Annual Report Form - naeyc.org · the program’s accreditation certificate for this anniversary date). Failure to submit an Annual Report within the established submission window

© 2018. National Association for the Education of Young Children. All other rights reserved. Program ID#

Annual Report Form

PURPOSE

The purpose of the Annual Report is to:

Ensure that accredited programs are continuing to meet the NAEYC Early Learning Programs Standards and Assessment Items.

Increase the accountability of the NAEYC Accreditation system for children, families, and all customers of NAEYC Accreditation.

Provide NAEYC with the most up-to-date information related to the program’s current daily operations and overall characteristics.

INSTRUCTIONS

The Annual Report is due on the first, second, third, and fourth anniversary of a program’s valid until date (refer to the program’s accreditation certificate for this anniversary date). Failure to submit an Annual Report within the established submission window will result in the revocation of the program’s accreditation. The Annual

Report will be accepted up to two (2) calendar months before the anniversary of the valid until date, but the postmark date of the Annual Report submission must be on or before the valid until date’s anniversary. A program that needs additional time is permitted to submit the Annual Report up to one (1) calendar month after the valid until date’s anniversary with a late fee of $150. In order to complete this report programs will need to refer to the assessment items, which can be found on the NAEYC Website.

TABLE OF CONTENTS

Section 1: Program Information (Pages 2-3)

Section2: Payment Information (Page 4)

Section 3: Licensing (Page 5)

Section 4: Program Operations (Page 6)

Section 5: Staff Qualification (Pages 7-10)

Section 6: Self-Assessment (Pages11-12)

Section 7: Rights, Responsibility and Submission Instructions (Page13)

Section 1: PROGRAM INFORMATION

Program Identification Program Name:

Legal name to appear on all correspondence and official documents from NAEYC, including the NAEYC Accreditation Certificate.

Program ID#:

Primary Contact Secondary Contact The Primary Contact is responsible for receiving written correspondence regarding the program's accreditation and can update NAEYC with changes to program information.

The Secondary Contact will be copied on all correspondence regarding the program's accreditation and can update NAEYC with changes to program information.

Name: Name:

Title: Title:

Phone: Fax: Phone: Fax:

Email: Email:

Additional Contacts Additional Contacts are authorized to receive confidential programmatic information from NAEYC. Programs may name up to three (3) additional contacts.

Name: Name: Name:

Title: Title: Title:

Multiple Programs within the Same Facility NAEYC Accreditation is granted to the overall program, and will not be granted to individual classes within a program. Throughout the NAEYC Accreditation process, all eligible classes a program serves must be reported and may be observed during a site visit. This includes classes within the program that operate during the summer and as after-school care.

A class can only be excluded from a center's NAEYC Accreditation only if it is part of a separate program that has a separate public identity. A program pursuing NAEYC Accreditation must notify NAEYC of all separate programs that operate within its facility and be able to demonstrate a separate a separate budget, administration, and license.

My program is the only program that operates within its facility. Yes No If no, use the space below to list other programs that operate within your program’s facility and describe how other existing programs are separate from your program. Include relevant information about how all other existing programs have a separate name, budget, administration, and license from your program.

If necessary, you may attach an additional page to continue your description of separate programs that operate within your program’s facility.

Security Clearance

Is a prior security clearance required for visitors to enter the program?

No Yes – If yes, provide the name and phone number for the proper authority outside of your program below.

Name: Email:

Relationship to program: Phone:

Annual Report Form Page 2 of 13

© 2018. National Association for the Education of Young Children. All rights Reserved. Program ID:

Section 1: PROGRAM INFORMATION

Program Address: Contact information will be posted on the NAEYC website when a program achieves NAEYC Accreditation.

Street Address: Suite/dept/floor:

City: State: Zip:

County: Country:

Phone: Fax:

Email Address: Website:

Mailing Address: To be used for written correspondence to the program.

Same as program address


City: State: Zip:

County: Country: Phone:

Billing Address: To be used for invoices sent to the program.

Same as program address Same as mailing address

Attention:

Organization Name (if different than program name):


City: State: Zip:

County: Country:

Email: Phone: Fax:

Shipping Address: To be used for the shipment of all NAEYC Accreditation Materials.

Same as program address Same as mailing address Same as billing address

Street Address:

No P.O. Boxes accepted Suite/dept/floor:

City: State: Zip:

County: Country: Phone:

Satellite Locations Only complete this section if any of the classes are housed in a satellite location. A program with satellite location(s) must meet the following criteria:

Have no more than 2 satellite locations; all locations are within a 5 mile radius of the primary location.

The satellite location/s enroll 60 or fewer children

Each satellite location must have the same program administration, budget, and public identity as the primary site

Satellite Site Address 1 Satellite Site 1 Name:


City: State: Zip:

Satellite Site Address 2 Satellite Site 2 Name:


City: State: Zip:



Section 2: PAYMENT INFORMATION

This form will not be processed until all applicable fees are paid in full. If payment is not received in full within 90 days, NAEYC reserves the right to withdraw the program from the accreditation process.

All fees are nonrefundable.

The accreditation fee is calculated based on the number of children enrolled in a program at the time this form is submitted. If the number of children changes for a defined portion of the year (for example, altered program operation during the summer), the program should report the number of children that typically applies throughout the majority of the school year. Reference the following rules to determine the number of children that determines the accreditation fee for your program.

Each child is only counted once. Each child of eligible age (birth through kindergarten) that is part of an eligible class is counted. All eligible classes MUST be included in

your program’s NAEYC Accreditation. Programs with Before & After-Care should only be included if program has NAEYC School Age Accreditation. For programs with hourly care or drop-in care classes in which the total number of children enrolled in the class exceeds the maximum

licensing capacity of the class, only the maximum licensing capacity of the class is counted.

Age Category Number of Children Enrolled

Infant (birth to 15 months)

Toddler/Twos (12 to 36 months)

Preschool (30 months to 5 years)

Kindergarten (public or private)

School-Age (NAEYC School Age Accreditation Only)

TOTAL Number of Children:

Fees Number of Children

$550 10 to 60 children




Add $150 for every additional 120 children

Late Fee

I acknowledge that this form is being submitted up to one (1) calendar month past the due date and the $150 late fee is included with the payment.

Section 2: PAYMENT INFORMATION (continued)

Choose ONE method of payment and include applicable information below. Check Check Number: Name on Checking Account:

Attach check to this form - If check is sent under separate cover, program ID number or other identifying information must be included on the check. Purchase Order Purchase Order Number: Name on Purchase Order:

Attach purchase order to this form.

If purchase order is sent under separate cover, program ID number or other identifying information must be included on the purchase order. Credit Card

VISA MasterCard Amex Name on card:

Credit Card Number: Credit Card Expiration Date: Month: Year:

Card billing address:

City: State: Zip:

Country:

I authorize NAEYC to charge the above credit card at the amount of $

Signature:



To be eligible for NAEYC Accreditation, programs that are eligible to be licensed or regulated in their jurisdiction must in fact be licensed or regulated or must be the in process of becoming licensed/regulated. Programs that are license-exempt and not otherwise regulated must voluntarily seek licensure. In states where license-exempt programs are legally prohibited from seeking licensure, programs must verify that they voluntarily comply with applicable licensing or regulatory standards. Report your current licensing/regulation status by selecting one of the four options below. You will be asked to provide current evidence of licensing status during your site visit.

Option 1: My program is licensed by the appropriate state agency.

My program is licensed by: State: Agency: with a:

Full License

Temporary License

Provisional License

Other:

My program is license-exempt, but voluntarily licensed. No Yes

My program’s license expires. No Yes – if yes, indicate expiration date:

License Number: Specialist Name: Phone:

Option 2: My program is regulated. Appropriate regulatory bodies refer to public agencies such as a board of education or the military.

My program is regulated by:

My program’s regulation expires. No Yes – if yes, indicate expiration date:

Option 3: My program is license-exempt, eligible for licensure, and has begun the application process to become licensed.

The application process for licensure was begun in: Month: Year:

With: State: Agency:

Until the program becomes licensed, I verify that: 1) The program administrator has reviewed the state’s licensing requirements; 2) The Board chair/president or owner has reviewed the state’s licensing requirements; 3) My program is voluntarily in compliance with the state’s licensing requirements; and 4) Upon registration of children in the program, my program provides families with a copy of the state’s licensing

requirements, informs families that the program is license-exempt, and informs families that the program is voluntarily in compliance with the state’s licensing requirements.

Option 4: My program is license-exempt, and legally prohibited from licensure.

I verify that: 1) The program administrator has reviewed the state’s licensing requirements; 2) The Board chair/president or owner has reviewed the state’s licensing requirements; 3) My program is voluntarily in compliance with the state’s licensing requirements; 4) Upon registration of children in the program, my program provides families with a copy of the state’s licensing

requirements, informs families that the program is license-exempt, and informs families that the program is voluntarily in compliance with the state’s licensing requirements;

5) The program has documentation of fire and health inspections; and 6) The program will have completed a criminal background check on all staff and have complied with state and federal

law concerning background checks. In addition, the program employs no individual convicted of a crime involving sexual abuse or child abuse or neglect.

Section 3: LICENSING/REGULATION

Licensing/Regulatory Status (includes programs that are license-exempt)



Section 4: PROGRAM OPERATIONS

Program Closures

My program operates 12 months/year. OR My program operates less than 12 months/year.

The program begins serving children on .

The program ends on .

Hours of Operation: Indicate the days of the week your program operates and time of day your program opens and closes each day.

Program is open 24 hours/day, 7 days a week

Days Open Monday Tuesday Wednesday Thursday Friday

Opening Time :

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

Closing Time :

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

:

a.m.

p.m.

Additional Information Note any special circumstances regarding your program’s schedule that may affect scheduling a site visit, such as classes that have different time frames than the Hours of Operation listed above.

Summary of Classes: Please report on all eligible classes your program serves.

Age Categories Part Day Classes (meet for <5 hrs)

Full Day Classes (meet for ≥5 hrs) Total Classes

Infant Class(es)

Toddler/Two Class(es)

Preschool Class(es)

Kindergarten Class(es)

Mixed Age Class(es)

TOTAL of all classes:



Administrative Staff Qualifications Option Guide

Use the guide below as a reference to indicate the qualifications of the administrative staff member(s) within your program. One person may meet the qualifications for both the Operational Administrator and the Pedagogical Administrator (one person meets A or B AND C or D), or two separate individuals may meet as either the Operational Administrator or the Pedagogical Administrator (one person meets A or B and a second person meets C or D). Operational Administrator: The administrator responsible for the operational leadership of the program, including functions such as business leadership, facilities management, legal and fiscal management, marketing, and use of technology. This administrator may have a title such as director, site manager, program manager or principal. Pedagogical Administrator: The administrator who provides program leadership in instructional matters, such as developmentally appropriate practice, curriculum and instruction, child assessment; and inclusion practices. This administrator may have a title such as director, assistant director, curriculum coordinator, or master teacher. Option If the Operational Administrator has this

qualification: You must provide this documentation:

A A Baccalaureate degree in any field and 9 college-level credits in business or program administration

1. a transcript reflecting an earned BA degree; OR 2. a diploma reflecting that a BA degree was completed; AND 3. transcripts showing at least college-level 9 credits in business

or program administration

B

A Baccalaureate degree in any field and a state-issued principal credential OR a state-issued education administrator or director

credential that has been reviewed and approved by NAEYC.

1. a transcript reflecting an earned BA degree; OR 2. a diploma reflecting a BA degree was completed; AND 3. a state-issued principal credential; OR 4. a state-issued education administrator or director credential

that has been reviewed and approved by NAEYC.

Option If the Pedagogical Administrator has this qualification: You must provide this documentation:

C A Baccalaureate degree in early childhood education (ECE) or a related major (child development, elementary education, early childhood special education).

1. a transcript that specifies an ECE, or related major and reflects that the degree was earned; OR

2. a diploma reflecting a BA degree that lists the ECE, or related major.

D

A Baccalaureate degree in any field with 36 ECE-related credits and field experience. Field experience may have been earned as part of student-teaching or other practicum work within a higher-education course. Field experience can also be documented as time spent employed as a member of an ECE teaching team.

1. a transcript reflecting an earned BA degree; OR 2. a diploma reflecting that a BA degree was completed; AND

3. transcripts reflecting at least 36 credits in ECE-related higher education; AND

4. documentation of field experience

E A Master degree, or higher in early childhood education (ECE) or a related major (child development, elementary education, early childhood special education).

1. a transcript that specifies an ECE, or related majors and

reflects that the degree was earned; OR

2. a diploma reflecting an MA degree, or higher, that lists the

ECE or related major.

Administrative Staff Qualifications

List one or two administrative staff members. Place an X in the box for the option the administrator fully meets. Do not attach documentation.

Operational Administrator

Option A B No options met

BA + 9 business credits

BA + state credential

Pedagogical Administrator

☐ Same person as Operational Administrator

Option C D E No options met ECE BA degree

ECE BA equivalent

ECE MA degree

Section 5: STAFF QUALIFICATIONS



https://www.naeyc.org/sites/default/files/globally-shared/downloads/PDFs/accreditation/early-learning/administrator_credentials_2018.pdf



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Section 5: STAFF QUALIFICATIONS continued

Teaching Staff Qualifications Option Guide

NAEYC defines teaching staff by the roles they fill within the class. Use the guide below as a reference to indicate the qualifications of teaching staff members on the following pages. Be sure to choose one option per teaching staff member, indicating the highest level of education obtained.

Option If the teaching staff member has this qualification:

He or she qualifies as:

Provide this documentation if needed:

A Current Child Development Associate (CDA) credential issued by the Council for Professional Recognition.

Assistant

Teacher Copy of currently valid CDA credential awarded by the Council for Professional Recognition

B

CDA Credential equivalent, defined by NAEYC as at least 12 college credits in ECE, child development, elementary education, or early childhood special education.

Assistant

Teacher

1. Transcript documenting 12 ECE credits (highlight credits) OR

2. Documentation from a college or university that would grant a minimum of 12 credits for a specified training program OR

3. Military training modules

C

An associate’s degree (AA) in ECE, child development, elementary education, or early childhood special education.

Teacher AND

Assistant Teacher

1. Transcript reflecting an earned AA degree that specifies major (highlight major) AND/OR

2. Diploma that lists the major field of study

D

The equivalency to an AA in ECE, defined by NAEYC as at least 60 college/university credits with at least 30 college credits in ECE, child development, elementary education, or early childhood special education.

Teacher AND

Assistant

Teacher

Transcript(s) documenting (highlight credits): 1. at least 60 college/university credits

INCLUDING 2. at least 30 credits in ECE, child

development, elementary education, or early childhood special education

E

A baccalaureate degree (BA) in ECE, child development, elementary education, or early childhood special education.

Teacher AND

Assistant Teacher

1. Transcript reflecting an earned BA degree that specifies major (highlight major) AND/OR


F

The equivalency to a BA or higher in ECE, defined by NAEYC as a

BA in any discipline AND o at least 36 college credits in ECE

or related fields OR

o State certificate to practice as a public school teacher, applicable to the age or grades of children served

Teacher AND

Assistant Teacher

1. Diploma OR transcript reflecting that a BA

degree or higher in any discipline was completed AND

2. Transcript(s) documenting at least 36 college credits in ECE, child development, elementary education, or early childhood special education (highlight credits) OR

3. State public school teaching certificate that lists the age or grade range of certification.

G A master degree (MA) or higher in ECE, child development, elementary education, or early childhood special education.

Teacher AND

Assistant Teacher

1. Transcript reflecting an earned MA degree or higher, and specifies major (highlight major) AND/OR




Teachers for All Eligible Classes in the Program

List teachers for each NAEYC-eligible class in your program. Make additional copies of this page if needed. Indicate the highest education option each staff member fully meets. Place “X” if a staff member does not meet any of the options. Do not attach documentation of qualifications.

C D E F G X

ECE AA Degree ECE AA Equiv. ECE BA Degree ECE BA Equiv. ECE MA Degree No options met

Staff First Name Staff Last Name Option

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Section 5: TEACHING STAFF



Assistant Teachers for All Eligible Classes in the Program

List assistant teachers for each NAEYC-eligible class in your program. Make additional copies of this page if needed. Indicate the highest education option each staff member fully meets. Place “X” if a staff member does not meet any of the options. Do not attach documentation of qualifications.

A B C D E F G X

CDA CDA Equiv.

ECE AA Degree

ECE AA Equiv.

ECE BA Degree

ECE BA Equiv. ECE MA Degree No options met

Equiv. ECE AA Degree ECE AA Equiv. ECE BA Degree ECE BA Equiv. ECE MA Degree No options met Staff First Name Staff Last Name Option

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Section 5: STAFF QUALIFICATIONS continued



10B.16 Evidence of licensing/regulatory status

Show that your program and your facility has a license to operate, or is regulated by an applicable public regulatory system. Your license or regulatory documentation indicates your program is in good standing with your regulatory y.

Evidence needed to meet this assessment item may vary from program to program. A fully valid and current license completely meets the assessment item and no additional evidence is needed to support “good standing” (see definition below). If there is some question about license status, programs must present additional evidence to support “good standing”. Programs that are license-exempt and not otherwise regulated need to execute a NAEYC “License-Exempt Acknowledgement Form” in order to meet this item. Such programs do not need to offer evidence of good standing, because they cannot. Regulated: Programs that are not licensed by a state government but are under the regulation of a public agency, such as Department of Defense or a board of education. Good standing: The program has a fully valid and current license or certification. Suspensions or revocations of licensing or regulatory statuses are NOT accepted as evidence of good standing. Examples of acceptable licensing/regulatory evidence: Full and current license or regulatory certificate, correspondence from licensing or regulatory body showing good standing or licensing extension, web link to state public licensing reports of program status, NAEYC “License-Exempt Acknowledgement Form”.

Section 6: SELF-ASSESSMENT

Topic Area 10F: Program Evaluation, Accountability, and Continuous Improvement

Please reflect on the items below and tell us what your program has done in the past 12 months to support continuous quality improvement. Do Not Attach Documentation.

10F.2: Show that when the annual comprehensive program evaluation is completed, program staff, families, and advisory or governance board members are given a report of the findings.

10F.3: Show or describe two examples of how you have used information from your annual comprehensive program evaluation to plan professional development.

10F.4: Show or describe two examples of how you have used information from your annual comprehensive program evaluation to improve program policies, procedures, or activities.

Required Documents for the Site Visit

The items below are required, and are assessed in the Program Portfolio. Failure of these items will cause a program to fail the entire assessment. Self-assess your current documentation to assure that each bullet point is addressed. If you are unsure whether your documentation is sufficient, call your NAEYC Program Support Specialist for assistance.

1B.10 Critical part of guidance/discipline policy Show that your guidance/discipline policy does not include any circumstances when it is permissible for staff to use any form of physical punishment, psychological abuse, or coercion when disciplining a child. Appropriate use of restraint for safety reasons is permissible.

Examples of physical punishment: shaking, hitting, spanking, paddling, slapping, jerking, squeezing, kicking, biting, pinching, excessive tickling, and pulling arms, hair, or ears; requiring a child to remain inactive for a long period of time. Examples of psychological abuse: shaming, name-calling, ridiculing, humiliation, sarcasm, cursing at, making threats; frightening a child; ostracism, withholding affection. Examples of coercion: rough handling (shoving, pulling, pushing, grasping of any body part); forcing a child to sit down, lie down, or stay down, except when restraint is necessary to protect the child or others from harm; physically forcing a child to perform an action (such as eating or cleaning up).



Program Professional Development Plan (PPDP)

Below is a checklist of best practices related to a program professional development plan (PPDP) Many of the best practices below are assessed on NAEYC’s updated accreditation site visit assessment. Related item numbers are shown.

Does your PPDP have the following characteristics? your PPDP have the following characteristics?

Item # YES NO In process

PPDP is a written document or form

PPDP is shared with staff 6D.14

Goal of your PPDP is to improve staff credentials and competencies

PPDP for each year is based on the needs identified through individual staff evaluations and your annual program evaluation.

10F.3

PPDP is updated at least annually (and more often as needed). 6D.13

Includes orientation methods and topics for new staff 6D.16

Orientation includes orientation to the specific curriculum your program uses. 6D.17

PPDP includes ongoing discussion of ethical issues 6B.4

PPDP explicitly considers continuing knowledge goals for administrators as well as other staff

6D.12

Identifies all professional development resources in your community

Does your PPDP track all teaching staff’s level of training in the following competencies?

Item # YES NO In process

Preparation to work with children and families of diverse races, cultures, and languages 6D.6

Knowledge of early childhood education curriculum approaches

Knowledge of the specific curriculum and assessment methods used in your program 6D.7

Communication and collaboration skills that prepare staff to participate as a member of a team

6D.8

Knowledge of child development that includes the specific age(s) and stages of the children they teach (infant, toddler/two, preschool, kindergarten, school age)

6D.9

Ability to adapt to the special circumstances of children in the program (e.g., military families, migrant, dual language learners, homeless, special education, trauma, rural, etc.)

6D.10

Staff who supervise or mentor other staff members are competent in adult supervision, mentoring, coaching, or leadership development.

6D.18

Indicate the types of professional development your program has accessed (for the entire staff or for individuals) in the past year. Item # YES NO In process

Coaching and/or mentoring experiences within your program

College credit-bearing coursework

In-service training

State-approved and/or state-required training workshops

Attendance at conferences

Pursuit of Child Development Associate credential

Pursuit of state professional credentials (teachers, administrators)

Other:

SECTION 6: SELF-ASSESSMENT continued



Section 7: SUBMISSION INSTRUCTIONS

Mail completed form to: Annual Report

P.O. Box 96037

Washington, D.C. 20090-6036

Email completed form to: [email protected]

NAEYC will ONLY accept Annual Reports through email if a credit card or purchase order payment is included. Programs paying via check

are not eligible to submit via email.

NAEYC accepts the postmark date as the submission date. NAEYC recommends that programs obtain written confirmation of receipt of all forms sent to NAEYC P.O. Boxes. NAEYC is not able to sign for materials that are delivered to a P.O. Box. Copy this form for your program’s records before submission. NAEYC will not return this form to the program.

Section 7: RIGHTS AND RESPONSIBILITIES

Program Rights

Right:

To access professional and timely support from NAEYC Accreditation of Early Learning Programs staff members

Right: To receive consistent updates on the NAEYC Accreditation process, policies, and procedures.

Right: To acquire the current NAEYC Early Learning Program Standards, including assessment materials and resources.

Right: To provide feedback to NAEYC Accreditation of Early Learning Programs regarding the NAEYC Accreditation process and the NAEYC Early Learning Program Standards.

Right: To be assured that program information provided to or collected by NAEYC Early Learning Programs remains confidential.

Section 7: RIGHTS AND RESPONSIBILITIES

Program Responsibilities

Responsibility: To understand the NAEYC Accreditation process and access the most current versions of the NAEYC Early Learning Program Standards, related assessment materials, and resources.

Responsibility: To involve all program stakeholders in a collaborative continuous quality improvement process.

Responsibility: To update NAEYC of any major changes related to the program, eligibility requirements, and critical incidents that may impact a program's quality.

Responsibility: To adhere to selected timelines for submission deadlines to avoid any penalty or lapse in accreditation.

Responsibility: To submit all applicable fees and forms to purse or maintain NAEYC Accreditation and avoid withdrawal from the accreditation process.

Signature

I have read and understand my program’s rights and responsibilities.

I verify that the information submitted in this form is accurate. If false or misleading information is ever provided to the NAEYC Early Learning Programs, I understand that my program’s pursuit of NAEYC Accreditation will cease and/or my program’s current accreditation may be withdrawn.

I verify that my program continues to meet all of the eligibility requirements for NAEYC Accreditation, as reported in the Application for NAEYC Accreditation (Step 2)

______________________________________ ___________________________________

Signature Date



mailto:[email protected]