Early Start in California: Help for Babies and Toddlers Under 3

Choose the day you called or wrote. If the agency records that day as your referral, day 45 is the usual last day for the first plan meeting.

Early Start in California · children under 3 · 45 calendar days

I called today. What happens in the next 45 days?

Choose the day you called or wrote. The day the agency records as your referral is the one that counts, so ask what it is. You see the usual latest day for the first plan meeting, called the IFSP meeting, and each step before it.

Choose the day you called or wrote

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Example: you called on Monday, March 1, 2027 First IFSP meeting, usually by Apr 15 2027. Day 45 is a Thursday.

The 45 days are calendar days. California law counts them from the day the written referral is received. The state regulation also counts a referral made by phone. We’d call, then send a short written request the same day and keep a copy. Ask which date the agency recorded.

The federal rule says the 45 days do not apply for any period when one of two things is true. One is an exceptional family circumstance that makes you or your child unavailable, written in your child’s record. The other is that the program asked for your consent to the evaluation or assessment more than once, wrote down each try, and still has none. After that, the program must finish the steps as soon as possible.

Mar 1 You calledApr 15 Day 45

The day you called A day inside the limit Day 45, the latest day for the meeting

The steps inside the 45 days

1. Day 0 · Mar 1, 2027 Referral

   You ask for an evaluation

   Who does it You, or anyone who knows your child. The Regional Center or school district must write down the date.

   You decide Whether to call, write or do both. A doctor’s referral is not required.

2. At referral Coordinator

   A service coordinator is assigned

   Who does it The Regional Center or school district assigns one when the referral is made. This person helps you through the evaluation.

   You decide Whether this person is a good match. You can ask for a different one.

3. Asked at referral Consent

   You are asked to agree in writing

   Who does it The agency gives you written notice and asks for your consent when it takes the referral. The service coordinator gets your written consent before the evaluation and assessment.

   You decide Whether to sign. Consent is voluntary, and you can take it back at any time.

4. Inside the 45 days Evaluation

   Evaluation and assessment

   Who does it Qualified staff from more than one field. The evaluation decides if your child is eligible. The assessment finds your child’s strengths and needs. Both are free.

   You decide Whether to take part in the family assessment. That part is voluntary.

5. By day 45 · Apr 15, 2027 IFSP meeting

   The first plan meeting

   Who does it You, the service coordinator and a person who took part in the evaluation. The meeting shares the results and decides eligibility, unless that was done at an earlier meeting. For an eligible child, it writes the first plan.

   You decide Who comes with you, and whether to meet by video or phone. You accept or decline each service. No service starts before you consent in writing.

After the first plan

These limits count from the day you consent to the plan, or from the plan’s own date. We can’t print those dates.

• 45 daysServices start. The state department says services start as soon as possible, and no later than 45 days after you consent in writing.
• 3 monthsA review. In California, the service coordinator reviews the plan at least every 3 months.
• 6 monthsA review, and a meeting in person. The federal rule sets a review every 6 months, or sooner if you ask. California requires a Regional Center to hold a meeting or visit in person if none took place in the previous 6 months.
• 1 yearA yearly meeting. A meeting at least once a year looks at the plan and changes it where needed.

Day 45 is the usual outer limit, and a program can move faster. This date leaves out any period when the count stops. The rules we read set no separate day count for the steps before the meeting. No date here is a promise about your child’s case.

A child referred fewer than 45 days before the third birthday is on a different rule. See what happens when a child turns 3 →

See every step and limit as a table

Each step from the referral to the first IFSP meeting, and what comes after. Example: you called on Monday, March 1, 2027.

Step	Who does it	What you decide	Limit	Source
Referral	You, or anyone who knows your child. The Regional Center or school district writes down the date.	Whether to call, write or do both. A doctor’s referral is not required.	Day 0: Monday, March 1, 2027	DDS Early Start FAQ, December 2025; 17 CCR 52060
A service coordinator is assigned	The Regional Center or school district.	Whether to ask for a different coordinator.	When the referral is made. No separate day count.	17 CCR 52120; 17 CCR 52060; DDS information packet, August 2025
Written notice and consent	The agency gives written notice and asks for consent when it takes the referral. The service coordinator gets your written consent before the evaluation and assessment.	Whether to sign. Consent is voluntary, and you can take it back at any time.	Asked when the referral is made. Consent to evaluate is obtained inside the 45 days.	17 CCR 52060; 17 CCR 52162; Government Code 95020
Evaluation and assessment	Qualified staff from more than one field. Both are free.	Whether to take part in the family assessment, which is voluntary.	Inside the 45 days. No separate day count.	Government Code 95016; 34 CFR 303.321; DDS, What is Early Start
The first IFSP meeting	You, the service coordinator and a person who took part in the evaluation.	Who comes with you, whether to meet by video or phone, and which services to accept.	No later than Thursday, April 15, 2027. That is 45 calendar days after the referral, unless the count stops.	Government Code 95020; 34 CFR 303.310 and 303.343
When the count stops	The program writes the reason in your child’s record.	Not a decision. It applies to an exceptional family circumstance that makes you or your child unavailable, or to consent for the evaluation or assessment that the program asked for more than once and did not get.	The 45-day limit does not apply for that period. The program must finish the steps as soon as possible after it ends.	34 CFR 303.310
Services start	The Regional Center or school district.	Which services you consent to.	As soon as possible, and no later than 45 days after you consent in writing. Depends on the day you consent.	DDS Early Start FAQ, December 2025
A review of the plan	The service coordinator.	Whether to ask for a review sooner.	At least every 3 months in California. Depends on the plan’s date.	Government Code 95018
A review, and a meeting in person	The service coordinator and the Regional Center.	Where and when an in-person meeting takes place.	A review every 6 months under the federal rule. A Regional Center must hold an in-person meeting or visit if none took place in the previous 6 months.	34 CFR 303.342; Government Code 95020
A yearly meeting	You and the plan’s team.	Whether the plan changes.	At least once a year. Depends on the plan’s date.	34 CFR 303.342
A referral fewer than 45 days before the third birthday	If the child may qualify for preschool special education, Early Start is not required to evaluate the child or hold the meeting.	Whether Early Start may refer your child to the school district.	Not drawn here	34 CFR 303.209

Who do I call, and when?

Call your Regional Center as soon as you are worried, and you do not need a doctor’s referral.

The Centers for Disease Control and Prevention (CDC) says “Don’t wait.” Its advice is to act when a child misses a milestone, loses a skill, or worries you. The CDC also says to talk with your child’s doctor and ask about a developmental screening. If you are still concerned after that, it says to call your state’s early intervention program. In California, that program is Early Start.

A Regional Center is a community-based nonprofit agency. The state contracts with it to serve people with developmental disabilities. California has 21 of them, and the state has a lookup by address. The state Department of Developmental Services (DDS) runs the BabyLine for referral information. Its number is 800-515-2229, and its email is earlystart@dds.ca.gov.

One group of children goes to the school district. These are children whose only disability is in vision, hearing or severe orthopedic impairment, or a mix of those, and who do not qualify for Regional Center services (Government Code 95014). DDS calls this a “solely low incidence” condition. For those children, DDS says to contact the school district. Regional Centers serve the other eligible children.

On the call, say your child’s age and what worries you. Then say, “I am referring my child to Early Start, and I am asking for an evaluation.” A phone call counts as a referral under the state regulation, and the agency must record the date. The state law counts the 45 days from receipt of a written referral. We’d send a short email or letter the same day and keep a copy, so the date is on paper. You don’t need a diagnosis first.

You will not be the only family calling. At the end of September 2026, the 21 Regional Centers had 56,572 children under 3 in Early Start. That is a month-end count of open Regional Center cases.

We don’t print a list of milestones of our own. The CDC publishes milestones by age, and it says they are no substitute for a screening. DDS’s eligibility guide names the kinds of delay to watch for.

Does my child qualify?

A child under 3 qualifies in one of three ways: a delay, an established risk condition, or high risk.

The agency decides which one applies, from an evaluation or, in some cases, from your child’s medical records. The rules are in Government Code 95014.

The first way is a developmental delay. The law sets it at a 25 percent delay in one or more of six areas:

• thinking (cognitive development)
• physical and motor development, including vision and hearing
• what your child can say or show (expressive communication)
• what your child understands (receptive communication)
• social or emotional development
• everyday skills (adaptive development)

Older pages may tell you something different. The state regulation still says “one third”, and it still lists five areas. The law changed on June 30, 2022, and the regulation has not caught up. The law is the higher authority, so we use 25 percent and six areas.

The second way is an established risk condition. That is a condition with a known cause that is likely to delay development. DDS gives Down syndrome, Fragile X syndrome and fetal alcohol syndrome as examples. DDS adds that a diagnosis of fetal alcohol syndrome alone does not guarantee eligibility.

The third way is high risk. The law describes a combination of medical risk factors. The state regulation asks for two or more factors from its list. The team must also find that the child needs services. One factor on the list is birth before 32 weeks, or a birth weight under 1,500 grams. Another is help from a breathing machine for 48 hours or longer in the first 28 days. There is one more high-risk route. It applies when a parent has a developmental disability and the child needs services.

Two rules protect a child from a wrong answer. The same regulation says a delay can’t be based on the normal process of learning a second language, or on cultural or economic factors. A federal rule also lets the evaluators use their professional judgment. They can find a child eligible when test scores alone do not. The evaluators can’t use that judgment to cancel a qualifying test result.

What happens in the 45 days after I call?

The agency assigns a service coordinator, asks for your consent, evaluates your child and holds the first plan meeting.

DDS lists those four steps inside 45 calendar days of the referral. The state regulation says the coordinator is assigned when the referral is made. The agency must also give you written notice and ask for your consent then (17 CCR 52060). The evaluation, the assessment and the meeting must all be finished within the 45 days (34 CFR 303.310). The rules we read give no earlier deadline for the evaluation.

The service coordinator is your one point of contact. This person helps you through the evaluation and later coordinates the services. DDS’s information packet says you can ask for a different coordinator.

The evaluation, the assessment and the services each need your signature first. The coordinator must get your written consent before the evaluation and assessment, and again before any service starts. Consent is voluntary, and you can take it back at any time.

The evaluation and the assessment are two different jobs. The evaluation decides whether your child is eligible. The assessment finds your child’s strengths and needs, and the services that fit them. The team includes people from more than one field (Government Code 95016). The team may ask about your family’s concerns and resources. That part is voluntary. Under the federal rules, the team works in your child’s own language unless that is clearly not possible. Medical records may also be used to find a child eligible without a new evaluation, if the records show a delay or a qualifying condition (34 CFR 303.321).

The first plan meeting must happen within the 45 days. It shares the results, decides eligibility and, for an eligible child, writes the first plan (Government Code 95020). State law lets the agency share the results and decide eligibility at an earlier meeting. You can bring a family member, an advocate or another parent. If you ask, the meeting is held by video or phone.

The federal rule says the 45-day limit does not apply for any period when one of two things is true. In the first, you or your child are unavailable because of an exceptional family circumstance, and the agency writes it in your child’s record. In the second, the agency has asked for your consent to the evaluation or assessment more than once, has written down each try, and still has no consent. When the reason ends or you consent, the agency must finish the steps as soon as possible (34 CFR 303.310).

A child referred fewer than 45 days before the third birthday is on a different rule. If the child may qualify for preschool special education, Early Start does not have to evaluate the child or hold a plan meeting. With your consent, it refers the child to the school district (34 CFR 303.209).

Day 45 is a legal limit, and agencies do not always meet it. The state reviewed 485 records from federal fiscal year 2024. In 369 of them, the evaluation, the assessment and the first plan meeting were all finished within 45 days. That is about 76 in 100, by our arithmetic. Another 63 were late because of a family circumstance in the record, such as illness or a missed appointment. The state counts those as on time, and that gives its published rate of 89.07 percent. The other 53, about 11 in 100, were late for reasons that include staff shortages and no written reason. If your date passes, ask your coordinator in writing for the reason.

What is in the plan, and where do services happen?

The plan is called an IFSP. Services are given in everyday places, such as your home or child care, where that is appropriate.

IFSP stands for Individualized Family Service Plan. It is the written plan you and the agency agree on. Government Code 95020 lists what it must hold:

• where your child is now in each area of development
• your family’s concerns and priorities, if you agree to include them
• the results you and the team expect, and how progress will be checked
• each service, with how often, how long, where and by what method
• the agency responsible, and the name of your service coordinator
• the date each service is expected to start
• the steps for the move to other services at age 3

The law calls the place for services a “natural environment”. The federal rule defines it as a setting that is natural or typical for a child the same age without a disability. DDS explains it as “the family home, childcare center, local playgroup, or wherever a child is during the day.” That can mean a visit at your home or at your child’s day care. If a service will happen somewhere else, the IFSP must give a reason (34 CFR 303.344). You can also ask for services by video or phone.

DDS lists the services an IFSP can include. Speech and language services, occupational therapy and physical therapy are on the list. So are family training and home visits, special instruction, audiology (hearing) and vision services. You choose which services to accept. Under the federal rules, you can decline one service and keep the others.

DDS says services start as soon as possible, and no later than 45 days after you consent in writing. After that, your coordinator reviews the IFSP at least every three months (Government Code 95018). You can ask for a review sooner. The federal rules add a meeting at least once a year to revise the plan. California also requires a Regional Center to hold a meeting or visit in person if none took place in the previous six months.

Early Start ends when your child turns 3. DDS’s information packet describes three paths at that age. A child may qualify for both the Regional Center and special education, for special education only, or for neither. DDS’s Early Start FAQ adds a fourth: a child the school district finds not eligible can still be eligible for Regional Center services. Our guide to turning 3 covers that handoff. A child under 5 may qualify for Regional Center services without a diagnosis (Welfare and Institutions Code 4512). The disability must not be only physical, and it must cause significant limits in at least two areas, such as self-care, language or learning. The rule is called provisional eligibility, and the Regional Center guide explains it. A third guide compares the IFSP with the school plans.

What will it cost?

The evaluation, the assessment and your service coordinator are free, and your insurance may be billed for therapy.

DDS states it this way: “There is no cost for evaluation, assessment and service coordination.” A federal rule says no fee may be charged to parents for those parts.

A Regional Center may refer you to a service that may help your family but does not meet your child’s developmental needs. It does not buy that kind of service, except durable medical equipment (Government Code 95020).

Private insurance works in a way you may not expect. State law says private insurance “shall be used” for medical services in the IFSP, other than evaluation and assessment (Government Code 95004). The state regulation says Regional Centers “are not required to obtain parental consent” before using it (17 CCR 52162). So a Regional Center may bill your private plan for therapy without asking you first. We could not confirm what happens when a family refuses to let its private plan be used.

The law attaches protections to that billing:

• Using your insurance can’t count toward your plan’s yearly or lifetime limits.
• It can’t reduce the coverage available to your family.
• It can’t be the reason your premium goes up.
• It can’t delay the services. The regulation says services “must begin as soon as possible.”
• The Regional Center “shall pay” the copayment, coinsurance or deductible for an IFSP service. The conditions are that your plan covers your child and no other party is responsible for the cost (Welfare and Institutions Code 4659.1).

The first three protections are in Government Code 95004. We could not confirm how a family claims the copayment in practice. Disability Rights California says the insurance rule “may include paying deductibles and co-payments.” It also says a slow answer from your insurer must not delay or deny your child’s service. Ask your coordinator who pays the copayment before the first session, and ask for the answer in writing.

Medi-Cal, California’s public health coverage, works differently. The Regional Center can’t require you to enroll in Medi-Cal to get services. If you are not enrolled, it needs your consent before it uses public coverage. It also needs your consent if using the coverage would lower your benefits, make your family pay money, or raise your premiums (17 CCR 52162). If you say no, your child still gets the IFSP services you agreed to.

The agency will ask for copies of your health coverage cards by the first plan meeting. If your family has no coverage, the law says the Regional Center “shall not use that fact to negatively impact the services” your child receives.

You may have read about Regional Center family fees. DDS says its three family fee programs have ended, two on July 1, 2024 and one on July 1, 2025. Nothing we read says any of them applied to Early Start.

Will this follow my child, and what if they say no?

The agency needs your written consent for the evaluation, the assessment and services, and you have three ways to challenge a decision.

Who sees my child’s information?

The federal rules generally require your consent before the agency shares information that identifies your child (34 CFR 303.414). The rules list exceptions. One is the notice to the school district near age 3. At least 90 days before the third birthday, the agency must tell the district about a child who may qualify for preschool special education. A child found eligible fewer than 90 days before the birthday follows the late-start rules in our turning 3 guide. DDS says the notice gives your child’s name, birth date, where your child lives and your contact details (Early Start FAQ). DDS reports to the federal government that California has no written policy that lets a parent object to the notice.

DDS also says that, with your permission, the agency can send the district a fuller referral. It can include your child’s recent IFSPs, evaluations and other important information. Our turning 3 guide explains the notice and what needs your permission.

Does immigration status matter?

DDS answers no. Its FAQ says, “A child’s or parent’s immigration status does not affect or determine eligibility for the early start program.” The same FAQ says eligibility is not based on family income. We did not read a federal immigration source on whether using Early Start counts in a public charge test. So we can’t answer that question here.

Will this label my child?

Early Start eligibility lasts until the third birthday, and then it ends. It does not carry over on its own. From age 3, Regional Center services and school services each have their own eligibility rules. The notice itself gives the district the items above. DDS says a referral with your child’s IFSPs and evaluations is made with your permission. Federal early intervention rules also allow a few other disclosures without permission, such as a court order or a health or safety emergency (34 CFR 303.414, 34 CFR 99.31).

What if the agency says no, or I disagree with the plan?

The agency must tell you in writing. The federal rules call this prior written notice. It comes a reasonable time before the agency starts, changes or refuses an evaluation or a service. The notice must give the reasons and list your rights, in words the public can understand. It must be in your language unless that is clearly not possible.

You then have three routes, and each has a time limit:

• Mediation is a meeting to settle the disagreement. You can ask at any time, and it must be finished within 30 days of your request.
• A due process hearing is a formal hearing before the state’s Office of Administrative Hearings. The normal limit is 30 days from the request to a written decision. A hearing officer can extend it at either side’s request (34 CFR 303.437).
• A state complaint goes to DDS, and anyone can file one. The problem must have happened within the past year, unless a longer period is reasonable because the problem continues (17 CCR 52170). The limit is three years when you ask for repayment or a corrective action. DDS must answer in writing within 60 days. That deadline is extended for events beyond DDS’s control. Any part of a complaint that is also in a due process hearing waits until the hearing ends.

Inside Early Start, your child keeps the IFSP services they already receive during mediation or a hearing (17 CCR 52172). That protection does not carry past the third birthday. If you disagree with the school district about the first individualized education program (IEP), Early Start services do not continue while the dispute runs. The district may offer other services, and with your consent it must provide them while the dispute is pending.

If you can’t write the complaint yourself, your service coordinator must help you or find someone who can.

The federal rules also say an agency may not use a hearing to challenge a parent’s refusal to give a consent the rules require.

DDS proposed changes to its Early Start regulations on October 30, 2026. The public comment period closes December 17, 2026. The changes are proposals and are not law yet (DDS notice). We read the state regulations on Cornell’s Legal Information Institute copy in November 2026.

This guide is information and is no substitute for legal advice. The Office of Clients’ Rights Advocacy gives free legal information and advice to people who use Regional Centers, and it can represent them. It looks at the merits of the case and its own resources when it decides how to help. DDS’s guide says it also helps people who are trying to become eligible. Its number is (800) 390-7032. Disability Rights California publishes a manual on early intervention rights.