Spark Rating Renewal Form #5 Professional Development Activities to Maintain Spark Standards

Complete this form to renew your Spark rating if you have chosen Option 5, Professional Development Activities to Maintain Spark Standards. It is to report on changes made to your program to maintain Spark standards based on professional development/training in the past 12 months. Refer to your Spark portfolio for guidance on standards. Information about rating renewal and Spark standards can be found at: https://oregonspark.org/current-participants/

Date * +

Program Name *

Provider Name *

License Number

Not Licensed

Current Star Rating *

ORO ID # (UID #) *

Contact Number *

Phone Type

Cell

Office

Home

Email Address *

Name of Person Completing Form (if different)

List 1-2 professional development/trainings that was taken in the last 12 months that enabled you to make improvements to your program. List the training and indicate which of the 5 Spark domains it falls under: Learning & Development (LD), Health & Safety (HS), Personnel Qualifications (PQ), Family Partnerships (FP), Administration & Business Practices (AB). Attach certificates or ORO documentation for each training.

	Name of Training	Date	Spark Domain
1	Name of Training	Date	Spark Domain
2	Name of Training	Date	Spark Domain
3	Name of Training	Date	Spark Domain

What was implemented in your program based on what was learned? Include any relevant documents and/or photos. *

Upload photos if applicable. You can upload up to 5 files

What was the impact on your program? *

Signature *

clear

Date of Completion * +