MY
EARLY YEARS PERSONAL EDUCATION PLAN: For
Looked after Children, pre-school age children (2 years old +) in
preschool, nursery or day care provision.
Note: If completing electronically click in grey rectangles and type. Navigate to boxes with mouse or cursor/arrow keys. Greyed boxes are tick boxes, click once to put ‘x’ in box, click again to remove. ‘X’ means ‘yes’, blank means ‘no’ if yes/no not stated.
About me:
My Name: |
My D.O.B: Yrs Months |
My Current Address: |
Date of this PEP: |
Date of next PEP review meeting: |
UPN: |
Frameworki no.: |
First Language: |
Ethnicity: |
SEN /Disability Status: |
Name of principal carer/s at the above address:
Home telephone :
Work telephone :
Mobile :
Email :
Name of Early Years Setting:
Address :
Key Person :
Telephone number :
Mobile :
Email :
Social Worker (SW) : SW Office Base : Telephone : Mobile : Email : Duty Contact Number : |
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People involved with my plan |
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Role |
Name |
Attended PEP Meeting? |
My Social Worker |
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My Carer(s) |
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My Early Years Key Person |
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Inclusion / SEN Coordinator |
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My Parent(s) |
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Other e.g., FIRST, Portage |
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Independent Reviewing Officer |
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Contact Sheet
Legal Status
Full Care Order (Section 31) Interim Care Order
Accommodated (Section 20) Prior to Adoption Placement
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NAME |
Who has parental responsibility? |
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Is there anyone who should not have contact with the child? |
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Who will be first point of contact for the Early Years Provider in an emergency (i.e. unplanned parent visit, medical)? |
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What position should the Early Years Provider take if contacted by any of the above persons who are not to be involved (e.g. contact social worker, police)? |
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Who will receive and respond to communication from the Early Years setting, including education reports? |
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Who will be the parent partner with the setting? (ie, attend parents meetings etc) |
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Who will give permission for trips / outings? |
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Who will sign the Home/Early Years Agreement? |
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Who takes responsibility on health issues e.g. immunization, taking medicines, sign the accident book? |
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Is permission given for taking or using of photographs of me? Yes or No |
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Are there any medical needs which the Early Years provider needs to be aware?
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Is there a health care plan agreed with those holding Parental Responsibility? |
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Is this child educated out of West Sussex Authority? YES NO
If so, name of Authority hosting Early Years education provision:
What action has been agreed between Authorities to support the PEP and planning?
All About Me
I like Doing:
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People I like:
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I am good at:
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I feel Happy when:
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I feel Sad when:
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I feel Angry when:
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I feel Scared when:
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I like Playing with:
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People who Help me:
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Something Special about me is:
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At home I like to :
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Carer / Parent Views
What does your child like to do at home?
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What activities do you do together to support your child’s learning (e.g. sharing books together, cooking)?
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What activities does your child attend or enjoy taking part in?
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What is your child’s preferred method of communication? Have you noticed any difficulties in how they relate to others or make friends?
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What routines are important to your child?
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How well does your child cope with a situation they are unsure of? If they become worried / scared, what strategies help to reassure them?
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Are there any times of the year / situations / celebrations that your child may find difficult to cope with?
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How do you think your child is getting on in the setting?
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Do you have any concerns about your child’s learning or development?
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Is there anything the setting can do to further support you? If yes, please state:
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Does your child’s Key Person regularly share information with you about your child?
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Information from Early Years Setting
When completing this form, please consider information used within the child Learning Journal, Individual Education Plan / Play Plan , Early Years Foundation Stage Profile (if applicable) or other tools used for recording child’s progress .
General Information about the child’s place at the setting: Date child first attended setting:
Number of hours registered to attend each week:
Number of hours registered to attend each day:
Monday: Tuesday: Wednesday: Thursday: Friday:
Does the child attend any other early years settings? Yes No
If yes, name the setting and key person
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Attendance: Have any patterns of non-attendance been identified? Yes No
If yes, what support has been put in place? |
Records for PEP meeting: Does the contact sheet need updating? Yes No
Has the child’s view sheet been completed? Yes No Has the carer / parent view sheet been completed? Yes No
Have records been used to monitor learning and development? Yes No |
Transition: Does an application need to be made for the next school / placement? Yes No
Who will make this application? :
Has a ‘transition plan’ and the ‘All about me’ and ‘Moving on’ sections Yes No of the Learning Journal been completed?
Does the child require any support in changing settings? Yes No
Who will provide this support? |
External Support Would support from the FIRST team benefit the child? Yes No
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Information from Early Years Setting – Progress Overview
Review of actions agreed in last EYPEP:
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Personal, Social and Emotional Development Summary of key skills, interests and characteristics of learning:
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Communication and Language
Summary of key skills, interests and characteristics of learning:
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Physical Development
Summary of key skills, interests and characteristics of learning:
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Next Steps in learning:
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Next Steps in learning:
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Next Steps in learning:
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Stage of Development |
Stage of Development |
Stage of Development |
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Self-confidence & self awareness |
Listening and Attention |
Moving and Handling |
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0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
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Making Relationships |
Understanding |
Health and self-care |
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0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
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Managing Feelings and Behaviour |
Speaking |
Stages in months – choose the band which is the current best fit for the child |
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0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
0-11 |
8-20 |
16-26 |
22-36 |
30-50 |
40-60+ |
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Additional comments:
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Action Plan
Action
Plan Record:
Record
below all actions and interventions that are needed to support the
child with their educational progress or social / emotional
development.
Date
of next PEP meeting ( approx 3 or 6 months ):
Form completed by:
Form distributed by:
May
2012 WSCC Early Years Personal Education Plan Page
2012 WINTEREARLY SPRING THURSDAY NIGHT TRACK RACING SERIES FEBRUARY
20122013 PEIMS DATA STANDARDS APPENDIX H EARLY NOTICE OF
2015 – YEAR IV MENTOR APPLICATION PRINT CLEARLY IN
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