Early Head Start Transition Planning Form

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Early Head Start Transition Planning Form
Child’s Name: __________________________
Date of Birth: __________________
Teacher Name: __________________________
Center: _______________________
Date Completed: ________________________
The purpose of this plan is to ensure the successful Transition of your child into Early Head Start
services. Parents and Teachers will benefit from this opportunity to communication specifically about
the needs of the child, Early Head Start procedures, environment, curriculums, routines and schedules.
1. This child likes:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
2. This child’s temperament is:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
3. This child’s individual physical needs are:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
4. I would like my child’s environment to be:
________________________________________________________________________
________________________________________________________________________
Revised 12/12
A division of Cumberland Community Action Program, Inc. (CCAP)

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