Ohio Department of Job and Family Services
CONTINUOUS IMPROVEMENT PLAN (CIP) FOR STEP UP TO QUALITY (SUTQ)
Programs are required to complete and submit this form when registering for Two to Five-Star Ratings in SUTQ. The completion and submission
of the form will be used to verify the Program Administration standard in the Administrative and Leadership Practices domain.
Program Name
Date of CIP
Name of Program Self-Assessment Tool Completed
Date Completed
Self-Assessment Tool Results (Goals and Action Steps): A minimum of one goal and action steps, for that goal, must be completed for a Two-Star
Rating and, a minimum of two goals and action steps for those goals must be completed for Three to Five-Star Ratings
*Goal (Self-assessment tool item addressed)
Action Steps
Person(s)
Resources Needed
Timeline
Progress Update
*Goal (Self-assessment tool item addressed)
Action Steps
Person(s)
Resources Needed
Timeline
Progress Update
*Goal (Self-assessment tool item addressed)
Action Steps
Person(s)
Resources Needed
Timeline
Progress Update
JFS 01509 (Rev. 10/2014) Page 1 of 5
*Goal (Self-assessment tool item addressed)
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
Parent Input: Program Goal(s) for program improvement based on parent input - Three to Five-Star Ratings
*Document how information was gathered (i.e. Parent Surveys, Parent Meeting Minutes, etc.)
*Goal
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
Staff Input: Program goal(s) for program improvement based on staff input - Three to Five -Star Ratings
*Document how information was gathered (i.e. Staff Surveys, Staff Meeting Minutes, etc.)
*Goal
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
JFS 01509 (Rev. 10/2014) Page 2 of 5
Formal Teacher Observation Results: Program goal(s) based on results of formal observations of lead and assistant teachers - Optional Points for Four to Five-Star Ratings
*Observation Results Addressed
*Goal (Infant Classrooms)
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
*Observation Results Addressed
*Goal (Toddler Classrooms)
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
*Observation Results Addressed
*Goal (Preschool Classrooms)
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
JFS 01509 (Rev. 10/2014) Page 3 of 5
*Observation Results Addressed
*Goal (School Age Classrooms)
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
Signature
Role
Date
Signature
Role
Date
Community Engagement: Program goal(s) for program improvement based on staff input - (Optional Points for Four to Five-Star Ratings)
*Document strategies that will be/are used to engage community partners in supporting children and family outcomes (3 points)
*Strategy
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
*Strategy
Action Steps
Person(s) Responsible
Resources Needed
Timeline
Progress Update
JFS 01509 (Rev. 10/2014) Page 4 of 5
Comments
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