Early Learning and Care Enrollment

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Preschool Interest Form
Head Start/ State Preschool for Children 3-5 years old

Free or Low Cost for Income Eligible Families

To enroll into Head Start or State Preschool for children 3-5 years old, please pick up an enrollment packet at Enrollment Center, located at 5601 47th Avenue, M-TH 8:00am-3:30pm (closed 11:30am-12:00pm for lunch) and Fri. 8:00am-11:00.

For information please fill out the Preschool Interest Form. A Child Development staff member will get back to you about next steps in registering your child for preschool.

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Early Learning and Care Enrollment Information

Be prepared to send the following documentation:

  • Proof of Birth-County issued Birth Certificate, duly attested baptism certificate, or a non-expired passport. When none of the foregoing is obtainable, the parent/guardian may provide any other appropriate means of proving the age of the child (Ed. Code 48002)
  • Immunization Record –Current and up-to-date. Both name and date of birth must be on the immunization record
  • Child’s TB Test (PPD) or Completed TB Risk Assessment (completed within the past 12 months)
  • Child’s Physical Exam (completed within the past 12 months) or an appointment date *
  • Child’s Dental Exam (completed within the past 12 months) or an appointment date
  • Child’s Medical Insurance Card
  • Proof of W.I.C. (if applicable)
  • Current and consecutive 30 days of any/all income documentation such as check stubs, disability, SSI/TANF/CalWorks statements for all adults
  • Employment Verification Form (Full-day and State preschool options)
  • Address Verification (current SMUD/PG&E/Water or lease/rental agreement) **
  • Birth Certificate(s) for all siblings under 18-years-old living in the home

In addition:

  • Need Verification (Full-day only) i.e., work schedule, school/training schedule or self-certification of seeking employment
  • Individualized Education Plan (IEP) if your child is receiving Special Education services, including speech
  • Health condition documentation; including but not limited to asthma, food allergy, heart history, seizure disorder and bee sting
  • Guardianship/Foster Care/Custody documents (if applicable)
  • If you would like to volunteer you must complete a volunteer packet and provide copies of a TB clearance (dated within 12 months) and Immunizations against Influenza, Pertussis and Measles

*Child’s Physical Exam is due within 30 days of enrollment or your child will be excluded until one is provided.

**If residing with another person (relative, etc.), please complete the Declaration of Residence form of the person identified on applicable verified address document.