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Run: Head Start Annual Program Self-Assessment Worksheet

Use this Head Start annual self-assessment worksheet to document progress on program goals, school readiness, service areas, compliance, and follow-up action...

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Assessment Overview

Assessment Year (required)

Enter the program year being assessed, such as 2025-2026.

Assessment Date (required)

Select the date the self-assessment was completed.

Program or Grantee Name (required)

Enter the Head Start grantee or program name.

Site, Region, or Service Area

Optional field for multi-site programs to identify the location or service area reviewed.

Assessment Team Lead (required)

Name and role of the person coordinating the self-assessment.

Program Goals and School Readiness Review

Progress Toward Program Goals (required)

Rate overall progress toward annual program goals based on available evidence.

Progress Toward School Readiness Objectives (required)

Rate progress toward school readiness objectives across domains such as language, literacy, math, social-emotional development, and physical development.

Evidence Sources Reviewed (required)

Select the data sources used for the self-assessment. Use only the sources actually reviewed.

Summary of Evidence and Findings (required)

Summarize the key evidence reviewed, notable trends, and overall findings. Avoid including unnecessary PII.

Service Area Self-Assessment

Education and Child Development Services (required)

Family Engagement and Partnerships (required)

Health, Mental Health, and Nutrition Services (required)

Disabilities, Inclusion, and ADA Reasonable Accommodation Practices (required)

Include review of inclusion practices and reasonable accommodation processes without collecting sensitive disability details unless necessary.

Key Strengths Identified (required)

Describe the strongest practices identified during the review.

Key Gaps or Concerns Identified (required)

Describe gaps, risks, or recurring issues that need improvement.

Governance, Compliance, and Operations

Governance and Policy Review Status (required)

Indicate whether governance and policy review items were completed satisfactorily.

Fiscal Controls and Resource Management Status (required)

Staffing and Training Status (required)

Compliance Concerns Identified

Select any compliance areas that require corrective action.

Yes No N/A

Compliance Notes

Provide brief notes on any identified compliance concerns. Do not include unnecessary PII.

Improvement Plan and Follow-Up

Priority Improvement Actions (required)

List the top actions needed to address findings from the self-assessment.

Action Owner (required)

Name or role responsible for tracking the improvement action.

Target Completion Date (required)

Select the target date for completing the highest-priority action.

Is additional follow-up required? (required)

Follow-Up Details

Describe the follow-up steps, monitoring method, and any milestones.

Attestation and Submission

Attestation (required)

Required acknowledgment before submission.

Yes No N/A

Submitter Name (required)

Enter the name of the person submitting the worksheet for review.

Submitter Role (required)

Enter the submitter's role or title.

Signature

Optional electronic signature if your workflow requires it.

Get your results

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Email (required)

Your name (optional)

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