Section II

##### Section II

##### A. State Policies, Procedures, Methods, and Descriptions

As checked below, the State hereby declares that it has or has not filed
the following policies, procedures, methods, and descriptions with the
U.S. Department of Education, and, as of the date of the signature
below, affirms and incorporates by reference those policies, procedures,
methods, and descriptions with respect to Part C of PL 108-446.

+---+---+---+---+---------+--------------------------------------------------+
| * |   |   |   |         | ***N = 'New' Policy and/or Procedure***          |
| C |   |   |   |         |                                                  |
| h |   |   |   |         | ***R = 'Revised' Policy and/or Procedure***      |
| e |   |   |   |         |                                                  |
| c |   |   |   |         | ***OF = Policy and/or Procedure is already 'On   |
| k |   |   |   |         | File' with the USDOE***                          |
| a |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| ( |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| ) |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| p |   |   |   |         |                                                  |
| p |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| c |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| b |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| . |   |   |   |         |                                                  |
| E |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| c |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| v |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| c |   |   |   |         |                                                  |
| u |   |   |   |         |                                                  |
| m |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| . |   |   |   |         |                                                  |
| * |   |   |   |         |                                                  |
+===+===+===+===+=========+==================================================+
| * |   |   |   | **No\   |                                                  |
| * |   |   |   | (***Po  |                                                  |
| Y |   |   |   | licies, |                                                  |
| e |   |   |   | proc    |                                                  |
| s |   |   |   | edures, |                                                  |
| \ |   |   |   | m       |                                                  |
| * |   |   |   | ethods, |                                                  |
| * |   |   |   | and     |                                                  |
| * |   |   |   | descr   |                                                  |
| ( |   |   |   | iptions |                                                  |
| P |   |   |   | have    |                                                  |
| o |   |   |   | not     |                                                  |
| l |   |   |   | been    |                                                  |
| i |   |   |   | pr      |                                                  |
| c |   |   |   | ovided. |                                                  |
| i |   |   |   | Provide |                                                  |
| e |   |   |   | date by |                                                  |
| s |   |   |   | which   |                                                  |
| , |   |   |   | State   |                                                  |
| p |   |   |   | will    |                                                  |
| r |   |   |   | submit  |                                                  |
| o |   |   |   | to OSEP |                                                  |
| c |   |   |   | r       |                                                  |
| e |   |   |   | equired |                                                  |
| d |   |   |   | do      |                                                  |
| u |   |   |   | cumenta |                                                  |
| r |   |   |   | tion.)* |                                                  |
| e |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| , |   |   |   |         |                                                  |
| m |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| h |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| , |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| c |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| p |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| b |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| g |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| u |   |   |   |         |                                                  |
| b |   |   |   |         |                                                  |
| m |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| w |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| h |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| h |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| p |   |   |   |         |                                                  |
| p |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| c |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| t |   |   |   |         |                                                  |
| h |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| N |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| w |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| , |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| R |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| v |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| s |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| , |   |   |   |         |                                                  |
| o |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| r |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| a |   |   |   |         |                                                  |
| d |   |   |   |         |                                                  |
| y |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| O |   |   |   |         |                                                  |
| n |   |   |   |         |                                                  |
| F |   |   |   |         |                                                  |
| i |   |   |   |         |                                                  |
| l |   |   |   |         |                                                  |
| e |   |   |   |         |                                                  |
| ' |   |   |   |         |                                                  |
| . |   |   |   |         |                                                  |
| ) |   |   |   |         |                                                  |
| * |   |   |   |         |                                                  |
+---+---+---+---+---------+--------------------------------------------------+
| * | * | * |   |         | **State Policies, Procedures, Methods, and       |
| * | * | * |   |         | Descriptions**                                   |
| N | R | O |   |         |                                                  |
| * | * | F |   |         |                                                  |
| * | * | * |   |         |                                                  |
|   |   | * |   |         |                                                  |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   |   |         | **State Policies and Procedures**                |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 1\. As required in 20 U.S.C. 1432(5)(A) and      |
|   |   |   |   |         | 1435(a)(1) the State has provided its policies   |
|   |   |   |   |         | and/or procedures regarding the State's          |
|   |   |   |   |         | definition of 'developmental delay' to ensure    |
|   |   |   |   |         | that a rigorous definition of the term           |
|   |   |   |   |         | 'developmental delay' will be used by the State  |
|   |   |   |   |         | in carrying out programs under this Part in      |
|   |   |   |   |         | order to appropriately identify infants and      |
|   |   |   |   |         | toddlers with disabilities that are in need of   |
|   |   |   |   |         | services under this Part.                        |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 2\. As required in 20 U.S.C. 1437(a)(4), if the  |
|   |   |   |   |         | State provides services to at-risk infants and   |
|   |   |   |   |         | toddlers through the statewide system, the State |
|   |   |   |   |         | has provided its: 1) description of services to  |
|   |   |   |   |         | at-risk infants and toddlers, and 2) definition  |
|   |   |   |   |         | of 'at-risk' under 20 U.S.C. 1432(5)(B)(i).      |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 3\. As required in 20 U.S.C. 1437(a)(9)(B) the   |
|   |   |   |   |         | State has provided its policies and/or           |
|   |   |   |   |         | procedures to ensure review of the child's       |
|   |   |   |   |         | program options for the period from the child's  |
|   |   |   |   |         | third birthday through the remainder of the      |
|   |   |   |   |         | school year.                                     |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 4\. As required in 20 U.S.C. 1437(a)(9)(C) the   |
|   |   |   |   |         | State has provided its policies and/or           |
|   |   |   |   |         | procedures to ensure the establishment of a      |
|   |   |   |   |         | transition plan, including, as appropriate,      |
|   |   |   |   |         | steps to exit from the program.                  |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   |   |         | ######### Optional Policies/Methods              |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   | N |         | > *Enter 'NA' in the cells to the left if the    |
|   |   |   | A |         | > State does not have a system of payment. (See  |
|   |   |   |   |         | > Section IV.A)*                                 |
|   |   |   |   |         |                                                  |
|   |   |   |   |         | 5\. As required in 20 U.S.C. 1432(4)(B) and      |
|   |   |   |   |         | 1437(a)(3)(A), the State has provided its        |
|   |   |   |   |         | policies and/or procedures that identify the     |
|   |   |   |   |         | State's system of payments for Part C services.  |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   | N |         | > *Enter 'NA' in the cells to the left if this   |
|   |   |   | A |         | > statement is not applicable; otherwise check   |
|   |   |   |   |         | > the 'N' cell under the 'Yes' column and attach |
|   |   |   |   |         | > all policies.*                                 |
|   |   |   |   |         |                                                  |
|   |   |   |   |         | 6\. As described in 20 U.S.C. 1435(c) the State  |
|   |   |   |   |         | has provided its policy, developed and           |
|   |   |   |   |         | implemented jointly by the lead agency and the   |
|   |   |   |   |         | State educational agency, under which parents of |
|   |   |   |   |         | children with disabilities who are eligible for  |
|   |   |   |   |         | services under 20 U.S.C. 1419 and previously     |
|   |   |   |   |         | received services under this part, may choose    |
|   |   |   |   |         | the continuation of early intervention services  |
|   |   |   |   |         | (which includes an educational component that    |
|   |   |   |   |         | promotes school readiness and incorporates       |
|   |   |   |   |         | preliteracy, language, and numeracy skills) for  |
|   |   |   |   |         | such children under this part until such         |
|   |   |   |   |         | children enter, or are eligible under State law  |
|   |   |   |   |         | to enter, kindergarten.                          |
|   |   |   |   |         |                                                  |
|   |   |   |   |         | > The statewide system ensures that\--           |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(A\) parents of children with disabilities    |
|   |   |   |   |         | > served pursuant to 20 U.S.C. 1435(c) are       |
|   |   |   |   |         | > provided annual notice that contains\--        |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(i\) a description of the rights of such      |
|   |   |   |   |         | > parents to elect to receive services pursuant  |
|   |   |   |   |         | > to 20 U.S.C. 1435(c) or under part B; and      |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(ii\) an explanation of the differences       |
|   |   |   |   |         | > between services provided pursuant to 20       |
|   |   |   |   |         | > U.S.C. 1435(c) and services provided under     |
|   |   |   |   |         | > part B, including\--                           |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(I\) types of services and the locations at   |
|   |   |   |   |         | > which the services are provided;               |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(II\) applicable procedural safeguards; and   |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(III\) possible costs (including any fees to  |
|   |   |   |   |         | > be charged to families as described in 20      |
|   |   |   |   |         | > U.S.C. 1432(4)(B)), if any, to parents of      |
|   |   |   |   |         | > infants or toddlers with disabilities;         |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(B\) services provided pursuant to 20 U.S.C.  |
|   |   |   |   |         | > 1435(c) include an educational component that  |
|   |   |   |   |         | > promotes school readiness and incorporates     |
|   |   |   |   |         | > preliteracy, language, and numeracy skills;    |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(C\) the State policy will not affect the     |
|   |   |   |   |         | > right of any child served pursuant to 20       |
|   |   |   |   |         | > U.S.C. 1435(c) to instead receive a free       |
|   |   |   |   |         | > appropriate public education under part B;     |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(D\) all early intervention services outlined |
|   |   |   |   |         | > in the child\'s individualized family service  |
|   |   |   |   |         | > plan under 20 U.S.C. 1436 are continued while  |
|   |   |   |   |         | > any eligibility determination is being made    |
|   |   |   |   |         | > for services under 20 U.S.C. 1435(c);          |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(E\) the parents of infants or toddlers with  |
|   |   |   |   |         | > disabilities (as defined in 20 U.S.C.          |
|   |   |   |   |         | > 1432(5)(A)) provide informed written consent   |
|   |   |   |   |         | > to the State, before such infants or toddlers  |
|   |   |   |   |         | > reach 3 years of age, as to whether such       |
|   |   |   |   |         | > parents intend to choose the continuation of   |
|   |   |   |   |         | > early intervention services pursuant to 20     |
|   |   |   |   |         | > U.S.C. 1435(c) for such infants or toddlers;   |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(F\) the requirements under 20 U.S.C.         |
|   |   |   |   |         | > 1437(a)(9) shall not apply with respect to a   |
|   |   |   |   |         | > child who is receiving services in accordance  |
|   |   |   |   |         | > with 20 U.S.C. 1435(c) until not less than 90  |
|   |   |   |   |         | > days (and at the discretion of the parties to  |
|   |   |   |   |         | > the conference, not more than 9 months) before |
|   |   |   |   |         | > the time the child will no longer receive      |
|   |   |   |   |         | > those services; and                            |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > \(G\) there will be a referral for evaluation  |
|   |   |   |   |         | > for early intervention services of a child who |
|   |   |   |   |         | > experiences a substantiated case of trauma due |
|   |   |   |   |         | > to exposure to family violence (as defined in  |
|   |   |   |   |         | > section 320 of the Family Violence Prevention  |
|   |   |   |   |         | > and Services Act).                             |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > The State shall submit to the Secretary, in    |
|   |   |   |   |         | > the State's report under 20 U.S.C.             |
|   |   |   |   |         | > 1437(b)(4)(A), a report on the number and      |
|   |   |   |   |         | > percentage of children with disabilities who   |
|   |   |   |   |         | > are eligible for services under 20 U.S.C. 1419 |
|   |   |   |   |         | > but whose parents choose for such children to  |
|   |   |   |   |         | > continue to receive early intervention         |
|   |   |   |   |         | > services under this part.                      |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > A description the funds (including an          |
|   |   |   |   |         | > identification as Federal, State, or local     |
|   |   |   |   |         | > funds) that will be used to ensure that the    |
|   |   |   |   |         | > option described 20 U.S.C. 1435(c)(1) is       |
|   |   |   |   |         | > available to eligible children and families    |
|   |   |   |   |         | > who provide the consent described in paragraph |
|   |   |   |   |         | > (2)(E), including fees (if any) to be charged  |
|   |   |   |   |         | > to families as described in 20 U.S.C.          |
|   |   |   |   |         | > 1432(4)(B).                                    |
|   |   |   |   |         | >                                                |
|   |   |   |   |         | > In accordance with 20 U.S.C. 1435(c)(5)(A),    |
|   |   |   |   |         | > when providing services to a child with a      |
|   |   |   |   |         | > disability who is eligible for services under  |
|   |   |   |   |         | > 20 U.S.C. 1419 the State is not required to    |
|   |   |   |   |         | > provide the child with a free appropriate      |
|   |   |   |   |         | > public education under part B for the period   |
|   |   |   |   |         | > of time in which the child is receiving        |
|   |   |   |   |         | > services under part C.                         |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   | N |         | > *Enter 'NA' in the cells to the left if this   |
|   |   |   | A |         | > statement is not applicable; otherwise check   |
|   |   |   |   |         | > either the 'N' or 'R' cell under the 'Yes'     |
|   |   |   |   |         | > column and attach appropriate written methods. |
|   |   |   |   |         | > See the optional technical assistance          |
|   |   |   |   |         | > checklist in Section V for full provisions of  |
|   |   |   |   |         | > 20 U.S.C. 1440.*                               |
|   |   |   |   |         |                                                  |
|   |   |   |   |         | 7\. The State has chosen to meet the requirement |
|   |   |   |   |         | to establish financial responsibility for early  |
|   |   |   |   |         | intervention services under 20 U.S.C. 1440(b)(1) |
|   |   |   |   |         | through 'appropriate written methods' under 20   |
|   |   |   |   |         | U.S.C. 1440(b)(3)(c) other than State statute or |
|   |   |   |   |         | regulation or signed interagency agreements.     |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   |   |         | ######### Descriptions                           |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 1\. As required by Section 427 of the General    |
|   |   |   |   |         | Education Provisions Act (GEPA), the State has   |
|   |   |   |   |         | identified barriers and developed strategies to  |
|   |   |   |   |         | address the barriers and has provided a          |
|   |   |   |   |         | description of the steps the State is taking to  |
|   |   |   |   |         | ensure equitable access to, and participation in |
|   |   |   |   |         | Part C.                                          |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 2\. As required in 20 U.S.C. 1437(a)(3)(B) the   |
|   |   |   |   |         | State has provided a description of early        |
|   |   |   |   |         | intervention services to be provided to infants  |
|   |   |   |   |         | and toddlers with disabilities and their         |
|   |   |   |   |         | families through the statewide system.           |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 3\. As required in 20 U.S.C. 1437(a)(5) the      |
|   |   |   |   |         | State has provided a description of the uses for |
|   |   |   |   |         | which funds will be expended in accordance with  |
|   |   |   |   |         | this part. *(See Section III.)*                  |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   | 6 |         | 4\. As required in 20 U.S.C. 1437(a)(6) the      |
|   |   |   | / |         | State has provided a description of its policies |
|   |   |   | 3 |         | and procedures that require the referral for     |
|   |   |   | 0 |         | early intervention services under this part of a |
|   |   |   | / |         | child under the age of 3 who -- (A) is involved  |
|   |   |   | 0 |         | in a substantiated case of abuse or neglect; or  |
|   |   |   | 6 |         | (B) is identified as affected by illegal         |
|   |   |   |   |         | substance abuse, or withdrawal symptoms          |
|   |   |   |   |         | resulting from prenatal drug exposure.           |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 5\. As required in 20 U.S.C. 1437(a)(7) the      |
|   |   |   |   |         | State has provided a description used to ensure  |
|   |   |   |   |         | that resources are made available under this     |
|   |   |   |   |         | part for all geographic areas within the State.  |
+---+---+---+---+---------+--------------------------------------------------+
|   |   | X |   |         | 6\. As required in 20 U.S.C. 1437(a)(8) the      |
|   |   |   |   |         | State has provided a description that ensures    |
|   |   |   |   |         | that, prior to the adoption by the State of any  |
|   |   |   |   |         | other policy or procedure necessary to meet the  |
|   |   |   |   |         | requirements of this part, there are public      |
|   |   |   |   |         | hearings, adequate notice of the hearings, and   |
|   |   |   |   |         | an opportunity for comment available to the      |
|   |   |   |   |         | general public, including individuals with       |
|   |   |   |   |         | disabilities and parents of infants and toddlers |
|   |   |   |   |         | with disabilities.                               |
+---+---+---+---+---------+--------------------------------------------------+
|   |   |   | 6 |         | 7\. As required in 20 U.S.C. 1437(a)(9)(A) the   |
|   |   |   | / |         | State has provided a description that ensures a  |
|   |   |   | 3 |         | smooth transition for toddlers receiving early   |
|   |   |   | 0 |         | intervention services under this part (and       |
|   |   |   | / |         | children receiving those services under by 20    |
|   |   |   | 0 |         | U.S.C 1435 (c)) to preschool, school, other      |
|   |   |   | 6 |         | appropriate services, or exiting the program,    |
|   |   |   |   |         | including a description of how: (i) the families |
|   |   |   | \ |         | of such toddlers and children will be included   |
|   |   |   | * |         | in the transition plans required 20 U.S.C.       |
|   |   |   |   |         | 1437(a)(9)(C); and (ii) the lead agency          |
|   |   |   |   |         | designated or established under 20 U.S.C.        |
|   |   |   |   |         | 1435(a)(10) will (I) notify the local            |
|   |   |   |   |         | educational agency for the area in which such a  |
|   |   |   |   |         | child resides that the child will shortly reach  |
|   |   |   |   |         | the age of eligibility for preschool services    |
|   |   |   |   |         | under part B, as determined in accordance with   |
|   |   |   |   |         | State law; (II) in the case of a child who may   |
|   |   |   |   |         | be eligible for such preschool services, with    |
|   |   |   |   |         | the approval of the family of the child, convene |
|   |   |   |   |         | a conference among the lead agency, the family,  |
|   |   |   |   |         | and the local educational agency not less than   |
|   |   |   |   |         | 90 days (and at the discretion of all such       |
|   |   |   |   |         | parties, not more than 9 months) before the      |
|   |   |   |   |         | child is eligible for the preschool services, to |
|   |   |   |   |         | discuss any such services that the child may     |
|   |   |   |   |         | receive; and (III) in the case of a child who    |
|   |   |   |   |         | may not be eligible for such preschool services, |
|   |   |   |   |         | with the approval of the family, make reasonable |
|   |   |   |   |         | efforts to convene a conference among the lead   |
|   |   |   |   |         | agency, the family, and providers of other       |
|   |   |   |   |         | appropriate services for children who are not    |
|   |   |   |   |         | eligible for preschool services under part B, to |
|   |   |   |   |         | discuss the appropriate services that the child  |
|   |   |   |   |         | may receive.                                     |
+---+---+---+---+---------+--------------------------------------------------+
|   | X |   |   |         | 8\. As required in 20 U.S.C. 1437(a)(10) the     |
|   |   |   |   |         | State has provided a description of State        |
|   |   |   |   |         | efforts to promote collaboration among Early     |
|   |   |   |   |         | Head Start programs under section 645A of the    |
|   |   |   |   |         | Head Start Act, early education and child care   |
|   |   |   |   |         | programs, and services under Part C.             |
+---+---+---+---+---------+--------------------------------------------------+

\* Revised 6/27/05

**B. Assurances and Optional Assurance**

**The State makes the following assurances and provisions as required by
Part C of the Individuals with Disabilities Education Act. (20 U.S.C.
1431 et.seq.)**

+-------+--------+----------------------------------------------------+
| *     |        | **Assurances\                                      |
| Check |        | ***(20 U.S.C. 1434;1435; and 1437(b))*             |
| and   |        |                                                    |
| enter |        |                                                    |
| da    |        |                                                    |
| te(s) |        |                                                    |
| as    |        |                                                    |
| a     |        |                                                    |
| pplic |        |                                                    |
| able* |        |                                                    |
+=======+========+====================================================+
| *     | **No\  |                                                    |
| *Yes\ | *      |                                                    |
| ***   | **(Ass |                                                    |
| (Assu | urance |                                                    |
| rance | cannot |                                                    |
| is    | be     |                                                    |
| h     | en     |                                                    |
| ereby | sured. |                                                    |
| p     | P      |                                                    |
| rovid | rovide |                                                    |
| ed.)* | date   |                                                    |
|       | on     |                                                    |
|       | which  |                                                    |
|       | State  |                                                    |
|       | will   |                                                    |
|       | co     |                                                    |
|       | mplete |                                                    |
|       | c      |                                                    |
|       | hanges |                                                    |
|       | in     |                                                    |
|       | order  |                                                    |
|       | to     |                                                    |
|       | p      |                                                    |
|       | rovide |                                                    |
|       | assura |                                                    |
|       | nce.)* |                                                    |
+-------+--------+----------------------------------------------------+
| X     |        | 1\. As applicable, the assurance found in OMB      |
|       |        | Standard Form 424(B) (Assurances for               |
|       |        | Non‑Construction Programs), relating to legal      |
|       |        | authority to apply for assistance; access to       |
|       |        | records; conflict of interest; merit systems;      |
|       |        | nondiscrimination; Hatch Act provisions; labor     |
|       |        | standards; flood insurance; environmental          |
|       |        | standards; wild and scenic river systems; historic |
|       |        | preservation; protection of human subjects; animal |
|       |        | welfare; lead‑based paint; Single Audit Act; and   |
|       |        | general agreement to comply with all Federal laws, |
|       |        | executive orders and regulations is in place.      |
+-------+--------+----------------------------------------------------+
|       | 6      | 2\. The State has adopted a policy that            |
|       | /30/06 | appropriate early intervention services are        |
|       | \*     | available to all infants and toddlers with         |
|       |        | disabilities in the State and their families,      |
|       |        | including Indian infants and toddlers with         |
|       |        | disabilities and their families residing on a      |
|       |        | reservation geographically located in the State,   |
|       |        | infants and toddlers with disabilities who are     |
|       |        | homeless children and their families, and infants  |
|       |        | and toddlers with disabilities who are wards of    |
|       |        | the State; and has in effect a statewide           |
|       |        | comprehensive, coordinated, multidisciplinary,     |
|       |        | interagency system to provide early intervention   |
|       |        | services, for infants and toddlers with            |
|       |        | disabilities and their families, that meet the     |
|       |        | requirements of 20 U.S.C 1433, 1434, and 1435.     |
+-------+--------+----------------------------------------------------+
| X     |        | 3\. The State has in effect a policy that ensures  |
|       |        | that appropriate early intervention services based |
|       |        | on scientifically based research, to the extent    |
|       |        | practicable, are available to all infants and      |
|       |        | toddlers with disabilities and their families,     |
|       |        | including Indian infants and toddlers with         |
|       |        | disabilities and their families residing on a      |
|       |        | reservation geographically located in the State    |
|       |        | and infants and toddlers with disabilities who are |
|       |        | homeless children and their families in accordance |
|       |        | with 20 U.S.C. 1435(a)(2).                         |
+-------+--------+----------------------------------------------------+
| X     |        | 4\. The State has in effect a timely,              |
|       |        | comprehensive, multidisciplinary evaluation of the |
|       |        | functioning of each infant or toddler with a       |
|       |        | disability in the State, and a family-directed     |
|       |        | identification of the needs of each family of such |
|       |        | an infant or toddler, to assist appropriately in   |
|       |        | the development of the infant or toddler in        |
|       |        | accordance with 20 U.S.C. 1435(a)(3).              |
+-------+--------+----------------------------------------------------+
|       | 6      | 5\. For each infant or toddler with a disability   |
|       | /30/06 | in the State, the State has an individualized      |
|       | \*     | family service plan in accordance with 20 U.S.C.   |
|       |        | 1436, including service coordination services in   |
|       |        | accordance with such service plan. (20 U.S.C.      |
|       |        | 1435(a)(4)) *See optional technical assistance     |
|       |        | checklist in Section V for all provisions of 20    |
|       |        | U.S.C. 1436.*                                      |
+-------+--------+----------------------------------------------------+
| X     |        | 6\. The State has a comprehensive child find       |
|       |        | system, consistent with Part B, including a system |
|       |        | for making referrals to service providers that     |
|       |        | includes timelines and provides for participation  |
|       |        | by primary referral sources and that ensures       |
|       |        | rigorous standards for appropriately identifying   |
|       |        | infants and toddlers with disabilities for         |
|       |        | services under this part that will reduce the need |
|       |        | for future services. (20 U.S.C. 1435(a)(5))        |
+-------+--------+----------------------------------------------------+
| X     |        | 7\. The State has a public awareness program       |
|       |        | focusing on early identification of infants and    |
|       |        | toddlers with disabilities, including the          |
|       |        | preparation and dissemination by the lead agency   |
|       |        | designated or established under 20 U.S.C.          |
|       |        | 1435(a)(10) to all primary referral sources,       |
|       |        | especially hospitals and physicians, of            |
|       |        | information to be given to parents, especially to  |
|       |        | inform parents with premature infants, or infants  |
|       |        | with other physical risk factors associated with   |
|       |        | learning or developmental complications, on the    |
|       |        | availability of early intervention services under  |
|       |        | this part and of services under 20 U.S.C. 1419,    |
|       |        | and procedures for assisting such sources in       |
|       |        | disseminating such information to parents of       |
|       |        | infants and toddlers with disabilities. (20 U.S.C. |
|       |        | 1435(a)(6))                                        |
+-------+--------+----------------------------------------------------+
| X     |        | 8\. The State has a central directory that         |
|       |        | includes information on early intervention         |
|       |        | services, resources, and experts available in the  |
|       |        | State and research and demonstration projects      |
|       |        | being conducted in the State. (20 U.S.C.           |
|       |        | 1435(a)(7))                                        |
+-------+--------+----------------------------------------------------+
| X     |        | 9\. The State has a comprehensive system of        |
|       |        | personnel development, including the training of   |
|       |        | paraprofessionals and the training of primary      |
|       |        | referral sources with respect to the basic         |
|       |        | components of early intervention services          |
|       |        | available in the State that                        |
|       |        |                                                    |
|       |        | \(A\) includes\--                                  |
|       |        |                                                    |
|       |        | (i) implementing innovative strategies and         |
|       |        |     activities for the recruitment and retention   |
|       |        |     of early education service providers;          |
|       |        |                                                    |
|       |        | (ii) promoting the preparation of early            |
|       |        |      intervention providers who are fully and      |
|       |        |      appropriately qualified to provide early      |
|       |        |      intervention services under this part; and    |
|       |        |                                                    |
|       |        | (iii) training personnel to coordinate transition  |
|       |        |       services for infants and toddlers served     |
|       |        |       under this part from a program providing     |
|       |        |       early intervention services under this part  |
|       |        |       and under part B (other than 20 U.S.C.       |
|       |        |       1419), to a preschool program receiving      |
|       |        |       funds under 20 U.S.C. 1419, or another       |
|       |        |       appropriate program; and                     |
|       |        |                                                    |
|       |        | \(B\) may include\--                               |
|       |        |                                                    |
|       |        | (i) training personnel to work in rural and        |
|       |        |     inner-city areas; and                          |
|       |        |                                                    |
|       |        | (ii) training personnel in the emotional and       |
|       |        |      social development of young children.         |
|       |        |                                                    |
|       |        | > (20 U.S.C. 1435(a)(8)(A) and (B))                |
+-------+--------+----------------------------------------------------+
|       | 6      | 10\. The State has policies and procedures         |
|       | /30/06 | relating to the establishment and maintenance of   |
|       | \*     | qualifications to ensure that personnel necessary  |
|       |        | to carry out this part are appropriately and       |
|       |        | adequately prepared and trained, including the     |
|       |        | establishment and maintenance of qualifications    |
|       |        | that are consistent with any State-approved or     |
|       |        | recognized certification, licensing, registration, |
|       |        | or other comparable requirements that apply to the |
|       |        | area in which such personnel are providing early   |
|       |        | intervention services, except that nothing in this |
|       |        | part (including this paragraph) shall be construed |
|       |        | to prohibit the use of paraprofessionals and       |
|       |        | assistants who are appropriately trained and       |
|       |        | supervised in accordance with State law,           |
|       |        | regulation, or written policy, to assist in the    |
|       |        | provision of early intervention services under     |
|       |        | this part to infants and toddlers with             |
|       |        | disabilities. (20 U.S.C. 1435(a)(9)).              |
+-------+--------+----------------------------------------------------+
| X     |        | 11\. The State has a single line of responsibility |
|       |        | in a lead agency designated or established by the  |
|       |        | Governor for carrying out --                       |
|       |        |                                                    |
|       |        | > \(A\) he general administration and supervision  |
|       |        | > of programs and activities receiving assistance  |
|       |        | > under 20 U.S.C. 1433, and the monitoring of      |
|       |        | > programs and activities used by the State to     |
|       |        | > carry out this part, whether or not such         |
|       |        | > programs or activities are receiving assistance  |
|       |        | > made available under 20 U.S.C. 1433, to ensure   |
|       |        | > that the State complies with this part;          |
|       |        | >                                                  |
|       |        | > \(B\) the identification and coordination of all |
|       |        | > available resources within the State from        |
|       |        | > Federal, State, local, and private sources;      |
|       |        | >                                                  |
|       |        | > \(C\) the assignment of financial responsibility |
|       |        | > in accordance with 20 U.S.C. 1437(a)(2) to the   |
|       |        | > appropriate agencies;                            |
|       |        | >                                                  |
|       |        | > \(D\) the development of procedures to ensure    |
|       |        | > that services are provided to infants and        |
|       |        | > toddlers with disabilities and their families    |
|       |        | > under this part in a timely manner pending the   |
|       |        | > resolution of any disputes among public agencies |
|       |        | > or service providers;                            |
|       |        | >                                                  |
|       |        | > \(E\) the resolution of intra- and interagency   |
|       |        | > disputes; and                                    |
|       |        | >                                                  |
|       |        | > \(F\) the entry into formal interagency          |
|       |        | > agreements that define the financial             |
|       |        | > responsibility of each agency for paying for     |
|       |        | > early intervention services (consistent with     |
|       |        | > State law) and procedures for resolving disputes |
|       |        | > and that include all additional components       |
|       |        | > necessary to ensure meaningful cooperation and   |
|       |        | > coordination. *See optional technical assistance |
|       |        | > checklist in Section V for full provisions of 20 |
|       |        | > U.S.C. 1440.*                                    |
|       |        | >                                                  |
|       |        | > (20 U.S.C. 1435(a)(10)(A)-(F)).                  |
+-------+--------+----------------------------------------------------+
| X     |        | 12\. The State has a policy pertaining to the      |
|       |        | contracting or making of other arrangements with   |
|       |        | service providers to provide early intervention    |
|       |        | services in the State, consistent with the         |
|       |        | provisions of Part C, including the contents of    |
|       |        | the application used and the conditions of the     |
|       |        | contract or other arrangements. (20 U.S.C.         |
|       |        | 1435(a)(11))                                       |
+-------+--------+----------------------------------------------------+
| X     |        | 13\. The State has a procedure for securing timely |
|       |        | reimbursements of funds used under this part in    |
|       |        | accordance with 20 U.S.C. 1440(a). *See optional   |
|       |        | technical assistance checklist in Section V for    |
|       |        | full provisions of 20 U.S.C. 1440.* (20 U.S.C.     |
|       |        | 1435(a)(12)).                                      |
+-------+--------+----------------------------------------------------+
|       | 6      | 14\. The State has procedural safeguards with      |
|       | /30/06 | respect to programs under this part, as required   |
|       | \*     | by 20 U.S.C. 1439. (20 U.S.C. 1435(a)(13)) *See    |
|       |        | optional technical assistance checklist in Section |
|       |        | V for full provisions of 20 U.S.C. 1415 and 1439.* |
+-------+--------+----------------------------------------------------+
| X     |        | 15\. The State has a system for compiling data     |
|       |        | requested by the Secretary under section 618 that  |
|       |        | relates to this part. (20 U.S.C. 1435(a)(14) and   |
|       |        | 1442)                                              |
+-------+--------+----------------------------------------------------+
|       | 6      | 16\. The State has a State interagency             |
|       | /30/06 | coordinating council that meets the requirements   |
|       |        | of 20 U.S.C. 1441. (20 U.S.C. 1435(a)(15)) *See    |
|       |        | optional technical assistance checklist in Section |
|       |        | V for full provisions of 20 U.S.C. 1441.*          |
+-------+--------+----------------------------------------------------+
|       | 6      | 17\. The State has policies and procedures to      |
|       | /30/06 | ensure that, consistent with 20 U.S.C 1436(d)(5):  |
|       |        | A) to the maximum extent appropriate, early        |
|       |        | intervention services are provided in natural      |
|       |        | environments; and B) the provision of early        |
|       |        | intervention services for any infant or toddler    |
|       |        | with a disability occurs in a setting other than a |
|       |        | natural environment that is most appropriate, as   |
|       |        | determined by the parent and the individualized    |
|       |        | family service plan team, only when early          |
|       |        | intervention cannot be achieved satisfactorily for |
|       |        | the infant or toddler in a natural environment.    |
|       |        | (20 U.S.C. 1435(a)(16))                            |
+-------+--------+----------------------------------------------------+
| X     |        | 18\. The State ensures that Federal funds made     |
|       |        | available under 20 U.S.C. 1443 will be expended in |
|       |        | accordance with this part. (20 U.S.C. 1437(b)(1)   |
+-------+--------+----------------------------------------------------+
| X     |        | 19\. The State ensures that it will comply with    |
|       |        | the requirements of 20 U.S.C. 1440. (20 U.S.C.     |
|       |        | 1437(b)(2))                                        |
+-------+--------+----------------------------------------------------+
| X     |        | 20\. The State ensures that the control of funds   |
|       |        | provided under 20 U.S.C. 1443, and title to        |
|       |        | property derived from those funds, will be in a    |
|       |        | public agency for the uses and purposes provided   |
|       |        | in this part and that a public agency will         |
|       |        | administer such funds and property. (20 U.S.C.     |
|       |        | 1437(b)(3))                                        |
+-------+--------+----------------------------------------------------+
| X     |        | 21\. The State ensures that provisions shall be    |
|       |        | made for\--                                        |
|       |        |                                                    |
|       |        | > \(A\) making such reports in such form and       |
|       |        | > containing such information as the Secretary may |
|       |        | > require to carry out the Secretary\'s functions  |
|       |        | > under this part; and                             |
|       |        | >                                                  |
|       |        | > \(B\) keeping such reports and affording such    |
|       |        | > access to the reports as the Secretary may find  |
|       |        | > necessary to ensure the correctness and          |
|       |        | > verification of those reports and proper         |
|       |        | > disbursement of Federal funds under this part.   |
|       |        | > (20 U.S.C. 1437(b)(4))                           |
+-------+--------+----------------------------------------------------+
| X     |        | 22\. The State ensures that the Federal funds made |
|       |        | available under 20 U.S.C. 1443 to the State\--     |
|       |        |                                                    |
|       |        | \(A\) will not be commingled with State funds; and |
|       |        |                                                    |
|       |        | > \(B\) will be used so as to supplement the level |
|       |        | > of State and local funds expended for infants    |
|       |        | > and toddlers with disabilities and their         |
|       |        | > families and in no case to supplant those State  |
|       |        | > and local funds. (20 U.S.C. 1437(b)(5))          |
+-------+--------+----------------------------------------------------+
| X     |        | 23\. The State ensures that fiscal control and     |
|       |        | fund accounting procedures will be adopted as may  |
|       |        | be necessary to ensure proper disbursement of, and |
|       |        | accounting for, Federal funds paid under 20 U.S.C. |
|       |        | 1443 to the State. (20 U.S.C. 1437(b)(6))          |
+-------+--------+----------------------------------------------------+
| X     |        | 24\. The State ensures that policies and           |
|       |        | procedures have been adopted to ensure meaningful  |
|       |        | involvement of underserved groups, including       |
|       |        | minority, low-income, homeless, and rural families |
|       |        | and children with disabilities who are wards of    |
|       |        | the State, in the planning and implementation of   |
|       |        | all the requirements of Part C. (20 U.S.C.         |
|       |        | 1437(b)(7))                                        |
+-------+--------+----------------------------------------------------+
| X     |        | 25\. The State assures that it shall provide other |
|       |        | information and assurances as the Secretary may    |
|       |        | reasonably require by regulation. (20 U.S.C.       |
|       |        | 1437(b)(8).                                        |
+-------+--------+----------------------------------------------------+
| ##### |        | ######### Optional Assurance                       |
| ####  |        |                                                    |
+-------+--------+----------------------------------------------------+
| X     |        | > *Enter 'NA" in the cells to the left if this     |
|       |        | > assurance is not applicable.*                    |
|       |        |                                                    |
|       |        | 26\. The State has adopted a policy that includes  |
|       |        | making ongoing good-faith efforts to recruit and   |
|       |        | hire appropriately and adequately trained          |
|       |        | personnel to provide early intervention services   |
|       |        | to infants and toddlers with disabilities,         |
|       |        | including, in a geographic area of the State where |
|       |        | there is a shortage of such personnel, the most    |
|       |        | qualified individuals available who are making     |
|       |        | satisfactory progress toward completing applicable |
|       |        | course work necessary to meet the standards        |
|       |        | described in 20 U.S.C. 1435(a)(9). (20 U.S.C.      |
|       |        | 1435(b))                                           |
+-------+--------+----------------------------------------------------+

\* Revised 6/27/05

**C. Certifications**

**The State Lead Agency is providing the following certifications:**

+---------+------------------------------------------------------------+
| **Yes\  |                                                            |
| **      |                                                            |
+---------+------------------------------------------------------------+
| X       | 1\. The State certifies that ED Form 80-0013,              |
|         | *Certification Regarding Lobbying*, is on file with the    |
|         | Secretary of Education.                                    |
|         |                                                            |
|         | > With respect to the *Certification Regarding Lobbying*   |
|         | > the State recertifies that no Federal appropriated funds |
|         | > have been paid or will be paid to any person for         |
|         | > influencing or attempting to influence an officer or     |
|         | > employee of any agency, a Member of Congress, an officer |
|         | > or employee of Congress, or an employee of a Member of   |
|         | > Congress in connection with the making or renewal of     |
|         | > Federal grants under this program; that the State shall  |
|         | > complete and submit Standard Form-LLL, "Disclosure Form  |
|         | > to Report Lobbying," when required (34 CFR Part 82,      |
|         | > Appendix B); and that the State Agency shall require the |
|         | > full certification, as set forth in 34 CFR Part 82,      |
|         | > Appendix A, in the award documents for all sub awards at |
|         | > all tiers.                                               |
+---------+------------------------------------------------------------+
| X       | 2\. The State certifies that it has met the certifications |
|         | in the Education Department General Administrative         |
|         | Regulations (EDGAR) at 34 CFR §80.11 relating to State     |
|         | eligibility, authority and approval to submit and carry    |
|         | out the provisions of its State application, and           |
|         | consistency of that application with State law are in      |
|         | place within the State.                                    |
+---------+------------------------------------------------------------+
| X       | 3\. The State certifies that the arrangements to establish |
|         | responsibility for services provided under Part C pursuant |
|         | to 20 U.S.C. 1440(b) are current as of the date of this    |
|         | Application certification. (20 U.S.C. 1437(a)(2) and       |
|         | 1440). *See Item 6 in Section II.A above regarding         |
|         | including, with this Application for the Secretary's       |
|         | review, 'other appropriate written methods' to meet the    |
|         | requirements of 20 U.S.C. 1440(b). Also see the optional   |
|         | technical assistance checklist in Section V for the full   |
|         | provisions of 20 U.S.C. 1440.*                             |
+---------+------------------------------------------------------------+

**D. Statement**

I certify that the State of California has provided the policies,
procedures, methods, descriptions, and assurances checked as 'yes' in
Sections II.A and II.B and the certifications required in Section II.C
of this application. These provisions meet the requirements of Part C of
the Individuals with Disabilities Education Act as found in PL 108-446.
The State will operate its Part C program in accordance with all of the
required policies, procedures, methods, descriptions, assurances and
certifications.

If any policies, procedures, methods, descriptions, and assurances have
been checked 'no', I certify that the State will operate throughout the
period of this grant award consistent with the requirements of the IDEA
as found in PL 108-446 and any applicable regulations, and will make
such changes to existing policies and procedures as are necessary to
bring those policies and procedures into compliance with the
requirements of the IDEA, as amended, as soon as possible, and not later
than July 1, 2006. (34 CFR §76.104)

I, the undersigned authorized official of the California Department of
Developmental Services, am designated under Part C by the Governor of
this State to submit this application for FFY 2005 funds under Part C of
the Individuals with Disabilities Education Act (IDEA).

+----------------------------------+-----------------------------------+
| Printed/Typed Name and Title of  |                                   |
| Authorized Representative of the |                                   |
| State:                           |                                   |
|                                  |                                   |
| Cliff Allenby, Director,         |                                   |
| Department of Developmental      |                                   |
| Services                         |                                   |
+----------------------------------+-----------------------------------+
| Signature:                       | Date:                             |
+----------------------------------+-----------------------------------+

###### 

######## **E. Certification Regarding Lobbying**

######## **CERTIFICATION REGARDING LOBBYING** 

Applicants must review the requirements for certification regarding
lobbying included in the regulations cited below before completing this
form. Applicants must sign this form to comply with the certification
requirements under 34 CFR Part 82, \"New Restrictions on Lobbying.\"
This certification is a material representation of fact upon which the
Department of Education relies when it makes a grant or enters into a
cooperative agreement.

As required by Section 1352, Title 31 of the U.S. Code, and implemented
at 34 CFR Part 82, for persons entering into a Federal contract, grant
or cooperative agreement over \$100,000, as defined at 34 CFR Part 82,
Sections 82.105 and 82.110, the applicant certifies that:

\(a\) No Federal appropriated funds have been paid or will be paid, by
or on behalf of the undersigned, to any person for influencing or
attempting to influence an officer or employee of any agency, a Member
of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the making of any Federal grant,
the entering into of any cooperative agreement, and the extension,
continuation, renewal, amendment, or modification of any Federal grant
or cooperative agreement;

\(b\) If any funds other than Federal appropriated funds have been paid
or will be paid to any person for influencing or attempting to influence
an officer or employee of any agency, a Member of Congress, an officer
or employee of Congress, or an employee of a Member of Congress in
connection with this Federal grant or cooperative agreement, the
undersigned shall complete and submit Standard Form - LLL, \"Disclosure
Form to Report Lobbying,\" in accordance with its instructions;

\(c\) The undersigned shall require that the language of this
certification be included in the award documents for all subawards at
all tiers (including subgrants and contracts under grants and
cooperative agreements) and that all subrecipients shall certify and
disclose accordingly.

As the duly authorized representative of the applicant, I hereby certify
that the applicant will comply with the above certification.

+-----------------------------------------------------------------------+
| NAME OF APPLICANT PR/AWARD NUMBER AND / OR PROJECT NAME               |
|                                                                       |
| California Department of Developmental Services 84.181A               |
|                                                                       |
| Infants and Toddlers with Disabilities                                |
|                                                                       |
| Part C of IDEA                                                        |
+-----------------------------------------------------------------------+
| PRINTED NAME AND TITLE OF AUTHORIZED REPRESENTATIVE                   |
|                                                                       |
| Cliff Allenby, Director                                               |
+-----------------------------------------------------------------------+
| SIGNATURE DATE                                                        |
+-----------------------------------------------------------------------+

ED 80-0013 06/04