Coaching Request for Silver/Gold (3-5 Star) Recovery
Cincinnati Preschool Promise is offering a limited amount of coaching and professional development support to our previously approved Tuition Assistance Providers that have lost high-quality rating. If you are interested, please complete the form below. You will receive a confirmation notice upon the team review. If you have any questions, contact Cincinnati Preschool Promise Provider Specialist Lindsey DiBlasi at ldiblasi@cincy-promise.org.
Name of Person Completing Request:
*
First Name
Last Name
Title/Position of Person Completing Request:
*
Name of Program (as listed of ODJFS License):
*
Child Care License Number (as listed of ODJFS License):
*
Program Type:
*
Please Select
Type A
Type B
Center
Preschool
Type B FCC - Do you have at least 1 CPP Tuition Assistance Child Enrolled in Your Program?:
Yes
No
Type A FCC - Do you have at least 2 CPP Tuition Assistance Children Enrolled in Your Program?:
Yes
No
Child Care Center/Preschool - Do you have at least 5 CPP Tuition Assistance Children Enrolled in Your Program?
Yes
No
Email Address of Person Completing This Request:
*
example@example.com
Best Phone Number of Person Completing Request:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Communication:
*
Email
Mail
Phone
How Many Preschool Classrooms Do You Have?:
*
Please Select
1
2
3
4
5
6
7
8
9
10
How Many Preschoolers Do You Have in Your Child Care Program?:
*
How Many Open/Vacant Seats Are Available?:
*
Tell Us How CPP Can Help:
*
Reason for Star Rating Change (Why you need support - Check all that apply):
*
Licensing Serious Risk Non-Compliance
Accumulation of Licensing Non-Compliance Points
Failed to Meet Star Rating Requirements
Please Upload SUTQ On-Site Verification Summary:
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If Selected "Other", please explain:
Coaching Focus Area: (What SUTQ standard(s) does your program need coaching support in? Check all that apply)
*
Curriculum and Planning
Child Screening and Assessment
Interactions and Environment
Program Administration
Staff Management
Staff Education
Professional Development
Transitions
Communication and Engagement
Other
If Selected "Other", please explain:
Did Your Program Receive Any Non-Compliances on Licensing Inspections Over the Past 12 Months?
*
Yes
No, we were fully compliant
Please Report All Non-Compliances Listed on Licensing Inspections Over the Past 12 Months (please ensure all sections below are completed):
Have You, or Are You Currently Working With a Coaching Agency? (If yes, which agency and who was your coach?)
*
Would You Like to Work With the Same Coaching Agency?
*
Yes
No
Any Coaching Agency is fine
N/A
Would You Like to Work With the Same Coach?
*
Yes
No
Any coach is fine
N/A
Please provide details about your previous coaching experience. If you have not received coaching in the past, N/A is acceptable.
*
What is the primary child assessment tool your preschool program use and how frequently does your program assess children with this tool within a program year? (Please ensure all sections below are completed)
*
What is the primary curriculum your preschool program uses? How satisfied are you with this curriculum?
*
Please Detail Why You Are Dissatisfied With the Current Curriculum Choice:
Comments:
Specify any additional CPP support needed: (Tell us why your program needs help. In order to be considered for the following support, your program must participate in the coaching process. Check all that apply)
*
CDA Assessment
CDA Course
CDA Renewal
Coaching Only
Training/Workshop
Other
Submit
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