LOS ANGELES UNIFIED SCHOOL DISTRICT Student Health and Human Services Division

District Nursing Services http://dns.lausd.net

HANDBOOK FOR SCHOOL NURSES (Selected Mandates/Policies/Procedures) © 1995

GENERAL INFORMATION 2008 – 2009

RAMON C. CORTINES, Superintendent of Schools CONNIE MOORE, Director of Nursing Services

DISTRICT NURSING SERVICES 1430 San Julian Street, #1 and #2 Los Angeles, CA 90015 (213) 765-2800 FAX: (213) 749-0553

SCHOOL MAIL District Nursing Services San Julian Annex, #1 & #2 1

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LOS ANGELES UNIFIED SCHOOL DISTRICT Student Health and Human Services Division District Nursing Services http://dns.lausd.net

NURSING ADMINISTRATORS’ ASSIGNMENTS 2008 - 2009 CONNIE MOORE, Director 1430 San Julian Street, #1 and #2 Los Angeles, CA 90015 TEL: (213) 765-2800 FAX: (213) 749-0553 E-mail: [email protected] School Mail:

RENE GONZALEZ, Asst. Superintendent 333 S. Beaudry Ave., 29th Floor Los Angeles, CA 90017 TEL: (213) 241-3840 FAX: (213) 241-3305 E-mail: [email protected]

District Nursing Services San Julian Annex, #1 & #2

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT NURSING OFFICE • Go EAST on 4TH ST • Turn RIGHT (south) onto S SAN PEDRO ST • Turn RIGHT (west) onto E 15TH ST • Turn RIGHT (north) onto SAN JULIAN ST • Turn RIGHT into the 2nd parking lot. DIRECTIONS FROM DISTRICT NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS • Exit LEFT out of parking onto SAN JULIAN ST • Turn RIGHT onto E 15TH ST • Turn LEFT onto MAPLE AVE • Turn RIGHT onto SANTA MONICA FREEWAY (I-10) going WEST • Merge onto the HARBOR FREEWAY (CA110) toward DOWNTOWN • Take the 4th ST/3RD ST exit • Take the 3RD ST – WEST ramp. • Turn LEFT onto BEAUDRY AVE

PARKING LOCATIONS FOR BEAUDRY – The main visitor parking location is the Visconti Apartment garage at the northwest corner of Miramar and Boylston. If the garage is full, parking lot attendants at the garage will re-direct you to an overflow lot. Please do NOT park in any overflow lot unless directed – your validation may not be honored. The garage is located at 1221 West Third Street immediately northwest of the Headquarters building. Visitors will enter through the easternmost entrance on Miramar just west of Boylston. DISTRICTWIDE PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Opportunity Schools & Programs Community Day Schools

702,000 27 523 19 117 117 45 19 5 9

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LOCAL DISTRICT 1 TRICIA CHICAGUS, Administrator 6505 Zelzah Avenue Reseda, CA 91335 TEL: (818) 654-1670 FAX: (818) 758-9961 E-mail: [email protected] School Mail:

JEAN BROWN, Superintendent 6621 Balboa Blvd. Van Nuys, CA 91406

District 1 Nursing Services Zelzah Site

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 1 NURSING OFFICE: • Go onto 4TH ST going EAST • Turn LEFT (north) onto S FIGUEROA ST (stay in the middle lane – North 110) • Turn LEFT (west) onto W 3RD ST (need to be in the right lane) • Merge onto 110 FREEWAY (Harbor) NORTH • Merge toward 101 FREEWAY HOLLYWOOD/VENTURA • Stay on the NORTH 101 VENTURA FREEWAY/VENTURA • Stay on the 101 VENTURA FREEWAY/VENTURA • Exit WHITE OAK AVE • Turn RIGHT (north) on WHITE OAK AVE. • Turn LEFT (west) on KITTRIDGE ST • Turn LEFT (south) on ZELZAH AVE • Turn RIGHT into the parking lot. (Back Bungalow next to the playground.) DIRECTIONS FROM DISTRICT 1 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS: • Turn LEFT (north) as you exit the ZELZAH parking lot • Turn RIGHT (east) on KITTRIDGE ST (stop sign) • Turn RIGHT (south) onto WHITE OAK AVE (signal) • Turn LEFT (east) onto FREEWAY 101 SOUTH VENTURA FREEWAY/LOS ANGELES • Continue on the 101 HOLLYWOOD FREEWAY/LOS ANGELES • Merge onto the 110 FREEWAY toward San Pedro (HARBOR FREEWAY). • Go towards DOWNTOWN (stay in right lane) off ramp toward 3RD ST. • Exit onto 3RD ST • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE OR • For the VISITOR’S PARKING LOT turn LEFT onto BEAUDRY AVE then turn RIGHT onto 3rd ST, turn RIGHT onto BOYLSTON AVE then turn LEFT onto MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON). LOCAL DISTRICT 1 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education State Pre-Kindergarten Programs Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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129,000 1 18 83 3 24 23 11 5 99 1 5

LOCAL DISTRICT 2 DOLORES APODACA, Administrator 5200 Lankershim Blvd. North Hollywood, CA 91601 TEL: (818) 755-5357 FAX: (818) 755-9531 E-mail: [email protected] School Mail:

ALMA PEÑA-SANCHEZ, Superintendent 5200 Lankershim Blvd. North Hollywood, CA 91601

Local District 2 ATTN: Nursing Services

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 2 NURSING OFFICE: • Go onto 4TH ST going EAST • Turn LEFT (north) onto S FIGUEROA ST • Turn LEFT (west) onto W 3RD ST • Merge RIGHT onto 110 FREEWAY (Harbor Freeway) NORTH • Merge toward 101 FREEWAY NORTH toward HOLLYWOOD • Keep LEFT to take the HOLLYWOOD FREEWAY (CA-170 N) toward SACRAMENTO • Take the MAGNOLIA BLVD exit • Turn RIGHT onto MAGNOLIA BLVD • Turn LEFT onto LANKERSHIM BLVD • Turn RIGHT into parking lot. DIRECTIONS FROM DISTRICT 2 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS • From MAGNOLIA BLVD turn LEFT onto the HOLLYWOOD FREEWAY (CA-170) SOUTH • HOLLYWOOD FREEWAY (CA-170) becomes the US-101 SOUTH • Merge onto the HARBOR FREEWAY (I-110) SOUTH toward SAN PEDRO • Go towards the DOWNTOWN off ramp toward 3RD ST • Exit onto 3RD ST • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE OR • For the VISITOR’S PARKING LOT turn LEFT onto BEAUDRY AVE, then turn RIGHT onto 3rd STREET, turn RIGHT onto BOYLSTON AVE then turn LEFT onto MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 2 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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94,776 4 14 69 1 18 20 7 1 88 0 0

LOCAL DISTRICT 3 SEROP HAKIMIAN, Administrator 3710 S. La Brea Ave. Los Angeles, CA 90016 TEL: (323) 421-2960 FAX: (323) 299-1373 E-mail: [email protected]

MICHELLE B. KING, Superintendent 3000 S. Robertson Blvd. Los Angeles, CA 90034

School Mail: Support Unit Central West District 3 Nursing Services La Brea Site, Building A DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 3 NURSING OFFICE: • Going SOUTHWEST on Beaudry Ave toward W 4th ST • Turn slight LEFT onto W 4th ST • Turn RIGHT onto S FLOWER ST • Turn RIGHT onto W 5th ST • Merge onto 110 FREEWAY (HARBOR) • Merge onto the I-10W toward SANTA MONICA • Exit onto the LA BREA AVE off-ramp going SOUTH • Go approximately 1 mile, the Office will be on the left side and parking is in front of offices. DIRECTIONS FROM DISTRICT 3 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS: • Turn RIGHT (north) exiting the parking lot onto S LA BREA AVE. • Turn RIGHT (east) onto the SANTA MONICA FREEWAY (I-10E) • Merge onto the HARBOR FREEWAY (110N) toward PASADENA • Take the 4TH ST/ 3rd ST ramp • Keep LEFT at the fork in the ramp (3rd Street) • Turn SLIGHT LEFT onto W 3RD ST • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR • For the VISITOR’S PARKING LOT go straight on 3rd STREET, turn RIGHT on BOYLSTON AVE. then turn LEFT on MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 3 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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74,037 1 14 73 4 17 17 7 3 74 0 1

LOCAL DISTRICT 4 RUBY PUGH, Administrator 4201 Wilshire Blvd, Ste 300 Los Angeles, CA 90010 TEL: (323) 932-4600 FAX: (323) 932-4636 E-mail: [email protected] School Mail:

RICHARD ALONZO, Superintendent 4201 Wilshire Blvd. Los Angeles, CA 90010

District 4 Nursing Services Harbor Bldg, Suite 300

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 4 NURSING OFFICE • Go SOUTH on BEAUDRY to 6th STREET • Turn RIGHT (west) on 6TH STREET • Turn LEFT (south) on VERMONT AVE • Turn RIGHT (west) on WILSHIRE BLVD • Parking lot is across the street. DIRECTIONS FROM DISTRICT 4 NURSING TO THE LAUSD BEAUDRY HEADQUARTERS: • Go EAST on WILSHIRE BLVD • Turn LEFT (north) onto VERMONT AVE • Turn RIGHT (east) onto W 6TH ST • Turn LEFT (north) onto S BEAUDRY AVE • For the VISITOR’S PARKING LOT turn LEFT on 3rd STREET, turn RIGHT on BOYLSTON AVE then turn LEFT on MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 4 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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84,000 9 17 71 2 11 15 4 2 92 2 4

LOCAL DISTRICT 5 OTHELLO CHILDRESS, Administrator 2151 North Soto Street Los Angeles, CA 90032 TEL: (323) 224-3370 FAX: (323) 224-3105 E-mail: [email protected] School Mail:

CARMEN SCHROEDER, Superintendent 2151 North Soto Street Los Angeles, CA 90032

District 5 Nursing Services Soto Street Annex

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 5 NURSING OFFICE • Go onto 4TH ST going EAST • Turn LEFT (north) onto S FIGUEROA ST • Turn LEFT (west) onto W 3RD ST • Merge RIGHT onto 110 FREEWAY (Harbor Freeway) NORTH • Take the US-101 N exit toward I-5/I-10 SANTA ANA • Keep LEFT to take I-10E toward SAN BERNARDINO • Take the STATE ST/SOTO ST exit. • Take the SOTO ST exit • Turn LEFT onto N SOTO ST • Turn LEFT into parking lot. DIRECTIONS FROM DISTRICT 5 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS • Turn RIGHT (south) exit parking lot onto SOTO ST • Turn LEFT to take the SAN BERNARDINO FREEWAY WEST (I-10 W) ramp. • Merge onto SAN BERNARDINO FREEWAY (I-10) toward HOLLYWOOD FREEWAY (US-101 LOS ANGELES) • I-10 WEST becomes US-101 NORTH • Take the HARBOR FREEWAY (CA-110) toward SAN PEDRO • Go towards the DOWNTOWN off ramp toward 3RD ST. • Exit onto 3RD ST • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR • For the VISITOR’S PARKING LOT turn LEFT onto BEAUDRY then turn RIGHT onto 3rd STREET, turn RIGHT onto BOYLSTON AVE then turn LEFT onto MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 5 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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90,000 6 20 64 2 18 14 5 1 89 0 2

LOCAL DISTRICT 6 MARYLIN BORING, Administrator 4247 Elizabeth Street Cudahy, CA 90201 TEL: (323) 560-4293 FAX: (323) 560-0521 E-mail: [email protected] School Mail:

MARTIN GALINDO, Superintendent 5800 S. Eastern Avenue Commerce, CA 90040

District 6 Nursing Services Hughes Satellite

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 6 NURSING OFFICE: • SOUTH on the 110 FREEWAY (Harbor) toward San Pedro • EAST onto the 10 FREEWAY toward SAN BERNARDINO • SOUTH on 5 FREEWAY toward SANTA ANA • SOUTH on 710 FREEWAY toward LONG BEACH • Exit on FLORENCE BLVD. • RIGHT (west) on FLORENCE BLVD, • LEFT (south) on ATLANTIC BLVD • RIGHT (west) on ELIZABETH ST. • Bungalow is on playground behind Theresa Hughes Elementary School. DIRECTIONS FROM DISTRICT 6 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS: • Go EAST on ELIZABETH ST • LEFT (north) on ATLANTIC AVE (which becomes ATLANTIC BLVD) • RIGHT (east) on FLORENCE BLVD. • NORTH on the 710 FREEWAY toward PASADENA • NORTH on 5 FREEWAY toward DOWNTOWN • WEST on 10 FREEWAY toward SANTA MONICA • NORTH on 110 FREEWAY, exit 3rd ST. west • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR • For the VISITOR’S PARKING LOT go straight on 3rd STREET, turn RIGHT on BOYLSTON AVE then turn LEFT on MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 6 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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61,000 3 4 46 4 6 5 2 1 48 0 0

LOCAL DISTRICT 7 MINOO MAASOUMI, Administrator 3710 S. La Brea Avenue Los Angeles, CA 90016 TEL: (323) 421-2850 or (323) 421-2880 FAX: (323) 299-1713 E-mail: [email protected]

CAROL TRUSCOTT, Superintendent 10616 S. Western Avenue Los Angeles, CA 90047

School Mail: District 7 Nursing Services Support Services Central West DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 7 NURSING OFFICE: • Going SOUTHWEST on Beaudry Ave toward W 4th ST • Turn slight LEFT onto W 4th ST • Turn RIGHT onto S FLOWER ST • Turn RIGHT onto W 5th ST • Merge onto 110 FREEWAY (HARBOR) • Merge onto the I-10W toward SANTA MONICA • Exit onto the LA BREA AVE off-ramp going SOUTH • Go approximately 1 mile, the Office will be on the left side and parking is in front of offices. DIRECTIONS FROM DISTRICT 7 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS

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• • • • • • •

Turn RIGHT (north) exiting the parking lot onto S LA BREA AVE. Turn RIGHT (east) onto the SANTA MONICA FREEWAY (I-10E) Merge onto the HARBOR FREEWAY (110N) toward PASADENA Take the 4TH ST/ 3rd ST ramp Keep LEFT at the fork in the ramp (3rd Street) Turn SLIGHT LEFT onto W 3RD ST For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR For the VISITOR’S PARKING LOT go straight on 3rd STREET, turn RIGHT on BOYLSTON AVE then turn LEFT on MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 7 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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72,000 3 19 47 2 10 10 3 2 63 2 0

LOCAL DISTRICT 8 YOLANDA LASMARIAS, Administrator 1208 Magnolia Avenue Gardena, CA 90247 TEL: (310) 354-3550 FAX: (310) 523-3249 E-mail: [email protected] School Mail:

LINDA DEL CUETO, Superintendent 1208 Magnolia Avenue Gardena, CA 90247

District 8 Nursing Services Gardena Health Center

DIRECTIONS FROM THE LAUSD BEAUDRY HEADQUARTERS TO DISTRICT 8 NURSING OFFICE: • Take the HARBOR FREEWAY (110) SOUTH • Exit at REDONDO BEACH BLVD • Turn RIGHT (west) onto REDONDO BEACH BLVD. • Turn LEFT (south) on VERMONT BLVD. • Turn RIGHT (west) onto MAGNOLIA AVE • Turn LEFT (south) at BUDLONG AVE (stop sign ) • Turn RIGHT into the parking lot.

DIRECTIONS FROM DISTRICT 8 NURSING OFFICE TO THE LAUSD BEAUDRY HEADQUARTERS: • Turn RIGHT (east) onto MAGNOLIA AVE as you exit the parking lot. • Turn LEFT (north) on VERMONT BLVD. • Turn RIGHT (east) onto REDONDO BEACH BLVD. • Take the HARBOR FREEWAY (110) NORTH • Exit on 3rd ST • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR • For the VISITOR’S PARKING LOT go straight on 3rd STREET, turn RIGHT onto BOYLSTON AVE then turn LEFT onto MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

LOCAL DISTRICT 8 PROFILE TOTAL STUDENT ENROLLMENT Primary Centers Early Education Centers Elementary & Magnets Span & Magnets Middle Schools & Magnets High Schools & Magnets Continuation Schools Special Education Schools Title I Schools Opportunity Schools & Programs Community Day Schools

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79,000 0 12 64 1 14 16 6 3 82 0 1

SPECIAL PROGRAMS PATTI HUTCHISON, Administrator 1430 San Julian Street, #9 Los Angeles, CA 90015 TEL: (213) 765-2877 FAX: (213) 765-3868 E-mail: [email protected] School Mail:

District Nursing Services San Julian Annex, #9

DIRECTIONS FROM LAUSD BEAUDRY HEADQUARTERS TO DISTRICT NURSING OFFICE • Go EAST on 4TH ST • Turn RIGHT (south) onto S SAN PEDRO ST • Turn RIGHT (west) onto E. 15TH ST • Turn RIGHT (north) onto SAN JULIAN ST • Turn RIGHT into the 2nd parking lot.

DIRECTIONS FROM DISTRICT NURSING OFFICE TO LAUSD BEAUDRY HEADQUARTERS • Exit LEFT out of parking onto SAN JULIAN ST • Turn RIGHT onto E 15TH ST • Turn LEFT onto MAPLE AVE • Turn RIGHT onto SANTA MONICA FREEWAY (I-10) going WEST • Merge onto the HARBOR FREEWAY (CA110) toward DOWNTOWN • Take the 4th ST/3RD ST exit • Take the 3RD ST – WEST ramp. • For the LAUSD Headquarters turn LEFT (south) onto BEAUDRY AVE. OR • For the VISITOR’S PARKING LOT go straight on 3rd STREET, turn RIGHT on BOYLSTON AVE then turn LEFT on MIRAMAR (Visconti Apartment Garage at the northwest corner of MIRAMAR and BOYLSTON).

SPECIAL PROGRAMS PROFILE AED/CPR Program Visually Impaired Program Carlson Hospital/Home School Program District Nursing Special Education Resources Programs Infant/Preschool Special Education Program Non-Public Schools/Charter Schools Programs

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Absences and Substitute School Nurse Assignments Carmen Montes, School Nurse………………..……………….……….…………..(213) 765-2817 Absence Reporting Tape Line.……………………………....…………….(213) 765-2802 Asthma Programs Susan LaCombe, School Nurse……………………………….…………………….(213) 765-2812 Districts 1 & 2 Leslie Sears, School Nurse……………………………….(818) 388-8675 Districts 1 & 2 Roberta Villanueva, School Nurse………..…...................(818) 427-9149 Districts 3 & 7 Alvis Van Buren, School Nurse…………..……………....(323) 810-0153 Districts 4 & 5 Yolanda Cuevas, School Nurse………….……………….(323) 810-1682 Districts 6 & 8 Annette Azcarate, School Nurse……………………….…(310) 606-1964 Teacher Advisor Raymond Kohl……………………………………………(213) 765-2807 FAX Referrals to (213) 323-5525 Breathmobile………………………………………………………………………..(323) 226-3813 Audiological Resource Unit (ARU) 16th Floor Beaudry Bldg….…………………………………………….…………...(213) 241-8258 Valley ARU (Rene)….……………………………………………………………...(818) 344-2413 FAX: (818) 705-2497 Audiometric Testing Program Carol Toyotome, Coordinating Audiometrist…………………..……………….….(213) 765-2888 San Julian Annex, #9 FAX: (213) 765-3869 California Children’s Services…………………………………………………………….1-800-288-4584 California Kids………………………………………………………………..…………….(818) 755-9700 CHAMP (Children’s Health Access and Medi-Cal Program) Sharon Swonger, Coordinator……………………………………………………....(213) 241-4293 FAX: (213) 241-6888 CHAMP Help-Line.………………………………………………………………..1-866-742-2273 Child Abuse Prevention Contact your Nursing Administrator. Additional Assistance: Office of Associate General Counsel Field Services………………….…..(213) 241-7600 333 South Beaudry Avenue, 20th Floor FAX: (213) 241-3313 Los Angeles, CA 90017 School Mail:

Office of the General Counsel Child Abuse Unit Beaudry Building – 20th Floor

Write CONFIDENTIAL on the envelope. Child Abuse Hotline……………………………………………………………...1 (800) 540-4000 To order Suspected Child Abuse Forms…………………………………………....(213) 639-4499

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Child Health and Disability Prevention (CHDP) Program Pat De Voe, School Nurse………………………………..………………………...(213) 765-2800 Clothes Closets CLOTHES CORNER……………………………………………………………....(818) 785-4134 14603 Hamlin Street, Van Nuys, CA 91411 Call for appointment:

Volunteer League of San Fernando Valley Tuesday, Wednesday, Thursday 9:30 a.m. – 1:00 p.m.

OPERATION SCHOOL BELL…………………………………………………...(323) 469-6017 1360 North St. Andrew Place, Hollywood, CA 90028 Open the 2nd, 3rd and 4th weeks of the month. Referrals for appointment must be made by a School Nurse, Counselor or Site Administrator. Communicable Disease Control ALL communicable diseases and rashes MUST be reported to…….…………..…(213) 765-2805 (Both students and staff) Barbara Woodard-Cox, School Nurse…………….……………………………..…(213) 765-2800 Community Resource Web Site……………………………………………..http://www.lacountyhelps.org Condom Information/ Health Education Tim Kordic, Advisor…………………………………………………………….....(213) 241-3519 Ric Loya, Consultant………….. ………………………………………………....(213) 241-3520 Health Education Program, Beaudry Bldg, 29th Floor…………………….….FAX (213) 241-6957 CPR/AED Program Patti Hutchison, Nursing Administrator, Special Programs…..….………………...(213) 765-2877 FAX (213) 765-3868 Credential Services Unit …………………………………………………………………...(213) 241-6520 D/HH (Deaf/Hard of Hearing) Program ……………..…………………..……………….(213) 241-8053 Emergencies Services Bob Spears, Director……………………………………………………………….(213) 241-3889 Employee Assistance Program…………………………………………………………….1-866-312-3077 Employee Health Services Rosa Mercado, MD, District Medical Advisor…………………………..………....(213) 241-6326 FAX: (213) 241-8918 333 South Beaudry, 14th floor Los Angeles, CA 90017 Tuberculosis Testing and Chest X-rays are no longer available (effective 8/30/08).

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Employee Recreation Units Los Angeles Unit – (corner of Pico and San Julian)…………………………….…(213) 743-3679 600 E. Pico Blvd, Los Angeles, CA 90015 Valley Unit – (Corner of Burbank and Capistrano)……………………..………….(818) 587-4363 5607 Capistrano Ave., Woodland Hills, CA 91367 South Unit…………………………………………………………………………..(310) 515-3010 2060 West 156th Street, Gardena, CA 90249 Beaudry Unit – (M, W, F 10:00 a.m. – 4:00 p.m.)………………………................(213) 241-5863 333 S. Beaudry Avenue, 14th Floor, Los Angeles, CA 90017 Employment Verification for Loan and Credit Applications……………………………..1-800-996-7566 Environmental Health and Safety………….………………………………………………(213) 241-3199 FAX (213) 241-6816 Food Services Branch……………………………………………………….……………...(213) 241-2985 Test Kitchen (Nutrition Services Unit)……………...…………….………………..(213) 625-5536 Food Services Branches……………………………………………………………1-800-300-3663 Food Services – Nutrition Specialist………………………………………………..(213) 241-2982 David Binkle Health Benefits Administration (Employee Health Insurance)………...……...………….(213) 241-4262 Website: http://benefits.lausd.net/ Email Inquires: [email protected] Health Care Assistant – Absence Line……………………………………………………..(213) 765-2803 Health Supply Office Bill O’Brien, Medical Supply Clerk.……………………..………..………………(213) 747-6725 FAX (213) 746-1798 School Mail: Health Supply Office, BSC Annex US Mail: 1307 San Julian Street, Los Angeles 90015 Human Resources Roger Buschmann, Chief Officer..………………………………………………...(213) 241-6131 Immigrant Assessment Center …………………………………………………………….(213) 482-3954 (Housed at Plasencia El. School in District 4) Infant Preschool Support Services PRE-SCHOOL SERVICES District 1 & 2

Myrna Agorrilla..………………………………...Pager (213) 470-0110 Office (213) 241-4713

District 1 & 2

Charito Lazaro..……..………………………….. Pager (213) 360-7529 Office (213) 241-4713

District 3 & 7

Janice Lough-Spillis…………….….……………Pager (213) 350-9677 Office (213) 241-4713

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District 4 & 5

Marlita Castillo…………………………………..Pager (213) 470-0129 Office (213) 241-4713

District 4 & 5

Brenda Clark……………………………………. Pager (213) 716-0053 Office (213) 241-4713

District 4 & 5

Jan Shacks……………...………………………..Pager (213) 360-7128 Office (213) 241-4713

District 6 & 7

Karen Schwarzmann………………….................Pager (213) 506-8007 Office (213) 241-4713

District 6 & 8

Champa Bhikha…………………………………Pager (213) 470-0027 Office (213) 241-4713

District 6 & 8

Diane Sopher……………………………………Pager (310) 201-1086 Office (213) 241-4713

INFANT SERVICES D/HH (Deaf/Hard of Hearing Program)…………………………………..Office Darlene Llorens………………………………………………Cell Phone Voice Mail PIVIT (Parents and Infants with Visual Impairments Together)…………Office Lisa Zindrowki…………………………………..……………Cell Phone

(213) 229-4713 (213) 435-9240 (213) 241-4754 (213) 229-4713 (213) 247-9489

Interscholastic Athletics/Sports Physicals Barbara Feige……………………………………………………………………… (213) 207-2200 FAX: (213) 207-2209 ITD (Information Technology Division) Help Desk……………………………………….(213) 241-5200 Kathryn Kurka Children’s Health Fund………..……………….........................................(213) 765-2800 LAPD – Non Emergency………………………………………………………………......1-877-275-5273 LAUSD Board Members…………………………………………………………………....(213) 241-6389 District 1 ……………………Marguerite Poindexter-La Motte…………………...(213) 241-6382 District 2 ……………………Monica Garcia (Board President)…………………..(213) 241-6180 District 3 ……………………Tamar Galatzan……………………………………..(213) 241-6386 District 4 ……………………Marlene Canter……………………………………...(213) 241-6387 District 5 ……………………Yolie Flores Aguilar..................................................(213) 241-6383 District 6…………………….Julie Korenstein………………………….................(213) 241-6388 District 7 ……………………Richard Vladovic…………………………………...(213) 241-6385 LAUSD General Information………………………………………………………………(213) 241-1000 Medi-Cal Administrative Activities Dale Reinert, Coordinator…………………………………………………………..(213) 241-0803 Medi-Cal Reimbursement Unit & Mandated Cost Recovery Program……………………(213) 241-0551 FAX (213) 241-8458 333 S. Beaudry Ave., 29th Floor Los Angeles, CA 90017 Sherry Purcell, Coordinator…...………………………..………………….(213) 241-0551 Bonnie Mims-Green, Resource Nurse………………………………...…...(213) 241-3851

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MOU (Memorandum of Understanding) John De Cecco, Director……………………………………………………………(213) 241-3872 Network for a Healthy California LAUSD Network for a Healthy California LAUSD ……………………………..………….(818) 609-2550 C/O Mulholland Middle School FAX (818) 609-2580 U.S. Mail: Network for a Healthy California LAUSD 6651 “C” Balboa Blvd. Lake Balboa, CA 91406 NPS (Non-Public Schools) Patti Hutchison, Nursing Administrator, Special Programs…..…………...............(213) 765-2877 Office of Risk Management and Insurance Services……………………………………...(213) 241-3139 FMLA (Family & Medical Leave Act)…………………………………………….(213) 241-3954 Student Accident Insurance – BRIDGE NORENA & ASSOCIATES..…….(818) 225-1627 x 303 or (323) 872-3831 x 303 Special Events Liability……………………………………………………………(213) 241-3065 or (213) 241-3016 Orthopedic Hospital/Urgent Care Children’s Emergent Fracture Care Treatment Seen at: Orthopedic Medical Center Urgent Care……………………………..……(213) 742-1162 2400 South Flower Los Angeles, CA 90007 Questions regarding services……………………………………………………….(213) 742-1330 Pest Control……………………………………………………………………...………….(213) 743-1102 Physical Therapy/Occupational Therapy (PT/OT)……………………..………………….(213) 241-8054 Poison Control………………………………………………………………...Nationwide 1-800-222-1222 California Only 1-800-876-4766 For Health Professional ONLY 1-800-411-8080 Pregnant/Parenting Teens Programs and Homeless Education Program Melissa Schoonmaker, Program Coordinator…….………………………………...(213) 765-2880 San Julian Annex, #7 FAX: (213) 765-3867 The McAlister School Programs for Pregnant Students………………...Cora Rigor, School Nurse • District 1 – McAlister Reseda Branch…….…………………………..(818) 886-2573 • District 2 – McAlister San Fernando Branch………………………….(818) 365-0731 • District 3 – McAlister Southwest Branch……………………………..(323) 293-5992 • District 3 – McAlister Westside Branch………………………………(310) 231-9190 • District 4 – McAlister Central Branch………………………………...(213) 389-6120 • District 4 – McAlister High School……………………………………(213) 381-2823 The Riley School Programs for Pregnant Students………………..Barbara Lawson, School Nurse • District 5 – Riley Eastside Branch……………………………………..(323)222-9797 • District 7 – Blanding Branch…………………………………………..(323) 563-6692 • District 8 – Riley Gardena Branch…………………………………….(310) 324-8942

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Ramona High School (District 5)…………………………………………………..(323) 263-7429 For School Nursing Information telephone Local District 5 Nursing ……..(323) 224-3370 Psychiatric Emergencies PMRT - Psychiatric Mobile Response Team (formerly called the P.E.T. Team) Now part of San Fernando Mental Health (does not include law enforcement) Hours: Monday – Friday 8:00 a.m. – 5:00 p.m. ……(818) 832-2410 [ask for PMRT] For after hours and weekends…………………………….……………...1-800-854-7771 PMRT – Local District One and Two ONLY………………………………………(818) 708-4500 Can call for triage at VCCS (Valley Children’s Coordinated Services) to help determine where to send the case. SMART - System Wide Mental Assessment Response Team – For violent cases First call 911 for LAPD Then call SMART……………..………………….……..…….…………...(213) 485-3300 Monday – Friday from 7:00 a.m. to 1:30 a.m. 24 hour/7 day coverage for SMART – after hours call same number and referral numbers that are given on the tape. School Mental Health Dr. Marlene Wong, Director of Crisis Intervention Services/OEHS.……………...(213) 241-2174 Gil Palacio, Director……….….………………..…………………………………..(213) 241-3841 97th Street Clinic…………………………………..……………………….(323) 754-2856 Jan Nolan Hyde Park……………………………………………..…………………...(323) 750-5167 Rosanna Rowles Cudahy……………………………………………………………………..(323) 869-1352 Socorro Valderrama Valley ………………………………………………………..…………….(818) 997-2640 Kelly Jones San Pedro……………………………………………………..…................(310) 832-7545 Suh Chen Hsiao School Nurse for Mental Health Counseling: Nancy Sanford, RN………………………………..…………..…………...(818) 997-2640 School Police …………..……………………………………………………….…………..(213) 625-6631 FAX (213) 742-0221 Special Education Home/Hospital…………………………………………………………(818) 509-8759 FAX (818) 505-0246 Carlson Home Instructional Program and Hospital School 10952 Whipple Street North Hollywood, CA 91602 Robin Schleifer, School Nurse……………...…………Voice Mail (818) 759-7676 Ext. 8 Joy Takahashi, School Nurse (3 days/week)…..………Voice Mail (818) 759-7676 Ext. 6 Refer to Bulletin BUL-1229.1 dated November 28, 2005, Division of Special Education, “CARLSON HOME INSTRUCTIONAL PROGRAM AND HOSPITAL SCHOOL-REVISED”.

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Special Education School Nurses HEALTH CARE ASSISTANT COVERAGE Nancy Hill………………………………………………………..…….…………...(213) 765-3875 FAX (213) 765-3868 District 1 Elissa Bender……………………………………………………………………….(818) 256-2900 FAX (818) 894-1786 District 2 Suzette Talbott…………………………………………………...………...............(818) 755-5437 FAX (818) 755-9531 District 3 and 4 Andrea Coleman.…………………………………………………………………...(213) 765-3879 FAX (213) 765-3868 District 5 and 6 Marilou Gutierrez…………………….…………………..…………………………(323) 224-3370 FAX (323) 224-3105 District 7 and 8 Jessie Cannon.……………………………………………………….……………...(323) 421-2831 FAX (323) 299-1668 Student Health and Human Services Rene Gonzalez, Assistant Superintendent………………………………………….(213) 241-3840 FAX (213) 241-3305 Student Medical Services Kimberly Uyeda, MD, MPH, Director………………..………..…………………..(213) 765-2830 1430 San Julian Street, #2 FAX (213) 765-3862 Los Angeles, CA 90015 SCHOOL PHYSICIAN ASSIGNMENTS District 1 Guilda Eshtehard, MD..………………………………Voice Mail (213) 765-8388 Pager (818) 609-2031 District 2 & 5

Pat Nishikawa, MD…………………………………..Voice Mail (213) 765-8383 Pager (818) 607-9291

District 3 & 7

Daryoosh Sami, MD ……………………………………..Pager (323) 912-0465

District 4

Rosina Franco, MD………………………………………Pager

District 6 & 8

Stephanie Quarles, MD…………………………………..Pager (818) 328-0166

(818) 948-0165

Physicians are responsible for special education evaluations, medical permits, exemptions, exclusions and any medical concerns from their respective Local Districts. Student Search (to locate School of Residence) For Elementary Schools………………….…………………………………………(213) 241-4617 For Secondary Schools……………………………………………………………..(213) 241-4850 Suicide Prevention Unit Richard Lieberman, School Psychologist………………….……..………………...(818) 705-7326 6651 Balboa Blvd, Van Nuys 91325 For emergencies……………………………………………………………(310) 650-1888

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Transportation Branch………………………………………………………...…………..(323) 342-1400 FAX (323) 221-3121 Enrique Boull’t, Director 2710 Media Center Drive Los Angeles, CA 90065 Dispatch………………………………………..……………………….…………..(323) 342-1460 Or 1-800-LABUSES (1-800 -522-8737) FAX (323) 221-3879 Vision Therapy………………………………………………………………………..…….(213) 241-8239 FAX (213) 241-8435 James Astle Beaudry Bldg., Floor 16th Visually Impaired Programs ALL Itinerant Vision Program referrals for students 3 years and older are processed by Eunice Kamimura, School Nurse Telephone Number………………………………………………………...(323) 962-9560 Voice Mail………………………………………………................(213) 228-9534 ext. 34 FAX Number………………………………………………………………(323) 465-5001 Frances Blend School for the Visually Impaired (an IEP is required for admission) Telephone Number ………………………………………………………..(323) 464-5052 FAX number ………………….. …………………………………………..(323) 466-2583 Elaine Bayan, School Nurse………………………………………...(323) 464-5052 x 116 PIVIT (Parents and Infants with Visual Impairments Together) Program for ages 0 to 3 years …………………………………… ……….(213) 229-4713 Lisa Zindrowki, School Nurse………………………Cell Phone (213) 247-9489 Welligent Health Manager Facilitator Vickey Conley, School Nurse……………………………………….……………...(213) 765-2800 Welligent Help Line (ITD)…………………………………………………………(213) 241-5200

31st DISTRICT PTA DENTAL CLINICS Hart Street (at Hart Street School) – for information call…………………….……………(818) 883-1029 21006 Hart Street, Canoga Park 91303 Telfair (at Telfair Avenue School) – for information call…...……………………………..(818) 899-0021 10911 Telfair Avenue, Pacoima 91331

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10th DISTRICT PTA HEALTH CENTERS Central Pat Castleberry, Clinic Manager………..…………………….…………………..(213) 745-7502 1000 Venice Blvd., Los Angeles 90015 (Registration $25.00) Services: Ophthalmology (every 2nd Friday) and Optometry (every Monday, Tuesday, 1st, 3rd & 5th Thursday and every Friday) (Glasses - $60.00. $40.00 deposit required for glasses) San Pedro Pat Castleberry, Clinic Manager…..……………………………………...............(310) 833-3594 704 West 8th Street, San Pedro 90731 (Registration $25.00) Services: Ophthalmology, Optometry, and CHDP Ophthalmology – 1st Friday of each 3rd month Optometry every Wednesday CHDP every Tuesday

31st DISTRICT PTA HEALTH CENTERS Hart Street (at Hart Street School) Grisel Ayala, Clinic Manager………………………………………...……………(818) 883-0360 21006 Hart Street, Canoga Park 91303 (Registration $15.00) Services: Optometry (Tuesday and Wednesday) Ophthalmology – by referral only to Central (Glasses start at $45.00) Telfair (at Telfair Avenue School) Karen Lenoski, Clinic Manager…………………………………………................(818) 899-6113 10911 Telfair Avenue, Pacoima 91331 (Registration $15.00) Services: Optometry (Monday and 2nd & 4th Thursday) CHDP (Tuesday) and Immunizations (Monday & Thursday) Ophthalmology – by referral only to Central (Glasses start at $45.00 - $55.00. $30.00 deposit required for glasses) REFERRAL FORM FOR PTA CLINIC Please continue to use the General Consent Form 33.367 when referring students to any of the PTA Clinics. This form requires that you must include address and directions to the clinic. Parent/Guardian must accompany the student. The School Nurse is the only person authorized to make PTA clinic appointments.

KATHRYN KURKA CHILDREN’S HEALTH FUND School Nurses and other employees may contribute to the Kathryn Kurka Children’s Health Fund, sponsored by the Los Angeles City School Nurses, through payroll deduction. Contributions may be made directly to this fund at any time. For questions and information on the use of Kathryn Kurka Children’s Fund, telephone District Nursing Services at (213) 765-2800. School Nurses may telephone the PTA Vision Clinics directly to make an appointment. Indicate use of the Kurka Funds without approval from Nursing Services.

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STAFF DUES $29.00 annually. Make check payable to L.A. CITY SCHOOL NURSES. Submit remittance to your Local Nursing Administrator today. ALL MEMBERS benefit from this; it is used for the following occasions: CEH/Hours Illness Bereavement Retirement

California State Provider Number Fee Long-term hospitalization flowers/plant Donation to Kathryn Kurka Children’s Health Fund LAUSD School Nurse Gold Pendant/Tie Pin (for at least 5 years of service)

EMPLOYEE ATTENDANCE POLICY While the vast majority of employees have a strong commitment to their work and excellent attendance, it is also clear that unnecessary absenteeism has a negative impact upon student achievement due to interruption of the continuity of instruction, and results in reduced productivity, loss of service, and significant costs to the Los Angeles Unified School District (LAUSD). The LAUSD Board of Education expects: • • • • •

•

employees to maintain regular attendance and avoid absenteeism; employees to work every hour that they are assigned; employees to be at their work stations on time every working day; employees to comply with legal restrictions, LAUSD policies and procedures, and respective collective bargaining rules regarding reporting of absences and providing appropriate documentation; supervisors to explain and insist upon regular attendance, maintain accurate employee attendance records, monitor employee attendance, provide performance feedback to employees and enforce all employee attendance policies and standards through employee performance evaluations and discipline processes; the District will make every attempt to avoid scheduling activities that contribute to staff absenteeism.

LAUSD seeks to assist administrators and supervisors to efficiently manage attendance, improve employee effectiveness through reduced absenteeism, and guide employees in appropriate use of illness and personal necessity time. Illness leaves are provided to ease the financial burden of employees who are unavoidably required to be absent from duty due to legitimate illness, injury, or personal necessity. Personal necessity leaves are provided for only eleven specific reasons. Employees who use illness and personal necessity leaves for unauthorized reasons are in violation of District policy and related laws. Failure to comply with this policy can result in appropriate disciplinary action, up to and including termination.

ABSENCES Tape Line:

ALL ABSENCES MUST BE REPORTED as soon as possible to the District Nursing Office including conference attendance (both off site and on LAUSD sites – e.g. Impact, TUPE, Family Life and Sex Education, etc.). Call the District Nursing Office tape to report an absence 24 hours/day at: (213) 765-2802 or you may call the Substitute Assignment Desk between 7:30 a.m – 3:30 p.m. at: (213) 765-2817 Use the 24 hour wallet-size “DISTRICT NURSING ABSENCE REPORTING CARD” when calling. Please follow ALL the instructions on this card. It is not easy to get information from a tape. Thank you for your cooperation.

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Using the Tape Line:

Please speak SLOWLY and DISTINCTLY. This is a voice activated tape so speak loudly or the tape will cut you off. If you are cut off or think you may have been cut off, please call again. If illness prevents you from speaking distinctly, ask someone else to make the call for you to provide all the required information. PLEASE STATE TYPES AND TIMES OF FIRST PROTOCOLS (including insulin administration). If your day of absence is a pupil-free or minimum day, please so state.

ALSO Notify:

You MUST also report your absence to your LOCAL NURSING ADMINISTRATOR as well as your SCHOOL OR ASSIGNED LOCATION.

Certification of Absence: The District Absence Forms include the absence for the Family and Medical Leave Act (FMLA) and/or the California Family Rights Act (CFRA). These forms do not replace or supersede the need to complete an official Leave of Absence Request Form (PC Form 5006 or HR Form 1065), when the absence exceeds 20 working days. In addition, the Certification of Absence forms must not be altered/modified in any way. These forms are considered legal documents upon signature of the employee. Certification/Request of Absence for Illness, Family Illness, New Child This form consists of five sections: Employee Information, Reason for Absence, FMLA/CFRA Information, Important LAUSD Information and Administrator/ Supervisor’s Acknowledgement. 1. Employee Information Section requires employee data: Name, employee number, work location, job title and telephone number where the employee can be most readily contacted. 2. Reason for Absence Section requires employee to provide absence data: indication of a new absence or extension of an ongoing absence, starting date and last date of absence or expected last date of absence, total time or expected total time of absence (weeks, days or hours) and the selection of type of absence. The types of absence are: a. employee’s personal illness/injury/disability/medical appointment; b. employee’s occupational illness/injury or act of violence; c. employee’s pregnancy-related illness/disability; d. accident involving the employee; e. illness/injury/disability of employee’s family member – the employee may request to use up to six days of personal necessity per fiscal year, or the employee may request to use up to six days of kin care per calendar year, however kin care is restricted for the use of illness for a parent, child, registered domestic partner or spouse, per Labor Code Section 233 (kin care); f. accident involving employee’s family member; and g. employee’s time-off for newborn/newly adopted/new foster care. 3. FMLA/CFRA Information Section addresses the requirements for a “serious health condition” absence. 4. Important LAUSD Information Section addresses the requirement for a Certificate of Health Care Provider. The certificate is required when requested by the Administrator/ Supervisor under FMLA, and/or District rules. The employee must also indicate if the request is for an unpaid leave of absence. 5. Administrator/Supervisor’s Acknowledgement Section requires the name and signature of the employee’s supervisor and the approval/disapproval of the absence. Principals do not sign this form. The Local Nursing Administrator is responsible for signing this form.

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Certification and/or Request of Absence for Non-Illness This form consists of three sections: Employee Information, Reason for Absence and Administrator/Supervisor’s Acknowledgement. 1. Employee Information Section requires employee data: name, employee number, work location, job title and telephone number where the employee can be most readily contacted. 2. Reason for Absence Section requires employee to provide absence data: indication of a new absence or extension of an ongoing absence, starting date and last date of absence or expected last date of absence, total time or expected total time of absence (weeks, days or hours) and the selection of type of absence. Time reporters may refer to the FMLA Supervisors’ Reference Manual or the Payroll Concepts Manual for the appropriate time/pay codes. Note: All type of absences selections must be made according to the applicable Board Rules, Personnel Commission Rules, Collective Bargaining Agreements and District Policies governing the employee.

The types of absences are: a. accident or imminent danger to employee’s property; b. accident to employee’s family members’ property; c. automobile failure if required for work performance (for employees in bargaining units A, B, C, D & S); d. registration or final exam in higher education (for employees in bargaining units A, C & S); e. religious holiday of employee’s faith; f. bereavement; g. conference approved by the District; h. Jury Duty or appearance in court under order – employee must provide the appropriate notification and documentation. (see additional information related to Unpaid Jury Duty.) i. vacation – for eligible regular classified and certificated “A” Basis employees. This request is subject to pre-approval only; and j. other absence – not specifically indicated above but provided in the collective bargaining agreement. 3. Administrator/Supervisor’s Acknowledgement Section requires the name and signature of the employee’s supervisor and the approval/disapproval of the absence. Principals do not sign this form. The Local Nursing Administrator is responsible for signing this form. All type of absence selections must be made according to the applicable Board Rules, Personnel Commission Rules, Collective Bargaining Agreements and District Policies governing the employee. The forms must be signed and dated by the employee under penalty of perjury. Forms must be submitted to the Local Nursing Administrator immediately upon return from absence. Employees are required to certify the reason for ANY absence. The District has the right to verify absences before authorizing compensation. Employees who fail to complete and sign necessary forms for absence may be unpaid until such documentation is completed and/or verified. (Article XII, Section 12.8) Refer to Bulletin BUL-1311.2 dated August 1, 2005, Accounting and Disbursements Division, “NEW CERTIFICATION OF ABSENCE FORMS” and

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Reference Guide No REF-1591 dated March 7, 2005, Division of Risk Management & Insurance Services, “FAMILY AND MEDICAL LEAVE ACT/CALIFORNIA FAMILY RIGHTS ACT - SUPERVISORS’ FMLA REFERENCE MANUAL (AND FMLA SUMMARY FOR SUPERVISORS)”.

PERSONAL NECESSITY ABSENCE Effective as of January 1, 2000, Labor Code Section 233, allows employees to use six additional days of accrued illness hours as Personal Necessity Leave solely for attending to the illness of a parent, spouse or child. These six days are in addition to the days currently provided by the Collective Bargaining Unit Agreement. You must have enough accrued illness hours to use the Personal Necessity days during the school year; otherwise they will be UNPAID days. If personal necessity absence is taken to attend to the illness of employee’s child, parent, or spouse, up to six additional days shall be allowed in any calendar year (to total 12 days maximum – see below) for a probationary, permanent, or provisional contract employees. However, this provision does not extend the maximum period of leave to which an employee is entitled under Family Care and Medical Leave, regardless of whether or not the employee receives sick leave compensation during the leave. [Article XII, Section 14.1 (a) (1).] The days allowed shall be deducted from and may not exceed the number of days of accrued full-pay illness leave to which the employee is entitled. The personal necessity leave shall not be granted during a strike, demonstration or any work stoppage. The employee shall be required to verify the nature of such necessity. Such statement shall be filed with the appropriate administrator no less than five working days in advance of a religious holiday, court appearance or school visitation. The immediate administrator shall take whatever steps reasonably necessary to become satisfied that a personal necessity within the limits of this section did exist. Reasons for Personal Necessity Absence Include: • death of close friend or relative not included in the definition of immediate family; • death of a member of the employee’s immediate family, when time is in excess of that provided for bereavement absence; • serious illness of a member of the employee’s immediate family; • accident involving the employee’s person or property or the person or property of a member of the employee’s immediate family; • birth of a child to the wife/partner of the employee, or adoption of a child by the employee; • religious holiday of the employee’s faith; • imminent danger to the home of the employee occasioned by a disaster such as flood, fire, or earthquake; • an appearance in court as a litigant. The clerk of the court must certify each day of necessary attendance as a litigant. The employee must return to work in cases where it is not necessary to be absent the entire day; • conference or convention attendance if approved by the District; and • attendance at the classroom of the employee’s own child or ward and meeting with the school administrator because of suspension as required by Section 48900.1 of the California Education Code.

BEREAVEMENT ABSENCES Three days of Bereavement Absence are granted if the deceased is a member of the employee’s immediate family. If out-of-state travel is required, five days of bereavement absence are granted if acceptable proof of death and relationship is provided and the leave/absence commences within 10 calendar days of the death. The immediate family is defined as the following relatives of the employee: • spouse or cohabitant* • parent (includes in-law, step and foster and parent of cohabitant)

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• • • • • •

child (includes son/daughter, son-in-law/daughter-in-law, step and foster and child of cohabitant) grandparent (includes in-law and step and grandparent of cohabitant) grandchild (includes grandchild of spouse, step grandchild and grandchild of cohabitant) brother sister any relative living in the employee’s immediate household.

Bereavement Absence is a gift from the District and is not deducted from your illness time. (Brother-in-law and sister-in-law are not defined as immediate family.) *Cohabitant is defined as the “equivalent of a spouse”.

FAMILY AND MEDICAL LEAVE ACT/CALIFORNIA FAMILY RIGHTS ACT AND PAID FAMILY LEAVE INSURANCE The Federal Family and Medical Leave Act (FMLA) and State of California Family Rights Act (CFRA) provide eligible employees with a maximum of twelve weeks of protected leave per year when the employee or a covered family member experiences a “serious health condition,” or when an employee requests time to bond with a child after the child’s birth or placement through adoption or foster care. The laws permit employers to designate such leave time concurrently with other types of leave such as Workers’ Compensation Leave. In addition, under certain circumstances, employers may allow or require employees to utilize vacation or illness time, while on FMLA or CFRA leave. FMLA/CPRA provides a maximum of 12 weeks of jobprotected absences for employees for certain family and medical reasons. LAUSD uses a “Variable Year Forward” for counting these 12 weeks. (When caring for a family member injured in the military, the employee may be eligible for 26 weeks.) • •

•

•

•

Eligibility: LAUSD employees must have been employed with the District for at least 12 months (the months need not to be consecutive) and have worked at least 130 workdays during the one year immediately preceding the effective date of each absence or leave. Qualifying: Qualifying reasons include a serious health conditions: a new child in the family; or a qualifying family member on active military duty. The FMLA process the absence is based on reasons that would qualify under FMLA/CFRA. The qualifying FMLA information must be provide within two business days of the employee’s return to work; or the District designated the absence as FMLA/CFRA resulting in time off that is not protected under FMLA/CFRA. Family Member Care: FMLA/CFRA protects for the care of qualifying family members (parent, spouse, child under 18, or Domestic Partner registered with the CA Secretary of State). When the care is for the member in U.S. military service, there are two more qualifying relationships a child of any age, and a qualifying “next of kin”. Advance Notice Rules: The employee needs to make a request at least 30 days before FMLA/CFRA leave is to begin. If notice of 30 days is not possible (such as a sudden illness) the notice needs to be given within two business days, or as soon as practicable. Whenever possible, if the need for a leave is foreseeable, the employee must make a reasonable, good faith effort to schedule the health treatment or health supervision to avoid disruption to the District’s operations. Notice must be provided to the employee’s immediate supervisor or other designee, in accordance with the rules of the employee’s site or office. Certification: The employer will normally require the employee to provide an FMLA certification by a health and recertification where permissible.

Refer to the Office of Risk Management and Insurance Services (213) 241-3139 for information related to Family and Medical Leave Act (FMLA) and the California Family Rights Act (CFRA); Bulletin No. 1504.2 dated March 25, 2008, Division of Risk Management and Insurance Services, “POSTING OF REGULATORY NOTICES RELATED TO FEDERAL AND STATE EMPLOYMENT LAWS”;

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Reference Guide No. REF-1591 dated March 7, 2005, Division of Risk Management and Insurance Services, “FAMILY AND MEDICAL LEAVE ACT/CALIFORNIA FAMILY RIGHT ACT – SUPERVISORS’ FMLA REFERENCE MANUEL (and FMLA SUMMARY FOR SUPERVISORS)”; Bulletins No. BUL-1205 dated July 29, 2004, Division of Risk Management and Insurance Services, “FAMILY AND MEDICAL LEAVE ACT/CALIFORNIA FAMILY RIGHTS ACT POLICY”; and Bulletin No. BUL-1085 dated June 15, 2004, Office of Risk Management and Insurance Services, “REQUIRED POSTING FOR PAID FAMILY LEAVE INSURANCE”.

PRINCIPAL-SCHOOL NURSE CONFERENCE All School Nurses are required to schedule a conference with their Principal(s) or School Site Administrator at the beginning of the school year. The purpose of this Principal/Site Administrator-School Nurse Conference is to establish rapport and promote a mutual understanding of student health needs for a particular school. A copy of the Suggestions for Principal-School Nurse Conference is on the back of the Principal-School Nurse Conference Form (Rev. 7/08). Use this as an original and make copies for each school site Principal/Site Administrator. After the conference, the enclosed form must be completed, signed by the Principal/Site Administrator and returned to the Local Nursing Administrator by Friday, October 24, 2008.

REQUEST FOR CONFERENCE, CONVENTION OR MEETING ATTENDANCE Conference and convention requests must be carefully reviewed and signed by the Local Nursing Administrator. A completed Request for Conference, Convention, or Meeting Attendance Form 10.12 (Rev. 8/05) must be submitted for processing no later than four (4) weeks prior to the date of the event. Conference attendance must lead directly to the professional growth of the employee and the improvement of the District’s educational program. If the same type of conference is offered in various locations, the employee must attend the conference closest to the employee’s home or work location. The appropriate Administrator or Superintendent may request a written or oral report of the conference. At least four (4) weeks prior to the event the School Nurse must: 1. submit to the Local Nursing Administrator a Request for Conference, Convention, or Meeting Attendance Form 10.12 (Rev. 8/05), rationale for request, and event documentation (brochure, announcements, etc.). 2. telephone the Substitute Assignment Desk at (213) 765-2817 or the tape line at (213) 765-2802 to report absence and protocols at the school. 3. submit signed acknowledgement form from your site administrator (obtain this form from your Local Nursing Administrator). Refer to Bulletin No. BUL 4037.1 dated February 1, 2008, Office of the Superintendent, “DISTRICT POLICY AND ATTENDANCE AT CONFERENCES, CONVENTIONS OR MEETINGS”.

DUTY HOURS Minimum on-site duty hours including beginning and ending times may differ depending upon the School Nurse’s schedule and site(s). According to the UTLA/District Contract it is agreed that the professional workday of a full-time regular employee requires no fewer than 8 hours of on-site and off-site work. The Professional workday DOES NOT CHANGE on Pupil Free days, minimum days, or shortened days. School Nurse hours require no fewer than 8 hours of on-site and off-site work.

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LUNCH AND NUTRITION CANNOT BE SUBSTITUTED FOR ON-SITE DUTY HOURS. ANY CHANGE FROM THE CONTRACT REQUIRES THE APPROVAL OF THE PRINCIPAL AND THE LOCAL NURSING ADMINISTRATOR.

2008 – 2009 PAYROLL CALENDAR Certificated employee time cards are faxed to the Local Nursing Administrative Office on the 27th of each regular month. (Fax on the Friday before if the 27th occurs on a weekend.) Send the original time card to the Local Nursing Administrative Office on the last day of the month. To access personal payroll information, visit the Payroll Services Branch on line.

SIGN-IN AND SIGN-OUT PROCEDURES AND TIME REPORTING FOR SCHOOL NURSES Effective July 1, 2003, all certificated itinerant employee time (including itinerant time paid with categorical or discretionary funds) is time-reported by the Local Nursing Administrator’s Office. School Site Administrators or the Administrator Designee must provide a sign-in and sign-out card. According to the contract, all employees (including ALL School Nurses) MUST sign-in and sign-out from the scheduled work location (Article IX 2.0). The Site Administrator and the Local Nursing Administrator MUST be notified if the School Nurse leaves the site anytime during the school day. The School Nurse must also notify both the Site Administrator and the Local Nursing Administrator when returning to school (including lunch time taken off site, or in the car). Always leave a telephone number with the Site Administrator where another School Nurse may be reached in case of a non life threatening emergency. Non-school site based personnel must also sign the itinerant sign-in book when serving a school and/or office site. The sign-in/sign-out card will be retained at the location for auditing purposes. A copy of the sign-in/sign-out card must be faxed to the Local Nursing Office by 8:00 a.m., the last workday of the month. All benefit certification forms (i.e. Illness, Personal Necessity, Bereavement) will be approved/signed and retained by the Local Nursing Administrator, along with the copies of sign-in/sign-out records. Employees are required to certify the reason for ANY absence. The District has the right to verify absences before authorizing compensation. Employees who fail to complete and sign necessary forms for absence may be UNPAID until such documentation is completed and/or verified. (Article XII, Section 12.8). All School Nurses must also complete a Nursing Services Time Card (Form 33.65 [Rev. 3/5/09] 2008-2009) and submit it to the Local Nursing Administrator at the end of each month. A copy of the Nursing Services Time Card should be faxed to the Local Nursing Administrator on the 27th of each month. (Fax on the Friday before if the 27th occurs on a weekend.) Refer to LAUSD Accounting & Disbursement Division, Payroll Concepts Manual by Payroll Services Branch Staff dated October 2003.

TIME REPORTING FOR MULTI-FUNDED PERSONNEL Federal and State regulations implemented by the California Department of Education require documentation from all School Nurses who are compensated from more than one funding source. This provides written proof that supports the use of the funds allocated for Nursing Services from any particular program. Your Nursing Administrator will provide you with a Multi-Funded Time Report (B), Daily Activity Log (C) and Time Accounting Log (D). The School Nurse will be required to certify by signature every month on this form (which is a combination of Attachment B, Attachment C and Attachment D of Bulletin BUL-2643.3 dated March 27, 2007). Your schedule may include a designation for specific School Nurse time purchased from selected funds. Account S536, N536, S539, N539, and others are subject to audit at any time. Account 2278 is the District Time provided to your school(s) and Account S046 and N046 is Title I. Suggestions for insuring accountability include the following actions: • Contact your site coordinator for the Compensatory Education Funds involved.

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Obtain a list of programs, goals and objectives. Obtain a list of students participating in the programs and file it in the Health Record Book. Develop a system for identification of Health Cards for students enrolled in various programs. Develop several strategies to meet the needs of students on specially funded days. Log daily activities. Mail the original signed Multi-Funded Time Report (B)/Daily Activity Log (C), and Time Accounting Log (D) to your Nursing Time Reporter each month.

All Multi-Funded personnel who are compensated from more than one funding resource are required to maintain a daily record of the number of hours and a log of daily activities provided to each program. At the end of each month, the record must be signed by the employee and certified by the Local Nursing Administrator. Supplemental funds cannot be used to provide School Nurse mandated services. The Government Accounting Office is holding these programs accountable for their expenditures so you may receive a visit from an auditor. Employees must certify the percentage of time being charged to program codes. The Multi-Funded Time Report (B)/Daily Activity Log (C), and Time Accounting Log (D) must be retained for five years for audit purposes. Your accurate recording and documentation is a critical factor in this reimbursable task. Refer to Bulletin No. BUL-2643.3 dated March 27, 2007, Accounting and Disbursements Division, “TIME REPORTING DOCUMENTATION FOR FEDERAL AND STATE CATEGORICAL PROGRAMS”.

EVALUATION OF HEALTH AND HUMAN SERVICES PERSONNEL - STULL EVALUATION The monitoring and evaluation of Health and Human Services personnel accountabilities are the joint responsibility of the site administrator and the Local Nursing Administrator. The UTLA-District Collective Bargaining Agreement (Article X, 2.0) indicates that there may be an opportunity for consultation between the site administrator and the employee’s technical supervisor, prior to issuing the annual evaluation. The Local Nursing Administrator is responsible for evaluating those areas of performance that are specific to the skills and knowledge necessary to carry out the duties of the School Nurse. Purpose:

These guidelines have been prepared to assist in the implementation of the requirements of California Education Code Section 44664 and Article X of the District-UTLA Agreement and to evaluate employee performance, provide assistance and remediation to employees whose performance is less than satisfactory.

Frequency:

Permanent – at least once every other year. Probationary and Conditional personnel – at least once each school year. District Interns, University Interns and Temporary Contract personnel – at least once each school year. Qualifying personnel – at least once each school year. Provisional and Pre-Intern – at least once each school year. Some personnel evaluated in the current year include: • personnel who were not evaluated for any reason in the previous school year; • personnel receiving a “Below Standard Performance” rating, until a rating of “Meets Standard Performance” is achieved; • personnel receiving a Notice of Unsatisfactory Service or Act(s) in the previous school year; and • personnel who are designated for evaluation.

Recent Legislative changes permit permanent staff to agree to evaluations completed in cycles of up to five years. If employees meet “highly qualified” criteria under 20 U.S.C. Section 7801, and have been employed by the District for at least 10 years, the period between evaluations may, at the joint discretion of the evaluator and the employee, be extended beyond the two-year period so that the evaluation may be made once in a three,

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four, or five-year period, subject to the specific limitations in the UTLA/LAUSD contract. School Nurses receive Stull Evaluations every year or every other year. Content:

Performance objectives are planned cooperatively with the Local Nursing Administrator.

Final:

Not less than 30 calendar days before the last regularly scheduled school day of the employee’s scheduled work year in which the evaluation takes place.

Stull Evaluation forms have been developed to correlate with the California Standards for the Teaching Profession; HOWEVER the Stull Evaluation process for School Nurses remains the same. The monitoring and evaluation of Health and Human Services personnel accountabilities is the joint responsibility of the site administrator and the coordinator of the specialty, i.e. Nursing, Psychiatric Social Worker. The following guidelines are provided to define the areas of evaluation in which the Nursing Administrator and the Site Administrator can provide support. The Site Administrator may provide information regarding: The maintenance of an assigned schedule: • regularly arrives on time; • regularly attends for the prescribed contracted day; • signs in and out according to school policy/procedure; and • notifies appropriate personnel when absent or tardy. The maintenance of evidence of effective planning and completion of tasks: • maintains appropriate Activity/Referral Logs; • prepares compliance and mandated reports in a timely fashion; • provides appropriate reports for IEP meetings and for parents if requested prior to IEP meeting; • provides Designated Instructional Services/Related Services as prescribed on IEP; and • implements service goals as prescribed on school site plan. The maintenance of appropriate professional relationships and communication with: • school staff • parents • students • other support personnel • community and public agencies The maintenance of a professional appearance. The performance areas monitored and evaluated by the Local Nursing Services Administrator include the evaluation of professional skills and performance of assigned objectives that includes demonstration of knowledge and application of accepted standards governing School Nursing Practice that adhere to the state and federal regulations. Acceptable standards include but are not limited to competency measures from: • State of California Nursing Practice Act • California Business and Professions Code, i.e., RN licensure, administration of medication • California Code of Regulations, i.e., communicable disease control • California Administrative Code, i.e., CHDP, security of records • California Civil Code, i.e., donation of blood, emancipated minor, immunization consents, AIDS confidentiality • California Education Code, i.e., state-mandated health assessments, family life education, specialized physical health care services • California Interscholastic Federation, i.e., sports clearance • California Labor Code, i.e., pregnant and parenting teens • California Highway Patrol Certification, i.e., transportation of bio-hazardous waste-disposal regulations. • OSHA Regulations, i.e., blood-borne pathogens training

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Local Nursing Administrators will also include the monitoring and evaluation of compliance to standards of practice by utilizing specific documents: • Health Records • IEP Forms • LEA Service Logs • Protocol Logs • Medication Records • Statistical Reports • California School Immunization Record (CSIR) • Health Office Daily Log • Electronic Documentation • Training Procedures/Documented The Local Nursing Administrator will provide the Final Stull Evaluation. To access the Initial Planning Sheet Form 1072, School Nurses may visit online at www.teachinla.com, HR Forms. If the Initial Planning Sheet is not returned to the Local Nursing Administrator in a timely manner (before the 8th week of the employee’s regular assignment basis), the Local Nursing Administrator may create an Initial Planning Sheet for the employee. Performance evaluations for District staff are also reflective of the District commitment for implementation of educational objectives in the Least Restrictive Environment (LRE). The Los Angeles Unified School District, Least Restrictive Environment Task Force maintains a District-wide plan for the integration of General Education and Special Education students. Federal and State laws clearly indicate a preference for placement of students in the general education classroom. The law also is clear in its intent that a student must be educated in the environment that is most appropriate and least restrictive for each individual student. All School Nurses, in accordance with their job description, assist schools in meeting performance outcomes. Job related activities include, but are not limited to: • evidence of collaboration between general education and special education personnel and with other pertinent community persons (e.g. nonpublic school personnel, special school staff, and other agencies with whom the District collaborates to provide services for students with disabilities); • evidence of the use of adaptations and accommodations specified in Individual Education Programs (IEPs) in order that students with disabilities have access to the general curriculum; • evidence of the use of differentiated instructional strategies and materials to meet individual student’s learning needs; • evidence that staff have provided opportunities for students with disabilities to access extracurricular activities; • use of a variety of assessment strategies in order to measure student’s progress authentically; and • provision of appropriate assessment accommodations for students with disabilities. Please refer to Bulletin No. BUL-1594.1 dated January 20, 2006, Division of Human Resources, “PERFORMANCE EVALUATION FOR CERTIFICATED BARGAINING UNIT PERSONNEL”.

GENERAL GUIDELINES – SCHOOL NURSE STATE MANDATED RESPONSIBILITIES The guidelines in this bulletin are intended for the Administrator and school staff members in order to clarify School Nurse responsibilities to assure State Mandates relating to student health and academic achievement are prioritized. The bulletin reviews the effective completion of the School Nurse State Mandates. Topics include emergency care, suspected child abuse/neglect reporting, immunization assessment/follow-up, tuberculosis screening assessment/follow-up, audiometric screening, vision screening, Child Health and Disability Prevention (CHDP) Program, parent/guardian notifications, referrals/follow-ups, Special Education services, record keeping/documentation, counseling/health education, staff in-services, occupational injuries/illnesses, Principal-School Nurse Conference, Health Office referrals and office assistance. School Nurses also provide

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annual in-services for staff and students (when applicable). In-services include but are not limited to: Bloodborne Pathogen training; first aid procedures; disaster preparedness; Safe and Healthy School Plan; specialized health care procedures and medication safety and delivery. Refer to Bulletin BUL-989 dated May 10, 2004, Student Health and Human Services, “GENERAL GUIDELINES – SCHOOL NURSE STATE MANDATED RESPONSIBILITIES”.

PROCEDURE FOR OPENING THE HEALTH OFFICE AT THE BEGINNING OF THE SCHOOL YEAR School Nurses are responsible for opening the Health Office at the beginning of the school year. School health records, medication, and equipment/supplies etc. need to be available for the safe delivery of the School Health Program. Introductions-Introduce yourself to the Staff at your school including but not limited to: • Principal - schedule a Principal-School Nurse Conference. • Assistant Principal(s) - schedule a time to discuss the budget and purchasing additional School Nurse time. • School Administrative Assistant (Office Manager) - schedule a time to discuss Health Office procedures, secure a map of the school campus, bell schedule, list of teachers/room numbers/grades, itinerant teachers’ days/times, location of the School Nurse mailbox, location of the school mailbags and US mailbox, the Health Office supplies/ordering procedures and the location of all Health Office keys including the extra set of keys. • Cafeteria Manager – schedule a time to discuss Food Handler Assessment/Certificates and students known to have dietary needs. • Plant Manager – schedule a time to discuss blood and body fluid spill clean-up procedures, disaster first aid kit maintenance, cot/mattress and linen cleaning service(some staff may choose to take home the Health Office linens for cleaning), and other Health Office related issues. • Other Personnel (Coordinators, Counselors, Clerical, etc). Maintenance of Health Office - It is a requirement of the School Safe Plan that all school offices, including the Health Office, be clean and free of hazards. • Plastic sheeting (Commodity Code 665-84-19150) and paper toweling (Commodity Code 475-6459200) for cots are available for purchase in the District Catalog in the First Aid Section (approximately 12 feet or 4 yards of plastic sheeting covers the pillow and the cot/mattress). Plastic sheeting is changed as needed and is also wiped as needed and at the end of each school day with Dispatch solution. The use of other cot covers may not be as easily disinfected. Cot linens require regular laundry service. Check with your School Administrative Assistant for school specific procedure. • Disinfectant Cleaner (known as Dispatch-Commodity Code 485-42-13000 for the 32 oz. trigger spray bottle or Commodity Code 485-42-13040 for the 64 oz. refill bottle), bleach, or soap and water may be used to disinfect various surfaces in the Health Office. (No other chemicals may be used per LAUSD policy.) Refer to the Dispatch website for product information – http://www.caltechind.com/dispatch/index.asp. • First Aid supplies should include an adequate reserve which may be ordered from the LAUSD Stores Warehouse Supplies and Equipment Catalog or any district approved vendor. • Ice packs are frequently used in the Health Office. Ice packs may be constructed of wet sponges or paper towels placed in plastic baggies. Staff and /or students may assist in the making of ice packs. Ice packs are placed in the Health Office refrigerator. No food or drink should be stored in the Health Office refrigerator. Medications requiring refrigeration must also be locked. The Plant Manager will telephone the Local Maintenance and Operations Specialist to have locks installed. Delivery and Storage of Medication-Specific Instructions regarding the General Principles of Medication Administration, Guidelines for the Medication Notebook, and Guidelines for Training Personnel in Medication Administration are available for reference in the Administration of Medication to Students in LAUSD Handbook (1999-2000).

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Protocol(s) and Specialized Procedures-Complete the Special Physical Health Care Services Form (Form 33.62, revised annually) and submit a copy to your Local Nursing Administrator by the specified date each School Year and as needed for update. In addition, submit a copy of each protocol (including the Physician and Parent Authorization Forms) to your Local Nursing Administrator. School Nurse procedures for students referred to the Health Office – students must be accounted for during the school day. Elementary students arrive at the Health Office with a written referral from a staff/faculty member. Secondary students arrive at the Health Office with a hall pass, a referral, a summons or a note from a staff/faculty member. Secondary students must be accurately signed in and signed out. The time in and time out must be accurately recorded and the disposition of the student must be documented. If the student is excused from school, appropriate paperwork for exclusion and readmission must be provided. School site procedures vary, however students who leave school during the school day must be released to a parent/guardian/individual on the emergency card or a parent/guardian designee. Students are not released to individuals under 18 years of age and identification is confirmed by the Site Administrative Designee. School Nurse who excludes a student must document the reason for the exclusion and the responsible designated adult who authorized the release of the student, or received the student. The Health Office sign in/out record is a legal document and must be completed accurately and retained for seven (7) years. Health Office Forms-Approved School Nurse/Health Office Forms are available online at LAUSD.net under “Student Health and Human Services Forms and Templates” site. Maintain an original copy of all Health Office forms in your files to be reproduced and used as needed. Copies should be available for use during computer/power outage. School Nurses do not create or alter approved forms. All current nursing forms have been approved by LAUSD Legal Counsel. School Nurses are not legally protected by the District if notification/ documentation, etc. are recorded on non approved forms/correspondences. There is a process for ordering District forms and publications (i.e., pamphlets, booklets, NCR forms) that are used district-wide and were printed in large quantities, stocked in the District’s Stores Warehouse, and ordered as needed by schools and offices. Frequently, forms became obsolete when revisions were required. To reduce waste and improve efficiency, many forms previously stocked in the Stores Warehouse will be available through electronic ordering through the Document Production Services Section (DPSS), formerly Reprographics Services Section or “Inside LAUSD”. These forms will be available from the DPSS and/or online once stock is depleted in the Stores Warehouse. A list of District forms and publications currently stocked in the Warehouse is provided in the Supplies and Equipment Catalog (S&E Catalog) under “Printed Forms and Publications.” These forms may be ordered by entering a stock requisition (SR) or an Over-the-Counter (OC) transaction in IFS. Health Record Book (AKA “Black Book”) – The Health Record Book contains a variety of information about the school’s demographics; students with special health needs, and school programs. It is critical to update the book regularly and maintain the book in an appropriate location. • General Information (Form 33.144 rev. 8/02)-should be completed as soon as possible. • School Demographics – include a copy of the school map, faculty list, bell schedule, and other pertinent school related information. • Protocols – this section should contain a list of all students who currently have protocols for Specialized Health Care (remember to maintain a separate Protocol Book with current Physician and Parent Authorization Forms and the Protocol Logs). • Guidelines for Substitute Nurses – (Elementary Rev. 7/19/01, Secondary Rev. 7/20/01) – complete at the beginning of the School Year and update as needed. • Exceptional Cases (Form 33.153 Rev. 4/01) – record the name and diagnosis for students who may require special consideration, special seating or special diets (e.g. Diabetes, Asthma, Orthopedic Impairment, etc.) • Itinerant Programs – include the type of each special program (e.g. APE, LAS, D/HH, etc) and pertinent information regarding the program and/or a list of students in each program. • Memorandum Form (Form 33.148 Rev. 4/01) – this form can be used by the School Nurse for different purposes (e.g. maintain a list of students who have failed the vision/color vision/dental screening/ students who require follow-up, student/adult cafeteria staff, specific policies for that

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school, notes regarding students, health office clerk/aids, duties and names of student service assistants (Teacher Assistants etc). Audiometry Survey – include audiometric screening schedule, pager numbers for the school audiometrist and pertinent information including a list of students who have failed the audiometric screening and require follow-up. Referrals – include information about local LAUSD clinics, community agencies and other referral resources. You may utilize the Memorandum Form (Form 33.148 Rev. 4/01) to maintain a list of students who have been referred. Readmissions/Exclusions – you may utilize the Memorandum Form (Form 33.148 Rev. 4/01) to maintain a list of students who have been excluded and readmitted.

Required In-services for School Staff and/or Students • Bloodborne Pathogens • First Aid Procedures Flip Chart (Form 33.137, Rev 9/98) or Emergency First Aid Guidelines for California Schools (dated 8/2004) • Disaster Preparedness/Crisis Management (when applicable) • Medication Safety and Delivery • Safe and Healthy School Plan Training • Others as needed (e.g. Diastat, Glucagon, Epi-Pen, Blood Glucose Testing) Refer to Reference Guide No. REF-1760.1 dated August 25, 2006, Business Services Division, “ORDERING DISTRICT FORMS AND PUBLICATIONS”.

SUBSTITUTE SCHOOL NURSE’S FOLDER Substitute School Nurse’s folder must be updated each school year due to personnel and other changes. Complete the forms (Elementary and Secondary have different forms) and place the folder in the top drawer of the desk. Please keep this information current. Each school should have its own folder. You may obtain forms from your Local Nursing Administrator.

REFRIGERATOR USE AND REPAIR Refrigerators in the Health Office must be clean and maintained at the correct temperature. When medications require refrigeration, the use of the refrigerator in the Health Office must also comply with California Administrative Code Title 5, 18170 which states that “Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees responsible for health supervision.” The Plant Manager will contact the Local Maintenance and Operations specialist to have locks installed. In addition, the California Code of Regulations, Section 5193 Bloodborne Pathogen Standard states “Food and drink shall not be kept in refrigerators, freezers, shelves, cabinets or on countertops or benchtops where blood or other potentially infectious materials are present.” The Health Office is defined as an area “where blood or other potentially infectious materials are present.” Staff and students should not store food or drinks in the Health Office refrigerator used for the storage of medication or for ice packs. Refrigerators in the Health Office units may need specialized repair. If the site Plant Manager is unable to repair the unit, School Nurses or the Plant Manager should initiate a request to the Refrigerator Trouble Call Unit at (213) 745-1600. Include the school site, address, telephone number, location code and describe the nature of the refrigerator problem. Refer to Bulletin No. BUL-3878.1 dated November 24, 2007, Student Health and Human Services, “ASSISTING STUDENTS WITH PRESCRIBED MEDICATION AT SCHOOL” and Refer to the California Code of Regulations Bloodborne Pathogen Standard.

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GENERAL GUIDELINES FOR STUDENT SUMMONS AND HALL PASSES In recognition of the importance of maximizing classroom instructional time in order in improve student achievement, LAUSD and UTLA developed guidelines as part of the negotiated contract. Local school decision-making councils are responsible for developing a public address system and hall pass/student summons policy consistent with the following criteria: • General public address announcements shall be limited to no more than ten (10) minutes per day during a designated announcement time, except for emergency situations. • The site administrator must approve emergency announcements. • Students may be summoned only by administrators, deans, counselors, nurses, school coordinators, and where appropriate, itinerant personnel. Classroom teachers may not summons students during instructional time. • The most appropriate time for summoning students for non-emergency purposes is the first ten and last five minutes of a class period and/or before or after recess or lunch. Approval for student summons during a class period may only be given for emergencies with approval of a site administrator. • The nature of an emergency must be determined by a site administrator or School Nurse. • The use of bells to call administrators or custodians during instructional time should be limited so as not to disrupt classroom instruction. • Policies and procedures for hall passes are to be included in the Student Codes of Conduct. An Early Leave Pass may be provided by the site administrator for students who use crutches or other mobility assistive devices. The purpose of the Early Leave Pass is to minimize the time students with crutches/etc. are in the hallways with the swift traffic during passing periods. Safety for all students/staff is the rationale for an Early Leave Pass. Parent permission should be documented any time a School Nurse is asked to provide an Early Leave Pass to any student. Maximizing instructional time is an important aspect of continued student achievement. While it is recognized that emergencies may create a need to cause an interruption of the school program, this type of interruption is to be kept to a minimum. Teachers who believe that classroom interruptions are not following either District or local school policy may utilize specific procedures to request assistance or submit a complaint. Refer to Memorandum MEM-3443 dated December 18, 2006, Chief Instructional Officer, Elementary and Chief Instructional Officer, Secondary, “MAXIMIZING INSTRUCTIONAL TIME”.

PROCEDURE FOR CLOSING THE HEALTH OFFICE AT THE END OF THE SCHOOL YEAR School Nurses are responsible for closing the Health Office at the end of the traditional calendar school year. School Health Records, medication, equipment and supplies need to be secured in a safe and appropriate manner. During the month of May – School Nurses should: • complete the information regarding student health issues of matriculating students and send via Confidential School Mail to the receiving schools. Use the Health Alert Form (Form 33.168 Rev. 11/2004) • complete the Request for Summer Repair of District Owned Wheelchairs. (Memorandum MEMO4256, dated May 19, 2008, Division of Special Education, “SUMMER WHEELCHAIR REPAIR” revised annually.). • place the Health Office supplies order with the appropriate Site Administrator for the coming school year. If you receive the supplies before the end of the year, inventory the supplies and secure them in a locked storage area. • check the supply of District approved forms and order, download and/or copy a supply sufficient to cover the Extended School Year (ESY)/Summer School and to begin the next school year.

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During the month of June – School Nurses should: • inform the parent(s)/guardian(s) that medications will be destroyed if the parent(s)/ guardian(s) do not take them home the last day of school. (Do not give medications to the student to take home.) Send new Request for Medication to be Taken During School Hours Form (Form 33.199 Rev. 9/07), and if the student will self administer medication you will need both the Request for Self-Administration of Medication During School Hours (Form 33.205 Rev. 9/07) and the Student Contract for SelfAdministration/Self Carry of Medication During School Hours Form (Form 33.205A Eng/Span Rev. 9/07). Send new Physician Authorization for Specialized Health Care Services Forms (Form 33.64 Rev. 6/2005), Parent Authorization for Specialized Physical Health Care Forms (Form 33.63 Rev. 5/01) and appropriate specific Nursing Protocol(s) Forms for the individual student, if necessary, home to be completed for the following school year. (Both protocol authorizations and request for medication form are now good for 1 calendar year). Transport the expired medications to the Local Nursing Office for disposal. • check the Emergency First Aid Kit (formally the Green Box) [Commodity Code 345-32-48275] for completeness and expired medications and order replacement supplies as necessary. (Emergency First Aid Kit Replacement of Expiring Items Commodity Code 345-32-48280). Expired medications should be transported to the Local Nursing Office. • secure Health Record Cards (Form 34-EH-6 Rev. 1/91 Commodity Code 966-12-15301) in a locked file cabinet. If student is moving to another school or graduating, the Health Record Card should be removed from the Health Office and transferred to the Education Office where the student’s Cumulative Records is maintained. • place the Notice of First Aid Forms (Form 33.13 E/S Rev. 8/02); Cautions Regarding Head Injury Forms (Form 33.14 Rev. 9/05), and Office Referral Forms (Commodity Code 966-12-18641) in a secure locked container and label the container with the School Year (maintain these records for seven years.) • notify the Plant Manager for the mattress and linen cleaning service. Replace any torn/worn plastic sheeting on the cot mattresses as needed. • secure countertop and desktop items in a locked drawer or a secured box to reduce/eliminate loss or damage during summer cleaning. • your Site Administrator may request that you return the Health Office keys. • tabulate your School Nurse Health Services Summary Report (33.182 rev, 3/03) for each school and submit to your Local Nursing Administrator. Your school site may be used for the Extended School Year (ESY) during the summer. Post the critical telephone numbers and school identification information (e.g. school telephone number, address, closest Health Department, etc. and numbers such as Plant Manager and School Administrative Assistant extensions.) This information is necessary if you are not working at your site during the summer. Provide your Local Nursing Administrator with the telephone number(s) where you can be reached during the non-traditional year.

PROCESSING OF MAIL Mail Unit drivers provide mail pickup and delivery to schools and offices daily between 7:00 a.m. and 2:00 p.m. The Mail Unit sorts and processes U.S. Mail and interoffice/school mail daily. All mail received at the Mail Unit, Procurement Services Center prior to 4:30 p.m. is sorted and processed the same day. Schools and offices are encouraged to use typewritten or computer-generated delivery addresses. U.S. MAIL GUIDELINES • Separate U.S. Mail from interoffice/school mail. Place interoffice/school mail in the mail bag. Place U.S. Mail in the yellow “LAUSD Mail Unit” tub. The tub must be placed next to the interoffice mail bag for pick-up by the Mail Unit driver. • Ensure that the individualized “bar code” label is in the holder on the side of the yellow “LAUSD Mail Unit” tub. Each school and office has a unique bar code for its location. Duplicate your bar code form as needed. For a copy of your bar code form, please call the Mail Unit at (562) 6549002.

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•

•

Do not seal letter or legal-sized envelope (First Class only). Envelopes are fed through and sealed by a meter machine in the Mail Unit. Therefore, First Class mail must be left unsealed, have the flaps overlapped (flaps straight up), by rubber banded and placed in the yellow “LAUSD Mail Unit” tub. Seal flats (manila envelopes). All flats and manila envelopes for First Class and Permit mail, must be sealed. If using flats or manila envelopes with clasps, seal the envelope with the gummed flap over the clasp so the edges of the clasp are not exposed.

INTEROFFICE/SCHOOL MAIL GUIDELINES • Place interoffice/school mail in the mail bag, separate from U.S. Mail. • All mail must have the school or office return address. • When addressing manila envelopes, “From” is on the left side of the envelope; “To” is on the right side. Properly formatted interoffice manila envelopes are available in the District’s Stores Warehouse. Use commodity codes 310-42-22290 (10” x 15”) or 310-42-22845 (10: x 13”). • The delivery address for elementary schools and elementary magnets should include the school name and mail letter code designation. See Reference Guide No. REF-1081 for letter code designations. • The delivery address for other schools must include the school name. • The delivery address for offices must include the office, name, floor and/or room number, if applicable. • Letter and legal-sized envelopes should be sealed or flaps tucked in. • Flats and manila envelopes should be sealed or clasped. • Minimum size for school mail is 3-1/2” x 5”. U.S. Mail and Inter-office mail will be given first priority. All other communications, such as event announcements, organizational flyers, job announcements bulletins, retirement notices, and newsletters, will be processed as time permits. Regular mass mailings of printed materials such as school newsletter, school rules, or dress codes are eligible for significant reduced rates as Non-Profit Permit Mail. School and offices are strongly encouraged to utilize this method when sending these materials. Refer to Reference Guide No. REF1330 for instructions on preparing Non-Profit Permit Mail or call the Mail Unit for assistance. RESTRICTIONS – Board Rule 1451 prohibits school service organizations such as Student Body organizations, Booster Clubs, PTA, Congress of Parents and Teachers, etc. from using District postage. Use of District funds for mailing flyers or brochures from vendors advertising uniforms, photography, and insurance, etc. is prohibited. Board Rule 1454 prohibits the use of District U.S. and interoffice/school mail for personal communications (e.g., invitations, greeting cards) by employees. Refer to Reference Guide REF-1330.2 dated October 31, 2007, Business Services Division, “NON-PROFIT PERMIT MAIL”; Reference Guide REF-1331.2 dated October 31, 2007, Business Services Division, “MAIL PROCEDURES”; and Reference Guide REF-1081.1 dated October 17, 2006, Business Services, “CODING OF SCHOOL MAIL”.

CASHING OF PERSONAL CHECKS USING STUDENT BODY FUNDS The District has a policy regarding cashing of personal checks using Student Body Funds. Personal checks will not be cashed for anyone. Post dated checks or 2-party checks shall not be accepted by anyone. At the direction of the Principal, certain checks may be accepted or cashed. Refer to Bulletin No.353 dated June 30, 2003, Budget Services and Financial Planning, “CASHING OF PERSONAL CHECKS USING STUDENT BODY FUNDS”.

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LOS ANGELES COUNTY TELEPHONE ACCESS 211 AND 399 To access social services in Los Angeles County, dial 2-1-1 to find help with the health and social services needed. Like 9-1-1 for emergency calls, 2-1-1 can connect to emergency food and shelter, support services for seniors and the disabled, childcare, employment assistance, child and adult protective services and legal assistance. This quick referral service is a partnership with United Way of Greater Los Angeles, which established 2-1-1 L.A. County more than 26 years ago. By substituting 2-1-1 for the myriad of toll-free and other numbers, Los Angeles County residents benefit by being able to quickly and easily get access to the social and disaster services they need. Motorists traveling along the freeway system in L.A. County can call for non-emergency roadside assistance by dialing 3-9-9 on their cell phones. Callers will be connected to a live operator, who will assist them in obtaining the appropriate service needed. This is an expansion of the freeway call box program, but without having to leave the car. Examples of non-emergency situations that should go to the 3-9-9 operator include running out of gas, a flat tire, or mechanical malfunction of the vehicle when it is out of the freeway travel lanes. This new 3-9-9 number for non-emergencies is expected to reduce the burden on the 9-1-1 system. Unsolicited requests to telephone area codes unfamiliar may result in unnecessary charges. The Better Business Bureau has advised that out of area calls to unfamiliar numbers in the following area codes 208, 809, 876 have resulted in exorbitant charges.

DISTRICT TELEPHONES TO MAKE PERSONAL CALLS AND USE OF PERSONAL CELLULAR TELEPHONE AND PAGERS The District policy as stated in Board Rules 1266 and 1471 prohibits the use of District telephones to conduct personal business. Pay telephones are available at all schools and offices for use by students and employees. If personal calls are made using District telephones, the user will be charged for the calls at current rates. Violations of applicable Board Rules or Administrative Regulations may also result in administrative disciplinary action. Personal use of cellular telephones is permitted on a limited basis and only if that person is authorized and/or assigned the equipment. Use of personal cellular telephones for personal telephone calls may be accomplished before and after duty hours, during nutrition and lunch. It should be noted that cellular telephones transmit Radio Frequency (RF) waves, and should NEVER be used, or turned ON during the following situations. The safety precautions below also apply to any two-way radio, pager, palm-top or lap-top devices that transmit RF waves: • • •

during a response to a bomb threat. The transmitted RF waves may, if used within 500 feet of an explosive device, cause it to detonate. in an explosive atmosphere, such as a painting booth or at a gasoline pump/station. The transmitted RF waves may cause a spark that could cause an explosion. near any explosive blasting caps. The transmitted RF waves if used within 500 feet of a blasting cap may trigger it and can cause an explosion.

Refer to Bulletin No. BUL-1612.1 dated March 22, 2006, Information Technology Division, “ACQUISITION AND USAGE OF CELLULAR TELEPHONES AND WIRELESS BROADBAND AIR CARDS” and Bulletin No. K-3 dated December 21, 1998, Information Technology Division, Office of the Chief Administrative Officer, “USE OF DISTRICT TELEPHONES TO MAKE PERSONAL CALLS”.

USE OF CELLULAR TELEPHONES AND PAGERS BY STUDENTS California Education Code, Section 48901.5 permits “the governing board of each school district, or its designee, to regulate the possession of any electronic signaling device that operates through the transmission

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or receipt of radio waves, including, but not limited to paging and signaling equipment, by pupils of school districts while pupils are on campus, while attending school-sponsored activities, or while under the supervision and control of school district employees.” It is the policy of the Los Angeles Unified School District (LAUSD) to prohibit the use of cellular phones, pagers, or any electronic signaling device by students on campus during normal school hours or school activities. Paging and signaling equipment devices covered by this policy include, but are not limited to, telephone cellular phones, text messaging cellular phones or pagers, camera phones, and Blackberries. General Guidelines: • Students are permitted to possess cellular phones, pagers, or electronic signaling devices on campus provided that any such device shall remain “off” and stored in a locker, backpack, purse, pocket, or other place where it is not visible during normal school hours, or school activities. • Students are permitted to use cellular phones, pagers, or electronic signaling devices on campus before and after school or school activities only. • Students must comply anytime a request is made by school personnel to cease the use of a cellular telephone, pager, or other electronic signaling device even before or after school. • If such a device is observed by staff, during school hours or activities, it shall be confiscated until redeemed by a parent or guardian. • Students and parents are to be advised of this prohibition annually, and are also to be advised that the District is not responsible for students’ lost or stolen cell phones or pagers. • An exception to this policy may be granted by the site administrator for purposes relating to the health needs of a student. Contact your Local Nursing Administrator for assistance with health issues related to student exceptions to the District Policy related to student use of cellular telephone(s)/pager(s). Refer to Bulletin No. BUL-2576 dated June 19, 2006, Office of the Chief Operating Officer, “USE OF CELLULAR TELEPHONES AND PAGERS BY STUDENTS”.

DISTRICT POLICIES ON TELECOMMUNICATIONS California Education Code, Section 17077.10 requires a telephone to be provided to the classroom in new facilities funded from the state. This same code requires the classrooms to be able to dial out directly to 9-1-1. To accomplish this, telephone service will be provided to the classroom when new Public Address systems are installed. These systems will be interfaced with the school’s telephone switchboard. It is necessary to program the switchboard to allow direct dialing to 9-1-1 from every classroom. Use of telephones in the classrooms is monitored by the individual schools to prevent false emergency calls, and provide security for the telephone equipment in the classrooms. In order to minimize potential abuse and to eliminate unnecessary toll and long-distance charges, all classroom telephones will be programmed to allow calling only to the Main Office of the school and to 9-1-1 directly. Long-distance service will be available to the greater Los Angeles metropolitan area for all telephone and FAX lines. This includes the following area codes: 213, 310, 323, 562, 626, 661, 714, 760, 805 (Simi Valley and Thousand Oaks only), 818, 909 and 949. All toll free area codes will also be included. Long distance access codes such as 10-10-xxx will not be allowed, as well as “0” for the operator. If a location needs to occasionally place a long-distance business telephone call outside of Los Angeles, they may do so through the operator at (323) 224-2444. After placing the call, select the option for the Telecommunications Branch and follow the prompts. Due to the surcharge for each call, information calls such as 4-1-1 are not available. If a School Nurse requires calling access to specific area codes from a school site on a routine basis for District business, fill out “Request for Long Distance Exception”. Fill out the extension or telephone number where access is needed, the area codes required and the reason for the request. Include the name of the person requesting the access, and the name and signature of the Site Administrator. A copy of the completed attachment must be FAXED to the Local Nursing Administrator.

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International calls may be placed through the telecommunications operator of LAUSD. If international calling is required - please contact the operator at (323) 224-2444. Refer to Bulletin No. BUL-1031.1 dated July 12, 2004, Office of the Chief Information Officer, “POLICIES ON TELECOMMUNICATIONS”.

ACCEPTABLE USE POLICY (AUP) FOR THE DISTRICT COMPUTER SYSTEMS The District has specific rules and regulations related to employee/student use of the LAUSD.net and computer systems. A statement acknowledging the District’s policy has been provided. Use of District computers should support the District’s overall educational objectives. Inappropriate use may lead to penalties, which include discipline and/or legal action, including but not limited to suspension, expulsion, or dismissal from employment with the District, or criminal prosecution by appropriate law enforcement agencies. If you have information regarding illegal/inappropriate use of the Internet or computer systems, report suspected fraud or abuse to the OIG Fraud Hotline (213) 241-7778, or toll free 1-(866) LAUSD-OIG (528-7364). Your telephone call is confidential and you may remain anonymous. You may also write to: the Office of the Inspector General, 333 S. Beaudry Avenue, 12th Floor, Los Angeles, CA 90017; or telephone (213) 241-7700, FAX (213) 241-6826 or e-mail: at [email protected] Refer to Bulletin BUL-999.3 dated June 13, 2007, Chief Information Officer, “ACCEPTABLE USE POLICY (AUP) FOR DISTRICT COMPUTER SYSTEMS”.

FEDERAL FALSE CLAIMS ACT POLICY The Los Angeles Unified School District participates in the Medi-Cal Administrative Activities (MAA) and the LEA Billing Option. The District recovers costs from the federal government to offset the expenses of existing programs and to fund supplemental health and human services. The “Federal Deficit Reduction Act 2005: Employee Education on False Claims Recovery” (sec. 6032) requires any agency receiving $5 million or more in federal reimbursement to provide training to employees and contractors participating in activities regarding the Federal False Claims Act. The False Claims Act (31 U.S.C. Sec. 3729) is a federal law that prohibits an individual or organization which receives money from the federal government from knowingly making, using or causing to be made or used, a false government. An important component of this law is the concept of “knowingly.” This is interpreted as meaning a person submits information that may be used in a Medi-Cal claim “knowing” that the information is false or fraudulent, in deliberate ignorance of the truth or accuracy of the information. In the Los Angeles Unified School District the documentation which is subject to False Claims Act requirements is generated in the Welligent system in two ways: 1. Time Surveys completed for the Medi-Cal Administrative Activities (MAA); and 2. services tracking documentation for certain medically necessary services provided to students with disabilities who are Medi-Cal eligible. Compliance with the False Claims Act is required for School Nurses who complete Time Surveys for the Medi-Cal Administrative Activities (MAA) and/or who complete service documentation for certain medically necessary services provided to students with disabilities who are Medi-Cal eligible. Employees who identify errors on their own records in Welligent are required to open unlocked records and make the necessary corrections immediately upon identifying the error. If a record is locked, the employee is required to contact the LAUSD Medi-Cal Reimbursement Program office immediately. Call (213) 241-3998 for errors on MAA documentation and (213) 241-0558 for errors on Service Tracking documentation for students with disabilities who are Medi-Cal eligible. District employees and contractors who participate in the Medi-Cal Administrative Activities (MAA) Program and/or the LEA Billing Option Program are required to complete False Claims Act training on an annual basis. False Claims Act Training will be conducted through the LAUSD Learning Zone. This year the training will be available beginning August 19, 2008. Employees will receive an e-mail message notifying them of their

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responsibility to complete this training. This self-directed 15-20 minute on-line training must be completed no later than September 12, 2008 Refer to Bulletin No. BUL-4396.0 dated August 18, 2008, Office of the Chief Academic Officer, “FEDERAL FALSE CLAIMS ACT POLICY”.

THE LEARNING ZONE The Learning Zone is a professional development and training portal created by the Los Angeles Unified School District. Web Based Learning (WBL) is a system that allows users access to a variety of programs for self paced learning. Many courses are offered to School Nurses using the Welligent system. School Nurses use the Learning Zone to complete training for Communicable Disease exclusions, health assessments, mass screenings, etc. School Nurses may return to the site to review as needed.

LAUSD E-MAIL ACCOUNTS The Information Technology Division (ITD) provides an email account upon request for all District employees and students of K-12 schools who are required to sign onto the District lausd.net domain to conduct Districtrelated business from a District office location. All employees and students receiving an email account from ITD are required to comply with BUL-999.3, the District’s Acceptable Use Policy (AUP) For District Computer Systems. All active District employees may activate a new email account by visiting https://idmlogin.lausd.net. (NOTE: This link only works from District locations.) The employee will be asked several questions to verify their identity, and then will be guided through the process of activating a new email account. If the employee experiences difficulty in using the self-activation system, or has difficulties with their existing account, they may request assistance by calling ITD Customer Support Services Center (Helpdesk) at (213) 241-5200. The employee will be requested to provide their employee number, user account (if known), and respond to a security question asked by help desk personnel. Refer to Reference Guide No. REF-1438.1 dated October 1, 2005, Chief Information Officer, “HOW TO OBTAIN A DISTRICT EMAIL ACCOUNT” and Bulletin BUL-999.3 dated June 13, 2007, Chief Information Officer, “ACCEPTABLE USE POLICY (AUP) FOR DISTRICT COMPUTER SYSTEMS”.

COPYRIGHT LAW – COMPUTER SOFTWARE Federal law and District policy prohibit the unauthorized copying and use of computer software programs. The Federal Copyright Act provides for the recovery of actual or statutory damages for violations of copyright infringement. Damages under federal law may be as much as thirty thousand dollars ($30,000) for non-willful violations of each work infringed, and as much as one hundred fifty thousand dollars ($150,000) for willful violations of each work infringed. Some cases may constitute criminal copyright infringement, which is punishable by fines of up to $250,000 and/or imprisonment for up to five years. The law does not exempt educational institutions from copyright laws. By law, Los Angeles Unified School District employees are subject to the U.S. Copyright Act of 1976. Use or copying of any software product in violation of the applicable license agreement is strictly prohibited. Any employee found copying software (other than for backup purposes) and/or giving software to any other person is subject to appropriate administrative and/or disciplinary action, including termination. The Information Technology Division completed an audit in 2004 to determine if sites had the appropriate licenses for software installed in District computers. Unlicensed software was identified and removed from computers. The revised bulletin in 2005 provides guidelines for Types of Software piracy, Software License Agreements, Acceptable Use of Computer Software and Responsibilities of District Personnel. A statement acknowledging the District’s Software Policy and Code of Ethics has been prepared for your signature. Return the form to your Local Nursing Administrator today.

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Refer to Bulletin No. BUL-716.2 dated October 1, 2005, Information Technology Division, “COMPLIANCE WITH THE 1976 UNITED STATES COPYRIGHT LAW – COMPUTER SOFTWARE”.

ANTI-VIRUS SOFTWARE To protect District computers against possible infections by computer viruses, the District has purchased a District-wide Anti-Virus software license. This license allows the Los Angeles Unified School District to use the software on any desktop computer in the District, and allows District employees (but not students) to install the software to their home computers. For computers connected to the Internet, the link to download the software is published on LAUSD’s Software Copyright Compliance website. Once the virus protection software is installed the Symantec Anti-Virus software will regularly go out to the Internet and obtain updates. District staff are also permitted to install this software on their home personal computers and may use the Compact Disc (CD) to do so. The CD should be checked out for installation on stand-alone computers at your site, or for staff home use. Any computer not connected to the Internet, i.e., stand-alone, must obtain new virus definition files and manually install them on those computers. It is recommended those virus definition files be downloaded from Symantec’s web site at http://www.symantec.com/avcenter/defs.download.html and be manually installed on those computers. Refer to “Frequently Asked Questions” on LAUSD’s Software Copyright Compliance website. No additional mailings for this version of the CD will be made. The enterprise license is a legal agreement between the District and the distributor of the Symantec Anti-virus software. The unauthorized use or installation of the software could be legally liable. All users must follow the agreement. Computer users should be advised that the use of magnets placed on or near hard drives, monitors, discs, or memory sticks may disable or destroy programs, data, and/or equipment. Refer to Bulletin No. BUL-716.2 dated October 1, 2005, Chief Information Officer, “COMPLIANCE WITH THE 1976 UNITED STATES COPYRIGHT LAW – COMPUTER SOFTWARE” for information on LAUSD policy as it relates to computer software and Bulletin No. BUL-717.1 dated February 6, 2004, Chief Information Officer, “ENTERPRISE LICENSE – SYMANTEC ANTI-VIRUS SOFTWARE”.

ELECTRONIC SESAC REPORTING The Family Education Rights and Privacy Act (FERPA) requires school districts to maintain and protect student records. The Individuals with Disabilities Education Act (IDEA) requires school districts to track students with disabilities, and be able to supply relevant information concerning these students on a prompt basis. The District has transitioned to electronic information gathering for the Special Education Student Assignment and Coordination (SESAC) report as part of the Integrated Student Information System (ISIS). This system meets FERPA and IDEA standards for data collection and protection of individual student records. It is important to note that complete and accurate SESAC data are critical in making decisions regarding the opening and closing of special education programs, along with related staffing. Special Education Student Assignment and Coordination (SESAC) is the District’s system to track students with disabilities as required by the Individual with Disabilities Act (IDEA). Welligent is the District’s primary special education data source. The data is extracted electronically on the second Friday of the month. Special Education Services assist students with disabilities to benefit from their general education program. The Welligent IEP Service Tracking System now maintains service data, which includes Health and Nursing Services. SESAC Reports should be submitted by School Nurses at schools where there are students who require protocols or monitoring for health reasons included on the student’s IEP. FAX a copy of the computer printout to your Local Nursing Administrator’s Office on the designated dates.

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Refer to Reference Guide No. REF-4417 dated August 18, 2008, Planning, Assessment and Research Division, “REPORTING 2008-2009 SESAC DATA USING WELLIGENT, ELEMENTARY AND SECONDARY SIS”.

NETWORK SECURITY MEASURES To ensure the LAUSD wide area network remains secure, measures are being taken to guarantee the security of the network. Firewalls are a technology that keeps out those individuals wishing to do damage to the network. The implementation of industry standards for security requires closure of firewall ports that leave the network vulnerable. This and other measures, such as frequent password changes, enhance security and therefore the reliability of the LAUSD wide area network. Security of information of particular concern to the District includes the following: • information protected by California Education Code and the Family Education Rights and Privacy Act (FERPA). This includes children’s names, children’s images, descriptions, addresses, telephone numbers, parent or guardian information, attendance, assessment information, transcripts, etc. • information protected by the Health Insurance Portability and Accountability Act (HIPAA). This includes student health information, medical and personal history, and also federal program eligibility records, disciplinary records, IEPs, special needs, etc. • information or services that are disallowed by the Children’s Internet Protection Act (CIPA). This includes but is not limited to “visual depictions that are obscene or, with respect to the use of computers by minors, harmful to minors”. • employee personal information. All District policies, including the LAUSD acceptable use policy (Bulletin No. BUL-999.3 dated June 13, 2007, Chief Information Officer, “ACCEPTABLE USE POLICY (AUP) FOR DISTRICT COMPUTER SYSTEMS”) and U.S. Copyright Laws must be observed. Refer to Bulletin No. K-24 (Rev.) dated November 4, 2002, Information Technology Division, Office of the Chief Information Officer, “LAUSD FIREWALL POLICY”.

UNITED STATES COPYRIGHT LAW COMPLIANCE The Los Angeles Unified School District and all its employees are subject to the provisions of the Copyright Act of 1976. District personnel will take an active role in assuring compliance with the United States copyright law and congressional guidelines. The District requires completion of specific forms when an employee requests duplication of copyrighted materials. Requests will be denied if the request violates the provisions of the copyright act of 1976. The District does not sanction illegal use or duplication in any form. Unlawful copies of copyrighted materials may not be produced or used on District-owned equipment, within District-owned facilities, or at Districtsponsored functions. Employees who knowingly and/or willingly violate the District’s copyright policies do so at their own risk and may be required to remunerate the District in the event of a loss due to litigation. It is the policy of the Los Angeles Unified School District to provide students with appropriate instructional materials that are relevant to the curriculum being studied and appropriate for the age and maturity level of the students being taught. Because of the widespread use of videocassette recorders, ease of home videotaping, and availability of rental videotapes and films, the Board of Education on October 17, 1988, established guidelines for the use of videotapes and films not owned, broadcast, or recommended by the District. Because of the emergence of new technologies, this policy now applies to the use of filmed programs in any format, including videocassette, 16mm film, DVD, CD-ROM, broadcast television, or streamed file. The term “audiovisual media” is used to refer to all formats.

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School Nurses should consult with the Local Nursing Administrator before using instructional materials for student lessons. The Site Administrator should be consulted to obtain the necessary parent/guardian permission letter. The following 10 guidelines for audiovisual materials are in effect. 1. Audiovisual media shown at a school must be relevant to the curriculum being studied and appropriate for the age and maturity level of students being taught. 2. Audiovisual media shown at a school must use the established District and State criteria for the evaluation of instructional materials, especially with respect to racial and gender stereotyping and the depiction of violence, even in animation. Refer to California State Education Code Sections 6004060045 and Section 60048 for the law that governs standards for evaluating instructional materials for social content or use the California Department of Education website to access Standards for Evaluating Instructional Materials for Social Content at: http://www.cde.ca.gov/ci/cr/cf/ documents/ socialcontent. pdf 3. Audiovisual media must be consistent with accepted standards of professional responsibility and must not reflect advocacy, personal opinion, bias, or partisanship. 4. Audiovisual media which have not been MPAA rated and are not owned, broadcast, or recommended by the District must be thoroughly reviewed by the instructor prior to their use. 5. MPAA MC-17 rated audiovisual media or any unrated material that might fall into this category shall not be shown in any elementary or secondary school classroom or as part of any District activity involving elementary or secondary school students. 6. MPAA R-rated audiovisual media or any unrated material that might fall into this category may be used in high school Grades 9-12 and in middle school Grades 7 and 8 with principal and parental written approval prior to the scheduled viewing date and must comply with the school’s policy on the evaluation and selection of instructional materials. 7. MPAA PG-13-rated audiovisual media or any unrated material that might fall into this category may be used in high school Grades 9-12 with the prior approval of the principal and must comply with the school’s policy on the evaluation and selection of instructional materials. In middle school Grades 7 and 8, written parental approval prior to the scheduled viewing date is also required. MPAA PG-13rated videotapes may not be shown in elementary schools or in middle school Grade 6. 8. MPAA PG-rated audiovisual media or any unrated material that might fall into this category may be used in elementary schools or in middle school Grade 6 with the prior approval of the principal and parents, and must comply with the school’s policy on the evaluation and selection of instructional materials. MPAA G-rated videotapes and films may be used in elementary schools with principal approval and teacher review. 9. If opinions differ over the appropriateness of the materials, the appeal process outlined in Article XXV, Sections 1.0 and 1.2 of the Agreement between the District and UTLA shall be followed. 10. The website for the Motion Picture Association of America contains a database of movie ratings. The URL is http://mpaa.org/filmratings.asp. When searching for a title, it is important to know as many details about the film as possible, such as producer, production date, cast, etc. because there are many films with the same title and the MPAA rating may be different for each one. For example, a search for Hamlet yielded four film titles with four different ratings – G, PG, PG-13, and R. Search results will show the film title, distributor, production date, rating and the reason for the rating. Many titles also contain a link to an additional database that provides further descriptive information that will help identify a film. The MPAA website also contains a listing of the TV Parental Guidelines, a rating system for all television programs which is modeled after the MPAA ratings. The TV Parental Guidelines may provide additional assistance in determining whether a film is appropriate. However, caution is necessary since the TV Parental Guide rating of a given film will most likely be based on an edited broadcast version and not the original uncut version, which may have received a harsher MPAA rating. More information about the TV Parental Guidelines may be found at http://www.tvguidlelines.org. Refer to Bulletin No. BUL-1270 dated August 31, 2004, Instructional Support Services, “GUIDELINES FOR THE USE OF AUDIOVISUAL MATERIALS NOT OWNED, BROADCAST, OR RECOMMENDED BY THE DISTRICT” and

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Bulletin No. BUL-714 dated January 8, 2004. Information Technology Division, “COMPLIANCE WITH THE 1976 UNITED STATES COPYRIGHT LAW”.

RECEIPT OF HONORARIA The Political Reform Act and the Fair Political Practices Commission Regulations prohibit elected officials from receiving honorarium payments. District employees designated in the LAUSD Conflict of Interest Code are prohibited from receiving honoraria from any source if they are required to report that source of income on their statement of economic interest. Honoraria include payments or consideration for any speech given (including public addresses, orations, oral presentations, panel participation, seminars and debates), articles published, or attendance at a private conference, convention, meeting, social event, meal or gathering. Refer to Bulletin No. L-15 dated August 1, 2001, Office of the General Counsel, “PROVIDE DISTRICT STAFF WITH INFORMATION CONCERNING RECEIVING HONORARIA”.

RECEIPT OF DONATIONS It is the intent of the District that no donation shall provide a substantial advantage in educational benefits to a school if such benefits cannot be balanced in all schools. For this reason the District has specific procedures for accepting donations. Consult with your Local Nursing Administrator. Refer to Bulletin No. C-66 (Rev.) dated January 8, 2002, Office of the Chief Financial Officer, “DONATIONS”.

MILEAGE Board Rule No. 1532 - “School Business Mileage – Definition – Calculation” “School Business mileage is defined as that mileage which accrues in any one day on school business. Such mileage shall be calculated from the regular headquarters of the employee to his/her various destinations, and return to such regular headquarters of the employee.” “In the event an employee does not visit his/her regular headquarters prior to his first trip on school business in any one day, he/she shall deduct from his/her total mileage: (1) the distance from his/her home to such first stop or (2) the distance from his/her home to his regular headquarters, whichever is the lesser.” “In the event an employee proceeds from his/her last destination on school business in any one day to his home, he/she shall deduct from his/her total mileage: (1) the distance from such last destination to his/her home, or (2) the distance from his regular headquarters to his/her home, whichever is the lesser.” In computing mileage, the school assignment for each day shall be considered headquarters for the day. Therefore, mileage shall be calculated from the daily headquarters to the various destinations during the school day. Mileage from home to school cannot be counted. Request for Reimbursement of Mileage “DAILY MILEAGE STATEMENT FOR PRIVATELY-OWNED CARS” (Form 34-AEH-12 Rev. 10/04) must be submitted to your Local Nursing Administrator each month. You may obtain the mileage form online. Mileage must be submitted promptly. Mileage cannot be paid if accrued for more than one (1) month.

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USE OF AN AUTOMOBILE The School Nurse Job Description requires that School Nurses have an active California Driver’s License, current and effective automobile insurance and the use of their own automobile during duty hours. School Nurses must be prepared to travel when requested and during emergencies. A copy of your current California Driver’s License and a copy of proof of current automobile insurance must be on file in your Local Nursing Administrator’s Office.

URBAN CLASSROOM TEACHERS/NURSES – EIS CONTRACTS (UCT) School Nurses assigned full-time to an EIS school are included in the UCT Program and are expected to carry out additional responsibilities, duties and hours (1/2 hour a day or a total of 2 ½ hours a week). Application and commitment forms are obtained from and signed by the Principal. Principals are responsible for collecting and submitting these forms directly to the Office of Integration.

BILINGUAL CLASSROOM TEACHERS/NURSES PROGRAM ( BCT) School Nurses who are bilingual and meet the A-level proficiency requirements may qualify for incentive pay according to the approved guidelines and funding. Documentation must be submitted to the Nursing Director each month. In order to qualify for this bilingual differential, more than 50% of the student population must need services in that specific language.

CHANGE OF NAME, ADDRESS AND /OR TELEPHONE NUMBER Changes must be submitted to the Local Nursing Administrator’s Office in writing. In addition, it is your responsibility to obtain HR Form 8201-16 (8/07) to change your address with the Personnel Division and Payroll Branch. Failure to do this can cause a delay in receiving your warrant. This form can be obtained from your individual school or on-line at the Payroll Services Branch under Payroll Forms. All Nursing correspondence and documentation must reflect your payroll name – i.e., A.B. Jones.

JURY DUTY It is District policy that employees will provide jury service during periods when the continuity of instruction and District operations will not be adversely affected. As provided under Article XII, Section 18.4 of the District-UTLA Agreement and Article XI, Section 8.0 (d) of the District-AALA Agreement, paid absence for jury duty shall be provided to certificated employees for up to twenty working days for involuntary jury service. For State/Superior/Municipal service paid absence is subject to the following conditions: • an employee summoned to involuntary jury duty which is to commence during the employee’s assigned or “on-track” period (including summer school/off-track/intersession assignment previously offered and accepted), shall notify the immediate administrator of such summons. FAX a copy of the summons to the Local Nursing Administrator. • as a condition for paid absence, the employee shall seek postponement of the jury service until the employee’s upcoming unpaid recess or “off-track” period, if the employee is summoned to start jury service during an assigned work period. When calling the court, employees will need to provide information contained in their summons and be prepared with a calendar to designate a specific reporting date during which they are on recess or “off-track” and can begin jury service. • involuntary jury service commenced during the employee’s recess or “off-track” period which inadvertently extends into the employee’s assigned or “on-track” period which inadvertently extends into the employee’s assigned or “on-track” period shall qualify as paid absence for up to twenty working days from the start of the assignment or track. The twenty day limit shall be subject only to such exceptions which may be agreed upon by the District and respective employee bargaining units.

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•

an employee who does not request postponement of the jury summons to a recess or “off-track” period will be granted unpaid absence for the jury service. Any unpaid, assigned hours may negatively impact the employee’s benefits, including the retirement benefit.

There is no paid absence for staff development “buy-back” days, including absence for reason of illness, personal necessity, jury service, etc. Therefore, employees whose jury service may unavoidable extend into their staff development “buy-back” days will not be granted paid absence for those days and may wish to request special consideration from the courts. All jury fees (excluding mileage) received by the employee while on District paid status shall be remitted to the Accounting and Disbursements Division, (213) 241-7889. Jury fees received while on District unpaid status are retained by the employees. The Los Angeles County Superior Court website is www.lasuperiorcourt.org/ and the U.S. District Court website is www.cacd.uscourts.gov/. For assistance or further information please contact LAUSD Personnel Research and Assessment Section at (213) 241-6356. Please refer to Bulletin No. BUL-4223 dated May 5, 2008, Human Resources Division, “JURY SERVICE FOR CERTIFICATED EMPLOYEES”.

COURT APPEARANCE AS A WITNESS An employee of the District may appear in response to a subpoena duly served when the employee is not a litigant in a grand jury case, a criminal case in California, or a civil case in a court within specific County boundaries. Specific days of attendance must be certified by the clerk of the court or designated court official. In any case when an employee is granted a paid leave to serve as a subpoenaed witness, any witness fees shall be collected by the employee and remitted to the Accounting and Disbursements Division. Refer to the agreement between the Los Angeles Unified School District and the United Teachers of Los Angeles 2005.

ATTIRE A professional appearance is expected at all times. All staff shall be required to show proper attention to personal cleanliness, health, neatness, safety and suitability of clothing and appearance for school activities. In every case the dress and grooming of staff shall be clean and shall not: • cause actual distraction from or disturbance in any school activity or actually interfere with participation in any school activity. • create a hazard to the safety of himself/herself or others. • create a health hazard. School Nurses DO NOT wear uniforms or “scrubs”. Clean smocks/lab coats may be worn

IDENTIFICATION BADGE Legislation, effective January 1999 requires that all persons employed as a “Nurse” must wear/display identification – including name and appropriate license initials (e.g. Jane Doe, R.N.) in 18 point/font letters. It is the responsibility of the School Nurse to obtain and wear this identification.

REGISTERED NURSE LICENSE RENEWAL • •

It is the responsibility of a School Nurse to renew the license when it is due. Renewal can be completed on-line at www.rn.ca.gov/licenses/lic-renewal.shtml#renrn.

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• • • •

Additional information may be obtained by telephoning (916) 322-3350. Your Nursing Administrator provides CEHs at staff development meetings offered throughout the year for eligible School Nurses. The LAUSD Nursing Provider number is 01791. School Nurses must keep their own documentation of all CEH’s. Submit a copy of the license to your Local Nursing Administrator and to DISTRICT NURSING SERVICES, San Julian Annex #1 and #2 RE: LICENSE RENEWAL. School Nurses may NOT be employed without a current active California RN License. School Nurses without an active California RN License will be placed on Unpaid Leave. Unpaid days affect retirement and benefits.

PROFESSIONAL LIABILITY INSURANCE PROGRAM Several companies offer professional liability/malpractice insurance. Many School Nurses choose to purchase optional insurance.

CHANGE OF ASSIGNMENT, SCHEDULES, TRANSFER AND INTERVIEW REQUEST All requests for change of assignment/schedule must be submitted in writing. To apply for a transfer you must have served in PAID status for at least 130 days each year for three consecutive years at the same location from which the transfer is sought. A limit of 2 locations may be requested. If you are interested in a change of assignment, schedule, or transfer, submit your written request on the “Request For Transfer Application Form – School Nurse Initiated” revised 2/08 as soon as possible. It must be received by the Director of Nursing prior to April 15 of each school year unless otherwise posted. Applications are valid for one calendar year. District and Local Nursing Administrators make ADMINISTRATIVE TRANSFERS for the good of the District.

LEAVES, RETIREMENTS AND RESIGNATIONS The Director of District Nursing Services MUST sign all papers for leaves, retirements and resignations. Requests must be submitted by the designated dates specified for each semester. Forms may be obtained from the District Nursing Office at San Julian Annex, Bungalow #1.

CERTIFICATED/CLASSIFIED PERSONNEL RETURNING FROM ILLNESS OR OTHER HEALTH PROBLEMS The School Nurse is not responsible for examining Certificated/Classified Personnel. Employees obtain their clearance from their Private Physician/Health Care Provider and/or, if necessary, from Employee Health Services. The Site Administrator should be provided with the Employee Health Services number (213) 241-6326.

UNPAID LEAVE OF ABSENCE AND MEDICAL BENEFITS If you are on an UNPAID Leave of Absence or otherwise in an UNPAID status, you will NOT be eligible for District contribution of insurance premiums until you return to PAID status. You will be billed for your insurance premiums and can continue to pay these directly for one year. UNPAID days do not count toward accrued retirement. For assistance, telephone the Health Insurance Section, (213) 241-4262. This is the employee’s responsibility.

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CALIFORNIA STATE TEACHERS’ RETIREMENT SYSTEM (CALSTRS) School Nurses planning retirement in 2008/2009, should notify the Nursing Administrator and the Director of District Nursing as soon as possible. The District Nursing Office appreciates your cooperation. For a Retirement Packet from the STRS LAUSD Office, telephone: (213) 241-5100 then “0”. Submission of retirement paper work is time sensitive. To rescind paperwork, employees have only 48 hours. School Nurses may request a service credit audit from LAUSD. Send a written request to Payroll Branch, Beaudry Bldg., 27th Floor, ATTN: Mary Epelle. Attach a copy of your CalSTRS statement, specify the years in question, and always include your employee number and contact information. School Nurses considering retirement are urged to undertake, well in advance of their retirement date, certain steps that are necessary to establish future benefits related to retirement allowance and health and welfare benefits. THE SCHOOL NURSE IS RESPONSIBLE FOR COMPLETING AND FILING ALL NECESSARY FORMS WITHIN THE SPECIFIED TIME LIMITS. Forms are available and may be filed up to six months before the date of retirement. Retirement information is available for members of the California State Teachers’ Retirement System (CalSTRS) at District-hosted pre-retirement seminars and in individual counseling sessions with a representative from CalSTRS. School Nurses anticipating retirement are encouraged to attend at least one preretirement seminar held at various District locations and to schedule an appointment for an individual counseling session. Schedules for pre-retirement seminars are publicized each fall in a Human Resource Division memorandum and announced throughout the year in District publications. Sessions include: • Pre-retirement Seminar. Presentations by CalSTRS representatives include an explanation of how the retirement allowance is calculated, beneficiary options, filing information, and updates on legislation. For a list of retirement seminars visit the Human Resources Retirement website at www.teachinla.com/retirement/. • Individual Counseling Session. Individual counseling sessions (including printed estimates of monthly allowance) are available by appointment. Appointments may be requested by telephoning the CalSTRS office at the Los Angeles County Office of Education, (562) 9226414. Appointments are particularly important for School Nurses who are (a) nearing retirement, (b) considering the pre-retirement election of an option, (c) interested in the effects of new legislation, or (d) contemplating a redeposit of previously withdrawn funds. A confirmation letter with the date, time and location for the appointment will be sent to the School Nurse’s home address by the CalSTRS office. School Nurses should take a representative pay stub from the current school year to their appointment. For additional retirement information, School Nurses may: write -

California State Teachers’ Retirement System P.O. Box 15275 Sacramento, CA 95851-0275

visit -

California State Teachers’ Retirement System 7667 Folsom Blvd. Sacramento, CA 95851 (by appointment only)

telephone -

California Public Service and Teletalk* (CA STRS) (800) 228-5453 or (916) 229-3870 or (916) 229-3879 www.calstrs.ca.gov

FAX: Website:

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*24-hour recorded messages providing information on a wide range of topics concerning CalSTRS rules and benefits. A touch-tone telephone is required. It is possible to resign/retire and be reemployed with the District as a limited substitute (retiree). Reemployment is contingent on current District needs. The candidate must meet the District Selection Standards that are in effect at the time of the application. In order to be considered for reemployment, the School Nurse must indicate such request on the Certificated Resignation Form. Additional services and information are available regarding Health and Welfare Benefits, Retirement Deductions, Refunds and Services Credit, Disability Allowance, Life Insurance and the Annuity Reserve Fund. Numerous changes have been made to the CalSTRS Benefit Program related to credible compensations expanded under Bill 2700, service credit, age factor, and final compensation. In addition, CalSTRS has implemented a MediCare Benefits Progam. School Nurses are strongly encouraged to meet with a CalSTRS counselor prior to retirement to be advised regarding these changes. Refer to Reference Guide No. REF-1450.1 dated May 5, 2008, Human Resources, “CALIFORNIA STATE TEACHERS’ RETIREMENT SYSTEM (CalSTRS) INFORMATION”.

HEALTH INSURANCE COVERAGE School Nurses new to the District are responsible for submitting the insurance papers to the Insurance Section promptly. You are not enrolled in the District Insurance Programs automatically. For assistance, telephone Benefit Administration Department, (213) 241-4262.

EMPLOYMENT VERIFICATION FOR LOAN AND CREDIT APPLICATIONS Effective November 1, 2000, employment and salary information for Loans and Credit Applications must be requested from the The Work Number at 1-800-996-7566 or www.theworknumber.com. The only information that the work location may provide by telephone is limited to whether or not a person is currently employed at that location. The response must be limited to “Yes” or “No”, and no additional information may be released or verified. Refer to Bulletin No. S-7 (Rev.) dated April 28, 2003, Human Resources Division, “EMPLOYMENT AND SALARY VERIFICATION”.

EMPLOYMENT VERIFICATION FOR CREDENTIAL RECOMMENDATIONS

CREDENTIAL

PROGRAMS

AND

PROFESSIONAL

Employment verification of public school service as a School Nurse for approved university credential programs and for professional credential recommendations to the State of California Commission on Teacher Credentialing must be requested from District Nursing Services. This recommendation must be signed by the Director of Nursing Services. School Nurses are often requested to provide references for Credential Programs. Whenever you are asked to complete a reference for any reason, always obtain a written request from the School Nurse who is asking you for a reference. Be specific when you address the reference. Do not use “To Whom It May Concern”. After completing the reference, make a copy for yourself and keep the copy in your personal file with the original reference request you received. Many credential programs have generic forms for references. Follow these same instructions for completing generic references. Always keep a copy for your files.

SALARY POINT CREDIT CLASSES The Salary Allocation and Master Plan Verification Unit have on-line instructions at www.lausdsalary.net. Telephone (213) 241-6121, FAX (213) 241-6828.

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Forms to be used: 31.24

Salary Point Request for Degree Differential – U-FORM – accredited University or College. Approval from the Director of Nursing Services is required. An official transcript from the college/university must be sent with the U-FORM.

32.27

Salary Point Request – NA-FORM – Non-Accredited Institution or Conference Meeting with BRN Credit. Continuing Education Units/Hours must be accepted by the California Board of Registered Nurses or accepted by the District. Courses must be directly related to the Professional Growth and Practice of School Nursing. Continuing Education Units/Hours 30 hours = 1 salary point. Original or photo copies of earned certificates must be sent to the District Nursing Office with the NA FORM. Credit earned during duty hours cannot be used toward salary point credit. Correspondence classes cannot be approved for salary point credit.

31.47

Salary Point Request for Travel – T FORM Travel Forms must have PRE-APPROVAL from the Director of Nursing Services.

All forms may be obtained from the Salary Allocation and Master Plan Verification Unit – (213) 241-6121 FAX (213) 241-6828 or on-line at www.lausdsalary.net. Information and forms available on-line must be completed as directed and submitted by School Mail to: District Nursing Services San Julian Annex, #1 Attach the appropriate transcripts and certificates*. All Salary Point Forms must be reviewed, approved, and signed by the Director. After approval the District Nursing Services office will forward the Requests to Salary Allocation for processing. *NOTE: CEH’S YOU RECEIVE AT NURSING STAFF DEVELOPMENT MEETINGS DO NOT COUNT TOWARD SALARY INCREMENT UNLESS SPECIFICALLY INDICATED ON THE CEH FORM.

MULTICULTURAL COURSE REQUIREMENTS To qualify for Schedule Advancement, the employee must have completed a minimum of four semester units or equivalent of study, authorized to meet the requirements of Section 44560 through 44562 of the California Education Code. This requirement will not be applicable to Schedule Advancements until the completion of four semester units or the equivalent. These units may also be used to meet the cumulative point total for Schedule Advancement.

HOME STUDY CORRESPONDENCE Salary Point Credit cannot be given for Home Study Correspondence. Field work occurs during duty hours therefore, Salary Point Credit cannot be given for the School Nurse Field Work Course offered in the School Nurse Credential Program at the University.

SCHOOL NURSE SERVICE CREDENTIAL School Nurses in California Public Schools are required to have a current Health Services Credential. Most Service Credentials are subject to renewal requirements every 5 years.

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To renew a Professional Clear Services Credential, the School Nurse who is the credential holder must fulfill the following requirements at five-year intervals: 1. Submit to the California Commission on Teacher Credentialing (CCTC) a completed credential renewal application, which includes the Professional Clear Credential Renewal Self-Verification. The application is completed – on-line ONLY. 2. Remit the appropriate fees to the CCTC. A fee is required for each credential submitted for renewal. Credentials are generally valid for five years. Early renewal is not in the best interest of the credential holder. Apply 3-4 months before the credential expiration date. Credential Applications may be obtained on-line at https://teachercred.ctc.ca.gov/teachers/RenewableSearchProxy For additional questions, telephone (888) 921-2682 or for an appointment telephone (916) 445-7254. After renewal of California Credentials, the Credential must be registered with the County Office of Education. Questions regarding the County copy of California Credentials are referred to the District Credential Office at (213) 241-6520. Documentation of your current credential(s) MUST be on file at all times. After completion of the on-line renewal process, print the information displayed on the screen. The page indicates the “Selected Credential Held”, and the “Details of Selected Credential”. Make a copy of this page and fax or send it to your Local Nursing Administrator and District Nursing Services. Request for verification of employment/years of service for credential renewal must be submitted to the Director, District Nursing Services. All School Nurses must maintain a current certificate for CPR (Cardiopulmonary Resuscitation). A copy of your current card MUST be on file. Submit to your Local Nursing Administrator. The Local Nursing Administrator’s Office will offer opportunities for the renewal of the CPR for Professional Rescuers certificate. Please refer to Bulletin No. S-2 (Rev.) dated May 12, 2003, Human Resources, “PROFESSIONAL CLEAR TEACHING AUTHORIZATIONS”.

MINIMUM AND SHORTENED DAY SCHEDULES By action of the Board of Education, policies have been established for minimum and shortened days. The student instructional minutes have been calculated to meet the annual required instructional minutes mandated in SB 813 and allow for 10 minimum or 20 shortened days. Year-round schools tabulate shortened/minimum days individually for each track. Shortened/minimum days are scheduled as required for local school program planning, staff development, parent-teacher conference, curriculum planning, preparation for Back-to-School Night, Open House, or other school-community activities. Local District Superintendents have the option to schedule uniform staff development days as part of the authorized allotment. Shortened/minimum days may not be combined with the Professional Development Banked Time Days. Minimum/shortened days and pupil free days do not change the School Nurse duty hours requirement. Refer to Bulletin No. BUL-3979.0 dated November 5, 2007, Deputy Superintendent Professional Learning, Development, and Leadership, “REQUEST FOR APPROVAL OF MINIMUM AND SHORTENED DAY SCHEDULES”.

BANKED TIME AT SCHOOL SITES – PROFESSIONAL DEVELOPMENT In recognition of the critical role of professional development to bring about improved student achievement, Professional Development Banked Time has been identified through the LAUSD/UTLA negotiated contract. The time that is provided on the Professional Development Banked Time Tuesday afternoons must be used for training to support District priorities. The following are guidelines for both elementary and secondary schools: • The required number of yearly instructional minutes for students remains the same. • There are no changes in the length of the nurse’s contractual workday.

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• •

Minimum and/or shortened days may not be combined with the Professional Development Banked Time. Banked time is for professional development. Should a school wish to schedule a faculty meeting following to continue professional development or to conduct school business, time may be scheduled after school, in keeping with established guidelines.

Refer to Memorandum No. MEM-4138.1 dated March 18, 2008, Deputy Superintendent Professional Learning, Development, and Leadership, “PROFESSIONAL DEVELOPMENT BANKED TIME DAYS FOR THE 2008 – 2009 SCHOOL YEAR, GRADES 1 - 12”.

SCHOOL DAY SCHEDULES Actual classroom instruction is defined as any regularly scheduled classroom activity offered under the direct supervision of a properly credentialed teacher employed by the school District for the number of minutes established by the District. Only time during which courses are available to all pupils is counted when determining instructional time offered. Actual passing time is not to exceed 10 minutes between classes of like programs and is allowed for those pupils changing instructors and/or courses. Passing time should be consistent between all classes. To maintain a safe environment School Nurses may provide extra passing time “passes” for students with casts/crutches, etc. Parents must be informed if an extra “passing” time “pass” is given to any student for any reason. Contact your Local Nursing Administrator for questions. Refer to Bulletin No. BUL-1918.0 dated August 17, 2005 Chief Instructional Officer, Elementary Instruction Services, “SCHOOL DAY SCHEDULE FOR REGULAR, MINIMUM, SHORTENED, AND BANKED-TIME DAYS”.

SAFETY AND HEALTH PROTECTION California law provides job safety and health protection for workers under the California Occupational Safety & Health Administration (Cal/OSHA). The law requires that a poster be displayed listing the basic requirements and procedures for compliance with the State’s Job Safety and Health Laws/Regulations. Posters may be obtained from the LAUSD Environmental Health and Safety Division, (213) 241-3199. In addition, the California Education Code (CEC) 49079 directs each School Principal to establish a file for all available confidential information regarding a regularly assigned student who during the previous 3 years engaged in misconduct that would/did constitute grounds for suspension or expulsion. Also referenced is information that the District shall make a good faith effort to inform teacher(s) of student misconduct. Such notification and information shall be based upon the records the District maintains in its ordinary course of business or has received from a law enforcement agency. Any such information shall be received by the teacher in confidence for the limited purpose of alerting the teacher and shall not be further disseminated by the teacher. Refer to Collective Bargaining Agreement between the United Teachers Los Angeles and the Los Angeles School District, Past Student Misconduct Article XXIV, Section 4.0.

REPORTING EMPLOYEE ADMINISTRATION (OSHA)

INJURIES

TO

OCCUPATIONAL

SAFETY

AND

HEALTH

Cal/OSHA Regulations require a specified reporting procedure for any serious injury, illness, or death of an employee occurring in a place of employment or in connection with any employment. Any serious injury, illness or death MUST be reported to the Local Nursing Administrator IMMEDIATELY. School site injuries must also be reported to the Site Administrator as soon as possible. The Site Administrator may designate additional reporting requirements. Cal/OSHA defines “immediately” as “as soon as practically possible but not longer than 8 hours after the employer knows or with diligent inquiry would have known of the death or serious injury or illness. If the employer can demonstrate that exigent circumstances exist, the time frame for

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the report may be made no longer than 24 hours after the incident”. “Serious injury or illness means any injury or illness occurring in a place of employment or in connection with an employment which requires inpatient hospitalization for a period in excess of 24 hours for other than medical observation or in which an employee suffers a loss of any member of the body or suffers any serious degree of permanent disfigurement, but does not include any injury or illness or death caused by the commission of a Penal Code violation, or an accident on a public street or highway.” The School Nurse may be asked to assist the Site Administrator with the OSHA report. Information includes but is not limited to: • time, date, description of accident, and nature of the injury; • employer’s name, address and telephone number; • name and job title of person reporting the accident; • address of site of accident; • name of person to contact at site of accident; • name, address employee number and home phone number of injured employee(s); and • location where injured employee(s) was moved to. Refer to Office of Environmental Health and Safety, SAFETY ALERT No. 05-01 dated January 2005, “CAL/OSHA LOG OF INJURIES AND ILLNESSES”; Office of Environmental Health and Safety, SAFETY ALERT No. 04-14 dated June 25, 2007, “ACCIDENT INVESTIGATION AND REPORTING” and Office of Environmental Health and Safety, SAFETY GRAM No. 02-09 dated December 2002, “REPORTING EMPLOYEE INJURIES TO OSHA”.

ACCIDENT INVESTIGATION AND REPORTING Cal/OSHA regulations require employers to report workplace injuries. LAUSD has developed the Injury/ Accident Investigation Report from the Office of Environmental Health & Safety (OEHS). This form is used for EMPLOYEES, STUDENTS AND VISITORS. The District’s Injury & Illness Prevention Program (IIPP) requires that Site Administrators investigate all workplace incidents within 24 hours and that Site Administrators e-mail the investigation report to the OEHS and the Office of Risk Management & Insurance Services (ORMIS). (Reports may also be faxed to OEHS at (213) 241-6816 and ORMIS at (213) 241-8993.) Section 4 and 7 are often completed by the School Nurse. School Nurses may also be asked to complete portions, or sections 1, 2, 3, 5 and 6 when the School Nurse has knowledge of information requested in those sections or if the School Nurse is directly involved. School Nurses continue to objectively record applicable information on the student’s Health Record Card. The School Nurse’s copy of the Injury/Accident Investigation Report (Revised 3/20/2007) should not be retained in the student’s Health Card. Refer to “Procedures for Recording and Securing the Health Record Card when a Student is Deceased” in this handbook. Always contact your Local Nursing Administrator’s Office when a child is deceased or there is a significant accident/illness/injury at your site. The Incident Report Form may be downloaded from the Office of Environmental Health and Safety website at lausd.oehs.org. The Incident Report Form cited in the SAFETY ALERT also covers property damage. Refer to the Office of Environmental Health & Safety, SAFETY ALERT, No. 04-14 dated Revised 6-25-07, “ACCIDENT INVESTIGATION AND REPORTING”.

PROCEDURES FOR WORK RELATED INJURIES OR ILLNESS Employers and employees have specific rights, responsibilities, and obligations should an employee suffer a work-related injury or illness.

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An employee may designate a personal physician to provide treatment in case of a worker’s compensation injury instead of using an authorized medical provider. Such designation must be made PRIOR to an industrial injury, and the physician’s area of expertise must be appropriate for the injury. The physician must agree, in writing, to the pre-designation. When an injury or illness occurs and emergency medical attention is required, immediately telephone 911 or your local emergency medical services provider. If non-emergency medical attention is required or is requested by the injured worker, refer to the list of approved doctors and facilities. Employees must be referred by the Site Administrator or designee only to medical providers listed in the directory at the school site. A current list of medical providers is available on the Sedgwick/Intracor website www.geoaccess.com/directoriesonline/intracorp/sedgiwick. For Dental-related injuries, telephone Sedgwick Claims Management System (CMS) at (626) 397-9200. Routine first-aid cases are not reported to Sedgwick CMS. These cases are defined as injuries or illnesses that do not require a doctor’s visit or outside medical attention and no time is lost after the date of injury; however, the incident should be documented on the INJURY/ACCIDENT INVESTIGATION REPORT (Revised 3/20/07) and maintained in the employee’s personnel file. If the employee should seek medical attention or lose time from work at a later date, report the claim to Sedgwick CMS immediately. State law requires the Employers’ Report of Injury to be completed within five days of notice of the injury. Prompt telephone reporting by the Site Administrator/designee will help to ensure compliance with the law and avoid financial penalties for late reporting. The Site Administrator is also legally responsible for providing this State of California form to the injured employee within 24 hours of notice of injury. The employee must complete the top section and return the form to the work location. The work location then completes the lower section of the form and distributes copies as follows: Carrier copy to: Sedgwick CMS P.O. Box 61563 King of Prussia, PA 19406 Claimant copy: To the employee Employer copy: To be retained at the work location For questions or assistance the following telephones numbers may be helpful: • Report Claims (800) 528-7392 • Sedgwick Claims Office (866) 247-2287 • Division of Risk Management Insurance Sections (DORMIS) (213) 241-3139 • Inspector General’s Fraud Hotline (213) 241-7778 • Integrated Disability Management (213) 241-3974 • Employee Health Services (213) 241-6326 If the School Nurse provides First-Aid or has contact with the injured employee his/her name will be documented on the form. When an employee is absent from work because of a work-related injury or illness, any time lost after the day the injury happened is time reported as “WC” for workers’ compensation. An employee who is absent from work due to a work-related injury must comply with all Personnel requirements, such as submitting leave of absence paperwork and medical verification of illness. An employee’s failure to comply with such requirements may result in disciplinary action (up to and including dismissal) and/or interruption of salary payments. The District has established a policy to return injured employees to gainful and productive employment by providing transitional work or reasonable accommodations which are within the employee’s medical restrictions. The Division of Risk Management and Insurance Services has established an Integrated Disability Management Department that is available to assist in identifying and providing modified or alternate duties or other accommodations. There are policies and procedures relating to the Stay at Work Program. All employees who return to work from an industrial injury leave must present a medical release signed by the appropriate doctor. If there is any question regarding the return to work (or restrictions), Site Administrators should contact Employee Health Services (213) 241-6326 and Integrated Disability Management (213) 241-3974.

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Workers’ compensation fraud and workers’ compensation claims abuse costs the District money that could be used for other purposes, such as textbooks, salaries, supplies, additional School Nurse Time, etc. If anyone has reason to suspect that a Worker’s Compensation Claim is fraudulent or that an employee is abusing Workers’ Compensation Benefits, please call the Office of the Inspector General’s Fraud Hotline at (213) 241-7778, or call Division of Risk Management Insurance Sections (DORMIS) at (213) 241-3139. If the School Nurse is injured, also telephone the Local Nursing Administrator. Complete the applicable work site paper work. The School Nurse should make and retain a copy and send a copy immediately to the Local Nursing Administrator. Refer to Memorandum No. MEM-1986 dated October 7, 2005, Division of Risk Management & Insurance Services Workers’ Compensation Branch, “IMPORTANT INFORMATION ABOUT THE DISTRICT’S COMPENSATION BRANCH” and Reference Guide No. REF-1279 dated September 3, 2004, Risk Management and Insurance Services, “WORKERS’ COMPENSATION PROCEDURES”.

WORK RELATED FATALITIES OR SERIOUS INJURIES Work related serious injuries or illnesses must be reported immediately to the Site Administrator and the Local Nursing Administrator. Site Administrators have been informed that a “serious injury or illness includes any injury or illness which requires hospitalization”. In addition, School Nurses also report communicable diseases even if there is no hospitalization associated with the illness. Always notify your Local Nursing Administrator whenever an unusual, serious, or critical incident occurs at/or adjacent to your school site. Always notify your Local Nursing Administrator if a regulatory agency arrives to conduct an inspection or submits a request for information. Such agencies include/but are not limited to Cal/OSHA, California Department of Health Services, County Department of Health Services, Cal/EPA and South Coast Air Quality Management District (SCAQMD). Refer to Bulletin No. C-7 dated March 22, 1996, Business Services Division, Office of the Superintendent, “REGULATORY AGENCY INSPECTION PROCEDURES”.

LEAD EXPOSURE DURING CONSTRUCTION AND RENOVATION Lead is a toxic metal and a common component in older paints. The neurotoxic properties of lead are particularly damaging to children, although lead poisoning can occur at any age. Potential lead exposures are primarily due to ingestion of lead paint chips or inhalation of lead dust. All buildings constructed prior to 1993 are presumed to have used lead-based paint. When these coatings are disturbed by sanding or scraping, lead paint chips or dust may be released. School Nurses are often consulted as a resource for potential hazards at school sites. Parents, staff and students should be reassured that the Office of Environmental Health and Safety and OSHA adhere to strict standards. To minimize potential lead exposures resulting from building repairs or renovation, it is necessary that proper containment procedures be followed whenever painted surfaces are disturbed. Containment typically consists of placing 6 mil plastic sheeting on the ground extending at least 10 feet beyond the work area. Bushes or shrubbery in the work area are covered as well, and access to the area restricted. Doors and windows adjacent to the work area are sealed with plastic sheeting and duct tape, the air handling systems are shut off and the fresh air intakes covered. If wind can blow dust or paint chips off the plastic sheeting, additional containment may be required. Health Offices and equipment must be protected from “Lead” dust. Use of proper plastic sheeting and proper containment strategies must be employed. Contact your Local Nursing Administrator. Refer to Office of Environmental Health and Safety, SAFETY ALERT, No.05-10 dated August 2005, “MODIFICATIONS TO BUILDING MATERIALS CONTAINING ASBESTOS OR LEAD” and

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Office of Environmental Health and Safety (OEHS), SAFETY ALERT, No. 03-10 dated July 2003, “PREVENTING LEAD EXPOSURE DURING CONSTRUCTION AND RENOVATION.”

DAILY FLUSHING REQUIREMENTS FOR NON-REFRIGERATED DRINKING FOUNTAINS Water that remains stationary within standard piping for extended periods of time can leach lead out of pipes joined with lead-containing solder as well as some brass fixtures or galvanized pipes. Flushing these fixtures has been found to be an effective means of reducing lead levels below the Action level (AL) set by the Environmental Protection Agency. Refrigerated drinking water fountains have been previously retrofitted and do not require daily flushing. Based on past studies of non-refrigerated drinking water fountains, all drinking water and food service faucets must be flushed for a minimum of 30 seconds prior to the first use each day. All fixtures and fountains that may be used for consumption of water or used for food preparation shall be flushed for a minimum of 30 seconds prior to the first use of the day. School Nurses flush the Health Office faucets, fixtures(s) and drinking fountains at the beginning of the day and record on the Daily Flushing Log for Individual Fixtures (Reference Guide No. REF-3930.1, Attachment B). If the fixture is inoperative, or if the water is discolored or has an odor, report this to the Site Administrator so that the Plant Manger is informed. At the end of each month the School Nurse responsible for flushing individual fountains in the Health Office will give the completed Reference Guide No. REF3930.1 Attachment B forms to the Site Administrator. Refer to Reference Guide No. REF-3930.1 dated May 9, 2008, Office of Environmental Health and Safety, DAILY FLUSHING REQUIREMENTS FOR NON-REFRIGERATED DRINKING FOUNTAINS”.

ASBESTOS INSPECTION AND ABATEMENT ACTIVITIES The Asbestos Hazard Emergency Response Act (AHERA) requires the District to annually notify workers and building occupants, or their legal guardians, of the asbestos inspection and abatement activities that will be performed twice per year. AHERA also requires the District to notify, in writing, parent, teacher, and employee organizations of the availability of site asbestos management plans and to include a copy of this notification in each site’s plan. All District sites are required by law to maintain an Asbestos Management Plan which must be maintained and available in the main office and must include a copy of the inspector’s written report. Small amounts of asbestos can be released into the air upon drilling, cutting into, or causing damage to the surface of these materials. In order to prevent such incidents, Federal and State regulations require the District to comply with specific control procedures whenever work is performed on building materials that may contain asbestos. School staff, students, and parents are prohibited from making any repairs or modifications to school buildings, including cutting, drilling into, or removal of any building components. Such components include, but are not limited to walls, ceilings, floors and cabinets. Repairs or modifications to building components may only be performed by properly trained District maintenance personnel or approved contractors. Any requests for physical changes or modifications to building components must be submitted in writing to the Site Administrator. Any damaged building components or surfaces (e.g., holes in walls) should be reported to the Plant Manager or Site Administrator as soon as possible. Care should be exercised when securing objects to wall surfaces, so as to avoid damage to the wall. Thumbtacks or small nails may be used as long as they do not gouge or mar the surface of the wall. Staff and students are not permitted to dismantle or attempt repairs on any type of District-issued equipment, such as film projectors, lighting devices, or electrical equipment, unless this activity is part of a District authorized curriculum. Equipment in need of repair should be reported to the Plant Manager. School Nurses are frequently consulted regarding potential hazards and the abatement process. Refer questions regarding health concerns related to asbestos to the Local Nursing Administrator. Asbestos Management information and current plans may be available – contact Asbestos Technical Unit at (213) 745-1450.

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Refer to Memorandum No. MEM-3922.0 dated October 8, 2007, Chief Facilities Executive, “NOTIFICATION OF ASBESTOS INSPECTION AND ABATEMENT ACTIVITIES” and Office of Environmental Health and Safety, SAFETY ALERT, No.05-10, August 2005, “MODIFICATIONS TO BUILDING MATERIALS CONTAINING ASBESTOS OR LEAD”.

PROCEDURES TO ACCESS SITES DURING NON-BUSINESS HOURS Vandalism, burglary, arson, and other crimes committed against District property annually cost millions of dollars and cause disruptions of the educational process. In an effort to reduce the number of such incidents, intrusion alarm systems have been installed at many sites. These systems are maintained by ITD and monitored by the School Police Department. When activation is received, a police officer is dispatched to the site and as necessary, the local police agency and/or fire department responds. False alarm activations reduce the number of available patrol units and can cause a serious reduction in the level of service. Further, city and county law enforcement agencies may charge the District for services when they respond to false alarms. Research has found that most false alarms are caused by employees accessing areas protected by an intrusion alarm system. The protection of District facilities can be greatly improved if the number of entries to sites during non-business hours is kept to a minimum. The site administrator shall assign specific employees the responsibility to turn on the intrusion alarm system upon closing the facility and to disengage the system immediately upon entering as the site is opened for business. The site administrator must provide written authorization for employees to enter the facility during non-business hours. The authorized employee shall, immediately upon entering the facility, telephone School Police to provide appropriate identification information and turn off the intrusion alarm system, if the site is so equipped. Just prior to departure, the employee must notify School Police and reactivate the alarm system. Employees shall have a copy of their completed authorization form in their possession when on site. Employees will be required to present this authorization form at the request of School Police personnel while on site. Refer to Bulletin No. BUL-2426 dated March 13, 2006, Office of the Chief Operation Officer, “PROCEDURES TO ACCESS SITES DURING NON-BUSINESS HOURS.”

VISITORS TO SCHOOL CAMPUSES The Los Angeles Unified School District is committed to providing a safe and secure learning environment for its students. The enhanced involvement and assistance of parents, community members, and organization representatives in school programs and activities have increased the number of school campus visitors. In some instances, campus visitors have created concerns for staff. Therefore, all school campus visitors must be informed and must adhere to the laws and school policies of campus visitors to school campuses, as stated in the California Education Code [Education Code §44810 (a); §44811; §51101,(a): (1), (2), (12)] and Board Rules (1265, 2002). Legal Requirements state: • Schools must develop and post a visitor’s policy. • All campus visitors must have the consent and approval of the principal/designee. Permission to visit must be given at the time requested if at all possible or within a reasonable period of time following the request. This does not preclude visits occurring on the same day as requested. • Children who are not enrolled at the school are not to be on the campus unless prior approval of the principal/designee has been obtained. • Parents do have the right to: be informed in advance of the procedures for visiting the school; request and obtain approval of the principal/designee to enter a school campus; observe in the classroom or classrooms in which their child is enrolled within a reasonable period of time after making a request; observe in the classroom or classrooms for the purpose of selecting the school in which their child will be enrolled, within a reasonable period of time after making a request; request a meeting with the classroom teacher and/or school principal/designee following the observation; and, meet with their

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child’s teacher(s) and/or the school principal/designee, within a reasonable period of time after making a request. Parents do not have the right to: willfully interfere with the discipline, order, or conduct in any school classroom or activity with the intent to disrupt, obstruct, or inflict damage to property or bodily injury upon any person; disrupt class work, extracurricular activities or cause disorder in a place where a school employee is required to perform his or her duties.

Adults and minors over 16 years of age who enter a school campus and fail to adhere to the posted “Visitor’s Policy” or who defy the principal/designee’s authority may be reported to the appropriate police agency and may be subject to criminal charges under the California Penal Code (Sec. 626.7, 626.8), the City of Los Angeles Municipal Code (Sec. 63.94), and/or the California Education Code [§44810(a), §44811(a)]. School Nurses may be confronted by individuals in the Health Office whose disagreement with the School Staff may result in negative behavior. Inform the Site Administrator if there is a problem. School personnel are protected by provisions in the California Education Code and the California Penal Code. THE CALIFORNIA EDUCATION CODE – Section 44811 refers to the disruption of class work or extracurricular activities; punishment and exemptions. . . . Any parent, guardian, or other person whose conduct in a place where a school employee is required to be in the course of his or her duties materially disrupts class work or extracurricular activities or involves substantial disorder is guilty of a misdemeanor which is punishable by a fine not exceeding one hundred dollars ($100), by imprisonment in the county jail for a period of not more than 10 days, or both. This section does not apply to any otherwise lawful employee concerted activity, including, but not limited to, picketing and the distribution of handbills. THE CALIFORNIA PENAL CODE – Section 626.7 refers to the failure to leave campus or facility, wrongful return penalties, notice and exceptions. . . . If a person who is not a student, officer or employee of a public school, and who is not required by his or her employment to be on the campus or any other facility owned, operated, or controlled by the governing board of that school, enters a campus or facility, and it reasonably appears that the person is committing any act likely to interfere with the peaceful conduct of the activities of the campus or facility, or has entered the campus or facility for the purpose of committing any such act, the Site Administrator/designee may direct the person to leave. If that person fails to do so or if the person willfully and knowingly reenters upon the campus or facility within thirty days after being directed to leave, or within seven days if the person is a parent or guardian of a student attending that school, he or she is guilty of a misdemeanor and shall be punished by a fine of not more than five hundred dollars ($500), by imprisonment in the county jail for a period of not more than six months, or by both fine and imprisonment. THE CALIFORNIA PENAL CODE – Section 626.8 refers to disruptive presence at schools; specified sex offender; offenses; punishment; notification. . . . Any person who comes into any school building or upon any school ground, or street, sidewalk, or public way adjacent thereto, without lawful business thereon, and whose presence or acts interfere with the peaceful conduct of the activities of the school or disrupt the school or its pupils or school activities is guilty of a misdemeanor if he or she does any of the following: • remains there after being asked to leave. • reenters or comes upon that place within seven days. • has otherwise established a continued pattern of unauthorized entry. Report incidents directed to/at the School Nurse to the Site Administrator and telephone your Local Nursing Administrator as soon as possible. Refer to Bulletin No. BUL-1325 dated October 11, 2004, Office of the Chief Operating Officer, “VISITORS TO SCHOOL CAMPUSES”.

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CURFEW ENFORCEMENT AND LOITERING The Los Angeles Unified School District and Los Angeles Police Department have joined collaboratively on a number of safety efforts including Safe Return to Schools, the Truancy Ordinance, and the Safe House Program. The curfew law prohibits anyone under the age of 18 from loitering during the hours of 10:00 p.m. until sunrise. Additionally, students under the age of 18 who are loitering in public places between 8:30 a.m. and 1:30 p.m. on school days may be subject to fines of up to $250 and/or 20 hours of community services. The Los Angeles Police Department is again requesting assistance in informing students, parents, and communities regarding its efforts regarding curfew enforcement. To report loitering or truancy Site Administrators/designees telephone (213) 625-6631. Refer to City of Los Angeles Municipal Code Ordinance #170523 (Effective October 1, 1995).

PARENT/STUDENT HANDBOOK The California Education Code mandates that school districts annually notify K-12 students and their parents or guardians about their rights and responsibilities relative to the Code’s statutory provisions. This notification is to be signed by the parent or guardian indicating receipt of the information and returned to the school. Examples of the types of mandated information are sexual harassment policies, Title IX notices, discrimination notices, uniform complaint procedures, required immunizations, directory information, integrated pest management policy, pupil records information, etc. The California Education Code (CEC) 49400 is the reference provided to allow School Nurses to provide necessary services that may not otherwise be specified. C.E.C. 49400 states “The governing board of any school district shall give diligent care to health and physical development of pupils, and may employ properly certified person for the work.” The California Administrative Code (CAC) Title 5, Section 306 is the reference provided to parents when students are sent home because they are not properly prepared for school. C.A.C. Tile 5, 306 states “A pupil who goes to school without proper attention having been given to personal cleanliness or neatness of dress, may be sent home to be properly prepared for school, or shall be required to prepare himself for the school room being entered.” In an effort to insure compliance and consistency and to relieve schools of the responsibility of gathering and duplicating the required notices, the District publishes a Parent/Student Handbook. It contains all of the statemandated notifications, including a form for the parent to sign and return relative to receipt of the document and the release of student information (federal rights and privacy). School Nurses should keep a copy of this publication for reference.

CAREGIVER AUTHORIZATION Students may not always reside with a legal parent/guardian. Family Code Section 6550-6552 allows a caregiver who is 18 years of age or older and signs the Caregiver Affidavit to enroll a minor in school and consent to school – related medical/dental care on behalf of the minor. A caregiver who is a relative and who completes the affidavit provided in Section 6552 and signs the affidavit shall have the same rights to authorize medical care and dental care for the minor that are given to guardians under Section 2353 of the Probate Code. The medical care authorized by this caregiver who is a relative may include mental health treatment. A person who acts in good faith on a caregiver’s authorization affidavit to provide medical or dental care, is not subject to criminal liability or to civil liability to any person, and is not subject to professional disciplinary action. A person who relies on the affidavit has no obligation to make any further inquiry or investigation. For purposes of this code, the following terms have the following meaning: “Person” includes an individual, corporation, partnership, association, the state, or any city, county, or other public entity or governmental subdivision or agency, or any other legal entity. “Relative” means a spouse, parent, stepparent, brother, sister, stepbrother, stepsister, half brother, half sister, uncle, aunt, niece, nephew, first cousin, or any person denoted by the prefix “grand” or “great,” or the spouse of any of the persons specified in this definition, even after the marriage has

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been terminated by death or dissolution. “School-related medical care” means medical care that is required by state or local governmental authority as a condition for school enrollment, including immunizations, physical examinations, and medical examinations conducted in schools for pupils. The caregiver affidavit is available as an attachment to BUL-1292. Refer to Bulletin No. BUL-1292 dated July 8, 2005, Educational Services, “ATTENDANCE PROCEDURES FOR ELEMENTARY AND SECONDARY SCHOOLS”.

WILLIAMS/VALENZUELA COMPLAINT PROCESS The Williams/Valenzuela Complaint Process, California Education Code Section 35186(f) provides important information about Parents and Guardians complaint rights regarding the following: • Every school must provide sufficient textbooks and instructional materials. Every student, including English Learners, must have textbooks or instructional materials, or both, to use in class and to take home or use after class to complete required homework assignments. • School facilities must be clean, safe, and maintained in good repair. • Each class should be assigned a teacher and not a series of substitutes or other temporary teachers. The teacher should have the proper credential and subject matter training to teach the class, including training to teach English Learners, if present. • Pupils, including English Learners, who have not passed one or both parts of the high school exit examination (CAHSEE) by the end of the 12th grade, are to be provided the opportunities to receive intensive instruction and services for up to two consecutive academic years after the completion of grade 12. Complaint Forms may be obtained from the Site Administrator or the District website www.lausd.net or telephone (213) 241-2597 or the Office of the Chief Operating Officer (213) 241-4133. A complaint may be filed anonymously and faxed to (213) 241-6947. Once the complaint is submitted, a remedy or resolution to the problem will take place within a reasonable time period but will not exceed 30 working days from the date the complaint was received. Complainants not satisfied with the resolution involving emergency or urgent school facilities/conditions can file an appeal to the Superintendent of Public Instruction. Jack O’Connell State Superintendent of Public Instruction California Department of Education 1430 N Street Sacramento, CA 95814 (916) 319-0800 Refer to Bulletin No. BUL-2362.7 dated May 12, 2008, Office of the Chief Operating Officer, “WILLIAMS/ VALENZUELA COMPLAINT PROCEDURES”.

STUDENT ACCIDENT AND HEALTH INSURANCE The LAUSD does not provide student accident insurance to help cover the costs of paramedic/ambulance care or transportation, or any medical, surgical, dental or hospital costs due to school related injuries to students (except under certain, narrow circumstances). However, all students within the District are eligible for enrollment in a number of student health insurance/ accident plans. These plans cover school related injuries and some cover injuries and illness not otherwise related to school. Plan summaries/enrollment forms are distributed to each household at the beginning of the year. Questions and requests for duplicate forms should be directed to the program administrator, BRIDGE NORENA AND ASSOCIATES INSURANCE AGENCY and/or www.bridgenorena.com.

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Students engaged in interscholastic sports are required by California Education Code sections 32220-32224 to have health or accident medical coverage. The plans referenced above are also meant to help parents comply with these State laws. Many students receive Medi-Cal reimbursed health services. Services reimbursed by Medi-Cal currently include certain health services for all students in the District as well as specific services for students with disabilities. The health related services for students with disabilities include both assessment and the treatment(s) specified on a student’s Individual Education Program (IEP) including: audiology, counseling, nursing services, occupational therapy, physical therapy, speech therapy, and transportation related to these services. Medi-Cal regulations set the same high professional standards for school-based providers as providers who work in hospitals, rehabilitation centers, and other settings. In seeking reimbursement LAUSD may need to release student records, medical information and/or other information pertaining to a student. School-based Medi-Cal reimbursement does not affect the child’s Medi-Cal benefits in other health care settings. There is no cap on Medi-Cal for students with disabilities in California. LAUSD never bills a family’s private insurance for the health care services specified on a child’s IEP. The District adheres to IDEA and its requirement to provide students with disabilities with a free and appropriate public education (FAPE). Parents of Medi-Cal eligible students may choose not to allow the LAUSD to seek reimbursement for the services provided to their child by requesting a Parent Medi-Cal Non-Authorization to Bill form from the LAUSD Medi-Cal office. Telephone (213) 241-0558. Additional or alternative assistance may be available through the Children’s Health Access and Medi-Cal Program (CHAMP). Parents can telephone the LAUSD CHAMP Helpline at (866) 742-2273 to get information and help with accessing, utilizing and retaining health insurance for their children ages 0-18. The website address is http://CHAMP.lausd.net. Schools can schedule outreach events for staff or parents by contacting the CHAMP office. Whenever possible School Nurses should encourage parents/guardians to investigate and/or enroll in the plan if it meets the health needs.

BLOOD DONATIONS (STUDENTS) Blood donation drives in cooperation with the American Red Cross and other blood procurement agencies that have a Memorandum of Understanding with the District may be held on high school campuses. School administration will notify parents/guardians of planned blood donor drives. Although California allows 16 year old minors to donate without parental consent, the District policy requires written parent/guardian consent for 16 years old. Written consent from the parent/guardian is not required for participation by students 17 years or older. Students should not donate blood sooner than 56 days from their last donation. Refer to Bulletin No. BUL-4152 dated March 3, 2008, Student Health and Human Services, “BLOOD DONATION DRIVES AND PARTICIPATION BY STUDENTS”.

READMISSION TO SCHOOL (STUDENTS) A student returning to school following a serious or prolonged illness, injury, surgery, or other hospitalization (including psychiatric and drug or alcohol inpatient treatment), must have written permission by the health care provider to attend school, including any recommendations regarding physical activity. Students returning to school following a serious communicable disease exclusion may need additional clearance for readmission. Contact your Local Nursing Administrator or District Nursing Services for assistance. All notification (by letter or telephone) regarding possible exposure to a communicable disease must be approved by the Director of Nursing Services and the Director of Student Medical Services. (The only exceptions are chickenpox and pediculosis.) Contact the Local Nursing Administrator for assistance with communicable disease readmission. Any agency requesting information regarding communicable disease or if any agency requests access to students or student records must be reported immediately to the Local Nursing Administrator. A student returning to school with sutures, “ace” bandages, slings, casts, crutches, splint(s)/brace(s), canes/walker or a wheelchair must have a physician’s written permission to attend school and must comply with any safety procedures required by the school administration and health services personnel. The school

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readmittance form (Form 33.09 Rev. 1/06) is available on-line. Readmittance of pupils with ace bandages, slings, sutures, braces, casts, crutches, wheel chairs and other ambulatory assisted devices (Form 33.12 E/S Rev 1/03) is also available on line. Please refer to Los Angeles Unified School District “Parent – Student” Handbook 2008-2009 and Bulletin No. BUL-2637.0 dated July 1, 2006, Student Health and Human Services, “YOUTH SUICIDE PREVENTION PROGRAM”.

STUDENT AND EMPLOYEE SECURITY Administrators and School Leadership Councils support Coordinated Safe and Healthy School Plan (formerly Safe School Plans). The District has practices to assist with the maintenance of a safe and healthy school site. Administrators are provided with guidelines to promote student and employee safety and security. School Nurses should review the Coordinated Safe and Healthy School Plan. Campus security is everyone’s responsibility. Please refer to Bulletin No. BUL-2368.1 dated March 6, 2006, Office of the Chief Operating Officer, “STUDENT AND EMPLOYEE SECURITY”.

CAMPUS PROTECTION PROCEDURES In response to concerns raised regarding the usage of the word “lockdown,” the District now uses the term “Campus Protection”. During campus protection episodes no one is allowed to enter or exit the school or individual classrooms. Telephone the Local Nursing Administrator if medication delivery to students is restricted or impeded. A campus protection is called by a law enforcement agency or the Site Administrator to secure the school during police action, campus intrusion, community incidents, hazardous material leaks or other incidents requiring either room or school security. The campus protection is terminated by the Site Administrator, after consultation with law enforcement, as necessary. A predetermined signal (bell, intercom, word of mouth) is used to enact campus protection procedures. Teachers/students are to remain in, or go to, their classrooms where windows and doors are to be locked and blinds closed. Students are kept away from windows and may not leave classrooms until the campus protection is terminated. When a “campus protection” is initiated and students/staff are outside, they should immediately proceed to the closest room and remain inside until the emergency is over. Good communication is essential. Contact your Local Nursing Administrator as soon as possible. Staff are given a status update frequently. When the emergency is concluded, a letter or other form of communication is usually sent to parents of all students. FAX a copy to your Local Nursing Administrator. School Nurses should make advance preparations and be aware of which students have special health/medication concerns. Refer to Reference Guide REF-1300.3 dated September 30, 2007, Office of Environmental Health and Safety, “EMERGENCY EXERCISE FALL 2007” (updated annually) and Reference Guide REF-1314 dated September 24, 2004, Office of Environmental Health and Safety, “EMERGENCY DRILLS AND PROCEDURES”.

SCHOOL CRIME REPORTING “It is the intent of the Legislature to ensure that schools, school districts, local government and the Legislature have sufficient data and information about the type and frequency of crime occurring on school campuses to permit development of effective programs and techniques to combat crime on school campuses.” (California Penal Code Section 628). It is not the intent of this process to require any individual to reveal confidential health information. Health Cards are confidential. For questions regarding health information telephone your Local Nursing Administrator.

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Refer to Bulletin No. Q-52 dated June 1, 2001, Office of the Superintendent, “CALIFORNIA SAFE SCHOOLS ASSESSMENT – REPORTING OF SCHOOL CRIME/INCIDENTS”.

SUSPECTED VIOLENT INJURY REPORT (SVIR) Pursuant to Penal Code Section 11160 . . . A report must be completed by any health practitioner employed in a health facility, clinic, physician’s office, local or state public health department, or a clinic or other type of facility operated by a local or state public health department who, in his or her professional capacity or within the scope of his or her employment, provides medical services for a physical condition to a patient whom he or she knows or reasonably suspects is a person who: • Obtained an injury resulting from a firearm (self inflicted or by another person) • Sustained any wound inflicted as a result of assaultive or abusive conduct. Assaultive or abusive conduct is defined to include 24 criminal offenses, among which are murder, manslaughter, torture, battery, sexual battery, incest, assault with a deadly weapon, rape spousal rape, and abuse of spouse or cohabitant/domestic violence. (Penal Code Section 11160) • Obtain a SVIR from your Local Nursing Administrator. • The written report shall be completed by the School Nurse as soon as possible. • FAX the written report to the Local Nursing Administrator. • Make a copy of the report for your files. • Make a copy of the report for School Police • Send the original report within two working days to the Local Law Enforcement Agency designated by LAUSD School Police. A graphic representation of injury(s) page (Body Map Page) may be completed by the School Nurse if requested by Local Law Enforcement. Reporting Physicians are required to complete this page (Penal Code Section 11161.3)

FIREARMS ON SCHOOL SITES California Penal Code Section 626.9 makes it a crime to possess a firearm on the grounds of a public or private school or within 1,000 feet thereof, with specified exceptions. Education Code Section 48915 requires school boards to expel students who are found to possess, sell, or otherwise furnish a firearm at school or at a school related activity. All individuals found in possession of firearms on District school property shall be reported to the appropriate law enforcement agency for prosecution under Penal Section 626.9. Students found in possession of firearms will be subject to mandatory expulsion under Education Code Section 48915. Employees found in possession of firearms on District property will be the subject of a recommendation for dismissal to the Board of Education. Refer to Bulletin No. J-3 dated March 26, 1998, Office of the Deputy Superintendent, Support Services, “ZERO TOLERANCE POLICY REGARDING FIREARMS ON SCHOOL DISTRICT PROPERTY”.

SAFE SCHOOL PLAN (Also now known as COORDINATED SAFE AND HEALTHY SCHOOL PLAN) The District’s goal is to ensure a safe, wholesome workplace for employees and a school environment conducive to learning. The District has identified standards and established procedures to prevent, reduce and eliminate safety hazards (including, but not limited to, violence, bias-motivated incidents, tobacco, alcohol and other drugs). In July 1994, a broad-based District School Safety Planning Committee was established, which included personnel from District units and Divisions dealing with safety-related issues, Bargaining Unit Representatives, an active coalition of parent and community members from 10th and 31st District PTA, the Parent Collaborative, District Advisory Councils and the Commissions. Recognizing the District’s

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commitment to a strong partnership with parents and the community, parents representing organizations, and individuals with a personal interest in school safety, have been encouraged to participate on the committee. California public schools are required to comply with the Federal “No Child Left Behind” legislation and California Education Code (CEC), Section 35294, dealing with the preparation of “Safe School Plans.” Each school is required to prepare such a plan to address violence prevention, student wellness, emergency preparation, traffic safety and crisis intervention. The Model Safe School Plan (SSP) has been developed for use as a template in preparing and annually updating Safe School Plans. The purpose of the template is to standardize Safe School Plans throughout the District and minimize the time required for annual updates. The SSP is comprised of two volumes: Volume 1 – CSHS (Coordinated Safe and Healthy School) Plan, Prevention Programs and Volume 2 – Emergency Procedures. Site Administrators are to ensure the updating of SSP, Volume 2 (Emergency Procedures) by October 1, 2008, and SSP, Volume 1 (CSHS Plan, Prevention Programs) by December 1, 2008. In order to meet the SSP deadlines, there are suggested meeting times and tasks to be accomplished by the School Safety Planning Committee using collaboration and input from all stakeholders. The Safe School Plan may also include a survey of the area surrounding each District school. The intent of this survey is to identify any potential “high risk” facilities sharing a property boundary with the school. The survey also documents industrial facilities within a 500 foot radius of each school. The information is available on the Office of Environmental Health and Safety (OEHS) website, www.lausd-oehs.org. School Nurses are often consulted regarding potential sources of contamination and odors. All incidents involving an off-site source of chemical odors should be reported to OEHS at (213) 241-3199 and the AQMD at (800) 288-7664. The School Safety Planning Committee involves the School Nurse. The School Safety Plan includes assessing school crime, identifying strategies and programs to promote school safety and address the schools procedures for complying with existing laws related to school safety, suspected child abuse reporting procedures, disaster procedures, routine and emergency response procedures; suspension, expulsion, or mandatory expulsion recommendations; procedures to notify teachers of dangerous pupils; sexual harassment policy; provisions of any school-wide dress code; procedures for safe ingress and egress; safe and orderly environment, and rules and procedures on school discipline. The comprehensive Safe School Plan must also comply with the principles of the Safe and Drug-Free Schools and Communities Act and address policies and procedures for dealing with hate crimes. The School Nurse is involved in many aspects of the safe school environment. The School Nurse may be consulted regarding foodborne illness and Food Handler’s Clearance Procedures. The program will also ask School Site Administration to “Create/Edit Off-Hours/Emergency Contact Information”. The information on this screen will be used to contact school site personnel in the event of any emergency. The information that is entered will be encrypted and sent only to the Los Angeles School Police Watch Commander. The program will allow the information to be updated and changed to reflect changes in school site personnel. The provision of the School Nurse personal information is at the discretion of the individual School Nurse. Mandated trainings are accomplished at least annually and as needed. When Safe School Plans are audited, the District’s Safety Officer may request a copy of the OSHA/Bloodborne Pathogen Plan Training participants. The Safety Officer will make and leave a copy of his/her report with the Site Administrator. Any negative finding in the audit, which reflects on the School Nurse, must be reported to the Local Nursing Administrator. Safety Officers are not authorized to “evaluate” the School Nurse and any such negative indications of School Nurse service are not valid. School Safety Plans are evaluated and amended annually and as necessary. School Nurses may be asked to serve as the Health Professional Resource for Safe School Committees. The school district receives funding from the State and Federal government by adhering to the regulations for safe school readiness as dictated in the Standardized Emergency Management System (SEMS). Many California schools implemented the National Emergency Management System (NEMS) in 2006. School Nurses are identified as first responders in the SEMS and NEMS. School Nurses also provide health program information and sign the scorecard and the Certification Page. Contact the Local Nursing Administrator for assistance.

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Refer to Reference Guide REF-1242.5 dated August 5, 2007, Office of Environment Health and Safety, “2008 – 2009 UPDATE OF SAFE SCHOOL PLANS VOLUME 1 CSHS PLAN (PREVENTION PROGRAMS) AND VOLUME 2 (EMERGENCY PROCEDURES)” and Refer to Memorandum No. MEM-1611 dated March 4, 2005, Office of Environmental Health and Safety, “INDUSTRIAL FACILITIES IN PROXIMITY TO SCHOOLS”.

EMERGENCY PROCEDURES REFERENCE GUIDE The District has a policy in the event of a major disaster during school hours. Information Technology Division has printed a REFERENCE GUIDE OF EMERGENCY PROCEDURES, Student Auxiliary Services. School Nurses may receive requests to provide inservice/professional staff development to school staff on Emergency Procedures and Disaster Preparedness. This flip chart is available to school sites. Contact Bob Spears in Emergency Services (213) 241-3889.

SCHOOL EMERGENCY RESPONSE BOXES As part of the Safe School Plan, each school stores written materials needed to manage a critical incident in the School Emergency Response Box. Every elementary school has one box, every middle school two boxes and every high school has three boxes. Schools who want to purchase additional boxes can order them through the District Warehouse using Commodity Code 345-32-48385. Currently, many schools are using electronic “paperless” records for storing student and school information. During an emergency, schools may not have access to electronic data and must instead refer to written records. The District’s Reference Guide provides a list of critical written materials and a recommended location for storing these materials for retrieval and use during an emergency incident. The School Emergency Response Box provides Site Administrators a central location for storing student and other information that is essential for the effective management of a critical incident. The School Emergency Response Box serves as a central portable repository for critical information that can be easily accessed and used during an emergency or shared with first responders. School Nurses are considered first responders. Schools are asked to use the School Emergency Response Box Information Inventory as a checklist for the contents of the box. The School Emergency Response Box must be kept in a secure location and be readily available in an emergency. Schools should put the boxes in the locked Emergency Supply Bin or in an alternative secure central location where it will be readily available for retrieval during an emergency. Specific staff should be assigned the responsibility of making sure that the School Emergency Response Box is retrieved and brought to the school’s command post. The contents of the box must be kept current. It is suggested that whenever computerized reports are run for changes in school calendar or schedule, extra copies be printed for inclusion in the box. School staff should also be vigilant for any information that would be of assistance during an emergency and should put copies in the box. The School Nurse may be asked to supply a list of students with Special Needs. The list should be placed in a sealed envelope and labeled “CONFIDENTIAL HEALTH INFORMATION. TO BE OPENED BY AUTHORIZED LICENSED PERSONNEL.” In the event that a campus must be evacuated and students moved to another facility, the School Emergency Response Boxes go with the students since it contains critical information needed to reunite students and parents. Refer to Reference Guide Number REF-3284.0 dated September 19, 2006, Office of Environmental Health and Safety, “SCHOOL EMERGENCY RESPONSE BOXES”.

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HAZARDOUS PRODUCTS AND HAZARDOUS WASTE DISPOSAL PROCEDURES A safe environment for student academic achievement is always a consideration. The District lists hazardous products into 4 categories based on the properties exhibited. Corrosive substances or vapors deteriorate or irreversibly damage body tissues with which they come in contact and erode the surface of other materials. Flammable substances are capable of burning in the air at any temperature. Toxic substances may poison, injure or be lethal when they are eaten, absorbed through the mouth and stomach, absorbed through the skin or inhaled into the lungs. Reactive substances can produce toxic vapors or explode when they react with air, water or other substances. In describing/charting episodes involving hazardous products, School Nurses should use these terms. Hazardous waste shall be stored in a closed Department of Transportation (DOT)-approved container and affixed with a hazardous waste label. The accumulation date must be filled out which is the date of the first drop of hazardous waste. Hazardous waste liquids shall be stored inside an approved secondary containment system. All hazardous waste storage areas are to be posted with a “Hazardous Waste Storage Area, Authorized Personnel Only” sign. In addition, the area shall be equipped with an eye wash station, telephone or hand-held two way radio and portable fire extinguisher. Hazardous waste storage areas are inspected weekly by District personnel to identify leaks or deterioration of containers or containment areas caused by corrosion. Inspection Forms must be maintained on site for at least three years. Most hazardous waste must be shipped within 90 days of the first accumulation date unless prior approval is obtained from OEHS. A registered hauler must ship the waste to a lawfully permitted facility. Biohazardous waste such as Sharps containers transported by School Nurses, must be accompanied by a completed tracking document (enclosed) and a valid, current Waste Hauler’s Permit (enclosed). Note: Thermostats, fluorescent lamps, light bulbs containing mercury, computer monitors and alkaline batteries are considered hazardous waste and should be collected in DOT-approved containers, affixed with a “Universal Waste” label and shipped by District Personnel to a permitted facility. Refer to Reference Guide REF-4149.0 dated February 26, 2008, Office of Environmental Health and Safety, “DISPOSAL PROCEDURE FOR HAZARDOUS WASTE AND UNIVERSAL WASTE” and Office of Environmental Health and Safety, SAFETY ALERT, No. 04-02 dated January 2004, “REPORTING SAFETY HAZARDS”.

REPORTING SAFETY HAZARDS Safety hazards must be reported to be corrected. School Nurses are often the recipient of these reports. It is essential that any safety hazard reported to the School Nurse be then reported to the appropriate school personnel for remediation. Each Local District has a Safety Officer from the Office of Environment Health and Safety (OEHS) assigned to serve the applicable schools. OEHS can be contacted at (213) 241-3199. Student and staff safety as well as legal considerations are important issues. If the reported safety hazard is not addressed, the Site Administrator should be provided with written documentation. (A copy of any School Nurse correspondence should be sent/faxed to the Local Nursing Administrator.) Refer to Office of Environmental Health and Safety, SAFETY ALERT, No. 04-02 dated January 2004, “REPORTING SAFETY HAZARDS”.

SEISMIC BRACING Seismic bracing is required for file cabinets, book shelves, and other heavy free standing objects to minimize hazards associated with falling objects in the event of an earthquake. School Nurses should not install new equipment, or relocate equipment which has been previously braced.

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Refer to SAFETY GRAM No. 02-05 dated June 2002, Office of Environmental Health and Safety, “SEISMIC BRACING”.

SHELTERING-IN-PLACE When a hazardous substance is released in outdoor air, “Shelter-in-Place” is a common method of protecting students and personnel from potential exposure. To be effective, this method depends on the rapid movement of students indoors, and the prompt shutdown of building ventilation systems to prevent outside air from entering the building. “Shelter-in-Place” should not be confused with “Campus Protection”, which isolates students from an act of violence or other physical hazard, and does not include the shutdown of air handling systems. In order to quickly implement the Shelter-in-Place procedure, it is necessary that facility personnel be familiar with the location and operation of the heating, ventilation and air conditioning (HVAC) system. In order to prepare for effective Shelter-in-Place, the Plant Manager and other members of the Security/Utilities Team have specific responsibilities. The School Nurse must isolate symptomatic students and treat for possible exposure to airborne hazardous substances. Contact your Local Nursing Administrator as soon as possible. For information related to Shelter-in-Place Procedures refer to the Office of Environmental Health and Safety (OEHS) Model Safe School Plan – Emergency Procedures. For the Model Plan contact OEHS at 1-888-4554665. Refer to Reference Guide REF-1314 dated September 24, 2004, Office of Environmental Health and Safety, “EMERGENCY DRILLS AND PROCEDURES” and Office of Environmental Health and Safety, SAFETY ALERT, No. 03-09 dated July 2003, “PREPARATIONS FOR SHELTERING-IN-PLACE”.

SCHOOL SITE EMERGENCY/DISASTER SUPPLIES After a catastrophic disaster many of the District’s 100,000 plus transported students may not be able to return home until the transportation system is restored. Also, the reunion of resident students and their parents may be delayed for the same reason. It is the responsibility of the school staff to care for students until they are reunited with their parents or approved designees. It is the responsibility of the Site Administrator to develop and implement plans to provide water, food and emergency supplies for at least 72 hours following a major emergency incident. School Nurses may be asked to serve as the Health Professional for procuring and safeguarding supplies and for providing assistance during the disaster. Schools should have one disaster kit per 400 enrollees. Students with special health needs should leave adequate medication/equipment for emergencies. Funding sources for disaster supplies are referenced in Reference Guide-802. Refer to Reference Guide REF-802 dated February 5, 2004, Office of the Environmental Health and Safety, “SCHOOL SITE EMERGENCY/DISASTER SUPPLIES”.

STORAGE OF EMERGENCY WATER The District has supplied schools with 55-gallon drums for storage of water to be used in case of an emergency. Storage of water in containers should be done carefully and efficiently to maximize storage time and to insure the water will remain usable when needed. Each school must have in storage a 3-day supply of emergency water, based on ½ gallon of potable water per day per person (total number of students and staff). A school of 500 would need 500 x ½ x 3= 750 gallons of water ÷ 55 equals 14 55-gallon drums. The 55gallon drums must be clean and meet Food and Drug Administration (FDA) and Department of Transportation (DOT) requirements for contact with food and water and be chemically purified with fresh, unscented liquid chlorine household bleach (5.25% sodium hypochlorite). Using two tablespoons of bleach per 55-gallon drum - do not over treat and do not use granulated (dry) bleach or scented liquid chlorine bleach or color safe bleach or bleach with added cleaners. They are poisonous. LAUSD has specific procedures for cleaning,

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filling, storing, refilling, labeling and checking the emergency water supply containers. For information regarding water quality storage and treatment telephone Environmental Health and Safety, Office of Emergency Services at (213) 241-3199. Refer to Reference Guide REF-801.1 dated June 10, 2008, Office of Environmental Health and Safety, “EMERGENCY WATER STORAGE” and Reference Guide REF-802 dated February 5, 2004, Office of Environmental Health and Safety, “SCHOOL SITE EMERGENCY/DISASTER SUPPLIES”.

CAFETERIA EMPLOYEES RESPONSIBILITIES DURING EMERGENCIES The LAUSD has specific procedures regarding the responsibilities of the cafeteria staff in an emergency situation occurring during working and non-working hours. School Nurses may be asked to assist at a school site designated as a Red Cross Shelter providing meals. Refer to Bulletin No. C-51 (Rev) dated April 24, 2001, Business Services Division, Office of the Chief Financial Officer, “RESPONSIBILITIES OF CAFETERIA EMPLOYEES DURING PERIODS OF EMERGENCY”.

EMERGENCY DRILLS AND PROCEDURES The Coordinated Safe and Healthy School Plan incorporates emergency drills and procedures. School Nurses should be familiar with District policies regarding emergency procedures and drills (e.g. fire, earthquake, drop, take over, campus protection). During an emergency/disaster the administrator shall instruct all students and staff to evacuate to the designated Emergency Assembly Area when appropriate. This allows for the accurate accounting of students and staff, provision of aid to those in need, and offers an opportunity to disseminate information. During an emergency, students shall remain on the school site until reunited with parents(s) or designees, and/or the Administrator determines if the environment is safe to disperse students to their homes. Use of the Request and Reunion Gates Procedure for release of students is highly recommended. Students traveling on school buses will receive instructions from bus drivers during any type of emergency. Buses may report to the nearest school after an emergency until further information is received. Civil Defense Policy, Public Law 875 Disaster Act allows administrators to require school employees to remain on site during specified emergencies/disasters. School Nurses must inform the Site Administrator and the Local Nursing Administrator as soon as possible when 9-1-1 has been called. Refer to Reference Guide No. REF- 1314 dated September 24, 2004, Office of Environmental Health and Safety, “EMERGENCY DRILLS AND PROCEDURES”.

SCHOOL TRAFFIC SAFETY AND EDUCATION The State of California, Department of Transportation (CALTRANS) and local law enforcement/ transportation agencies establish traffic safety requirements for school sites, including those associated with the posting of warning signs, pavement markings, crossing guards, on-street parking restrictions, safe routes to school, stop signs and traffic signals. The Office of Environmental Health and Safety (OEHS) works with these agencies to assist school administrators in receiving necessary support for resolving traffic safety issues. The District has resources available to assist with Traffic Safety (e.g. restricted parking, crosswalks, advance warning signs, pavement markings, traffic controls, and crossing guards) and safety education. For Traffic Safety Information, telephone the Office of Environmental, Health and Safety (213) 241-3199.

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Refer to Office of Environmental Health and Safety, SAFETY ALERT, No. 05-07 dated May 2005, “SCHOOL TRAFFIC SAFETY TIPS” and Reference Guide No. REF-1404 dated November 5, 2004, Office of Environmental Health and Safety, “SCHOOL TRAFFIC SAFETY”.

CALIFORNIA SAFETY HELMET LAW California State Law requires all children ages 17 and under to wear a safety helmet whenever riding a bicycle, scooter, rollerblades, and skateboard. The law requires the riders of motorized scooters and motorized skateboards to be at least 16 years of age and wearing a safety helmet. In 2001, the National Highway Traffic Safety Administration reported 732 fatalities and 45,277 injuries involving pedal cyclists. Schools must implement a policy enforcing the California State Safety Helmet Law. Local law enforcement and School Police cite students riding bicycles, scooters, skateboards, motorized scooters, rollerblades, and motorized skateboards without helmets. Law enforcement will also issue a notice for the violators to attend the School Safe Traffic Zone Unit citation diversion class to satisfy the Los Angeles County Superior Courts requirements, so that court fees may be waived. The School Safe Traffic Zone Unit offers traffic safety education programs and will visit all elementary, middle and high schools during the school year. This program instructs students in traffic laws and helmet usage. To schedule a school visit, contact School Safety Traffic Unit at (213) 241-7887. Refer to Reference Guide No. REF-1242.4 dated August 15, 2007, Office of Environmental Health and Safety, “2007-2008 Update of Safe School Plans Volume 1 (Prevention Programs) and Volume 2 (Emergency Procedures).”

EMERGENCY AND NONROUTINE TRANSPORTATION OF STUDENTS When transportation cannot be provided by the Parent/Guardian/Adult Designee, or when District, other agency, or emergency vehicles are not available, District personnel may provide student transportation. Specific procedures are followed and they include but are not limited to the following: • An adult listed on the emergency card must be present to receive the student(s) at the destination. • Drivers must not transport more persons than the vehicle was originally designed to carry safely or than the vehicle has seat belts. • Drivers and passengers must all wear seat belts and remain belted until exiting the vehicle. • Children under 40 pounds or 4 years old and under must be in a child restraint when riding in the vehicle. Children under 60 pounds or 6 years old must be in a booster seat. • Drop-off and pick-up children on the passenger side of the vehicle (next to the curb). • Do not pick-up or drop-off children on the opposite side of the street and cause children to jay walk, cross the street without adult supervision or walk between vehicles. Do not park in traffic lanes when picking up or dropping off children. • Follow all traffic lights, speed limit signs, crosswalk markings, and school crossing guards. • The “Authorization for Emergency/Non-Routine Transportation” Form must be signed by the Principal or authorized Certificated Designee and retained at the school site. • When transporting a student to a prearranged appointment, a Field Trip Slip [Form 34-EH-17 (Rev) 5/02] must have been signed by the parent/guardian/authorized caretaker. Critical emergencies require immediate attention. When a School Nurse or Administrator identifies a student as having a critical emergency: • Paramedics should be summoned directly through 9-1-1. • The parent/guardian/designee should be notified. • The Administrator or designee should take a copy of the student’s emergency card, accompany the ambulance to the hospital, and remain until a family member or representative arrives. • The Health Card never leaves the school site. • The Local Nursing Administrator must be telephoned as soon as possible.

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A copy of the student’s emergency card must be kept with the School Administrative Assistant or with another Principal’s designee and a copy should be provided to the School Nurse for follow-up. The California Education Code (CEC) 49408 is the reference provided to parents/guardians regarding the requirement to provide schools with the emergency card. C.E.C 49408 states “For the protection of a pupil’s health and welfare, the governing board of a school district may require the parent or legal guardian of a pupil to keep current at the pupil’s school of attendance, emergency information including the home address and telephone number, business address and telephone number of the parents or guardian, and the name, address and telephone number of a relative or friend who is authorized to care for the pupil in an emergency situation if the parent or legal guardian cannot be reached.”

A critically ill student is not to be transported by school personnel. Refer to Bulletin No. Z-53 dated March 4, 1999, Division of Student Health and Human Services, Deputy Superintendent, Operations and Support Services, “EMERGENCY AND NONROUTINE TRANSPORTATION OF STUDENTS” and Office of Environmental Health and Safety, SAFETY ALERT No. 05-07 dated May 2005, “SCHOOL TRAFFIC SAFETY TIPS”.

BUS ACCIDENT PROCEDURE Pupils traveling on school buses will receive instructions from bus drivers during any type of emergency. Buses may report to the nearest school after an emergency until further information is received. The School Nurse will observe/inspect any student with a complaint of an injury and send the completed School Nurse Report – Student Bus Accident Form (Rev. 9/90) to the Local Nursing Administrator. Special Education students and/or those students who have limited ability to report a health complaint will be observed/inspected by the School Nurse. Please make a Bus Accident Folder containing the necessary forms to be completed should you be requested to go to a school or to the bus location to check students. Contact your Local Nursing Administrator when responding to a bus accident. TRANSPORTATION STUDENT BEHAVIOR The safe and orderly transportation of students necessitates responsible behavior by students while boarding, riding or alighting from school buses. Guidelines and procedures have been adopted to encourage and promote safe and orderly transportation. All transported students and their parents, upon commencing a District transportation program, receive school bus transportation information that includes a list of standards of behavior related to riding a school bus. The District has a specific process to address student misconduct. Students (including Special Education students) may be suspended from bus transportation. Refer to Reference Guide No. REF-3775.0 dated July 1, 2007, Business Services Division, “SAFE RIDING PRACTICES PROGRAM” and Bulletin No. BUL-631 dated December 2, 2003, Business Services Division, Chief Operating Officer, “GUIDELINES AND PROCEDURES RELATING TO STUDENT BEHAVIOR ON SCHOOL BUS”. PARENTS/GUARDIANS ON SCHOOL BUSES The District has a specific process for parents/guardians riding school buses. The Transportation Branch regularly receives requests from parents/guardians to ride school buses as observers and/or to participate in an activity with their child at the school. Requests are also received to allow a nontransported student to ride the bus for an inter-home visitation with a traveling student. There are procedures to process these requests and to insure proper identification of adults or non-regularly

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transported students riding the school bus. The bus driver will permit the parent/guardian or authorized student to ride the bus upon: • receiving notification from the Area Bus Supervisor of the request. • receiving from the parent the pink copy of Form 78.226 signed by the principal. The bus driver will keep this form and return it to the Area Bus Supervisor. Form 78.226 is provided to the parent by the Site Administrator. After the parent signs the form and returns it to the Administrator, the Administrator submits the form to the Area Bus Supervision at least 24 hours prior to the requested date(s). Refer to Bulletin No. BUL-1863.0 dated August 3, 2005, Business Services Division, “PROCEDURES TO PERMIT PARENTS/GUARDIANS TO RIDE IN SCHOOL BUSES”. TEACHER/BUS DRIVER COOPERATION The conduct of students on school buses requires the assistance of teachers/coaches. The Board requirements and the duties of teachers/coaches are important for bus safety. There are many examples of serious situations that could develop if safety rules such as remaining seated, quiet conversation, keeping arms and body inside the bus, etc., are not enforced. To be sure that the school trip is as safe as possible, both driver and teachers must strictly enforce these bus safety rules. Before a bus trip it is the duty of the teacher/coach to complete a “School Bus Passenger List” with the students’ name, home addresses, telephone numbers, parent’s names and work telephone numbers. A copy of this form must be given to the bus driver before departure. This list will be used by school personnel on the trip to notify parents in the event of an accident, breakdown, or other problem. Refer to Bulletin No. BUL-1335 dated October 19, 2004, Business Services Division, “TEACHER/BUS DRIVER COOPERATION ON THE BUS”. PROCEDURES FOR BUS DELAYS Conditions may result in the late arrival of buses. Conduct of students at bus stops, bus stop supervision and notification of delays is included in a notification to students/parents/guardians every year. There is a specific process for students to follow if a bus is late by more than 20 minutes. Refer to Reference Guide No. REF-909.1 dated April 15, 2008, Business Services Division, “LATE BUS INSTRUCTION FOR STUDENTS”. BUSES FOR STUDENT TRIPS The safe transportation of students requires strict adherence to the State law as well as the District’s rules and regulations. There is a specific process for arranging District bus and private school bus transportation. Please telephone the Transportation Branch Accounting Unit at (323) 342-1320, Bus Operations Dispatch at 1-800-522-8737, or (323) 342-1460 for assistance in arranging District Transportation for student trips. Transportation requests for all students trips must be received a minimum of 15 working days prior to the trip. Refer to Bulletin No. BUL-1521 dated February 1, 2005, Business Services Division, “BUSES FOR STUDENT TRIPS AND OTHER SCHOOL ACTIVITIES”. SCHOOL JOURNEYS/FIELD TRIPS School journeys and field trips are authorized by school site Principals. The Principal is responsible for ensuring the safety of students as well as the educational value of each trip. Students with current IEPs and 504 plans are eligible to participate in such activities. School Nurses may be asked to prepare a health plan to meet the specific needs of students. The School Nurse may be asked to provide information to assist students with special health needs. A lift bus may be required for a “physically disabled” student. Communication with parents is essential. Parents should be encouraged to make arrangements if their daughter/son requires injectable medications (e.g. insulin)

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during the field trip. At this time there is no separate budget allocation to provide a substitute School Nurse to attend a field trip. For assistance with health plans for field trips and requests for assistive personnel contact your Local Nursing Administrator. Parents/Guardians must provide written permission when School Nurses transport students for planned appointments or scheduled activities (e.g. audiometrist exam). For such purposes the School Nurse must have parent/guardian complete and sign the permission for field trip and authorization for medical care. (Form No. 34-EH-17 Rev. 5/02) Refer to Reference Guide No. REF-2111.0 dated July 24, 2006, Office of Instruction, “FIELD TRIPS HANDBOOK AND REVISED PROCEDURES” and Reference Guide No. REF-3775.0 dated July 1, 2007, “SAFE RIDING PRACTICES PROGRAM”. EARTHQUAKE EMERGENCY PLANS FOR BUSES If a major earthquake causes extensive roadway and structural damage within the boundaries of the Los Angeles Unified School District (LAUSD), a Transportation Branch emergency plan is necessary to insure the safety of traveling students. The procedures in this plan applies to students riding both LAUSD and contract buses. This plan will be implemented only in case of a major earthquake (usually 5.0 or above on the Richter scale) and/or where there is obvious and widespread damage to roads and structures. In minor earthquakes, “take cover” procedures will be initiated for students and buses will be parked in a safe location off the road or freeway. If there is no reported damage to roads and structures, normal operations should resume in about 15 minutes. For emergency plans refer to required procedures specific to early morning earthquakes, earthquakes occurring with students aboard buses, earthquakes occurring while students are in school, and earthquakes occurring when students are participating in out of area trips. Bus drivers who are not at a school site at the time of the earthquake will drive to their first pickup school if possible, or the nearest school or bus lot that can be accessed safely and wait for further instructions before proceeding. Parents are often desperate for information following a major earthquake. The Transportation Branch will open parent concern lines at 1-800-LA BUSES or 1-800-522-8737. However, because of the high volume of anticipated calls, there is no guarantee that all incoming calls can be received and answered in a major emergency. Radio and TV announcements will be made by the District and parents should be advised to monitor those broadcast. Refer to Bulletin No. BUL-698 dated December 22, 2003, Business Services Division, “TRANSPORTATION BRANCH EARTHQUAKE EMERGENCY PLANS”. BUS TRAFFIC IN AND AROUND SCHOOL SITES LAUSD informs students and school staff of the safety procedures to be observed whenever there are moving vehicles in or around the school grounds. Periodic assemblies and other programs throughout the school year should include reminders that accidents can very easily happen through unsafe acts and “horse play” around moving vehicles on school grounds. Teachers, administrators and supervising personnel should assure the safety of students around such areas. When students come within ten feet of a vehicle while it is in motion, the driver must stop until the way is clear. Adherence to and enforcement of the eight-miles-per-hour speed limit on school grounds is imperative. Refer to Bulletin No. BUL-910 dated April 13, 2004, Business Services Division, “BUS TRAFFIC IN AND AROUND SCHOOL SITES”.

DISCIPLINE FOUNDATION POLICY: SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT The LAUSD believes that every student, pre-school through adult, has the right to be educated in a safe, respectful and welcoming environment. Every educator has the right to teach in an atmosphere free from

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disruption and obstacles that impede learning. This is achieved through the adoption and implementation of a consistent school-wide positive behavior support and discipline plan for every school in LAUSD. All school level discipline plans will be consistent with the Culture of Discipline: Guiding Principles for the School Community and Culture of Discipline: Student Expectations. This includes teaching school rules and socialemotional skills; reinforcing appropriate student behavior; using effective classroom management and positive behavior support strategies by providing early intervention for misconduct and appropriate use of consequences. The District’s adoption of this foundation policy establishes a framework for developing, refining and implementing a culture of discipline conducive to learning. School-wide positive behavior support is based on research that indicates the most effective discipline systems use proactive strategies designed to prevent discipline problems. Before consequences are given, students must first be supported in learning the skills necessary to enhance a positive school climate and avoid negative behavior. In the event of misconduct, there is to be the appropriate use of consequences. Ongoing monitoring shall be used to ensure that equitable school-based practices are implemented in a fair, non-discriminatory and culturally responsive manner. The District’s Culture of Discipline: Guiding Principles for the School Community establishes a standard for all LAUSD schools. All District schools are required to align their school’s discipline plans and rules to this District standard. The goal is to maximize consistency in school-site practice, while allowing schools to personalize rules, provided they are consistent with the tenets and content of this bulletin. All students, parents, teachers, school administrators, school support personnel, school staff, visitors and community members are expected to understand and model the Culture of Discipline: Guiding Principles for the School Community and implement them at every institutional level. Culture of Discipline: Student Expectations provides additional guidance to students regarding appropriate behavior. It is only with the understanding, collaboration and cooperation of everyone who has a stake in the education of our youth that we can succeed in creating learning environments that are conducive to optimum academic achievement for all students. The successful implementation of this policy is everyone’s responsibility. Every student, parent/caregiver, teacher, administrator, school support personnel, school staff, Local District Staff, Central Office staff, visitor and community member engaged in education activities has a role. This includes: • supporting a school-wide positive behavior support and discipline plan consistent with the tenets of this policy; • knowing, communicating and consistently monitoring this policy, the Culture of Discipline: Guiding Principles for the School Community, and the school-wide positive behavior support and discipline plan; • maintaining open lines of communication between staff, students and parents/caregivers; • using positive response strategies and appropriate corrective feedback for disruptive students (see Attachment I); and • collaborating and partnering with after-school programs and outside agencies, when appropriate. The Bulletin outlines responsibilities for students, parents/caregivers, teaching staff, administrators, visitors, community members, and support services personnel. School Nurses are support service personnel who are responsible for teaching, enforcing, advocating and modeling Culture of Discipline: Guiding Principles for the School Community, and for supporting the implementation of a school-wide positive behavior support and discipline plan to maintain a safe and nurturing school climate. School support personnel are responsible for monitoring, reinforcing and acknowledging appropriate behaviors consistent with Culture of Discipline: Student Expectations and the school rules. In addition, school support personnel will assist students in accessing appropriate resources, directly matching student needs to available resources. When student behavior disrupts the learning or working environment, the appropriate school support personnel will work collaboratively with teachers and other school and District personnel to develop and implement plans for more intensive instruction and support, which includes working with District and community resources. Refer to Bulletin No. BUL-3638.0 dated March 27, 2007, Educational Services, “DISCIPLINE FOUNDATION POLICY: SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT”.

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ANTIBULLYING POLICY (IN SCHOOLS, AT SCHOOl-RELATED EVENTS AND TRAVELING TO AND FROM SCHOOL) In keeping with its responsibility to provide a safe and healthy environment for all students and staff, the Los Angeles Unified School District requires all schools and all personnel to promote among students and staff mutual respect, tolerance, and acceptance. The District will not tolerate any behavior that infringes on the safety or well-being of any student or staff member and will not tolerate retaliation in any form when bullying has been reported. A student or a staff member shall not intimidate or bully any other student or staff member through words or actions. Personnel at all levels must provide information on the prevention and correction of bullying to students, parents, and staff and are responsible for taking corrective action to prevent bullying in school, at school events, and to or from school. School Nurses have an obligation under District policy to report incident(s) of bullying directed at him or her at any time without fear of retaliation. Perpetrators may be students, staff, or non-school based individuals. “All students and staff of public primary, elementary, junior high and senior high have the inalienable right to attend campuses which are safe, secure and peaceful.” [Article 1, Section 28 (c) of the California State Constitution]. Bullying is defined as aggressive behavior that involves an imbalance of real or perceived physical or psychological power among those involved. Typically, the behavior is repeated over time and includes the use of hurtful words and/or acts. Bullying behavior may include, but are not limited to, the following: Verbal: Hurtful name-calling, teasing, gossiping, making threats, making rude noises, or spreading hurtful rumors. Nonverbal: Posturing, making gang signs, leering, staring, stalking, destroying property, using graffiti or graphic images, or exhibiting inappropriate and/or threatening gestures or actions. Physical: Hitting, punching, pushing, shoving, poking, kicking, tripping, strangling, hair pulling, fighting, beating, biting, spitting, or destroying property. Emotional (Psychological): Rejecting, terrorizing, extorting, defaming, intimidating, humiliating, blackmailing, manipulating friendships, isolating, ostracizing, using peer pressure, or rating or ranking personal characteristics. Cyber Bullying: Sending insulting or threatening messages by phone, e-mail, Web sites, or any other electronic or written communication. The Los Angeles Unified School District has a policy for the prevention of bullying and a policy on conflict resolution. Strategies to stop bullying include but are not limited to: • the distribution of student and staff questionnaires on bullying including information on the extent of the problem, problem solving techniques, awareness, rules of conduct and interventions. • the notification to parents and strategies for parent involvement in solving bullying issues. • the implementation of a classroom program against bullying. • the initiation of procedures to intervene fairly and effectively to help both the victim and the bully. School Nurses (as all District Staff) have a responsibility to: • create an environment where students understand that bullying is inappropriate and will not be tolerated. • discuss with students all aspects of the antibullying policy and strategies to prevent bullying. • encourage students to report bullying incidents. • learn to recognize the indicators of bullying behavior. • intervene immediately and take corrective action when bullying is observed. • understand individual responsibility not only to intervene when bullying is observed, but also, to report incidents and actions to appropriate District offices or outside agencies, as required. It is important to note that bullying may, at times, be part of a continuum of violence and that some bullying actions can and do constitute other categories of misconduct such as sexual harassment, hate crimes, assault, or child abuse, and as such, they would violate other District policies. When bullying behavior does escalate to the level of violating other District policies, District personnel are obligated to adhere to appropriate District reporting guidelines and may be required to report to one or more of the following District offices or outside agencies: the Educational Equity Compliance Office, the Student Discipline Proceedings Unit, a Local District Office, LAUSD School Police, Local Law Enforcement, and/or the Department of Children and Family Services. Contact the Local Nursing Administrator for assistance with Reporting Requirements.

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Refer to Bulletin No. BUL-1038.1 dated August 16, 2004, Office of the Chief Operating Officer, “ANTIBULLYING POLICY (IN SCHOOLS, AT SCHOOL-RELATED EVENTS, AND TRAVELING TO AND FROM SCHOOL)”.

MANDATED REPORTING OF CERTAIN STUDENT BEHAVIOR The law requires that certain student behavior must be reported to teachers pursuant to Education code (E.C.) Section 49079 and Welfare and Institutions Code (W.I.C.) Section 827. For compliance with E.C. Section 49079, mandated reportable acts are those that would also have been a reason for suspension or expulsion. These acts are include sexual harassment, hate violence, threats, intimidation against District personnel and pupils; and terroristic threats. “Yellow Folders” are files that the Principal must establish for every student at his or her school for whom the District has a record indicating that the student engaged in, or was reasonable suspected to have engaged in, any of the mandated reportable acts. The “Yellow Folder” contains hardcopy information of the student’s E.C. 49079 records and W.I.C. Notices. It is not part of the student’s cumulative records or health record and must be maintained at the student’s school of attendance. Most health information and the Health Record Cards are confidential and are not shared or copies, except with written parent/guardian permission and as mandated by Court Order or during designated times of emergency. Refer to Bulletin No. BUL-3929.1 dated March 3, 2008, Student Health and Human Services, “MANDATED REPORTING OF CERTAIN STUDENT BEHAVIOR”.

STUDENT EXPULSION GUIDELINES Legal mandates and District policies/procedures regarding student expulsions apply to all schools and students of the District, including special education students. The School Nurse must complete a report summarizing the student’s health. This form should contain only minimal/essential health information and is intended for use by the School Nurse assigned to the Student Expulsion Intervention Unit. Contact your Local Nursing Administrator for assistance. Refer to Bulletin No. P-61 dated April 11, 1994, Office of the Deputy Superintendent, “GUIDELINES FOR STUDENT EXPULSION” (for Student Health Summary Form use Attachment “J” contained in the Bulletin).

STUDENT SUSPENSION GUIDELINES In recent years legislation has changed the student suspension policies and procedures. These procedures are consistent with State and Federal Laws and reflect Board of Education policy. Whenever a student who receives special education services engages in conduct that warrants a suspension, an IEP team meeting should be convened immediately upon the student’s return to school. The meeting must occur within 10 days of the suspension. School Nurses may provide additional, recent health information when applicable. Refer to Bulletin No. BUL-3819 dated August 21, 2007, Student Health and Human Services, “GUIDELINES FOR STUDENT SUSPENSION”.

GUIDELINES FOR THE SCHOOL ATTENDANCE REVIEW BOARD (SARB) AND SITE SCHOOL NURSES State law mandates the School Attendance Review Board (SARB). The purpose of the SARB is to provide a coordinated community effort to meet special needs of students with school attendance problems. The Credentialed School Nurse is one of the active members of this Board. A School Nurse who is scheduled in the

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Local Nursing Administrator’s office serves as the SARB School Nurse. The role of the School Nurse with the SARB process is to be the consultant with expertise to interpret and evaluate the presence or absence of medical and health conditions that affect school attendance. The Site School Nurse should receive the SARB Student Health Information/Site School Nurse to SARB School Nurse Form (Form 33.59 Rev. 5/06) from the Pupil Services and Attendance (PSA) Counselor at least three weeks prior to the scheduled SARB meeting. The PSA Counselor completes the top portion of the form. The School Nurse then completes Form 33.59 and faxes the information for the designated student(s) to the SARB School Nurse in the Local Nursing Administrator’s Office at least two weeks prior to the scheduled meeting. The School Nurse should then mail (school mail) the original Form 33.59 to the Local Nursing Administrator. No copies should remain at the school site. (The Site School Nurse may attend the SARB meeting with the approval of both the Site Administrator and Local Nursing Administrator. The School may contact the SARB School Nurse for the scheduled time.) After the SARB meeting, the SARB School Nurse will send information to the Site School Nurse using the Student Health Information Follow-Up/SARB School Nurse to Site School Nurse Form (Form 33.58 Rev. 5/06). Refer to the California Education Code: Article 6, Sections 48290, 48263, 48200, and 48293 and the California Welfare and Institutional Code: Section 601.1.

POSSESSION OF DISTRICT EQUIPMENT OFF-SITE District equipment and/or supplies may not be loaned to any District employee, group or other person for personal use. Equipment, which is temporarily taken away from a site to perform District functions must be strictly controlled and accounted for. Refer to Office of the Chief Financial Officer, Bulletin No. DB15 (Rev), “Written Authorization for Possession of District Equipment Off-Site” to obtain the form for written authorization to remove equipment. The time period that equipment is temporarily away from the site should be kept at a minimum and should not exceed six months. All such equipment must be returned to the site prior to taking the annual equipment inventory. Highly desirable and portable equipment, such as computers, typewriters, VCR’s and televisions, must be anchored with security devices and housed in rooms that can be secured. When these items are not in use, they should be stored in secured rooms or locked closets. Equipment shall not be taken home to be stored. In addition, all highly desirable and portable equipment items must be permanently marked “Los Angeles Unified School District” in a prominent area on the equipment. Refer to Bulletin No. BUL-953 dated May 10, 2004, Accounting and Disbursements Division, “CONTROL OF SITE EQUIPMENT” and Bulletin No. DB-15 (Rev) dated July 25, 2001, Division of Accounting and Disbursements, Office of the Chief Financial Officer, “WRITTEN AUTHORIZATION FOR POSSESSION OF DISTRICT MATERIAL OFF-SITE”.

BOMB THREATS The LAUSD has developed policies to assist administrators dealing with bomb threats. Procedures include a “Report of Bomb Threat” form included in the bulletin. The form outlines specific questions to ask the caller. School Nurses should use this form if they receive a bomb threat. Notify the Local Nursing Administrator as soon as possible. Refer to Bulletin No. N-49 (Rev) dated July 13, 2001, Educational Services, Office of the Deputy Superintendent, Instruction, “BOMB THREATS”.

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BIOTERRORISM (BT) In the aftermath of September 11, 2001, the Centers for Disease Control and Prevention (CDC) have provided school districts with critical information related to bioterrorism. The use of biological agents is attractive to terrorists because mass casualties can be incurred at a very low monetary cost to the terrorist. The production technology is readily available and the risk of detection is low. Production can be easily concealed due to the legitimate use of laboratory equipment for pharmaceutical and vaccine production. Terror and panic in the population can be caused by usage of historical scourges such as smallpox, plague, and anthrax. In addition, the delayed onset of illness in victims allows the perpetrator to escape long before detection, after an attack. There are many other challenges in recognizing a bioterrorist attack. Because of incubation periods, victims will most likely be widely dispersed before symptoms occur. The early signs and symptoms of possible bioterrorism (BT) agents are, for the most part, nonspecific. Most health care workers are generally not familiar with these rare organisms and the diseases they cause. Additionally, some organisms or their toxins could be dispersed in an airborne form, resulting in a different clinical presentation than what occurs with naturally acquired infection. Until recently, the current public health surveillance system, which depends primarily on passive reporting of confirmed disease cases, was not adequate for early detection. To prepare for potential BT, the Centers for Disease Control and Prevention (CDC) has defined three categories of high priority agents that pose a risk to national security (shown in Tables 1 and 2). Category A organisms are highest priority because they: a) can be easily disseminated or transmitted person-toperson; b) cause high mortality, with potential for major health impact; c) might cause panic and social disruption; and d) require special action for public health preparedness. Category B and C organisms are of descending concern. Since most American physicians have never seen any of these diseases, it is important that School Nurses should familiarize themselves with their signs and symptoms. School Nurses should refamiliarize themselves with techniques used to address decontamination, infection control, preparation for excess ill students and adults, and school security measures. The first cases resulting from a bioterrorist attack are likely to be detected by an astute clinician in an emergency department or a School Nurse. Early detection and rapid reporting to the Local Nursing Administrator will be critical in minimizing the impact of an attack. Bioterrorist attacks are likely to present as acute outbreaks of an unusual syndrome, or outbreak of illness in the wrong season or geographic area. The most critical step in response is early recognition that something unusual is occurring. Primary health care providers including School Nurses will probably be the first to observe and report bioterroristassociated illness or injuries. ALERT: To ensure legal authority for public health surveillance of possible biological terrorist (BT) events, effective immediately, smallpox has been added to the list of suspected or confirmed communicable diseases that are required to be reported. Contact your Local Nursing Administrator immediately. Table 1: Category A Agents – Highest Priority Agents and The Diseases They Cause Microorganism Bacillus anthracis Clostridium Botulinum (botulinum toxin) Hemorrhagic fever viruses (Venezuelan Equine Encephalitis, Ebola, Marburg, Lassa Fever, etc.) Yersinia pestis Variola major Francisella tularensis

Disease Anthrax Botulism Hemorrhagic fever Plague Smallpox Tularemia

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Table 2: Category B and C Agents Category B Coxiella burnetti (Q fever) Brucella species (brucellosis) Burkholderia mallei (glanders) Ricin toxin Ricinus communis (from castor beans) Epsilon toxin of Clostridium perfringens Staphylococcal enterotoxin B

Category C Nipah virus Hantaviruses Tickborne hemorrhagic fever viruses Tickborne encephalitis viruses Yellow fever Multi-drug resistant tuberculosis

Refer to Bulletin No. Z-72 dated September 3, 2002, Division of Student Health and Human Services, Office of the Senior Deputy Superintendent, Education Services, “BIOTERRORISM PREPAREDNESS RESPONSE: HEALTH PERSPECTIVE”.

WEAPONS OF MASS DESTRUCTION/WEAPONS OF MASS EFFECTS INCIDENTS The United States Department of Justice has published The Emergency Response Guidelines for Weapons of Mass Destruction Incidents. The words “Weapons of Mass Destruction” are changing to more accurately describe situations, such as the World Trade Center attack using a jet aircraft as a “weapon”. The new terminology being introduced by the Department of Defense is “Weapons of Mass Effects”. Key terms for school personnel have been identified. The following are the terms and definitions most relevant to the weapons of mass destruction (WMD) and potential protective actions. 1. Boiling Point is the temperature at which an agent boils. 2. Evacuate means to move all individuals from a threatened area to a safer place. To perform evacuation, there must be enough time for individuals to be warned, to get ready, and to leave an area. If there is enough time, evacuation is the best protective action. Begin evacuating individuals nearby and other individuals who are outdoors and/or in direct view of the scene. Send evacuees to a definite place, by a specific route, far enough away so they will not have to be moved again. Document who has been displaced and the relocation site. 3. Evaporation Rate is the rate at which a liquid changes to vapor at normal room temperature. 4. Expansion Ratio is the amount of gas that will be released from a liquid when it boils off (e.g. expansion ratio of 700:1 means that there will be 700 gallons of gas from 1 gallon of liquid). 5. Incubation Period is the period of time between exposure and the onset of symptoms. 6. Isolate Hazard Area and Deny Entry means keep all individuals away from the area if they are not directly involved in emergency response operations. Unprotected emergency responders should not be allowed to enter the isolation zone. This “isolation” task is done first to establish control over the area of operations. This is the first step for any protective actions that may follow. 7. Protective Actions are those steps taken to preserve the health and safety of emergency responders and the public during an incident involving releases of Weapons of Mass Destruction. Individuals in this area should be evacuated and/or sheltered inside buildings. 8. Rate of Action is the amount of time for a toxin to have an effect on the human system. 9. Sign is something you can see – a vapor cloud or blast effects. 10. Shelter-In-Place means individuals inside school buildings should remain inside until the danger passes. In the case of short-term releases and toxic vapor clouds, the material may be deflected by a multi-story building and pass by without affecting the occupants of the building. Shelter-In-Place

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protection is used when the evacuation of students cannot be performed. Direct individuals inside the building to close all doors and windows and to shut off all ventilating, heating, and cooling systems. Shelter-In-Place protection may not be the best option if (a) the vapors are flammable; (b) if it will take a long time for the vapors or gases to clear the area; or (c) if the buildings cannot be closed tightly. Vehicles can offer some protection for a short period if the windows are closed and the ventilating systems are shut off. Vehicles are not as effective as buildings for shelter-in-place protection. It is vital to maintain communications with competent individuals inside the building so that they are advised about changing conditions. The individuals sheltered should be warned to stay far from windows because of the danger from glass and projectile metal fragments if there is a fire and/or an explosion. 11. Symptom is something that a victim can tell you about – pain, discomfort, etc. 12. Vapor Density is how much an agent weighs compared to air. Air equals 1; therefore, any agent with a Vapor Density greater than 1 is heavier than air. 13. Vapor Pressure is the pressure exerted by a vapor in equilibrium with its solid or liquid phase. Contact your Local Nursing Administrator if you have questions and for additional information.

ZERO-TOLERANCE POLICIES FOR DRUG, ALCOHOL AND TOBACCO FREE SCHOOLS AND WORKPLACES In accordance with the provisions of the Federal and State Legislative Mandates, the District hereby notifies its employees and students of its commitment to promote and maintain a workplace and school environment that is drug, alcohol, and tobacco free. NOTICE TO ALL EMPLOYEES – DRUG FREE AND ALCOHOL FREE WORKPLACE The Federal Government has adopted various anti-drug regulations that require employers, including School Districts, to take certain measures to ensure that the workplace is free from illicit drugs and alcohol. These regulations are included in the Drug Free Workplace Act of the Drug Free Schools and Communities Act Amendments of 1990 and the Title IV Safe and Drug Free Schools and Communities Act of 1994. As required by these acts, the Los Angeles Unified School District hereby notifies its employees as follows: 1. The manufacture, sale, distribution, dispensing, possession, or use of illicit drugs and alcohol is prohibited in any and all District workplaces. 2. Violation of District Policy (reference in #1) by any employee will result in appropriate administrative or disciplinary action, including, but not limited to written reprimand, suspension, termination, and/or the requirement for satisfactory participation in and completion of a Drug and Alcohol Abuse Assistance or Rehabilitation Program. 3. Employees are required to notify the Employee Relations Section, Personnel Division, at (213) 2416591, of any criminal drug and alcohol statute conviction for a violation occurring in the workplace no later than five (5) days after such conviction. 4. Within thirty (30) days of receiving the required notice (referenced in #3), the District shall take appropriate administrative or disciplinary action (referred in #2). Sources of information and assistance concerning problems relating to substance abuse are available. The District provides a confidential employee assistance program to employees who wish assistance or information in matters related to various areas of personal problems, including drug and alcohol abuse. Employees and family members who need assistance in these areas are encouraged to use the District’s Mental Health Chemical Dependency Resource twenty-four hours a day, seven days a week, and the Districtsponsored health insurance plans, as appropriate. Effective January 1, 2003, the Employee Assistance

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Program through the Mental Health Network (MHN) was replaced by United Behavioral Health (UBH) which can be reached toll-free at 1-866-312-3077 twenty-four hours a day, seven days a week. NOTICE TO ALL EMPLOYEES – TOBACCO FREE SCHOOLS The Federal and State Governments have adopted various anti-tobacco laws that require schools to have adopted and fully implemented tobacco-free environment policies. These regulations are included in the Federal Goals Law, which took effect in December 1994, and California State Assembly Bill 816, which took effect July 11, 1994. As required by these laws, the Los Angeles Unified School District hereby notifies its employees as follows: 1. Smoking and the use of all tobacco products shall be prohibited on all District property, including District-owned or leased buildings and in District vehicles at all times by all persons, including employees, students, and visitors at any school or District site or attending any school sponsored events. (In accordance with California Assembly Bill 816 [1994], and Federal Legislation [Title IV], the District implemented the Tobacco-Free Workplace Policy on January 1, 1995.) 2. Violation of Paragraph 1 by any employee will result in appropriate administrative or disciplinary action, including, but not limited to, a counseling interview, verbal warning, and/or written reprimand. Refer to Bulletin No. BUL-3630 dated March 28, 2007, Office of the Chief Operating Officer, “IMPLEMENTING ZERO-TOLERANCE POLICIES FOR DRUG, ALCOHOL AND TOBACCO FREE WORKPLACES”.

PREVENTIVE MEASURES, MANDATORY PROCEDURES, AND LEGAL REQUIREMENTS FOR STUDENTS REGARDING DRUGS, ALCOHOL AND TOBACCO The Los Angeles Unified School District does not tolerate the use, possession, or sale of drugs, alcohol, or tobacco by students on school campuses or at school-sponsored activities. School administrators must take immediate action to prevent, discourage, and eliminate the use or possession of drugs, alcohol, and tobacco on campus and at school activities. School administrators should use a variety of measures to address these issues, including education, intervention, and discipline. The disciplining of students who possess, use, or sell drugs, alcohol, or tobacco must be in accordance with District policies concerning suspensions, opportunity transfers, and expulsions. All students enrolled in Grades K-12 shall be provided with integrated and coordinated alcohol, drug and tobacco education programs. These programs should be based on student needs and educationally sound and legally acceptable educational practices. Furthermore, these programs should be age-appropriate and developmentally based and provide instruction for all students regarding the prevention or reduction of the use of drugs, alcohol, and tobacco. The School Nurse may be consulted as a resource for these programs. School Nurses may also be the site resource for that mandatory provision of referral resources for students and families. Some parents may request that their child be allowed to carry medications. To avoid a violation of the drugfree school policy, specific procedures must be adhered to in these rare instances. School site administrators have been informed of the District Policy related to prescribed and over-the-counter medications. Students may take prescribed medication and over-the counter- drugs during school hours provided that the appropriate District forms for such purposes are completed, signed, and on file. The purpose of this policy is twofold: to establish a safe and effective means whereby students may take needed medication at school and to ensure that the protection of all students will be maintained. Students who are required to take physician-prescribed or over-the-counter medication during the regular school day shall be provided assistance by the School Nurse or other designated school personnel. All approved medications must be housed in the School Nurse’s office along with the appropriate District forms for authorization signed by both the physician and the parent or guardian; however, it would be preferable if physicians could establish a medication schedule that would eliminate or minimize the need for a student to take medication during school hours. Parents or guardians should be urged to ask their physician to consider such a schedule. With the written opinion of the parent, physician, and School Nurse that a student is physically, mentally, and behaviorally capable of assuming the responsibility for self-administering the medication, the student may be allowed to carry prescribed

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medications, such as an inhaler, an epi-pen, or other medications when the medications are needed to prevent possible life-threatening emergencies. The signature of the Site Administrator is also required. A specific and detailed procedure is necessary for any student who is carrying any medication. The paperwork must be completed and signed prior to the student carrying medication. All documents must be reviewed and updated annually and as needed. Pupil records are confidential and should only be disclosed in a manner that complies with Federal and State law. Documents generated, obtained, or maintained during the course of an investigation pertaining to a student’s violation of District policy concerning the use of drugs, alcohol, or tobacco are deemed pupil records. California Education Code Section 49079 requires a school administrator to inform the teacher of each pupil who has engaged in, or is reasonably suspected to have engaged in, any misconduct as defined in Education Code Sections 48900 et. seq. Such information shall be based upon records that the District maintains in its ordinary course of business and must be accessible for review by teachers for at least three years from the date the misconduct occurs. This does not include Health Cards/records. In implementing this requirement, great care must be exercised to protect the confidentiality of this information. Refer to Bulletin No. BUL-3878.1 dated September 24, 2007, Student Health and Humans Services Division, “ASSISTING STUDENTS WITH PRESCRIBED MEDICATION AT SCHOOL” and Bulletin No. BUL-3277 dated October 1, 2006, Student Health and Human Services Division, “PREVENTIVE MEASURES AND MANDATORY PROCEDURES FOR STUDENTS WHO VIOLATE LAWS REGARDING DRUGS, ALCOHOL, AND TOBACCO”.

EQUITY NONDISCRIMINATION CONFORMING STUDENTS

RELATED

TO

TRANSGENDER

AND

GENDER

NON-

California law and District policy require that all programs and activities and employment practices should be conducted without discrimination based on sex, sexual orientation, or gender identity. The District Reference Guide intended to advise District staff regarding issues relating to transgender and gender nonconforming students in order to create a safe learning environment for all students, and to ensure that every student has equal access to all components of their educational program. The following terms are defined in the guide: • “Transgender students” refers to students whose gender identity is different from their sex at birth, and whose gender expression is different from the way males or females are expected to look or behave. • “Gender identity” refers to one’s understanding, interests, outlook, and feelings about whether one is female or male, or both, or neither, regardless of one’s biological sex. • “Gender expression” refers to the way a person expresses her or his gender, through gestures, movement, dress and grooming. • “Gender Nonconforming Students” refers to students that have a gender expression that does not conform with stereotypical expectations, for example, “feminine boys,” “masculine girls,” and students who are androgynous. Another example might be the boy who comes to school in clothing that some might perceive as “girls’ clothing,” or the girl who plays games on the playground that might be perceived as “boys’ games.” PLEASE NOTE: The definitions provided are not meant to label a student but are intended as functional descriptors. The following guidelines are provided for District Staff: • Issues of Privacy: All persons, including students, have a right to privacy; this includes keeping a student’s transgender status private. Therefore, school personnel should not disclose a student’s transgender status to others, including parents, and/or other school personnel, unless there is a specific “need to know.” Whenever discussing a particular issue such as conduct, discipline, grades, attendance, or health with a transgender or gender nonconforming student, focus on the conduct or particular issues, and not on

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any assumptions regarding the student’s actual or perceived gender identity. When school personnel must contact the parents of a transgender or gender nonconforming student, the “best practice” would dictate that the student should be consulted first to determine an appropriate way to reference the student’s gender identity. •

Official Records The District is required to maintain a mandatory permanent pupil record which includes the legal name of the pupil and the pupil’s sex. The District will change a student’s official records to reflect a change in legal name or gender upon receipt of documentation that such legal name or gender has been changed pursuant to a court order.

•

Names/Pronouns Students are to be addressed by a name and pronoun that corresponds to the gender identity that the students consistently assert at school. Students may request to be addressed by their “preferred name” (and preferred pronoun) that corresponds to their gender identity without obtaining a court order or without changing their official records. This reference guide acknowledges that inadvertent slips or honest mistakes in the use of the “preferred” names or pronouns might occur, but it does not condone an intentional and persistent refusal to respect a student’s gender identity.

•

Restroom Accessibility Schools may maintain separate restroom facilities for male and female students. At the discretion of the school administrator, a student may be provided access to a restroom facility that corresponds to the gender identity that the student consistently asserts at school. If the student and administrator feel that there is a reason or desire for increased privacy and safety, regardless of the underlying purpose or cause, any student may be provided access to a reasonable alternative restroom such as a single stall “unisex” restroom. In all instances, decisions about alternative restroom use should be governed by the school administrator’s judgment concerning the safety and best interests of the student in question. The Health Office restroom(s) may be utilized for assisting any student. However, the Health Office restroom is most often reserved for students who are ill or require protocol administration or assistance.

•

Locker Room Accessibility Schools may maintain separate locker room facilities for male and female students. Schools may, however, provide a student access to a locker room facility that corresponds to the gender identity that the student consistently asserts at school. If there is a reason or desire for increased privacy and safety, regardless of the underlying reason, any student may be provided access to a reasonable alternative locker room such as: 1. Use of a private area (i.e., a nearby restroom stall with a door, an area separated by a curtain, a P.E. instructor’s office in the locker room, or a nearby health office restroom). 2. A separate changing schedule (either utilizing the locker room, before or after the other students).

•

Sports and Physical Education Transgender and gender nonconforming students are to be provided the same opportunities to participate in physical education as are all other students. Participation in competitive athletic activities and contact sports are to be resolved on a case-by-case basis.

•

Dress Codes Schools may adopt a dress code and it should be applied uniformly to all students. However, a transgender and/or a gender nonconforming student has the right to dress in accordance with the gender identity that the student consistently asserts at school, within the constraints of the school dress code, as it relates to health and safety issues (e.g. prohibitions on wearing gang symbols, regalia, and apparel).

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•

Discrimination/Harassment Complaints alleging discrimination or harassment based on someone’s actual or perceived transgender or gender nonconforming identity are to be handled in the same manner as other discrimination/harassment complaints.

Refer to Reference Guide REF-1557 dated February 15, 2005, Office of the General Counsel, “TRANSGENDER AND GENDER NONCONFORMING STUDENTS – ENSURING EQUITY AND NONDISCRIMINATION”.

PREGNANT MINORS AND PARENTING MINORS COMPLIANCE SERVICES Title IV, Safe and Drug-Free Schools and Communities entitlement and the Tobacco-use Prevention Education entitlement and grant makes the following services available to every pregnant minor and minor parent: • referral to perinatal and related support services; • outreach services and assessment of smoking status; • individualized counseling and advocacy services; • motivational messages and cessation services, if appropriate; • incentives to maintain a healthy lifestyle; • follow-up assessment; and • maintenance and relapse-prevention services. In elementary schools, pregnant minor students and parenting minor students should be referred to the School Nurse or outside agencies through the School Nurse. Information on outside agencies may be obtained from Health Education Programs at (213) 241-3520. In secondary schools, pregnant minor students and parenting minor students may be referred to the Tobacco-Use Prevention Education (TUPE) coordinator at (213) 2413515, the IMPACT coordinator, or the School Nurse to assure that such students receive the services appropriate either on campus or conducted by outside agencies. Refer to LAUSD Pregnant & Parenting Teens Program School Nurses and Bulletin No. BUL-3276.1 dated August 15, 2007, Student Health and Human Services, “COMPLIANCE ON SERVICES FOR PREGNANT MINORS AND PARENTING MINORS”.

PREGNANT AND PARENTING STUDENTS EDUCATIONAL RIGHTS The Los Angeles Unified School District (District) is committed to the protection of the educational rights of pregnant and parenting students. Pregnant and parenting students, regardless of their marital status, have the same right as any other student to attend any District school or program and to do so in an environment free of discrimination or harassment. The District shall make reasonable adjustments to facilitate the equal access and full participation of pregnant and parenting students. It is the goal of the District to provide pregnant and parenting students with the educational options, resource information, and access to support and advocacy services that they need to achieve educational success. Rights of Pregnant and Parenting Students are specified by Title IX which states: • No student or applicant for enrollment will be subject to discrimination on the basis of that student’s pregnancy at any stage of pregnancy, childbirth, false pregnancy, termination of pregnancy, recovery from pregnancy, or parental or marital status. • Pregnant and parenting students, regardless of their marital status, have the same rights as other students to remain in their current educational program or to attend any District school or program for which they would otherwise qualify and to do so in an environment free of discrimination or harassment. • Pregnant and parenting students must have full access to the same programs and activities for which they would otherwise qualify, including, but not limited to, graduation, awards, ceremonies, field trips, student clubs, after-school activities, and any other school-related programs/activities. As such, students cannot legally be expelled, suspended, or otherwise excluded from, or required to participate

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• •

in school programs/activities solely on the basis of their pregnancy-related conditions or parental/marital status. District schools and programs shall make reasonable adjustments to facilitate the equal access and full participation of pregnant and parenting students. Schools may require a female student to provide written permission from her licensed healthcare provider that she is physically and emotionally able to remain in or participate in a school activity or program only if such permission is also required for other health conditions or temporary disabilities requiring medical care.

Pregnancy has been determined to be the greatest single cause of school dropout for female students. Teenage fathers are also significantly less likely to complete high school than their non-parent peers. Schools can help to ensure the educational success of both teen parents and their children by protecting their educational rights, providing high quality educational options, and assuring access to needed support services such as child care and case management. Title IX of the Educational Amendments of 1972 states, “No person…shall, on the basis of sex, be excluded from participation in, denied the benefits of, or be subjected to discrimination under any educational program or activity receiving federal financial assistance.” No student or applicant for enrollment will be subject to discrimination on the basis of that student’s pregnancy, childbirth, false pregnancy, termination of pregnancy or recovery there from. Pregnant students or teen parents have the right to enroll in any school or program for which they would otherwise qualify at any stage of the pregnancy. They have the right to remain in their regular or current school program, including elementary or secondary schools, honors and magnet programs, special education and non-public school placements, alternative/options programs, migrant education, free and reduced lunch programs and services for English Learners, and any others for which they are otherwise qualified. This would also include participation in the following: graduation, awards, ceremonies, field trips; student clubs, councils, after-school activities, and any other school-related programs. Students cannot legally be expelled, suspended, or otherwise excluded from, or required to participate in school programs solely on the basis of their pregnancy-related conditions, or marital or parental status. Pregnant and parenting students will also benefit from information about District and community resources, especially those that may assist them in gaining support and services to stay in school. When a school staff member becomes aware of a student’s pregnancy or impending fatherhood, staff should make sure the student is made aware of her or his educational rights and informed of programs and services that may assist them. Pregnant and parenting students have the right to attend school in an environment free of discrimination and harassment. Schools must make reasonable adjustments to facilitate full participation and must treat pregnancy and related conditions as they treat any other medical condition. Health plan, medical benefits and related services and accommodations to facilitate full participation are to be provided to pregnant students in the same manner as these services are provided to students with any other “temporary disabilities.” District schools and programs shall make reasonable adjustments to facilitate the equal access and full participation of pregnant and parenting students. Such adjustments, implemented on a case-by-case basis, may include, but are not limited to, the following: • providing hall passes for bathroom use as needed; • scheduling classes in more accessible locations; • allowing elevator access when needed and possible; • allowing additional time for passing periods and nutrition and lunch; • providing alternative activities in physical education programs when requested by the student and her medical provider; • arranging for school-based independent study during an extended pregnancy-related medical absence; and • allowing scheduling flexibility whenever possible to enable full participation and reduce school absences due to medical concerns. Examples of such flexibility could include: o facilitating track changes to minimize loss of school time and to provide access to childcare; o allowing students to remain in school when a change of school is a hardship (documentation may be required); and o allowing a reduced schedule of classes or contracts for a student with medical complications.

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Schools may require a student to provide written permission from her licensed healthcare provider that she is physically and emotionally able to continue to participate in a school activity or program only if such permission is also required for other students’ health conditions or temporary disabilities requiring medical care. For example, a student who has been hospitalized due to childbirth may be required to submit a medical permission for re-entry to school if such permission is also required of a student who has been hospitalized for other types of medical treatment or conditions. Pregnant and parenting students are entitled to participate in physical education and school sports on the same basis as other students. A school may ask a student to obtain certification of a licensed healthcare provider regarding her participation only when such certification is required of other students for other conditions requiring the attention of a licensed healthcare provider. When students cannot meet the requirements of the regular physical education curriculum, schools must provide students with an alternative physical education curriculum. This alternative curriculum should be modified as needed to meet the demands of each student’s health and physical limitations as defined by their licensed healthcare provider and should provide physical education credit. Pregnant and parenting students have the right to have their health and personal information kept confidential. Information about students’ pregnancies and related conditions should not appear in their cumulative or health record and cannot be used when they are being considered for educational or job opportunities, awards or scholarships. Personal information students share with licensed school personnel such as a School Nurse, social worker, psychologist, or licensed counselor is confidential and should not appear in student’s educational records. School staff shall not discuss students’ confidential information or communications without their permission. An exception to this rule of confidentiality includes, but is not limited to, a reasonable suspicion of child abuse or a clear and present danger to the health or safety of the student. Minors have a statutory right to consent to medical care related to pregnancy, pregnancy prevention, including contraceptive services, and other reproductive health services including pregnancy termination. This right applies to all youth and not just pregnant and parenting teens, and means that minors may receive confidential medical services as described above without the knowledge or consent of their parent or guardian. In addition, any written verification regarding confidential medical services shall not appear in students’ school records and shall be kept in a separate confidential file. In recognition of this right, the Education Code states that school authorities may excuse any pupil from school for the purpose of obtaining confidential medical services without the knowledge or consent of a parent or guardian. The information about the right to be excused from school for confidential medical services is provided to parents and guardians on the “Emergency Card” signed at the time of enrollment. It is District policy that, “School authorities may excuse any pupil in grades 7-12 from the school for the purpose of obtaining confidential medical services without the consent of the parent or guardian.” In addition, schools may NOT require that students obtain written parental permission prior to releasing students from school to receive confidential medical services and may NOT notify parents when students leave school to obtain such services. The School Nurse should refer the student to the Site Administrator for an excused absence form and/or a pass to leave campus. Every child between the ages of 6 and 18 has the right and the obligation to attend school. Pregnant and parenting students who are minors have the same obligation to meet compulsory school attendance laws as any other students. This attendance obligation applies to minor students regardless of their marital or parental status. Under the Education Code, absence from school for students’ own illnesses or medical appointments during school hours is considered an excused absence. Students with excused absences such as pregnancyrelated illnesses or the medical care of related conditions shall be treated like all other students with excused absences. Students shall also be considered excused when their absences are due to the illness or the medical appointment of a child for whom students are the custodial parents. Students with excused absences shall be allowed to complete all assignments and tests missed, or a reasonable equivalent of the work missed, during the absence. Students shall be given full credit upon satisfactory completion of that work in a reasonable time

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period. A school may require verification of appointments from pregnant students’ licensed health care providers, or the licensed healthcare providers for students’ children, if such verification is also required from students for other medically related absences. Any such oral or written verification, however, shall not appear in the student’s school records and shall be kept in a separate confidential file. Students are entitled to an extended absence or leave of absence for reasons of pregnancy and related conditions. Schools shall not check out students who have been absent more than five days or adopt an “automatic drop” policy. Documentation from students’ licensed health care providers may be required for verification of pregnancy and medically-related conditions if it is also required for all absences due to medical conditions. A leave of absence may be for as long a period of time as deemed medically necessary by students’ licensed healthcare providers. At the conclusion of a leave, students must be reinstated at the school with the same status as before the leave began. Written permissions from a licensed healthcare provider are required for readmission as it is required for readmission to school after all absences due to medical conditions. The Berenece Carlson Home/Hospital School Program (Carlson) provides instructional services to meet the needs of students with serious, disabling medical illnesses or conditions that prevent their school attendance. Pregnancy alone is not considered a serious, disabling condition preventing school attendance, and pregnant students are not generally eligible for Home/Hospital School Services. However, referral to the Carlson program may be indicated in cases of pregnancy or postpartum complicated by serious, disabling illnesses or medical conditions which prohibits a students’ attendance in school or independent study. Pregnant students may elect to enroll in one of the District’s Pregnant Minor Schools such as McAlister or Riley High School (McAlister or Riley). Enrollment must be completely voluntary and students may not be denied access to their regular school programs. Using the Caregiver’s Authorization Affidavit, students may be enrolled in school by relative or nonrelative caregivers over age 18 with whom the students reside. Schools shall not prohibit enrollment to pregnant and parenting minor age students, living with an adult relative or non-relative caregivers who have completed the affidavit. Refer to LAUSD Pregnant and Parenting Teens Program School Nurses; Bulletin No. BUL-2521.1 dated June 7, 2006, Office of the General Counsel, “TITLE IX POLICY/COMPLAINT PROCEDURES” and Bulletin No. BUL – 2060.0 dated October 25, 2005, Student Health and Human Services & the Office of the General Counsel, “PREGNANT AND PARENTING STUDENTS EDUCATIONAL RIGHTS”.

NOTICE OF NONDISCRIMINATION/TITLE IX POLICY/COMPLAINT PROCEDURES The Los Angeles Unified School District (District) does not discriminate on the basis of race, color, national origin, sex (including sexual harassment), physical or mental disability, or age (40 and above) in any of its policies, procedures, or practices, in compliance with Federal Civil Rights Laws: Title VI of the Civil Rights Act of 1964 (pertaining to race, color and national origin), Title IX of the Education Amendments of 1972 (pertaining to sex), Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, Title II (pertaining to disability), and the Age Discrimination Act of 1975. State laws and District policies further provide that the District does not discriminate on the basis of religion, ancestry, marital status, sexual orientation, medical condition (cancer related), political belief or affiliation, or in retaliation. The District is committed to providing a learning and working environment in which all individuals are treated with respect and dignity. Each student and employee has a right to learn and work in an environment that is free from unlawful discrimination. No District student or employee shall be excluded from participation in, be denied the benefits of, or be subject to discrimination on the basis of sex, sexual orientation, or gender in any District educational program or activity.

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This nondiscrimination policy covers admission or access to, or treatment or employment in, the District’s programs and activities, including Vocational Education. The lack of English language skills will not be a barrier to admission or participation in the District’s programs. All employees will so conduct themselves in the course of their employment by word, gesture, act and demeanor so as to assure that all others will be accorded just and equitable consideration, regard and treatment. Prejudice or unlawful discrimination in any form is deemed to be unethical, as well as illegal, and will not be tolerated. Any violation of this policy will result in disciplinary action. The Uniform Complaint Procedures may be used for complaints or noncompliance involving the following educational programs and complaints alleging violations of the following nondiscrimination protections: adult basic education; allegations of unlawful discrimination/ harassment on the basis of sex, sexual orientation, gender identity, ethnic identification, race ancestry, national origin, religion, color, age, mental or physical disability by local agency that is funded directly or receives any state funds; career and technical education; child care and development programs; child nutrition programs; consolidated categorical programs; Indian education; migrant education; special education programs. Refer to Memorandum No. MEM-4208.0 dated May 28, 2008, Office of General Counsel, “NONDISCRIMINATION REQUIRED NOTICES – 2008-2009” Memorandum No. MEM-4210.0 dated May 28, 2008, Office of General Counsel, “UNIFORM COMPLAINT PROCEDURES (UCP) 2008-2009” Memorandum No. MEM-3671 dated May 15, 2007, Office of the General Counsel, “ORDERING AND DISTRIBUTION OF STUDENT BROCHURES – ‘TITLE IX AND NONDISCRIMINATION’ AND SECTION 504 AND STUDENTS WITH DISABILITIES”; and Bulletin No. Q-49 dated September 7, 1998, Office of the Superintendent, “POLICY STATEMENT REGARDING PREJUDICE AND DISCRIMINATION”.

ACT OF VIOLENCE When an act of violence is reported, the Site Administrator or designee shall: telephone 9-1-1 for paramedics or other emergency services to transport the employee to the nearest hospital if the employee is seriously injured. If the injury is not a serious one, have an on-site School Nurse (if available) or other qualified person provide first aid. An employee requiring treatment beyond first aid, but who does not require emergency medical treatment, should be referred to a member of the District Medical Provider Network. The Site Administrator should report the incident immediately to the School Police Department for investigation and if the employee involved is a member of UTLA, the Chapter Chair should also be notified, unless the employee requests that the notification not be made. There are several forms to be provided by the Site Administrator: • State of California “Employee’s Claim for Workers’ Compensation Benefits Form” (DWC 1, Attachment A) after completing the employer’s section. • A copy of “Benefits and Responsibilities of Employee Injured as a Result of an Act of Violence” (Attachment B). Retain a signed copy. • The “Special Physical Injury/Alleged Act of Violence Report”, (Attachment C). Have the employee complete Section 1. • The “Workers’ Compensation Injury Report Worksheet” (Attachment D). A report of injury to Sedgwick Claims Management Services, Inc., must be submitted within 24 hours by calling 1-800LAUSDWC. The form is then maintained at the work site. • The LAUSD Incident Report Form (Attachment E) will be distributed as indicated on the form. The incident report form must be completed whether or not the incident is deemed an act of violence. If the incident involves a violent act committed by a student, appropriate disciplinary action may be involved.

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Employees who are unable to receive the forms at the time of the injury will receive the forms from the administrator at the employee’s home address. Refer to Bulletin No. BUL-1603 dated September 8, 2005, Risk Management and Insurance Services, “ACT OF VIOLENCE”.

POLICY STATEMENT REGARDING SEXUAL HARASSMENT It is the policy of the Los Angeles Unified School District to maintain a working and learning environment that is free from sexual harassment. Sexual harassment by employees or students is a form of sex discrimination in that it constitutes differential treatment on the basis of sex, and for that reason, is a violation of State and Federal Laws and a violation of this policy. The District considers sexual harassment to be a major offense, which can result in disciplinary action to the offending employee or the suspension or expulsion of the offending student. Any student or employee of the District who believes that she or he has been a target of sexual harassment shall bring the problem to the attention of the Site Administrator or Title IX Complaint Manager so that appropriate action may be taken to resolve the problem. Complaints will be promptly investigated in a way that respects the privacy of the parties concerned. The District prohibits retaliatory behavior against anyone who files a sexual harassment complaint or any participant in the complaint investigation process. California Education Code Section 212.5 and Title 5 of the California Code of Regulations, Section 4916, define sexual harassment as unwelcome sexual advances, requests for sexual favors, or other verbal, visual, or physical conduct of a sexual nature made by someone from or in the work or educational setting, whether it occurs between individuals of the same sex or individuals of opposite sexes, under any of the following conditions: • Submission to the conduct is explicitly or implicitly made a term or condition of any individual’s employment, academic status, or progress. • Submission to, or rejection of, the conduct by an individual is used as the basis of employment or academic decisions affecting the individual. • The conduct has the purpose or effect of having a negative impact upon the individual’s work or academic performance, or of creating an intimidating, hostile, or offensive work or educational environment (also known as “hostile environment”). • Submission to, or rejection of, the conduct by the individual is used as the basis for any decision affecting the individual regarding benefits and services, honors, programs, or activities available at or through the educational institution. Pursuant to Title 5, California Code of Regulations, Section 4910(k) “Gender,” Section 4910(v) “Sex,” and Section 4910(w) “Sexual orientation, “ are defined as follows: • Gender shall mean a person’s actual sex or perceived sex and includes a person’s perceived identity, appearance, or behavior, whether or not that identity, appearance, or behavior is different from that traditionally associated with a person’s sex at birth. • Sex shall mean the biological condition or quality of being a female or male human being. • Sexual orientation shall mean actual or perceived heterosexuality, homosexuality, or bisexuality. Examples of Conduct Which May Result in Sexual Harassment: Sexual harassment may include, but is not necessarily limited to, the following: • Verbal – unwelcome conduct such as the use of suggestive, derogatory, or vulgar comments; the use of sexual innuendo or slurs; making unwanted sexual advances, invitations, or comments; pestering for dates; making threats; and/or spreading rumors about or rating others as to their sexual activity or performance. • Visual – unwelcome conduct such as the display of sexually suggestive objects, pictures, posters, written material, cartoons, or drawings; the use of graffiti and/or computer-generated images of a sexual nature; and/or the use of obscene gestures or leering. • Physical – unwelcome conduct such as unwanted touching, pinching, kissing, patting, or hugging; the blocking of normal movement; stalking; assault; and/or physical interference with work or study directed at an individual because of the individual’s sex, sexual orientation, or gender.

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Threats, demands, or pressure to submit to sexual requests in order to keep a job or academic standing or to avoid other loss, and/or offers of benefits in return for sexual favors.

All Employees shall: • cooperate with the District’s efforts to eliminate and prevent sexual harassment; • encourage anyone alleging that he or she is a target of sexual harassment to report such an incident; • cooperate in any investigation of a sexual harassment complaint; and • guard against any actions that would be considered retaliatory against another employee or student who has filed or is participating in an investigation of a sexual harassment complaint. Sexual harassment complaints may require additional reporting. The District has dual responsibilities with respect to cases of inappropriate sexual conduct toward a student. In such cases, District employees have a duty not only to report the incident as suspected child abuse to a child protective agency, but also to respond promptly and equitably to the report of sexual harassment. Therefore, a report alleging sexual harassment conduct could possibly require (1) a report of suspected child abuse, (2) a sexual harassment investigation, and (3) the imposition of discipline on the person accused of the conduct. A determination of whether child abuse or sexual harassment occurred involves very different standards and outcomes. Suspected child abuse investigations involve addressing possible criminal conduct; they are not designed to address issues concerning the educational environment of students. Making a report of suspected child abuse does not relieve the District of its responsibility to take administrative action to investigate and determine whether sexual harassment had occurred. Child abuse reporting procedures, sexual harassment policies and procedures, and disciplinary policies, and procedures must be effected in a coordinated manner. If it is suspected that conduct by a student or employee could constitute both child abuse and sexual harassment, the child abuse report should be filed immediately as required by District procedures. Immediate steps should also be taken, however, to protect any alleged victim of sexual harassment. In addition, as soon as the law enforcement agency completes its investigation or notifies the District to “handle the situation administratively,” school Site Administrators are responsible for implementing the steps outlined in this policy for conducting a prompt investigation into whether sexual harassment had occurred. Contact the Local Nursing Administrator when the School Nurse is asked to assist with multiple reporting requirements. Investigation of complaints includes interviews. The School Nurse may be asked to assist with health related issues before, during, or after an interview/investigation. To reach a decision about whether the conduct described in the complaint violates the District’s sexual harassment policy, the following questions should be asked: 1. Is the conduct of a sexual nature? 2. Is the conduct unwelcome? (Determine if any consensual conduct was nonetheless unwelcome based on the totality of the circumstance.) 3. Does the conduct create a hostile environment for the alleged target of the harassment? 4. Is the conduct severe or persistent or pervasive? 5. Does the conduct limit the individual’s ability to participate in or benefit from an educational program or activity? If the answer to question one through five is “yes,” the conduct may be considered sexual harassment. However, conduct that does not rise to the level of sexual harassment may still be considered inappropriate behavior and may require that corrective actions be taken. The original Confidential Complaint/Investigation Form (TIXCMPLNT Rev 6/04) is kept in a separate school file. The health card will record objective charting by the School Nurse related to health concerns. Because of District (and individual) liability involved under Title IX of the Education Amendments, it is important that every member of a school’s staff be knowledgeable of students’ rights and protections under Title IX. All school staff should be familiar with the District’s policies and procedures in regard to sexual harassment. Current State and Federal requirements provide procedures for investigating student-to-student, adult-to-student, and student-to-adult complaints of sexual harassment. All complaint forms are included in the bulletin. Contact your Local Nursing Administrator for assistance. Refer to Memorandum No. MEM-4208.0 dated May 28, 2008, Office of the General Counsel, “NONDISCRIMINATION REQUIRED NOTICES – 2008-2009”;

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Bulletin No. BUL–1347 dated November 15, 2004, Office of the General Counsel, “CHILD ABUSE AND NEGLECT REPORTING REQUIREMENTS” and Bulletin No. BUL-3349 dated November 29, 2006, Office of the General Counsel, “SEXUAL HARASSMENT POLICY (STUDENT-TO-STUDENT, ADULT-TO-STUDENT, AND STUDENT-ADULT)”.

CODE OF CONDUCT WITH STUDENTS The most important responsibility of the Los Angeles Unified School District (District) is the safety of our students. Employees and all individuals who work with or have contact with students, are reminded that there is a fine line between being sensitive to and supportive of students and a possible or perceived breach of responsible, ethical behavior. The District encourages the cultivation of positive relationships with students, however employees and all individuals who work with or have contact with students are expected to use good judgment and are cautioned to avoid situations, including but not limited to: • meeting individually with a student behind closed doors regardless of gender; • remaining on campus with student(s) after the last administrator leaves the school site (There are exceptions to this rule, such as teachers rehearsing for a drama, music or an academic decathlon activity with students.); • engaging in any behaviors, either directly or indirectly with a student or in the presence of a student, that are unprofessional, unethical, illegal, immoral, or exploitative; • giving student gifts, rewards, or incentives that are not school-related and for which it is directly or implicitly suggested that a student is to say or do something in return; • making statements or comments, either directly or in the presence of a student, which are not ageappropriate, professional, or which may be considered sexual in nature, harassing, or demeaning; • touching or having physical contact with a student that is not age-appropriate or within the scope of the employee’s responsibilities and/or duties; • transporting student in a personal vehicle without proper written administrator and parent authorization forms on file in advance; • taking or accompanying student off campus for activities other than a District-approved school journey or field trip; • meeting with or being the company of student off campus, except in school-authorized and/or approved activities; • communication with student, in writing, by telephone/email/electronically, via Internet, or in person, at any time, for purposed that are not specifically school-related; • calling student at home or on their cell phone, except for specific school-related purposes and/or situations; • providing student with a personal home/cell telephone number, personal email address, home address, or other personal contact information, except for specific school-related purposes and/or situations. Even though the intent of the employee may be purely professional, those who engage in the above behavior(s) are exposing themselves to the possible perception of impropriety. When allegations of inappropriate behavior are made, the District is obligated to investigate the allegations and, if warranted, take appropriate administrative or disciplinary action. There are instances, when an ill or injured student does not require response by emergency medical services and 9-1-1 is not activated. If the parent/guardian is not available to transport the ill or injured student, the School Nurse may be asked to assist with transportation. In most cases, the School Nurse remains at the school site. If the School Nurse is directly involved with transporting the student, then the best procedure is to have the Site Administrator designate a staff/faculty member to drive while the School Nurse attends to the health needs of the student. The School Nurse notifies the Local Nursing Administrator when leaving/returning to the school site. Refer to Memorandum No. MEM-4400.0 dated July 30, 2008, Office of the Superintendent, “CODE OF CONDUCT WITH STUDENTS – DISTRIBUTION AND DISSEMINATION”.

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SEXUAL HARASSMENT POLICY (EMPLOYEE TO EMPLOYEE) The Los Angeles Unified School District is committed to maintaining a working and learning environment that is free from sexual harassment. Sexual harassment of or by employees, students, or persons doing business for the District, is a form of sex discrimination in that it constitutes differential treatment on the basis of sex, or actual or perceived sexual orientation or gender. As such, it is a violation of state and federal laws and a violation of this policy. The District has a Bulletin, which has been in effect since August 2005, specific to sexual harassment – employee to employee. This is in addition to the Bulletin and Reference Guide in the section titled “Policy Statement Regarding Sexual Harassment”. The District considers sexual harassment to be a major offense, which can result in disciplinary action to the offending employee including but not limited to dismissal. Any employee of the District who believes that she or he has been a target of sexual harassment shall bring the problem to the attention of the Site Administrator or designee so that appropriate action may be taken to resolve the problem. Complaints will be promptly investigated in a way that respects the privacy of the parties concerned. The District prohibits retaliatory behavior against anyone who files a sexual harassment complaint or any participant in the complaint investigation process. California Education Code Section 212.5 and Title 5 of the California Code of Regulations, Section 4916, define sexual harassment as unwelcome sexual advances, requests for sexual favors, or other verbal, visual, or physical conduct of a sexual nature made by someone from or in the work or educational setting, whether it occurs between individuals of the same sex or individuals of opposite sexes, under specific conditions. Title 5, California Code of Regulations, Section 4910(k) defines “Gender,” Section 4910(v) “Sex,” and Section 4910(w) “Sexual orientation”: Gender shall mean a person’s actual sex or perceived sex and includes a person’s perceived identity, appearance, or behavior, whether or not that identity, appearance, or behavior is different from that traditionally associated with a person’s sex at birth. Sex shall mean the biological condition or quality of being a female or male human being. Sexual orientation shall mean actual or perceived heterosexuality, homosexuality, or bisexuality. Examples of conduct which may result in sexual harassment: Verbal – unwelcome conduct such as the use of suggestive, derogatory, or vulgar comments; the use of sexual innuendo or slurs; making unwanted sexual advances, invitations, or comments; pestering for dates; making threats; and/or spreading rumors about or rating others as to their sexual activity or performance. Visual – unwelcome conduct such as the display of sexually suggestive objects, pictures, posters, written material, cartoons, or drawings; the use of graffiti and/or computer-generated images of a sexual nature; and/or the use of obscene gestures or leering. Physical – unwelcome conduct such as unwanted touching, pinching, kissing, patting, or hugging; the blocking of normal movement; stalking; assault; and/or physical interference with work or study directed at an individual because of the individual’s sex, sexual orientation, or gender. Threats, demands, or pressure to submit to sexual requests in order to keep a job or academic standing or to avoid other loss, and/or offers of benefits in return for sexual favors. For assistance telephone Cheryl Broussard, Supervising Equal Opportunity Investigator, Equal Opportunity Section at (213) 241-7685. Contact your Local Nursing Administrator. Refer to Bulletin No. BUL-1893.1 dated August 1, 2005, Office of the General Counsel, “SEXUAL HARASSMENT POLICY (EMPLOYEE-TO-EMPLOYEE).

SEX OFFENDER NOTIFICATIONS California’s Megan’s Law allows law enforcement to notify the public, including educational institutions, of serious and high-risk sex offenders who reside in or are employed in the community. AB 796 (effective July 1, 1999) provides that any employee, public education institution, or day care facility, who receives such information from a law enforcement entity, may disclose that information in the manner and to the extent authorized by the law enforcement agency. The statute further provides that the institution and its employees are immune from civil liability as a result of the dissemination of information. The School Police Department

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is the District’s liaison with the local law enforcement agency to determine the expectations for information distribution and the scope of disclosure. The Los Angeles Unified School Police Department contacts the municipal law enforcement agency, collaborates, and develops the parameters of the dissemination of information to school personnel, students, and parents. The purpose of Megan’s Law has remained the same since the inception of the statute: to provide the public with information that will provide for its protection from convicted sex offenders. Although school districts are not mandated to notify parents or the community when they are informed of a dangerous sex offender, the Los Angeles Unified School District is committed to providing a safe environment for all its employees and students by compliance with the requirements of AB 796. When information is provided to the School Nurse regarding a sex offender, the School Nurse should notify the Site Administrator and the Local Nursing Administrator as soon as possible. The scope of disclosure and information distribution is the responsibility of the School Police Department and the local law enforcement agency. Refer to Bulletin No. BUL-3422 dated February 21, 2007, Office of School Police Department, “SEX OFFENDER NOTIFICATIONS”.

CHILD ABUSE SECTION 11166 of the California Penal Code mandates the reporting of suspected Child Abuse. A statement acknowledging the District’s policy requires employee signature. The District has dual responsibilities with respect to inappropriate sexual conduct toward a student. The District has a duty to report cases of suspected child abuse to a child protective agency and also a responsibility under Title IX of the Education Amendments of 1972 to respond promptly and equitably to reports of sexual harassment. Conduct constituting sexual harassment may result in disciplinary action to the offending employee or to the offending student in grades 4 through 12. Therefore, a report of inappropriate sexual conduct could possibly require: (1) child abuse reports, (2) a sexual harassment investigation, and (3) the imposition of discipline on the perpetrator of the conduct. The Safe School Plan includes the District Policy and California State Law Compliance regarding reporting child abuse. The plan includes the opportunity for administrators to designate a staff member (School Nurse, counselor, administrator) as an available resource to assist employees in meeting their suspected child abuse reporting responsibilities. Mandated reporters may file jointly, but must adhere to the reporting requirements. Reporting anonymously does not provide required documentation of mandated reporting. School Nurses are mandated reporters. Pursuant to State law and District policy, ALL District employees are mandated reporters of suspected child abuse/neglect. State law applies to ALL District employees, including: certificated employees, health practitioners, school police, employees of child care centers, instructional aides, teachers’ aides, teachers’ assistants, and classified employees. State law provides immunity from civil or criminal liability for mandated reporters who file suspected abuse/neglect reports. The District will defend employees who file reports consistent with policy in the course of their employment against any actions/claims that may be made as a result of the reports. Failure to comply with this policy may subject an employee to disciplinary action, professional and/or personal liability. State law and District policy require that mandated reporters sign a statement acknowledging the responsibility to serve as a mandated reporter of abuse and neglect. This statement must be signed at the time of initial employment and again at each site to which the employee is assigned. School Nurses may respond to all schools in the District, therefore your signature is required once at the beginning of each school year and again at the beginning of each calendar year. Child Abuse includes physical abuse and sexual abuse. Certain sexual conduct, even between consenting parties, may constitute child abuse. Child abuse reporting laws require mandated reporters to report as suspected child abuse, conduct that has been defined as unlawful under the California Penal Code. These acts are reported as child abuse. Non-Consensual acts of sexual abuse must be reported (even when the perpetrator is a minor). It is important to note that in instances of suspected child-on-child sexual abuse, both children may be reported as victims depending on age and circumstances. Consensual sexual acts or “lewd and

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lascivious” conduct involving a minor (i.e., where you do not have a reasonable suspicion of “abuse”) must be reported in the following circumstance: (1) The minor is under 14 and the partner is 14 or over; or (2) The minor is 14 or 15 years of age and an adult 10 years older or more are engaged in “lewd and lascivious conduct”; or (3) The minor is under 16 and an adult 21 years old or over are engaged in consensual sexual intercourse. A minor’s pregnancy in and of itself does not constitute child abuse. One must consider the age of the minor at the time of conception and the circumstances under which conception occurred (e.g., physical abuse, duress, statutory sexual assault). However, since there is no obligation to ask for ages of the minor and partner, the School Nurse should still telephone the appropriate agency and complete the SS8572 report. Child Neglect is the negligent treatment or maltreatment of a child by a person responsible for the child’s welfare indicating harm or threatened harm to the child’s health or welfare. (Includes acts or omissions.) “Severe neglect” is defined as the negligent failure to protect a child from malnutrition or medically diagnosed non-organic failure to thrive, causing or permitting the child’s person or health to be endangered. Such neglect includes the intentional failure to provide the child with adequate food, clothing, shelter, supervision or medical care. Willful Cruelty or Unjustifiable Punishment is defined as a situation where any person willfully causes, inflicts or permits unjustifiable physical pain or mental suffering, or a caregiver willfully causes or permits the child to be placed in a situation in which the child’s person or health is endangered. Endangerment and cruel punishment are both reportable categories of child abuse which do not require that injury be sustained. The child protective services agencies that service LAUSD include (but may not be limited to): • Los Angeles County Department of Children and Family Services. • Local law enforcement agencies (i.e., police and sheriffs’ departments). By law, the Los Angeles Unified School Police Department is not a child protective services agency and is not authorized to take reports or to investigate allegations of child abuse/neglect. Child protective services and law enforcement personnel are not to divulge the name of the reporting party. Each District employee has an affirmative duty to report suspected child abuse. Reporting must be immediate and according to the law. No removal or arranging of any clothing to permit a visual inspection of the underclothing, breast, buttocks, or genitalia of the pupil shall be permitted. When two or more persons who are required to report are present and jointly have knowledge of a known or suspected instance of child abuse, and when there is agreement among them, the telephone report may be made by a member of the team selected by mutual agreement and a single written report may be made and signed by such selected member of the reporting team. Any member who has knowledge that the designated member failed to report the incident shall thereafter make the report. Never assume the report has been made. Consultation with school medical professionals (School Nurses and Doctors) does not remove the individual reporting responsibility of the employee referring the reportable victim to the School Nurse/Doctor. Mandated reporters must file reports of suspected child abuse/neglect with any child protective services agency. A report of suspected child abuse is to be made to one agency only (except in the case of child abuse occurring at any early education center or preschool). It is the responsibility of the child protective services agency to determine which agency will handle the report and they may reroute the report as they determine. When a suspected abuse/neglect report is made, the individual who observed or has knowledge of the abuse makes the report in two parts: (1) a telephone report; and (2) a written report. The telephone report must be made IMMEDIATELY or as soon as practically possible; the written report must be completed and mailed within 36 hours of receiving the information concerning the incident. Mandated Reporters identify themselves as Mandated Reporters and use their full name. Use your school site or Nursing Office address and telephone number. Complete all items of the SS8572 Form. During the report document the date and time the call is made. Record contact person’s name, title, position, I.D./badge number. Apprise the contact person of the time school is dismissed and how the child goes home (i.e., bus, parent.) Ascertain and record (in a personal note) the agency’s plan regarding what action will be taken, including when an investigation will be initiated, if the contact person indicates an investigation will occur. Clarify and record the agency’s directive as to what the school should/should not do regarding the reported incident/victim/perpetrator. Have the contact person read back the report information verbatim. If advised by the contact person that there will be no

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investigation and/or you are to handle the suspected abuse/neglect administratively, your reporting obligation still requires you to complete and submit the written report on the appropriate form. School Nurses complete BOTH forms – SS8572 and OES 900 when reporting suspected child abuse or neglect. Any information the reporter receives describing how injuries occurred or any aspect of the allegations should be reported verbatim as space allows on the appropriate form(s) ONLY. Quotation marks should be used where appropriate. The OES 900 Form replaces the DOJ 900 Form. (Some portions of the OES 900 form include the collection of evidence, toxicology samples, diagnostic studies, etc. the School Nurse writes NA in those areas.) The School Nurse may be asked to photograph any indicators of abuse. Any indicator of abuse observed during a child’s examination may be photographed; however these photographs may only be given to the child protective services agency along with the report. Photo documentation is reported by the School Nurse on the OES 900 Form. Students who may be victims may volunteer, but may not be asked to remove or arrange any clothing to permit a visual inspection of the under clothes, breast, buttocks, or genitalia. Recording incidents of suspected child abuse on the Health Record would destroy the confidential nature of the information and may compromise an investigation. However, the Registered Nurse License requires that the School Nurse objectively chart on the Student’s Health Record any injury, observation, first aid or care provided to the student. Therefore, statements of personal judgment or opinions concerning the child, the incident or the suspected cause of the injury are NOT to be charted on the Student’s Health Record. Chart the objective findings and care provided ONLY. Both the OES 900 and the SS8572 forms are available on-line. The OES 900 Form is available at www.oes.ca.gov. The SS8572 form is available to complete on line if the School Nurse has already completed the telephone report and been provided with a log-in number by the Department of Children’s Family Services (DCFS) individual who received the report. When a law enforcement agency receives the SS8572 report, the report is not available/fillable on-line. Telephone report immediately. The Bulletin contains telephone numbers for the Abused Child Units within the City Jurisdiction and within the County Jurisdiction. When in doubt use 1-800-540-4000. Send completed reports to the appropriate destination within 36 hours. Make a copy of the OES 900 and keep the yellow copy of the SS8572 for your personal file. To order Suspected Child Abuse Reporting Forms telephone (213) 639-4499 or 1-800-540-4000. For further information, contact the Office of Associate General Counsel Field Service at (213) 241-7600, and your Local Nursing Administrator. School Nurses/Employees are requested to send a copy of the completed report via School Mail to the Child Abuse Prevention Office at: Field Services Team Office of the General Counsel Beaudry Building, 20th Floor (Write CONFIDENTIAL on the envelope) School Nurses also report suspected Dependent Adult/Elder Abuse. A separate form from the State of California – Health and Welfare Agency is completed. Form SOC 341 from Adult Protective Services at 1 -(800) 992-1660 or from Ombudsman for Adult Group Home Children at 1- (800) 334-9473. Law Enforcement Departments – use the applicable information when possible. If in doubt or to order additional forms use 1-800-540-4000. When reporting to law enforcement, complete and mail the written report (SS8572) to the same department within 36 hours of the allegation (write ATTN: ABUSED CHILD UNIT on envelope). Refer to Bulletin No. BUL-1347 dated November 15, 2004, Office of General Counsel, “CHILD ABUSE AND NEGLECT REPORTING REQUIREMENTS”.

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EMPLOYEE-TO-STUDENT SEXUAL ABUSE The Los Angeles Unified School District is committed to maintaining a learning environment that is free from sexual abuse of students. Allegations of sexual abuse must be reported in accordance with applicable law and District policy. Upon receipt of any information requiring mandatory child abuse reporting for allegations of sexual abuse, reporters must file a report with the appropriate law enforcement agency, provide a copy of the report to the Site Administrator, the Local Nursing Administrator and inform Employee Relations and their Staff Relations/HR Labor Representative. The Site Administrator will then provide a copy of the report to the Local District Superintendent or Unit/Division Head. However, if the allegation involves the Site Administrator, the reporter should file a report with the appropriate law enforcement agency, provide a copy of the report to the Local District Superintendent or Unit/Division Head, and inform Employee Relations and the Staff Relations/HR Labor Representative. Refer to Bulletin No. BUL-3357.0 dated October 19, 2006, Office of the General Counsel, “EMPLOYEE-TOSTUDENT SEXUAL ABUSE AND RELATED DISCIPLINE POLICY.”

DEPENDENT/ELDER ADULT ABUSE AND NEGLECT REPORTING REQUIREMENTS The Board of Education and District staff recognize that students have greater opportunities to benefit from instruction when they are safe and secure. It is the responsibility of all staff to increase students’ opportunities for learning by protecting them from abuse and neglect by collaborating with other persons mandated to report abuse and neglect; becoming knowledgeable about abuse and neglect, its indicators and ramifications; and cooperating with public agencies responsible for protecting dependent and elder adults. Therefore, it is District policy that all employees shall comply with State law regarding Dependent/Elder Adult Abuse and Neglect Reporting. Each District employee has an affirmative duty to report suspected dependent/elder adult abuse. State law provides immunity from civil or criminal liability for mandated reporters who file suspected abuse/neglect reports. The District will defend employees who file reports consistent with policy in the course of their employment against any actions/claims that may be made as a result of the reports. Failure to comply with this policy may subject an employee to professional and personal liability. The bulletin specifies definitions related to Elder Adult Abuse and Neglect: • Adult Protective Services Agency is an agency authorized to take reports of suspected abuse of dependent/elder adults, as defined by law. Adult Protective Services Agencies include Adult Protective Services or any local law enforcement agency except school police. • Dependent Adult is a person 18-64 years of age who resides in this state and who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights, including, but not limited to persons who have physical or development disabilities, or whose physical or mental abilities have diminished because of age. Developmentally disabled adult students suspected of being abused are to be reported as dependent adults on Form SOC 341. • Elder Adult is a person 65 years of age or older. • Abandonment – The desertion or willful forsaking of an elder or a dependent adult by anyone having care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody. • Abduction – The removal from this state and the restraint from returning to this state of any elder or dependent adult who does not have the capacity to consent as well as the removal from this state or the restraint from returning to this state of any conservatee without the conservator’s consent or a court order. • Abuse of an elder or a dependent adult – Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or mental suffering; or the deprivation by a care custodian of goods or services that are necessary to avoid physical or mental suffering. • Financial abuse – When a person or entity takes, appropriates or retains (or assists in the taking, appropriating, or retention of) real or personal property of an elder or dependent adult to a wrongful use and/or with intent to defraud.

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Isolation – Intentionally preventing an elder or dependent adult from receiving mail or calls; telling a caller or a visitor that an elder or dependent adult is not present or does not wish to talk, or does not wish to meet where the statement is false and prevents the elder of dependent adult from having contact with family, friends, or others; false imprisonment, or physical restraint to prevent the elder or dependent adult from meeting with visitors.

School Nurse reporting procedures include both the telephone report and the written report. The initial telephone report to an Adult Protective Services Agency, which the mandated reporter must make as soon as practically possible upon reasonable suspicion of dependent/elder abuse, includes • the name of the person making the report; • the name and age of the elder or dependent adult; • the present location of the elder or dependent adult; • the names and addresses of family members or any other person responsible for the elder or dependent adult’s care; • the nature and extent of the elder or dependent adult’s condition; • the date of the incident; and • any other information, including information that led that person to suspect elder or dependent/elder adult abuse, as requested by the Adult Protective Services Agency representative. If the suspected abuse allegedly occurred in the community, including school, the mandated reporter must contact the Adult Protective Services Hotline: 1-888-202-4248; after hours: 1-877-477-3646. The written report, Form SOC 341, must be completed within 2 working days of the telephone call. It must be mailed to: Adult Protective Services Centralized Intake Unit 3333 Wilshire Boulevard, Suite 400 Los Angeles, CA 90010 FAX (213) 738-6485 (If the Suspected Elder Abuse occurred in a long term care facility use 1-800-334-9473 or after hours 1-800-231-4024). School Nurses who want to discuss a situation of possible abuse, telephone 1-888-202-4248 to speak with an Adult Protective Services representative. When the alleged perpetrator is a District employee and the School Nurse is a witness or a recipient of information about suspected dependent/elder adult abuse, the School Nurse must immediately telephone the appropriate adult protective agency and follow-up with a written report in accordance with the procedures outlined in the bulletin and this handbook and immediately advise their Local Nursing Administrator of the alleged conduct (such notification may be oral or in writing). The Site Administrator must also be informed. Upon receipt of this information, the Site Administrator must also complete a telephone/written report. The District has dual responsibilities with respect to inappropriate sexual conduct toward a student. The District has a duty to both report cases of suspected dependent/elder adult abuse to an Adult Protective Services Agency and an additional responsibility under Title IX to respond promptly and equitable to reports of sexual harassment [Bulletin No. BUL-3349.0 dated November 29, 2006, Office of General Counsel, “SEXUAL HARASSMENT POLICY (STUDENT-TO-STUDENT, ADULT-TO-STUDENT, AND STUDENT-TOADULT)]. Therefore, a report of inappropriate sexual conduct could possibly require: (1) a suspected abuse report, (2) a sexual harassment investigation, and (3) the imposition of discipline on the perpetrator of the conduct. Prohibited actions including the following: The individual’s reporting responsibility must not be impeded, inhibited, or assumed by an employee’s administrator, colleague or supervisor, nor may any person be subject to sanctions of any kind for making such a report. School police or security officers must not be asked to, and may not, investigate reports of alleged dependent/elder adult abuse. The reporting employee must not seek to verify the suspicion or prove that abuse has occurred. Investigation (questioning witnesses, obtaining written statements) as well as notification (family, alleged perpetrator), counseling, and/or family intervention are the responsibility of the Adult Protective Services Agency. Under no circumstances should a staff member be required to explain or justify a decision to report or be compelled to meet with the alleged perpetrator named in the report. Any individual(s) bringing forth an allegation of abuse should not be made to repeat the allegations(s) or to provide a written statement regarding the allegation(s) prior to the report being made.

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Likewise, if a dependent or elder adult discloses that he/she was abused, the dependent or elder adult should not be asked to provide a written statement or to repeat the information to other staff at the site. Mandated reporters should never contact the reportable victim’s home or the alleged perpetrator prior to making the report if abuse is suspected. Mandated reporters should not contact the reportable victim’s home or the alleged perpetrator once the report is made unless approval is obtained from the investigating agency or until the agency investigation has been completed. Prior to making a report, mandated reporters should never conduct an investigation of any kind once abuse is suspected. Mandated reporters shall not be retaliated against for reporting under these procedures and applicable laws. Failure to report suspected dependent/elder adult abuse is punishable by incarceration and fines. State law provides immunity from civil or criminal liability for mandated reporters who file suspected abuse/neglect reports. The contents of Suspected Dependent Adult/Elder Abuse reports must remain confidential. Only certain individuals – staff directly involved in the specific case and Adult Protective Services Agency representatives – may have access to information regarding the report. To ensure confidentiality for all parties, no other individual, including clerical and other office staff, may read, type, file or be apprised of reports of suspected dependent/elder adult abuse. Reports are to be completed only by the reporter and may be handwritten, printed or typed. Any violation of confidentiality in these reports is a misdemeanor punishable by not more than six months in the county jail, by a fine of five hundred dollars ($500), or by both fine and imprisonment. Should a relative/alleged perpetrator request information about a report, why a report was made and/or who made the report, he/she should be referred to the appropriate Adult Protective Services Agency. Staff may discuss the legal requirements as well as the District’s policy and procedure for dependent/elder adult abuse reporting with a relative/alleged perpetrator but never the specific/contents of a report. Refer to Bulletin No. BUL-2449.0 dated June 1, 2006, Office of the General Counsel, “DEPENDENT/ELDER ADULT ABUSE AND NEGLECT REPORTING REQUIREMENTS”.

DOMESTIC VIOLENCE/SUSPECTED ABUSE According to Penal Code Section 11160 any health practitioner employed in a health facility; clinic; physician’s office; local or state public health department; or public health department operated clinic or facility is required to make a report if she/he provides medical services for a physical condition to a patient who she/he knows or reasonably suspects is: • suffering from any wound or other physical injury inflicted by his or her own act or inflicted by another where the injury by means of a firearm and/or • suffering from any wound or other physical injury, that is the result of assaultive or abusive conduct. Assaultive or abusive conduct is defined to include 24 criminal offenses, among which are murder, manslaughter, torture, battery, sexual battery, incest, assault with a deadly weapon, rape, spousal rape, and abuse of spouse or cohabitant and is reportable. The health practitioner is required to make a report by telephone immediately or as soon as practically possible and send a written report to a local law enforcement agency within two working days. Civil and criminal immunity is provided health practitioners who make required or authorized reports pursuant to legal provisions. Violation of this law is a misdemeanor.

SCHOOL PROCEDURES DURING HEAVY RAIN OR FLOOD CONDITIONS The Los Angeles Unified School District encompasses a large geographical area. During times of heavy rains or flooding, various areas within the District may be impacted more heavily than others by severe inclement weather conditions. The Los Angeles County Flood Control District monitors heavy rain and/or flood conditions on a 24-hour basis. Additional information is gathered from the weather bureau, police, Sheriff’s Department and the District. When weather conditions become severe, District emergency personnel review the impact of the conditions on District operations. The Superintendent of Schools may authorize the closure of any school(s).

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Procedures for school closures during Non-School Hours: School information will be disseminated to the media through the Office of Communications regarding hazardous conditions. School closures and staff direction will be officially announced from the Superintendent’s Office at the following time: 1. 6:00 a.m. – First school closure announcements. 2. 7:00 a.m. – Final deadline to make school closure announcements. 3. Schools not officially closed by the Superintendent by the above times will open with School Nurses reporting as usual. 4. In the event that certificated and classified staff are unable to report to their respective job locations, they are directed to contact their immediate supervisor. School Nurses telephone their Local Nursing Administrator. 5. The Controller will issue directions regarding payment to all personnel who followed the correct procedure reporting an absence during a declared closure. During School Hours: The School Police Chief will notify the Office of the Administrator, School Operations and Safety who will notify Local District Superintendents, Office of Emergency Services, Office of Communications, and all schools and offices affected by the unsafe conditions caused by heavy rains and flooding. Since students are safer on school premises under the supervision of school staff, every alternative to partial or total dismissal is considered. Local District Superintendents will determine the action to be taken during emergency inclement weather conditions. Notify your Local Nursing Administrator if an unsafe situation/or school closure is identified for your school. Resource numbers for School Nurses: • District’s Information number – (213) 241-1000 • School Police Department – (213) 625-6631 • Environmental Health and Safety Branch – (213) 241-3199 • LAUSD Transportation Branch Dispatch – (323) 342-1460 or 1-800-LA-BUSES • Interscholastic Athletics Offices – (213) 745-1980 • National Weather Service – (805) 988-6610 • Office of Emergency Services – (213) 241-3889 Administrators may send a parent letter when heavy rains or flood conditions are anticipated and school closure(s) are declared by the District. Notify your Local Nursing Administrator if your school/site is scheduled to close. Refer to Bulletin No. REF-1614 dated March 11, 2005, Office of Environmental Health and Safety, “SCHOOL PROCEDURES DURING HEAVY RAIN OR FLOOD CONDITIONS”.

AIR POLLUTION The Los Angeles Unified School District has established procedures for the notification of appropriate school sites and offices in the event of an air pollution episode. An air pollution episode has occurred whenever: air pollution levels exceed Federal Clean Air Standards; a health advisory is issued; or an episode is declared by the South Coast Air Quality Management District (SCAQMD) or California Air Resources Board (CARB). Daily air pollution information can be obtained from SCAQMD by calling 1-800-CUT-SMOG (1-800-2887664). In the event a health advisory is issued or air pollution episode declared, the Office of Environmental Health and Safety (OEHS) will initiate specific procedures. OEHS will FAX or telephone a message to Student Information Systems Branch and each Local District Office. Schools will be notified by a notice posted on the “Inside LAUSD” intranet site. Schools must check “Inside LAUSD” at approximately 12:00 noon each day to determine if a health advisory or air pollution episode has been predicted for the following day, or if one is currently in progress. (OEHS will also FAX or telephone a message to each Local District Office and to Student Information Systems Branch for posting on “Inside LAUSD” to terminate an alert.) Administrators at school sites will alert staff (and other site users) regarding the health advisory. Physical activity restrictions follow specific guidelines:

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Students and staff with special health problems should follow any additional precautions recommended in writing by their physician. This information must be recorded on the student’s/employee’s Health Card. During outdoor Interscholastic Athletic Programs, games/events should begin if a pollution episode is expected but has not yet occurred. If a Stage I Episode is in effect, the outdoor game/event should be cancelled and rescheduled. If a Stage 2 or Stage 3 Episode is in effect, the game/event must be cancelled and rescheduled.

The OEHS and SCAQMD recommend specific limits on physical activities for each type of episode: • Unhealthful Air Quality (exceeding the Federal Clean Air Standards): Susceptible individuals (e.g., children with heart or lung disease) or healthy individuals that are experiencing adverse health effects should minimize outdoor activity. For example, participation in calisthenics, basketball, running, soccer, football, tennis, swimming and water polo should be canceled. • Health Advisory Episodes (applies only to ozone): All children should discontinue vigorous outdoor exercise lasting longer than one hour. Susceptible individuals, such as those with heart or lung disease, should avoid outdoor activities. • Stage 1 Episode: Children must discontinue all vigorous outdoor activities regardless of duration. All outdoor physical education classes, sport practice and athletic competitions should be canceled and rescheduled, if possible. • Stage 2 and 3 Episodes: All children must discontinue outdoor activity. Implement Rainy Day Procedure. Children should remain indoors during lunch and nutrition breaks. All outdoor physical education classes, sports practice and athletic competitions must be canceled and rescheduled.

Site Administrators are responsible for posting signs. Smog Alert Signs must be posted at main entrances and the Main Office following notification of a predicted air pollution episode. The sign will correspond to the smog alert level: Stage 1, Stage 2, or Stage 3. Written or public address system announcements may be used in conjunction with posting signs to notify students and staff of the predicted health advisory or air pollution levels for the following day and the resulting changes in scheduled activities. When Site Administrators, teachers, staff, students and parents need to report any air quality or health concern they may contact the Office of Environment Health and Safety at (213) 241-3199 or via the OEHS Website at www.lausd-oehs.org/index.asp. In addition to notifying OEHS, such concerns may also be directed to the appropriate governmental agency: Air Quality Concerns: South Coast Air Quality Management District (AQMD), 1-800-CUTSMOG (1-800288-7664). Health Concerns: Los Angeles County Department of Health Services, Toxics Epidemiology Program, (213) 738-3220. School Nurses need to know which students may need particular attention due to health issues and should notify the Local Nursing Administrator. Refer to Office of Environmental Health and Safety, SAFETY ALERT No. 05-09 dated August 2005, “REPORTING SCHOOL AIR QUALITY AND HEALTH CONCERNS” and Reference Guide No. REF-886.1 dated August 2, 2007, Office of Environmental Health and Safety, “HEALTH ADVISORY/AIR POLLUTION EPISODES PROCEDURES”.

INDOOR ENVIRONMENTAL QUALITY The Los Angeles Unified School District strives to provide a working and learning environment that is safe, healthy and productive. This includes maintaining classrooms and offices with adequate lighting, good air quality and free of excessive noise. There are several requirements and recommendations that will help maintain indoor environmental quality with District offices and classrooms. Indoor Air Quality • Keep the Heating, Ventilation and Air Conditioning (HVAC) system turned “ON” whenever classrooms or offices are occupied.

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Keep thermostats and air ducts/air returns free of obstruction that could impede air flow or interfere with proper operation of the HVAC system. Remove common sources of indoor air pollution such as cleaning materials, deodorizers, cosmetics and perfumes, art supplies, and pesticides. Other sources of indoor air pollution include new building materials such as cabinets and walls made of pressed wood, new carpets, carpet backing and adhesives, and other furnishings. These products can emit small amounts of chemical vapors or gases, often accompanied by an odor, and can cause irritation to the eyes, nose and upper respiratory system. The effect of these “fixed” sources of air contaminants can be minimized through increased ventilation. However, more significant exposures may require assessment and mitigation by the Office of Environmental Health and Safety (OEHS). The Plant Manager should check to ensure the proper function and venting of gas heaters, furnaces, and other combustion equipment and periodically clean upholstered furniture, carpets and rugs, and maintain floors, ceilings and walls free of dust and debris and ensure that all chemicals used within the indoor environment have been approved for District use by OEHS. A complete list of OESHapproved chemical products may be downloaded at http://www.lausd-oehs.org.

School Nurses should assist with the maintenance of a fragrance free school/office site whenever possible. Strong fragrances may provoke allergic reactions, asthma episodes, which may lead to absenteeism and result in decreased academic performance. Noise and Lighting Concerns about proper lighting and excessive classroom noise should be reported to the Plant Manager and the Site Administrator who will also report to OEHS at (213) 241-3199, as these conditions may seriously impair the learning environment. Copying machines may create a health/safety hazard with indoor air quality pollution and with noise pollution. Copy machines may also emit harmful emissions. These hazards can come from breathing in the vapors, gases, and particles emitted by these machines. In addition, some of the chemicals used in photoduplication equipment (such as acrylates, styrene, and other off-gassing thermal degradation products) can cause an allergic contact dermatitis, which is a type of skin rash. Dry process photocopy machines can emit: volatile organic compounds (VOCs), trichlore ethylene (TCE), and benzene particulates in the exhaust such as carbon black and nitropyrenes which can easily be inhaled. Another concern is ultra fine particles (UFP). UFPs stay airborne for long periods of time and move easily through cracks in walls and floors. Ozone and nitrous oxide gas are additional dangers from copying machines. The Unified States Environmental Protection Agency (EPA) has recommendations for minimizing health effects from copiers. Regular maintenance is essential. The EPA also recommends that large volume copiers be isolated in a separate area with their own ventilation system that is exhausted to the outside. This area must have a lot of outdoor air and the air should not be recirculated throughout the rest of the building. Copy machines that are used occasionally should be located in well-ventilated rooms or within 10 feet of an exhaust vent. Copier machines should not be located in the health office. Refer to Office of Environmental Health and Safety (OEHS), SAFETY ALERT No. 05-02 dated January 2005, “INDOOR ENVIRONMENT QUALITY”.

HEAT STRESS Heat stress is the overall effect of excessive heat on the human body. Prolonged exposure to high air temperatures or to high humidity at even more moderate temperatures may cause the body temperatures of people of all ages to rise and produce one or more of the signs of heat stress affecting the ability to learn, work, or even play. Those at highest risk are the very young, the elderly, people with acute or chronic health problems, and people using certain medications or taking illicit drugs. Not all people tolerate heat to the same extent. Contributing factors in heat stress episodes include but may not be limited to: air temperature,

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humidity, air circulation, radiant heat, air pollution, classroom temperature, classroom location, appropriate clothing, physical conditioning, acclimation to heat, intensity, type and duration of exercise, fluid intake and medical problems and use of medications. Authorities in the fields of medicine, environmental and occupational hazards, and safety have thoroughly studied heat stress and have issued guidelines pertaining to modifying physical activity and school or work schedules. It is recommended that temperature and humidity readings be obtained from the National Weather Bureau, (805) 988-6610. Readings for local areas may be obtained by contacting the appropriate District/Unit/Division Office. Local news reports on radio and television also carry this information. School Site Administrators have specific guidelines for conducting classroom activities on very hot, humid days. These guidelines consider room ventilation, air circulation and activities. Any devices used for ventilation must meet appropriate standards. Specific guidelines for outdoor activities include the intensity of exercise, clothing and air quality conditions. The School Nurse is often consulted regarding hydration. The following guidelines are used. Water must be available. Personal water containers are recommended for use when heat is excessive as a means to prevent dehydration. A personal water container is a firm, non-breakable plastic receptacle which is no more than 9” high and 4” wide that will hold no more than 32 ounces of water. The container may have a pressure seal, screw or pop-up cap, or a straw drink device on its top. The use of all other types of personal water containers is prohibited. The following are recommended precautions: • For health reasons, water containers should not be shared. • For safety reasons, students should not run with straws or containers in the mouth. • For safety reasons, containers may not be used while riding District buses. Students should be encouraged to drink water before entering the bus. • Students should not bring containers to physical education activity areas unless given permission by the physical education teacher. Additional strategies for preventing heat stress include the use of a “cool room”. A “cool room” should be established for use by students showing early signs of heat stress. This room should provide maximum coolness possible. During an emergency, if an air-conditioned classroom is to be used as a “cool room” and is occupied by students, the students should be moved to another location. During excessive heat the “cool room” should be available for use at all times during the school day. If possible, the “cool room” should be located near restrooms and should be equipped with chairs, cots, or mats; running water or adequate amounts of cool dispensed water; telephone or functioning communication with the main office; refrigerator or ice chest with ice and cold compresses; and basic first aid supplies. It should be supervised by the School Nurse or staff trained to recognize signs and symptoms of heat stress and administer first aid. Employees with specific health problems should make them known to Site Administrators. Students with certain health problems may require more attention. If students complain about the heat, allow them to rest or see the School Nurse who may want to have their health status clarified by a parent or guardian. A specific heat stress chart showing related conditions, sign/symptoms and heat-related First Aid strategies is available. School staff should be informed annually regarding heat stress and the school procedures in the event of heat episodes. Refer to Bulletin No. BUL-963 dated April 1, 2004, Student Health and Human Services, “GUIDELINES FOR PREVENTING HEAT STRESS.”

PROTECTIVE CLOTHING AND SUNSCREEN California Education Code (CEC) 35183.5 mandates that students be allowed to wear protective gear (hats, clothing, sun visors, and/or sunglasses) while outdoors at recess, gym, etc. The CEC also allows schools to regulate the type of sun protective clothing/head gear. Schools are not required to provide protective materials. Students are permitted to use sunscreen (over the counter) as an allowable sun protection measure for their outdoor activities while at school.

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Refer to Parent-Student Handbook 2008 – 2009, page 18 and Bulletin BUL-963 dated April 1, 2004, Student Health and Human Services, “GUIDELINES FOR PREVENTING HEAT STRESS”.

POISON CENTER Please make note of these numbers: California Poison Centers General Public Health Education Materials Nurses and Physicians ONLY (Restricted)

1-800-876-4766 1-800-582-3387 1-800-411-8080

ASSESSING AND MANAGING THREATS As a result of the recognition that a variety of threat and crisis situations can and do occur in a district of this size, a task force developed and published, in the 2002 bulletin, the first guidelines for threat assessment and management. The necessity of responding to a variety of threats and crises in the District over the past decade and the publication of the Secret Service Report, in collaboration with the US Department of Education and the National Institute of Justice, on “The Prevention of Targeted Violence in Schools,” prompted the development of guidelines to assess and manage threats made against students, school staffs and/or school facilities. The plan addresses the following concerns: 1) how to respond appropriately to threats that could precipitate a crisis; 2) how to re-establish the safety and security of the school site; and 3) how to provide appropriate psychological intervention services that can help minimize and perhaps prevent emotional damage to those who are affected. All threats made against individuals or groups by other identified or unknown individuals or groups must be taken seriously and investigated to determine whether they pose a real danger to students or staff. Threats which may initially appear or ultimately prove to be pranks or hoaxes are also taken seriously due to the severe disruption that false threats often impose on the daily operation of a school. The systematic and orderly assessment and evaluation of a threat is conducted as quickly as possible by the School Threat Assessment and Management Team in close working collaboration with the Local District Operations Coordinator. Every school should have a threat assessment and management protocol outlined in its school safety plan. This protocol should identify the school police officer and administrator on campus who will initially receive, review and investigate threats and when appropriate, refer threats to the School Threat Assessment and Management Team. School Nurses are vital members of the team, and the School Nurse expertise regarding possible biohazards is essential. One of the responsibilities of the School Threat Assessment and Management Team is to gather pertinent information in order to evaluate the nature and validity of a threat. One record which requires the School Nurse’s expertise and confidential interpretation is the student’s Health Record Card. Discipline records and written assignments are often reviewed. Interviews with other students, friends, parents and staff may occur. Threats must be assessed and managed in consideration of the conditions, risk factors and warning signs, including circumstances or events that potentially may have caused a particular person to make a threat. A threat, whether or not it is carried out, may result in an assessment. Not all indicators will require a full threat assessment or will require participation by all members of the team. Each behavior must be taken into context and handled in a common sense approach. A threat may target an individual (e.g., a note threatening physical harm to a specific person) or may target a particular group on campus, the entire school or the community (e.g., a phone call suggesting an explosive device is located somewhere on or near the school site). Additionally, administrators and staff should remember that persons other than students may be responsible for making threats and may also be the identified targets or victims of threats. This includes employees and community members. The process of threat assessment management is investigative, information driven, fact based and prevention oriented. It includes the following four steps:

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1. Identify the type of threat and the individual(s) making the threat. 2. Assess the warning signs, risk factors, stabilizing factors and potential precipitating events to arrive at an informed opinion. Findings may range from no evidence of violence or intimidation of others to a high violence potential requiring arrest or hospitalization. Risk assessment attempts to answer three questions: Is the individual moving on a path towards violent action? Is there evidence to suggest movement from thought to action? What can be done to control the progression of the threat? Assessment of the warning signs requires an evaluation of threatening oral, written or electronic communications. 3. Develop a course of action or strategy to control the threat. Consider all options including setting parameters with administrative, mental health, legal, or criminal justice resources. 4. Recommend appropriate action to the Site Administrator. 5. Continue to inform your Local Nursing Administrator with all situation updates (including faxing correspondence informatives and other pertinent information to the Local Nursing Office). Following the resolution of a threat situation, a debriefing for members of the Threat Management Team should be held. The principal/designee should determine whether additional staff, student body, or community needs should be addressed. Refer to Bulletin No. BUL-1119.1 dated December 7, 2005, Office of the Chief Operating Officer, “ORGANIZING FOR ASSESSING AND MANAGING THREATS”.

CRISIS INTERVENTION The necessity of responding to a variety of crises in the District over the past two decades prompted the development of a comprehensive Crisis Intervention Plan. The plan addresses the following concerns: 1. how to respond appropriately to incidents that could precipitate a crisis; 2. how to re-establish the safety and security of the school site; and 3. how to provide appropriate psychological intervention services that can help minimize and perhaps prevent emotional damage to those who are affected. Since the issuance of the original bulletin, there have been many events and incidents in the District schools which have resulted in a need for intervention services to help students and/or staff deal with psychological trauma. Intervention during crisis situations has become widely recognized as a necessary action in order to prevent or minimize the emotional damage to the persons involved. In addition, several violent gun related tragedies, including some that occurred on school campuses in California, have focused attention on the importance of adding a threat assessment and management component, which establishes policies and procedures to evaluate and deal with threats directed toward individuals, groups, or an entire school or community. School crisis team members shall be selected from regular school staff and from Local District personnel assigned to the schools (e.g., administrators, teachers, clerical and support staff, School Nurses, psychologists, police officers, PSA counselors, psychiatric social workers, etc). School crisis teams shall schedule regular meetings to update their knowledge of crisis intervention materials, procedures and techniques, as well as to improve, refine and upgrade their skills. Local District Crisis Teams are deployed by the Local District Office. School Nurses must notify the Local Nursing Administrator immediately of any crisis or unusual occurrence. Refer to Bulletin No. BUL-962.1 dated December 7, 2005, Office of the Chief Operating Officer, “ORGANIZING FOR CRISIS INTERVENTION” and Bulletin No. BUL-1119.1 dated December 7, 2005, Office of the Chief Operating Officer, “ORGANIZING FOR ASSESSING AND MANAGING THREATS”.

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MEDIA EVENTS An occurrence at your school may become significant and involve the Media. The District provides a Public Information Specialist to assist Administrators when information must be released to the press. School Nurses should not assume the responsibility for representing the District’s position. Telephone the Local Nursing Administrator ASAP when a significant event occurs at or near your school site or you are visited by or you are anticipating a visit from a distinguished visitor. Be prepared to relate specific details of the incident and to FAX any documents to your Local Nursing Administrator’s Office. FAX a copy of any correspondence sent to a student’s home(s) by the School Administrator to the Local Nursing Administrator’s office.

CALIFORNIA COMPREHENSIVE SEXUAL HEALTH AND HIV/AIDS PREVENTION EDUCATION ACT

California Schools are required to provide specific instruction related to sexual health. Schools must provide students with the knowledge and skills necessary to protect their sexual and reproductive health from unintended pregnancies and sexually transmitted diseases; and to encourage all students to develop healthy attitudes about adolescent growth and development, body image, gender roles, sexual orientation, dating, marriage, and family. School Districts may provide comprehensive sexual health education – which means education regarding human development and sexuality, including education on pregnancy, family planning, and sexually transmitted disease – in Grades K through 12. School Districts may use trained District personnel or preapproved outside consultants who know the most recent medically accurate research on human sexuality, pregnancy, and sexually transmitted diseases. The instruction must meet the following requirements: • The instruction and the materials used to teach must be suitable for the intellectual, emotional, and behavioral ability of students of the age being taught. • All information taught must be medically accurate and objective, meaning it must be verified or supported by research conducted in the scientific method, reviewed by scientific peers, and recognized as accurate and objective by federal agencies and professional organizations with expert knowledge in health matters. • Instruction must be available on an equal basis to a student who is an English learner consistent with the existing curriculum and alternative options for an English learner. • Instruction and materials must be appropriate for use with students of all races, genders, sexual orientations, ethnic and cultural backgrounds, and students with disabilities. • Instruction and materials must be appropriate for students with disabilities through modified curriculum, materials, instructional format, auxiliary aids, and other means. • Instruction and materials must encourage students to talk with their parents or guardians about human sexuality. • Instruction and materials must teach respect for marriage and committed relationships. • Starting in Grade 7, instruction and materials must teach that not having sexual intercourse is the only certain way to prevent sexually transmitted diseases and that not having sexual intercourse has other personal and social benefits as well. Also, instruction and materials must provide medically accurate information on other methods of preventing pregnancy and sexually transmitted diseases. • Starting in Grade 7, instruction and materials must provide students with skills for making and carrying out responsible decisions about sexuality. • Starting in Grade 7, instruction and materials must provide students with information on the fact that a parent or other person who surrenders physical custody of a baby three-days old or younger at a lawfully identified hospital will not be prosecuted according to the Health and Safety Code and the Penal Code. California Education Code Section 51210 mandates health education in Grades 1-6, and Section 6004(b) mandates drug and alcohol-resistance instruction in Grades K-12. To that end, Second Step and Too Good for Drugs should continue to be taught. Teachers are encouraged to use the new K-5 textbook and the support

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materials in the spring semester. The focus of the second semester will be on the nutrition chapter in the new health textbook. In spring 2005, the Board of Education adopted and purchased new health textbooks from Macmillan/McGraw-Hill titled Health and Wellness for Grades K-5. The textbook and support materials have been issued to schools, and District professional development for teachers was conducted in the fall of the 2006-2007 school year. California Education Code Section 51550, parent notification of family life and sex education courses, states that governing boards of public schools may not require students to attend any class in which reproductive organs and their functions and processes are described, illustrated, or discussed. If classes are offered, parents and guardians of all students must be notified in writing. The Grade 5 growth and development supplemental materials require a parental permission slip prior to the teaching of the growth and development lesson by the School Nurse. Principals are asked to send the parental permission slip with each fifth grade student prior to the growth and development lesson given by the School Nurse in the Spring. Grade 5 growth and development materials may be distributed to the School Nurse or the Principal’s designee for use during the growth and development lesson in fifth grade. Schools may store the materials in a secure location until used by the School Nurse or the Principal’s designee to teach the lesson. School Districts that teach comprehensive sexual health education earlier than Grade 7 may provide ageappropriate and medically accurate information on any of the general topics described. Starting in Grade 7 or earlier schools must also meet the following requirements: • Instruction and materials must not teach or promote religious doctrine. • Instruction and materials must not reflect or promote bias against any person on the basis of sex, ethnic group identification, race, national origin, religion, color, mental or physical disability or ancestry, gender, or sexual orientation. California schools are required to provide instruction related to HIV/AIDS prevention. School Districts must provide students in Grades 7 to 12 with HIV/AIDS-prevention education at least once (5 class periods in LAUSD) in middle school and once (5 class periods in LAUSD) in high school from instructors trained in teaching the subject. HIV/AIDS-prevention education, whether taught by School District personnel or outside consultants, must meet specific requirements and must accurately reflect the latest information and recommendations from the United States Surgeon General, the Federal Centers for Disease Control and Prevention, and the National Academy of Sciences. Requirements include: • information on the nature of HIV/AIDS and its effect on the human body; • information on the manner in which HIV is and is not transmitted and on activities that present the highest risk of HIV infection; • discussion of methods to reduce the risk of HIV infection and instruction that emphasizes that sexual abstinence, monogamy, avoidance of multiple sexual partners, and avoidance of intravenous drug use are the most effective means of HIV/AIDS prevention and that includes statistics on the latest medical information on the success and failure rates of condoms and other contraceptives in preventing sexually transmitted HIV infection and on methods that may reduce the risk of HIV transmission from intravenous drug use; • discussion of the public health issues associated with HIV/AIDS; • information on local resources for HIV testing and medical care; • instruction on the development of refusal skills to help students overcome peer pressure and use effective decision-making skills to avoid high-risk activities; and • discussion about societal views on HIV/AIDS and instruction that emphasizes understanding of stereotypes, myths about HIV/AIDS, and compassion for people living with HIV/AIDS. School Districts must develop and provide in-service training on HIV/AIDS-prevention education jointly with the State Department of Education and the District’s teachers who will teach the HIV/AIDS-prevention education.

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Qualified teachers/instructors must receive in-service training on HIV/AIDS-prevention education periodically to enable personnel to learn new developments in the scientific understanding of HIV/AIDS. Such in-service training should be voluntary for personnel who have demonstrated expertise or have received in-service training from the State Department of Education or the Federal Centers for Disease Control and Prevention. School Districts may expand HIV/AIDS in-service training and include personnel who provide comprehensive sexual health education to enable them to learn of new developments in the scientific understanding of sexual health. School Districts may contract with outside consultants who are experts in comprehensive sexual education or HIV/AIDS-prevention education, who have developed multilingual curricula, or who have developed curricula appropriate for persons with disabilities to deliver the instruction or train School District personnel. Schools should establish procedures that make it easy for parents and guardians to review materials and evaluation tools related to comprehensive sexual health education and HIV/AIDS-prevention education so that they can decide whether or not to have their child participate in all or part of the instruction or evaluation. Schools should honor the principle that parents and guardians have the ultimate responsibility for imparting values regarding human sexuality to their children. A parent or guardian of a student has the right to have the child participate or not participate in all or part of comprehensive sexual health education, HIV/AIDSprevention education, and assessments related to that education under the following conditions: • At the beginning of each school year or for a student who enrolls later, schools must notify parents or guardians about instruction in sexual health education and HIV/AIDS-prevention education and research on student health behaviors that will be used in instruction. The notice to parents or guardians must include all of the following information: o that the written and audiovisual education materials used in comprehensive sexual health education and HIV/AIDS-prevention education are available for inspection; o whether the comprehensive sexual health education and HIV/AIDS-prevention education will be taught by District personnel or by outside consultants; o that the parent or guardian has the right to request a copy of Chapter 5.6 California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act; and o that the parent or guardian may request in writing that his or her child not receive comprehensive sexual health education or HIV/AIDS-prevention education. • The Los Angeles Unified School District only requires passive consent (notification) for HIV/AIDS Prevention Education taught in the classroom. Schools must continue to meet the requirements of the California Education Code which states that NO questionnaire, survey, or examination containing any questions about the student’s personal beliefs or practices in sex, family life, morality, or religion or any questions about the student’s parents’ or guardians’ beliefs and practices in sex, family life, morality, and religion can be administered to any student in Grades K-12 unless the parent or guardian of the student is notified in writing that this test, questionnaire, survey, or examination is to be administered and the parent or guardian of the pupil gives written permission for the student to participate in the activity. Anonymous, voluntary, confidential research to measure student’s health behaviors and risks, attitudes and practices relating to sex may be administered if parents/guardians are notified in writing and given the opportunity to review material and to request in writing that his/her child not participate. A student must not attend any class in comprehensive sexual education or HIV/AIDS-prevention education or participate in any anonymous, voluntary, and confidential test, questionnaire, or survey on student health behaviors and risks if the school has received a written request from the student’s parent or guardian excusing the student from participation. A student must not be subject to disciplinary action, academic penalty, or other penalty if the student’s parent or guardian declines to permit the student to receive comprehensive sexual health education or HIV/AIDS-prevention education or to participate in anonymous, voluntary, and confidential tests, questionnaires, or surveys on student health behaviors and risks. While comprehensive sexual health education, HIV/AIDS-prevention education, or an anonymous, voluntary, and confidential test, questionnaire, or survey on student health behaviors and risks is being administered, an alternative educational activity must be made available to students whose parent or guardian has requested that they not receive the instruction or participate in the test, questionnaire, or survey.

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CONDOM AVAILABILITY PROGRAM In 1992, the LAUSD Board of Education approved a policy to make available condoms to students in high schools unless parents do not consent. Condoms are being supplied at no charge to the District from the Office of AIDS Programs and Policy of the County of Los Angeles Department of Health Services in an ongoing effort to mitigate the spread of sexually transmitted disease, including HIV infection, among LAUSD high school students. The County Office of AIDS Programs and Policy is “committed to ensuring that students, community-based health providers, parents, and School Administrators understand the importance of promoting the availability of these risk-reduction tools given the continuing impact of HIV on our school age youth.” While the District does offer education that emphasizes abstinence as the only one hundred percent effective method of preventing infection, the proper use of a condom does provide protection against sexual transmission of the HIV/AIDS virus. Each high school should have a committee that oversees the implementation of the approved policy on the availability of condoms as a means of preventing HIV/AIDS infection and that acts as a resource to the entire school community. Suggested committee membership is as follows: Principal or designee Health Teacher School Nurse IMPACT Coordinator Physical Education Teacher or a Coach Other staff members who might be interested The committee should be included in the decision-making process, which will consist of answers to the following questions: What information will be given to students? Who will provide the information? Where will condoms be made available? Who will make the condoms available? In adherence to LAUSD Board of Education Policy, a nonconsent form is to be given to students upon enrollment at the school in the enrollment packet. Condoms can be ordered by faxing the order form to the HIV/AIDS Prevention Unit at (213) 241-6957. The telephone number for assistance is (213) 241-3520. Refer to Bulletin No. BUL-1132.2 dated January 25, 2008, Student Health and Human Services, “COMPLYING WITH THE CALIFORNIA COMPREHENSIVE SEXUAL HEALTH AND HIV/AIDS PREVENTION EDUCATION ACT (SB 71)”; Reference Guide No. REF-3432.0 dated December 6, 2006, Student Health and Human Services, “HEALTH CONTENT USED BY OUTSIDE SPEAKERS FOR CLASSROOMS REQUIRES LAUSD APPROVAL”; and Bulletin No. BUL-1270 dated August 31, 2004, Instructional Support Services, “GUIDELINES FOR THE USE OF AUDIOVISUAL MATERIALS NOT OWNED, BROADCAST, OR RECOMMENDED BY THE DISTRICT”.

HEALTH EDUCATION The School Nurse is an integral part of any health instruction for students. Health education standards, curriculum content, approved teaching aids/video tapes and parent/guardian consent forms must be standardized for use by all School Nurses. The State Board of Education adopts the formal standards in health education. School Nurses must use the LAUSD approved curriculum for health education. The California

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Education Code outlines the health curriculum content in presentations by outside speakers on AIDS prevention. The curriculum must: • be medically accurate, research and science based, peer reviewed, and accepted by reputable agencies such as the Centers for Disease Control and Prevention; • stress that abstinence is the only 100% effective method for prevention and provide accurate information on the risks of failure of other kinds of contraception; • present the emotional and psychological consequences of having sexual intercourse outside of marriage and of unwanted pregnancy; • stress the importance of abstaining from sexual intercourse until ready for marriage; • advise students on the laws related to their financial responsibility to children born in and out of wedlock; • advise students that it is unlawful for males and females of any age to have sexual intercourse with males or females under 18 years of age to whom they are not married; • emphasize that students have the power to control their personal behavior and should base their actions on reasoning, self-discipline, sense of responsibility, self-control, and respect for oneself and others; and • teach students not to make unwanted physical or verbal sexual advances; how to say no to such advances; what constitutes verbal, physical, and visual sexual assault; what constitutes nonconsensual sexual advances, nonconsensual physical sexual contact, and rape by acquaintance (or date rape); and the legal consequences of date rape. School Nurses provide in-services for staff related to various health topics. A review of First Aid Procedures can be accomplished by reviewing the First Aid Procedures Flip Chart (Form 33.137 Rev. 9/98) or Emergency First Aid Guidelines for California Schools (8/04). This inservice is required to be provided to school staff every year and more often if necessary. For this mandatory in-service and other staff in-services use Training Log Form 33.204A Rev 8/04. For Bloodborne Pathogen Training use the NCR Health and Safety Training Form. School Nurses obtain this form from the Local Nursing Administrator’s Office. For staff training related to a specific student’s protocol(s) or procedure(s) use student specific Training Form 33.204B Rev. 3/07 (enclosed). School Nurses are often asked to facilitate speakers for sensitive topics. School Nurses must know the Board approved curriculum content and approved speakers. Contact your Local Nursing Administrator for assistance. Refer to Bulletin No. BUL-1132.2 dated January 25, 2008, Student Health and Human Services, “COMPLYING WITH THE CALIFORNIA COMPREHENSIVE SEXUAL HEALTH AND HIV/AIDS PREVENTION EDUCATION ACT (SB 71)” and Bulletin No. BUL-1270 dated August 31, 2004, Instructional Support Services, “GUIDELINES FOR THE USE OF AUDIOVISUAL MATERIALS NOT OWNED, BROADCAST, OR RECOMMENDED BY THE DISTRICT”.

HEALTH STANDARDS FOR MIDDLE AND HIGH SCHOOLS In the past two years, the Los Angeles Board of Education has passed resolutions affecting the health lessons mandated by the California State Education Code. For Grades 1-6 science teachers must teach 6 weeks of health each semester (total of 12 weeks); Grade 7 must include one full semester of health education. Students must also complete a full semester of health education in high school. School Nurses are often asked to assist in classroom instruction. School Nurses are an excellent health resource. Adherence to the health framework and the District standards are required when providing health information. Download the Health Framework for California Public Schools at the California Department of Education’s Web site: http://www.cde.ca.gov/ci/he/cf/index.asp. You can also download the LAUSD health standards at the Health Education Web site: http://www.lausd.k12.ca.us/lausd/offices/hep/index2.html.

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MEETING THE REQUIREMENTS OF THE “NO CHILD LEFT BEHIND ACT” OF 2001 AND TITLE IV, SAFE AND DRUG-FREE SCHOOLS The Los Angeles Board of Education approved the District’s LEA Plan as required by the No Child Left Behind Act of 2001. This plan delineates how the District will comply with the law for all categorical programs receiving federal funds. Title IV of the Safe and Drug-Free Schools and Communities Act plays an important role in the LEA Plan. No Child Left Behind has identified a performance goal for all to achieve: All students will be educated in learning environments that are safe, drug-free, and conductive to learning. In addition, as part of the state’s Coordinated Compliance Review (CCR) for Title IV, the District must provide drug, alcohol, tobacco, and violence-prevention instruction for each student every year in Grades K though 12 to be in compliance. The Health Education Programs Office and the Title IV and Tobacco Use Prevention Education Advisory Committee, following the guidelines set forth by the federal government and the California Department of Education, have identified scientifically based and research-validated curriculums for each grade level in the District’s LEA Plan. Only those curriculums approved by the State are to be used for drug, alcohol, tobacco, and violence-prevention instruction for compliance. Curriculums for elementary schools include Too Good For Drugs (K-5); Second Step is a violence prevention curriculum (K-5). Other elementary curriculums are Lessons in Character; STAR: Responsibilities Skills, and Discover Skills for Life. Curriculums for middle schools include Too Good for Drugs and Second Step (Grade 6) and Project Alert, Project Toward No Tobacco Use and Second Step for Grades 7 and 8. Curriculums for high schools, continuation schools and option schools include Project Toward No Drug Abuse; Minnesota Smoking Prevention; Class Action and Missing Link. School Nurses are the health resource for many health teachers. Refer to Bulletin No. BUL-3403 dated November 21, 2006, Senior Deputy Superintendent, Educational Services, “MEETING THE REQUIREMENTS OF THE NO CHILD LEFT BEHIND ACT OF 2001 AND TITLE IV, SAFE AND DRUG-FREE SCHOOLS AND COMMUNITIES ACT”.

CLEANING MOUTHPIECES OF BRASS AND WOODWIND MUSICAL INSTRUMENTS It is important to follow District procedures for cleaning mouthpieces to safeguard the health of students and others. Students with cuts, abrasions, or lesions in the mouth must be cleared by the School Nurse and issued a mouthpiece used only by that student. Refer to Bulletin No. M-88 (Rev.) dated May 24, 1996, Division of Instruction, “CLEANING MOUTHPIECES OF BRASS AND WOODWIND MUSICAL INSTRUMENTS”.

POLICY ON RESTROOM ACCESS, CLEANLINESS AND REPAIR Restrooms must be accessible, clean, safe, stocked, and in working order. In the fall of 2003, the California State Legislature passed into law two bills making it mandatory to use school maintenance funds to ensure that all facilities, including restroom facilities for pupils, are functional and that they meet the local hygiene standards generally applicable to public facilities. This includes: • keeping all student restrooms open during non-class periods and sufficient restrooms open to meet student needs during classes, • cleaning regularly, • maintaining in fully operational condition, and • stocking with soap and paper supplies. Any school district that fails to meet this standard will become ineligible for State school facilities deferred maintenance matching funds. The Los Angeles Unified School District could lose approximately $25 million

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per year in State deferred maintenance matching funds if we do not keep our student restrooms up to this standard. In January 2004, the Board of Education approved a Facilities Health and Safety Initiative which requires the Superintendent: • to highlight the District’s health and safety standards for cafeteria and restrooms on-line at www.lausd-oehs.org. • to provide a semi-annual report on the health and safety of cafeteria and bathroom facilities, trends, and corrective actions planned and taken. • to develop a process and procedure to involve parent volunteers in restroom and cafeteria inspections. • to brief local elected officials with jurisdictions within District boundaries on related District efforts, policies, and procedures so that they may be informed in their legislative activities and constituent interactions. In January 2004, the District and the L.A. City Attorney’s Office unveiled the details of a comprehensive Campus Safety Initiative (CSI) to effectively address health and safety concerns at District campuses. City and County inspectors will conduct joint inspections with District inspectors, as well as independent inspections, to monitor and assess current District inspections methods. They will continue to monitor the progress of the District’s program and provide advice and training to assist the District with effective implementation of changes. The District has policies and procedures to ensure that students have access to clean, functional restrooms. State Legislation enacted requires clean, functional restrooms and imposes penalties for non-compliance. All schools must make restrooms available to adequately serve student needs throughout the school day. Site plans must be maintained for each secondary school to specify where student restrooms are located and when they will be open each day. Information concerning availability of restrooms must be shared with the student body, faculty and parents at each school. An appropriate staff member must provide timely access for any student needing use of a restroom. Site Administrators are ultimately responsible to ensure that restrooms are clean, in good repair and open throughout the school day. Standards must be met in the cleaning and monitoring of restrooms. All surfaces and fixtures are to be disinfected and free of all soil and litter. All paper and soap dispensers are to be stocked throughout the school day. All trash receptacles are to be emptied, relined, and disinfected. Floors are to be swept and mopped. Unpleasant odors must be eliminated. Twice per day, student restrooms are to be spot cleaned, trash disposed of and soap and paper supplies restocked. A full restroom cleaning/restocking is to be completed by the evening Custodial Staff. A Restroom Service Log is completed by the Custodial Staff. Local District Superintendents’ staff shall inspect bathrooms at a minimum of thirty-three schools per week throughout the year. All District employees are encouraged to randomly inspect restrooms when visiting a school. Anyone inspecting a restroom is to report cleanliness issues or repair needs to the Principal or Plant Manager. Plant Managers are to maintain a Plant Manager’s Trouble Call Log to resolve all cleanliness and repair calls. Some restroom problems require immediate attention because there may be a health/safety issue (broken water line, sewer line stoppage, exterior restroom doors that will not lock). An Emergency Trouble Call should be initiated. The LAUSD Restroom Hotline is (800) 495-1191or via the web at www.laschools./org/rrhotline. The LAUSD has procedures in place for reporting school cleanliness problems. School cleanliness problems are referred to the Site Administrator. Immediate health and safety issues should also be referred to the Local Nursing Administrator. Refer to Bulletin No. BUL-735.1 dated July 30, 2007, Office of the Superintendent, “POLICY ON RESTROOM ACCESS, CLEANLINESS AND REPAIR”.

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FOOD HANDLERS School Nurses will continue to examine students, designated staff and volunteers in their schools. When special events are held at the school, parents handling food need to be examined by the School Nurse prior to the special event. All Special Education Assistants, Special Education Trainees and Health Care Assistants are required to have a Food Handler’s Health Certificate. The Class Description for each of these Class Codes states “an LAUSD Food Handler’s Certificate must be obtained upon appointment and renewed annually.” Use the Food Handler’s Health Certificate. These forms are in the District Warehouse and are ordered by the School Administrative Assistant – Commodity Code #966-12-15295. When examining individuals who are required to have a Food Handler’s Health Certificate check for the following: • HAIR – inspect scalp and facial hair to ensure that there are no lesions or open sores and inspect the hair for pediculosis. • TEETH AND MOUTH – inspect the mouth for cavities/dental decay, sores and oral hygiene status. • NAILS – inspect around the nails for any open sores, evidence of nail biting, acrylic or false nails, and nail polish. Food handlers and staff providing physical care to students must have fingernails that are kept short and manicured (no artificial nails and/or nail polish). Skin injuries must be covered with a band aide before gloving. Consult Employee Health Services (213) 241-6326 regarding any chronic nail or skin condition. • SKIN – inspect the hands and arms for any open sores or lesions, scabies, and other dermatological problems. After examining the individual, provide the Cafeteria Manager or appropriate personnel with the original Food Handler’s Health Certificate and retain a copy for your records. If a condition exists that needs remediation, advise the individual and make a notation on the certificate. If in the School Nurse’s opinion the condition requires remediation before the individual should be allowed to prepare or serve food then document that on the Certificate and give the certificate to the appropriate Site Administrator who is responsible for follow-up. (e.g. dental caries should receive appropriate attention before preparing and serving food/beverage.) Cafeteria employees are required to read and sign the “Information for Cafeteria Employees” Form provided to them by the Business Services Division, Food Services Branch. This form requires adherence to a dress code which includes, but is not limited to, “clean teeth/breath, a daily bath and no strong perfumes”. Nails are required to be short, clean and free of nail coating and nail polish. The form specifies no false nails or acrylic nails. Refer to Bulletin No. BUL-1645.1 dated April 7, 2008, Student Health and Human Services, “INFECTION CONTROL GUIDELINES FOR PREVENTING THE SPREAD OF COMMUNICABLE DISEASES”.

FOOD BORNE ILLNESS OR CONTAMINATION LAUSD has specific steps to follow in the event a student or adult becomes ill and food prepared or served on District property is the suspected cause of the illness. All suspected food shall be removed from use immediately, labeled clearly, and placed under refrigeration. Do not discard any food. Samples of the suspected food MUST be kept for the County Health Department and/or the Food Services Branch Nutrition Services Section – (213) 241-2985. If foreign objects are found in cafeteria food, the school staff should keep the object(s) found and the food item in which it was found. The Cafeteria Manager telephones the Food Services Branch, Nutrition Services, Test Kitchen at (213) 625-5536 for further instructions. The School Nurse must telephone the Local Nursing Administrator. Because the District cannot oversee preparation methods used elsewhere, food prepared in private homes and brought on to school grounds for distribution at special events is restricted in accordance with Board Rule 2320 which states, “Food prepared outside of school premises shall not be served on school premises except as provided by Board Rules, Administrative Regulations, or the National School Lunch Program, or requirements of the Student Health and Human Services Divisions.” The School Nurse MUST contact the Local Nursing Administrator immediately.

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Refer to Bulletin No. C-32 (Rev) dated February 14, 2001, Business Services Division, Chief Financial Officer, “EMERGENCY PROCEDURES – POSSIBLE FOOD BORNE ILLNESS OR CONTAMINATION”.

INFECTION CONTROL GUIDELINES FOR PREVENTING THE SPREAD OF COMMUNICABLE DISEASES Preventing the transmission of communicable disease must have the highest priority. The Los Angeles Unified School District provides guidelines for all District personnel to prevent the spread of communicable disease. Teaching and supervision of preventive measures for the control of communicable disease is a School Nursing function. School Nurses on an individual basis or group sessions will conduct in-service instruction. District Physicians are available as a resource. Orientation and training must be on going and include new personnel. Personnel involved in the care of students with medical conditions that require specialized physical health care procedures and/or assistance with hygiene or feeding will receive annual training in Bloodborne Pathogens and Universal Precautions. Transmission of disease occurs more readily in very young and/or disabled children who require close personal physical care. Strict procedures and techniques must be used at all times in all settings. Staff will be trained in the required procedures and techniques before care is give. Infection can be transmitted directly or indirectly, depending on the nature of each disease. Direct transmission can occur in such ways as touching, droplet spray from sneezing/coughing and close physical contact with body fluids, excretions, secretions and discharges. Indirect transmission can occur through contaminated food, water and objects such as towels, toys, eating utensils, clothing, and diapers. Infected persons may not know they are infected or may not share this information with others therefore, adherence to Universal Precautions by all members of the school community, staff and students is critical. •

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Hand washing is the single most important procedure for preventing the spread of disease and physically removes microorganisms from the hands. School Nurses instruct students and staff regarding the need to wash hands properly: o Use liquid soap/detergent and running water (preferable warm). Bar soap can harbor microorganisms. o Rub all areas of hands and wrists in a circular motion briskly for 10-15 seconds. o Clean fingernails. Food handlers are not to wear nail polish/acrylic nails and to keep their own nails short for easier cleaning. o Rinse well under running water. o Dry thoroughly with paper towels; turn off water using the paper towels; wipe surfaces around sink and then discard the towels. Use of gloves – ALWAYS WEAR SINGLE USE DISPOSABLE GLOVES WHEN CLEANING UP BLOOD SPILLS, PERFORMING SPECIALIZED PHYSICAL CARE PROCEDURES OR WHEN PERFORMING PERSONAL CARE. o Gloves must be changed after each procedure and between students. o Use gloves one time and then dispose of them in the proper manner. o Wash hands with soap and water immediately after removing the gloves. (If hands or other skin areas are contaminated with blood or other body fluids when gloves are not used, the skin should be properly washed at once with soap and water. The danger is greater when you have open lesions or breaks in the skin.) Clean up and disinfection – General guidelines o Treat all blood and body fluids (urine, feces, purulent discharges, vomitus, saliva, mucus, nasal discharge) as though they are infectious. o All supplies needed are to be made available in all schools, offices, and other workplaces. o Do not ask students or volunteers to help. o Call the plant manager for assistance when appropriate. o FOR WASHABLE SURFACES ALWAYS USE FRESHLY MADE 1:10 BLEACH SOLUTION (1 PART BLEACH TO 9 PARTS COLD WATER) WHEN CLEANING UP BLOOD. o After the bleach solution has been in contact with the surface for 1 minute, rinse the area with water to prevent possible corrosion. If a mop, broom, or dust pan is used in the clean up, rinse it in the bleach solution.

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Waterless Hand Sanitizers – the waterless alcohol free hand sanitizers are approved by the District for student use. Waterless hand sanitizers are available for purchase through the LAUSD Stores Warehouse Catalogue using Commodity Code 435-70-38045. In areas where soap and water are not available the Hand Sanitizers dispensers may be mounted on classroom walls or placed on counter tops. The Plant Manager should be consulted when dispensers and affixed.

Refer to Bulletin No. BUL-1937.1 dated April 7, 2008, Student Health and Human Services, “REPORTING COMMUNICABLE DISEASES”; Bulletin No. BUL-1645.1 dated April 7, 2008, Student Health and Human Services, “INFECTION CONTROL GUIDELINES FOR PREVENTING THE SPREAD OF COMMUNICABLE DISEASES”; Bulletin No. BUL-3845 dated July 31, 2007, Instructional Services, Elementary; Instructional; Services, Secondary; and Division of Risk Management & Insurance Services, “LIVE ANIMALS IN CLASSROOM, SERVICE ANIMALS, AND SCHOOL SPONSORED AND NON-SCHOOL SPONSORED ACTIVITIES INVOLVING ANIMALS” and Bulletin No. Z-51 dated August 4, 1998, Student Health and Human Services “RISK OF SALMONELLA INFECTION FROM REPTILES”.

PREVENTION AND MANAGEMENT OF SKIN INFECTIONS PREVENTION OF THE SPREAD OF SKIN INFECTIONS Prevention is one of the most important steps in managing a skin infection or other communicable disease at school. Different infectious agents have different modes of transmission, but bacterial infections are generally communicable through skin-to-skin contact, and some infectious agents can be transmitted on shared object or items. Skin infection agents are rarely transmissible through the air or by respiratory droplets. The following is the same guidance given by the State and County Department of Public Health: All staff providing care to students with skin infections should: • Practice universal precautions (See BUL-1645, “Infection Control Guidelines”). • Use vinyl gloves when touching infected areas or changing dressings. • Dispose of contaminated material in appropriate receptacle. • Wash hands thoroughly before and after touching infected skin. All members of the school community should: • Practice good hand hygiene – wash hands thoroughly with soap and warm water for at least 30 seconds after using the restroom, before eating or preparing food, after coughing or sneezing, or whenever there is bare skin contact with others or with shared surfaces of equipment. When water is not readily available, use a waterless hand cleanser as directed and make sure hands are free of visible dirt. • Avoid sharing personal items such as towels, washcloths, clothing or uniforms. • Keep skin infections and wounds covered with a clean, dry bandage until healed. • Use a towel or clothing to avoid bare skin contact with shared gym or athletic equipment (e.g., benches or mats) and wipe down equipment after use. • Avoid touching or coming into contact with another’s skin infection. • Be on the lookout for children and staff with skin infections and report skin infections to the School Nurse immediately. In an effect to help schools deal with possible skin infections due to methicillin-resistant Staphylococcal aureus (MRSA), or any infectious agent, the District has guidelines summarizing existing policy and procedures and highlighting new information and material made available at the local, state and federal level. Skin infections are common in school age children and can usually be managed with minimal disruption of the educational process. Skin infections can be caused by a variety of infectious agents, including bacteria (e.g., Staphylococcal [staph] and Streptococcal [strep]

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spec.), viruses (e.g., herpes simplex), fungus (e.g., tinea or ringworm), and mites (e.g., scabies). Many students and staff may be carriers of these organisms (especially bacteria and viruses) but demonstrate no clinical symptoms. For example, 30-40% of the population has staph in their nose and people may have strep in their throats but be unaffected by the bacteria. Staph bacteria are one of the most common causes of skin infections in the United States. Most of these skin infections are minor (such as pimples and boils) and can be treated without antibiotics, but occasionally serious infections require antibiotic treatment. MRSA is a type of staph infection that is resistant to amny common antibiotics. In the last 10 years, there have been an increasing number of skin infections in the community and in schools due to MRSA. It is important to realize that there are two types of MRSA in the United States: community associated MRSA and health care associated MRSA. Health care associated MRSA is found among person who have been hospitalized and tend to be chronically ill. Community associated MRSA is typically found in healthy people that have not been previously hospitalized. In both types, children are the least likely to get an die from their infections than adults. Nevertheless, there have been reports of community MRSA being spread among members of sports teams. These and other instances highlight the serious nature of MRSA and have made headlines in national and local media. It is sometimes very difficult for school personnel to distinguish skin infections caused by different bacteria, viruses and fungal agents. The medical diagnosis usually requires specific testing to be performed in a health care setting. The medical diagnosis may not be readily available to schools, either because the test has yet to be performed or the individual may not want to disclose confidential medical information to the school. Therefore, schools should not require a “confirmation” to initiate infection control procedures. It is important to treat all skin infections with a standard set of procedures. This will help decrease the spread of disease and eliminate wasted time while waiting for a diagnostic test to be performed. All School personnel are advised to: • Refer students with infections of the skin to the School Nurse or Principal designee, especially if the infection is an open or draining wound. • Notify the School Nurse or Principal designee when parents report, or student or staff self report, a serious skin infection. • Maintain the medical confidentiality of any suspected case. • Practice classroom and school-specific measures to prevent the spread of infectious disease. The School Nurse should • Evaluate any reported case of infection and determine if the student or staff member meets any criteria for exclusion (e.g., draining skin infections that appear to be worsening or cannot be covered and contained) and if applicable determine if exclusion is limited to exclusion from athletics or other activities where skin-to-skin contact is anticipated, or if exclusion from school is warranted. • Contact the parent/guardian if further treatment by a health care professional is needed. It is not necessary to receive a final laboratory report of the etiology of the skin infection unless it will make a difference in the follow-up of the case or their contacts. There is no need to require that a child or staff member must be on antibiotics to return to school. • Provide the parent with information/referrals if requested. • Consult with the Local District Nursing Administrator if you have any questions regarding skin infection management of a student/employee. • Irregular cases or outbreaks should be reported to the Nursing Administrator immediately. Two or more new cases of the same serious skin infection within a classroom or group of students (e.g., team or club) within a 2-week period is considered reportable. (Recurrent skin infections in the same child should not count as “new” infections for the purpose of identifying and reporting a possible outbreak.)

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CLEANING AND DISINFECTING SCHOOLS Almost all serious skin infections are spread through skin-to-skin contact and through surfaces that have come in contact with open skin lesions or wound drainage. When wounds or skin infections are properly covered with bandages or clothing, the likelihood of contaminating surfaces is greatly decreased. Routine cleaning using detergent-based cleaners will help remove most infectious disease agents from school surfaces. However, in the event that a skin infection, of any etiology, has resulted in contamination of surfaces at the school, cleaning and disinfection should occur: The Principal or Principal Designee should: • Determine the need to disinfect by conferring with the School Nurse about the case if he/she is available. The most important consideration is whether there was infected skin contact or wound drainage onto a surface or onto other personnel at the school. • Closure of the school is not necessary. • Disruption of the classroom is rarely necessary. If unusual circumstances make closure of classroom(s) necessary, consult with the Nursing Administrator. • Disinfection of the classroom or other affected school areas usually occurs once and is at the end of the school day. NOTIFICATION OF PARENTS, STAFF AND COMMUNITY Notification to parents, staff and the community is reserved for instances where: 1. there is a serious disease, 2. students or staff have likely exposure to the infectious agent, 3. there is a recommended action to prevent the progression or spread of disease (e.g., an antibiotic or immunization), and 4. the time period in which that recommended action is effective has not passed. It is rare that a case of a skin infection, including those caused by MRSA, would be a cause for notification. Consultation with District Nursing Services and Student Medical Services is necessary before written notification for parents/staff occurs. Refer to Reference Guide No. REF-4035 dated November 26, 2007, Student Health and Human Services, “MANAGEMENT OF SKIN INFECTIONS (INCLUDING MRSA) IN SCHOOL SETTINGS”.

REPORTING COMMUNICABLE DISEASES The California Education Code (CEC) the California Administrative Code (CAC) and the Healthy Safety Code (H&SC) specify the measures necessary for prevention and reporting for a suspected communicable/infectious disease. In outbreaks of any illness affecting over 10% of students enrolled and problems related to tuberculosis control in students are reported to the School Nurse. The School Nurse must telephone the Local Nursing Administrator and the office of the Director, District Nursing Services before 4:00 p.m. on the day of occurrence. Problems related to tuberculosis control in employees are referred to Employee Health Services, Personnel Division, at (213) 241-6326. The school’s responsibility to notify school employees and the parent/guardian of children exposed to a communicable disease is based on several factors determined by school health personnel. Factors considered are: • Is the disease spread by school contact? • Is the disease serious enough to warrant investigation or prophylactic treatment by the student’s private physician or the County Department of Public Health? • Is there an action the parents or school employees should or could be taking? Contact the Local Nursing Administrator, the Director, Student Medical Services, and the Director, District Nursing Services, must be consulted before any notification (written or oral) to parent/guardian or school employees regarding possible exposure to any communicable disease. In the case of exposure to a vaccinepreventable disease, students with incomplete immunization status may be excluded from school at the

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discretion of the County of Los Angeles Department of Public Health. These may include exposures to pertussis, measles, and mumps. Chicken pox notification information letters are to be sent to parent/guardian of all students and to all employees when chickenpox is first identified in the school, for each new semester. Sample letters are available. Contact your Local District Nursing to log the first case of chickenpox in the Fall and in the Spring. Some students with immune system defects, or those taking certain medications for leukemia, organ transplants or steroid dependent asthmatic students are to be notified promptly by telephone whenever school exposure to chickenpox occurs. Outbreaks of chickenpox, (5 cases during a 3-week period) must be reported to the Local Nursing Administrator. The School Nurse should review the immunization record of each of the children and note the date of varicella immunization (if immunized) before reporting the outbreak. Refer to Bulletin No. BUL-1937.1 dated April 7, 2008, Student Health and Human Services, “REPORTING COMMUNICABLE DISEASES”.

SERVICE ANIMALS AND ACTIVITIES INVOLVING ANIMALS, INSECTS AND REPTILES In the continued effort of the Los Angeles Unified School District to provide a safe working and learning environment, the District has specific guidelines to permit animal(s), insect(s) or reptile(s) on District property and/or facilities. Events involving live animal(s), insect(s), or reptile(s) are allowed on District property and/or facilities during school hours as long as the guidelines set herein are met and approval is obtained prior to the event. Approval must first be obtained from the Principal. The Principal should notify his/her Local District Operations Coordinator and contact the Division of Risk Management and Insurance Services at (213) 2413065 at least 30 days prior to the event. Parents should be notified and consent obtained for the students to participate in the planned event, if it is a District sponsored event. The parent notification must disclose the date, time, type of animal, and nature of interaction with student. Parent consent must be obtained for students to participate in any District sponsored event which will involve live animals. The Principal should notify the School Nurse of the event involving animals in case of an emergency. In the event of an emergency, contact 9-1-1 immediately for treatment and Animal Control for immediate removal of the animal, insect or reptile. The contact name, business name, address, and telephone number of the owner or organization providing the animal(s), insect(s) or reptile(s) must be provided to the Division of Risk Management and Insurance Services at (213) 241-3065. The owner or organization providing the animal(s), insect(s), or reptile(s) must be in full control at all times. The owner or organization must provide care, supervision and will be solely responsible for handling the animal(s), insect(s), or reptile(s). The animal(s), insect(s) or reptile(s) must have current vaccinations and immunizations common to that species. Certificate of Vaccination, USDA Certificate of Licensed Class Exhibitor, USDA Inspection Report, Permit from Department of Fish and Game and/or Public Health License must be provided to the Division of Risk Management and Insurance Services at (213) 2413065. The owner must always carry equipment sufficient to clean up the animal’s waste, immediately remove the waste and be responsible for the proper disposal of the animal’s waste. The owner or organization, at its sole cost and expense, shall provide and keep in force during the live animal event, insurance coverage. Adequate proof of said insurance must be provided to the Division of Risk Management and Insurance Services prior to the event taking place. The policy shall name the Los Angeles Unified School District and its Board Members as additional insured. Insurance limits required may vary depending on the type of contact and species and animal(s), insect(s) and reptile(s). Please contact the Division of Risk Management and Insurance Services at least thirty (30) days prior to your event for assistance in processing your request to have live animal(s), insect(s), and/or reptile(s) on District property/facilities. Animal events on campus that are not District sponsored and/or occur after hours must meet the same guidelines. In addition the organization seeking to utilize District property/facilities must first coordinate with the school site, prior to obtaining a lease agreement through Asset Management and Leasing and approval from the Division Risk Management and Insurance Services. School Nurses should contact the Local Nursing Administrator to obtain the Guidelines For Live Animal Events on School Sites Form (Rev. 9/2000).

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The Americans With Disabilities Act allows individuals to use service dogs when necessary. Guide dogs/service animals are permitted on District property and/or at District-sponsored activities for persons with disabilities. Service animals whose behavior poses a direct threat to the health or safety of others or is disruptive to the campus community may be excluded at the time of the threat/disruption, regardless of training or certification. A service animal is any guide dog, signal dog or other animal individually trained to do work or perform tasks for the benefit of an individual with a disability, including but not limited to guiding individuals with impaired vision, alerting individuals with impaired hearing, providing minimal rescue or protection work, pulling a wheelchair or fetching dropped items. The service the animal is providing must be directly related to the functional limitation of the person’s disability. Service animals are working animals, not pets. A service animal must be specifically trained to perform a service function. The service animal should wear a harness, cape, identification tag or other gear that readily identifies its working status. The partner/handler must be in full control of the service animal at all times. The care and supervision of a service animal is solely the responsibility of its partner/handler. The service animal must be on a leash at all times. All service animals should have an owner identification tag. The partner/handler must always carry equipment sufficient to clean up the animal’s waste, immediately remove the waste, and be responsible for the proper disposal of the animal’s waste. The partner/handler of a service animal may be asked to remove any animal that is unruly or disruptive (e.g. barking, running around and causing disruption) from District property and/or facilities at the time of the disruption. If the improper behavior happens repeatedly, the handler may be required to take significant steps to mitigate the behavior before bringing the animal onto District property and/or facilities. Mitigation may include muzzling a barking animal, obtaining a refresher training course for both the animal and the handler, or other appropriate measures. To ensure the safety and security of the school community, students, staff, and community members who are training service animals, voluntarily or for compensation, are not allowed to bring the service animal in training to District facilities or to participate in District-sponsored activities. All questions regarding a service animal on a school site or a District facility or an employee who requests a service animal should be directed to Integrated Disability Management at (213) 241-3139. Therapy or companion animals, including pets, are not service animals, are not covered under the Americans with Disabilities Act, therefore, are not permitted on District facilities or at District-sponsored activities. Injuries or bites from any animal, insect or reptile require appropriate health care, referral, and documentation. Contact the Site Administrator and the Local Nursing Administrator. Refer to Bulletin No. BUL-3845 dated July 31, 2007, Instructional Services, Elementary, Instructional Services, Secondary and the Division of Risk Management & Insurance Services, “LIVE ANIMALS IN CLASSROOM, SERVICE ANIMALS, AND SCHOOL SPONSORED AND NON-SCHOOL SPONSORED ACTIVITIES INVOLVING ANIMALS”.

REPORTING ANIMAL BITES To report dog and other animal bites: follow District procedures for first-aid, parent notification, incident report and then complete the County of Los Angeles Department of Health Services Form for Veterinary Public Health and Rabies Control Program – medical Professional & Other organizations. The Animal Bite Report Form is available from LA Public Health at http://lapublichealth.org/vet/biteintro.htm (then “click” on the Animal bite Report Form link). If a computer is not available, School Nurses may obtain the Animal Bite Report Form from District Nursing Services. Once this non-electronic form is completed fax to: Veterinary Public Health at (562) 401-7112. Telephone (877) 747-2243 to confirm receipt of the fax. Wild rat bites are reported are reported directly by telephone to the Vector Management Program (626) 4305461. Follow District procedures for first-aid, parental notification and incident report procedures. State laws and District policy have been established to govern the study, care and treatment of live animals in the classroom. There is a risk of salmonella infections from reptiles. Human infection from reptiles such as iguanas, turtles, and snakes has occurred as a result of direct or indirect contact with such animals or their cages. Hand washing after handling animals is very important to reduce the risk of disease transmission.

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Refer to Bulletin No. BUL-1937.1 dated April 7, 2008, Student Health and Human Services, “REPORTING COMMUNICABLE DISEASES”; Bulletin No. BUL-1645.1 dated April 7, 2008, Student Health and Human Services, “INFECTION CONTROL GUIDELINES FOR PREVENTING THE SPREAD OF COMMUNICABLE DISEASES”; Bulletin No. BUL-3845 dated July 31, 2007, Instructional Services, Elementary; Instructional; Services, Secondary; and Division of Risk Management & Insurance Services, “LIVE ANIMALS IN CLASSROOM, SERVICE ANIMALS, AND SCHOOL SPONSORED AND NON-SCHOOL SPONSORED ACTIVITIES INVOLVING ANIMALS” and Bulletin No. Z-51 dated August 4, 1998, Student Health and Human Services “RISK OF SALMONELLA INFECTION FROM REPTILES”.

PEDICULOSIS (HEAD LICE) EXCLUSION/READMISSON POLICY District policies and guidelines ensure that the best evidence is used to evaluate and manage students suspected of head lice. • The Communicable Diseases in Schools (Reference Guide), 3rd Edition, 2005 includes the following recommendations for exclusion and readmission of students with head lice: o Exclusion is warranted “when a student has the signs and symptoms of infestation (the most specific being the presence of a live louse). The condition does not warrant immediate exclusion. Inform parents of suspected infestation and avoid any activity that involves the child in head-to-head contact with other children or sharing of any head gear until the end of the school day.” o Readmission occurs “after the child has received the proper treatment they may return to school. While the removal of nits is desirable, the presence of nits alone (after treatment) is not sufficient criteria to exclude children from school.” • Bulletin BUL-1937.1 Reporting Communicable Diseases contains language stating “Students may be excluded for head lice at the end of the school day, but readmitted after appropriate treatment is instituted. The presence of nits alone (after treatment) is not an absolute indication for exclusion and children should not be absent from school for extended periods of time due to this treatable condition.” The bulletin contains an Informational Fact Sheet that the Site Administrator may send when 2 or more identified cases are found in a classroom. Site Administrators with questions should be referred to Student Medical Services at (213) 765-2830.

MANDATE TO PROVIDE INFORMATION REGARDING AIDS/HIV AND HEPATITIS B INFECTIONS TO ALL DISTRICT EMPLOYEES (ANNUAL SCHOOL NURSE INSERVICE TO STAFF) School Districts are required by the California Health and Safety Code, CAL/OSHA and OSHA to provide all employees with information against the work place transmission of bloodborne diseases such as HIV/AIDS and Hepatitis B. Universal Precautions and Post Exposure procedure information must be included in the annual training. Schedule the in-service dates with the Principal. The original training log is to be signed by the participants attending the in-service and maintained at the school site. Send two copies to your Local Nursing Administrator for review and then a copy will be forwarded to the District Nursing Services CD Nurse. LAUSD Environmental Health and Safety personnel may request a copy of the form if your school is audited. Be sure to write on the form the start time and end time of your in-service (including your preparation time – e.g. 1:30 p.m. – 3:30 p.m.) In-service materials are available from the CD Nurse at District Nursing Services at (213) 765-2805. Refer to Bulletin No. BUL-1958.1 dated August 7, 2006, Student Health and Human Services, “MANDATE TO PROVIDE INFORMATION REGARDING HIV/AIDS AND HEPATITIS B INFECTIONS TO ALL DISTRICT EMPLOYEES” and

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Bulletin No. BUL-4088 dated January 15, 2008, Student Health and Human Services, “STUDENTS WITH HIV/AIDS INFECTION”.

GUIDELINES FOR ADULT BLOODBORNE PATHOGEN EXPOSURE Post exposure incidents are: a prick with a contaminated needle, blood/bloody body fluids splashing on the mucous membranes (eye, nose or mouth) or blood/bloody body fluids splattering on skin with open cuts or scrapes and human bites that break the skin while in the performance of the employee’s duties. In the event of an exposure incident, the Site Administrator or designated employee shall immediately (after first aid is administered): 1. telephone Employee Health Services - (213) 241-6326. 2. document the circumstances of the exposure – Injury/Accident Investigation Report. 3. report claim to SEDGWICK CMS at 1 (800) 528-7392 and refer the employee for medical evaluation. 4. forward all medical information to Employee Health Services, 333 So. Beaudry, 14th Floor, Los Angeles, CA 90017. FAX (213) 241-8918 The School Nurse should immediately contact the Local Nursing Administrator and District Nursing Services CD Control at (213) 765-2805. Medical information regarding the incident is CONFIDENTIAL and must not be included in the site’s written report. For further information, the employee should contact Employee Health Services. Refer to Reference Guide No. REF-1279 dated September 3, 2004, Risk Management and Insurance Services, “WORKERS COMPENSATION PROCEDURES”.

GUIDELINES FOR CHILD ON CHILD BLOODBORNE PATHOGEN EXPOSURE The Child on Child Bloodborne Pathogen Exposure is defined as any event in which the exchange of blood or body fluids is possible between students. Some examples are human bites, fighting, body piercing, etc. occurring on campus or during school activities. A student (or staff member) may come in contact with a syringe of unknown origin on or near campus. • Place the syringe into a sealed plastic bag and then place the bag into an envelope. • The gloves used by the individual who collected the syringe must also be placed in the plastic bag. • On the envelope prior to placing the syringe inside, record on the envelope the name of the school site, the name of the child or staff member, the location where the syringe was found and the date. • Immediately contact the Local Nursing Administrator and the District Nursing Service CD Nurse. • Place the envelope with the syringe in the Health Office (preferably in an empty Sharp container). Specific steps must be accomplished immediately: 1. Identify all individuals involved. 2. Assess the injury(s) a. Location b. Type c. Condition of the skin d. Amount of blood or body fluid exchanged 3. Wash all areas that may have contacted blood or body fluids. Use soap and water and wash vigorously for at least one (1) minute. Flush with cool water if there is blood or body fluid contact with the eye(s) or mouth for 10 – 15 minutes. 4. Determine the Hepatitis B Vaccination status and any medical condition that may be a factor. Contact District Nursing Services immediately if there is a known HIV/AIDS health issue – TIME IS CRITICAL.

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5. The Site Administrator should notify the parents/guardians of the incident. The School Nurse should refer the parent/guardian to their health care provider or the Department of Health Services (DHS) Comprehensive Health Center. Specifically ask the parents/guardians if there are any known conditions that may pose additional risk to any of the individuals involved. The parent/guardian may then indicate that there is an additional risk to individuals who may have come in contact with their child’s blood or body fluid. If the parent/guardian reveals this information, request that the family/child’s physician be available for consultation to the physician of any individual who may have been in contact with blood or body fluid. The School Nurse should ask for the name, address, telephone number of the physician and request that the parent/guardian telephone their family/child’s physician regarding the incident. Request that the parent/guardian give their permission for the sharing of the relevant health information with other physician(s) of individuals who may have been in contact with blood or body fluid. 6. The School Nurse documents objective information on the Health Record Card. Charting should include a description of the injury; location; type; condition of the skin; type of contamination; amount of blood or body fluid exchanged; first-aid; parent notification; referral procedure and specific referral resources. The School Nurse should immediately contact the Local Nursing Administrator and District Nursing Services CD Control at (213) 765-2805. 7. The Site Administrator/designee initiates/completes the appropriate Incident Report. Refer to Bulletin No. BUL-1645.1 dated April 7, 2008 Student Health and Human Services, “INFECTION CONTROL GUIDELINES FOR PREVENTING THE SPREAD OF COMMUNICABLE DISEASES”.

CALIFORNIA LAW: WASTE MANAGEMENT ACT Provisions in the California Medical Waste Management Act require any Nurse transporting biologics and/or syringes to: 1. carry a California Limited Quantity Hauling Exemption Permit; 2. carry and complete a Tracking Document; and 3. wear gloves when transferring Biohazardous Waste. The tracking document shall include, but is not limited to, all of the following: 1. The name, address, telephone number, and registration number of the transporter. 2. The type and quantity of medical waste transported. 3. The name, address and telephone number of the generator. 4. The name, address, telephone number, permit number, and the signature of an authorized representative of the permitted facility receiving the medical waste. 5. The date that the medical waste is collected or removed from the generator’s facility, the date that the medical waste is received by the transfer station, and the date that the medical waste is received by the treatment facility. Any hazardous waste transporter or generator transporting medical waste in a vehicle shall have a tracking document in his or her possession while transporting the medical waste. The transporter or generator transporting medical waste shall maintain its copy of the tracking document for three years. A California Limited Quantity Hauling Exemption Permit and a Tracking Document is provided to School Nurses each year. School sites order gloves. Each Health Office will have a Sharps container located in a designated area, safeguarded, and appropriately labeled and kept in a locked cabinet. Please do not overfill containers. Only closed LAUSD provided labeled biohazardous waste containers with a tracking document will be accepted.

DISPOSABLE HAZARDOUS WASTE AND BIOHAZARDOUS WASTE The District has a procedure for the disposal of Hazardous Waste and Unapproved Hazardous Materials. A Hazardous Waste is any waste material that, because of its quantity, concentration, physical or chemical characteristics, poses a significant hazard to human health and safety and its environment. In accordance with

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State and Federal Regulations, appropriate management of hazardous waste requires special hauling, packaging, and labeling prior to disposal for shipment off site. Only trained, authorized personnel are allowed to package hazardous waste. Disposal of hazardous waste must meet specific regulatory requirements. Red Bags are used for Biohazardous waste and require special handling and should NOT be used for the disposal of diapers or routine first aid materials. Red Bags should not be placed in the school trash. Regulations controlling the disposal of Hazardous Waste make individuals and businesses liable for noncompliance. Site staff must be aware of these substances and ensure that they are handled with appropriate safety precautions and disposed of when necessary. Please contact a CD Nurse at (213) 765-2805. School sites have Sharps containers that must be stored, transported and disposed of in a specific process. Expired medications may be transported to the Local Nursing Office for disposal. School Nurses may also deliver Sharps containers to the Local Nursing Administrator’s Office for transportation to the designated disposal site. Sharps containers that are ready for disposal should not be stored for more than seven days. Sharps containers are ordered through the school using Commodity Code Number 9489300033 (3.3 qt.) located in the LAUSD Stores Catalog. Schools should plan to order at least two Sharps containers at a time. Schools should always have a back up Sharps container. Remember all Sharps containers must be stored in a locked cabinet not on a desk or counter tops. The cabinet should be labeled with the words “Sharps Waste” or with the international biohazard symbol and the word “BIOHAZARD”. Biohazardous waste shall be placed in a red biohazardous bag conspicuously labeled with the word “Biohazard Waste” or with the international biohazard symbol and the word “BIOHAZARD”. The bag should be tied to prevent leakage or expulsion of contents during all future storage, handling, or transport. This bag shall be placed in a rigid container for storage, handling or transport. The outside of the container shall be labeled with the word “Biohazard Waste” or with the international biohazard symbol and the word “BIOHAZARD”. Consult with the Plant Manager so that he/she can arrange for appropriate disposal of “Biohazard Waste”. The generator transporting medical waste (biohazardous waste and Sharps waste) shall maintain a completed tracking document of all medical waste removed for treatment or disposal. Discarded and/or expired medications should be brought to Bill O’Brien at 1307 San Julian Street or collected at your Local District Nursing meeting for delivery to Bill by arrangement with your Local District Nursing Administrator. If the School Nurse transports the expired medications to Bill O’Brien directly, please remove all identifying student’s information from medication containers and unnecessary packaging. Medication should not be placed in Sharps containers, garbage/waste cans or toilets. Refer to Reference Guide No. REF-4149.0 dated February 26, 2008 Office of Environmental Health and Safety, “DISPOSAL PROCEDURES FOR HAZARDOUS WASTE AND UNIVERSAL WASTE”.

IMMUNIZATION REQUIREMENTS FOR SCHOOL ENTRY The District Bulletin reflects the current immunizations required by the State of California for school entry. The law allows (a) parent/guardian to choose an exemption from immunization requirements based on his/her personal beliefs, and (b) physicians of the children to elect medical exemptions. See the back of the blue California School Immunization Record (PM286) for instructions and the affidavit to be signed by the parent/guardian electing the personal beliefs exemption. A list of pupils with exemptions must be maintained so they can be excluded during a disease outbreak if necessary. A parent/guardian who does not have a written immunization record for his/her child is to be referred to his/her Physician or the Health Department to obtain the required immunizations and/or written immunization verification prior to enrollment. Students without immunization records will not be enrolled. There is no grace period. For special circumstances related to the “Homeless” refer to the “Homeless Children and Youth in School” section. Transfer students, both interstate and intrastate, will no longer be given up to 30 school days of conditional attendance while waiting for arrival of the immunization records from the previous school. Students from other countries must meet the same requirements as any student entering school for the first time.

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LAUSD sending schools should complete the Immunization Section on the Pupil Accounting Report (PAR) when a student transfers, or give the parent/guardian a copy of either the California School Immunization Record (CSIR) Card or Immunization Record to take to the receiving school. Transferring students include Elementary Students advancing to Middle School and Middle School Students advancing to High School. Receiving schools must request immunization documents directly from the parent, determine admission status, and follow up as indicated. In unusual circumstances only, telephone/FAX confirmation that immunizations are complete to date may be accepted from another LAUSD school for enrollment purposes, pending receipt of records. Follow-up must be done to assure that records are received and do meet the State requirement. Contact the Local Nursing Administrator for schedules. Refer to Bulletin No. BUL-1660.3 dated April 7, 2008, Student Health and Human Services, “IMMUNIZATION GUIDELINES FOR SCHOOL ADMISSION”.

CALIFORNIA SCHOOL IMMUNIZATION RECORD PM 286 (CSIR) The CSIR card is to be completed for ALL students enrolled in LAUSD schools including Children’s Centers. School Nurses are not required to sign the CSIR card. The State of California prohibits the use of any and all labels on CSIR cards. The California School Immunization Record (CSIR) “BLUE CARD” can be printed by the school computer for primary grades Pre-K through 5th and for secondary schools utilizing the State approved CSIR Program and fiiled in the CUM folder. School personnel should enter the student immunization information in the computer and then print the CSIR document on blue paper. The CSIR documented information must be verified with a copy of the original immunization document presented at the time of enrollment. Keep a supply of the original hard copy CSIR cards for parents who wish to sign waivers for all or part of the immunizations or TB Test.

STUDENT TUBERCULOSIS CLEARANCE REQUIREMENTS General Guidelines: 1. The Mantoux Test is required. The Tine Test is not acceptable. 2. K or New to school first graders must have a documented Mantoux Test during the previous 12 months. 3. Students entering a California school for the first time in other grades must have a documented Mantoux Test at some previous time. 4. Students transferring from another California School ARE EXEMPT from the TB Clearance Requirement. 5. The results of the Mantoux Test must be recorded on the Physician’s Report or other official document before school admission. 6. Chest X-ray (when skin test reaction is 10 mm induration or greater) must be done within 20 school days after the Mantoux Skin Test is read. Bulletin No. BUL-1659.1 dated April 7, 2008, Student Health and Human Services, “TUBERCULOSIS EXAMINATION REQUIREMENT FOR STUDENTS NEW TO CALIFORNIA SCHOOLS”.

TUBERCULOSIS CLEARANCE REQUIREMENTS FOR EARLY CHILDHOOD EDUCATION DIVISION (ECED) STUDENTS Children entering in an Early Education Center, State Preschool, or Preschool Collaborative Classroom Program must have a Mantoux Tuberculin Skin Test before admission to the program. Reports of Mantoux Tests administered by the Los Angeles County Department of Health Services, private physicians or clinics are acceptable. The official report must be current, within one year of enrollment. The report must have a reading within 72 hours of the administration of the Mantoux Test. If the Mantoux Test is positive, a diagnostic chest

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x-ray report is required. The official chest x-ray results must be provided within 20 school days and students must be excluded after 20 days if the official chest x-ray results have not been provided. (The Mantoux Test is not currently required for School Readiness Language Development Program – SRLDP preschool students.)

READING TUBERCULIN SKIN TESTS FOR ADMISSION Reading, documentation and follow-up of Mantoux Skin Tests is the responsibility of the Los Angeles County Health Services or the Health Care Provider. Although the School Nurse possesses the skills to read tuberculin skin tests, it is requested that the School Nurse NOT read these skin tests given by any other provider. The skin test has to be recorded on the ORIGINAL document. Problems related to Tuberculosis control in students are reported to District Nursing Services, Communicable Disease Control Nurse at (213) 765-2805.

EMPLOYEE TUBERCULOSIS CLEARANCE REQUIREMENTS Every four years an employee should receive a notice and is required to present evidence of freedom from active Tuberculosis by Mantoux Tuberculin Skin Test or chest X-ray if the Mantoux Skin Test was positive. An employee may get a Tuberculosis Clearance from a Public Health Agency or personal health care provider. An employee who has a chest X-ray or Mantoux Tuberculin Skin must submit the report, properly identified with the employee number and payroll name to Employee Health Services, Beaudry Building, 14th Floor, (213) 241-6326. The employee should keep a copy of the report for his/her records.

VOLUNTEER TUBERCULOSIS CLEARANCE REQUIREMENTS Volunteers requiring Tuberculosis Clearance are those in regularly scheduled contact with students in an instructional setting and other indoor areas (e.g., cafeteria). This may exclude volunteers who assist with proms, occasional student body events, duplicating materials, and other intermittent or solitary tasks. Volunteers must have proof of Tuberculosis Clearance within 6 months prior to volunteering. The initial examination must consist of a Mantoux Skin Test. Volunteers with a documented positive skin test must show proof of a negative chest X-ray. Volunteers with a negative skin test must repeat the skin test every 4 years. Volunteers with a positive Mantoux Test must furnish a certificate from a Health provider every 4 years showing he/she is free from active Tuberculosis. The form to be used to document evidence of freedom from Tuberculosis is contained in Bulletin No. DT-2 dated April 13, 1998, School Volunteer Program Office, Office of the Deputy Superintendent, Government Relations and Public Affairs, “ESTABLISHING AND ADMINISTRATING SCHOOL VOLUNTEER PROGRAMS”.

ANNUAL PESTICIDE USE NOTIFICATION The District has adopted an Integrated Pest Management (IPM) Policy. This policy includes notifying parents/guardians and staff of pesticide use. During the school year, it may be necessary to apply pesticides at school to avoid serious health problems posed by pests and/or to maintain the integrity of a structure. If you or your staff would like to be notified each time a pesticide application is scheduled at your school or office you or your staff must complete a form and return it to the Site Administrator. Refer to Office of Environmental Health and Safety, SAFETY ALERT No. 04-12 dated November 2004, “ANNUAL NOTIFICATION OF ENVIRONMENTAL HEALTH AND SAFETY PROCEDURES”.

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HOMELESS CHILDREN AND YOUTH IN SCHOOLS On January 8, 2002, President Bush signed the 2001 No Child Left Behind Act into law. This legislation reauthorized the McKinney-Vento Homeless Assistance Act for Homeless Children and Youth, under NCLB, Title X, Part C. This law entitles all homeless school-aged children to the same free, appropriate public education that is provided to non-homeless students. Accordingly, schools are required to remove barriers to the enrollment, attendance, and success of homeless students in school. The basic educational protections of the reauthorization apply to all school districts in all fifty states. The McKinney-Vento Act, as federal law, supersedes state and local educational law and policy. The District participates in the McKinney-Vento Homeless Assistance Act for Homeless Children and Youth. This is implemented through the Homeless Education Program. The Program implements the District’s homeless education policy, coordinates the identification of homeless children and youth, arranges the transportation assistance for homeless children and youth, resolves school disputes, provides supplemental support services to enhance educational achievement, collaborates with homeless service agencies, and conducts parent education workshops for homeless parents. The McKinney-Vento Act defines a “homeless” student as one between the ages of two and eighteen, who 1) lacks a fixed, regular, and adequate nighttime residence, and 2) may include at least one of the following: • has a primary nighttime residence that is a shelter, • temporary living accommodations including motels/hotels, • lives in a car, park, or abandoned building, • lives in a trailer park or camping area with his/her family, • lives “doubled-up” where one family lives with another, • is abandoned in hospitals, • resides in a home for unwed mothers as a school-aged, unwed mother, • is awaiting foster care, • is placed by the state in an emergency shelter, • lives in an abandoned building, parked car, or other facility unfit for habitation, • are migratory children who qualify as homeless, • are abandoned, runaway or throwaway youth. All Local Educational Agencies (LEA’s) – school districts, independent charter schools, and county offices of education – must designate a School Site Homeless Liaison for homeless children/youth. The District is responsible, through the liaison and designated staff, for ensuring the identification, enrollment, attendance, and success of students in homeless situations. The Homeless Education Office serves as the liaison for the District. The Office is responsible for coordinating with school sites and local districts. The local district Coordinator of Pupil Services and Attendance shall designate a PSA Counselor as the homeless education liaison for the local district. The local homeless education liaison will be responsible for implementing the No Child Left Behind Act (NCLB) homeless education mandates at the local district level and reporting the data to the Homeless Education Program Liaison. “Enroll” and “enrollment” for homeless students are defined as attending classes and participating fully in school activities. The school shall immediately enroll the child/youth in school, even if records normally required for enrollment, such as academic records, proof of residency, medical records, immunizations, are lacking. A thirty day conditional enrollment is to be granted if immunization records are not available at the time of enrollment/registration. Enrollment MUST NOT be delayed. School staff should coordinate efforts with local clinics, agencies, and shelters in the community to provide access to immunizations and other needed social services for homeless children, such as: • complete the Needs Assessment form; • providing a list of free clinics and their locations, where available, where parents and shelter providers can obtain immunizations for children; • follow-up on all referrals; • establishing and maintaining regular contact by School Nurses and health coordinators with local shelters in the area;

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establishing and maintaining regular contact with agencies that provide social services to homeless children in the area; and providing information regarding nutrition programs, transportation, assistance with special education and tutoring programs, pre-school, magnet, gifted/talented and ESL programs and before and after school programs.

The enrolling school shall immediately contact the last school of attendance to obtain relevant academic, health and other relevant records that are lacking at the time of enrollment, and establish an in-school file of identified homeless students, containing CONFIDENTIAL intake information to facilitate referral to needed educational assessment and/or support services. The form is provided ONLY to assist school staff and is NOT to be included in the permanent cumulative record. Any record ordinarily kept by the school, including immunization and/or medical records, academic records, birth certificates, guardianship records, and evaluations for special services or programs, regarding each homeless child or youth shall be maintained. Records are to be available in a timely fashion when a child or youth enters a new school or district; and in a manner consistent with the Family Educational Rights and Privacy Act (FERPA) [20 U.S.C. 1232g] and California Education Code section 49060 et seq. Like all parents, parents and caregivers of homeless students are required to submit emergency contact information. Students may attempt to enroll without a parent or guardian. “Unaccompanied Youth” are defined as youth who are not in the physical custody of a parent, guardian or caregiver and includes youth who have run away from home or have been told to leave home. These students have the right to enroll without a parent, guardian, or caregiver. The Bulletin states that after enrollment is complete, homeless students in need of additional educational support shall be referred to the school site support services personnel, such as the School Nurse, school psychologist, psychiatric social worker, counselor, and/or the after school program coordinator, as appropriate. Refer to Bulletin No. BUL-1570.1 dated March 5, 2008, Student Health and Human Services, “ENROLLMENT/SUPPORT OF HOMELESS CHILDREN AND YOUTH IN SCHOOLS” and Bulletin No. BUL-787 dated July 1, 2004, Student Health and Human Services, “GUIDELINES FOR SCHOOL ENROLLMENT OF STUDENTS IN OUT-OF-HOME CARE”.

WORK REQUEST PERMIT School Nurses may receive a request to complete information for a work request for a student. Form OLSE277 (Rev. 12/03) contains a section to be completed by a licensed physician and surgeon. The School Nurse should make a copy of the form; check the student’s Health Record Card; advise the Counselor if there are non-confidential health issues and return the form to the Counselor or Site Administrator for their signature and processing.

GUIDELINES FOR VOLUNTEER WORKERS ASSISTING THE SCHOOL NURSE Volunteers are not recommended in the Health Office due to patient and family confidentiality issues and potential exposure to contagious diseases. Bulletin No. Z-35 guidelines for volunteer workers assisting the School Nurse has not been replaced. The School Nurse may request a volunteer to escort students for vision or other screenings.

VOLUNTEER HEALTH AND MENTAL HEALTH SERVICES TO STUDENTS The Division of Student Health and Human Services has the responsibility to provide support to the instructional program and reduce any barriers to the academic achievement of students. Schools are encouraged to collaborate with city, county, and community based service providers in order to integrate school based and community based efforts for improved child, youth and family outcomes.

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All health and mental health services provided at no cost to the District are considered volunteer services. These include mental health professionals (psychiatrists, psychologists, licensed clinical social workers and licensed marriage and family therapists), and health professionals (physicians, dentists, optometrists, nurses) working through public and/or private organizations. In order for a community based agency or any non-District person(s) to render volunteer mental health and/or physical health services on a school campus, a Service Delivery Application to Provide Volunteer Health and Mental Health Services at District Locations and a Memorandum of Understanding For Volunteer Health and Mental Health Services at District Locations (MOU) must be completed and be on file with the Community Partnerships and Medi-Cal Programs office. Volunteer services may not commence until the Site Administrator has received notification, that the Community Partnerships and Medi-Cal Programs office has approved the volunteer’s application and Contract Administration Branch has approved the MOU. Care should be taken in engaging individuals and agencies to work with the students in the mental and physical health areas. Volunteer health service providers, such as psychiatrists, psychologists, licensed clinical social workers, licensed marriage and family therapists, physicians, dentists, optometrists, and nurses must have current and appropriate state certification to perform services and must work within their scope of practice. The intent of any services should be to supplement and enhance health services to students, not supplant the services already being provided. The trend is to have schools coordinate community services for students and their families. ALWAYS contact your Local Nursing Administrator when other Health Professional Groups request access to your school site. There are a range of services which may be offered to students; however, all individuals and approved agencies MUST meet specific criteria for service delivery and supervision. All individuals/groups must have a signed Memorandum of Understanding (MOU) before services can begin. DISTRICT NURSING SERVICES MUST VERIFY THAT A SIGNED MEMORANDUM OF UNDERSTANDING (MOU) HAS BEEN APPROVED PRIOR TO THE COMMENCEMENT OF SERVICES. Physicians and other qualified emergency medical personnel may volunteer their services at school sporting events and other related events. For information relating to sporting events, contact Student Medical Services and/or the office of Interscholastic Athletics for information and an application. For additional information on relevant District policies, procedures and resources, contact the appropriate office: District Nursing Services Community Partnerships & Medi-Cal Program (MOU) School Mental Health Crisis Intervention Services Student Medical Services Interscholastic Athletics

(213) 765-2800 (213) 241-3872 (213) 241-3841 (213) 241-2174 (213) 765-2830 (213) 745-1980

Your Local Nursing Administrator is to be contacted if approval has been provided. Many times questions and concerns are initiated years after a program is introduced to a school. If you have questions and/or concerns contact your Local Nursing Administrator. Refer to Bulletin No. BUL-1559 dated January 6, 2005, Student Health and Human Services, “DELIVERY OF VOLUNTEER HEALTH AND MENTAL HEALTH SERVICES TO STUDENTS”.

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AUDITS/REPORTS Immunization Assessments are due in LAUSD Nursing Administrator’s Office on Wednesday, October 1, 2008. • Immunization Assessment of Kindergarten Students – Annual Report – School Summary Sheet • Immunization Assessment of Early Education Center and State Pre-K Tuberculosis Skin Test Report Form is due in the LAUSD Nursing Administrator’s Office on Wednesday, November 12, 2008. • Tuberculosis Skin Test Report Form – School Mandate Child Health and Disability Prevention (CHDP) Program • Individual School Data Report (Form No. PM 272) • CHDP Program Annual Report is due in the LAUSD Nursing Administrator’s Office on Wednesday, November 12, 2008. F0R ALL REPORTS USE ONLY THE CURRENT YEAR’S FORMS. DO NOT SEND THESE FORMS DIRECTLY TO THE HEALTH DEPARTMENT. Reports are sent to the Local Nursing Administrator. All reports submitted on line, must be printed and a copy sent to the Local Nursing Administrator.

MANDATED COST AND MEDI-CAL COST RECOVERY PROGRAMS The Mandated Cost Recovery Program and the Medi-Cal Cost Recovery Program are opportunities for the School District to collect revenue for specific duties/tasks performed by School Nurses. Documentation and maintenance of accurate records are essential steps in the recovery process. The Welligent Health Manager has eliminated the need to document on paper. Documentation is required in Welligent for the following: • Mass Screenings: scoliosis • School Nurse Health Assessment (Special Education) • Special Procedures (Protocols) and Medications Required forms are: • Form 33.75 Annual Report of Scoliosis Screening • Form 33.74 Rev. 8/06 Child Health and Disability Prevention Program Individual School Annual Report • Medi-Cal Form 303 School Nurse Protocol Log Use the paper documents only if you are unable to log into Welligent or if personnel do not have a Welligent account. Medi-Cal Form 308 Rev. 3/03, The School Nurse Health Office Daily Log may be used to log Health Office visits. Form 33.84 E/S Rev.08/02 – The Pupil Health Exclusion and Form 33.85 E/S Rev. 10/05 the Pediculosis (Head Lice) Exclusion letter are available in Welligent. Parents/Guardians will continue to receive a copy of the Pupil Health Exclusion and the Pediculosis (Head Lice) Exclusion letter.

SCHOOL NURSE HEALTH SERVICES SUMMARY REPORT •

Annual Statistical Report (School Nurse Health Services Summary Report) Data from the Annual Statistical Report is used for information needed by budget and various other divisions. It is anticipated that your reports will be as accurate as possible. You MUST INCLUDE LOCATION CODE ON EACH REPORT. Magnet schools, continuation schools and regular schools each have a separate annual statistical School Nurse Health Services Summary Report Form No. 33.182 (Rev 3/03). (School Nurses serving in a summer schedule at school site(s) must submit a copy(s) of their summer statistics on the School Nurse Health Services Summary Report to the Local Nursing Administrator and also leave a copy of the report(s) in the School Nurse’s mail box).

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The Summary Report is confidential; any requests for copies must be referred to the Director, District Nursing Services at (213) 765-2800. Complete and submit to your Local Nursing Administrator by Friday, May 29, 2009.

YOUTH SUICIDE PREVENTION PROGRAM The growing rate of suicide and of suicidal behavior among children and adolescents was recognized by the California State Legislature in 1983 with the passage of Senate Bill 947 authorizing the creation of a statewide Youth Suicide Prevention School Program. In January 1986, the Los Angeles Unified School District Board of Education took action to direct the superintendent and staff to develop and implement a youth suicide prevention program to include both educational and intervention components. The adolescent suicide rate has tripled in the past four decades, and suicide is now the third leading cause of death in the 10 to 19 age group. Eleven percent of high school students have made at least one suicide attempt, while 40 percent have indicated serious suicidal thoughts. Even among children and pre-teens, suicide attempts are becoming more prevalent. The Center for Disease Control has reported that from 1980-1992 the rate of suicide among children aged 10-14 years increased by 120 percent. Because of this critical need for coping skills on the part of students and the belief that school personnel can be instrumental in helping to save lives, the District’s suicide prevention program has been developed with specific goals, objectives, and curriculum. The goals of the youth suicide prevention program are to reduce the incidence of suicide and suicide attempts and to increase coping skills among students in the District. The objectives of the program are to increase the knowledge of staff concerning indicators of students-at-risk and resources for help which may be available to these students; to increase, through classroom instruction, the cognitive understanding of students concerning indicators of possible risk factors in themselves and other students and resources for help; to increase the awareness of parents concerning indicators of possible risk factors in their children and resources for help; to identify students who are at risk; to provide direct intervention services for students and parents as appropriate; to provide post crisis activities and services to reduce trauma in students, parents, and school staff in the event of a suicide or suicide attempt. The District’s suicide prevention program includes three phrases – prevention, intervention, and postvention – with appropriate implementation components for each phase. The prevention phase consists of an instructional component, a staff awareness component, including school staff training, defining the levels of risk and the actions required, and a parent awareness component. The intervention phase establishes a process for identifying at risk students and providing direct intervention referral services to students and parents. Instructions for suicide youth intervention are: • supervise the student – obtain adult assistance; • assign a designated reporter; • collaborate with administration and crisis team personnel (if available); • contact/warn/assist parents and Protective Services; • provide resources to parents and staff when needed • utilize law enforcement when needed. The postvention phase consists of activities, services, and post-crisis trauma strategies. Applicable curriculum, pamphlets and forms are available and referenced in the Youth Suicide Prevention Bulletin. Specifics of the Risk Assessment Referral Data (RARD) are also included. Refer to Bulletin No. BUL-2637.0 dated July 1, 2006, Student Health and Human Services, “YOUTH SUICIDE PREVENTION PROGRAM” and Memorandum No. MEM-3342.0 dated October 3, 2006, Student Health and Human Services, “FORMS OF THE YOUTH SUICIDE PREVENTION PROGRAM.”

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SUICIDE – RISK ASSESSMENT REFERRAL DATA (RARD) A student returning to school following a serious or prolonged illness, injury, surgery, or other hospitalization, must have written permission by a California licensed health care provider to attend school, including any recommendations regarding physical activity. Students with serious or prolonged mental illness and/or hospitalization for mental illness must return to school with written permission from the appropriate licensed physician. If the School Nurse is not provided with the appropriate return to school documentation, the School Nurse should immediately contact District Nursing Services at (213) 765-2800. The Risk Assessment Referral Data (RARD) document which is available on-line through the District’s website and is required to be completed by a staff or faculty member, or a member of the crisis team, for every student referred as “At-Risk” for suicide. This form is the only one utilized in the process and is maintained as part of the student’s confidential health record. It is not to be filed in the cumulative records. School Nurses are members of the crisis team. The RARD was revised in May 2006 and may be completed (but not saved) electronically or completed using a paper copy of the form. Document all applicable areas on the form. Following completion of the RARD: • • • • •

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Electronically print or make 2 copies. Crisis team members, staff and faculty (other than the School Nurse) will notify the School Nurse of the RARD completion. School Nurses document the completion of the RARD on the Health Card – include the date and the name of the individual completing the RARD. File one copy of the RARD in the student’s confidential health file (NOT the Cumulative Folder). Send the second copy through school mail to: Suicide Prevention Unit (SPU) School Mental Health Valley Clinic Balboa Site If a student for whom a RARD has been completed transfers to another LAUSD school, the crisis team member documents the school transfer on the RARD (Item 17) then contacts and sends the RARD to the receiving school. If a student for whom a RARD has been completed transfers to a school OUTSIDE the District, the crisis team member documents the school transfer on the RARD (Item 17) and contacts the receiving school when appropriate. All copies of the RARD are then sent via school mail to the SPU. At the end of the school year, the RARDs for students who are transitioning to middle or high school must be updated (Item 17) and sent on to receiving schools.

For suicidal emergencies telephone 9-1-1 and then contact your Local Nursing Administrator. To contact Rich Lieberman, Director, Suicide Prevention Unit telephone (818) 705-7326. For emergencies, telephone (310) 650-1888. Refer to Bulletin No. 2637.0 dated July 1, 2006, Student Health and Human Services, “YOUTH SUICIDE PREVENTION PROGRAM” and Memorandum No. MEM-3342.0 dated October 3, 2006, Student Health and Human Services, “FORMS OF THE YOUTH SUICIDE PREVENTION PROGRAM”.

WELLIGENT HEALTH MANAGER Welligent Health Manager is the software application which meets FERPA and HIPAA requirements for managing student health information and student health encounters. Welligent is being utilized to document student health encounters including: • Health Assessments for Special Education purposes; • medications;

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special procedures (protocols); and screenings (individual and Mass Screenings).

Training for all School Nurses is available through a variety of methods. School Nurses may use on line web based modules that are accessed via the Learning Zone; Instructor Led Training sessions; individual one on one session(s) with Local District Nursing Super Users. Super Users are School Nurses that have had additional training in the Welligent Health Manager. There are two Nursing Super Users for each Local District Nursing Office. School Nurses may request assistance from Nursing Super Users or LAUSD Help Support at (213) 241-5200.

SPECIAL EDUCATION POLICIES AND PROCEDURES MANUAL The Special Education Policies and Procedures Manual (burgundy notebook published July 2007) explains the District Special Education Policies and implementation of procedures. It is a reference tool for School Administrator, teachers, Special Education itinerant and support staff. The 2007 manual is aligned with Final IDEA Regulations which took effect October 2006. Sections include: • The Special Education Process • Special Education Guidelines • Additional sections include information on Rights, Support, Assistance and Terminology Refer to the Los Angeles Unified School District Special Education Policies and Procedures Manual dated July 2007.

MODIFIED CONSENT DECREE The Modified Consent Decree holds the District accountable for compliance with applicable Federal and State Special Education Laws and Regulations. This is overseen by the Office of the Independent Monitor. There are 19 results-based outcomes that the District is working to meet. A yearly School Self Review Checklist is completed by each school. The checklist assists schools in determining compliance with the Individuals with Disabilities Education Act (IDEA) and the District’s Special Education policies and procedures. It is the responsibility of the Site Administrator to ensure that the “checklist” is completed and submitted in the designated time frame. Refer to Reference Guide No. REF-2624.2 dated July 2008, “SCHOOL SELF REVIEW CHECKLIST, STUDENTS WITH DISABILITIES, 2008 – 2009”.

COMPLAINT RESPONSE UNIT/PARENT RESOURCE NETWORK The Complaint Response Unit (CRU)/Parent Resource Network (PRN) was established to respond to concerns of parents of students with disabilities. PRN services may be accessed by calling (800) 9338133. The PRN is staffed by parents of students with disabilities that have been trained in responding to parents’ concerns and service as a liaison to district staff regarding parent complaints. The Unit is responsible for accurately recording all parent inquires and complaints that they receive by telephone or in writing. The District will then provide parents with a written response. In addition the Unit records all school responses to specific parent inquiries. Refer to Reference Guide REF-1341.4 dated September 25, 2007, Division of Special Education, “COMPLAINT RESPONSE UNIT FOR PARENTS OF STUDENTS WITH DISABILITIES”.

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GUIDELINES FOR INDIVIDUALIZED HEALTH ASSESSMENT AND THE PARTICIPATION OF THE SCHOOL NURSE IN THE INDIVIDUALIZED EDUCATION PLAN (IEP) PROCESS The Credentialed School Nurse is a team member in the IEP Process and should be designated as an assessor and a participant in the computerized IEP system. THE HEALTH ASSESSMENT (HA) A signed current consent to assess with “Health and Development” and “Nurse/Physician” marked (within 60 days) is required when a Special Education Assessment by the School Nurse is requested (for initial, annual and 3 years). Send a copy of the completed health assessment and the signed copy of the consent to the Local Nursing Administrator’s office. A summary of the student’s Health Record Card and the vision/hearing screening do not require a signed consent. • If in the professional opinion of the School Nurses, the student’s health warrants the expertise of the School Physician, he/she will refer to Student Medical Services; • The initial Health Assessment will be completed in all areas related to the suspected disability; • Vision and hearing should be assessed within 1 year of the IEP; • The Health Assessment is completed in the Welligent System; and • Parents/guardians may request in writing a copy of the Health Assessment report be mailed to them 5 days prior to the date of the IEP meeting. THE PRESENT LEVEL OF PERFORMANCE (PLP) The Present Level of Performance (PLP) Summary may be written in advance of the meeting. • Prior to the IEP, the information and its confidentiality should be discussed with the parent by the School Nurse • The PLP written by the Credential School Nurse should not be altered. • If additional Health Information becomes available at the IEP meeting, a Credentialed School Nurse should be consulted prior to including this information in the IEP summary. • The health summary is written to include educationally relevant health development and medical information. The summary should be written in language easily understood by lay personnel and the parent/legal guardian and should address the following 4 areas: o Student strengths o Area(s) of need o Impact of Disability on Academic and Overall Educational Performance o Modifications and Accommodations SCHOOL NURSE ATTENDANCE AT IEP MEETINGS The School Nurse Must attend an IEP Meeting to interpret the Health Assessment and recommend necessary services/accommodations when there is a significant health issue(s). The School Nurse MAY attend the IEP meeting, provide a report and depart the meeting before the meeting is finished only when the Member Excusal Form has been completed prior to the meeting. The School Nurse attendance is NOT required if the PLP summary does not indicate that there is a significant health issue. If the School Nurse is not in attendance and a health question arises the School Nurse must be consulted by telephone. THE IEP PROCESS •

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The Annual Review The School Nurse provides updated health information only if there is an on-going health issue that requires monitoring. No formal assessment is required and no new consent is needed if the School Nurse does not reassess the student. A significant change in the student’s health status that impacts the educational program requires a new assessment plan. The Three-Year Comprehensive Re-Evaluation The purpose of the Three-Year Comprehensive Re-Evaluation is to provide an opportunity to update the current health information related to the student’s progress in the educational

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setting. At the annual IEP before the Three Year Comprehensive Re-Evaluation is due, the IEP Team will determine if a Comprehensive Re-Evaluation is necessary. The School Nurse should be a part of this decision if there is a significant health issue. The Transition IEP The Transition IEP is convened when a student moves from one level to the next level. The School Nurse reviews the “Health Questionnaire for School Enrollment” and writes the PLP for a student transitioning from pre-school to elementary school. When this transition IEP is a review of records only no new consent is required. The Exit IEP The Exit IEP is conducted when Special Education Services are no longer required. It also occurs when a student graduates or becomes age 22. The 30 Day Placement IEP The 30 Day Placement occurs when students enter school with an active IEP. These students must be placed immediately in accordance with the current IEP. The assessment and an IEP are held within 30 days for a student entering Los Angeles Unified School District from another state.

Refer to Reference Guide No. REF-3804.0 dated July 23, 2007, Division of Special Education, “INDIVIDUALIZED EDUCATION PROGRAM (IEP) TEAM MEMBERSHIP REQUIREMENTS AND THE IEP TEAM MEMBER EXCUSAL PROCESS”; Reference Guide No. REF-1888.1 dated July 2, 2007, Division of Special Education, “DISTRIBUTION AND USE OF REVISED SPECIAL EDUCATION POLICIES AND PROCEDURES MANUAL (JULY 2007): REVISION TO DISTRICT POLICY”; Bulletin No. BUL-2087.0 dated July 5, 2006, Division of Special Education, “MOBILITY OPPORTUNITIES VIA EDUCATION (MOVE) PROGRAM”; Bulletin No. BUL-2030.0 dated October 21, 2005, Education Services, “GUIDELINES FOR AN INDIVIDUALIZED HEALTH ASSESSMENT AND THE PARTICIPATION OF THE SCHOOL NURSE IN THE INDIVIDUALIZED EDUCATION PLAN (IEP) PROCESS” and Bulletin No. BUL-1686.0 dated April 12, 2005, Division of Special Education, “ROLES, RESPONSIBILITIES AND AUTHORITY OF INDIVIDUALIZED EDUCATION PROGRAM (IEP) TEAMS”.

DO NOT RESUSCITATE (DNR) ORDERS Some students have serious health issues and a parent/legal guardian may ask the School Nurse or staff member to accept a Do Not Resuscitate (DNR) Order from a Physician. Do NOT accept the Physician’s order and immediately refer any request for a DNR to the Local Nursing Administrator and to District Nursing Services.

MOBILITY OPPORTUNITIES VIA EDUCATION (MOVE) The Mobility Opportunities Via Education (MOVE) is a program designed to teach students with moderate to profound physical disabilities basic functional motor skills needed for relative independence within the school, home and community environments. MOVE combines natural body mechanics with an instructional process to help students acquire increasing amounts of motor abilities necessary for sitting, standing, and walking and by so doing provides access to core instruction. The MOVE Program is currently available in Special Education Schools. The MOVE Program is designed to: • provide a systematic instructional approach to acquisition of functional motor skills; • enable students to use existing skills to assist them in learning to sit, stand, and walk; • provide instructional objectives for students to naturally practice functional motor skill while engaged in educational or leisure activities during the school day; • provide a means to measure small increments of functional motor skills;

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provide the student with the basic motor skills needed for the development of other skills such as expressive language and self care as well as access to core instruction; and reduce the time and energy requirements for custodial care and increase the use of functional skills in the educational environment.

The School Nurse works with the classroom teacher to obtain the annual medical clearance and the parental consent. Once the School Nurse has the consent, only necessary health information may be provided to the teacher(s), physical therapist(s) and the other authorized District staff. Refer to Bulletin No. BUL-2087.0 dated July 5, 2006, Division of Special Education, “MOBILITY OPPORTUNITIES VIA EDUCATION (MOVE) PROGRAM”.

LEAST RESTRICTIVE ENVIRONMENT (LRE) INITIATIVE: INTEGRATION OF GENERAL AND SPECIAL EDUCATION The Los Angeles Unified School District operates schools for ALL children, including those with diverse learning needs. However, historically the District has not maximized opportunities to integrate general and Special Education programs and students. In order to be compliant with Federal and State law, the District has changed from considering Special Education as a separate placement. Instead, Special Education is viewed as a set of services to meet each identified student’s individual education needs provided among his or her age-appropriate nondisabled peers, to the maximum extent appropriate. To the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled; and that special classes, separated schooling or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability of the child is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily. [10 U.S.C. 1412(a)(5); 34 C.F.R. 300.550(b)(1-2)]. Although the Federal and State laws clearly indicate a preference for placement in the general education classroom, the law is clear that a student must be educated in the environment that is most appropriate and least restrictive for each individual student. The School Nurse is the technical expert to further determine if the educational environment is also the safest environment. The District accountability for compliance is published in a benchmark schedule. The compliance is listed by documenting the achievement of the goal year by year from December 2002 to December 2006. In December 2006 it is expected that 100% of all schools in the District will have a natural proportion of their school population identified as eligible for special education services (i.e., falling within the range from 4% above or 4% below the mean percentage of LAUSD students identified as eligible for Special Education). Meeting this requirement is dependent upon the development and implementation of a school level Least Restrictive Environment (LRE) Plan which will expand LRE options to students with disabilities. Refer to the Special Education Manual dated July 2007, “SPECIAL EDUCATION POLICIES AND PROCEDURES MANUAL”.

SPECIAL EDUCATION AND PARENT PARTICIPATION All school personnel shall be informed that the Individuals with Disabilities Education Act (1997) intends that parents of students with disabilities be fully informed, in the form of communication they use best. To meet this intent, District forms, notices and procedural guides designed for parents of students with disabilities are being developed to be readable and linguistically appropriate to the extent required by law. These forms, notices and procedural guides include Special Education forms, notices and guides, Section 504 forms and notices, Student Success Team forms, and disciplinary notices and forms. Refer to the Special Education Manual dated July 2007, “SPECIAL EDUCATION POLICIES AND PROCEDURES MANUAL”.

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REQUEST FOR ASSESSMENT REPORT PRIOR TO IEP MEETING Parents/guardians may request a copy of the Health Assessment report be mailed to them five (5) days prior to the date of the Individualized Education Program (IEP) meeting. If parents/guardians do not request the written assessment report prior to the IEP meeting, the case carrier will provide a copy of the assessment report to the parents/guardians at the IEP meeting. Parents/guardians may request that the School Nurse’s written assessment report be translated into their primary language if it is feasible for the District to do so. Parents of currently enrolled or former pupils have the right to access any and all pupil records related to their children that are maintained by school districts or private schools. A pupil record is defined as information relative to an individual pupil gathered within or without the school system and maintained within the school system, regardless of the physical form in which it is maintained. Any information which is maintained for the purpose of a second party review is considered a pupil record. Examples include special education assessment reports, contents of cumulative records, and pupil grades. A pupil record does not include informal notes related to a pupil complied by a school officer or employee which remain in the sole possession of the maker and are not accessible or revealed to any other person except a substitute. Draft Welligent IEP pages that identify the student and are maintained in the Welligent system and/or are available to another person are considered a pupil record and parents have the right to receive copies of, or review them, subsequent to their written request. Parental requests for copies of pupil records, including draft Welligent IEP pages, or to inspect and review such records during regular school hours shall be granted within five business days following the date of request. Refer to the Special Education Manual dated July 2007, “SPECIAL EDUCATION POLICIES AND PROCEDURES MANUAL Part II, Chapter 4, Section VI” and Reference Guide No. REF-3719.0 dated May 29, 2007, Division of Special Education, “PARENTAL ACCESS TO DRAFT WELLIGENT IEP PAGES”.

ADULT ASSISTANCE (AA) Adult Assistance (AA) is an educational support delivered by any member of the school site team for a student who requires support in the areas of behavior or health. Adult Assistance is not an assistant/trainee position assigned to a student. When Adult Assistance is being considered fro health issues, the School Nurse (in collaboration with the Site Administrator): • completes the Review for Support Services Due to Health Needs (Form 33.20 Rev. 6/07) Form; • submits the completed Review for Support Services Due Health Needs form to District Nursing/ Special Programs Nursing for review prior to the IEP meeting; • attend the IEP; • completes the PLP; • writes on the IEP (page 12) o A description of the student’s health care needs; o A description of the health support to be provided; o A statement identifying the parts of the instructional day when adult assistance will be provided including the time and frequency of the support. • document the need for the Adult Assistance must be indicated on Page 8, Section M, #10. Refer to Reference Guide No. REF-2481.1 dated January 3, 2008, Division of Special Education, “ADULT ASSISTANCE (AA) TO SUPPORT STUDENTS WITH ASSESSED BEHAVIORAL AND/OR HEALTH CARE NEEDS”.

SPECIAL EDUCATION TRANSPORTATION Transportation services for students with disabilities are based on their eligibility. When transportation is required by the IEP, it is know as a “related services”. • Students generally require transportation if the IEP cannot be implemented at their School of Residence because programs and services are not available at the school. Students may also require

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transportation due to a health condition, lack of ability to communicate or lack of awareness of safety dangers. Transportation services determined by the IEP Team may be provided either as school-to-school or home-to-school. Students who receive home to school transportation services must be received at the delivery address by an adult authorized by the parent or school. The IEP also determines the need for additional services such as devices assistance on the bus, therapy at other sites, the use of assistive mobility devices (such as wheelchairs or walkers), and assistive devices such as safety vests.

Students who are medically fragile should be seated on the bus where it best meets their needs. • Students with brittle bone disease should not ride in the back of the bus to avoid unnecessary bouncing. • Students with frequent seizures should be seated where the bus driver or bus assistant can observe them. • Students with respiratory equipment or tracheotomies should be seated near the Health Care Assistant assigned to them. The Bus Driver is responsible for the safety of all students on the bus. • Wheelchairs must be inspected by Transportation Branch prior to services commencing. • Medications can only be transported inside sealed, clearly labeled envelopes and must be handed directed to the driver. Medications are not dispensed by the bus driver. Air conditioned (climate controlled) buses may be required for some students with specific health conditions. • The need for a climate controlled bus must be designated on the IEP and documented with a Physician’s written request. • The School Nurse notifies the Local Nursing Administrator’s Office and Student Medical Services at (213) 765-2830 Refer to Special Education Policies and Procedures Manual, July 2007.

ALLOCATION FOR SUPPORT OF SPECIAL EDUCATION COMPLIANCE The Special Allocation for Support of Special Education Compliance is intended as a supplement to the school budget to be used in conjunction with all available resources at a school site. Selected funds are designated to be used for specific supplies as well as substitute coverage for the School Nurse or additional School Nurse time. Refer to Memorandum No. MEM-3830.0 dated August 12, 2007, Division of Special Education, “SPECIAL ALLOCATION FOR SUPPORT OF SPECIAL EDUCATION COMPLIANCE (PROGRAM 2817)”.

POLICIES AND PROCEDURES FOR THE USE OF LOW INCIDENCE FUNDS Low Incidence (LI) Funds are used to provide specialized books, materials and equipment as required by a student with an LI disability: • hearing disorders, • visual impairment and • severe orthopedic impairment. The provision of LI equipment is based on an assessment by personnel knowledgeable of the three disabilities and related to goals on the student’s IEP. “Knowledgeable Personnel” are related services providers and/or appropriately certificated teachers. Document on the IEP the assessment and the equipment obtained for a student stays with the student if the student changes schools sites, including a change to another school district or an independent charter school in California. It is the responsibility of the receiving school to have the equipment moved. For assistance in transferring equipment contact the Complex Project Manager or the District approved contracted mover – Bill Doherty, American Relocation Movers at 1-800-381-4527 ext 121.

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Refer to Bulletin BUL-3666.0 dated July 23, 2007, Division of Special Education, “POLICIES AND PROCEDURES FOR THE USE OF LOW INCIDENCE FUNDS”.

BEHAVIOR INTERVENTION REGULATIONS FOR STUDENTS WITH DISABILITIES WITH SERIOUS BEHAVIOR PROBLEMS Behavior problems may impede the student’s educational progress and require intervention. The Behavior Intervention Case Manager (BICM) is a designated site-based certificated staff member who has received training in behavior analysis with an emphasis on positive behavior interventions. Development of a Behavior Intervention Plan (BIP) shall be considered by the IEP team when previous behavioral approaches addressing behavior that impedes learning are found to be ineffective or for a serious behavior where an emergency intervention was used. Behavior problems may be routine, non-routine, serious, or classified as an emergency. Behavior problems may impede the student’s educational progress and require intervention. A serious behavior problem can be also self-injurious, assaultive or cause property damage, which, if allowed to continue could lead to suspension or expulsion; OR if severe, pervasive, and maladaptive would require frequent and systematic application of behavioral interventions. A behavior emergency is the demonstration of a serious behavior problem which has not been exhibited previously, which poses a clear and present danger for serious bodily harm to the individual or others, and which cannot be immediately prevented by a less restrictive response than the temporary use of an emergency intervention. The School Nurse is often called when an emergency behavior intervention is required. District approved emergency behavior interventions, including the temporary use of techniques to physically contain a behavior (i.e., physical restraint of one or more limbs), may be used only by trained personnel when absolutely necessary and as a last resort, to control unpredictable, spontaneous behavior which poses a clear and present danger of serious physical harm to the individual or others or considerable property damage which, if allowed to continue, could lead to suspension or expulsion; AND cannot be immediately prevented by a less restrictive response. The Modified Consent Decree (MCD) Annual Plan requires that all schools establish a process by which academic and behavioral interventions are provided and documented. Intervention records must be made available to assessors and IEP teams when a student is being considered for Special Education eligibility and services. Refer to Bulletin No. BUL-3958.0 dated October 1, 2007, Division of Special Education, “DETERMINING THE NEED FOR BEHAVIOR INTERVENTION THERAPY AS A RELATED SERVICE FOR STUDENTS WITH DISABILITIES”; Bulletin No. BUL-2075.0 dated October 24, 2005, Division of Special Education, “ESTABLISHMENT AND DOCUMENTATION OF INTERVENTION PROCEDURES FOR STUDENTS SUSPECTED OF EMOTIONAL DISTURBANCE” and Bulletin No. H-50 (Rev.) dated February 17, 2003, Office of Special Education, “BEHAVIOR INTERVENTION REGULATIONS FOR STUDENTS WITH DISABILITIES WITH SERIOUS BEHAVIOR PROBLEMS”.

DOCUMENTATION OF INTERVENTION PROCEDURES FOR STUDENTS SUSPECTED OF EMOTIONAL DISTURBANCE It is the District’s policy, in accordance with the Modified Consent Decree, that District staff complete the nine actions described in this Bulletin for all students suspected of having a disability under the category of emotional disturbance. The Modified Consent Decree (MCD) Annual Plan required that all schools establish a process by which academic and behavioral interventions are provided and documented. In addition, intervention records must be made available to assessors and Individualized Education Program (IEP) teams

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when a student is being considered for Special Education eligibility and services. The MCD Outcome 18 describes the actions that must be taken by each school site prior to referral for special education to ensure a comprehensive assessment that considers the student’s cultural, linguistic and behavioral interventions strategies attempted prior to referral for Special Education consideration. Every school Site Administrator is responsible for the implementation of these actions. In order to comply with requirements outlined in the MCD Annual Plan, each school must take the following actions: 1. Establish a Student Success Team or similar review process. 2. Identify core team members – the School Nurse is often identified. 3. Identify staff to coordinate process. 4. Communicate referral process to school staff. 5. Establish a meeting calendar. 6. Identify potential intervention strategies, resources, services and programs. 7. Identify staff responsible for implementation of the recommended interventions. 8. Establish a process for evaluating the effectiveness of intervention provided. 9. Document intervention provided. All academic and behavioral intervention provided for a student must be documented. For schools who have not established a method for documenting interventions, a sample “Student Intervention Record” is provided in the Bulletin. This record is to be used to document each intervention provided and the result of that intervention. A separate record is to be used for each intervention. A copy of the “Student Intervention Record” or school developed intervention record is to be filed in the student’s cumulative folder and not in the Health Card. In addition, a copy of these records must be provided to each assessor and the IEP team. The School Nurse participation in the process is documented on the Health Card. Refer to Bulletin No. BUL-3958.0 dated October 1, 2007, Division of Special Education, “DETERMINING THE NEED FOR BEHAVIOR INTERVENTION THERAPY AS A RELATED SERVICE FOR STUDENTS WITH DISABILITIES” and Bulletin No. BUL-2075.0 dated October 24, 2005, Division of Special Education, “ESTABLISHMENT AND DOCUMENTATION OF INTERVENTION PROCEDURES FOR STUDENTS SUSPECTED OF EMOTIONAL DISTURBANCE”.

SPECIAL DIET POLICY Federal regulations require that dietary modifications be made for students who meet the criteria of “Special Needs Definitions”. Such students must have a completed “Medical Statement” submitted for evaluation and approval to the Nutrition Specialist assigned to that school. Special diets are only provided for: • Students with disabilities or medical conditions which limit a major life activity. • Students with life threatening food allergies. Special diets are not provided to accommodate personal preferences, food intolerances or religious beliefs. • Complete applicable sections • Provide the form to the parent for signature and for physician completion; • Copy the form for your records; • Provide a copy to the Cafeteria Manger; • Send the original via School Mail to: Margaret West Newman Nutrition Center Test Kitchen Special Diets must be updated annually. If you have questions, telephone the Test Kitchen at (213) 625-5536, or FAX questions to (323) 343-1894. Notify the Local Nursing Administrator regarding the students at your school who require special diets. Refer to Interoffice Correspondence to Cafeteria Managers, From Margaret West dated August 11, 2008 Memo No. 100, “PROCEDURE FOR REQUESTING A SPECIAL DIET”. Contact person is Margaret West at (213) 625-5536 ext. 17. Call for current forms.

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PROCEDURES TO AMEND THE IEP TO CONFORM WITH THE STATE MANDATED ASSESSMENTS

The No Child Left Behind Act requires that students with disabilities be included in state accountability systems. Since 1997, the Individuals with Disabilities Education Act (IDEA) has required that “children with disabilities are included in general state and district-wide assessment programs, with appropriate accommodations and modifications in administration, if necessary.” [34 C.F.R. Part 300.138 (a)] Each state has a responsibility to develop guidelines for participation of children with disabilities in alternate assessments for those children who cannot participate in state and district-wide assessment programs [34 C.F.R. Part 300.138 (b)] The District has procedures for amendments to the Individualized Education Program (IEP) to ensure that the IEP accurately reflects each student’s participation. The School Nurse should assist all students with decreasing health barriers which might reflect on the student’s ability to perform for assessments, tests, and academic performance throughout the school year. Refer to Special Education Policies and Procedures Manual dated July 2007.

SECTION 504 AND STUDENTS WITH DISABILITIES Section 504 of the Rehabilitation Act of 1973 is a civil rights statue that prohibits discrimination/ harassment on the basis of a disability in any program or activity receiving federal funds. School districts must provide students with disabilities with a “free appropriate public education” (FAPE) to meet their educational needs as adequately as the District would meet the educational needs of students without disabilities. The United States Department of Education defines an “Individual with a Disability” as • having a physical or mental impairment which substantially limits one or more major life activities.; • has a record of having such impairment; or • is regarded as having such an impairment. (If the student has a temporary disability, the 504 team should consider the duration and the severity of the disability.) Accommodations • must be documented on the Section 504 Accommodation Plan. • Modify or substantially change the content. • Are developed to address the disability(s) and should be related to the student’s identified disability. • Should be well defined, relevant, realistic and measurable. The Section 504 Plan shall include the following components: • a statement of the student’s physical or mental disability; • a date when the plan is to be re-evaluated (every three years or sooner as appropriate); • the specific educational area(s) that are impacted by the disabling condition; • the specific accommodations needed to enable the student to have the same access to the instructional program as all other students; • a statement of the specific and measurable times (frequency) when accommodations are to be implemented; • the person(s) to be responsible for implementing the accommodations; and • a Behavior Support Plan, if the student’s behavior warrants it. Once completed, a copy of the 504 Plan should be provided to the team members and those responsible for implementation. A staff member is designated as a case manager to monitor the student’s progress and ensure that documentation is current and placed in the student’s cumulative record. There are special provisions regarding confidentiality of health records, and information pertaining to any HIV/AIDS status. For instructions on handling these records, contact Student Medical Services at (213) 765-2830 and the Local Nursing Administrative Office.

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There is formal process to exit a student from Section 504. A re-evaluation of a student may be indicated. In that instance, a Section 504 re-evaluation meeting should be conducted to determine whether or not the student continues to meet the eligibility criteria under Section 504. A student who is currently using illegal drugs or alcohol, and is to be disciplined by the school for use or possession of illegal drugs or alcohol, loses the procedural protections provided by Section 504. However, in some cases, a student who has a Section 504 Plan may not be subjected to a disciplinary action which changes placement (disciplinary opportunity transfer/recommendation for expulsion) or when the total number of days of suspension in a school year totals 10 or more days. A request for funding for minor renovations (i.e. ramps, bathroom modifications) can be made when necessary to ensure access for individual students needing placement in currently inaccessible programs by following the procedures outlined in Reference Guide No. REF-1446.1, “Requests Related to Program Accessibility under the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 – Revised,” dated July 26, 2005, issued by the Division of Special Education. Attendance at extracurricular activities and equal access are important safeguards for students with a 504 Plan. “For existing facilities, both Section 504 and Title II of the ADA require public entities and recipients to operate programs or activities so that the programs and activities are readily accessible. School Nurses are an important part of a 504 Team. The evaluation, eligibility decision and development of a Section 504 Plan are team decisions. Plans: • are completed at the school of attendance; • should be completed within a reasonable amount of time (not to exceed 60 days); and • are periodically re-evaluated (at least every three years). Refer to Bulletin No. BUL-4045.0 dated January 15, 2008, Office of the General Counsel, “SECTION 504 AND STUDENTS WITH DISABILITIES”.

OXYGEN USE IN SCHOOLS Oxygen use in schools requires special clearance and training for the personnel at the school site. The Site Administrator consults with the Office of Environmental Health and Safety (OEHS), Transportation Branch and District Nursing Services and/or Student Medical Services to obtain: • Appropriate signs which must be posted where oxygen is used and or stored. • ABC fire extinguisher(s) must be located on the bus, in the classroom and wherever the oxygen is stored. • Additional oxygen which must be secured. The Site Administrator contacts OEHS for clearance regarding proper handling and storage of oxygen. The School Nurse contacts the Local Nursing Administrator and consults with the District Nursing Services Special Education Nurse at (213) 756-2800 for guidance and direction. • Obtains Physician and Parent Authorization for Oxygen Administration which should include o the liter flow; o special instructions; and o specific observable symptoms for administration for any PRN orders. • Consults with the oxygen vendor to arrange in-service for school personnel. • Calculates the amount of oxygen needed for student to safely attend school. • Notifies Transportation when the student is medically cleared to attend school. (The Transportation Branch must inspect and approve the method of securing the oxygen during transportation.) (323) 342-1390 • Trains and supervises the appropriate personnel who accompany the student with oxygen during the school day, during school-sponsored activities and during transportation.

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Refer to Bulletin No. BUL-2356.0, dated March 1, 2006, Division of Student Health and Human Services, “OXYGEN USE IN SCHOOLS”.

PROTOCOLS Students may require Specialized Physical Health Services (protocols) during the school day. These procedures: • Are necessary during the school day for the student to attend school. • Can be performed by individuals with no prior medical training. • Do not require an extensive amount of time for their administration. Written authorization is required from the health care provider who provides treatment and from the parent for each of the protocols. (Form 33.64 Revised 6/05 and Form 33.63 Rev. 5/01) Protocols must be renewed annually. LAUSD protocols are available on the District Nursing Website. Each protocol includes information on the performance of the procedure and the supplies provided by both the parents/guardians and by the District. Section 49423.5 of the California Education Code (CEC) authorized Credentialed School Nurses to assign and train Unlicensed Assistive Personnel (UAP) to provide protocols during the school day. These services are provided under the supervision of the Credentialed School Nurse. • Supervision includes the review, observation and instruction in the performance of the procedure. • The School Nurse determines the level of supervision: immediate, direct or indirect (available by some electronic means). • The School Nurse directs the care by: o assigning the specified procedure; o providing student specific training including care of the equipment and the environment; o insuring competency in the performance of the procedure(s); o monitoring the performance of the assigned task on a regular basis; and o ensuring accurate documentation of the services. • The following forms are used to document training and supervision: o Training Log (Form 33.02A Rev. 8/04 for Staff) o Training Log (Form 33.20B Rev. 3/07 for an individual student) o Medication & Protocol Checklist for Unlicensed Assistive Personnel (Form 33.206 Rev. 8/04) • Specialized Physical Health Care Services (Form 33.62, revised yearly) must be completed at the beginning of each school year and returned to the Local Nursing Administrator by the due date. Revise and update information on this form as changes occur during the school year. Forward these updates to your Local Nursing Administrator.

LICENSED PROFESSIONAL HEALTH CARE PROVIDERS (LPHCP) Students who require ongoing assessment such as students on a ventilator require Licensed Professional Health Care Services (LPHCP). Such providers may be Registered Nurses or Licensed Vocational Nurses (LVN). • These services may be provided by the family through other funding sources such as Medi-Cal, Regional Center of California Children Services (CCS) or LAUSD contracts with Non Public Agencies. • Contact District Nursing Services/Special Programs and your Local District Nursing Administrator when there is an IEP which may require an LVN. • The “Agreement for On-Site Services by Licensed Professional Health Care Provider” must be completed annually by all LPHCP’s.

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CONFIDENTIAL HEALTH RECORDS INFORMATION PROTECTION POLICY It is the policy of the Los Angeles Unified School District (LAUSD) to protect sensitive information. The purpose of Bulletin No. BUL-1077.1 is to define the requirements for maintaining the security of information within and outside the District. As a public institution, much of the information possessed by the District is a matter of public record. However, there are types of information requiring extreme care and sensitivity in handling, such as student health records. There are severe penalties when these records are mishandled and/or transferred to the wrong party. Note: Restrictions on information release are increasing and new laws to protect privacy are constantly being passed, and older ones strengthened. The new policy is a General Information Protection Policy and is not intended to cover all laws concerning privacy rights and the handling of sensitive information. Different types of information within the District have different levels of sensitivity. Some information, like that available on the District’s website, is considered freely accessible public information. Other types of information are protected by State or Federal law. District Information falls into one of four basis security levels: 1. Public Information: Information published on the District’s public website or in other written District publications. For example, the District collects data on the number of students currently enrolled District-wide and that information is available on the District’s website. This is an example of Public Information. 2. Non-published Public Information: Information that exists in the form requested, but has not been published. Summarized student attendance data is not published but is public information. This is an example of Non-Published Public Information. 3. Non-Public Information: Information that may or may not exist in the form requested, but by policy the District prevents it from publication. For example, the District will not reveal the results of evaluations of proposals prior to an award of an RFP and/or a recommendation to the Board. This would be an example of Non-Public Information. 4. Protected Information: Information that is protected by special laws. For example, student records, student and employee health records, and social security numbers, are each covered by specific privacy laws and rules. People outside the District seek information for a variety of reasons. Information in categories 3 and 4 should not be released. Employees of the District often need access to sensitive information. •

EMPLOYEES RESPONSIBILITY Every employee of the school district must ensure the proper protection of information, either in paper or electronic form. An employee is not to take sensitive records home nor leave them lying unprotected in the open, such as on a desk, where they can be accessed. School Nurses should lock up the Health Record Cards. The School Nurse and Site Administrator/Designee should have the only keys. An employee is not to convert sensitive information into an electronic format and send it unprotected through email or over the Internet. The Welligent System is being analyzed due to the numerous reports from various disciplines regarding the lack of the systems’ security. Whenever requests for access to information are made, school administrators must evaluate whether it is proper to release information. It is best to err on the side of protecting information rather than risk violating an employee’s or student’s rights of privacy.

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PROTECTED HEALTH INFORMATION MUST BE KEPT CONFIDENTIAL. Protected health information (PHI) must be kept confidential at all times and may only be used and disclosed in accordance with this policy. This means you cannot disclose PHI to any other person unless authorized by this policy. This includes disclosures made verbally in person or by telephone, and in writing by mail, fax or email. This prohibition on uses and disclosures also means that you cannot repeat information you hear, make copies of information you receive, or share passwords or

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log in information with others unless authorized by this policy. The bulletin devotes 5 pages to protecting health information. There are serious legal penalties for the unauthorized use or disclosure of PHI. Do not take any chances. Contact your Local Nursing Administrator and/or the Office of General Counsel whenever you have a question about this policy or the use or disclosure of protected health information. •

VIOLATIONS OF POLICY 1. Violations of this Information Protection Policy may result in discipline, up to and including dismissal of personnel violating the policy. 2. Violations of certain portions of this policy may also be violations of State and/or Federal Law. Failure of personnel to comply with these policies could result in the employee being sued for a violation of privacy rights, or being prosecuted by a governmental agency charged with enforcing those rights.

The Los Angeles Unified School District Policy relating to the Health Information Portability Accountability Act (HIPAA) is an attachment to Bulletin No. BUL-1077.1. Refer to Bulletin No. BUL-1077.1 dated December 5, 2006, Office of the General Counsel, “INFORMATION PROTECTION POLICY”.

PROCEDURE FOR RECORDING AND SECURING THE HEALTH RECORD CARD WHEN A STUDENT IS DECEASED Properly closing a Health Record Card for a student who has died is an essential responsibility of the School Nurse. Always begin by reviewing the Health Record Card for accuracy and completeness, and update necessary information prior to any charting relating to the student’s death. • Telephone the Local Nursing Administrator for assistance before finalizing the documentation on the Health Record Card. Health Record Cards may be subpoenaed for use when litigation occurs. • Verify the Student's Name and Birthdate. (Several students may have the same name.) • Review the Health Record Card for accuracy and completeness, and update necessary information prior to adding the documentation concerning the student’s death. • Record the circumstances surrounding the student’s death. Include the last date of attendance, if known; what, where, when, why and how the death occurred. • Notify the Local Nursing Administrator and LAUSD Communicable Disease Control Nurse if the student died as a result of a communicable disease. (Check immunization documentation for accuracy and completeness.) • Final charting on the Health Record Card should include that the Health Record Card was submitted to the appropriate Site Administrator in charge of the Health Records for any student who no longer attends that school site. Document the date and the Administrators name and title. (e.g. Jane Doe, Assistant Principal.) • Complete necessary Risk Management documentation – Injury/Accident Investigation Report- if the child died or was injured at school and submit the form(s) (Injury/Accident Investigation Report form) to the appropriate Site Administrator for processing and mailing. Fax the form(s) to your Local Nursing Administrator. Telephone the Local Nursing Administrator for assistance before finalizing the documentation on the Health Record Card. Health Record Cards may be subpoenaed for use when litigation occurs.

PUPIL RECORDS: CONFIDENTIALITY PROCEDURES, ACCESS, CHALLENGE TO CONTENT Legislation regarding parent access to and the confidentiality of pupil records mandates specific parent rights with respect to privacy, access to, and challenge of pupil records. The LAUSD maintains records in accordance with Federal and State statutes affecting pupil records. Pupil records do not include informal notes related to a pupil compiled by a school employee which remain in the sole possession of the maker and are not accessible or revealed to any other person except a substitute (for Nursing, it is the substitute School Nurse).

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The Site Administrator is responsible for the maintenance and security for pupil records. The School Attendance Review Board (SARB) may access EDUCATIONAL records. The School Nurse does not provide the Health Card to any non-health professional. It is the responsibility of the School Nurse to interpret necessary health information contained in the Health Card for the non-health professional. No student, parent or other volunteer office worker shall be allowed to read, file, compile data, transport or otherwise handle information directly related to an identifiable pupil, other than directory information, unless such worker has authority to access such confidential information. Access to, and release of, pupil record information shall be limited to those individuals legally authorized to receive such information and shall be provided only when the request for information is supported by a legitimate education interest (the receipt of information is germane to the pupil’s education). In general, parents/guardians have absolute right of access, inspection, interpretation, review, a copy of and/or a challenge to the content of pupil record. When inspection and review of records is requested by a parent/guardian, access must be provided within five (5) calendar days of the request. Access may be provided during regular school hours. A request for pupil records may be presented at the school by a Department of Children’s & Family Services worker (social worker), a probation officer, a court appointed special advocate, or the student’s attorney. The principals have been directed by the LAUSD Field Services Attorney (213) 241-7600 to advise the requestor that a separate order for records specifically naming the child or written authorization from the parent/guardian is required without consultation from the Field Attorney or the referenced documentation. Schools should not release records with a blanket order. A log or record (Pupil Record Access Log) shall be maintained for each pupil’s record which lists all persons, agencies, or organizations requesting or receiving information from the record and the legitimate interests. Telephone your Local Nursing Administrator for assistance. A school or District employee as designated by the principal should be present to assist and oversee the inspection of the records. The parent may also request assistance from school staff in interpreting records. The School Nurse may assist with interpretation of the School Health Record. Inserts in the Health Record Card envelope – e.g. notes from physicians/clinics/emergency rooms, etc. should be removed from the Health Card envelope and not be included in the review, inspection or duplication unless written permission from those health providers/facilities has been provided to the school/School Nurse to release the information to the parent/guardian. Bulletin 2469 “Pupil Records: Access, Confidentiality and Notice of Educational Rights” from the Office of the Chief Operating Officer dated April 24, 2006 has a section related specifically to specialized professionals: “There are certain school district employees who maintain unique relationships with students. These employees have specialized training or hold specific licenses, certificates and/or credentials. They are required to exercise a greater degree of care to protect the confidentiality of information obtained within the context of their professional relationship with the student. Some examples of these employees include school psychologists, social workers, nurses, certain counselors, physicians and individuals working under the direct supervision of the above-named professionals. The confidential records are NOT pupil records and must be maintained by the specialized professional separate from the student’s pupil record files.” The Health Card is a confidential HEALTH record. The School Nurse must be consulted for Health Card information (except the immunization records). Accurate recording on the Health Card is critical. Only objective entries of first-hand observation or statements are permissible. Unsupported conclusions should be avoided. Consult the Local Nursing Administrator for questions related to health records. Refer to Bulletin No. BUL-2469 dated April 24, 2006, Office of the Chief Operating Officer, “PUPIL RECORDS: ACCESS, CONFIDENTIALITY, AND NOTICE OF EDUCATIONAL RIGHTS”;

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Bulletin No. BUL-2433 dated April 3, 2006, Office of the Chief Operating Officer, “CHALLENGING THE CONTENT OF A PUPIL RECORD” and Bulletin No. BUL-1926.0 dated November 7, 2005, Office of the Chief Operating Officer, “REQUESTS TO CHANGE A PUPIL GRADE”.

HEALTH INFORMATION CARD (CONFIDENTIAL) Dissemination of Confidential Health Information to appropriate District personnel is critical to ensure the safety of students and staff, to fulfill the School Nurses’ obligation, to provide necessary information and to uphold the regulations related to confidential information/records. A Generic Confidential Health Information Page (Form No. 33.00 9/2005) has been created to replace the Green Health Information Card. The health issue should only be revealed to select staff when knowledge of the health issue is important for the student’s academic progress and/or the maintenance of a safe environment. Telephone the parent/guardian to inform them that the Confidential Health Information Form is being circulated. Document on the Confidential Health Information Form and on the student’s Health Record Card the telephone number, date, time and the person (or answering machine) that received the message. The Confidential Health Information form has been developed for specific conditions including Asthma (Form 33.01 Rev. 9/2005), Diabetes (Form 33.02 Rev. 9/2005), Seizure Disorder (Form 33.03 Rev 9/2005), Severe Allergies (Form 33.05 9/2005) and a Generic Form (33.00 9/2005). Every effort to inform and obtain a parent/guardian signature regarding staff/faculty notification of asthma, diabetes, seizures, etc. is made. As with the green card, you may contact the parent/guardian by telephone. Document on the form and on the students’ Heath Record Card the telephone number, date, time, and the person (or answering machine) that received the message that the form will be circulated. Confidential Health Information should be circulated to appropriate personnel each semester and a copy should be provided to the teacher. The original is to be retained in the student’s Health Record Card. Contact your Local Nursing Administrator for assistance.

RECORDS FOR NON-LAUSD STUDENTS Students and parents/guardians of students who have graduated or no longer attend LAUSD may request past records. Individuals should be referred to: LAUSD Student Record Unit P.O. BOX 3307 Los Angeles, CA 90051-1307 Specific information must be included in the written request for records. Include: • the correct spelling of your name while attending school; • date of birth; • place of birth; • name of school attended; • date graduated if applicable; • driver’s license number or social security number for ID; • money order payable to Los Angeles Unified School District; • name of parents; and • sign and date the request. Questions should be directed to the Student Records Unit at (323) 224-5950. Refer to Bulletin No. BUL-1077.1 dated December 5, 2006, Office of the General Counsel, “INFORMATION PROTECTION POLICY”.

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MEDICATION DISPENSED IN SCHOOL All medication administered at school requires written authorization from the licensed health care provider and the parents/guardians. This includes over the counter medication and medication that the students carries and self-administers. Injectable medications require special arrangement – contact you Local Nursing Administrator. The following authorization forms are available on-line at the District Nursing Services website and also through Inside LAUSD. • Request for Medication To Be Taken During School Hours (Form 33.199 Rev. 9/07) • Request for Self-Administration of Medication During School Hours (Form 33.205 Rev. 9/07) • Authorizations must contain all the information requested on the form. • A new authorization is required when there is a change in the medication including dose or if/when there is a change in the licensed health care provider. • Authorization must be renewed annually based on the calendar year. • A FAX copy is acceptable. • Verbal/telephone orders and verbal parent requests are not accepted. Forms are available in 7 languages: English, Armenian, Chinese, Korean, Russian, Spanish and Vietnamese. Students may be capable of safely and competently carrying and self administering their own mediation. California state law allows students of any age to carry and self-administer inhaled asthma medication and auto-injectable epinephrine. When students carry/self administer medications additional documentations is required by the student/parent, School Nurse and the Site Administrator. Complete: • The Student Contract for Self-Administration Self/Carry of Medication During School Hours (Form 33.205A Eng/Span 3/07) and • Request for Self-Administration of Medication During School Hours (Form 33.205 Eng Rev. 9/07) Misuse of self-administered medications is subject to disciplinary action. (California Education 48900). Parents of students with asthma often request self administration protocols. Asthma Action Plan (AAP) are accepted for administration and self-administration of asthma medication. • The School Nurse reviews the AAP to verify that it contains all the required information including the release of liability by parents for self-administration. • The Student Contract for Self Administration of Medication During School Hours (Form 33.205 Eng. Rev. 9/07) must also be completed if the student is self-carrying medication. • The additional LAUSD forms are not required if the Asthma Action Plan is complete and the contract is signed. • California State Law allows students of any age to carry and self-administer inhaled asthma medication and auto-injectable epinephrine. The School Nurse transcribes the written authorization for medication(s). Review each request for completeness and to verify that the medication can be safely administered at school. Medication orders should be entered into the student’s electronic health record using the Welligent Health Manager. School Nurses, Licensed Vocational Nurses, and Health Care Assistants document medication administration in Welligent. Other personnel designated by the Site Administrator and trained annually by the School Nurse will continue to document on the School Medication Record. Credentialed School Nurses train school staff to administer medication. The Site Administrator designates individuals for Medication Administration at school and during school sponsored activities. Use the Training Log Form 33.404 Rev. 8/04 for the medication training for school staff annually and as needed. When training staff for a specific student medication or procedure also use the Student Specific Training Log (Form 33.204B Rev. 3/07) for students with new medication orders for diastat. Medication errors must be reported immediately to the Site Administrator and the Local Nursing Administrator. The School Nurse must document the error on the Health Record Card. The parent/guardian and the health care provider must be contacted.

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Missing/stolen medication must be reported immediately to the parent/guardian, the Local Nursing Administrator, the School Nurse and the Site Administrator. The Site Administrator will also notify School Police. Provide the following information when reporting missing/stolen medications: • school site and location code; • date and time of loss; • medication(s); • location where medications were kept at time of disappearance; • location of medication cupboard key, and • personnel with access to medication cupboard key. Refer to Bulletin No. BUL-3878.1 dated September 24, 2007, Student Health and Human Services, “ASSISTING STUDENTS WITH PRESCRIBED MEDICATION AT SCHOOL” and Reference Guide No. REF-1526 dated January 19, 2005, Student Health and Human Services, “SELFADMINISTRATION OF INHALED ASTHMA MEDICATION AND AUTO-INJECTABLE EPINEPHRINE”.

STUDENTS WITH DIABETES Diabetic Students in LAUSD-Guidelines for School Nurse (Rev. 3/00) is the School Nurse’s reference for planning the management of a student with diabetes care at school. All students with diabetes need protocols. Ongoing communication between the family, school and healthcare providers is crucial to providing safe care at school. • Diabetes Management Information for School Staff o This information is to be included on an IEP or a 504 Plan. • Confidential Health Information for Student with Diabetes (Form 33.02 9/2/2005) o This form MUST be completed to notify the student’s teacher(s) about their conditions and any special needs they may have. o Be certain to obtain the parent(s)/guardian(s) consent and document on the form and on the student’s Health Record Card the telephone number, date, time and the person (or answering machine) that received the message that the form will be circulated. • Diabetes – Hypoglycemic Reaction (Rev. 11/06) o All students with diabetes MUST have this protocol. • Diabetes – Blood Glucose Testing (Rev. 11/06) • Glucagon Injection: A Medical Emergency Procedures (11/06) o Glucagon is a procedure used during a diabetic medical emergency. It is NOT a routine order for diabetic students in school and requires specialized training for school staff. o Use Request for Medication To Be Taken During School Hours (Form 33.199 Rev. 9/07) and o The protocol form on the standardized diabetic protocols from the physician. • Request for Medication To Be Take During School Hours (Form 33.199 Rev. 9/07) o This form MUST be completed if the student requires any type of insulin or diabetic medication. • Request for Self-Administration Medication During School Hours and Student Contract for SelfAdministration/Self Carry of Medication During School Hours (Form 33.205A Eng/Span Rev. 8/07) – both forms MUST be completed if the student requires self-administration of medication. • All protocols require: o Physician Authorization For Specialized Physical health Care Services (Form 33.64 Rev. – 7/05) and o Parent Authorization For Specialized Health Care (Form 33.63 – Rev. 5/01) Insulin Pump – Continuous Subcutaneous Insulin Infusion: Guidelines for School Nurse (2/2000) is a reference when the student has an Insulin Pump. Standardized protocols from local health care facilities are accepted – LAUSD Physician Authorization and Request for Medication During School Hours are NOT required in addition to their forms. Facilities that use their own standardized protocol include: CHLA, Kaiser, CHOC, UCLA, LAC/USC, and Miller Children’s Hospital. Some health care providers also use the PADRE (Pediatric Adolescent Diabetes Research and Education) forms.

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The School Nurse trains and supervises designated school personnel in the protocols for Diabetic Management. Designation school staff must be trained on blood glucose testing and carbohydrate calculations. Training of designed school personnel is documented on the Training Log (Form 33.204 Rev. 4/02). Due to the increasing number of students who routinely receive insulin at school, all paper work must be current and accurate. A School Nurse from another site or another licensed healthcare provider may be contacted to provide insulin on a day the regular School Nurse is not available. Non-licensed school personnel DO NOT “supervise” or “monitor” students with insulin pumps. Non-licensed school personnel may “observe” students who self administer insulin via the insulin pump. Since orders for Insulin, carbohydrate counting, base doses and correction doses change frequently, be sure that the most recent physician’s orders are clearly indicated and notify your Local Nursing Administrator when there are updates and changes in the student’s Diabetic Management Plan. School Nurses may NOT accept or act on parent/guardian generated changes or modifications to the medication administration directions in the Authorized Health Care Provider’s statement unless the school receives such changes in writing from the authorized health care provider.

STUDENTS WITH ASTHMA All students with Asthma who require any medications and/or a nebulizer treatment during the school day MUST have signed medication orders and/or protocols. Communication between the School Nurse, parents, physicians and the student is necessary to assist in the development of an effective asthma management plan for the school day. The following asthma forms can be obtained from the District Nursing website: http://dns.lausd.net. • Confidential Health Information for Students with Asthma (Form 33.01 9/2005) – This form MUST be completed to notify the student’s teacher(s) about their conditions and any special needs they may have. • Request for Medication to be Taken During School Hours (Form 33.199 Rev. 9/07) – This form MUST be completed if the student requires any type of asthma medication (e.g. inhalers, oral asthma medications, and/or medication required for a nebulizer treatment). • Request for Self-Administration Medication During School Hours (Form 33.205 Rev. 9/07) and Student Contract for Self-Administration/Self Carry of Medication During School Hours (Form 33.205A Eng/Span Rev. 9/07) – Both forms MUST be completed if the student requires selfadministration of asthma medication. California Education Code 49423.1 authorizes a pupil to carry and self-administer inhaled asthma medication if the school district receives a written statement from the physician detailing the method, amount, and time schedules by which the medication is to be taken and a written statement from the parent or guardian. Specified disciplinary actions are permissible pursuant to Section 48900 of the California Education Code if that pupil uses the inhaled asthma medication in a manner other than as prescribed. • Asthma – Mechanical Nebulizer Treatment (Rev. 11/06) – A protocol is required for students needing nebulizer treatments during the school day. • All protocols require: Physician Authorization for Specialized Healthcare Services (Form 33.64 Rev. 7/05) and Parent Authorization for Specialized Physical Healthcare (Form 33.63 Rev. 5/01). • Training Log (Form 33.204 Rev. 8/04) – Staff who have been designated by the Site Administrator as persons who can administer asthma medication(s) and/or nebulizer protocols when the School Nurse is not available MUST receive an annual in-service by the School Nurse. Keep a copy of the training log for the school site and submit a copy to the Local Nursing Office. The applicable physician/parent written statements must be provided at least annually or more frequently if the medication dosage, frequency of administration, or reason for administration changes. School Nurses may NOT accept or act on parent/guardian generated changes or modifications to the medication administration directions in the Authorized Health Care Provider’s statement unless the school receives such changes in writing from the authorized Health Care Provider. If a student presents with an Asthma Action Plan consult with your Local Nursing Administrator or Student Medical Services.

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The LAUSD has a specialized program including a Breathmobile and School Nurses who assist in the Asthma Program. Telephone your Local Nursing Office for information. Telephone your Local Nursing District Office after contacting 9-1-1 whenever a student experiences a severe asthmatic episode. Refer to Bulletin No. BUL-3878.1 dated September 24, 2007, Student Health and Human Services, “ASSISTING STUDENTS WITH PRESCRIBED MEDICATION AT SCHOOL” and Reference Guide No. REF-1526 dated January 19, 2005, Student Health and Human Services, “SELFADMINISTRATION OF INHALED ASTHMA MEDICATION AND AUTO-INJECTABLE EPINEPHRINE”.

STUDENTS WITH SEVERE ALLERGIES All students requiring medication(s) for emergency treatment of severe allergies MUST have signed medication orders and protocols on file. Communication between the School Nurse, parent/guardian, healthcare provider and student is necessary to assist in the development of an effective allergy management plan. The following forms are used: • Confidential Health Information for a Student with Severe Allergies (Form 33.05 9/2005) • Request for Medication to be Taken During School Hours (Form 33.199 Rev. 9/07) • Student Contract for Self-Administration/Self Care of Medication During School Hours (Form 33.205A Eng/Span Rev. 3/07) – if applicable. • Self-Administration of Medication During School Hours (Form 33.205 Rev, 9/07) • Individual Emergency Care Plan – include the Plan in the IEP or Section 504 Plan if applicable. • Medical Statement to Request a Special Diet (8/11/08) – used if a student has a severe food allergy. The following are resources for the School Nurse: • Training Staff to Administer Auto-Injector Epinephrine – Guideline for the School Nurse (9/02) • Emergency Treatment of Anaphylaxis – Epinephrine Auto-Injector (Epi-Pen) Protocol (Rev. 11/06) • Training Log (Form 33.204 8/04) used to document annual and as needed training. Notify Local Nursing Administrator any time auto-injectable epinephrine is administrated at your school site. Refer to Bulletin No. BUL-3878.1 dated September 24, 2007, Student Health and Human Services, “ASSISTING STUDENTS WITH PRESCRIBED MEDICATION AT SCHOOL” and Reference Guide No. REF-1526 dated January 19, 2005, Student Health and Human Services, “SELFADMINISTRATION OF INHALED ASTHMA MEDICATION AND AUTO-INJECTABLE EPINEPHRINE”.

CHILD HEALTH DISABILITY PREVENTION (CHDP) PROGRAM Los Angeles Unified School District is a Child Health and Disability Prevention (CHDP) Program provider with the State of California. The CHDP Program is a “financial need based” program that provides free health assessments and medical services to all eligible students from birth through 18 years of age. Many physical and mental disabilities can be prevented, or their impact lessened, with early recognition and treatment of defects. There is a State mandate requiring that a physical examination be on file for all first grade students. Priority for CHDP exams in the Fall is given to first grade students who are not in compliance with the physical examination requirement. School programs are scheduled for the school year and notifications are sent to the School Nurses.

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A component of the CHDP examination is a blood lead assessment. If a blood lead assessment needs to be performed, the parent/guardian will be referred to a Certified Blood Lead Testing Laboratory or to their own health care provider. The blood lead test results received by the District will be entered into the student’s Welligent electronic health record. The School Nurse will also be notified if a student needs nutritional counseling and follow-up for any elevated blood lead level. Refer to Bulletin No. BUL-2514.0 dated October 23, 2006, Student Health and Human Services, “CHILD HEALTH AND DISABILITY PREVENTION (CHDP) PROGRAM”.

STUDENT MEDICAL EXEMPTION AND EXCLUSION POLICY AND PROCEDURES The Los Angeles Unified School District has policies and procedures for withholding school attendance by medical exemption and medical exclusion for students in regular classes with no Individualized Education Program (IEP) currently in effect, and for students with IEP’s, regardless of class placement. There are also other types of medical exclusions for all students. A parent/guardian, Principal/designee or school personnel may request that exemption from partial or total school attendance is in the best interest of the student until suitable medical or educational intervention can be provided. Medical exemptions occur with parental consent. When an emption is requested by a parent/guardian or private physician on a medical basis only: the parent/guardian must furnish to school authorities satisfactory evidence of the child’s physical and/or emotional condition upon which the exemption is sought. Such evidence shall be in the form of written communication from a private physician, psychiatrist, licensed medical agency and/or mental health agency. After the receipt o the information from the private physician or agency, the School Nurse will complete Form 33.2 “Request for Medical Exemption” (Section A) and forward it along with the written evidence to the School Physician. When an exemption is requested by a School Principal or Designee the School Nurse will make a conference appointment for parent/guardian and the School Physician. The following items shall be available by the Site Designee to the Physician at the time of the conference: • Cumulative record; • Teacher(s) ‘s anecdotal records(s); • Documentation regarding remedial measures taken; and • Any pertinent information from other school personnel and/or private or public agencies who have had contact with the student or the student’s family. The School Nurse will make available the Health Record Card and the School Physician will then • review the above information; • examine the student, if indicated; • confer with the parent/guardian and Princial or designee; • complete or update the Medical Evaluation (Form 33.21), if indicated; and • complete the Request for Medical Exemption including signatures of Principal and parent/guardian. NOTE – Prior to a Request for Exemption, the School Principal must document the students behavior, conference with the parent/guardian, make appropriate modifications and creative measures. If the Request for Exemption is denied the parent/guardian is reminded that the student does need to attend school according to the California Education Code. If the student does not continue to attend, then the Principal will request assistance from the Pupil Services and Attendance Unit. If the Medical Exemption is granted the exemption will clearly state the recommended number of hours the student may attend daily, if the exemption is for a part day. Exemptions are not written to tolerance. The expiration date of an exemption will be no longer than 50 calendar days, including weekends, holidays, and days off-track. Exemptions/exclusions are issued only once per year. They may not be predated or postdated, and are not renewable. In traditional calendar schools, medical exemptions or exclusion may not extend beyond the end of the school year in June

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and in year-round schools, they are not to be written when a student is off-track for the purpose of preventing his/her return. The exemption becomes effective on the date it is signed by the parent/guardian, School Physician, and Principal. The original forms completed during the Exemption process are forwarded by the School Physician to Student Medical Services. Copies are provided to the Local District Superintendent, to the Principal and to the parent/guardian. A copy is also provided to the School Nurse for the Student’s Health Record Card. When a medical exclusion is considered there must be clear evidence of potentially hazardous behavior and a refusal by the parent/guardian to consent to a medical exemption. The Principal notifies the Local District Superintendent and then contacts the School Physician who completes the Medical Recommendation for Exclusion. There are attendance guidelines while awaiting a decision from the Physician. If the student constitutes a “clear and present danger to life, safety, or health of pupils or school personnel,” then the School Principal may exclude the student. (California Education Code, Section 48213) If the student does not constitute a “clear and present danger of life, safety, or health of pupils or school personnel,” the student remains in school until the Board of Education approves or disapproves the Recommendation for Exclusion. The School Principal will notify the parent/guardian and the Local District Superintendent within 24 hours of this Recommendation for Exclusion. The Local District Superintendent/designee will review the Recommendation for Medical Exclusion at the local district within 5 days. The committee will include the School Physician and the Psychological Services Coordinator. The parent/guardian of the student and the student, if appropriate, will be invited. If the need for exclusion is substantiated, it will be referred to the Board of Education within 48 hours. A copy of the documentation will be provided to the School Princial and the parent/guardian. The School Nurse will also receive a copy for the Health Record Book. Any student, regular or with disabilities, who causes or attempts to cause injury to other person, damage to property of another or the school, or otherwise willfully defies the authority of teachers, supervisors, or administrators may be suspended or expelled as authorized by law; however, special procedures apply in the case of students with IEP’s. Consult with your Local Nursing Administrator for assistance. Other Medical Exclusions may also be recommended – • Immunization Requirement Exclusions o Any student admitted to school conditionally, who fails to obtain the required immunization within the time periods specified, must be excluded from school and/or children’s infant center until he/she receives the required vaccine(s). o When a student who has not been completely immunized against a particular communicable disease is believed to have been exposed to the disease, the School Nurse must report this information to the Communicable Unit for further follow-ups. • Tuberculosis Examination Requirement Exclusions o Students who do not meet the tuberculosis examination requirement are to be excluded from school. A student may be readmitted when he/she provides written evidence that the required examination has been given and interpreted. • Contagious or Infections Diseases o Students with communicable diseases are excluded and readmitted in accordance with the guidelines ser forth in “Communicable Diseases in Schools, A Reference Guide, 3rd Edition, 2005.” o Students with communicable diseases not addressed in “Communicable Diseases, in Schools,” must be referred to the Director, Student Medical Services. o When a student is excluded for a contagious or infectious disease, the exclusion notice is usually signed by the School Principal or designee upon recommendation of health personnel and the exclusion becomes effective immediately. Refer to Bulletin No. BUL-3219.2 dated April 7, 2008, Student Health and Human Services, “STUDENT MEDICAL EXEMPTION AND EXCLUSION POLICY AND PROCEDURES”.

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HOME AND HOSPITAL INSTRUCTION PROGRAM (CARLSON HOME INSTRUCTION PROGRAM AND HOSPITAL SCHOOL) It is the policy of the LAUSD in accordance with state law, that students whose medical needs or other circumstances prevent them from attending school shall continue to receive an educational program. Instruction in the home or hospital is provided in accordance with District policy and state law for eligible students whose non-contagious temporary medical disability prevents attendance in regular day class or alternative educational program for a limited period of time. The intent of this service is to maintain continuity of the student’s instruction program during the interim period of disability. A home/hospital teacher provides instruction in subjects/courses correlated with the student’s school program to the extent possible. Home/hospital instruction is designed as a temporary service. It does not replace, over an extended period of time, the regularly required instructional program. Instruction in the home or hospital may be offered for a temporary period of time to eligible students for both medical and non-medical reasons as approved by a California licensed physician, a Special Education Support Unit Administrator or the Administrative Coordinator of the Nonpublic Services Department. Instruction in the home/hospital is provided for eligible students, including those with a current Individualized Education Program (IEP) or a Section 504 Plan, who meet specific eligibility. Students who reside within the boundaries of the Los Angeles Unified School District may be eligible for instruction in the home if: 1. The student has a non-contagious condition(s) or temporary physical disability that cannot be accommodated at his/her school. School age students who are homebound are eligible for instructional services on their first day of confinement when such confinement is anticipated to result in non-attendance for more than ten (10) consecutive school days, as verified by the medical diagnosis of a California licensed physician/psychiatrist. The parent must authorize the temporary transfer of educational duties. or: 2. The student is authorized to receive home instruction by the Special Education Support Unit Administrator or the Administrative Coordinator of the Nonpublic Services Department. The parent must authorize the temporary transfer of education duties. (For some secondary students, Teleteaching – instruction via telephone – may be more appropriate.) Students who reside within the boundaries of the Los Angeles Unified School District may be eligible for instruction in the hospital when the attending physician/psychiatrist estimates hospitalization for more than ten (10) consecutive school days and authorizes service to begin. The parent must authorize the temporary transfer of education duties. Only hospital personnel may refer for this service. Request for home/hospital teaching may be made by the student’s cumulative record carrying school, medical care provider or social worker. Upon request, the cumulative record carrying school must provide the parent with “Medical Referral for Home Instruction/Teleteaching” or “Psychiatric Referral for Home Instruction/Teleteaching”. It is the responsibility of the parent/guardian to fax the completed form to: Carlson Home Instructional Program and Hospital School at (818) 505-0246 or submit by mail to: “School Nurse, Carlson Home Instructional Program and Hospital School, 10952 Whipple Street, North Hollywood, CA 91602. School Nurse questions may be directed to the Home/Hospital School Nurse at (818) 759-7676 ext. 8. The request for Non-Medical Referral for Interim Home Instruction/Teleteaching is completed by the school and sent to the Special Education Support Unit Administrator or Administrative Coordinator of Nonpublic Services Department for authorization. There is a separate form for the Medical Referral for Hospital Instruction. This process is activated and completed by hospital staff only. When the student is discharged from the Home/Hospital Instructional Program the cumulative record carrying school must readmit the student when the student provides a completed medical release from his/her attending California licensed physician/psychiatrist, as appropriate, into the same or similar instructional program as offered prior to enrollment in the home/hospital program including Magnet schools and previously non-capped students at their previous school of residence and convene an IEP or Section 504 Plan meeting within thirty

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(30) days of student readmittance to address a change/update in medical information, goals, objectives and/or educational placement, if needed. Teachers for home instruction for preschool Special Education students are not assigned by Infant Pre-School Support Services. The school or center should forward The Medical Referral For Home Instruction Form to: Infant Pre-School Support Services, Beaudry 17th Floor. Contact your Local Nursing Administrator for questions/assistance. When Home/Hospital Instruction is offered to the student, the School Nurse documents on the student’s Health Card the date, who provided the form and the parent/guardian’s response/action. Document and reference the Return to School Permission From the Health Care Provider when the student returns to school. Refer to Bulletin No. BUL-1229.1 dated November 28, 2005, Division of Special Education, “CARLSON HOME INSTRUCTIONAL PROGRAM AND HOSPITAL SCHOOL-REVISED”.

INDEPENDENT STUDY PROGRAMS Independent Study is a voluntary alternative instructional strategy by which all enrolled students may reach District curriculum objectives and fulfill graduation requirements outside of the regular classroom setting. Any student enrolled in any District school program is eligible to enroll in Independent Study. All students enrolled in Independent Study shall receive appropriate existing services and resources to enable them to complete their Independent Study successfully and shall be ensured the same access to all existing services and resources as available to other students in the school of enrollment. No temporarily disabled pupil may receive individual instruction through independent study. However, if the temporarily disabled pupil’s parents and the District agree, the pupil may receive instruction through Independent Study instead of instruction through home and hospital. An individual with exceptional needs may not be enrolled in Independent Study unless his or her Individualized Education Plan specifically provides for such enrollment. Students enrolling in Independent Study must meet immunization requirements. Refer to Bulletin No. M-128 dated May 31, 2001, Educational Services Division, Office of the Deputy Superintendent, Instruction, “GUIDELINES FOR INDEPENDENT STUDY PROGRAMS”.

OPPORTUNITY TRANSFERS (O.T.s) Opportunity Transfers (O.T.s) are carefully planned transfers from one District school to another. There are two purposes for O.T.s: (1) to promote the positive social and/or academic adjustment of a particular student and (2) to promote school safety for all students. The Opportunity Transfer of a Student who receives Special Education Services constitutes a change in placement and requires parental consent. Students who receive Section 504 accommodations may be issued O.T.s only if the 504 plan can be fully implemented at the receiving school. If the 504 plan cannot be fully implemented, the Section 504 committee (Student Success Team) at the sending school must complete a Reevaluation and Manifestation Determination prior to the student being issued an O.T. The checklist for O.T. specifically includes input from the School Nurse. Bulletin Z-58, dated April 20, 1999, Attachment A includes the analysis of school records – “Health Card” and a referrals section – “School Nurse”. The School Nurse reviews the Health Card and signs off for both areas in the appropriate section. Refer to Bulletin No. Z-58 dated April 20, 1999, Student Health and Human Services, Deputy Superintendent, Operations and Support Services, “OPPORTUNITY TRANSFERS (O.T.s).

EMERGENCY USE OF HAND-HELD RADIOS Non-Police Personnel who request assistance for emergency conditions using the School Police Department’s primary frequency must follow specific District directives.

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Refer to Bulletin No. BUL-3857.0 dated August 20, 2007, School Police Department, “EMERGENCY BROADCAST ON SCHOOL POLICE FREQUENCY”.

AUTOMATED EXTERNAL DEFIBRILLATOR (AED) Many schools have Automated External Defibrillators (AED) on site. Trained personnel will use an AED to treat persons who succumb to sudden cardiac arrest (SCA). AEDs will be used on persons who are unconscious, not breathing and not exhibiting signs of circulation. There are specific polices/procedures and regulations for schools with AEDs as sited in the California Health and Safety Code 1797.196, the California Civil Code 1714.21, California AB 2083, and California Code of Regulations Title 22: • Expected AED users must complete a training course in cardiopulmonary resuscitation and AED use that complies with regulations adopted by the Emergency Medical Services (EMS) Authority and the standards of the American Heart Association (AHA) and the American Red Cross (ARC). • All trained personnel must have a current certificate of completion by one of the above mentioned providers (EMS, AHA, ARC). The Site Administrator/Designee is responsible for ensuring that all trained CPR/AED responders certification is current. Personnel required training may register for a CPR/AED class on the Learning Zone. For further assistance, please contact the Special Programs’ Nursing Administrator at District Nursing Services – (213) 765-2877. • The Site Administrator/Designee will designate the trained employees available to respond to an emergency. A sufficient number of trained personnel should be designated to guarantee at least one trained CPR/AED responder will be on site during school hours and school sponsored events. • Any person who renders emergency care or treatment on a person in cardiac arrest by using an AED must activate the emergency medical services system (paramedics must be called) as soon as possible, and after any use of the AED, a report must be called to the District Nursing Services Special Programs Nursing Administrator who will then notify the appropriate licensed physician (Student Medical Services for students and Employee Health for any staff, adult(s) or visitors). • The AED located at the school or administrative office shall be maintained and regularly tested according to the operation and maintenance guidelines set forth by the manufacturer and in accordance with any other applicable state and federal authority. • The AED is checked for readiness daily, monthly and after each use and includes verification that all equipment and accessories necessary for support of the medical emergency is available. The Daily/Monthly Readiness Status will be performed by trained personnel designated by the Site Administrator/Designee at each school or administrative office and documented on the Daily/Monthly Readiness Status Checklist. o Daily Readiness Status Checks are done once each school day. o Monthly Readiness Status Checks are performed each calendar month. o The trained personnel performing the Daily and Monthly Checklist must notify the Administrator/Designee and District Nursing Services Special Programs Nursing Administrator immediately if any problems with the AED are determined. • The Administrator/Designee will annually notify all employees as to the purpose and location of all AED units on campuses and administrative offices. They will ensure that the school administrators and staff receive a brochure that describes the proper use of an AED and that the brochure is posted next to each AED unit. AED Emergency Response Team members will also be trained in Universal Precautions against Bloodborne Pathogens. The members of the Response Team shall be considered employed in a sensitive occupation and offered Hepatitis B vaccination free of charge or offered an affidavit of declination for the Hepatitis B vaccine. The Administrator/Designee will ensure that trained personnel responding to the CPR emergency will document each AED Emergency Response incident. For students, employees or visitors: Document an incident involving the use of an AED on an Injury/Accident Investigation Report and the Confidential Report of Automated External Defibrillator (AED) Incident Report and forward to the appropriate designees as indicated on the forms. No copies of these reports are to be maintained at the school. School Nurses who respond to an incident involving a student will record accurate nursing assessments on the student’s Health Record Card. The Administrator/Designee will follow the procedures in reporting other illness, accidents or

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injuries to employees. The Administrator/Designee will schedule a post debriefing session within 4 business days of the AED event for the initial responders. The responsibilities of the School Nurse include: 1. maintaining current CPR/AED certificate; 2. assisting as needed with the AED Emergency Response Site Plan; 3. assisting in personnel CPR/AED training; 4. assisting with Injury/Accident Investigation Report and the Confidential Report of Automated External Defibrillator (AED) Incident Report; and 5. assisting with post-incident reviews if appropriate.

FIRST AID PROCEDURES The School District procedures for First Aid are referenced in the First Aid Procedures flip chart, Form 33.137 (Rev 9/98). Extra flip charts may be ordered from the District Warehouse by the School Administrative Assistant – Commodity Code #966-12-78998. In 2005 the Emergency Medical Services Authority of California sent the Emergency First Aid Guidelines for California Schools to all California public schools. This reference, created in August 2004, is considered a standard and provides information especially helpful for schools in parts of the State not serviced on a regular basis by Credentialed School Nurses. The LAUSD Emergency First Aid Procedures flip chart (Form 33.137 Rev. 9/98) is still used for training staff. If schools are utilizing adjunct information in the Emergency First Aid Guidelines for California Schools, the school should continue to: • telephone 9-1-1 immediately for major emergencies; • adhere to all LAUSD policies; • perform all LAUSD procedures; • follow physician orders; • use only LAUSD approved forms; • document accurately; • maintain confidentiality; and • report all gunshots, stabs, etc. to the Local Nursing Administrator. The School Nurse MUST review the First Aid Flip Chart procedures with staff at the beginning of the School Year and throughout the school year, as needed. Use Training Log Form 33.204A Rev 8/04 –for this inservice. Retain a copy of the Training Form as documentation of your First-Aid In-services and send a copy to your Local Nursing Administrator’s Office. CONTINUE TO USE the “Notice of First Aid”, when notifying the parent/guardian regarding First Aid rendered. Document the injury and that the “Notice of First Aid” was sent and record on the Health Card. Retain the copies of “Notice of First Aid” Form (No. 33.13 E/S Rev. 8/02) for seven years. “First Aid Notices” not stored in the Health Card, must be stored in a box by month. Seal the box at the end of the school year and label it: NOTICE OF FIRST AID, THE SCHOOL YEAR, (e.g. 20072008) and THE NAME OF YOUR SCHOOL. Clearly print your name e.g. Jane Doe, R.N. School Nurses will complete the Injury/Accident Investigation Report Form. Many adults and children wear jewelry that may indicate an alert for a particular health/medical condition. Although the District does not provide this type of identification, there are sponsored memberships available from different companies. The Office of Risk Management and the Local Nursing Administrator’s Office must be informed prior to any special event involving the potential for the delivery of First Aid/CPR by the School Nurse (e.g. Health Fairs, Book Fairs, Back to School Night, Open House, etc.). There is a special log, which includes the District’s waiver and Release of Liability/Hold Harmless Agreement that must be completed when the School Nurse provides First Aid/CPR. The form is available from your Local Nursing Administrator’s Office. You must have the form PRIOR to the event.

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REPORTING FIREARM INJURIES School Nurses during the course of their professional capacity, must report when they provide health services for a physical condition which is reasonably suspected as being a wound or other injury inflicted by his/her own act or inflicted by another where the injury is by means of a firearm. The School Nurse must report to the Local Nursing Administrator immediately. Advise the Site Administrator who will notify the school police, the Local District Operations Director and the local law enforcement agency. A written report must be sent to the local law enforcement agent within two working days. (Penal Code Section 11160) contact the Local Nursing Administrator to obtain a Report Form.

MAINTAINING AQUATIC SAFETY AND SCHOOLS HAVING SWIMMING POOLS Aquatics are an integral part of both the elementary and the secondary physical education core curriculum. The purpose of the swimming program is to teach students to swim with the basic swimming strokes. Since the District offers classes in swimming during the school year at elementary and secondary schools and at several pools operated by the recreation departments of the city and the county, it is of the utmost importance to maintain facility inspections and to follow safety regulations in and around swimming pools. Regulations must be understood by all staff and are taught to all students prior to in-pool activity of any kind. A certificated physical education teacher provides instruction with a lifeguard on duty. To ensure appropriate swimmer supervision, a certified lifeguard should be on duty at all times the pool is in use. The lifeguard’s sole responsibility is surveillance. Lifeguards serving in this capacity have no teaching responsibilities or other duties, which could distract them from swimmer surveillance. Lifeguard service is described in Section 24100.1 of the Health and Safety Code. A lifeguard is provided where either swimming pools or natural bathing places are used. There shall also be a designated aquatics supervisor who is at least eighteen (18) years of age and who shall possess an American Red Cross Lifeguard Training Certificate or its equivalent certificate. Lifeguard service shall be provided at a ratio of one (1) lifeguard for each twenty-five (25) students in the water. A first-aid kit is to be fully stocked and the location clearly marked. School Nurses will be asked to review and sign the swimming permission slip form. This form attached to Bulletin 1454.1 is provided to a parent/guardian by the swimming instructor before students are selected for participation in the aquatic swimming program. Parents/ guardians are asked to provide information on this form related to any current medication(s) and dosage(s), any history of seizures, bowel/bladder control dysfunction, ear infections, etc. Notify the Local Nursing Administrator and the School Physician if the student has a history of bowel/bladder dysfunction, a history of seizures, or any other health condition that might constitute a safety hazard to the students or others participating in water activities. There are minimum procedures to follow in the event of a fecal spill in the pool. The site designee will evacuate the pool. Vacuum and remove the solids. Chlorinate the pool. Wait one hour and re-test water. Reopen pool when chlorine level returns to normal range (1.0 – 3.0 p.p.m.) and has been documented in the appropriate log. If a student complains to the School Nurse of eye irritation as a result of pool use, the School Nurse shall confer with the plant manager/pool custodian to check the chemical levels. If the chemical levels of the pool meet the above criteria, no further action is indicated. If chemical levels are out of range, the plant manager/pool custodian shall take immediate action to bring pool chemicals to proper range. School Nurses follow First Aid Procedures for eye injuries, notify the parent/guardian, complete the notification of first aid and document on the Health Record Card. Notify the Site Administrator and the Local Nursing Administrator. Refer to Bulletin No. BUL-1454.1 dated July 18, 2006, Instructional Services, Secondary and Elementary, “MAINTAINING AQUATIC SAFETY IN SCHOOLS HAVING SWIMMING POOLS”.

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HEAD INJURY NOTIFICATION PROCEDURES Head injuries may be potentially serious. The “Cautions Regarding Head Injury” is provided by the School Nurse or Principal to the parent/guardian of ALL head injury victims. Always use this form when notifying the parent/guardian regarding head injuries. Document the head injury and that the notice “Cautions Regarding Head Injury” was sent and recorded on the Health Card. Retain the copies of “Cautions Regarding Head Injury” (Form No. 33.14 E/S Rev. 9/05) for seven years. Head injury notices not stored in the Health Card must be stored in a box by month. Seal the box at the end of the school year and label it: CAUTIONS REGARDING HEAD INJURY, THE SCHOOL YEAR, (e.g. 2007-2008) and THE NAME OF YOUR SCHOOL. Clearly print your name e.g. Jane Doe, R.N. School Nurses will complete the Injury/Accident Investigation Report Form.

KILLER BEES Occasional rainfall, flowers and warmer temperatures present an ideal climate for bees. Of special concern is the infiltration of a hive by highly defensive bees, also know as “africanized” or “killer” bees. Their presence will increase the chance that someone will be stung. School Nurses should learn about their behavior and take precautions to reduce the risk of serious injuries. Although they are identical in appearance to the bees normally found in Southern California, when threatened, these highly defensive bees attack in greater numbers and will pursue intruders over a greater distance. This type of bee is particularly upset by noise, therefore, lawn mowers, string trimmers, air blowers and other power equipment should not be operated without first surveying the surrounding area. The custodial and gardening staffs at school sites are critical to the control of bees. Custodians should make a concerted effort to look for bee activity each day on their rounds. A large number of bees observed in an open area are probably a swarm. This is not as dangerous as a hive, which will typically be located in a hollow structure. Bees make their hives in many unusual places, including old tires, water meter boxes and holes in walls. Holes created by contractors and maintenance personnel performing Bond and other repair projects may be a home for bees. This is of particular importance around pipes and conduits, where existing holes may have been enlarged as installations occurred. To prevent hives, custodial staff will remove potential nesting areas and make trouble calls to close holes in walls as soon as they are observed. Only appropriately trained personnel should attempt to control bees. Spraying them with water or other substances will only agitate them. If bees are detected on a school site, the Site Administrator or plant manager will make a trouble call, providing the location of the sighting and a description of the activity observed. If no one has been stung, the problem is reported as urgent via the trouble call system at (213) 7451600. If anyone has been stung (and particularly if multiple stings have occurred), this should be reported as an emergency telephone 9-1-1. The Site Administrator will report directly to the Pest Management Department at (213) 743-1102. The closest available technician will be dispatched to your location. If bees are detected on a neighboring site, the Site Administrator will first inform the property owner and then contact Environmental Health and Safety at (213) 241-3199. Students and staff should be aware of appropriate actions to take if attacked by bees. Experts suggest that you: • Cover your head and face and take shelter in the nearest car or building. • Do not swat at bees while making your escape since this will agitate them further. • Do not attempt to remove bee stingers until you are safely out of danger, and do not squeeze the venom sack, as this will increase the amount of venom that enters your body. • Use your fingernail or a credit card to scrape the stinger off. • Wash the sting area with soap and water. • Apply an ice pack for a few minutes to relieve pain and swelling. The First Aid procedure for single bee stings should be implemented, carefully observing the individual. Use the Epi-Pen for any students with the applicable protocol(s). An individual who has been stung repeatedly, who develops vision or breathing difficulties, or who is normally allergic to bee stings should seek medical attention immediately. Telephone 9-1-1 and notify your Local Nursing Administrator. For printed material on bees, telephone the Los Angeles County Agricultural Commisioner’s Africanized Honey Bee Hotline at (800) BEE-WARY. (1-800-233-9279)

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Refer to Memorandum No. Y-5 dated July 23, 1999, Division of Facilities Services, “DISTRICT READINESS FOR KILLER BEES”.

WEST NILE VIRUS/MOSQUITO CONTROL District schools have requested assistance in the handling of dead birds found in school yards. These requests have been related to recent concerns about the West Nile Virus. The County Department of Health Services reports that the West Nile Virus is spread to humans most commonly through the bite of a mosquito which has been infected with the virus. Most mosquitoes do not carry the virus, and the risk of serious human illness is extremely low, with more than 80% of those exposed to the virus experiencing no symptoms at all. Those that develop symptoms may experience headaches, fever, body aches, skin rash or swollen lymph glands. Staff and students who suspect they may be infected should be referred to their physician or a public health clinic. Some students have allergies to insect repellants. School Nurses do not recommend specific products. Refer parents/guardians/students to their health care provider. Stagnant water sources are areas where mosquitoes breed. Refer complaints or observations of potential stagnant water sources to the Site Administrator. Dead birds on campus must be removed quickly by appropriate personnel. Gloves should be used and the bird carcass placed in a sealed double bag. The Department of Health Services may want to test the bird. Site Administrators may telephone the Office of Environmental Health and Safety (213) 241-3199 or Pest Management (213) 743-1102. School Nurses refer symptomatic students/staff to their health care provider. Confirmed cases must be reported to the Local Nursing Administrator’s Office and to District Nursing Services. District Nursing Services is responsible for tracking West Nile Virus incidents involving District students and staff and reporting these to the appropriate agencies. Specifically, District Nursing Services is responsible for: • responding to medical inquiries regarding West Nile Virus and if necessary referring these to Student Medical Services or appropriate agency for follow-up action; • serving as liaison between the District and County Department of Health Services; • referring to the Integrated Pest Management Coordinator at (213) 743-1102 issues associated with pesticide spraying by City or County agencies. The Integrated Pest Management Coordinator may in turn contact agency representatives; • reporting stagnant water at Vector Management Program – Rodent control only (626) 430-5450. Telephone your Local Nursing Administrator. Refer to Reference Guide REF-1304 dated September 16, 2004, Office of Environmental Health and Safety, Maintenance and Operations, and Student Medical Services, “WEST NILE VIRUS PRECAUTIONS” and Office of Environmental Health and Safety, SAFETY ALERT, NO. 04-07 dated July 2004, “WEST NILE VIRUS PRECAUTIONS”.

AVIAN INFLUENZA (BIRD FLU) PRECAUTIONS Avian flu, like other types of influenza, is caused by a virus. Avian influenza affects birds and usually does not cause disease in humans. However, there have been rare cases where a particular avian flu virus (the most publicized is labeled H5N1) has caused human infection-these cases have only been in Asian and southeast Asian countries and among persons who have direct contact with infected poultry or contaminated surfaces (e.g. persons working on chicken farms). While there are very rare cases of the virus spreading from one person to another, the CDC does not report any evidence of this strain of avian flu continuing to spread beyond one person. Therefore, the current cases of avian flu in humans are not the type of infections that lead to outbreaks or “pandemics”. Unfortunately, one of the characteristics of all influenza viruses is the ability to change over time and because of this the H5N1 and other strains of avian flu may one day be able to easily infect humans and spread person-to-person. This is why there has been so much media attention on the “bird flu pandemic,” as it represents a very serious health crisis.

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Surveillance, Detection, and Treatment: It is possible that travelers returning from affected countries, and who have contact with infected poultry by spending time on farms, in live food markets, and touching contaminated surfaces in those settings could be exposed to the virus. Avian flu infections in humans can result in typical “flu” symptoms or more severe, life-threatening diseases. U.S. Health Departments have received guidance and have developed specific plans for surveillance and preparedness around avian flu. Issues and Recommendations for Schools are: • Domestic birds in classrooms: There have been no cases of domestic birds contracting avian flu (H5N1) at the time this memorandum was issued. The risk of any avian flu in non-poultry farm settings is extremely low. However, there are general measures that can prevent all types of avian diseases among domestic pet birds. o Wash hands thoroughly with soap and water or a waterless hand cleanser before and after handling birds. o Adults should disinfect and keep cages clean using appropriate personal protective equipment (PPE). Refer to the District’s Integrated Pest Management “Pest of the Month” Newsletter No. 7 (2006) for more information on PPE needed when cleaning bird droppings. o Keep classroom pets isolated from wild birds, new birds, or those returning from travel. o Report sick or dead birds to authorities within the school and local health department. Issues and questions regarding sick or dead poultry (chickens) should be addressed to the California Department of Food and Agriculture (CDFA) at (800) 491-1899. •

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Wild birds on school campuses: As with domestic birds and livestock, there are currently no known cases of wild birds transmitting avian flu (H5N1) to the U.S. Since local birds carry other diseases, basic hygienic precautions are warranted. o Outdoor eating areas should be clean and free from contamination by birds and other animals. Maintenance and operations personnel should be notified if there are specific issues regarding wild birds interfering with the cleanliness of the school campus. Refer to the Integrated Pest Management program’s “Pest of the Month” Newsletters No. 6 and 7 (2006). o Report dead wild birds to authorities within the school. In certain cases (dead jays or crows) during West Nile Virus season, consider calling the Department of Health Services hotline for West Nile virus: 877-WNV-BIRD (877-968-2473). All other cases concerning clusters of dead birds should be referred to Los Angeles County Veterinary Public Health at (877) 7472243. General recommendations regarding the prevention of influenza: The following must be stressed as the best methods to decrease the spread of all types of viral infections and they represent the most practical steps students and school personnel can take at this time: o Wash hands frequently, especially after coming in contact with animals or contaminated surfaces. Use soap and water when possible; when not possible, use a waterless hand cleanser available to schools and classrooms through the general supply catalog. o Cover your cough-preferably with a tissue or with your sleeve. o Stay at home when you are sick to prevent the spread of your illness to others and to hasten your recovery. o Get the flu shot annually through your regular health provider.

Refer to Memorandum No. MEM-2092 dated November 7, 2005, Student Health and Human Services, “AVIAN INFLUENZA (BIRD FLU) PANDEMIC PRECAUTIONS”.

TOXIC SHOCK SYNDROME PREVENTION Toxic Shock Syndrome (TSS) is a severe acute disease caused by infection with strains of staphylococcus aureus, phase group I, that produces a unique enterotoxin. TSS is most common in menstruating women using tampons. The removal of tampons in LAUSD schools followed the recommendation from the LAUSD Director of Student Medical Services, the American Academy of Pediatrics and members of the obstetrical gynecological task force investigating toxic shock syndrome. Tampons are not distributed/sold in LAUSD schools.

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WELLNESS POLICY AND THE GOALS FOR PHYSICAL EDUCATION The District recognizes the connection between health and academic achievement. The students and families in the District are facing increasing health risks that can affect their wellness and ultimately affect their quality of life and possible life span. The District is committed to providing an environment where students can learn to make healthy choices for lifelong health. The LAUSD Board of Education adopted the policy on Wellness and the Blueprint expands on the policy. These documents, developed by the Coordinated School Health District Council, are translated into Spanish and available on the web (July 1, 2008).

GOALS FOR PHYSICAL EDUCATION There is a direct connection between physical activity, health and academic achievement. Time goals for physical education are: • All students in all grades should experience quality physical education, in a sequential and comprehensive, enjoyable, safe and secure learning environment. • To provide adequate space to maximize practice opportunities for each child. • To provide adequate equipment for students to be actively engaged individually, with partners, or in small groups to maximize practice opportunities. • To ensure physical education class sizes are comparable to class sizes in other subject areas where possible. • To provide physical education teachers instructional guides that support a written, comprehensive, and sequential standards-based physical education curriculum to use in their classes. • To ensure all students in Grade 9 are enrolled in a physical education course to participate in the required Fitnessgram© test (EC 51241). Starting July 1, 2007 students in Grade 9 not passing the Fitnessgram© test will lose the current two-year exemption from physical education and will be placed in subsequent physical education courses with an opportunity to retake the Fitnessgram© test. • Be able to offer extracurricular physical activity programs for elementary, middle, and high school students before and after school with physical activity clubs or intramural programs, in a variety of supervised activities. This is a policy of the State of California Department of Education and the Los Angeles Unified School District. Refer to Bulletin No. BUL-2528.0 dated July 18, 2006, Chief Instructional Officers, Secondary and Elementary, “K-12 PHYSICAL EDUCATION PROGRAMS”.

HEALTH RELATED FITNESS REQUIREMENTS AND PHYSICAL FITNESS TEST The Physical Education Model Content Standards for California Public Schools for Kindergarten through Grade Twelve (2004) emphasizes health-related fitness and ensures that schools are in compliance with state and federal mandates governing physical education. During the months of February, March, April, or May, the District administers to each pupil in grades 5, 7, and 9 the physical performance test designated by the State Board of Education. The Fitnessgram© developed by the Cooper Institute is the selected physical performance test for the State of California. Each physically disabled pupil and each student who is physically unable to take the entire physical performance test shall be given as much of the test as his or her condition will permit (EC §60800.a.). At the high school level, all 9th grade students are to be administered the Fitnessgram© physical performance assessment whether enrolled in ADV PE 1AB or ADV PE 2AB or as a 9R (ninth grade student based on credits) students, or any other physical education course as a 9R student.

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Each school district shall submit to the California State Department of Education, at least once every two years, the results of its physical performance testing. In addition to the results of the physical performance testing being mailed home to the pupil and parent, informal test results may be provided orally as the pupil completes testing. The schools role is to: • emphasize the importance of physical and health-related fitness; • analyze test results; • establish a schedule for physical fitness participation; • develop individualized student programs when necessary; • assess the effectiveness of the program; • provide appropriate Physical Education materials; and • document and retain the school fitness plan and all related documents. School Nurses and teachers collaborate in accomplishing the safe and healthful completion of the fitness requirements. School Nurses should notify the teacher to ensure that students with physical disabilities both short term and long term are accommodated accordingly. There are time requirements for physical education which are intended to ensure that physical education is an integral part of the educational program for all students. • Elementary – students in grades 1-6 shall have 200 minutes of physical education each 10 school days, exclusive of lunchtime and recess (EC §51210). • Span Schools – students with 1st through 8th grade configurations shall have 200 minutes of physical education each 10 school days, exclusive of lunchtime and recess (EC §51223). • Secondary – students in grades 7-12 shall have 400 minutes of physical education each 10 schools days (EC §51222). • Students shall have physical education every year in grades 1-9, with one additional year required in high school for graduation (EC §51225.3). High schools must also provide opportunities for students to participate in elective physical education classes each year. Refer to Bulletin No. BUL-2528.0 dated July 18, 2006, Chief Instructional Officers, Secondary and Elementary, “K-12 PHYSICAL EDUCATION PROGRAMS” and Bulletin No. BUL-783 dated February 16, 2004, Instruction Services, “PHYSICAL AND HEALTH RELATED FITNESS REQUIREMENTS, GRADE K-12”.

PHYSICAL EDUCATION EXCUSES An excuse (less than 10 weeks) from a physical education class may be granted to a student who is unable to participate in regular or modified curriculum for a temporary period of time due to illness or injury. A parent’s written request for an excuse will be accepted for up to 5 days; thereafter, a written request is needed from the student’s health care provider. School Nurses in secondary schools use Form 33.10 Rev 1/2006, “Health Office Referral to Physical Education Teacher” to notify the teacher when a physical education day(s) are excused. School Nurses document on the student’s Health Card when providing a Physical Education excuse to a student. Refer to Bulletin No. Z-22 dated February 1, 1998, Student Health and Human Services, “EXCUSE OR EXEMPTION FROM PHYSICAL EDUCATION FOR MEDICAL REASONS”.

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PHYSICAL EDUCATION EXEMPTIONS All children, unless specifically excused or exempt, are required to participate in a physical education program (EC §51222 and EC §51241). The Individuals with Disabilities Education Improvement Act of 2004 (IDEA), and federal regulations define “Special Education” as specially designed instruction to meet the unique needs of a child with a disability, including instruction in the classroom and instruction in physical education (20 U.S.C.§1401[29];§34 C.F.R. §300.26). Like all Special Education, physical education should be provided in such a manner that promotes maximum interaction between children with disabilities and their non-disabled peers. Temporary exemption from participating in a physical education course may be granted (EC§51241) to a pupil if the pupil is one of the following: • ill or injured and a modified program to meet the needs of the student cannot be provided; and • enrolled for one-half, or less, of the work normally required for full-time pupils. Permanent exemption from participation in a physical education course may be granted if the pupil complies with any one of the following: • is 16 years of age or older and has been enrolled in the 10th grade for one academic year or longer and has passed both the ADV PE 1AB and ADV PE 2AB; • is enrolled as a postgraduate pupil; or • is enrolled in a juvenile home, ranch, camp, or forestry camp school where pupils are scheduled for recreation and exercise. This pertains to the time the student is enrolled in these programs. Students with disabilities, which are temporary in nature, are not eligible for Special Education and/or related services as the disability will diminish significantly or will disappear over time. Some examples are broken bones, pulled ligaments and muscles, and infections. Since APE is a Special Education service, children with temporary disabilities are not eligible for APE services. However, some students with temporary disabilities may need modifications such as “no running,” “no contact sports,” or “use of crutches” as determined by a physician and in consultation with the parent and student to determine the extent to which a student may participate in the physical education program. (5CCR§3051.5(a)) Refer to Bulletin No. BUL-2528.0 dated July 18, 2006, Chief Instructional Officers, Secondary and Elementary, “K-12 PHYSICAL EDUCATION PROGRAMS” and Bulletin No. BUL-2457.0 dated May 8, 2006, Instructional Services, Secondary, “PHYSICAL EDUCATION EXEMPTIONS”.

PROCEDURES FOR OFF-CAMPUS PHYSICAL EDUCATION Secondary Schools may have students who possess exceptional talent or ability far beyond that of their peers. The talent or ability is being extended or perfected in an off-campus, non-school related environment under supervision of an authority competent to assist students towards maximum achievement. In the area of physical education, such activities as golf, gymnastics, skating, swimming, tennis, and others may require the student to practice vigorously as much as three to five hours daily outside of school time. School Administrators may accommodate the time pressures exerted upon students. Criteria for qualification for offcampus physical education activities, the acceptable procedures to be followed, and the way students can maintain credit for graduation if they qualify for off-campus physical education are outlined in the bulletin. No Independent Study credit will be given for private lessons or instruction for which the student, parent or guardian pays a fee. In lieu of credit, a notation of “requirement met” may be place on the student’s cumulative record at the discretion of the School Principal. Once the notation of “requirement met” is made on the paper cumulative records, the student must be entered into course number, 33-99-49, with “PE requirement met” noted in the CL section of the ISIS system. A Principal who so identifies a student as participating during non-school time in such an activity which requires an intensive amount of practice may permit the student to use the off-campus activity to meet the physical education requirement but may not allow credit towards graduation. The student must take five units of credit in any other class on the master program to maintain credit for graduation. Therefore, students who meet the physical education requirement may not begin school after the regular starting time or leave school before the regular dismissal time. This is a District policy and a recommended State law.

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Refer to Bulletin No. BUL-2528.0 dated July 18, 2006, Chief Instructional Officers, Secondary and Elementary, “K-12 PHYSICAL EDUCATION PROGRAMS” and Bulletin No. BUL-2457.0 dated May 8, 2006, Instructional Services, Secondary, “PHYSICAL EDUCATION EXEMPTIONS”.

PHYSICAL EXAMINATIONS FOR ALL INTERSCHOLASTIC ATHLETICS Each student planning to participate in Interscholastic Athletic Competition must pass a Physical Examination by a California Licensed Physician and Surgeon (there are some instances when under the supervision of a California Licensed Physician and Surgeon, you may accept a completed physical examination form from a Certified Nurse Practitioner or Physician Assistant). The Los Angeles Unified School District Policy has a specific policy for participation in California Interscholastic Federation (CIF) competition. Medical approval must be obtained PRIOR to participation in practice and/or competition. Cheerleaders, members of the Drill team, and members of the Marching Band are not covered by the California Interscholastic Federation (CIF) Regulations. The School Nurse shall obtain and evaluate an Interim Health History (Form 34-H-235) and screen the Health Record each year for District Clearance. Students who have no record at school of a previous Physical Examination should provide evidence of an examination before participating in these activities. A new bulletin and updated forms are in the development process by the District Student Medical Services. Refer to Bulletin No. Z-9 dated September 1, 2001, Student Health and Human Services, “PREPARTICIPATION PHYSCIAL EVALUATION AND MEDICAL CLEARANCE OF STUDENTS PARTICIPATING IN INTERSCHOLASTIC ATHLETICS”

STUDENTS RUN LA (SRLA) “Students Run LA” recruits more than 3000 students from 100 LAUSD high schools and middle schools to participate on teams that work on conditioning while building self confidence and self-esteem. This program prepares students to run in the LA Marathon. There are some students in our District that do not have access to regular health care and, therefore, may have difficulty getting medical clearance to participate in the program. School Nurses DO NOT provide clearance for SRLA students. Student Medical Services conducts sports physical clearance exams for groups of students at some of our underserved high schools. The School Physicians are available to provide sports physical exams for students wishing to participate in Students Run LA during regular scheduled sports physical days (which typically require at least 15 consented students.) If you have questions or need to schedule a sports physical day on your campus, please contact Student Medical Services at (213) 765-2830. Because Student Run LA is a community program and is not a Los Angeles United School District program, School Nurses DO NOT supply copies of any physical examinations, or sports physical examinations to Students Run LA staff. The student’s Health Card and contents are confidential health information.

MEDICAL ATTENDANT AT ATHLETIC EVENTS The presence of a medical attendant at certain athletic events is required by various California Interscholastic Federation (CIF) and Los Angeles City Section Interscholastic Athletics Committee (IAC) policies. These policies specify that a licensed Physician, School Nurse or EMT/Paramedic must be in attendance to provide emergency first aid and stabilization at designated contests. The District has always provided liability coverage for physicians or surgeons assisting at athletic events whether or not they are being compensated or are volunteers. School Nurses, as paid employees, are also automatically covered. Refer to Bulletin No. Z-48 dated June 15, 1998, Student Health and Human Services, Deputy Superintendent, Support Services, “MEDICAL ATTENDANT AT ATHLETIC EVENTS”.

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HEALTHY BEVERAGE SALES ON SCHOOL CAMPUSES Only food and beverages authorized for sale at District schools outside the National School Lunch and Breakfast Programs (including but not limited to the Student Store, Vending Machines, fundraising, etc.) before, during and until one half hour after the end of the school day at all sites accessible to students shall meet federal, state and local nutritional standards. During this timeframe, the District’s secondary Associated Student Body organizations and other approved groups should only sell approved fruit juices, water and electrolyte beverages in compliance with the District’s ASB contract with the Pepsi Bottling Group. The District’s Procurement Services Group is currently working in conjunction with school Site Administrators, the School Fiscal Services Division, and other District staff to determine the viability of securing a District wide contract for snacks. Federal, State and local laws regulate competitive food sales, prohibit the sales of “foods of minimal nutritional value,” mandate compliance with health codes and prohibit the sale of food near campuses. In 2002, in response to the national childhood obesity epidemic, the LAUSD Board of Education began further restrictions of foods sold on school campuses. The Healthy Beverage Motion went into effect in January of 2004 and restricted the sale of beverages on campus to “healthy” beverages. In October, 2003 the Obesity Prevention Motion was passed. This motion went into effect in July of 2004 and restricts the sale of foods on District campuses to foods that meet the District’s nutritional standards regarding both the nutrient content of the food and the portion size. These two new policies require that all groups (Associated Student Body organizations, clubs, Booster Clubs and parent groups, etc.) and vending machines selling food and beverages on campus ensure the items meet federal, state and local nutritional and sanitation standards. Federal, State and local laws regulate food and beverage sold on campus before, during or until ½ hour after the end of the regular school day. Foods must meet the following criteria: • meet the nutritional standards outlined in the Healthy Beverage and Obesity Prevention Motions; and • comply with all applicable federal, state and local regulations, including health codes. Vending machines in faculty rooms that are provided by faculty organizations are not subject to these criteria, provided that these machines are not accessible to students. The Food Services Branch determines which foods and beverages comply with the District’s nutritional and sanitation standards and manages the café-la.org website which lists the approved and unapproved foods and beverages. Principals or their designee will review all foods and beverages to be sold on campus before, during or until ½ hour after the end of the regular school day, by any group (including, but not limited to Associated Student Body organizations, clubs, Booster Clubs and parent groups, teachers and other school staff) and vending machines to ensure compliance with local, state and federal laws. In addition, during this timeframe, fruit juices, water and electrolyte beverages at secondary campuses must be sold in compliance with the District wide ASB contract with the Pepsi Bottling Group. Refer to the Food Services Branch web site: http://cafela.lausd.k12.ca.us, to determine if foods and beverages meet the District’s nutritional and sanitation standards and all other applicable federal, state and local regulations. Only the flavors, brands, and product codes listed as approved may be sold to students. The site also provides information on how to submit products for approval. The Board of Education voted to ban soft drink sales on school campuses effective January 1, 2004. The vote is part of the District response to childhood nutrition concerns and a growing epidemic of childhood obesity and other serious health-related issues. The new policy: • bans the sale of soft drinks on school campuses as of January 1, 2004; • prohibits schools from entering into new or renewing/extending a contract for the sale of any nonapproved beverage; • authorizes only approved beverages to be sold in vending machines, cafeterias, and student stores; • establishes an audit program with the Office of the Inspector General that will monitor compliance; • assists in implementation by disseminating information on healthy beverage sale options; and

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establishes a working group to develop an implementation plan including a revenue model to make up for the anticipated net loss of Associated Student Body (ASB) monies related to the ban on soft drinks.

Healthy beverage choices include: • fruit based drinks composed of no less than 50% fruit juices with no added sweeteners, artificial flavors or colors; • drinking water with no additives except those minerals normally added to tap water; • milk and flavored milks; • soy milk; • rice milk; • electrolyte replacement drinks; and • caffeinated beverages containing naturally occurring caffeine in cocoa with less than 20 milligrams per 12 oz. serving; no artificial sweeteners, flavors or colors. Beverages NOT allowed: • regular and carbonated beverages (including sports drinks); • caffeinated beverages such as coffee, tea, and chai; • beverages with herbal additives; • beverages containing vitamin and mineral additives; amd • any beverage in a glass bottle. The District has a centralized contract for Healthy Beverages. Schools no longer enter into individual contracts at their sites for water, electrolyte drinks, and fruit juices. However, approved soy milk products and other approved dairy products not sold in the cafeteria can still be individually contracted for with other vendors. For additional information regarding healthy beverages, telephone Food Services Branch (213) 241-2985. Refer to Bulletin No. BUL-2022.0 dated September 28, 2005, School Fiscal Services Division, “SALE OF BEVERAGES AT SCHOOL SITES”; Bulletin No. BUL-1908.0 dated August 31, 2005, Business Services Division, “GUIDELINES FOR SALE OF FOOD/BEVERAGES ON CAMPUS BY STAFF, STUDENTS, AND PARENTS – IMPLEMENTING THE HEALTHY BEVERAGE AND OBESITY PREVENTION MOTIONS AND APPLICABLE FEDERAL, STATE, AND LOCAL LAWS”; Bulletin No. BUL-1820.1 dated June 23, 2005, School Fiscal Services Division, “IMPLEMENTATION OF THE CENTRALIZED HEALTHY BEVERAGE CONTRACT ON SCHOOL CAMPUSES” and Bulletin No. BUL-732 dated February 4, 2004, Division of Business Services, “BOARD ADOPTED MOTION TO PROMOTE HEALTHY BEVERAGE SALES ON SCHOOL CAMPUSES”.

VENDORS AT OR NEAR SCHOOL CAMPUSES Many school campuses experience problems associated with vendors at or near the school perimeter. Food vendors in particular can pose a serious health risk for our students, and the operation of any vendor can contribute to traffic hazards by obstructing sidewalks and forcing students to walk in the street. The City of Los Angeles Municipal Code prohibits vendors from selling items within 500 feet of a school property line. (80.73 Los Angeles Municipal Code – Peddlers Near School: It shall be unlawful for any person to stop, stand or park any vehicle, wagon, or pushcart for the purpose of peddling, hawking, displaying or offering for sale there from any goods, wares, merchandise, fruit, vegetables, beverages, or food of any within 500 feet of the nearest property line of any school. This includes, but is not limited to catering trucks or ice cream trucks.) For schools located outside the Los Angeles City limits, the County Ordinance prohibits vendors from selling food items within 1,000 feet of a school property line. (7.62.071 Los Angeles County Ordinance – Peddlers of

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Edible Products Near Schools: Any person engaged in the business of peddling or selling liquids or edibles for human consumption shall not engage in business within 1,000 feet from any school property boundary, while children are going to or leaving school during opening or closing hours or during the noon recess period.) Report any vendor violating the above-mentioned Code or Ordinance to the Site Administrator. Notification of School Police at (213) 625-6631 may be necessary. School Police will follow-up with the appropriate regulatory agencies. Refer to Bulletin NO. BUL-577 dated October 14, 2003, Office of Environmental Health and Safety, “VENDORS AT OR NEAR SCHOOL CAMPUSES”.

ORAL HEALTH ASSESSMENT SCREENING On January 1, 2007, Legislation was chaptered into California Education Code Section 49452.8 which mandates an oral health assessment for kindergarten and certain first-grade enrollees. Kindergarten students while enrolled in a public school, or first-grade students not previously enrolled in a public school, must present evidence of having received an oral health assessment by May 31 of the school year. This assessment may be performed no earlier than 12 months prior to the date of the initial enrollment of the student into a public school. This law will impact students currently enrolled in kindergarten or first grade. The oral health assessment may be performed by a licensed dentist or other licensed or registered dental health professional. Although physicians, nurse practitioners, and School Nurses can, and do, perform visual dental inspections, the law currently does not allow these providers to complete the mandated oral health assessment. A waiver may be signed by the parent/guardian if unable or unwilling to comply with the oral health assessment. There is no penalty for students and families who are not able to comply with the oral health assessment. Students may not be excluded from school for noncompliance with the assessment or waiver. Each public school is required to notify parents or legal guardians of kindergarten students or first-grade students who have not previously attended kindergarten in a public school of the oral health assessment requirement every year. This notification should include a notification letter and a copy of the Assessment/ Waiver form. After distribution of the notification letter and the Assessment/Waiver form, each public school is required to collect the Assessment/Waiver forms returned by parents or guardians by May 31 of each school year. Schools must maintain the privacy of students’ health information. After the Assessment/Waiver forms are collected at each school, a member of the schools clerical office staff, under the direction of the Principal, should review the forms and complete the data report for the school. The original returned Assessment/Waiver forms should be kept in the student’s educational record. Each school with students subject to the oral health assessment requirement will complete the data report for the school and enter it into the District’s web-based database. This database is reached at http://sms.lausd.net under “Oral Health Assessment-School Data Reporting Form.” The District will compile the data for submission to the County Office of Education as required by law. Some parents/guardians may not have a family dentist or may have difficulty finding a dental office. A notification letter for dental and health insurance resources has been prepared and is provided by the school staff to parents who request assistance. Oral health is integral to overall health, as tooth decay is the most common chronic disease in childhood. Untreated tooth decay contributes to lost school hours, negatively impacts learning, interferes with eating, contributes to poor self-esteem, and can cause considerable pain. Although tooth decay is caused by an infectious agent, it is a preventable disease and one where early intervention is important for better health outcomes.

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Refer to Bulletin No. BUL-3585.4 dated February 11, 2008, Student Health and Human Services, “ORAL HEALTH ASSESSMENT FOR KINDERGARTEN OR FIRST-GRADE ENTRY”.

SCOLIOSIS SCREENING Scoliosis screening is a mandate for School Nurses. Students to be screened are: • 7th grade girls • 8th grade boys • all age appropriate students in ungraded school settings • all referred students and all students who required follow-up, any age or grade. Use Scoliosis Screening Follow-up Notice Form No. 33.72 (Rev. 4/2001) English/Spanish Outside agencies are NOT allowed to do this screening. Prior to the initiation of the screening program, parents/guardians should be informed in their primary language about the plan to conduct scoliosis screening and of their right to refuse to consent for their child’s participation (Education Code Section 49451). Such refusals must be submitted to the school in writing. Adhere to the proper procedure when scoliosis screening students. 1. Screen boys and girls separately. 2. Each student should be screened individually, in private. 3. Provide an area near the examination area where students can change their clothing, if necessary. 4. Have the boys strip to the waist. 5. Have the girls wear clothing that can be removed easily when entering the screening area. Girls may remove their arms from their sleeves and put their shirts/tops around their necks. 6. Have students loosen their waist bands for observation of the waistline. 7. Make optional the removal of shoes or sneakers before screening. 8. Make arrangements for extra privacy in special cases; for example, girls without bras or obese students. 9. Avoid all unnecessary comments regarding student examination. Every student is screened in a series of positions. The 4 positions are: 1. standing position (back) 2. forward bending position (Adams) 3. standing profile position 4. standing position (facing screener) Data to to: 1. 2. 3. 4. 5. 6. 7. 8.

be recorded on the Student Health Record and signed by the School Nurse includes but is not limited date results non-screening requests (refusals) re-screening information referral information evaluation results monitoring information all other pertinent information

Students with any positive findings are to be re-screened in a separate session by a different qualified screener. (Re-screening does not require additional parent/guardian consent). Parent notification and physician referral must be in writing in the primary language. Notification must include: 1. an explanation of scoliosis; 2. information on the importance of early treatment; and 3. public services available after diagnosis for treatment.

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Any of the following conditions constitutes a referral: 1. significantly elevated or prominent shoulder (greater than 1” difference) and/or significantly elevated or prominent scapula (greater than 1” difference); 2. thoracic and/or lumbar rib prominence (seven degrees or greater if using a scoliosis measurement); 3. excessive thoracic kyphosis (which does not reverse when the head is lifted in the Adams position); 4. excessive lordosis. 5. waistline asymmetry (elbow to waist); 6. leg length difference greater than ½ inch; or 7. persistent back pain with or without deformity. Follow-up by the School Nurse should include information, explanation and support for the student and the parent/guardian. Special services may include: 1. modification of the physical education program; 2. supervision of exercises; 3. care of the brace and prescribed weaning period; 4. counseling related to weight control, diet, exercise, medication, etc.; or 5. support group information The Standards for Scoliosis Screening in California Public Schools California Department of Education, 2007 ISBN 978-0-8011-1676-6. Annual Report of Scoliosis Screening – Form No. 33.73 Rev. 8/05 – is due in your Local Nursing Administrator’s office on Friday, May 29, 2009. Refer to Bulletin No. Z-20 dated February 1, 1998, Student Health and Human Services, “SCOLIOSIS SCREENING”.

VISION SCREENING California public schools are committed to providing equal educational opportunities to all students. To fulfill this commitment, schools need to identify students with physical disabilities that could adversely affect learning so that the students can receive appropriate care. The school vision testing program plays a vital role in the early identification of serious vision problems that might negatively affect both the health and learning of children. Vision screening is a mandate for School Nurses. The District policy states students to be screened are: • Kindergarten • first California enrollment • 2nd grade • 5th grade • 8th grade • any referred students (any age or grade) • male students are also screened once for color vision using the Pseudo-Isochromatic Plates Vision screening students in non-mandated grades may be reported as an acceptable activity to record on the Multi-Funded Time Report (B)/ Daily Activity Log (C) and Time Accounting Log (D). The additional recommended procedures which also may be included on the Multi-Funded Time Report (B)/ Daily Activity Log (C) and Time Accounting Log (D) are: • Cover Test • Near Point of Accommodation Test • Near Point of Convergence Test • Penlight Test for Strabismus • Hyperopia Test

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For the mandated screening process follow the procedure in A Guide for Vision Testing in California Public Schools (Revised 2/05). To prepare equipment for the Vision Screening Mandate: 1. Place the optotype chart or other screening device at one end of the room with 10 feet or 20 feet of unobstructed floor space immediately in front of it (depending upon the chart). 2. Mark a line with tape at either 10 feet or 20 feet in front of the chart. 3. Place the chart so that the center is approximately at the student’s eye level. 4. Place the chart so that it cannot be seen by students waiting to be screened. 5. For preliterate students or for students with special needs who are unable to use the letter chart, use other appropriate optotype tests such as the Illiterate “E” Charts or other approved symbol charts. 6. The room should be a quiet area, free of distractions. 7. The room must be large enough - 10 feet or 20 feet of testing space. 8. Ensure normal classroom lighting for the screening room. 9. Protect students from a light source other that the light of the chart (including window light, wall reflections, or light above or behind the chart). Suggested Vision Screening Guidelines include: 1. Position the student 10 feet or 20 feet from the appropriate chart, depending on the chart used. The student’s eyes must be parallel to and directly above the line. 2. Have the student cover the left eye with a cupped hand (make sure that the student does not apply pressure to the eye). Use an eye occluder if available. Clean reusable occluders after each use. Ensure that the eye remains covered. Follow the same procedure for the right eye and then both eyes together. 3. Instruct the students who wear glasses to keep their glasses on. Then test the student first with glasses on and then test without glasses. 4. Test the right eye first, then the left eye, then both eyes. A standardized routine avoids confusion and facilitates recording. Observe the student for squinting, forward leaning, or turning the head during testing. 5. Begin testing with the 20/40 – foot line and proceed with testing through the 20/20 – line. Testing beyond the 20/20 – foot line is not necessary. 6. Use the “E” Chart (or other age-appropriate tests) for preliterate students, preschool students, ESL students or those students with special needs who are unable to read the letters chart. To record Vision Screening results: 1. Record visual acuity separately for the right eye, for the left eye and for both eyes together. 2. Record visual acuity as a fraction. The numerator represents the distance from the chart and the denominator is the number of the lowest line read successfully. A student is usually considered to have “passed” a line when he/she can correctly identify more than half of the total letters or symbols on the line. “R” or “O.D.” denotes the right eye and the “L” or “O.S.” denotes the left eye, and O.U. denotes both eyes together. Record the lowest line the student read. e.g. R 20/20 and L 20/40. 3. Compile a list of the students who need follow up. 4. Retest students suspected of having a vision difficulty prior to sending a referral to the parent/guardian. 5. Record the results on the Student’s Health Card Record and in Welligent. Notify the parent/guardian when the student fails the Vision Screening. Any one of the following results is considered failure. 1. a visual acuity of 20/50 or worse for children under five years of age; 2. a visual acuity of 20/40 or worse for children six years of age or older; 3. for children of all ages, a difference of visual acuity of 2 lines or more on the chart; or 4. a manifestation of significant signs or symptoms (through a student’s behavior, complaints, appearance, performance, or physical activity) that suggest a visual difficulty. Complete the Report of Vision Screening (Form 33.190 E/S Rev. 5/01) and send the form home to the parent/guardian via U.S. mail.

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The Color Perception Test is required for male students once during the school enrollment years. 1. Use the Pseudoisochromatic or Isochromatic Plates. 2. Use normal lighting. 3. Demonstrate for the students how to use the soft, dry paintbrush or cotton-tipped swab to trace the symbols on the color plate. 4. If a student fails the Color Screen Perception test inform the parent/guardian. Complete the Information Report of a Color Vision Test (Form 33.191 Rev. 1/06) and send the form home to the parent/guardian. Advise the parent/guardian to consult with a physician or eye care specialist for additional information on color vision deficiency. Most often, color deficiency is nonprogressive, cannot be corrected, and does not affect visual acuity. 5. After consulting with the parent/guardian, inform the teacher(s)/counselor(s) of the student’s color vision deficit. Documentation, referral, remediation and follow up are integral parts of the entire vision screening process. Record and sign on the Student’s Health Record Card the date and the results for all vision screenings (including color vision screening). If the student fails the screening, re-screening the student is recommended but no longer required. Record the screening date (and re-screening date when applicable), the results of the screening and the date of written notification to the parent/guardian. Also document any follow-up and all other pertinent information. Keep an accurate statistical record of the number of students screened, rescreened, referred and remediated. All students who fail the visual acuity screening must be referred and follow-up must be documented. Refer questions to your Local Nursing Administrator.

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INDEX A Absences and Substitute Nurse Assignments…………………………………………....……….……..13, 22-27 Acceptable Use Policy (AUP) for District Computer Systems…………………………………………............40 Access 211 and 399……………………………………………………………………………………………..38 Access Sites During Non-Business Hours……………………………………………………………………...58 Accident Investigation and Reporting…………………………………………………………………………..54 Accident Report Forms…………………………………………………………………………………………54 Act of Violence……………..………………………………………………………….……………….…...88-89 Administrators, Nursing……………………………………………………….………...................................3-12 Adult Assistance (AA)……………….……………………………………………………………….……….135 AED/CPR…………………………………………………………………………………………….......154-155 AIDS/HIV Information Mandated for All District Employees…………………………………………..119-120 Air Pollution……………………………………………………………….…………..….……………….99-100 Allergies, Severe……………………………………………………………………………………………....149 Animal Bites……………………………………………………………………………………………...118-119 Animals – Service Animals and Activities Involving Animals…………………………………………..117-118 Annual Pesticide Use Notification…………………………………………………………………………….124 Antibullying…………………………………………………………………………………........................75-76 Anti-Virus Software…………………………………………………………………………………………….42 Appropriate Behavior with Students…………………………………………………………….. …………….91 Aquatic Safety in School Swimming Pools…………………………………………………………………...156 ARU (Audiological Resource Unit)………………………………………………………………. …………..13 Asbestos Inspection and Abatement Activities……....………………………………..……........................57-58 Assessing and Managing Threats………………………………………………………………………...103-104 Asthma (Students)………………………………………………………………………………………..148-149 Asthma Programs………………………………………………………………………………………………13 Athletics Physical Exam………………………………………………………………………........................163 Attire…………………………………………………………………………………..…….……………….…47 Audiometry Section………………………………………………………………………………………….…13 Audits/Reports……………………………………………………………………….......................................128 Automobile………………………………………………...……………….……………………………….….46 Avian Influenza (Bird Flu) Precautions……………………………………………………………….…158-159

B Banked Time at School Sites - Professional Development…………………………...…………………….52-53 Behavior Intervention Regulations for Students with Disabilities with Serious Behavior Problems………....137 Behavior, Mandated Reporting (Student) …………….………………………………………………...……..76 Bereavement Absences…………………………..………………………………..….....……………..……25-26 Beverage Sales……………………………………………………………………………………………164-165 Bilingual Classroom Teachers/Nurses Program ………………………..……………………………….……..46 Biohazardous Waste……………………………………………………………………………………...121-122 Bioterrorism (BT)……………………………………………………………......…………………….........78-79 Blood Donations (Students)……………………………………………...……………………………………..62 Bloodborne Pathogen Exposure, Adult………………………………………………………………………..120 Bloodborne Pathogen Exposure, Child on Child ………………………………………………..……….120-121 Bomb Threats…………………………………………………………………………………….……………..77 Breathmobile……………………………………………………………………………………………………13 Bullying……………………………………………………………………………………………………..75-76 Bus Accident Procedure…………………………………………………………………………………..........71

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INDEX C Cafeteria Employees Responsibilities During Emergencies..…………………………………..………............69 California Children’s Services………………………………………………………………………….............13 California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act……………...........105-107 California Kids………………………………………………………………………….…………….………...13 California Physical Fitness Test……………………………………………………………………….....160-161 California Safety Helmet Law………………………………………………………………….…....................70 California School Immunization Record (CSIR) PM 286…………………………………….……………....123 California State Teachers’ Retirement System (CalSTRS)…………………………………........................49-50 Campus Protection Procedures…………………………………………………………………........................63 Caregiver Authorization…………………………………………………………………………….............60-61 Carlson Home Instructional Program and Hospital School………………………………………………152-153 Cashing of Personal Checks Using Student Body Funds……………………………………….……...............37 Cellular Phones (Personal)………………..………………………………………………………...............38-39 Certificated/Classified Personnel Returning from Illness or Other Health Problems…………….……………48 CHAMP…………………………………………………………………………………………………………13 Change of Assignment/Transfer and Interview Request………………….……………………........................48 Change of Name, Address, or Telephone Number……………….…………………………….........................46 Child Abuse ………….………………………………………………………………………………....13, 93-95 Child Health and Disability Prevention (CHDP) Program………..……….…………………............14, 149-150 Cleaning Mouth Pieces of Brass and Woodwind Musical Instruments….…………………………………....110 Closing the Health Office at the End of the School Year…………………………………………………...35-36 Clothes Closets………………………………………………………………………………………….………14 Code of Conduct with Students………………………………………………………………………..………..91 Communicable Disease Control………………………………………..…………………………….14, 113-124 Community Resource Website………………………………………………………………………………....14 Complaint Response Unit for Parents of Student with Disabilities……………………………………….…..131 Condoms Information..……………………………………………………………………………………14, 108 Conference, Convention, or Meeting Request…………….…………..……………………………………….27 Confidential Health Records Information Protection Policy (Records) ………………………...............142-143 Coordinated Safe and Healthy School Plan (formerly known as Safe School Plan)…………………..…...64-66 Copyright Law –Computer Software…………………………………………………………………….....41-42 Court Appearance as a Witness…………………………………………………………………. ……..……...47 CPR/AED…………………………………………………………………………………………….14, 154-155 Credential (School Nurse Service)………………………………..………………………..………………51-52 Credential Services Unit…………………………………………………………………………………….....14 Crisis Intervention…………………………………………………...………………………………………..104 Curfew Enforcement and Loitering……………………………………………………………………………60

D D/HH………………………………………………………………………………………………….…….…..14 Daily Flushing Requirements for Non-Refrigerated Drinking Fountains……………………………………...57 Deceased Student………………………………………………………………………………….…..............143 Dependent/Elder Adult Abuse and Neglect Reporting Requirements…………………………….………...96-98 Diabetes…………………………………………………………………………………………….…….…....147 Disaster Supplies for School Site…………………………………………………………………..……….…..68 Discipline Foundation Policy: School-Wide Positive Behavior Support…………………………..…........73-74 Disposable Hazardous Waste………………………………………………………………………....….121-122 District Equipment Off-Site……………………………………………………………………….…….……..77 District Nursing Services………………………………………………………………………….…..……...….3 District Policies on Telecommunications………………………………………………….…….……..…...39-40

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INDEX D (continued) District Superintendents…………………………………………………………………………………...….4-11 District Telephone to Make Personal Calls & Use of Personal Cellular Phones & Pagers…………………….38 Documentation of Intervention Procedures for Students Suspected of Emotional Disturbance…………137-138 Domestic Violence/Suspected Abuse…………………………………………………………………………..98 Donations, Receipt of….……………………………………………………………………………………......45 Do Not Resuscitate (DNR) Orders………………………………………………………………………..…...133 Drug, Alcohol, Tobacco (Students)………………………………………………………...……………….81-82 Duty Hours…………………………………………..…………………………………………....................27-28

E Elder Adult Abuse and Neglect Reporting Requirements…………………………………………………..96-98 Electronic SESAC Reporting ……………………………………………………………………….............42-43 E-Mail Accounts (LAUSD)…………………………………………………………………………………….41 Emergency and Non-Routine Transportation of Students…………………………………..........................70-71 Emergency Drills and Procedures…………..………………………………………………..............................69 Emergency Procedures Reference Guide………………………………………………………………………66 Emergency Response Boxes……………………………………………………………………………………66 Emergency Services, Bob Spears, Director…………………………………………………………………….14 Emergency Use of Hand-Held Radios…………………………………………………............................153-154 Emergency/Disaster Supplies/Water for School Sites...………...……………………………………..........68-69 Emotional Disturbance – Documentation of Intervention Procedures for Students Suspected of ED…...137-138 Employee Assistance Program……………………………………………………………………………….…14 Employee Attendance Policy …………………………………………………………………………………..22 Employee Health Services………………………………………………………………………………...........14 Employee Injury Reporting…………………………………………………………………………………53-54 Employee Recreation Units…………………………………………………………………………………….15 Employee Returning from Illness or Other Health Problems………………………………………………..…48 Employee TB Clearance Requirements………...………………………………………..……........................124 Employee to Student Sexual Abuse…………………………………………………………………….………96 Employment Verification for Credential Programs and Professional Credential Recommendations……….…50 Employment Verification for Loan and Credit Applications……………………………………………....15, 50 Environmental Health and Safety………………………………………………………………………….…...15 Equity Non-Discrimination Related to Transgender & Gender Non-Conforming Students……………….82-84 Evaluation of Health and Human Services Personnel (Stull)……………………………….........................29-31 Expulsion Guidelines ………………………………………………………………………………………….76

F Family & Medical Leave Act/ California Family Rights Act & Paid Family Leave Insurance (FMLA/CFRA)..….................................................................................................................................26-27 Federal False Claims Act Policy…………………………………………………………………………….40-41 Field Trips…………………………………………………………………………………….…………......72-73 Firearms on School Sites…...…………………………………………………………………………………...64 Firearms Injuries, Reporting of…………………………………………………………………………….….156 First Aid Procedures ……………………..………………………………………………………….….........155 Flood/Heavy Rain Procedures……………….………………………………………………...……….…...98-99 Food Borne Illness or Contamination……………….…………………………………….……………...112-113 Food Handlers………………………………………………………………….……………………………...112 Food Services Branch………………………………………………………………………….…………...…..15

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INDEX G General Guidelines – School Nurse State Mandated Responsibilities……………………………… ……..31-32 General Guidelines for Students Summons and Hall Passes …………………………………………… …….35 Guidelines for Adult Bloodborne Pathogen Exposure………………………………………………….…… .120 Guidelines for Child on Child Bloodborne Pathogen Exposure………………………………………….120-121 Guidelines for Individualized Health Assessment and the Participation of the School Nurse in the Individualized Education Plan (IEP) Process…………………………………...132-133 Guidelines for the School Attendance Review Board (SARB) and Site School Nurses ………......... .......76-77 Guidelines for Volunteer Workers Assisting the School Nurse………………………………………… …..126

H Hazardous Products and Hazardous Waste Disposal Procedures……………………………………………....67 Head Injury Notification Procedures…………………………………………………………………….……157 Health Benefits (Employee Health Insurance)…………………………………………………………..….….15 Health Care Assistant Absence Line…………………………………………………………………….……..15 Health Education/Condom Information……….…………………………………………………….........108-109 Health Education………………………………….…………………………………….……………...…108-109 Health Information Card (Confidential)…………….………………………………………............................145 Health Insurance Coverage …..………………….…………………………………………………………..…50 Health Office Day to Day Running………….……………………………………………………………...32-34 Health Office Refrigerator Repair……………………………………………………………………….……..34 Health Related Fitness Requirements and Physical Fitness Test…..…………………………………….160-161 Health Standards for Middle and High Schools…………………………………….………………………...109 Health Supply Office…………………………………………………………………….……………………..15 Healthy Beverage Sales on School Campuses…………………………………………..……………….164-165 Heat Stress………………………………………………………………………………………….….…101-102 Helmet Law……………………………………………………………………………….……........................70 Hepatitis B Information Mandated For All District Employees………………………………….….…..119-120 HIPAA (Health Information Portability Accountability Act)………………………………………...….142-143 HIV/AIDS Prevention Education Act……………………………………………………………………105-107 Home Study Correspondence……………………………………………………………..…............................51 Home/Hospital Program (Carlson Home Instructional Program & Hospital School)………….........18, 152-153 Homeless Children and Youth in Schools ……………………………………………………….….…..125-126 Honoraria, Receipt of…………………………………………………………………………….……… ……45 Human Resources, Roger Buschmann, Chief Officer…………………………………………….………… ..15

I Identification Badge……………………………………………………………………………........................47 Immigration Assessment Center …………………………………………………………………………..…..15 Immunization Requirements for School Entry………………………………………………………......122-123 Independent Study Programs…………………………………………………………….…………….…..…153 Indoor Environmental Quality ………………………………………………………………….………..100-101 Infant Preschool Support Services…………………………………………………….………....…........... 15-16 Infection Control Guidelines for Preventing the Spread of Communicable Diseases…….……………..113-114 Insurance – Employees……………………………………………………………………………..…….15 Insurance – Students…………………………………………………………………………………..61-62 Internet Policies……………………………………………………………………………………..…….40 Interscholastic Athletic/Sports Physicals……………………………………………………………..…..16, 163 ITD Help Desk………………………………………………………………………………………..………..16

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INDEX J Jury Duty……………………………………………………………………………………................46-47

K Kathryn Kurka Children’s Health Fund…………………………………….………………………….…...16, 21 Killer Bees………………………………………………………………………………………………..157-158

L LA County Telephone Access 211 and 399……………………………………………………………….……38 LAPD Non-Emergency……………………………………………………………………………………........16 LAUSD Board Members………………………………………………………………………………….…….16 LAUSD E-Mail Accounts ……………………………………………………………………………...............41 LAUSD General Information……………………………………………………………………......................16 Lead Exposure during Construction and Renovation.…………………………………………....................56-57 Learning Zone………………………………………………………………………………………….……….41 Least Restrictive Environment (LRE) Initiative: Intergration of General and Special Education …..……….134 Leaves, Retirements and Resignations………………………………………………………...…………….….48 Lice Exclusion/Readmission Policy……………………………………………………………………….…..119 License Renewal (RN)……………………………………………………………………………….……...47-48 Licensed Professional Health Care Providers (LPHCP)…………………………………….……….………..141 Local District Offices…………………………………………………………………………………..….....4-12 Low Incidence Funds………………………………………………………………………..…..…..136-137

M Mail…………………………………………………………………………………………………….36-37 Mandate to Provide Information Regarding AIDS/HIV and Hepatitis B Infections to all District Employees (Annual School Nurse Inservice to Staff)……….…….......119-120 Mandated Cost and Medi-Cal Cost Recovery Programs….………………………………….….......16, 128 Mandated Reporting of Certain Student Behavior……………………………………………….….....….76 Media Events………………………………………………………………………………...……….…..105 Medical Attendant at Athletic Events………………………………………………………….….……..163 Medi-Cal Administrative Activities……………………………………………………………..…...........16 Medi-Cal Cost Reimbursement Unit & Mandated Cost Recovery Program………………….…..... …....16 Medical Exemption and Exclusion Policies and Procedures…………………………………..…....150-151 Medication Dispensed in School…………………………………………………………................146-147 Meeting the Requirements of the “No Child Left Behind Act” of 2001 and Title IV, Safe and Drug-Free Schools…………………………………………………………………………110 Mental Health (School)………………………………………………………………………...................18 Mileage...………………………………………………………………………………….……….….......45 Minimum and Shortened Day Schedules……………………………………………….………..………..52 Modified Consent Decree (formerly Chanda Smith Decree) ……………………………….…….……..131 MOU (Memorandum of Understanding)…………………………………………………….……….…...17 MOVE Program…………………………………………………………………………….…….…133-134 MRSA and Other Skin Infections………………………………………………………….....……..114-116 Multicultural Course Requirements………………………………………………………….…….….......51 Multi-Funded Time Reporting…………………………………………………………….…………...28-29

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INDEX N Network for a Healthy California, LAUSD…………………………………………………………………….17 Network Security Measures…………………………………………………………………………………….43 No Child Left Behind Act………………………………………………………………………………..……110 Notice of Nondiscrimination/Title IX Policy/Complaint Procedures…..…………………………….……..87-88 Non-LAUSD Student Records………………………………………………………………………..……….145 Non-Public Schools (NPS)…......……………………………………….………………………………………17 Nursing Administrators………………………………………………….……………………………………3-12

O Occupational Therapy/Physical Therapy(OT/PT)…..……………………………………………….…………17 Office of Environmental Health and Safety………………………………………………..…….…………….15 Office of Risk Management and Insurance Services…………………………………………….…..…………17 Opening the Health Office for the Beginning of the School Year……………………………….…..……...32-34 Opportunity Transfers (O.T.)………………………………………………………………….…….………...153 Oral Health Assessment Screening………………………………………………………….….…….......166-167 Orthopaedic Hospital/Urgent Care …………………………………………….…………………………….…17 OSHA (Occupational Safety & Health Administration)……………………….…………….. .................53-56 Oxygen Use in Schools.……………………………………………………………….………………….140-141

P Parent/Student Handbook………………………………………………………………….…………………..60 Payroll Calendar……………………………………………………………………………………………….28 Pediculosis (Head Lice) Exclusion/Readmission Policy.…………………………………………………….119 Personal Calls………………………………………………………………………………………………….38 Personal Necessity Absence..……………………………………………………………….…………………25 Pest Control……………………………………………………………………………………………………17 Pesticide Use Notification (Annual)………………………….………………………….…………………..124 Physical Education Goals…………………………………………………………………………………….160 Physical Education Excuses………………………………………………………………………………….161 Physical Education Exemptions ……………………………………………………………………………..162 Physical Education (Procedures for Off-Campus)………………………………………………………162-163 Physical Examinations for All Interscholastic Athletics….………………………………………………….163 Physical Fitness Test………………………………………………………………………..……………160-161 Physical Therapy/Occupational Therapy (PT/OT)…………………………………………………..………...17 Policy on Restroom Access, Cleanliness and Repair………………………………………...…………..110-111 Policy Statement Regarding Sexual Harrassment……………………………..………………………..…..89-91 Poison Center Hotlines……………………………………………………………………..…...………........103 Poison Control……………………………………………………………………………….…………..…….17 Pool Safety………………………………………………………………………………….…………..…….156 Positive Behavior Support (Discipline Foundation Policy)...…………………………………..………..…73-74 Possession of District Equipment – Off-Site…………………………………………….….…………..……..77 Pregnant/Parenting Teens Program & Homeless Education Program………..…….…………..…..17-18, 84-87 Pregnant and Parenting Students Educational Rights…………………………………..…………….…....84-87 Pregnant Minors and Parenting Minors Compliance Services………………………………….……..……....84 Prevention and Management of Skin Infections………………………………………………….……..114-116 Preventive Measures, Mandatory Procedures, and Legal Requirements for Students Regarding Drugs, Alcohol and Tobacco..………………..…...……...…………………………………………81-82

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INDEX P (Continued) Principal–School Nurse Conference….…………………………………..……………….………..……..........27 Procedure for Recording and Securing the Health Record Card When a Student is Deceased........................143 Procedures for Closing the Health Office at the End of the School Year ………………………….............35-36 Procedures for Off-Campus Physical Education……………………………………………………..…..162-163 Procedures for Opening the Health Office at the Beginning of the School Year …………….……….…....32-34 Procedures for Serving Students with Disabilities Under 504……………..……………………..……...139-140 Procedures for Work Related Injuries or Illness…………………………………………….........................54-56 Procedures to Access Site During Non-Business Hours ………………………………………..……….……..58 Procedures to Amend the IEP to Conform With the State Mandated Assessments…………..………….…...139 Processing of Mail ……………………………………………………………………………..……….…..36-37 Professional Liability Insurance Program ………………………………………………………….……...…...48 Protective Clothing and Sunscreen………………………………………………………………….…....102-103 Protocols……………………………………………………………………..………………….……………..141 Psychiatric Emergencies……………………………………………………….………………..…...…………18 PTA Health Centers…………………………………………………………………………………............20-21 Pupil Records: Confidentiality Procedures, Access, Challenge to Content………………………..….....143-145

Q

R RARD (Risk Assessment Referral Data)…………………………………………….…………...…129-130 Reading TB Skin Test………………………………………………………………….………….…......124 Readmission to Work (Employee) Following Illness………………………………………………….….48 Readmission to School (Students)………...………………………… ………………….……..……...62-63 Receipt of Donations…………………………………………………………………..…………..…..…..45 Receipt of Honoraria……………………………………………………………………..…………..…....45 Records for Non-LAUSD Students……………………………………………………….……..............145 Referral Form for PTA………………………………………………………………….………..…...…...21 Refrigerator Use and Repair…..………………………………………………………….…….................34 Reporting Animal Bites………………………………………………………………….………….118-119 Reporting Communicable Diseases……………………………………………………….………...116-117 Reporting Employee Injuries to OSHA…………………………………………………….………….53-54 Reporting Firearm Injuries……………………………………………………………………….………156 Reporting Safety Hazards………………………………………………………………………….……...67 Request for Assessment Report Prior to IEP Meeting……………………………………………….…..135 Request for Conference, Convention or Meeting Attendance…………………………….........................27 Restroom Policy – Access, Cleanliness and Repair……………………………………...…………110-111 RN License Renewal…………………………………………………………………………………..47-48

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INDEX S SARB (School Attendance Review Board)……………………………………………………..….……….76-77 Safe School Plan (Now Knows as Coordinated Safe and Healthy School Plan.……………………….…...64-66 Safety and Health Protection………………………………………………………………………..……..…...53 Salary Point Credit Classes………………………………………………………………………….….......50-51 School Crime Reporting ……………………………………………………………….………….….….…63-64 School Day Schedule……………………………………………………………..………………….….….…..53 School Emergency Response Boxes………………………………………………….……………..……...…..66 School Mental Health………………………………………………………………..……………….….……..18 School Nurse Health Services Summary Report…………………………………………..…………......128-129 School Nurse Service Credential……………………………………………………………........................51-52 School Nurse State Mandated Responsibilities – General Guidelines……………………………….…..…31-32 School Police…………………………………………………………………………...…………………........18 School Procedures During Heavy Rain or Flood Conditions……………………………………….….…...98-99 School Site Emergency/Disaster Supplies ………………………………………………………………….….68 School Traffic Safety and Education……………………………………………………………….……….69-70 Scoliosis Screening……………………………………………………………………….........................167-168 Section 504…………………………………………………………………………...…………….….....139-140 Seismic Bracing………………………………………………………………………………..……......…..67-68 Services Animals and Activities Involving Animals, Insects, and Reptiles……………….…..……..…..117-118 SESAC Reporting……………………………………………………………………………....……..…….42-43 Sex Offender Notifications…………………………………………………………………..…….….….…92-93 Sexual Abuse (Employee to Student)………………………………………………………..……….….……..96 Sexual Harassment (Student)….…………………………………………………………..…….…….….…89-91 Sexual Harassment Policy (Employee to Employee) ….…………………………………..………….….…....92 Sheltering-in-Place………………………………………………………………………..………….….……...68 Sign-In and Sign-Out Procedures……………………………………………………………….….…….…….28 Site Access During Non-Business Hours…………………………………………………….…..…..…….…..58 SPECIAL EDUCATION • Adult Assistance (AA)………………………………………………………………………..……...135 • Allocation for Support of Special Education Compliance…………………………………..…..…...136 • Behavior Intervention Regulations for Students with Disabilities with Serious Behavior Problems………………………………………………….………………………….……..…....137-138 • Complaint Response Unit/Parent Resource Network……………………..………….…….….……..131 • Do Not Resuscitate (DNR) Orders………………………………………………….…….………….133 • Guidelines for Individualized Health Assessments & Participation of School Nurse in the IEP Process………………………………………..……………………………………………….…132-133 • Home and Hospital……………………………………………………………………………8, 152-153 • Least Restrictive Environment (LRE) Initiative: Integration of General & Special Education……...134 • Licensed Professional Health Care Providers (LPHCP)……………………………………………..141 • Low Incidence Funds (Policies and Procedures)………………………………………………..136-137 • Mobility Opportunities Via Education (MOVE)…………………………………………..……133-134 • Modified Consent Decree…………………………………………………………………………….131 • Oxygen Use in Schools………………………………………………………………………….140-141 • Procedures to Amend the IEP to Conform with the State Mandated Assessments…………….…….139 • Protocols……………………………………………………………………………………….……..141 • Request for Assessment Report Prior to IEP Meeting……………………………...……..…............135 • Special Diet Policy……………………………………………………………………………..…….138 • Special Education & Parent Participation…………………………………………………………....134 • Special Education …………………….……………………………………………...………….131-141 • Special Education Policies and Procedures Manual…………………………………………….…....131 • Special Education School Nurses……………………………………………………………………...19

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INDEX S (continued) • Special Education School Site Checklist for Student With Disabilities ……………………..………131 • Special Education Transportation……………………………………………………………….135-136 Special Diet Policy……….…………………………………………………………………………..……..…138 Special Events Liability……………………………………………………………………………….............155 Staff Dues……………………………………………………………………………………………..…..........22 State Mandated School Nurse Responsibilities……………………………………………………..……....31-32 Statistical Reports…………………………………………………………………………………….......128-129 Storage of Emergency Water ……………………………………………………………………….……... 68-69 STRS……………………………………………………………………………………………….……......49-50 Student Accident and Health Insurance……………………………………………………………..….......61-62 Student and Employee Security……………………………………………………………………...……..…..63 Student Expulsion Guidelines…………………………………………………………………….…………….76 Student Health and Human Services…………………………………………………………………….….…..19 Student Medical Exemption and Exclusion Policy and Procedure…………………………………….…150-151 Student Medical Services/School Physicians………………………………………………….…………….…19 Student Search (to Locate School of Residence)……………………………………………….………….…..19 Student Summons and Hall Passes – General Guidelines…………………………….…………………….….35 Student Suspension Guidelines……………………………………………………….………………….…….76 Student TB Clearance Requirements…………………………………………………..……………….……..123 Student Use of Cellular Telephone and Pagers………………………………………..……………..….….38-39 Students Run LA(SRLA)…………………………………………………………….……………….……….163 Students with Asthma……………………………………………………………………………….……148-149 Students with Diabetes…………………………………………………………………………….……..147-148 Students with Severe Allergies…………………………………………………………………………….….149 Stull Evaluation……………………………………………………………………………………….…..…29-31 Substitute Nurse’s Folder…………………………………………………………………………….……...….34 Suicide Prevention Program (Youth)……………………………………………………………….….….…..129 Suicide Prevention Unit……………………………………………………………………………….…….….19 Suicide-Risk Assessment Referral Data (RARD)……………………..……………………………….…...…130 Sunscreen………………………………………………………………………………............................102-103 Suspected Violent Injury Report (SVIR)………………………………………………………….…………....64 Suspension Guidelines……………………………………………………………………………………….…76

T Telecommunications…………………………………………………………………...………....................39-40 Telephones, District for Personal Use……………………………………………………………….….….…...38 Threat Assessment…………………………………………………………………………………….….103-104 Time Reporting for Multi-Funded Personnel………………………………………………………….……28-29 Title IX Policy and Complaint Procedures………………………………………………………….……...87-88 Toxic Shock Syndrome Prevention (Tampons)…………………………………………………….………...159 Traffic Safety and Education……………………………………………………………………….…….…69-70 Transfer Request………………………………………………………………………………………..………48 Transgender & Gender Non-Conforming Students………………………………………............................82-84 Transportation (Routine)…………………………………...………………………………………..…..…..71-73 Transportation Branch………………………………………………………………….……………....…….....20 Transportation (Special Education)……………………………………………………………………....135-136 Transportation of Students (Emergency and Non-Routine)……………………………….……………..…70-71 Tuberculosis Clearance Requirements (Early Childhood Education Students) …………………………123-124 Tuberculosis Clearance Requirements (Employees)………………………………………………………….124 Tuberculosis Clearance Requirements (Students)…………………………………………………………….123 Tuberculosis Clearance Requirements (Volunteers)…………………..………………………………….…..124

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INDEX U United States Copyright Law Compliance………………………………………………………….…43-45 Unpaid Leave of Absence and Medical Benefits………………………….………………..…………..…48 Urban Classroom Teachers/Nurses (UCT in EIS Schools)……………….……………..…………….….46 Use of Automobile …………………………………………………………………………….................46 Use of Cellular Telephones and Pagers by Students …………………………………………….……38-39

V Vendors at or Near School Campuses………………………………………………………………165-166 Violence ……………………………………………………………………………………………….88-89 Vision Screening……………………………………………………………………………...……..168-170 Vision Therapy………………………………………………………………………………………….....20 Visitors to School Campuses…………………………………………………………………….…….58-59 Visually Impaired Programs…………………………………………………………………….…….…..20 Volunteer Health and Mental Health Services to Students………………………………................126-127 Volunteer TB Clearance Requirements…………………………………………….……………………124 Volunteers in Health Office……………………………………………………………………….……..126

W Waste Management Act (California Law) ……………………………………………………….…………...121 Weapons of Mass Destruction/Weapons of Mass Effects Incidents…………………………….…….……79-80 Welligent Health Manager…………………………………………………………………….…...…20, 130-131 Wellness Policy and the Goals for Physical Education…………………………………………….……..…..160 West Nile Virus/Mosquito Control………………………………………………………………….……..….158 Wheel Chair Repair…………………..……………………………………..………………........................35-36 Williams/Valenzuela Uniform Complaint Process………………………………………………….……....….61 Work Related Fatalities or Serious Injuries………………………………..……….……………..……..……..56 Work Related Injuries or Illness Procedures…………………………………………………….……..…...54-56 Work Request Permit…………………………………………………………………………………..…..….126

X/Y/Z Youth Suicide Prevention Program……………………………………………………………………….…129 Zero-Tolerance Policies for Drug, Alcohol and Tobacco Free Schools & Workplaces…………………...80-81

Dedicated to Leslie Orth, Retired Nursing Coordinator and Past President of the Kathryn L. Kurka Children’s Health Fund, Inc. November 29, 1927 – April 17, 2008 and Marian Mendoza, School Nurse September 18, 1957 – March 15, 2008 180

TO THE WORLD YOU MIGHT JUST BE ONE PERSON BUT TO THE ONE PERSON YOU MIGHT JUST BE THE WORLD

To each School Nurse Thank You for all you do for the Students in the Los Angeles Unified School District

Our Students Are Our World

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