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NEW STUDENT ENCLOSURES Checklist

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NEW STUDENT ENCLOSURES Checklist NEW STUDENT ENCLOSURES Checklist Admission Policy (sign & return) Attendance Agreement during COVID-19 (initial, sign and return) Personal Rights: LIC613A (sign & return) Parent’s Rights: LIC995 (sign & return) Signature Page (sign & return) Identification & Emergency Information:LIC700 (complete & return) Child’s Preadmission Health History: LIC702 (complete & return) Physician’s Report Form:LIC701 (complete & return – physician’s signature required) Consent for Medical Treatment:LIC627 (complete & return) Lead Safety Signature Page (sign & return) Earthquake Disaster Kit Information Special Issues Letter Allergy Letter The Effects of Lead Exposure Pamphlet Parent Handbook Parent Handbook Addendum during COVID-19 LA CANADA FLINTRIDGE COMMUNITY CENTER PRESCHOOL ADMISSION AGREEMENT 2020-2021 Welcome to the LCFCC Preschool. We are pleased that you will be joining our preschool family for the 2020-21 school year. Our fee schedule is as follows: 2 days per week - $315.00 per month 3 days per week - $400.00 per month 5 days per week - $515.00 per month Tuition for the school year is divided into ten monthly payments with the FIRST payment due by August 1, 2020. Subsequent payments are due on the first of each month beginning in September and are considered delinquent after the tenth of the month. A late charge of $10.00 will be assessed for payments received after the tenth of the month. Please make checks payable to CCLCF. Prepaid tuition is not refundable. A four-week written notice is required for termination of your financial agreement. Any tuition and/or fee changes are modified the beginning of each fiscal year. Our school year will begin September 9, 2020 and end June 11, 2021. We typically follow the La Canada School District Calendar for holidays and vacations. LCFCC Preschool reserves the right to dismiss a child from enrollment in the school for the following reasons: 1. Noncompliance of request for state requirements of immunizations and emergency information. 2. Repeated delinquency of tuition payments without willingness to discuss a payment plan with the school director. 3. Children who exhibit special needs beyond the training or physical limitations of the school or requires more attention than our child/teacher ratio allows. 4. Children whose special needs require a fundamental alteration or significant modification within our program to the point that it alters the essential nature of our preschool philosophy, curriculum, or accommodations. 5. Children who are not toilet-trained to the extent of needing a diaper or pull-up during school hours. This is a Licensing requirement and must be followed. I have read and agree to the Admission Policy of the LCFCC Preschool. Parent’s Signature: _______________________________ COVID-19 Public Health Emergency Special Program Attendance Agreement Please read and initial each statement below. 1. _____ I understand that during this COVID-19 Public Health Emergency, I will NOT be permitted to enter the LCFCC Preschool beyond the designated drop-off and pick-up area. I understand that this procedure change is for the health and safety of all persons present in the facility and to limit to the extent possible everyone’s risk of exposure. 2. _____ I understand that if there is an emergency requiring me to enter the facility beyond the designated drop-off/pick-up area, I must use hand sanitizer and be wearing a mask before entering. While in the facility, I must practice social distancing and remain 6ft from all other people, except for my own child. 3. _____ I understand that to enter the facility premises my child must be free from COVID-19 symptoms. If, during the day any of the following symptoms appear, my child will be separated from the rest of the children and staff in the preschool. I will be contacted and my child must be picked up from the facility within 30 minutes of being notified. Symptoms include: Fever of 100.3 degrees or higher Dry cough Shortness of breath Chills Loss of taste or smell Sore throat Muscle aches While we understand that many of these symptoms can also be related to non- COVID-19 related issues we must proceed with an abundance of caution during this Public Health Emergency. These symptoms typically appear 2-7 days after being infected, so please take them seriously. Your child will need to be symptom free without any medications for 72 hours before returning to the preschool. 4. _____ I understand that my child’s temperature will be taken a minimum of once per day while on preschool premises. 5. _____ I understand that my child must wear a mask to the best of their ability, especially when physical distancing is not achievable. 6. _____ I understand that my child will be required to wash their hands using CDC recommended handwashing procedures throughout the day using running water and rubbing with soap for at least 20 seconds. 7. _____ I understand that I must send my child with a healthy morning snack each day. 8. _____ I understand that outside of care, in order to control my child’s exposure in the community, I will comply with any and all state, county or local safety orders. 9. _____ I will immediately notify LCFCC Preschool Administration if I become aware of any person with whom my child or I have had contact exhibits any of the symptoms listed in Number 3, above. 10._____ I understand that while present in the Preschool each day my child will be in contact with children, families and other employees who are also at risk of community exposure. I understand that no list of restrictions, guidelines or practices will remove 100% of the risk of exposure to COVID-19 as the virus can be transmitted by persons who are asymptomatic and before some people show signs of infection. I understand that I play a crucial role in keeping everyone in the facility safe and reducing the risk of exposure by following the practices outlined herein. I, ____________________________ certify that I have read, understand and agree to comply with the provisions listed herein and within the LCFCC Preschool Parent Handbook Addendum. I acknowledge that failure to act in accordance with the provisions listed herein, or with any other policy or procedure outlined by LCFCC Preschool will result in a leave of absence. I acknowledge that care for my child will be suspended if it is determined that my actions, or lack of action, unnecessarily exposes another employee, child, or their family member to COVID-19. No refunds will be given. Child’s Name:_____________________________ DOB:____________________ Parent’s Name: _____________________________ Parent’s Signature: _____________________________ Date ______________ STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES PERSONAL RIGHTS Child Care Centers Personal Rights, See Section 101223 for waiver conditions applicable to Child Care Centers. (a) Child Care Centers. Each child receiving services from a Child Care Center shall have rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with daily living functions, including eating, sleeping, or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. (4) To be informed, and to have his/her authorized representative, if any, informed by the licensee of the provisions of law regarding complaints including, but not limited to, the address and telephone number of the complaint receiving unit of the licensing agency and of information regarding confidentiality. (5) To be free to attend religious services or activities of his/her choice and to have visits from the spiritual advisor of his/her choice. Attendance at religious services, either in or outside the facility, shall be on a completely voluntary basis. In Child Care Centers, decisions concerning attendance at religious services or visits from spiritual advisors shall be made by the parent(s), domestic partner(s), or guardian(s) of the child. (6) Not to be locked in any room, building, or facility premises by day or night. (7) Not to be placed in any restraining device, except a supportive restraint approved in advance by the licensing agency. THE REPRESENTATIVE/PARENT/DOMESTIC PARTNER/GUARDIAN HAS THE RIGHT TO BE INFORMED OF THE APPROPRIATE LICENSING AGENCY TO CONTACT REGARDING COMPLAINTS, WHICH IS: NAME ADDRESS CITY ZIP CODE AREA CODE/TELEPHONE NUMBER DETACH HERE TO: PARENT/DOMESTIC PARTNER/GUARDIAN/CHILD OR AUTHORIZED REPRESENTATIVE: PLACE IN CHILD'S FILE Upon satisfactory and full disclosure of the personal rights as explained, complete the following acknowledgment: ACKNOWLEDGMENT: I/We have been personally advised of, and have received a copy of the personal rights contained in the California Code of Regulations, Title 22, at the time of admission to: (PRINT THE NAME OF THE FACILITY) (PRINT THE ADDRESS OF THE FACILITY) (PRINT THE NAME OF THE CHILD) (SIGNATURE OF THE REPRESENTATIVE/PARENT/DOMESTIC PARTNER/GUARDIAN) (TITLE OF THE REPRESENTATIVE/PARENT/DOMESTIC PARTNER/GUARDIAN) (DATE) LIC 613A (1/08) STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING DIVISION CHILD CARE CENTER NOTIFICATION OF PARENTS’ RIGHTS PARENTS’ RIGHTS As a Parent/Domestic Partner/Authorized Representative, you have the right to: 1. Enter and inspect the child care center without advance notice whenever children are in care. 2. File a complaint against the licensee with the licensing office and review the licensee’s public file kept by the licensing office.
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