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HomeMy WebLinkAboutMINUTES - 08052008 - C.23 (5) r CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: AUGUST 05, 2008 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) Ohe NOTICE TO CLAIMANT and Board Action. All Section references are to copy of this document mailed to California Government Codes. • you is'your notice of the action taken on your claim by the Board of CLAIM AGAINST ANTIOCH UNIFIED -visors. (Paragraph IV below), SCHOOL DISTRICT 11�1a;F Pursuant to Government Code AMOUNT: UNLIMITED LIABILIT JUL 0 2 200�e n 913 and 915.4. Please note all "Warnings". CLAIMANT:%'AMcGRAW COUNTY )OUNSEL -TaN I ai /nook,4 OVO4IL MARTINEZ CALIF. ATTORNEY: UNKNOWN DATE RECEIVED: JLI[Y 02, 2008 ADDRESS: 5085 CREST BARK CIRCLE BY DELIVERY TO CLERK ON: JULY 02, 2008 ANTIOCH, CA 94531 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above-noted claim. JOHN CULLEN, r Dated: JULY 02, 2008 By: Deputy 11. FROM.: County Counsel TO: Clerk of the Board of S erviso-s ( his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to appl/1y11 for leave to present a late claim (Section 911.3). (./Other: -T-he- .�-t-►-l�ocky to tTl �k OD 1 b LS I�1GJ- is, <. s L b<« o f-co-&yz�. Dated: ����� By: m� Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARD ORDER: By unanimous vote of the Supervisors present: (� This Claim is rejected in full. O Other: I certify that this is a hue and correct copy of the Board's Order entered in its minutes for this date. � Dated: *%-4W dQ CULLEN, CLERK, By Deputy Clerk WARNI.N (Gov. code section 913). Subject to certain exceptions,you have only six(6) months from the date this notice was personally served or deposited in the snail to file a court action on this claim.See Government Code Section 945.6.You may seek the advice of an attorney of your choice in connection wide this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warning See Reverse Side ofThis Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Date ��IF 40 �411_1OHN CULLEN, CLERK By Deputy Clerk BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. A claim relating to a cause of action for � s�x monthsr injury afterothe or to nal of thpersonal e cause of perty or growing crops shall be presented no action. A claim relating to any other cause of action shall be presented not later than one year after the accrual of the cause of action. (Gov. Code § 911.2.) B Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Adr,i3'sttration Building: 651 Pine Street, Martinez CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By: 1 G(`n�C` "CC--A�_G w Reserved for Clerk's filing stamp Cc��� Hcore c� m0noq ) REC - �V �r� DC►(1 Cly. q 1531 ) JUL 0 ` 2008 or Against the County of Contra Costa CLERK gOAnG CONOO 7 C `TA F +'rSORS A�oCV\ -04 pc District) sC° (Fill in the name) The undersigned claimant herel� cTakes claim against the County of Contra Costa or the above-named or\v \, and in support of this claim represents as follows: \,:district in the sum of$ � ab:�,to PP 1. When did the damage or injury occur? (Give exact date and hour) Feb . \ to 9VC3"-,k zp° \-lad zoo,& 2. Where did the damage or injury occur? (Include city and county) 3�ack O�a�noc�d 1--1L'c We School Cpr� a Co smo Cov n f �Z3C etc<t�v�� �\\ 4=,�tivch ( VS. 3. How did the damage or injury occur? (Give full details; use extra paper if required) o\ca\�C)h o . Co�� tits"o nal � Stvcl�n� � and ec�lvCA owl 1Z�g1n�S. �f J Emot-ional Sh cgJ a�el Un-Glue Men VOL\ �,nai�Sh 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? VeGtVeSs c6,5�-CTV_A 0�' z�w�tS VAD,V,C�pv S 6�S,CC)Tf a 5 What are the names of county or district officers, servants, or employees causing the damage or injury? C (jc�cf MoVA,FCL >� \��G t`�15 1 L�rtvt SV e✓e+�S µr. "Ce\aw 6 What damage or injuries do your claim resulted? (Give full extent of injuries or damages two estimates for auto damage.) Met1�CO3� e Q U )' v e claimed. Attach (Include 7. How was the amount claimed above computed. de the estimated amount of any at'e ��d prospective injury or damage.) \A�.l Ch�\� m k Ce_ co eM hor�a� We,\\ be,V n �s p 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made oon�account of this accident o�injury: DATE Gov. Code Sec. 910.2 provides"The claim shall be signed by the claimant or by some person on his behalf." SEND NOTICES TO• (Attorney] 1 Name and address of Attorney C r (Claimant's Signature) (Address) Telhone No. C12�J' 0�1 Telephone No. ) p ........................................................................... .........� PUBLIC RECORDS NOTICE: Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any attachments, addendums,or supplements attached to the claim form, including medical records, are also subject to public disclosure. . .......................................................................... . ........� NOTICE: Section 72 of the Penal Code provides: with i^.ter:t to defraud, presep-t� fnr alinwance or for pavment to any state board or officer, or Lvery p;ron ;;ho, to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000), or by both such imprisonment and fine. Social Security Administration Supplemental Security Income Notice of Planned Action Date: January 3, 2008 .. Claim Number: 000011858 01 MB 0 360 1227,M10,044 011858 B63 0851100F07924 TAMERA SHAVON MCGRAW FOR JACQUI TAEMAR LAMA M OORE 4730 STERLING HILL DR -- ANTIOCH CA 94531-7673 IISL,,I��I,ISI.�,II.���ill���l,ll�,I:,�I��lI���I!,il��•.�LII Type of Eligibility: f6- - bd*\_\4 fNephCub --- ��-- --- ----- t-looce_ C� nh�c(en-� 03 kOA IRamoa --- - - - ----- - _ ---- -- - --__ _ _-_ �ec�al C-,�.�a�d�ar1__c�.nol �y�e1�_�hc�►�_.-fie_ -- --- -- aki CG 00 s aod _ eC►cleSS C�;S�egaro( tO�C' V-� hk s a - -Q_ pare n , andtn' y eh�HCl' CP _zoo-1 _ I'� St-lC4 Teac'n Knee\v-n lolt–- --- -- --- --- �,C\ N-ha.-� m C coov\vh CT\(:i �---- -- -X-%m CcoP Y- �_ ce Jac�ok --- Wh;ch ones aA�ended avn ____.-----.---- ard c)n e 1--1cs . L�� _ 5�e� �� c yc eel l------ --A�ke,� wo )m vohl 4-t., es-\d a P _. S AUens AA-"\aA- Yoe- af-t i-\oV Q oua e.d tt T)os-eo V5- cxi-\Ck ,CWwtf) o��ce-, ��cedv rad 5a�e a��c�,s '�e��5e d man 4- oF M OL:t esme* ,P\on w:At�n'n play 5 uo kch ane. Meta\ ��res� ccd by lynt o� M` Rc t vermeil ce%yz--� T UOCC) PO< Vr O\dcl q the V(f Yn e a�--�CrDf(Xff* Iwas to b �� ��rnec�:a�el o�r�d a lan . developed w���� �0 doU.{S , �ha� was mat ; doe c`Glnec , �Ai . St) eCV 3 nktded to t6\ h.�5t CiQrl tD Cl�\e A�� oLA QS q ;ac-b.I .1. �lecteel t� �na�e done c�nd dol � germs t k)VAV work cd. Zf\ Ak-\t moayh P A- p \ Z co,��ae�ed pcacece csaAled Pans o�nec . j �� s my �econct time � ICC&--d office ea�Vcs- l(A 4y- t&w� c �ce d��e l,)a.5 d9ay becwse \�k)e c� y C�vaCd \--kC V- -VAW was ane �kc tc!V l am q - 01 ` ..� diol not- aoc- m �� � � w j c� d t� t� V�c Lncw ornd mean c�- ee a d waSAnW tea# 1e �ac� \tne opk�oo_-_-tt. oto a,�) he o`cos �. Xke-(- T C C6 ane v�mCLVI OVA VIC) t v , Op lk�it - _ r his a.nd �rem.�-en C�c�o�n �In �n attorneys clt actio the dam e 3 Ot cl ane n �. g to " ChAd�g eMVt Ooaa "C4� and ane - �CN Pet)Oc are vl o\lch(\ and __-ane �c-�ncol a1�o opted t� 1c�l,cl__1 CA0.3 oo ve me 4x c cc o� C om' o�- dja oLl - --- - - -- -- -- e�e - ` e �� �� Go, f. c�cade�S abbu-� ��rnateS beio 5xA a c�d �w e aha h � � _ M-� o� ,thy s __cNam :vecn ane cvnocce The Pcow yarn. z as Pbcmed oP WO-,-j wa zo b W, M C�a� an) Z -- - h y � ao d� wa.� ��d , w b smoke o c s , lu.,)06ci be V re skAla ANTIOCH UNIFIED SCHOOL DISTRICT 5000 - STUDENTS 5600 - STUDENT RIGHTS INTERROGATIONS INTERVIEWS AND SEARCHES (Page 2 BP 5610 C . Interview by Others. Without prior clearance from the site administrator/ designee, students may not be interviewed by anyone other than a District employee, a Child Protective Services worker, or a law enforcement officer. II . Administrators have the right to �school lockers and personal belongings located on District property. TK� should be reasonable and related to tho school officials' duties such as when there is a reason that the student is concealing materialT the possession of which is prohibited by law or the policies or procedures of the District . Maximum effort will be made to: A. Protect each student' s constitutional rights to personal privacy. B. Act in the best interest of students and the welfare of the total District . III . If a student possesses, sells, or otherwise furnishes a firearm at school or a school event, the principal or designee must notif1, rale appropriate local law enforcement authorities . Legal Reference: Ed,,_:,ition Code, Section 48906 Originating Office: Educational Services Division Effective Date: 12-8-98 Revis bate,^ . 3-27-96 10-10-79 (5318) Black Diamond Middle School Antioch, CA 94531 SUMMARY AND SCORE REPORT Name: Moore, Jacqui School: BDMS Date of Birth: 09/05/1994 Teacher: Karen Elliot Age: 13 years, 8 months Grade: 7.8 Sex: Male Examiner: Lynn Stevens Date of Testing: 04/21/2008 TESTS ADMINISTERED WJ 111 Tests of Achievement BACKGROUND ferred for testing by his aunt_ Mailing in all of his classWnd she wants to Mensure that Jacqui does not have a learning disability. i's teachers,�at though fie Is p 0itive in class he generates very little work. rk was referred to the Student Success Team for accommodations and modifications to help him with performance. The' _met with uardian present and refer directly f ithout any recommendations for accommodations. No secondtICWa was se n assessment form was sent home and returned signed. Jacqui's guardian is followin ug with testing for ADD as she does not have his earlier records to verify that diagnosis. OBSERVATIONS Teachers report that Jacqui often does not complete tasks in class and that he does not hand in homework assignments but that when engaged in the classroom exhibits the ability to do his work and understands the curriculum being taught. When Jacqui was asked what he attributed his lack of academic success to, he said that sometimes the work is too hard and sometimes he forgets to turn in his assignments.tHe presents as a very 116 in young man, polite and willing toe *i> = SUMMARY OF TEST RESULTS Jacqui's fluency with academic tasks is within the low range of others at his grade level. His academic skills and his ability to apply those skills are both within the average range. When compared to others at his grade level, Jacqui's performance is high average in basic reading skills; average in reading comprehension and written language; low average in broad reading, mathematics, and written expression; and low in math calculation skills. ANTIOCH UNIFIED SCHOOL DISTRICT 5000— STUDENTS 5600—STUDENT RIGHTS INTERROGATIONS AND SEARCHES AR5610 1 ith a student search, the following procedures shall be used. A. B. Conduct a reasonable search of the student's person, lockers, or other location under student's control, with an administrator or staff member as a witness. C. If practicable, have student present during any locker search, along with an administrator or staff member as witness. D. Prevent destruction or other disposition of any materials. E. F. Call police if necessary; turn over materials to police for further investigation. G. Consider immediate suspension and possible expulsion. H. Note: Should the student refuse to submit to a search of his/her person, the police should be called immediately if there is a reasonable basis for believing that the student is concealing material, the possession of which is prohibited by law or the policies or procedures of the District. Legal References: Originating Office: Educational Services Division Reviewed by the Board: 04/26/06 Revision Dates: 10/10/79 (5318) Notice of Procedural Safeguards Page 1 of 12 Special Education Rights of Parents and Children Under the Individuals with Disabilities Education Act, Part B • Notice of Procedural Safeguards • Revised January 2008 Note: The term school district is used throughout this document to describe any public education agency responsible for providing your child's special education program. The term assessment is used to mean evaluation or testing. Federal and state laws are cited throughout this notice using English abbreviations, which are explained in a glossary on the last page of this notification. What is the Notice of Procedural Safeguards? This information provides you as parents, legal guardians, and surrogate parents of children with disabilities from three (3) years of age through age twenty-one (21) and students who have reached age eighteen (18), the age of majority, with an overview of your educational rights or procedural safeguards. The Notice of Procedural Safeguards is required under the Individuals with Disabilities Education Act (in English, referred to as IDEA) and must be provided to you: 4. en ou ask Afor a copy; ❖ ur ad for a ❖ Each time are gi' n an assessment plan to evaluate your child; Upon receipt of the first state or due process complaint in a school year; and ❖ When the decision is made to make a removal that constitutes a change of placement. (20 USC 1415[d]; 34 CFR 300.504; EC 56301[d] [2], EC 56321, and 56341.1[g] [1]) What is the Individuals with Disabilities Education Act (IDEA)? IDEA is a federal law that requires school districts to provide a "free appropriate public education" (in English, referred to as FAPE) to eligible children with disabilities. A free appropriate public education means that special education and related services are to be provided as described in an individualized education program (in English, known as IEP) and under public supervision to your child at no cost to you. May I participate in decisions about my child's education? You must be given opportunities to participate in any decision-making meeting regarding your child's special education program. You have the right to Wicipate in IEP team meetings about the identification (eligibility) r educational placement of your child and other matters relating to your chit USC 1414[d] [1]B—[d][1][D]; 34 CFR 300.321; EC 56341[b], 56343[c]) Notice of Procedural Safeguards CDE, T07-037, English, Arial font Page 2 of 12 The parent or guardian, or the local educational agency (LEA), has the right to participate in the development of the IEP and to initiate their intent to electronically audiotape the proceedings of the IEP team meetings. At least 24 hours prior to the meeting, the parent or guardian shall notify the members of the IEP team of their intent to record a meeting. If the parent or guardian does not consent to the LEA audiotape recording an IEP meeting, the meeting shall not be recorded on an audiotape recorder. Your rights include information about the availability of FAPE, including all program options, and all available alternative programs, both public and nonpublic. (20 USC 1401[3], 1412[a][3]; 34 CFR 300.111; EC 56301, 56341.1[g][1] and 56506) Where can I get more help? When you have a concern about your child's education, it is important that you contact your child's teacher or administrator to talk about your child and any problems you see. Staff in your school district or special education local plan area (in English, referred to as SELPA) can answer questions about your child's education, your rights, and procedural safeguards. Also, when you have a concern, this informal conversation often solves the problem and helps to maintain open communication. Additional resources are listed at the end of this document to help you understand the procedural safeguards. Notice, Consent, Assessment, Surrogate Parent Appointment, and Access to Records Prior Written Notice When is a notice needed? This notice must be given when the school district proposes or refuses to initiate a change in the identification, assessment, or educational placement of your child with special needs or the provision of a free appropriate public education. (20 USC 1415[b][3] and (4), 1415[c][1], 1414[b][1]; 34 CFR 300.503; EC 56329, and 56506[a]) The school district must inform-ISi!u about proposed evaluations of your child in a written notice or an assessment plan vwMIJIffleen (15) days of your written request for evaluation. The notice must be understandable and in your native language or other mode of communication, unless it is clearly not feasible to do so. (34 CFR 300.304; EC 56321) What will the notice tell me? The Prior Written Notice must include the following: 1. A description of the actions proposed or refused by the school district; 2. An explanation of why the action was proposed or refused; 3. A description of each assessment procedure, record, or report the agency used as a basis for the action proposed or refused; 4. A statement that parents of a child with a disability have protection under the procedural safeguards; Notice of Procedural Safeguards CDE, T07-037, English, Arial font Page 3 of 12 5. Sources for parents to contact to obtain assistance in understanding the provisions of this part; 6. A description of other options that the IEP team considered and the reasons those options were rejected; and 7. A description of any other factors relevant to the action proposed or refused. (20 USC 1415[b][3] and [4], 1415[c][1], 1414[b][1]; 34 CFR 300.503) Parental Consent When is my approval required for assessment? You have the right to refer your child for special education services. You must give informed, written consent before your child's first special education assessment can proceed. The parent has at least fifteen (15) days from the receipt of the proposed assessment plan to arrive at a decision. The assessment may begin immediately upon receipt of the consent and must be gompleted and an IEP developed within sixty(60) days of your consent. When is my approval required for services? You must give informed, written consent before your school district can provide your child with special education and related services. What are the procedures when a parent does not provide consent? If you do not provide consent for an initial assessment or fail to respond to a request to provide the consent, the school district may pursue the initial assessment by utilizing due process procedures. If you refuse to consent to the initiation of services, the school district must not provide special education and related services and shall not seek to provide services through due process procedures. If you refuse all services in the IEP after having consented to those services in the past, the school district must file a request for mediation or a due process hearing. If you consent in writing to the special education and related services for your child but do not consent to all of the components of the IEP, those components of the program to which you have consented must be implemented without delay. If the school district determines that the proposed special education program component to which you do not consent is necessary to provide a free appropriate public education to your child, a due process hearing must be initiated. If a due process hearing is held, the hearing decision shall be final and binding. In the case of reevaluations, the school district must document reasonable measures to obtain your consent. If you fail to respond, the school district may proceed with the reevaluation without your consent. (20 USC 1414[a][1][D] and 1414[c]; 34 CFR 300.300; EC 56506[e], 56321[c] and [d], and 56346) DIA Moy BLACK DIAMOND MIDDLE SCHOOL 4730 STERLING HILL DR. * ANTIOCH,CA 94531 * * Phone (925) 776-5500* Fax (925) 779-2600 * TIM COOPER Principal MICHELLE GOODMAN Vice Principal MONIFA WILLIAMS Vice Principal May 1, 2008 Dear Ms. McGraw, I have received your written complaint regarding our procedure of checking student for sagging pants. The purpose of the check for sagging pants arose from a large number of students violating the dress code policy that you noted on page 6 of our planner. In our attempt to reduce the number of students that were "sagging" on campus we would periodically check the students. The style in which student wear clothes today, many students wear "tall Tshirts' that come down to the student thighs and sometime knees. The purpose of"the tall T' is to cover sagging pants and/or undergarments that students are wearing. However, and more importantly, students are using this style of dress to conceal illegal contraband on school grounds, which becomes a safety issue for the staff and students here I understand your concern regarding your child's feelings and the feelings of every student on this campus. When we spoke on the phone the other day about this situation, I informed you that if your child was sagging, that I would personally investigate the matter and determine if he was sagging or not. I believe the message may have been misconstrued, in the sense that I was not saying that I would perform the sag check on your child, but would visually inspect to see if he was sagging without being invasive. Fortunately, we have not had an issue with your child sagging here on our campus. After reading your letter and consulting with district office personnel on this issue, we have decided to discontinue the random checks for students sagging to ensure the self esteem and academic progress of our student is not affected Thank you for sharing your concerns Sincerely, Tim Cooper Y 1 am C, "Ad " Avli CGch UY c ccs Ik*5{v kcf cicodk Level ht k-5 t,rn c"llcd3 CUA CL's(A rlTV1{n5ka✓l f-cCai- 16Amal-etcclI pec► ,�� �� . (Acc any L-ertrn� f, ���b�i� f1 cS c c� r r , YA �Q% �-h Y abk'It h . �$� � car � � 1U Icor-.n / cccmPreher car kcioao"'I jChoc,i c.�1v0�rvl'lYlC✓1�. CUr 11" t Va 1 A Special Education Local Plan Area INDIVIDUALIZED EDUCATION PROGRAM Assessment Plan DISTRICT SCHOOL DATE LC Birthdate CC ( r C Last Name First Nate Middle Initial REASON FOR .REFERRAL LAO, A ) In order to meet your child's individual education needs, tby appropriately qualified staff-, and, when appropriate, suitable interpreters, prerecorded tests in the individual's primary language or materials modified to accommodate sensory deficits may be used. The result of completing these assessments may be a recommendation for special educational placement or services. ___Educr.tional Readiness: To measure skills, readiness and achievement in the areas of reading, written language, spelling and arithmetic skills. (Descnixm of Proac&rm,k1atcr.&) Social/Emotional: To see how s/he views her/himself and how s/he gets along with other people. ------ toampeaaofProcebuaMazenaisl— ---- �Motor/Perceptual Development: To measure how a child coordinates body movement and how s/he perceives the world through sensory input. — (cle",an ofProca&rmMatenals) Communication Development: To measure how the child understands and uses language and speech. (De,R,p„«,ofF'N kummw',alsl x Intellectual Development: To measure how well an individual remembers what s/he has seen and heard and how well that ---��� • information is used to solve problems. These tests reflect ieaming rate and help to predict school performance. �,) (Rsrnpnon ofProcodu�v Matmakl __Alternative Means: (Describe) x, Deveiopmental History: To survey the pattern of the chlid's groawth,-nd de-,c.uprne.f,. T;r:�. Include a Personal Care and Living Skills: To see what an individual can do independently. Career Assessment: To measure vocational awareness, interests,and aptitude. Recent P ssgssments to be considered: Other: rc,c fY1 nt✓ r t' rYXi b'1 C e Letters used above indicate which of the following will conduct the assessntent(s).• IV❑School Nurse ©Psychologist FS—P-1 Speech and Language Therapist QT Special Education Teacher Other(s): _ Primary language of pupil Other language spoken in home _ If primary ianguage is other ,[,un E,,8;1b t. CLC.^ ❑ PEP Language P70f".:c._.nccy test date PLEASE SUBMIT, AS SOON AS POSSIBLE, ANY ADDITIONAL. INFORMATION YOU WOULD LIKE TO HAVE CONSIDERED AS PART OF THE IEP PROCESS. DEVELOPED BY: � ' `��� TITLE: (Is e�va j L heck one: ❑ I give my consent to complete the abo%c assessment. I understand that the results will be kept confidential, I will be invited to attend a meeting to discuss the results and I may request written copies of the findings. It is also my understanding that no placement or sen•ice will result without my written pemassion. ❑ I hereby deny consent to conduct assessment described. Child's Social Security No. PARENT'S SIGNATL)RE :xtiDATE: Form 8588 Updated 7,'01 Assessment Plan Revised 9.1.9 SCREENINGS ❑New Referral Vision: CONTRA COSTA ❑Annual Referred ❑ Passed ElSpecial Education Local Plan Area ❑Triennial Date ❑Transition Hearing: _ Individualized Educational Plan (IEP) El Review Referred ❑ Passed ❑ Program Description Summary Next Review: DATE May 1,2008—part I STUDENT NAME Jacclui Moore DATE OF BIRTH 09/05/1994 DISTRICT OF RESIDENCE AUSD SCHOOL BDMS ' GRADE 7 CURRENT ATTENDANCE DISTRICT AUSD SCHOOL BDMS Student meets eligibility criteria for special education services due to OPTIONS CONSIDERED ® General Education ® Instructional Support Program ❑ Related Service ❑ Service Specific Class ❑ Service Specific Separate Class ❑ Non-Public School Services ❑ State School ❑ Home/Hospital Instruction ❑ Other IEP TEAM RECOMMENDED OPTION: Percent in non-integrated setting %, rationale: Rationale for Least Restrictive Environment: ❑ Needs can be met at attendance area school❑Needs cannot be met at attendance area school PROGRAM DESCRIPTION SUMMARY Program/Service *Dates of Service *Frequency Services,Instruction,Location _ to to to to to * While school is in session and student is available. YES NO ❑ ® Student requires extended year program.(Choosing"Yes"requires use of Comments and Clarification Form) ❑ Z Student requires special education transportation.(Choosing"Yes"requires use of the Transportation Eligibility Criteria form.) ❑ ® Student requires: Modified Physical Education❑ Adapted Physical Education❑ Progress on IEP goals will be reported by: ❑ Report Card ®Other progress reports Please indicate agreement by initialing: I have received copies of the Individualized Education Program, assessment reports, Parent's Right/Procedural Safeguards and the formation and decisions indicated above have been explained to me. X participated in the development of this IEP and I give my consent to the IEP as written and the services required to implement the program. I do not give my consent to the IEP as written. I refuse special education services. / �( PARENT/GUARDIAN(S) SIGNATURE any x vi ` l� �f I l DATE STUDENT SIGNATURE: I have been informed of the rights that will transfer to me at age 18 OTHER TEAM MEMBERS: The following persons affirm that they attended the Individualized Bducation Program Team meeting. Admin.or Designee- Date �.r Spec.Ed.Teacher ( d �.�•�'� .) Date ' General Ed.Teacher Date Name/Title Date Name/Title Date Name/Title Date Name/Title Date Name/Title Date Name/Title Date Name/Title Date Namerritle Date Name/Title Date ❑ See Comments and Clarification Page Attached ❑ Transition Plan Attached Pagel of Program Description Summary May 2006 ANTIOCH UNIFIED SCHOOL DISTRICT 5000 - STUDENTS 5600 - STUDENT RIGHTS INTERROGATIONS, INTERVIEWS, AND SEARCHES BP 5610 I . Interviewing of -Students . _ MWand duty to regulate and control the student while in atten ance at school and to prevent;.. wi r ct of school work. However, it is the Board's desire to cooperate with public agencies . A. Interview by Law Enforcement Officers . Law enforcement officers, properly identified to a site administrator/designee, may interview students on the school premises during the school day. 1 . Prior to t_he interview with a student, the law enforcement officer and the site administrator or designee shall hold a brief pre-interview meeting. In most cases, the law officer will agree that the site administrator or designee may be present in the inter- view wit_ -; the student . In special circumstances, the officer way exclude the site administrator. The interview itself is to be conducted by the law enforcement officer, who is solely responsible for advising the student about legal rights . 2 . The school shall provide, upon request from the law enforcement officer, information contained on the student's emergency card. No information from the student's official cumulative file shall be released until all formal legal requirements (parent release or subpoena) have been satisfied. B. Removal from School . If in the course of an investigation the law enforce- ment officer decides to remove a student from school , the site administrator/designee shall immediately take steps to notify the parent/guardian or responsible relative of the minor regarding the release of the minor to such officer, the place to which the minor is reportedly being taken, and the reason for the removal, except in cases of suspected child abuse when the law specifically prohibits this parent notification. (Education Code, Section 48906) W n LA n w (—D to n o :3. ro w w 5M.�< w O n o n a 0. n n S 1 Uo w a d n CM c w C •' r, _' c 'IQN' c 0 = N 2 C ry n S_ w G v n n �. ,^p n _ ^', w G w CL n w p e w s s o ° ^ N o n C. < a c o o R m n O O v O C O C ce n E a p 0.� y R7 0. 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