3. Alcohol / Drug Care Services, Inc.: Serenity Inn

August 1, 2014 Learning Site Agreement (LSA) in Place - “Approved” Community Partners

Message for Faculty:  Please contact Stacy Becker x4963 if you have any questions regarding whether an agency or program is “approved”; some community programs may be covered by currently “approved” agencies with the Learning Site Agreement (LSA) and Learning Site Self-Assessment (SSA) already in place.  This is a resource list for faculty use only; it is not designed to be directly distributed to students.

Risk Management paperwork required of students at ALL organizations – on campus (HSU Direct Programs) and off campus:  The Learning Plan, Participation Guidelines, Student Time Log, and Release of Liability forms are required of HSU students for Service Learning and Academic Internship placements for academic credit.  For more information and direct links to required forms, please see our website at: http://www.humboldt.edu/cslai/  Additionally, specific agencies may have their own required documents. For these forms and further assistance, please contact Stacy Becker at the Center for Service Learning & Academic Internships, 122 Gist Hall, 826-4963, or email [email protected]

Community-Based Organizations, Schools & Businesses covered by LSA – “Approved”:

1. Access Humboldt 2. Adult Day Health Care of Mad River 3. Alcohol / Drug Care Services, Inc.: Serenity Inn 4. Alder Grove Charter School 5. Arcata Animal Hospital 6. Arcata Christian School 7. Arcata Core Pilates for HSU Kinesiology Dept. Academic Interns 8. Arcata Economic Development Corporation 9. Arcata House Partnership 10. Arcata Playhouse 11. Area 1 Agency on Aging 12. Baroni DBA Plaza Home 13. Baroni Designs 14. Bay Area Packaging [Lafayette, CA] 15. Bear River Band of Rohnerville Rancheria / Bear River Casino 16. Big Brothers Big Sisters of the North Coast 17. Bird Ally X [inc. Humboldt Wildlife Care Center] 18. Blue Lake Family Resource Center 19. Bonanza Ranch 20. Boys and Girls Club of the Redwoods [inc. Club Houses, Teen Center, Teen Court] 21. Bureau of Land Management – Arcata Field Office 22. California Conservation Corps: Watershed Stewards Project 23. Camp Gold Arrow [Clovis, CA] 24. CarStations, Inc. 25. Catholic Charities of the Diocese of Santa Rosa [inc. Betty Kwan Chinn Homeless Foundation; and Betty Chinn Day Center in Eureka] 26. Cher-Ae Heights Indian Community of the Trinidad Rancheria 27. Children of the Redwoods Infant & Toddler Center 28. City of Arcata An additional City of Arcata Volunteer Packet, including livescan/background check, is required of all students serving with the City in ongoing volunteer positions; this packet will be distributed as needed by the City staff overseeing the student. Please inform the HSU Center for Service Learning & Academic Internships (CSLAI) about ANY placements with City programs, as these need to be reported to the City Personnel Director, Danette Demello. At the Arcata Marsh, "Interpretive/Marsh tours" work ONLY is covered by the City of Arcata LSA. For more info, please contact the CSLAI at x 4963. 29. City of Blue Lake 30. City of Billings, Montana [inc. Environmental Affairs Division; Water Treatment Plant Lab; Planning Division] 31. City of Eureka 32. City of Fortuna [inc. Parks & Recreation; Planning Division; River Lodge Conference Center; Finance Dept.] 33. Clarke Museum 34. Coastal Grove Charter School 35. Coast Central Credit Union 1 36. College of the Redwoods 37. Commercial Fishermen's Wives of Humboldt 38. Community Alliance with Family Farmers [inc. Farm to School Docent Program-at Redwood Roots Farm; and Harvest of the Month programs] 39. Companion Animal Foundation [Sunny Brae location] 40. Consumer Credit Counseling Service of the North Coast 41. County of Humboldt [all departments; inc. Headwaters Fund, Coroner's Office…] Please inform the HSU Center for Service Learning & Academic Internships (x 4963) about any placements with County program), as these need to be reported to the Deputy County Administrative Officer, Amy Nilsen. 42. Court Appointed Special Advocate of Humboldt (CASA) 43. Cumulus Media San Francisco [San Francisco, CA; Includes KFOG 104.5, KNBR 680, 107.7 The Bone, KGO 810, KSFO 560] 44. Dell'Arte International 45. Dick Taylor Craft Chocolate 46. Discovery Museum [inc. Discovery Camp] 47. Dominique Lascaud Production [France] 48. East Bay Regional Park District [Oakland, CA] 49. Emma Center 50. Environmental Protection Information Center (EPIC) 51. EPT Rehabilitation for HSU Kinesiology Dept. Academic Interns 52. Fire and Light 53. Fit Nor Cal 54. Food for People [Humboldt County Food Bank] 55. Friends of the Dunes 56. Fuente Nueva Charter School 57. Gala Events and Weddings 58. Girl Scouts of Northern California 59. Gracelyn Home Care 60. Green Diamond Resource Company 61. Greenway Partners 62. Growing Tree Family Child Care for HSU Child Development Dept. placements 63. Headlands Center for the Arts 64. HealthSPORT [Arcata] for HSU Kinesiology Dept. Academic Interns 65. Holly Yashi 66. Hoopa Tribal Civilian Community Corps/AmeriCorps on Native Lands 67. HSU Bookstore 68. Humboldt Area Foundation [inc. Redwood Coast Rural Action, Humboldt Made] 69. Humboldt Arts Council [inc. Morris Graves Museum] 70. Humboldt Bay Harbor District 71. Humboldt Bay Municipal Water District 72. Humboldt Baykeeper 73. Humboldt Center for Constitutional Rights 74. Humboldt Community Access and Resource Center (HCAR) [inc. 2-1-1 Humboldt, The Studio & Cheri Blackerby Gallery] 75. Humboldt Community Breast Health Project 76. Humboldt County Central Democratic Committee 77. Humboldt County Historical Society 78. Humboldt County Office of Education: Programs [SSAs Received: Court & Community Schools—Student Assistance Center.] 79. Humboldt County Office of Education: Afterschool Consortium [SSAS received: Blue Lake Union School, Bridgeville School, Peninsula School, Redway School, Scotia School, So. Fortuna Elem, Toddy Thomas, Trinidad Union School] 80. Humboldt County Resource Conservation District 81. Humboldt Crossfit 82. Humboldt Domestic Violence Services 83. Humboldt Folklife Society 84. Humboldt Hotsauce 85. Humboldt Light Opera Company 86. Humboldt Mediation Services 87. Humboldt Patient Resource Center 88. Humboldt Physical Therapy, Inc. for HSU Kinesiology Dept. Academic Interns 89. Humboldt Regeneration 90. Humboldt Senior Resource Center [Arcata Senior Lunch Site] 91. Humboldt Trails Council [inc. Volunteer Trail Stewards] 2 92. Hydesville Elementary School District 93. Ink People Center for the Arts [inc. all sponsored programs] 94. Isportsweb.com, LLC [Internet based business] 95. Jacoby Creek Land Trust 96. Jessicurl 97. Kayak Zak's [inc. Big Lagoon Park Rd.; 115336 Hwy 101, Trinidad; Indian Beach, Trinidad] 98. Kokatat 99. KRCR - TV Channel 7 [Redding, CA] 100. LatinoNet 101. Lima’s Pharmacy 102. Little Learners Preschool for HSU Child Development Dept. placements 103. Little Redwoods Preschool for HSU Child Development Dept. placements 104. Los Angeles Valley College [Valley Glen, CA] 105. Los Bagels 106. Lost Coast Brewery & Café 107. Lost Coast Communications, Inc. [inc. KHUM, KSLG, KWPT, KXGO, LOCO-Lost Coast Outpost] 108. Mad River Alliance [for OFF site (HSU self-directed) work only; expires 4/17/15] 109. Mad River Brewing Company 110. Mad River Montessori Preschool 111. Mad River Radio [expires 10/2/14] 112. Manila Community Services District [inc. Manila Community Resource Center] 113. Marimba One 114. Martial Athletics for HSU Kinesiology Dept. Academic Interns 115. Mattole Unified School District [inc. North Coast Learning Academy, Mattole Valley Charter School, etc.] 116. McKeever Energy and Electric, Inc. 117. McKinleyville Community Services District [inc. First Five Playgroup hosted by MCSD Parks & Rec] 118. Medical Staffing Network 119. Miranda’s Rescue 120. National Center for Youth Law [Oakland, CA] 121. National Park Service: Redwood National Park 122. Natural Decadence 123. NBC Universal Bravo Network [Burbank, CA] 124. Northcoast Children’s Services [inc. the following 16 Head Start or State Preschool locations: Alice Birney; Crescent City; Fortuna; Jefferson; McKinleyville; Orleans; Pine Grove; Rio Dell; Smith River; Sonoma Street; Toddy Thomas Head Start - Preschool; Willow Creek; Winzler; Worthington; Children of the Redwoods Infant Toddler Center; Children of the Redwoods Head Start.] 125. North Coast Co-op 126. North Coast Rape Crisis Team 127. North Coast Veterans Resource Center 128. North Coast Veterinary Hospital [Arcata, Fortuna] 129. Northcoast Environmental Center 130. Northern California Indian Development Council 131. Northern California Small Business Development Network/Office for Economic, Community & Business Development 132. Northern Redwood Federal Credit Union 133. Northtown Coffee 134. Office of Assemblyman Wesley Chesbro 135. Ohana Organics 136. Ohlone College [Fremont, CA] 137. Open Door Community Health Centers 138. Planwest Partners 139. Praxis Fitness, LLC for HSU Kinesiology Dept. Academic Interns 140. Professional Climbers International Ops [Portland, OR] 141. Q Center [Portland, OR] 142. Rancho Santiago Community College District on behalf of Santa Ana Community College [1530 W. 17th St. Santa Ana, CA] 143. Redwood Acres – 9th District Agricultural Association 144. Redwood Alliance [inc. Zero Waste Humboldt; Hope Coalition] 145. Redwood Capitol Bank 146. Redwood Coast Energy Authority 147. Redwood Coast Montessori for HSU Child Dev. Dept. Academic Interns 148. Redwood Community Action Agency (RCAA) [inc. Youth Services Bureau- RAVEN Project; Family Services Division-Multiple Assistance Center (MAC); Natural Resources Division; etc.] 3 149. Redwood Community Radio – KMUD 150. Redwood Empire Public Television, Inc. –KEET TV 151. Redwood Region Economic Development Commission 152. Redwoods and Rivers [Big Bar, CA] 153. Redwoods Rural Health Center 154. Regents of the University of California, on behalf of University of California Cooperative Extension Humboldt-Del Norte Counties [inc. 4-H Youth Programs] for HSU Kinesiology Dept. Academic Interns 155. Rehabilitation and Wellness Centers (LP) [inc. Granada, Seaview, Pacific, Eureka, Fortuna sites] 156. Remote Control Productions [Santa Monica, CA] 157. Rohnerville School District 158. Sainte Partners II, L.P. [for KVIQ-Channel 6, Eureka, CA] 159. Salvation Army: Silvercrest Residences 160. Samoa Peninsula Fire District 161. Sanctuary Forest 162. Santa Cruz Museum of Art and History [Santa Cruz, CA] 163. Scribe America for HSU Kinesiology Dept. Academic Interns 164. Scripps Research Institute [La Jolla, CA] 165. Sewell Gallery 166. Seventh Generation Fund for Indian Development 167. Six Rivers Planned Parenthood 168. South Bay BMW [Torrance, CA] 169. Southern Humboldt Community Park 170. St. Bernard’s Catholic School 171. St. Joseph Hospital System [This is a “Clinical and non-clinical training Affiliation Agreement;” expires 5/2/17. Covers Santa Rosa Memorial Hospital, SRM Alliance Hospital Services dba Petaluma Valley Hospital, Queen of the Valley Medical Center, St. Joseph Hospital in Eureka and Redwood Memorial Hospital. No SSAs on file.] for HSU Kinesiology Dept. Academic Interns 172. State of California - California Department of Corrections and Rehabilitation - Division of Adult Parole Operations [expires 1/15/15] 173. StreamGuys, Inc. 174. Streamline Planning Consultants 175. Sun Valley Group [this agency may require HSU Intellectual Property Addendum, depending on internship work] 176. The Mill Yard 177. The Watershed Center [inc. Indian Valley Summer Camp] 178. Timber Ridge [McKinleyville & Eureka sites] 179. Tri-County Independent Living 180. Trikone [San Francisco, CA] 181. Trillium Charter School 182. Trinidad Museum 183. Trumpet Behavioral Health 184. UPLIFT San Diego [San Diego, CA; covers multiple sites under this agency] 185. U.S. Coast Guard [Marine Safety Detachment Unit - Humboldt Bay] 186. U.S. Fish and Wildlife – Humboldt Bay National Wildlife Refuge 187. U.S.D.A. Six Rivers National Forest - Supervisor's Office [SSA for Bayshore Way Office] 188. Union Street Charter School 189. United Indian Health Services [inc. Potawot Community Health Garden] 190. United Way of the Wine Country – Humboldt/Del Norte Region 191. United States Servas 192. University of California, Office of the President [Oakland, CA] 193. Vector Rehabilitation for HSU Kinesiology Dept. Academic Interns 194. Vixen Kitchen 195. Westside Community Improvement Association [Jefferson Community Center] 196. Williamson Financial Group 197. Wing Inflatables 198. Wiyot Tribe 199. Wool Tree Mill 200. Yurok Tribe: All Programs except Head Start 201. Yurok Tribal Head Start

4 Additional “Approved” Community Partners

Hum. Co. Schools/Districts Covered by Teacher Education Agreements 2013-14 (The Teacher Ed Agreements in place with the following entities have HSU – Related Programs been approved by the HSU Risk Manager as sufficient to cover both (No LSA required) Service Learning and Academic Internship placements, as well as Teacher Ed students):

1. Arcata School District 2. Blue Lake Union School District HSU Programs/Departments 3. Bridgeville School (No LSA required) 4. Columbia Elementary School District The Learning Plan, Participation Guidelines, Student Time Log, and 5. Cotati-Rohnert Park Unified S.D. of Sonoma Co. Release of Liability forms are required of HSU students serving with 6. Cuddeback Union School District HSU programs for academic credit (see examples below). Please note: 7. Cupertino Union School District students serving in HSU Programs MUST be supervised by professional 8. Cutten Elementary School District 9. Del Norte County School District (non-student) staff. 10. Eureka Unified School District 11. Evergreen Union S.D. of Shasta Co. Examples: 12. Ferndale Unified School District 1. Advancement Foundation 13. Fieldbrook School District 2. Associated Students 14. Fortuna Union Elem School District 3. CA Center for Rural Policy 15. Fortuna Union High School District 4. HSU Academic Departments 16. Freshwater School District 5. HSU Center for International Programs 17. Garfield School District 6. HSU Children’s Center [reserved for Child Dev. Classes] 18. Gateway Unified School District 7. HSU: Marketing and Communications (Marcom) 19. Green Point School District 8. HSU Natural History Museum 20. Humboldt County Office of Education 9. HSU: Student Health Center 21. Jacoby Creek Charter School District 10. HSU: The Studio School 22. Junction Elementary School District 11. HSU: Marine Lab 23. Klamath-Trinity Joint Unified School District 12. Indian Tribal Education & Personnel Program (ITEPP) 24. Kneeland Elementary School 13. KHSU 25. Lake Elsinore Unified School District 14. MultiCultural Center 26. Lakeport Unified School District 15. Schatz Energy Research Center 27. Los Angeles Unified School District 16. Sponsored Programs Foundation [inc. TRiO Upward Bound] 28. Los Gatos – Saratoga UHSD 17. University Center 29. McKinleyville Union School District 18. Y.E.S. Programs [different risk mgt paperwork may be 30. Mendocino Unified School District required] 31. Newport-Mesa Unified School District 32. Northern Humboldt Union High School District 33. Orick School District The following HSU programs are NOT available as 34. Pacheco Union SD Learning Sites, due to no professional (non-student) staff 35. Pacific Union School District [inc. Pacific Union Adult School] 36. Peninsula Union School District available for supervision: 37. Rescue Union School District 1. Campus Center Appropriate Technology 38. Rio Dell School District 2. Eric Rofes Queer Resource Center 39. Rohnerville School District 3. Graduation Pledge Alliance 40. San Lorenzo Valley Unified School District 4. Student Access Gallery 41. Santa Cruz City Schools District 5. Women's Resource Center 42. Scotia School District 43. Shasta Union High School 44. Sonoma County Office of Education HSU “OTHER OUTSIDE” Programs (LSA required): 45. South Bay Union School District In addition to the Learning Plan, Participation Guidelines, Student 46. Sweetwater Union High School District Time Log, and Release of Liability forms, each of the following 47. Temecula Valley Unified SD programs may have its own agency-specific volunteer forms naming 48. Trinidad Union School District 49. Trinity Alps Unified School District the student a volunteer of its own program. These sites include: 50. Yreka Union High School District  HSU Bookstore [LSA in place]  Northern California Small Business Development Network/ Office for Economic, Community, & Business Development: [LSA in place]

5 Additional “Approved” Community Partners

Hum. Co. Schools/Districts Covered by Teacher Education Agreements 2013-14 (The Teacher Ed Agreements in place with the following entities have HSU – Related Programs been approved by the HSU Risk Manager as sufficient to cover both (No LSA required) Service Learning and Academic Internship placements, as well as Teacher Ed students): Kinesiology / Recreation Administration -- Academic Internship “Approved” Sites

Message for Faculty:  Please contact Stacy Becker x4963 if you have any questions regarding whether an agency or program is “approved”; some community programs may be covered by currently “approved” agencies with the LSA already in place.  This is a resource list for faculty use only; it was not designed to be directly distributed to students.

“Approved” Agencies covered by LSA “Approved” Agencies covered by “Clinical Agreements” [grey highlights =local/available for other HSU departments] Updated 7/3/13

1. 101 Surf Sports [San Rafael, CA] 1. Alderete Chiropractic 2. 24 Hour Fitness Super Sport [Lakewood, CA] 2. Athletic Evolution 3. Accelerate Sports Performance [San Francisco, CA] 3. Carmichael Training Systems 4. Adrenaline Performance Center [Montreal, Quebec] 4. Cressey Performance, LLC 5. Apple Wellness [Austin, TX] 5. Duke University Health System, Inc. (annual auto renewal) 6. Arcata Core Pilates 6. Elemental Training Center 7. Body Kinetics [Novato & Mill Valley Sites] 7. Enloe Medical Center 8. Cardiovascular Associates of Marin [Larkspur, CA] 8. Fit Stop Human Performance Lab 9. Cornerstone Physical Therapy [Cottonwood, CA] 9. Green Mountain at Fox Run 10. Delaware North Company (DNC) – Wellness Center [Yosemite, CA; 10. Health Solutions, Inc. includes all areas, Community Wellness Center, Pool, etc.] 11. L & T Health & Fitness 11. Department of Veteran's Affairs San Diego Medical Center [San 12. Mad River Hospital - Pre-Physical Therapy and Exercise Science Diego, CA] 13. Mustang Soccer League 12. Diakadi Body [San Francisco] 14. New York University- Hospital for Joint Diseases [inc. Harkness Center for 13. ept Rehabilitation [Eureka, CA] Dance Injuries] 14. Good Samaritan Hospital/ Cardiac Rehabilitation [Los Angeles, CA] 15. Notre Dame 15. HealthSPORT [Arcata] 16. Orange County Fire Authority 16. Heart Works Cardiac Rehab Center [Santa Rosa, CA] 17. Physiotherapy Associates 17. Humboldt Physical Therapy, Inc [Arcata, CA] 18. Plus One Health Management, Inc. (Marathon Energy Club) 18. Iconic Innovations, Inc. [Studio City, CA] 19. Providence Health & Services Alaska 19. Jill B. Nimble/Nimble Training [Santa Rosa, CA] 20. ReActive Gym 20. Kern County Public Health Services Department [Bakersfield, CA] 21. Redwoods Community College District 21. Martial Athletics [Arcata, CA] 22. Renown Health [Expires 6/9/17] 22. NYU Hospital for Joint Diseases [inc. Harkness Center for Dance 23. St. Joseph Hospital System [This is a “Clinical and non-clinical training Injuries] Affiliation Agreement;” expires 5/2/17. Covers Santa Rosa Memorial 23. Philippi Sports Institute [Las Vegas, NV] Hospital, SRM Alliance Hospital Services dba Petaluma Valley Hospital, 24. Plus One Holdings, Inc. [inc. San Jose CA Cisco Systems] Queen of the Valley Medical Center, St. Joseph Hospital in Eureka and 25. POM Wonderful Fitness Center [Del Rey, CA] Redwood Memorial Hospital. No SSAs on file.] 26. Praxis Fitness, LLC 24. Scripps Hospital 27. Rawmana Fitness [San Diego, CA] 25. South Side Strength & Fitness 28. Regents of the University of California, on behalf of University of 26. TJ's Gym California Cooperative Extension Humboldt-Del Norte Counties [inc. 27. University of Pittsburgh 4-H Youth Programs] 28. Valley Medical Center 29. Scribe America 29. Velocity Sports, Dublin 30. Shasta Family YMCA [Redding, CA] 30. Yosemite Community College District - Columbia 31. Sports Reaction Center [Bellevue, WA] 32. St. Joseph Hospital [Expires 7/30/17. Covers Kinesiology Pre-Physical Therapy Practica only- no “Hands on.” SSA on file for: St. Jo’s Physical Therapy Dept- 2700 Dolbeer, Eka.] 33. Tahoe Whitewater Tours [Truckee, CA] 34. The Oaks at Ojai [Ojai, CA] 35. University of Colorado at Boulder 36. University of Southern California - Recreational Sports 37. Vector Rehabilitation 6 Additional “Approved” Community Partners

Hum. Co. Schools/Districts Covered by Teacher Education Agreements 2013-14 (The Teacher Ed Agreements in place with the following entities have HSU – Related Programs been approved by the HSU Risk Manager as sufficient to cover both (No LSA required) Service Learning and Academic Internship placements, as well as Teacher Ed students):

7 LSAs in Progress – NOT yet “Approved”

Grey Highlights: Please contact Stacy Becker (x4963 [email protected]) if you have any questions or are overseeing a clearly identified student wishing to serve as an Academic Intern or via a Service Learning course at this agency. We have made MANY efforts (in some cases over a period of years) to establish the Learning Site Agreement paperwork with these larger state/national agencies, which have been unable to resolve legal contractual issues. We can begin the process again when HSU students are clearly identified as wishing to serve in Academic Internship or Service Learning positions at sites under these agencies.

1. California Department of Fish & Wildlife 2. California State Parks 3. Disney World Wide Services, Inc. 4. Ebert Capital Management [5/23/14: HOLD-We can re-approach when there is a student definitely being considered for internship] 5. Humboldt County Republican Central Committee [Need Site Self-Assessment from agency; multiple requests have been made] 6. Humboldt Plan It Green 7. John Madsen Performance [Sandy, UT] [For KINS dept. only] 8. Kaiser Permanente [South Sacramento, CA] [For KINS dept. only] 9. MedX of Estes [Estes Park, CO] [For KINS dept. only] 10. National Marine Fisheries Service 11. National Park Service [at national level- beyond Redwood Natl. Parks] 12. Om Shala Yoga LLC 13. Redwood Strength 14. Sonoma County Water Agency [Santa Rosa, CA] 15. State of California - Superior Court of California [Eureka, CA] 16. The Getty Fitness Center [Los Angeles, CA] [For KINS dept. only] 17. Toucan, Inc 18. University of California San Francisco [Orthotics and Prosthetics Center] [For KINS dept. only] 19. U.S. Fish & Wildlife Service: Arcata Office 20. U.S. Navy Marine Mammal Program [San Diego, CA] [On Hold: this entity will not consider the LSA paperwork until an HSU student is clearly identified and accepted into their Internship program.] 21. U.S.D.A. Forest Service [national] 22. Ventura County Fire Department