Oregon Program of Quality

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OREGON’S QUALITY RATING & IMPROVEMENT SYSTEM MULTI-SITE PROGRAM REGISTRATION FORM This form is to be completed by programs who would like to use the multi-site portfolio process. One Registration Form is needed for each group of multi-site programs. How it works: Multi-site programs identify one program that they choose to be the main site. The main site submits a full portfolio that includes evidence for all standards. The individual sites will receive a simpler, shorter portfolio to complete. The scores from the common evidence that is sent with the main portfolio will be used when reviewing the individual site portfolios. Qualifications: To qualify to use the multi-site process, programs must meet the following requirements in addition to the Commitment to Quality requirements: • • •

There are 2 or more separate sites and license numbers. One mailing address and contact person will be designated for all sites. The programs use all of the common evidence in the common evidence checklist.

Common Evidence Checklist

Check if applies

     

Programs must use all of the common items listed to qualify.

Learning and Development LD1 LD2 LD9 LD10 LD11 LD12

Common philosophy Common curriculum(s) Common policy on screening and referral (if applicable) Common policy on group size, child-staff ratios, etc. Common policy on adult child interactions Common policy on behavior management

Health and Safety

   

HS1 HS3

Common policy for managing health and hygiene practices Common policy on healthy eating habits



PQ5 Common policy about ethics training Family Partnerships

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FP1 Common policy about using family input FP2 Common policy on communicating with and including families Administration and Business Practices

     

AB1 AB2 AB3 AB4 AB5

Common business practices, policies & procedures Common policies on professional working climate Common policies about personnel evaluation Common practices promoting positive working relationships and professionalism Common comprehensive program evaluation

AB6

Common benefits are offered to encourage retention

HS5 Common policy on collaboration with health and related service professionals HS6 Common policy on screen time Personnel Qualifications

Yes, our programs meet all of the above requirements. _________________________ Signature

I:\train\QRIS\Multi-site\Final Documents\Multi-site application 12-1-15 final.docx

MULTI-SITE PROGRAM REGISTRATION FORM, PAGE 2 Complete the information below and include this form with all of the applications for Commitment to Quality for each licensed site. Please send them together. Contact person for all sites:

Title:

Email Address: (of contact) Main Mailing Address:

Phone: (

) ___________________

________________________________________________________________

Name of main site:

Street Address City

State

License # of main site:

1. Name of individual site :

License # of individual site:

2. Name of individual site :

License # of individual site:

3. Name of individual site :

License # of individual site:

4. Name of individual site :

License # of individual site:

5. Name of individual site :

License # of individual site:

6. Name of individual site :

License # of individual site:

7. Name of individual site :

License # of individual site:

8. Name of individual site :

License # of individual site:

9. Name of individual site :

License # of individual site:

10. Name of individual site :

License # of individual site:

11. Name of individual site :

License # of individual site:

12. Name of individual site :

License # of individual site:

13. Name of individual site :

License # of individual site:

14. Name of individual site :

License # of individual site:

15. Name of individual site :

License # of individual site:

16. Name of individual site :

License # of individual site:

17. Name of individual site :

License # of individual site:

18. Name of individual site :

License # of individual site:

19. Name of individual site :

License # of individual site:

20. Name of individual site :

License # of individual site:

Attach additional sheets if necessary. I:\train\QRIS\Multi-site\Final Documents\Multi-site application 12-1-15 final.docx

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