Stage 2. To be completed by Settings in partnership with parent/carer

Early Years SEN Targeted Support Request for Service Involvement

Notes on completion of this form:

This request will provide the early years Parenting & Families Teamwith information aboutyour childcare settingand targeted support required. The information will be used to determine the level of support provided for the childcare setting as appropriate. It is therefore important for practitioners to work closely with the child’s parents / carers and other specialists as necessary in compiling this information. The initial EY SEN Targeted Support forward planning record of discussion with parents meeting is key to ensuringclarity and shared purpose, the setting should convene a meeting with parents/carers to discuss the individual child and complete the form.

Once completed, please discuss this Request for Service Involvement with the Parenting & Families Worker during the weekly SEND Drop in at your local Children’s Centre.

SECTION 1:

Setting Name & Address:
Telephone no:
Setting SENCO:
Form completed by: Position:
Date:

SECTION 2:

Please indicate what you would you like to gain from the involvement of the Early Years Parenting Families Team?
The list below identifies the main areas in
which we can work in partnership with services/settings
  • Additional advice or support developing ILDPs, Person centred approaches, observation and/or assessment
  • Additional advice or support in relation to practice/strategies
  • Coaching, mentoring ,role modelling
  • Training/co-delivery on a specific issue e.g. attend a staff meeting
  • Advice and support for the family regarding funded nursery education(e.g. 30hours,
tax free childcare)
Please add additional information as appropriate

SECTION 3:

Parental consent for the Early Years Parenting &Families Team involvement – Please ensure you bring a copy of the completed Early Years SEN Targeted Support Forward Planning (Record of discussion with parents)

SECTION 4:

To be completed by the setting SENCO:

This referral has been discussed and agreed Parent/carers and evidence can be provided in relation to the statements below:
  • The initial EY SEN Targeted Support forward planning record of discussion with parents
  • Evidence of attendance at SEND Drop Ins, attendance at SENCO Training or Networks
  • Evidence of what the setting has already done/put in place, i.e. Evidence of strategies & outcomes
Please note receiving Early Years SEN Targeted Support does not constitute to additional funding, resources or equipment this may be considered following discussion with the Early YearsParenting & Families Worker and at the discretion of the Early Years SEN Panel.
The child must reside in the borough Buryand be eligible for 2, 3 or 4 year funding in order to access any additionalfunding, resources or equipment.
Name:
Signed: Date:

Early Years SEN Targeted Support 2017

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