Intake Process—Birth to Three Years of Age

Children develop at different rates and in different ways. Differences in development may be related to personality, temperament, and/or experiences. Some children may also have health needs that affect their development. The first five years are very important in a child’s life. The sooner a concern is identified, the sooner a child and family can receive specialized services to support growth and development. Parents, family members, and caregivers may have concerns about a child’s development and seek help when needed. It is always a good idea for families to discuss any questions they may have with the child’s doctor.

Anyone can make a referral, including parents, legal guardians or conservators, medical care providers, neighbors, family members, foster parents, and daycare providers. Professionals and concerned persons may make a referral, however, the permission of the parent or legal guardian is necessary. Legally ordered evaluations may come from the courts or the Department of Children and Family Services (DCFS).

In order to determine your child’s eligibility, Westside Regional Center (WRC) will conduct a comprehensive intake process including an evaluation of your child’s developmental level and a review of available medical records/history. The application contains all the information required for WRC to initiate the intake process.

How Do I Apply?

Westside Regional Center (WRC) will initiate an intake process to determine if your child meets eligibility conditions for the Early Start Program. WRC looks into a child’s developmental, social, and medical history. This information may come from outside sources or from in-home interviews, examinations, and testing. There is no cost to you for any of the tests or other services that we provide during the intake process. Below is a step-by-step overview of this process.

Step 1

Family members, physicians, schools, and/or hospitals may contact the Intake Department at WRC to refer a baby or young child.

Step 2

You will complete the intake application with any records, including private evaluations and other pertinent medical records. You will be asked to complete and sign parent consent forms, which are essential to complete the process.

Step 3

You will be contacted to schedule evaluations that may take place at the home, school, and/or WRC. These include (1) family intake evaluation by an Intake Counselor, (2) developmental evaluation, and (3) other evaluations as needed (e.g. speech/language, medical, etc.).

Step 4

An eligibility team will meet to review your child’s records and evaluations. You are invited to be present at this meeting. Once a decision has been made, you will receive a letter informing you of your child’s eligibility status. If not eligible, the intake team will provide you with appropriate community resources. If you disagree with the eligibility decision, you have the right to appeal the decision.

Submitting An Application and Consent Forms

An application must be completed in order to assist WRC to determine eligibility for the California Early Start Program. Below you can find all the necessary forms required for WRC to initiate the evaluation process. The collection of the information on this application is required by the State of California, Department of Developmental Services. To begin the process:

Step 1

Complete the application as accurately as possible.

Step 2

Sign the consent forms for evaluation and services. The evaluation process cannot begin prior to receipt of your written consent.

Step 3

Fill-in, print out, sign, and submit the entire application and the consent forms to WRC’s Early Start Intake Department.

To submit your application, you may choose one of the following:

1. Scan the documents and send them as an email attachment to IntakeUnderAge3@westsiderc.org
2. Provide all documents in person to the receptionist at Westside Regional Center (please follow social distancing protocols).
3. Fax the documents to (310) 258-4059
4. Mail the documents to:

Need Help Filling Out Your Application?

Application questions can be answered by our culturally sensitive staff. 

Resources

Reasons for Concern

• This brochure is a collaborative effort between the Department of Developmental Services and the California Department of Education. The brochure is designed to facilitate finding and identifying young children who may benefit from early intervention or specialized education services and to encourage appropriate referrals regarding these children to Early Start and special education preschool services.
• Available in: English | Hmong | Spanish | Vietnamese | Chinese | Korean

A Message from California’s Surgeon General, Dr. Nadine Burke Harris about Free Early Start Services

Early Intervention is key to helping your baby or toddler who may have developmental delays and/or disabilities. Learn more about free services & supports in this Public Service Announcement about Early Start with California’s Surgeon General Dr. Nadine Burke Harris. Para subtítulos en español, haga clic en Configuración [CC], luego en Subtítulos y, después seleccione español.