Certification of Health and Safety Screening

This form may be used to fulfill the OHS requirement that the grantee governing body submit a signed certification of compliance with all applicable health and safety requirements within 75 calendar days of the start of the program or school year, or within 75 calendar days of the start of the five year project period when the five year project period begins during the program or school year. The form must be submitted to OHS in the Head Start Enterprise System (HSES) immediately thereafter.

Governance puzzle pieces.The signatures on this form attest that an agency has completed a health and safety screening of each site where children receive Head Start/Early Head Start services, consistent with the terms and conditions of the Notice of Award (NoA). Certification of Health and Safety Screening» [PDF, 64KB]


Certification of Health and Safety Screening. HHS/ACF/OHS. 2013. English.

Last Reviewed: June 2013

Last Updated: August 10, 2015