WAD (Wednesday) Publication Date. September 16, 2015

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1 Directive to Administrators (Specify which administrators) WAD (Wednesday) Publication Date WAD Notice Number No. of Page All Site Administrators WAD Title Vision and Hearing Screenings From Kim Coates (Cabinet member or approved by one below) Inform Title Executive Director, School Health Programs, SFCSD September 16, 2015 Signature Date Due (if applicable) N/A 1 of 12 Not Applicable After May 31, 2016 Telephone ( x ) Certificated Staff ( x ) Classified Staff ( x ) Parents ( x ) Post on Bulletin Board ( x ) Other: As Needed Administrative Directive WHO: All Site Administrators and Teachers WHAT: Vision and Hearing Screening for school age children is required by state law (CA Ed Code, Section 49452). The following children in SFUSD are to receive vision and hearing screening during the school year: Students in grades 1 and 4; Referrals from other elementary, middle and high school grade levels; Students being referred for initial psycho-educational testing; Students with IEPs with upcoming Triennial Reviews. WHEN: WHY: HOW: School Year Poor vision and hearing in children can interfere with coordination, acquisition of skills, achievement of developmental milestones, and the ability to learn properly. Early detection of vision and hearing loss can provide the opportunity to correct the problem earlier, and with less interference to learning. Responsibilities of Site Administrator Enter screening dates on master calendar. o Please do not schedule field trips that include students being screened on screening date. Please contact Kim Levine at at School Health Programs ASAP for any screening dates requiring rescheduling. Notify staff of screening dates and procedures. o Screening instructions and materials will be mailed to your school site two weeks prior to screening. If you do not receive your materials, please contact Kim Levine at Review and implement instructions provided in this WAD. o Students must be supervised by certificated staff at all times. Any student arriving to the screening without the presence of certificated staff will be turned away. o Within two weeks after screening, SFCSD Health Workers will record screening results in students cum folders. Referrals for students who did not pass the screening will be prepared and given to Site Administrator for mailing. Please make cum folders, envelopes, and workspace available for Health Workers. Middle Schools- please create your own screening schedule that includes the teacher name and room number. See sample screening instructions and sample referral forms. Vision and hearing screenings occur on the same day for Middle Schools. High Schools vision and hearing screenings are usually conducted by School District Nurses assigned to the site. Screening Results - For all high school screenings and all screenings done on dates other than the designated screening dates (see attached vision and hearing screening schedule), a designated employee at the site needs to add the screening results into the students cum folder and into Synergy. Attached, please find the following documents related to SFUSD s vision and hearing screening: o Vision Screening Instructions o Vision Screening Site Information Request o Principal Letter and Vision Screening Procedure o Vision and Hearing Screening Teacher Referral Forms o Hearing Screening Site Information Request Form o Hearing Screening Instructions and Information o Middle School Screening Instructions for Vision and Hearing o Middle School Hearing and Vision Screening Teacher Referral Form o Hearing and Vision screening protocol for Special Education students o Vision and Hearing screening schedules Responsibilities of Student, Family, and Community Support Department Notify Site Administrator of screening dates (see attached screening dates) Provide screening instructions and materials to school sites (see attachments). Schedule, coordinate, and orient qualified screeners as necessary. On elementary and middle school designated screening dates (see attached vision and hearing screening schedule), SFCSD Health Workers will record screening results in the student s cum folder and into Synergy. A list of students that do not pass the screening, and next steps will be provided to the Site Administrator at this time. Provide on-going consultation to school sites/screening teams Provide school sites with updated referral information. If you have any questions, please contact the Nurse of the Day at Signature Cabinet Member Kevin Truitt Title: Associate Superintendent of Student, Family and Community Support Department SAN FRANCISCO UNIFIED SCHOOL DISTRICT WEEKLY ADMINISTRATIVE DIRECTIVE (WAD)

2 SFUSD's VISION SCREENING SCHEDULE October 2015 December 2015 February Paul Revere K-8 1 Starr King 1 Alvarado 9 Malcolm X 3 CIS 2 Miraloma 13 Sheridan 4 El Dorado 4 Alamo 15 L R Flynn 7 Lafayette 4 ML King 16 WM Cobb 8 Harvey Milk 5 C. Lilienthal Mad. K-2 19 Bryant 10 Ulloa 9 Bessie Carmichael 20 Marshall 11 Monroe 11 Jefferson 22 Fairmount 14 JY Chin 12 C. Lilienthal Scott Bret Harte 15 George Peabody 16 New Traditions 26 Junipero Sierra 17 Francis S. Key 18 Vis. Valley ES 27 VV MS 18 Willie Brown 27 Sanchez 19 Commodore Sloat 29 Chavez January G J. Lau Noth Beach 29 Bessie Carmichael Redding 23 GJ. Lau Chinatown 7 AF. YU 25 Sherman November AP. Giannini MS 26 W. Portal ( 2 Drs) 2 Daniel Webster 8 Rosa Parks March Charles Drew 11 Sutro 1 Mission Ed Center 3 Roosevelt MS 12 Grattan 3 Lakeshore 5 Guadalupe 12 Aptos 4 Sunset 5 James Denman MS 14 R.L. Stevnson 7 Yic Wo 6 Buena V./Horace K-8 15 SF Montessouri 8 Jean Parker 9 McKinley 19 Spring Valley 10 Longfellow 9 Francisco MS 21 ER Taylor 11 CHINESE Ed. Center 10 Argone 21 Rooftop Jose Ortega 10 Francisco MS 22 Diane Feinstein 15 Rooftop K-4 12 Hillcrest 25 Garfield 17 Sunnyside 12 ISA Glen Park 22 Clarendon 13 G W Carver 16 Cleveland 17 McCoppin 17 James Lick MS. 19 Lawton K-8 RED is screened by Mary Main 19 Everett Marina and Presidio - TBD 20 John Muir 24 SF Community

3 SFUSD HEARING SCREENINGS SCHEDULE September 2015 December 2015 February Sheridan 1 Buena Vista/HM 2 McCoppin 22 Marshall 2 SF Community K-8 3 Glen Park 23 Sanchez 3 Lawton K-8 4 Jose Ortega 24 Bryant 4 Sunset 4 ML King 25 WM Cobb 7 F S Key 5 Vis Valley 28 J. Serra 8 Charles Drew 9 Alice Fong Yu 29 Cleveland 9 Hillcrest 10 ER Taylor 30 Chavez 10 Bessie Carmichael K-5 11 Clarendon 11 Rosa Parks 12 Garfield October McKinley 16 Sutro 1 G.W. Carver 15 Redding 17 Lakeshore 2 Tenderloin 16 Jean Parker 18 G Moscone 5 Fairmount 18 Willie Brown 15 Hoover MS 19 Sherman 21 Flynn January Daniel Webster 5 Yick Wo March John Muir 6 Alamo 1 SF Montessori 27 Vis Valley MS 7 Sunnyside 2 C. Lilienthal Mad. K-2 29 Bessie Carmichael 7 AP Giannini 3 G J Lau /North Beach 8 Alvarado 4 G J Lau/ Chinatown November Chinese Ed. Center 2 Monroe 11 J. Y. Chin 9 Mission Edu. Center 3 Malcolm X 12 Argone 10 Rooftop K-4 3 Roosevelt MS 12 Aptos MS 11 Diane Feinstein 4 Bret Harte 13 Commodore Sloat 15 C. Lilienthal / Scott 5 Starr King 14 Grattan 5 James Denman MS 15 Spring Valley 6 Chinese Immersion 15 George Peabody (portables) 9 Lafayette 21 New traditions Marina and Presidio - TBD 9 Francisco MS 21 Rooftop 5-8 Red is screened by Mary Main 10 Paul Revere 22 Guadalupe 10 Francisco 25 Miraloma (portables) 12 Harvey Milk 25 RL. Stevenson 12 ISA Ulloa 13 El Dorado 27 Jefferson 17 James Lick MS 28 Longfellow 19 Everett MS 29 West Portal

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