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Get ecers score sheet

Er Code: ___ ___ ___ Date of Observation: __ __ / __ __ / __ __ m m d d y y Home: _____________________________________ Facility Code: ___ ___ ___ Number of children with identified disabilities: ___ ___ Provider(s): __________________________________ Provider Code: ___ ___ Check type(s) of disability: □ physical/sensory □ social/emotional Number of providers present: ___ ___ Birthdates of children enrolled: youngest __ __ / __ __ / __ __ Number of children enrolled: ___ ___ old.

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