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Chawanakee USD  |  E  6173  Instruction

Education For Homeless Children   

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Exhibit 1

DISTRICT EXPLANATION OF DECISION

RELATED TO ELIGIBILITY, SCHOOL SELECTION, OR ENROLLMENT

Instructions: The following form provides notice and explanation to a student's parent/guardian or an unaccompanied youth regarding the district's decision related to student eligibility, school selection, or enrollment.

Date:______________ Name of person completing form: _________________________

Title:__________________________ Phone number: _________________________

In accordance with the federal McKinney-Vento Homeless Assistance Act (42 USC 11431-11435), this notification is being provided to either:

Name of parent(s)/guardian(s): _____________________________________________

Name of unaccompanied student:____________________________________________

School requested:________________________________________________________

District's placement decision (name of school):________________________________

Action(s) proposed/refused by the district related to eligibility, school selection, or enrollment:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

The district's determination regarding eligibility, school selection, or enrollment was based upon the following evidence and for the following reasons:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Other options that the district considered, if any, included the following options which were rejected for the following reasons:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

Factors relevant to the district's decision and information related to the eligibility or best interest determination including the facts, witnesses, and evidence relied upon and their sources, if any:

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

You have the right to appeal this decision to the district Superintendent. To do so, contact the district's homeless liaison listed below within the next ___(insert number of days)___ days to request a Dispute Form. You may provide written or verbal documentation to support your position, and may also seek the assistance of social services, advocates, and/or service providers in the dispute process. The Superintendent or designee will review all the evidence and will notify you of his/her decision within ___(insert number of days)___ days.

If you are not satisfied with the Superintendent's decision, you may appeal to the ______(insert county name)_________ County Office of Education. If you are not satisfied with the county office's decision, you may then appeal to the California Department of Education. The district's homeless liaison can assist you with this appeal.

CONTACT INFORMATION:

District Liaison: The district liaison is one of the primary contacts between homeless families and school or district staff. He/she is responsible for coordinating services to ensure that homeless students enroll in school and have the opportunity to succeed academically, and mediates enrollment disputes as needed.

Name of district's homeless liaison: Co-ordinator of Child Welfare & Attendance

Address: P.O. Box 400, North Fork, CA 93643

Phone number: (559) 877-6209

County Liaison: If you appeal the district's decision to the county office of education, the district liaison shall forward all written documentation and related paperwork to the homeless liaison at the county office. The county liaison will review the materials and determine the eligibility, school selection, or enrollment decision within five working days of receiving the materials. He/she will notify you of the decision.

Name of County Office of Education homeless liaison: MCOE Assistant Superintendent

Address: 1105 California -145, Madera, CA 93637

Phone number: (559) 673-6051

State Coordinator: If you appeal the county office's decision to the California Department of Education, the county homeless liaison shall forward all written documentation and related paperwork to the State Homeless Coordinator. The state coordinator will review the district, county office, and parent/guardian information and will notify you of the decision within ten working days of receiving the materials.

RIGHTS:

Pending the final resolution of this dispute, including the period of all appeals, the student has the right to immediately enroll in the school requested and to participate fully in school activities at that school.

Exhibit CHAWANAKEE UNIFIED SCHOOL DISTRICT

version: April 4, 2017 North Fork, California

_____________________________________________________________

Exhibit 2

EDUCATION FOR HOMELESS CHILDREN

DISPUTE FORM

Instructions: This form is to be completed by a parent/guardian or student when a dispute regarding enrollment has arisen. As an alternative to completing this form, the information on this form may be shared verbally with the district's liaison for homeless students.

Date submitted:______________________

Student's name:____________________________________________________________

Name of person completing form:_____________________________________________

Relation to student:_______________________________________________________

Address:________________________________________________________________ ___

Phone number:______________________________________________________________

Name of school requested:_____________________________________________________

I wish to appeal the eligibility, school selection, or enrollment decision made by:

__ District liaison __ District Superintendent __ County office of education liaison

Reason for the appeal: You may include an explanation to support your appeal in this space or provide your explanation verbally.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I have been provided with:

__ A written explanation of the district's decision

__ Contact information for the district's homeless liaison

__ Contact information for the county office of education's homeless liaison

__ Contact information for the state homeless coordinator

Exhibit CHAWANAKEE UNIFIED SCHOOL DISTRICT

version: April 4, 2017 North Fork, California