5) days notice is given, and a quorum is present.   
4) Removal of Policy Council Officers - Any Policy Council officer may be removed 
from office at any time upon the affirmative vote of two-thirds (2/3) of the Policy 
Council members present and voting at a regularly constituted meeting; provided, 
however, that at least five (5) days prior written notice is given to all Policy Council 
members of said meeting and the proposed removal action is included on the 
agenda. 
 
ARTICLE VII: REMOVAL OF POLICY COUNCIL MEMBERS 
1) A member who misses three consecutive meetings or who misses a total of four 
meetings will be deemed to have vacated his/her membership on the Policy Council. 
2) Removal for Cause: Upon the affirmative vote of at least two-thirds (2/3) of the 
members present and voting at a meeting, the Policy Council may remove a Policy 
Council member for cause. A member who does not follow the Code of Ethical 
Conduct may be removed for cause (See page 16). 
3) Whenever a vacancy occurs on the Policy Council for any reason, the vacancy may 
be filled by special election in a manner consistent with Article IV. 
 
ARTICLE VIII: FINANCIAL, EMPLOYMENT, AND MEMBER CONFLICT OF INTEREST 
1) Ineligible Persons - No member can serve on Policy Council when or if there is a 
conflict of interest.  By definition, a conflict of interest is when a member of the Policy 
Council meets the following criteria: 
a) Has an immediate family member which includes the spouse, significant other, 
parents and grandparents, children and grandchildren, brothers and sisters, 
mother-in-law and father-in-law, brothers-in-law and sisters-in-law, daughters-in-
law and sons-in-law, and adopted and stepfamily members who are employed by 
the Head Start program or any of its delegate agencies. 
b) Holds a contract or has an immediate family member, as defined above, that 
holds a contract with the Head Start program or any of its delegate agencies. 
2) The Policy Council shall abide by all current Federal, State, and City regulations 
regarding financial conflict of interest as well as nepotism in employment, the 
acceptance of gifts, gratuities and prohibition against partisan political activity.

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3) Every member shall read and sign the City of Phoenix Conflict of Interest Affidavit 
(See page 15). 
 
ARTICLE IX: AMENDMENT 
These Bylaws may be altered, amended or repealed at any regular meeting by a two-
thirds (2/3) vote of the members present, provided that not less than five (5) days’ notice 
has been given to all members of the Policy Council and a copy of the proposed 
amendment sent with the notice.

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Head Start Birth to Five Program 
Policy Council Impasse Procedures 
 
City Council considers proposed decisions by the Policy Council, and the Policy Council 
considers proposed decisions by the City Council. An impasse and/or internal dispute 
shall be defined as occuring when the City Council and the Policy Council disagree on a 
proposed decision. An impasse occurs when the City Council and the Policy Council 
have not come to an agreement within fifteen (15) working days or by the next regularly 
scheduled Policy Council meeting, whichever occurs later.  It is expected that the City 
Council and Policy Council will make every effort to resolve the disagreement prior to 
adopting the mediation and/or arbitration procedures. If there is a disagreement, the 
City Council and the Policy Council are required to notify each other in writing why it 
does not accept the decision.  
 
Mediation is processes in which trained mediators help the involved parties reach a 
negotiated resolution. Mediation allows the parties involved to retain control of a 
disagreement and jointly explore and reconcile differences themselves. It empowers the 
parties involved to create their own solutions and allows for direct communication 
between all parties in hopes of gaining a better understanding of each other’s views.  In 
addition, mediation saves money and allows for disagreements to be resolved in an 
efficient process. Failing resolution at the mediation level, the City Council and Policy 
Council shall move to arbitration. 
 
Mediation Procedures 
 
The following mediation procedures shall be adopted in an effort to resolve a 
disagreement: 
 
1. When a disagreement arises between members of the City Council and the 
Policy Council, each policy group shall designate a subcommittee of no more 
than three (3) members. The members shall have a direct discussion with each 
other at a public meeting to make a good faith effort to resolve their differences 
on an amicable basis. The subcommittee shall follow Open Meeting Law 
Guidelines.

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2. Failing resolution at the discussion level, the subcommittee shall make a 
recommendation to the City Council and Policy Council at their next regularly 
scheduled meeting to make a motion to engage in mediation. 
 
3. The Education Division shall inform the Human Services Department (HSD) 
Director in writing as soon as possible that mediation is taking place to resolve a 
disagreement. 
 
4. The subcommittee shall, at a joint meeting, select a mediator utilizing the list of 
mediators provided by the City of Phoenix.  The qualified mediators will not have 
any affiliation with HSD. 
 
5. If the disagreement between the City Council and the Policy Council relates to 
termination or denial of refunding the Head Start grant, HSD shall notify the 
Regional Office within ten (10) working days.  If the Council is proposing to deny 
the refunding application, HSD shall notify the Regional Office immediately, or no 
later than ninety (90) days prior to the refunding date. 
 
6. The mediator shall hold as many subcommittee meetings as reasonably 
necessary to resolve the disagreement in a timely manner.  All meetings will be 
held in compliance with the Open Meeting Law Guidelines. 
 
7. Failing resolution at the mediation level, the subcommittee shall make a 
recommendation to the City Council and the Policy Council at their next regularly 
scheduled meeting to make a motion to engage in the arbitration to resolve the 
impasse.  See “Arbitration Procedures” section. 
 
8. Mediator fees may be charged to the Head Start grant in the amount equal to the 
usual and customary fees charged within the City of Phoenix market area with 
the approval of the responsible Federal official. 
 
 
Arbitration Procedures 
 
The following procedures shall be adopted if the impasse moves to arbitration: 
 
1. The Policy Council shall submit a written notice regarding the impasse to the City 
Council and the City Manager or the City Manager’s designee.  The notice will be 
delivered with three (3) working days if the impasse was not resolved through 
mediation.  The written notice will describe the nature of the impasse and request 
from the City Manager or designee a list of qualified arbitrators.  The City Council 
and Policy Council shall each designate a subcommittee of no fewer than three 
(3) people to select and brief the arbitrators as described below.

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2. The City Manager or designee shall forward a list of qualified arbitrators to the 
subcommittee within three (3) working days after receipt of written notice from 
the subcommittee.  The qualified arbitrators on the list will not have any affiliation 
with HSD. 
 
3. The subcommittee of the City Council and the Policy Council shall each select an 
arbitrator for representation, respectively. If a selected arbitrator is unable to 
serve, the impacted subcommittee shall select another arbitrator from the list.  
Upon agreeing to serve, the arbitrators shall meet within five (5) working days of 
selection. The arbitrators shall select a third arbitrator from the approved list.  
This third arbitrator will serve as the Arbitration Committee Chair. 
 
4. Within three (3) working days of selecting their prospective arbitrator, each 
subcommittee shall provide each arbitrator with a one-page outline of the 
impasse, the position, and requested remedy of the City Council and Policy 
Council respectively. 
 
5. The Arbitration Committee Chair shall call a public meeting, in accordance with 
Open Meeting Law Guidelines, of the Arbitration committee within ten (10) 
working days after the complete formation of the Arbitration Committee. The 
Committee Chair will facilitate discussion between the arbitrators.  In the event of 
an impasse, the Committee Chair will make a final decision on the impasse.  The 
findings of the Arbitration Committee shall be final and binding on the City 
Council and the Policy Council.  A final report of the Arbitration Committee shall 
be forwarded to the City Manager, the City Council, and the Policy Council. 
 
6. The Human Services Department will notify the Federal Regional Office of the 
decision and pay related arbitration and mediation costs.

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Head Start Birth to Five Program 
Policy Council Conflict of Interest Affidavit 
 
 
 
 
________________________________       
__________________________ 
 Name 
 
 
 
     
 
 
Program 
 
I have read and accept full responsibility for my role as a Policy Council member as 
outlined in the Policy Council Bylaws and the Code of Ethical Conduct.  
 
I pledge that I do not have an immediate family member who is a City of Phoenix 
Head Start employee. Neither I, nor any member of my immediate family has a 
contractual or financial interest, such as employment in the City of Phoenix Head 
Start program or any of its Delegate Agencies. An immediate family member 
includes spouse, significant other, parents and grandparents, children and 
grandchildren, brothers and sisters, mother-in-law and father-in-law, brothers-in-law 
and sisters-in-law, daughters-in-law and sons-in-law, and adopted and stepfamily 
members. 
 
If at any time during my membership a conflict of interest occurs, I shall immediately 
notify the City of Phoenix Head Start Birth to Five program. 
 
_________________________ 
 
 
 
_____________________ 
Signature  
 
 
 
            
           Date

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Head Start Birth to Five Program  
Policy Council Code of Ethical Conduct 
 
We believe it is the role of every person in Head Start to treat staff, families, children 
and the general community with respect and dignity.  It is the expectation that members 
of the Policy Council conduct themselves in a professional manner. Being a 
representative of a delegate agency or Grantee Operated Program is very important as 
it relates to program governance and general operations in Head Start.   
 
As a member of the Policy Council, I will adhere to the following: 
 
 Treat staff, families, children and the general community with respect and dignity  
 Conduct myself in a professional manner remembering I am representing the Head 
Start Birth to Five program  
 Demonstrate courtesy (waiting your turn to talk, give input, etc.) 
 Dress appropriately (business casual is recommended) 
 Accept and value diversity 
 Stay on task and be fully engaged in meetings (limiting sidebar conversations) 
 Consider what is best of the entirety of the program in my decision making  
 
___________ As a parent member, I will adhere to the Head Start Delegate Agency 
Standards of Conduct. 
 
___________ As a community representative, I will adhere to the City of Phoenix Head 
Start Standards of Conduct. 
 
 
The following behaviors will not be accepted under any circumstances: 
 
 Making threats to staff, children and/or families 
 Swearing, cursing or smoking at any Head Start event/ activity/ meeting 
 Bringing drugs, alcohol, or weapons to Head Start sites 
 Violating any program policies and procedures

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 Accepting or soliciting gratuities, favors or anything of monetary value from 
contractors or parties to subcontracts, unless the gift is unsolicited is of nominal 
value, and the financial interest is not substantial 
 
If any of the above behaviors occur, I understand that as a member of the Policy 
Council, I will be asked to stop the inappropriate behavior immediately and/or may be 
asked to leave the meeting/activity.  
 
 
If I fail to adhere to the Code of Ethical Conduct, I will be removed from the Policy 
Council permanently.   
 
_______________________ 
 
 
 
 
_____________________ 
Policy Council Member  
 
 
 
 
 
Date

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City of Phoenix Education Division 
Standards of Conduct 
 
 
 
I, ______________________________ understand the importance and role of the 
Head Start program staff in maintaining safety and security for all children enrolled and 
will follow the Head Start Program Performance Standard on safety practices and 
standards of conduct. 
 I will respect and promote the unique identity of each child and family and refrain 
from stereotyping on any basis of race, gender, ethnicity, culture, religion, 
disability, sexual orientation, family composition and gender identity. 
 I will comply with program confidentiality policies concerning personally 
identifiable information about children, families, and other staff members in 
accordance with Head Start Performance Standards and any applicable federal, 
state, or local laws. 
 I will ensure that no child is left alone and unsupervised. 
 I will implement positive strategies to support children’s well-being and prevent 
and address children’s challenging behavior. 
 I understand that I must not:  
(A) Use corporal punishment 
(B) Use isolation to discipline a child 
(C) Bind or tie a child to restrict movement or tape a child’s mouth 
(D) Use or withhold food as a punishment or reward 
(E) Use toilet learning/training methods that punish, demean, or humiliate 
a child 
(F) Use any form of emotional abuse, including public or private 
humiliation, rejecting, terrorizing, extended ignoring, or corrupting a 
child 
(G) Physically abuse a child 
(H) Use any form of verbal abuse, including profane, sarcastic language, 
threats, or derogatory remarks about the child or the child’s family; or 
(I) Use physical activity or outdoor time as a punishment or reward 
 I will not solicit or accept personal gratuities, favors, or anything of significant 
monetary value from contractors or potential contractors.  
   
By signing below, I acknowledge that a violation of these standards may result in 
disciplinary action up to and including termination.  Consequences will not be taken 
lightly. This is a serious matter and I will be held accountable to the fullest.

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Signature:  
Date: