All About ExCEL: ExCEL After School Program Manual

All About ExCEL: ExCEL After School Program Manual

ExCEL After School Program Manual –August 2013

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The ExCEL website is the best source for information. Detailed powerpoints and documents can be found at:

http://www.healthiersf.org/ExCELafterschool/Resources/index.php

Table of Contents

I. Program and Grant Requirements Page 2

II. CDE Attendance Targets Page 2-3

III. After School Program Requirements Page 3-6

IV. Audit and Quality Action Plan Review Page 6-7

V. Fiscal Management Page 8

VI. Guidelines for Charging Fees Page 8

VII. Instructional Aide Requirements Page 9

VIII. After School Program Contracts Page 9-10

IX. After School Program contract invoicing Page 10

X. Custodial & Real Estate Page 10

XI. SFUSD Technology Access Page 10

Appendix I: ExCEL Attendance Guidelines

Appendix II: Early/Late Release Policies

Appendix III: Invoice and Contract

Appendix IV: Academic Liaison

Appendix V: ExCEL Lesson Plan Template

Appendix VI: Family Literacy

Appendix VII: CCTC Foreign Transcript requirements for Instructional Aide requirement

Appendix VIII: Subcontractor Requirements

Appendix IX: Student Forms (injury, incident, field trip etc)

Appendix X: Allowable Expenses

Appendix XI: Snack FAQ

Appendix XII: Equitable Access



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I. Program and Grant Requirements:

• ExCEL After School Programs are funded by BASE grants: ASES and/or 21st Century for Elementary, Middle,

K-8, and ASSETS grants for High Schools

• ASES grants are 3 year renewable funding sources

• 21st Century and ASSETS grants are 5 year grants which sunset (end) and sites whose funded has ended must

be re-applied for through an RFA process

• ExCEL elementary and middle school BASE grants can ONLY be used to provide after school programming

daily (176 days) immediately after the school day.

• ExCEL High School ASSETS base grants can be used to operate programs before school, after school, and

weekends in accordance with grant guidelines.

• Some sites may also receive 21st Century related grants including Equitable Access (to be used to support

full inclusion of targeted student groups including EL, learning support, mental health staffing) and Family

Literacy (to be used to provide literacy and career support for the adult family members of ExCEL program

participants)

II. CDE Attendance Targets based on grant amounts

The California Department of Education bases attendance targets on the TOTAL grant amount awarded to a

school site. Failure to maintain at least 85% attendance rates can result in Involuntary Reductions.

The ExCEL After School Program office submits attendance reports to CDE in January and July. Attendance

numbers are based on the data input into the EMS on line attendance system. Program must input attendance

a regular basis to ensure accurate and timely reporting. All attendance entered into the EMS must be verifiable

through EMS mandated sign in sheets.

Calculating attendance:

• High School ASSETS grant attendance targets are calculated based upon $10/day/student

• Elementary and Middle School BASE grant attendance targets are calculated based upon

$7.50/day/student

Example:

High School grant award of $150,000/ 180 days/$10= 84 students daily

Elementary grant award of $130,000/ 180 days/ $7.50 = 98 students daily

California Education Code Section 8483.7 requires CDE to reduce grants awards if:

• In the most recent year, attendance is less than 75% of the targeted attendance level

OR

• In two consecutive years, attendance is less than 85% of the targeted attendance level.



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Jan 2010-June 2010 July 2010-Dec 2010 Jan 2011-June 2011 July 2011-Dec 2011

6,104 6,004 6,314 6,205

Jan 2010-Dec 2010 Jan 2011-Dec 2011 Target

Annual Attendance 12,108 12,519 15,000

Attendance % 80.7% 83.5%

� In the most recent year, is attendance less than 75% of the targeted attendance level? NO

� In two consecutive years, is attendance less than 85% of the targeted attendance level? YES

� Will the site receive an involuntary reduction: YES

III. After School Program Requirements:

• Provide a comprehensive After School Program that consists of a balance of academic and enrichment

activities, including physical activity components. High schools must provide credit recovery.

• A maximum 20:1 student to staff ratio is required

• Certificated staff must be paid through SFUSD extended hours process

• All staff who directly supervise students must meet the minimum qualifications of an instructional aide

in SFUSD and have TB and finger printing clearance per District requirements

Hours of Operation:

Elementary and Middle Schools:

• MUST commence immediately following every regular school day

• Must operate a minimum of 15 hrs/wk

• MUST remain open until at least 6:00pm every day

High Schools:

• Must operate a minimum of 15 hrs/wk

• May operate a after school & any combination of before school, weekends, summer, intercession, and

vacation



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Participation and Attendance:

• All Schools have a Daily Minimum Participation TARGET Based upon the size of the grant award.

Attendance rates must be maintained from 85-100% of target to avoid funding reductions from the

California Department of Education.

• K-5 Students: FULL Program*EVERY DAY*

• Grades 6-12 Students: Minimum: 9 HOURS/ week* AND 3 DAYS / week*

Early Release Policies:

Each program should be familiar with the ExCEL Early Release Policy and guidelines (see Appendix XX).

Elementary and Middle After School Programs must implement the ExCEL early release policy consistently at

ALL program sites.

Attendance Tracking and Data Entry:

Each program should be familiar with the ExCEL Attendance guidelines (See Appendix XX). Each site is

responsible to:

• Train staff on sign in/out procedures and EMS data entry.

• Designate staff to oversee and support sign in/out process and required follow up.

• Daily review of sign in/out sheets – Any incomplete or missing information should be corrected

immediately.

• Regularly crosscheck your hard copy count with the EMS total. Ensure your hard copies match the data

entered into the EMS.

Professional Days:

• Three (3) days per year for the purpose of providing professional development to program staff using

funds from the local grant award.

• Student attendance cannot be counted on the days the program is not in operation.

• Parents must be notified in advance of the planned professional development days to allow ample time

for them to make alternative arrangements for their child(ren) for the after school hours on these

designated days.

• All professional development training must be included in the program plan and listed on an annual

calendar.

Drop In Policy : (per CDE):

• The Legislature intended that elementary students attend the full program and participate in the entire

program: nutritious snack, homework help/tutoring, academic support and enrichment.

• The reality is that not all students will attend the full program every day, hence the flexibility allowed via

an early-release policy.



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• The after school component was never intended to be a drop-in, childcare, or elective program. The

goal of the after school component is to support student success in school through academic support

and enrichment.

Crises Response Manual

As part of after school program contract, there is an expectation is that each site has its own crises

response plan and that there are practice drills with students on a regular basis.

Each school site is also required to have a crises response plan which you may want to familiarize

yourself with.

Student, Family, Community Support Department has a Crises Response Manual to refer to when developing

your plan.

Mandated Reporting - Child Abuse Considerations: Please review the excellent PowerPoint presentation on the

ExCEL website: http://www.healthiersf.org/ExCELafterschool/Resources/documents/CrisisResponseandChildAbuseReporting.ppt

Feeding the mind and body : Food Guidelines:

• No sugar sweetened beverages

• No foods with hydrogenated fat

• No candy, ice cream, gum, potato chips, etc.

Allowable: Pretzels, non-hydrogenated goldfish, rice cakes, bagel chips, and air popped popcorn.

• Only reimbursed for 100% juice drinks – not juice cocktails, juice drinks, punch, orange drink,

Gatorade, vitamin water, Tampico

• In terms of After School Snack fruit or vegetable based drinks are used to meet the fruit/vegetable

requirement and is NOT considered a beverage.

• It must to be 100% Juice (no added sugar) and the serving size is ¾ of a cup or 6oz.

Food Handlers Certification Requirement: By the start of each school year, each program site is required to have

at least one program staff certified as a Food Handler by the SF Department of Public Health. Any program staff

who works with food must complete the on line food handlers course. For school year 2013-2014, this

requirement must be in place by January 1, 2014.

Moving the body; moves the mind: Physical Activity Guidelines

• Every student has the opportunity to participate in at least at 30 minutes of daily physical activity.

• The opportunities should be built in the weekly program schedule.

• Develop strategies to integrate physical activity into other parts of program activities.



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Feeding the soul: Transformational Relationships

• Restorative Practice: SFUSD is committed to transforming relationships through restorative practices.

• As leaders in the after school program, your modeling of building positive relationships will be

transformational for the district.

Components of a program that integrates restorative practices values and concept includes:

Using the circle process to build community:

• Shift away from traditional/punitive discipline practices

• Embrace the concept of doing things "with" one another and creating a sense of inclusion and shared

responsibility

• Use restorative questions to repair harm and restore community

• Use circle process to address larger behavior issues and respond to harm

IV. Audit and Quality Action Plan Review:

ExCEL Programs are reviewed through the following processes:

• ASES Audit Review

• 21st Century/ASSETS Audit Review

• Federal Program Monitoring Review

• Region 4 Technical Assistance Site Visits

Due to the extensive compliance and oversight reviews related to the grant funding sources, it is critical that

Lead Agencies and Site Coordinators maintain accurate, compliant paperwork and documentation as required by

the ExCEL office. Each year a number of sites are randomly selected for one or more of the above audits.

Quality Action Plan: At the ExCEL August Institute, program sites will have the opportunity to develop a Quality

Action Plan (QAP) based on the results of the previous year’s evaluation results. As a follow up to the

development of the QAP, ExCEL will provide technical assistance and support to achieve the goals of the QAP.

The technical assistance and support will consist of:

• The QAP will be due by the end of the first week of school

• Your DC will visit your site in September/October to review the QAP and provide any technical

assistance support needed.

• ExCEL will provide professional training opportunities and coaching to support the goals of the QAP.

• Your DC will visit each site in Jan-March and complete a site visit report on the progress towards

meeting the goals of the QAP.

• For Audit purposes, each site visits will also include compliance check of audit related items below.



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Audit related items:

Hours of Operation/Program Elements (Review of weekly program schedule)

� Required number of program hours are met (15 hours/week for high school AND* until at least 6 pm for

elementary/middle)

� There is a balance of program activities: academic, enrichment, recreation, snack

� Physical activity is scheduled for at least 30 minutes per day

Attendance Review (Review of prior week attendance documentation)

� Required ExCEL sign in/out forms used

� Master Sign in/out sheet used

� All 4 pieces of sign in/out consistently in evidence* (Elementary/middle only)

� Early Release policy consistently utilized* (Elementary/middle only)

� Student signature count matches daily total (review 1 day)

Staff Ratio

Staff ratio meets 20:1 requirement

Snack

� SFUSD snack served

OR

For sites with non SFUSD snack,

� Menu of weekly/monthly snack components provided

Snack components served to students today (at least two of the following):

� Grain/Bread (1 serving).

� Milk (1 cup or 8 oz.).

� Protein/Meat or Meat Alternate (1 oz.).

� Fruit, Vegetable or 100% Juice (3/4 cup).

Food Guidelines:

� No sugar sweetened beverages

� No foods with hydrogenated fat

� No candy, ice cream, gum, potato chips, etc.



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V. Fiscal Management

All programs are expected to ensure that staff is familiar with allowable expenses and invoice documentation

requirements. (See Appendix X for Allowable Expenses guidelines.) This will facilitate faster turn around of

monthly invoices.

Invoicing and Allowable Expenses General Guidance:

• Expenses must supplement and not SUPPLANT expenses. Items purchased must be utilized entirely for

ExCEL student programming or multiple funding sources must be utilized i.e. match funds.

• Furlough days- NO on-site activities or programming for students taking place during SFUSD furlough

days may be billed.

• School-wide expenses may not be funded solely using ExCEL grant funds. With pre-approval, a portion of

event, postage or other related expense might be allowable if directly related to the ExCEL program

students.

• It is difficult to be all-inclusive in a list of what is allowed. We cannot anticipate everything so when in

doubt, ASK before you spend. We want to work with you to “get it right” and to make the invoicing

process as simple as possible.

• All ExCEL Approval forms must be submitted for review and pre-approval IN ADVANCE of any

expenditures or related activities taking place.

Budget Revisions:

Budget revisions are accepted twice a year in November and March. Budget revisions after March are on a case-

by-case basis. Please confer with your District Coordinator.

VI. Guidelines for Charging Fees

The intent of the ASES or 21st CCLC programs is to establish local programs that offer academic assistance and

enrichment to students in need of such services regardless of their ability to pay.

The SFUSD is committed to providing services to all SFUSD students regardless of their ability to pay.

• Fees include any fees charged to families:

• This includes, but is not limited to: tuition, enrollment fees, application fees, snack fee, supplies fees

etc.

• Programs that opt to charge fees may not prohibit any family from participating due to its financial

situation. All program materials related to outreach and enrollment must state clearly that no child will

be denied services due to inability to pay.

• Programs that opt to charge fees must offer a sliding scale of fees and scholarships for those who cannot

afford the program.

• Income collected from fees must be used to fund program activities specified in the grant application.

Funds generated from fees are subject to audit and program monitoring so programs must maintain

documentation for a period of five (5) years.



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VII. Instructional Aide Requirements

Direct supervision of pupils refers to all adults who count towards the required 20:1 pupil-to-staff ratio. Any

adult who is responsible for a group of students and is included in the site count to meet the minimum ratio

is included in this definition and must meet the Instructional Aide Requirements defined by the District. All

program staff and volunteers on campus with students must have TB/Fingerprinting clearance. This includes

AmeriCorps members, volunteers, and any other staff in contact with students. The instructional aide

requirement applies to any staff members who are directly supervising students, regardless of the funding

source used to pay them. After school program staff that meet the Instructional Aide requirement are

eligible to apply for the SFUSD on call substitute pool

Instructional Aides are required to have ONE of the following:

• An AA degree or higher

or

• Official transcripts reflecting 48 college units and a high school diploma/equivalent

Or

• Completion of CBEST and a high school diploma/equivalent or successful passage of the SFUSD

Instructional Aide exam ( see calendar for IA exams offered through the course of the year through

ExCEL.)

VIII. After School Program Contracts

After school program contracts are renewed on an annual basis. Around January of each year, school site

principals are sent award notification and asked to select a Lead Agency and submit a Consultant/Contractor

Request (CCR) form by mid-January. The CCR designates the Lead Agency and lists the amount of the after

school program contract. The Board of Education ( BOE) through the K-Resolution process must approve all

contracts. K—Resolutions are submitted to the BOE beginning in February. Once the BOE has approved the

K-Resolution, ExCEL will send the Lead Agency contract documents to complete within a 2-3 week period.

Once contract documents are submitted they are reviewed by ExCEL and Contracts and then routed for

signatures. Once all signatures are secured, the contract is routed to Purchasing for a Purchase Order (PO)

to be generated. The executed contract and PO is then sent to the contractor. No programs can start

without an executed contract.

Contract Amendments are considered on a case-by-case basis as they involve the same process as above.

Carry over: There are no carry over funds allowed from year to year. SFUSD bills CDE on a cost

reimbursement basis. Any funds not expended by the end of the fiscal year cannot be billed to CDE. As such

all POs are liquidated at the end of the fiscal year. It is absolutely necessary to invoice on a monthly basis

and to meet end of the year invoice deadlines.



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Matching funds: Each after school program contracts requires a 33% match (in-kind or cash/grants). Each

after school contract Lead Agency is required to report match contribution in the EMS. Matching fund

contribution should be reported by October 1st each year and finalized by May 31st of each year.

IX. After School Program Contract Invoicing

The ExCEL After School Program Office only accepts cost reimbursement invoices. No advance payment

requests are accepted. Once a contract and PO is generated, the ExCEL After School Program Office will

generate an invoice template for the fiscal year. Please follow the directions on the invoice template and be

sure to follow the allowable expenses guidelines when invoicing.

Invoices are reviewed by your DC and forwarded for on line payment. Invoices are due by the 5th of the

month on a monthly basis. Delays in invoicing will result in delays in payment. The final invoice is generally

due on or near July 15th. Failure to submit an invoice by the deadline will result in payment being delayed

until the Fall of the next fiscal year as BOE approval is required.

X. Custodial and Real Estate:

Each after school program is required to submit a Facilities Use Permit application prior to the start of program.

For school year programs no fees apply. For summer programs, permit fees are billed to cover summer

custodial costs. SFUSD Facilities Use Permit:

http://www.healthiersf.org/ExCELafterschool/Resources/documents/FacilityUsePermit2012.pdf

Top 10 reasons for delays in FUP processing

1. Missing pages – there are 5 total pages for the permit (not including addendums)

2. Missing ExCEL signature

3. Missing principal signature

4. Missing # of students served

5. Missing initials on page 5 of the permit

6. Program hours do not match the hours in the rate sheet

7. Program dates do not match the hours in the rate sheet

8. No application for use of cafeteria/kitchen if you check “Kitchen” – there is a cost associated

9. Missing designation of bathrooms per Section 8

10. Insurance not being up to date

XI. SFUSD Technology access

Each program site should use the SFUSD Guest Wireless access for EMS and email needs. For those sites that do

not have access to the SFUSD Guest Wireless, the ExCEL After School Program has an agreement for one staff

from each program site to have access to SFUSD technology for the purposes of EMS and email access. All sites

An SFUSD Technology application must be signed by the Principal and submitted to ExCEL. SFUSD Technology

Access: http://www.healthiersf.org/ExCELafterschool/Resources/documents/SFUSD-TechnologyAccess.pdf



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Appendix I: ExCEL Attendance Guidelines

Revised May 2013

ExCEL After School Program Attendance Guidelines- Elementary/Middle School

Consistent Record Keeping and 100% Accuracy

All students sign in/out must be documented using a standardized ExCEL sign in/out sheet printed from the EMS.

Elementary students must be signed out by an authorized adult unless specific written permission has been secured by the parent/guardian.

Middle school students may sign themselves in and out from the program.

Authorized program staff and/or parent/guardian may sign in/out students from the program.

What This Means for Site Operations:

• Train staff on sign in/out procedures and EMS data entry. • Designate staff to oversee and support sign in/out process and required follow up. • Daily review of sign in/out sheets – Any incomplete or missing information should be corrected immediately. • Regularly cross check your hard copy count with the EMS total. Ensure your hard copies match the data entered

into the EMS.

On a Daily Basis:

Review daily sign in/out sheets - Any incomplete or missing information should be corrected immediately including missing early release codes.

Only count those students who have completed all of the fields on the Sign In/Out sheets.

Put a dot next to each student being counted for attendance.

For those programs who use sign in/out sheets for students who are not reported in the EMS attendance count: o Review daily sign in/out sheets and highlight in BLUE those students who do not count towards the EMS

attendance count. Note on the bottom right corner of page.

Write the EMS student count page total on the bottom right hand corner and circle the number.

Write the EMS student count day total on the top page of the day’s package and circle the number.

Enter data into EMS.

Verify number of students in the hand count to the number reported in EMS.

On a Monthly Basis:

Randomly select one day out of the month.

Print out Complete Participation Attendance Sheet from the EMS.

Cross reference to the master sign in/out sheet.

ExCEL Attendance Must-DOs

All Elementary and Middle school sites must use the SFUSD ExCEL Daily Sign In/Out sheet as the Master Sign In Sheet printed from the EMS.

All students present are signed in at the beginning of program and signed out when they leave.

All students who leave before the 15 minute of time before the close of program, MUST have the proper Early Release code recorded on the sign in/out sheet as well as the time of departure. The EMS has a function that allows for an Early Release code to be auto populated for those students who leave early on a regular basis. If the site chooses to use this function, there MUST be an Early Release form on file for audit purposes for each student with an auto populated code.

Revised May 2013

ExCEL After School Program Attendance Guidelines for High School

Consistent Record Keeping and 100% Accuracy

All students sign in/out must be documented using a standardized ExCEL sign in/out sheet printed from the EMS.

Authorized program staff and/or parent/guardian may sign in/out students from the program.

What This Means for Site Operations:

• Train staff on sign in/out procedures and EMS data entry. • Designate staff to oversee and support sign in/out process and required follow up. • Daily review of sign in/out sheets – Any incomplete or missing information should be corrected immediately. • Regularly cross check your hard copy count with the EMS total. Ensure your hard copies match the data entered

into the EMS.

On a Daily Basis:

Review daily sign in/out sheets - Any incomplete or missing information should be corrected immediately.

Only count those students who have completed all of the fields on the Sign In/Out sheets. (if times are listed)

Put a dot next to each student being counted for attendance.

For those programs who use sign in/out sheets for students who are not reported in the EMS attendance count: o Review daily sign in/out sheets and highlight in BLUE those students who do not count towards the EMS

attendance count. Note on the bottom right corner of page.

Write the EMS student count page total on the bottom right hand corner and circle the number.

Write the EMS student count day total on the top page of the day’s package and circle the number.

Enter data into EMS.

Verify number of students in the hand count to the number reported in EMS.

On a Monthly Basis:

Randomly select one day out of the month.

Print out Complete Participation Attendance Sheet from the EMS.

Cross reference to the master sign in/out sheet.

ExCEL Attendance Must-DOs

All High School sites must use the SFUSD ExCEL High School Sign In sheet as the Master Sign In Sheet.

High School: The Master Sign In Sheet can be created in two ways: o OPTION 1:

All students sign-in present on one activity/master/group sign-in sheet. Any secondary sign-in sheets are to be used for tracking purposes ONLY.

o OPTION 2: Attendance is taken at a set program time (“Homeroom Model”). During this time, designated

staff and or students sign themselves in for the individual program activity. These sign in sheets become the Master Sign In sheet.

NOTE: o The Master Sign-In Sheet is used in EMS Reporting and is provided to auditors for back up

documentation. o The Master Sign-In sheet can be broken up into multiple sheets and students would report to their

designated sign-in area. For example: A-L, M-O, P-S, T-Z OR Room 110, Room 212, Room 215, Room 313, etc.



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Appendix II: Early/Late Release Policies

SFUSD�ExCEL�After�School�Program�Early�Release�Policy�(This�Policy�shall�be�posted�in�a�conspicuous�location)�

ExCEL After School Program Early Release Policy – revised May 2013

��ExCEL�program�sites�operate�ASES�and�21st�Century�grant�funded,�comprehensive�after�school�programs�daily.�Programs��funded�through�these�grants�are�required�to�commence�immediately�upon�conclusion�of�the�regular�school�day,�operate�a�minimum�of�15�hours�per�week,�and�remain�open�until�at�least�until�6:00�PM�on�every�regular�school�day.��

Student�Attendance�Expectations:��

� Elementary�students�are�expected�to�attend�the�entire�program�every�day�it�operates.��

� Middle�school�students�are�expected�to�attend�at�least�nine�hours�and�three�days�per�week.�Priority�for�after�school�slots�will�be�given�to�middle�school�students�who�attend�five�days�per�week.��

� Priority�for�student�enrollment�in�the�after�school�programs�is�given�to�students�who�fully�participate�in�program�offerings.��

�

Allowable�Reasons�for�Early�Release��Exceptions�to�the�attendance�expectations�for�Elementary�and�Middle�school�students�are�included�in�the�following�list�of�allowable�reasons�for�early�release:��

��Each�after�school�program�site�will�reference�the�appropriate�allowable�reason�for�early�release�by�indicating�the�corresponding�numerical�code�in�the�Early�Release�Column�of�the�daily�sign�out�sheet,�as�well�as�the�time�of�the�student�departure.��Student�sign�in/out�procedures��All�student�sign�in/out�must�be�documented�using�a�standardized�ExCEL�sign�in/out�sheet�from�the�EMS.�Elementary�students�must�be�signed�out�by�an�authorized�adult�unless�specific�written�permission�has�been�secured�by�the�parent/guardian.�Middle�school�students�may�sign�themselves�in�and�out�from�the�program.��Student�dismissal��The�SFUSD�ExCEL�after�school�dismissal�policy�includes�the�utilization�of�a�fifteen�minute�window�of�time�before�the�close�of�program�for�parents�to�pick�up�their�children.�This�15�minute�timeframe�accommodates�San�Francisco’s�specific�community�needs�of�the�city-based�schools�with�limited�parking�and�traffic�issues�that�necessitate�a�staggered�pick�up/dismissal�schedule.�Under�this�written�early�release�policy,�student�dismissal�during�the�15�minute�time�period�does�not�necessitate�utilization�of�early�release�coding�or�designating�a�specific�reason�for�departure�from�the�program,�and�students�will�be�documented�as�having�fully�participated�in�the�daily�program�offerings.��

Students�from�early�start�elementary�schools�(7:50am�to�1:50pm)�attending�the�program�may�be�allowed�to�be�signed�out�as�early�as�5:00pm�since�it�is�expected�they�will�benefit�from�15�hours�of�programming�per�week.�Students�from�these�early�start�elementary�schools�who�leave�at�5pm�or�later,�do�not�need�to�use�an�early�release�code�and�students�will�be�documented�as�having�fully�participated�in�the�daily�program�offerings.�Students�from�these�early�start�elementary�schools�will�have�the�option�to�attend�until�6:00pm�if�their�parent/guardian�chose�to�utilize�the�full�program�each�day.��Site�Discretion��Each�ExCEL�AfterSchool�Program�site�has�the�discretion�to�modify�the�priority�attendance�section�and/or�student�dismissal�protocols�of�this�policy�to�tailor�the�policy�to�the�specific�needs�of�their�community,�with�the�written�approval�from�the�ExCEL�After�School�Program�office.�

1.�Parallel�Program�� 5.�Transportation�2.�Family�Emergency�� 6.�Community�Safety�3.�Personal�Family�Circumstance�� 7.�Child�Accident/Injury�4.�Medical�Appointment� 8.�Other�Conditions��

2012-2013

ExCEL Before School Programs

Late Arrival Policy

ExCEL Before school Programs are here to assist in SFUSD students’ education. In order to

ensure that our students get the most of this support and in fulfillment of the requirements set

by the legislation, enrolled students should attend the before school programs for the full

program length each day.

The SFUSD ExCEL Program has established the following policies regarding late arrival for

before school program activities:

All students must attend a minimum of 45 minutes of the scheduled daily 90 minute

programs.

All students must be provided a nutritious breakfast, per grant guidelines.

If a student must arrive late, the following are the allowable reasons for late arrival:

1. Parallel Program

2. Family emergency

3. Personal Family Circumstances

4. Medical appointment

5. Transportation

6. Community Safety

7. Child Accident

8. Other condition

Each ExCEL program site will indicate the time of arrival on the daily sign in sheet for any late

student, indicating the appropriate allowable reason for late arrival.

All students sign in/outs must be documented using a standardized ExCEL sign in/out sheet.

Updated as of : 5/14/2012

ExCEL Supplemental Early Release Policy

ExcEL program sites operate ASES and 21st Century grant funded, comprehensive supplemental

programs during non-school days. Many of these programs operate during summer months.

Students are requested to attend the entire program offerings every day of program operation.

Students will maximize program benefits through consistent, sustained participation in comprehensive

program offerings.

Allowable Reasons for Early Release from Supplemental Program

Allowable reasons for early release from program activities are as follows

1. Parallel program

2. Family emergency

3. Personal Family Circumstances

4. Medical Appointment

5. Transportation

6. Community Safety

7. Child Accident

8. Other Condition

Each ExCEL program site will reference the appropriate allowable reason for early release by indicating

the corresponding numerical code in the Early Release Column of the daily sign out sheets, as well as the

time of student departure.

Student sign/out procedures

All students sign in/outs must be documented using a standardized ExCEL sign in/out sheet. Elementary

students must be signed out by an authorized adult unless specific written permission has been secured

by the parent/guardian. Middle school students may sign themselves in and out from the program.

Student dismissal

The SFUSD ExCEL dismissal policy includes utilization of a fifteen minute window of time before the

close of program for parents to pick up their children. This 15 minute timeframe accommodates San

Francisco’s specific community needs of city-based schools with limited parking and traffic issues that

necessitate a staggered pick up/dismissal schedule to ensure safe dismissal of students. Under this

written early release policy, student dismissal during the 15 minute time period does not necessitate

utilization of early release coding or designating a specific reason for departure from the program, and

students dismissed during the 15 minute timeframe will be documented as having fully participated in the

daily program offerings.

Site Discretion

Each ExCEL Supplemental Program site has the discretion to modify the student dismissal protocols of

this policy to tailor the policy to the specific needs of their community, with the written approval from the

ExCEL office.



13

Appendix III: Invoice and Contract

ExCEL ALLOWABLE EXPENSES LIST FOR CBO CONTRACTS

As of August 2013 (changes are noted with an*)

1 | P a g e A u g u s t 2 0 1 2

GENERAL GUIDANCE:

Expenses must supplement and not SUPPLANT school activities. Items purchased must be utilized

entirely for ExCEL student programming or multiple funding sources must be utilized i.e match funds.

Furlough days- NO on-site activities or programming for students taking place during SFUSD furlough

days may be billed.

School-wide expenses may not be funded solely using ExCEL grant funds. With pre-approval, a portion of

event, postage or other related expense may be allowable if directly related to the ExCEL program

students.

Please note: It is difficult to be all inclusive in a list of what is allowed. We cannot anticipate everything

so, when in doubt, please ASK your District Coordinator. We want to work with you and make the

invoicing process as simple as possible.

All ExCEL Approval forms must be submitted for review and pre-approval IN ADVANCE of any


ADMINISTRATIVE EXPENSES:

The following are examples of Administrative expenses, which are included in the allowable administrative

maximum of up to 7.5% of contract direct expenses per year. Such costs should NOT be submitted as itemized

DIRECT expenses on invoices. Examples include:

Copy machine rental

HR/Personnel related costs i.e. job posting, fingerprinting/ background checks, TB tests

Management salaries

Mileage/gas/muni pass for staff/parking

Rentals (excluding PD-related training space)

NON ALLOWABLE EXPENSES

Tips/optional gratuity for services is not an allowable expense using ExCEL Funds

Apps: “Apps” related application/monthly fees for electronic/computer devices are also NOT allowed.

Gift cards or purchases with gift cards

No “lost receipt” payments

Yearbooks are not allowable expenses.

Food for weekly meetings, refreshments for field trips, club meetings. A nutritious snack is required;

however refreshments are not allowed.

T-shirts for program staff

Any supplies for fundraising events or incentives– e.g. cooking supplies for bake sales, raffle tickets,

costume winner prize, carnival supplies, rewards for good behavior, etc.

Supplies for holiday enrichment activities – e.g.: materials for Lunar New Year, Valentine’s Day, St.

Patrick’s Day, Easter, Halloween, and Christmas.

Pizza



2 | P a g e A u g u s t 2 0 1 2

Any costs related to entertainment, amusement, social activities. Examples: Final party supplies, BBQ

supplies, Final Party Food, Lights On Dessert/table covers, YAC field trip ice cream, Hospitality

meetings, staff retreats, movie tickets, Great America, D.J.s, dances, jumpy houses.

Gifts for teachers, parents, students, etc . For example: flowers, birthday gift, get well cards

Any personal expenses including but not limited to medicine, staff parties, fundraisers, other

expenses not-related to ExCEL are NOT allowed.

EQUIPMENT: CBOs may not purchase EQUIPMENT valued at $500 or more per item. For ELECTRONICS,

*iPads or COMPUTERS, A Principal Expenditure Request Form and a quote from IT must be submitted to

your ExCEL District Coordinator for approval. These items may only be purchased through the SFUSD

Purchasing Department and tagged/inventoried according to SFUSD protocol.

ALLOWABLE EXPENSES FY 2013-2014

EXPENSE ITEM RELATED POLICY INVOICE DOCUMENTATION

Americorps Non-school day portion to be paid by ExCEL only up to 50% of CBO cost

Invoice/General Ledger (GL)

Benefits If related to Direct Service staff position (ex. Site Coordinator)

GL

Direct Service Staff Site Coordinator/Assistant Coordinator and Program Leaders (Line Staff) are the only CBO staff positions to be funded using ExCEL funds

GL

Non Consumable Supplies ($100-$500 value per item)

Individual items which value $100-$500 and will be utilized for multiple years must be tagged and added to the ExCEL site inventory list upon receipt; Annual inventory must be submitted. Tagging: School site code/Year/month/item number i.e. XXX-YYYY-ZZ-00A Property of SFUSD ExCEL ASP.

Receipt/GL

Professional Development for Direct Service Staff

Training, conference registration etc. not to exceed $5000 per fiscal year using BASE grant

Invoice/GL

Supplies for Program <$1500 per order

"Consumable" items (i.e. glue, paper, cookies supplies, crayons, board games, books)

GL/receipts

Snacks/Food for students Must adhere to the SFUSD Wellness policy and grant required USDA guidelines (see attached). Additionally:

No sugar sweetened beverages

No foods with hydrogenated fat

No candy, cookies, cake, ice cream, gum, potato chips, pizza, etc.

Allowable: Pretzels, non-hydrogenated goldfish, rice cakes, bagel chips, air popped popcorn.

Receipts



3 | P a g e A u g u s t 2 0 1 2


PRE-APPROVAL REQUIRED

Supplies for Program >$1500 per order

Must submit CBO Expenditure Approval Form Expenditure Approval Form; GL/Receipts

Youth Stipends Allowable for HS ASSETS grants. Must submit CBP Expenditure Approval form

Expense Approval Form; Receipts

Off Site Program Activity Including Transportation*

Pre-approval is required. Submit the CBO Expenditure Approval Form. The program activity should be integral to the program summary and a lesson plan is required. The lesson plan must have specifically stated educational

objectives*

Invoice/GL; Off Expenditure approval form with lesson plan; sign in sheet, receipts

Subcontractor Must submit CBO Expenditure Approval Form for pre-approval and conform with SFUSD subcontracting requirements for insurance, TB, etc.

Invoice requires proof of payment, description and dates of services provided

Digital Media (DVDs, VHS, CDs)

Must submit CBO Expenditure Approval Form; with attached lesson plan and justification of use


Video/computer games and/or consoles

Must submit CBO Expenditure Approval Form with attached lesson plan and justification of use


Tshirts/sweatshirts/other custom printed materials* for participants

Must submit CBO Expenditure Approval Form. Tag line

required:

ExCEL After School Program Logo (on ExCEL website)

Name of School

SFUSD

Expense Approval Form, Receipts

School Wide Events

Must submit CBO Expenditure Approval form and

identify matching funds

Expenditure Approval form, Receipts

Invoice Dos & Don’ts

Do:

1. DO include back up documents and spreadsheets outlining the amount billed to ExCEL.

If only a certain percentage of staff salary will be billed to ExCEL, please indicate on your

back-up documents or create a spreadsheet outlining the amount billed to ExCEL.

2. DO make sure photocopied receipts are clear with items purchased and prices clearly

legible.

3. DO make sure each receipt is itemized. For receipts from small businesses (produce

stores, neighborhood stores) that do not offer itemized receipts, please list items that

were purchased on the copy of the receipt.

4. DO be sure to circle the total on the receipt.

5. DO be sure to indicate the reason for purchase, for example: “materials for cooking

class.”

6. For Internet purchases, DO be sure to indicate the purchase on your General Ledger OR

provide a credit card statement indicating that this purchase was paid for.

7. For items that need approval, DO be sure to include a copy of the signed CBO Expense

Approval Form for that particular purchase you are billing for.

8. DO make sure the math adds up!

9. DO Email your DC in advance about unique situations relating to the invoice. Don’t wait

for us to figure it out. This will delay the processing of your invoices.

10. DO make sure you turn in Budget Revisions on time. Budget Revisions are done twice a

year (November and February).

11. DO be sure to include a detailed lesson plans that includes educational objectives if

purchases of junk food-like materials for a lesson or activity were made, please include a

detailed lesson plan.

Don’t:

1. DON’T include receipts not billed to ExCEL. This will cause confusion and slow down

processing. If it is easier to photocopy receipts together, please clearly cross out receipts

not included in the billing with a large “X” (Costco puts a slash across their receipts at

the door so please don’t do the slash) and clearly note “not ExCEL.”

2. DON’T include personal items on receipts.

3. DON’T include a lost receipt document. No lost receipts!

4. DON’T Draw out a receipt. If the copy is too light, try to make a darker copy.

5. DON’T include information that is not pertinent!

6. DON’T invoice over the contracted amount for the year.

7. DON’T invoice over the administrative budget for the year.



14

Appendix IV: Academic Liaison

Updated July 2013

Page | 1

ExCEL Academic Partnership Framework

In order to improve and strengthen the academic support provided to students in ExCEL

After School Programs, the ExCEL Office has actively solicited input and ideas from key

stakeholders to inform our approach. The framework described below represents our

best current thinking on building academic partnerships based upon the insights and

expertise of San Francisco educators and after school practitioners.

PURPOSE OF ACADEMIC PARTNERSHIP FRAMEWORK:

For all ExCEL After School Program sites to develop solid academic program

components that support student skill building, contribute to academic achievement,

and are based upon strong partnership between the CBO Lead Agency and the School

Day Staff.

KEY ELEMENTS:

1) Shared priorities for student success in ExCEL After School programs

2) Strategic Utilization of Academic Liaison Role –a designated certificated teacher

or non-credentialed staff person identified by the school site principal to serve in

an academic leadership position

3) Intentional Communication and information sharing between school day and

after school staff

4) Leveraged funding including grant funds, school site funds, DCYF SF Team grant,

and Equitable Access funds to provide additional direct services and professional

development (when available)

SHARED PRIORITIES

Each school site team consisting of the principal, site coordinator, and academic liaison

will define and develop realistic site-level priorities for student success that align with

and complement school day achievement goals. These priorities will translate into an

annual plan of academic supports to be provided in the afterschool program.

Updated July 2013

Page | 2

ACADEMIC LIAISON ROLE: (formerly referred to as Lead Teacher)

Each ExCEL site will designate a school day staff member to act as the designated

Academic Liaison to support the after school program’s academic framework. The

Academic Liaison will serve in a leadership capacity to guide and develop the

academic component. Recognizing that each school site has unique goals and objectives

as articulated in the Balanced Scorecard, each school can craft the Academic Liaison role

to ensure coherence between the school day goals and after school program. When

possible, Academic Liaison duties can be combined with IRF or other instructional

leadership positions.

The Academic Liaison will:

1. Meet regularly with the Site Coordinator to coordinate and support

implementation of academic-based activities.

2. Act as the designated communication liaison between school day and after school

staff, representing the interests and initiatives of the after school program to

school day teachers and vice versa.

Key activities and strategies the Academic Liaison provides will include:

1. Using student level data to inform planning and implementation of the after

school academic component(s). Utilizing data from the SFUSD Student

Information System as well as scores from appropriate skill assessments to

identify students in need of extra support, group students, select curriculum,

design program elements and/or structure appropriate homework help and

tutoring systems. At the high school level, the Academic Liaison will coordinate

ExCEL’s credit recovery efforts.

2. Training and coaching for after school staff members to strengthen their role in

supporting academic achievement. The Academic Liaison will strategically train

and coach after school program staff to support provision of quality instructional

practices.

3. Based upon site priorities, the Academic Liaison may also choose to provide one

to one, small group, or large group tutoring sessions with students in the after

school program.

Updated July 2013

Page | 3

NOTE: ExCEL sites implementing 21st Century Equitable Access grant, School Loop

after school pilot, and/or SF Team Program will ensure that the Academic Liaison

role encompasses and informs these academic efforts.

COMMUNICATION

ExCEL school sites will establish solid communication systems to share information and

strengthen collaboration between school day staff and afterschool staff. This may

include emails, homework binders, grade level meetings, team meetings, etc. Some

sites may opt to utilize School Loop as a communication tool. Teachers and after school

staff may also communicate informally to coordinate additional supportive resources for

targeted students.

LEVERAGED ACADEMIC RESOURCES AND PROGRAMS

School sites with additional funding sources and programs for academic intervention

services will strategically leverage those resources and strategies to develop a

coordinated approach. Examples of such resources/programs include: 21st Century

Equitable Access, School Loop pilot program, and DCYF SF Team grant awards.

Updated July 2013

Page 1 of 2

SFUSD ExCEL After School Program Academic Liaison

Responsibilities and Commitments Description of Position Under the direction of the Site Administrator (principal), and in collaboration with the after school program Site Coordinator, the Academic Liaison serves as the liaison between school day and after school staff. The Academic Liaison’s primary function is to build and coordinate the academic components of the ExCEL After School Program. The Academic Liaison Position provides overall leadership and expertise to inform the academic component of the ExCEL After School Program. When possible, Academic Liaison duties can be combined with IRF or other instructional leadership positions. The Academic Liaison will:

1. Meet regularly with the Site Coordinator to coordinate and support

implementation of academic activities.

2. Act as designated communication liaison between school day and after school

staff, representing the interests and initiatives of the after school program to

school day teachers and vice versa.

Key activities and strategies the Academic Liaison provides will include: 1. Using student level data to inform planning and implementation of the after school

academic component(s). Utilizing data from the SFUSD Student Information

System as well as scores from appropriate skill assessments to identify students in

need of extra support, group students, select curriculum, design program elements

and/or structure appropriate homework help and tutoring systems. At the high

school level, the Academic Liaison will coordinate ExCEL’s credit recovery efforts.

2. Training and coaching for after school staff members to strengthen their role in

supporting academic achievement. The Academic Liaison will strategically train

and coach after school program staff to support provision of quality instructional

practices.

3. Based upon site priorities, the Academic Liaison may also choose to provide one to

one, small group, or large group tutoring sessions with students in the after school

program.

NOTE: ExCEL sites implementing an Equitable Access grant, School Loop after

school pilot, and/or SF Team Program will ensure that the Academic Liaison role

encompasses and informs these academic efforts.

Updated July 2013

Page 2 of 2

Qualifications Summary

Candidates for the Academic Liaison(s) should meet the following qualifications:

Current employment as a credentialed teacher at the school site or other non-credentialed staff member approved by Site Principal

Strong communication (oral/written), presentation, organization and collaboration skills

Familiarity with school site goals and priorities

Experience implementing system-wide strategies

Demonstrated leadership experience at school site

Willingness to provide assistance and support for academic tutors Final selection of the Academic Liaison is determined by the Site Principal.

Time Commitment and Compensation:

The Academic Liaison stipend compensation for completing the required service hours (listed below) by a certificated SFUSD teacher is $5,000 per school year for K-8 Academic Liaisons and $3,000 for High School Academic Liaisons, split evenly into two payments (one in January and in June), contingent upon completion of required hours. Other staff will be compensated at their established extended calendar hourly rates. FOR CERTIFICATED TEACHERS: STIPEND - The required number of hours to be worked for full stipend compensation is: o Elementary/Middle School teachers: 170 hours o High School teachers: 102 hours ECR - Certificated Teachers utilizing ECRs will need to submit timecards each pay period for hours worked. FOR CLASSIFIED STAFF: The number of hours for other employee classifications must be calculated according to established SFUSD pay rates and will be paid using ECRs. Staff will need to submit timecards each pay periods for hours worked.

Hours worked will include time spent working to actively support the after school program, attending ExCEL trainings and meetings, coordination and planning meetings with site coordinator, and completing a brief end of the year summary report (and other documentation upon request).

A site may opt to utilize more than one staff person to fulfill the Academic Liaison duties and share the time commitment and compensation.



15

Appendix V: ExCEL Lesson Plan Template

Key Points for Planning *ExCEL Lesson Plans* ExCEL Theory of Action:

Regular Participation In High Quality Programs Has Direct Benefits for Youth and Contributes to Other Positive Outcomes Program Attendance Safe Improved safety English Fluency Supportive New skills and experience Academic Performance Interactive Strong relationships with peers and adults Higher Test Scores Engaging Improved academic behaviors Diverse, accessible, inclusive School engagement School‐day aligned Skill‐Building Physically active

Habits of the Mind in after school:

• Persistence Managing Impulsivity • Listening to Others with Understanding and Empathy Thinking Flexibility • Thinking About Our Thinking Striving for Accuracy and Precision • Questioning and Posing Problems Applying Past Knowledge to New Situations • Thinking and Communicating with Clarity and Precision Gathering Data through all the Senses • Creating, Imagining, and Innovating • Taking Responsible Risks • Thinking Interdependently

Restorative Practice: PRINCIPLES THAT REFLECT THE VALUES AND CONCEPTS FOR IMPLEMENTING RESTORATIVE PRACTICES

• Relationships are central to building community • Builds systems that address misbehavior and harm in a way that strengthens relationships. • Focuses on the harm done rather than only on rule breaking • Gives voice to the person harmed • Engages in collaborative problem‐solving • Empowers change and growth • Enhances responsibility

Physical Education:

Activities or Curriculum that provide at least 30 minutes of movement and teach…. • Cooperative skills • Decision making • Positive social skills

Additional Notes:

FY2013‐2014

TOPIC: ACADEMIC ENRICHMENT RECREATION/PHYSICAL ACTIVITY RESTORATIVE PRACTICE PRINCIPLES (CHECK OFF FOCUS AREA(S)) :

Relationships are central to building community Engages in collaborative problem‐solving. Empowers change and growth. Enhances responsibility

Habits of the Mind in after school (CHECK OFF FOCUS AREA(S) : Persistence Managing Impulsivity Listening to Others with Understanding and Empathy Thinking Flexibility Thinking About Our Thinking Striving for Accuracy and Precision Questioning and Posing Problems Applying Past Knowledge to New Situations Thinking and Communicating with Clarity and Precision Gathering Data through all the Senses Creating, Imagining, and Innovating Taking Responsible Risks Thinking Interdependently

EXPECTED STUDENT LEARNING OUTCOMES: (Be Specific) MATERIALS: ACTIVITY:

Program Leader’s Name:

Grade:

Date/Day of Week:



16

Appendix VI: Family Literacy

ExCEL After School Programs 21stCCLC Family Literacy Grant Requirements

for ALL ExCEL programs (including ASES, 21st Century and ASSETS programs)

REVISED 07.2013

FAMILY LITERACY is one of two 21st Century optional grants that are available on a competitive basis. Note: Family Literacy grant funds may be expended only for those services and supports for which they were granted.

FUND USES:

• The funds should be spent for on‐going programs and services for parents and adult family members of ExCEL after school students.

• Family Literacy funds cannot be the only funding source used to support “combination” events that serve the entire school community. For such joint efforts, the costs must be paid using multiple funding sources.

• A portfolio of funded activities and resources must be submitted to ExCEL at the end of each semester. o Requirements are listed on the Portfolio Coversheet form

• All activities/events must be pre‐approved by the ExCEL Family Literacy District Coordinator prior to

implementing to ensure full grant access and reimbursement.

The following are recommended options for compliant expenses using grant funds:

Up to .25 FTE Parent Liaison plus related fringe costs @ 20%

Supplies and instructional materials (not to exceed $3000 per site)

Translator staffing costs for materials and during activities

Adult education classes: 2‐3 eight‐week classes/year; minimum of 20 students per class required

Monthly workshops/trainings related to family literacy needs and role of child's primary teacher

Healthy snack for each Family Workshop

ExCEL After School Programs 21stCCLC Family Literacy Grant Requirements

REVISED 07. 2013

FAMILY LITERACY is one of two 21st Century optional grants that are available on a competitive basis. Note: Family Literacy grant funds may be expended only for those services and supports for which they were granted.

FUND USES:

• The funds should be spent for on‐going programs and services for parents and adult family members of ExCEL after school students.

• Family Literacy funds cannot be the only funding source used to support “combination” events that serve the entire school community. For such joint efforts, the costs must be paid using multiple funding sources.

• A portfolio of funded activities and resources must be submitted to ExCEL at the end of each semester. o Requirements are listed on the Portfolio Coversheet form

• All activities/events must be pre‐approved by the ExCEL Family Literacy District Coordinator prior to

implementing to ensure full grant access and reimbursement.

The following are recommended options for compliant expenses using grant funds:

Up to .25 FTE Parent Liaison plus related fringe costs @ 20%

Supplies and instructional materials (not to exceed $3000 per site)

Translator staffing costs for materials and during activities

Adult education classes: 2‐3 eight‐week classes/year; minimum of 20 students per class required

Monthly workshops/trainings related to family literacy needs and role of child's primary teacher

Healthy snack for each Family Workshop

ExCEL FAMILY LITERACY FREQUENTLY ASKED QUESTIONS

CAN FUNDS BE USED TO:

Allowable? Related Questions‐

Contract with City College to provide adult education classes for ExCEL parents

YES

Purchase translation computer software Family Literacy funds can be used to transport adult/caregivers

Workshops related to job skills and employment preparation for parents and adult family members of ExCEL program participants

Teacher hours at a School Wide Event for parents/guardians to increase their knowledge and skills to support student academic success

Yes, with matching funds from School Site

Teachers extra hours to conduct grade level meetings with parents to increase parent/guardian skills/competencies that support their child’s academic success Extra hours for After School Program Site Coordinator to coordinate family literacy programming

Funds can be used towards a portion of the ASP Coordinator’s position If it is part of their 1.0 FTE. No overtime is allowed using Family Literacy funds.

Travel for parents and students to colleges and universities for tours related to higher education opportunities for students

$2000 limit; Target ExCEL families. Match recommended.

Family Literacy Events/workshops/classes must be held during the after school hours.

No, events/workshops/classes may be offered at days/times that meet parent’s scheduling needs.

Purchase of furniture for school’s Family Resource Center

No, furnishing of Family Resource Centers is not allowable.

Important: When in doubt, please contact the ExCEL office with questions about proposed expenditures at your site. Please submit and secure written approval for expenses before expending funds.

Thank you.



17

Appendix VII:

CCTC Foreign Transcript requirements for

Instructional Aide requirement

CL-635 05/12 Page 1 of 3

FOREIGN TRANSCRIPT EVALUATION

Individuals who have completed college or university course work at an institution in a country other than the United States must obtain a complete evaluation of foreign transcripts, degrees*, and other relevant documents prior to applying to the Commission for a California credential, permit, or certificate. A detailed, course-by-course, foreign transcript evaluation is required any time foreign course work is used to meet any credential requirement, even if the foreign course work has been accepted by a college or university in the United States. The only exception to this is for those individuals applying for an Emergency 30-Day Substitute Permit, for which a general report is sufficient. Foreign transcripts must be evaluated by one of the approved organizations listed on this leaflet in order to be accepted by the Commission. These organizations are private enterprises who charge a fee for their services. Individuals seeking a foreign transcript evaluation must follow the procedures outlined by the organization providing the evaluation. In all instances, original, official documentation will be required when requesting the evaluation. *The bachelor’s degree requirement for California certification refers to the equivalent of a four-year (or more) college-level program. Individuals who obtained a credential or teaching certificate in a jurisdiction outside of the United States should also submit a photocopy of that document to the evaluating agency AGENCIES APPROVED BY THE COMMISSION FOR FOREIGN TRANSCRIPT EVALUATION

Academic & Professional International Evaluations, Inc. P.O. Box 5787 Los Alamitos, CA 90721-5787 (562) 594-6498 Website: http://www.apie.org

Academic Credentials Evaluation Institute P.O. Box 6908 Beverly Hills, CA 90212 (310) 275-3530 (800) 234-1597 Fax: (310) 275-3528 Website: http://www.acei1.com

Academic & Credential Records, Evaluation & Verification Services (ACREVS) 1776 Clear Lake Avenue

Milpitas, California 95035-7014 (866) 583-4834 Toll Free

(408) 719-0015 Email: [email protected] Website: http://www.acrevs.com

State Of California Commission On Teacher Credentialing

1900 Capitol Avenue Sacramento, CA 95811-4213

Email: [email protected] Website: www.ctc.ca.gov

http://www.apie.org/�

http://www.acei1.com/�

mailto:[email protected]�

http://www.acrevs.com/�


http://www.ctc.ca.gov/�

CL-635 05/12 Page 2 of 3

American Education Research Corporation P.O. Box 996 West Covina, CA 91793-0996 (626) 339-4404 Fax: (626) 339-9081 Website: http://www.aerc-eval.com

Educational Credential Evaluators, Inc. P.O. Box 514070 Milwaukee, WI 53203-3470 (414) 289-3400 Fax: (414) 289-3411 Email: [email protected] Website: http://www.ece.org

Educational Records Evaluation Service 601 University Avenue, Suite 127 Sacramento, CA 95825 (866) 411-3737 (916) 921-0790 Fax: (916) 921-0793 Email: [email protected] Website: http://www.eres.com

Institute for International Credentials Evaluations at California State University, Fresno 5150 North Maple Avenue, M/S JA56 At California State University, Fresno Fresno, CA 93740-8026 (559) 278-7622 Fax: (559) 278-7879

Email: [email protected] Website: http://www.csufresno.edu/issp/home/index.shtml

International Education Research Foundation, Inc. Credentials Evaluation Service P.O. Box 3665 Culver City, CA 90231-3665 (310) 258-9451 Fax: (310) 342-7086 Email: [email protected] Website: http://www.ierf.org Request a Detailed Report. On an IERF’s application, Section 2, please check the following:

1. Professional Licensing/Certification. Field: Teaching State: CA

http://www.aerc-eval.com/�


http://www.ece.org/�


http://www.eres.com/�


http://www.csufresno.edu/issp/home/index.shtml�


http://www.ierf.org/�

CL-635 05/12 Page 3 of 3

World Education Services (WES) P.O. Box 5087 Bowling Green Station New York, NY 10274-5087 Telephone: (212) 966-6311 Fax: (212) 739-6239 Email: [email protected] Website: http://www.wes.org

AND

WES - San Francisco Regional Office Telephone: (415) 677-9378 Fax: (415) 677-9333 Email: [email protected]

Additional Information All of the listed evaluation agencies offer rush services at an additional cost. Contact the agency for more information on fees and other requirements for the evaluation. If you are seeking a credential to teach in the public schools of California, refer to the leaflets below for specific requirements for teachers prepared outside of the United States.

• Elementary Teaching (Multiple Subject Teaching Credential) (CL-871) • Secondary Teaching (Single Subject Teaching Credential) (CL-870) • Special Education Teaching (Education Specialist Instruction Teaching Credential) (CL-872) • Day-to-Day Substitute Teaching (Emergency 30-Day Substitute Teaching Permits) (CL-505P) • All Other Teaching – visit the Commission’s website at http://www.ctc.ca.gov


http://www.wes.org/�


http://www.ctc.ca.gov/credentials/leaflets/cl871.pdf�



http://www.ctc.ca.gov/credentials/leaflets/cl505p.pdf�

http://www.ctc.ca.gov/�



18

Appendix VIII: Subcontractor Requirements

San Francisco Unified School District

ExCEL After School Programs

Subcontractor FAQ Fall 2012

Per the After School Program Contract:

• Subcontractors are subject to the prior approval by the district (30 days)

• Contractor is responsible for subcontractors including but not limited to:

a. Section 9 (“Independent Contractor”),

b. Section 10 (“Insurance”),

c. Section 11 (“Indemnification”),

d. Section 22 (“Criminal Background Checks; Subsequent Arrest Notification”),

e. Section 23 (“Tuberculosis Testing”)

f. Section II(g)(1) of Appendix A (Instructional aide qualifications )

• If a subcontractor is listed in an executed contract, the subcontractor has been approved. You

are required to ensure that the subcontractor has the required TB/CBC, insurance, etc.

• If a subcontractor is not listed in your executed contract, you must request approval at least 30

days prior to the start of the subcontractor. Attach a copy of the MOU, insurance

documentation and TB/CBC clearance.

• Insurance: If the subcontractor is an individual, they must meet the insurance requirements for

an “Individual Services Agreement”. If the subcontractor is an organization, they must meet the

insurance requirements for an “Organizational Services Agreement”.

• An organization or individual providing services for fee OR at no cost is considered a

subcontractor in terms of TB/CBC clearance and insurance documentation.

SFUSD – Services Agreement for Individuals: FY 2012-2013

Page 12 of 19

9. INDEMNIFICATION

Contractor shall indemnify and hold harmless the District, its Board, officers, employees and agents from, and, if requested, shall defend them against any and all claims, demands, liabilities, obligations, losses, damages, judgments, costs or expenses (including legal fees and costs of investigation) (collectively “Claim”), whether actual or alleged, arising directly or indirectly from or in any way connected with the performance of this Agreement, including but not limited to any Claim for personal injury, death, property damage, loss of profits, infringement upon intellectual property rights, failure to comply with the criminal background check requirements of Education Code section 45125.1 and/or disclosure of confidential information which might be obtained by Contractor or Contractor’s agents or employees during the performance of this Agreement. Notwithstanding the foregoing, Contractor shall have no obligation under this Section with respect to any Claim that is caused by the active negligence or willful misconduct of District and which is not contributed to by any act or omission (including any failure to perform any duty imposed by law) by Contractor or Contractor’s agents or employees.

10. INSURANCE

a. Without in any way limiting Contractor’s liability pursuant to the “Indemnification” section of this Agreement, Contractor shall procure and maintain during the full term of this Agreement the following insurance amounts and coverage: 1) General Liability Insurance with limits not less than $250,000 (Two Hundred Fifty

Thousand dollars) 2) Automobile Liability Insurance with limits not less than $100,000 (One Hundred

Thousand dollars) each occurrence Combined Single Limit for Bodily Injury and Property Damage, including Owned, Non-Owned and Hired auto coverage, as applicable

b. General Liability policy must provide the following: 1) Name as Additional Insured the San Francisco Unified School District, its Board, officers

and employees. 2) That such policy is primary insurance to any other insurance available to the Additional

Insured, with respect to any claims arising out of this Agreement and that such policies apply separately to each insured against who claim is made or suit is brought.

c. All policies shall provide thirty (30) days advance written notice to the District of cancellation, non-renewal or reduction in coverage to the following office:

Contracts Office 135 Van Ness Street, Room 102 San Francisco, CA 94102 d. If any policies are written on a claims-made form, Contractor agrees to maintain such coverage

continuously throughout the term of this Agreement and, without lapse, for a period of three years beyond the expiration of this Agreement, such that should occurrences during the Agreement term give rise to claims made after expiration of the Agreement, such claims shall be covered.

e. Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit or provides that claims investigation or legal defense costs are included in such general annual aggregate limit, such annual aggregate limit shall be double the occurrence or claims limits specified above.

f. Should any required insurance lapse during the term of this Agreement, requests for payments originating after such lapse shall not be processed until the District receives satisfactory evidence of reinstated coverage as required by this Agreement, effective as of the lapse date. If insurance is not reinstated, the District may, at its sole option, terminate this Agreement effective on the date of such lapse of insurance.

g. Before commencing any operations under this Agreement, Contractor must provide the District with the certificates of insurance, and additional insured policy endorsement and with insurers satisfactory to the District, evidencing all coverages set forth above, and shall furnish complete copies of policies promptly upon the District's request. Contractor also understands and agrees that the District may withhold payment for services performed for any violations of the insurance provisions of this Agreement.

SFUSD – Services Agreement for Individuals: FY 2012-2013

Page 13 of 19

h. Approval of the insurance by the District shall not relieve or decrease the liability of Contractor hereunder.

For Individual $10,000.00 and under insurance waiver approved by:

CABINET MEMBER SIGNATURE:

INSERT CABINET MEMBER NAME

CABINET MEMBER TITLE: INSERT CABINET MEMBER TITLE

11. LIABILITY OF DISTRICT DISTRICT’S PAYMENT OBLIGATIONS UNDER THIS AGREEMENT SHALL BE LIMITED TO THE PAYMENT PROVIDED FOR IN SECTION C (“COMPENSATION”) OF THIS AGREEMENT. DISTRICT SHALL NOT BE LIABLE FOR ANY SPECIAL CONSEQUENTIAL, INDIRECT OR INCIDENTAL DAMAGES, INCLUDING BUT NOT LIMITED TO LOST PROFITS IN CONNECTION WITH THIS AGREEMENT.

12. DEFAULT

Contractor shall be in default if Contractor: (a) fails to perform any term, covenant, or condition contained in this Agreement; (b) files or is the subject of a petition for bankruptcy or insolvency; or, (c) has a court-ordered receiver or trustee appointed with respect to Contractor’s assets.

13. REMEDIES

If a default under Section 12 (“Default”) has occurred and is continuing, the District may, individually or in combination with any other remedy: a. terminate this Agreement; b. offset the amount of any outstanding liability of Contractor against funds otherwise due and owing

hereunder or any other agreement with Contractor; c. withhold funds due hereunder; d. cure the default, in which event all amounts expended by the District in effecting such cure shall

be payable upon demand, with interest from the date of incurrence at the maximum rate permitted by law; or

e. exercise any other remedy available by law. The District shall have no obligation to exercise any of the foregoing remedies.

14. TERMINATION FOR CONVENIENCE

District may terminate this Agreement without cause or penalty upon thirty (30) days’ prior written notice to Contractor. In such event, Contractor shall continue to perform services until the termination effective date and Contractor will be paid for those services satisfactorily performed through such date.

15. CONFLICT OF INTEREST

a. Conflict of Interest Standards. The following is a brief overview of conflict of interest laws and policies. Contractor is responsible to know, and comply with, the full requirements of the law.

SFUSD – Services Agreement for Organizations: FY 2012-2013

Page 10 of 19

GENERAL CONDITIONS TO PERSONAL SERVICES AGREEMENT FOR ORGANIZATIONS 1. AVAILABILITY OF FUNDS; BUDGET AND FISCAL PROVISION; TERMINATION IN THE

EVENT OF NON-APPROPRIATION a. This Agreement is subject to the budget and fiscal policies, regulations and practices of the

District, and approval and appropriation of funds for this Agreement. Charges will accrue only after prior written authorization is provided by the District’s Board of Education, proper execution of this Agreement by the parties, and certification by the Chief Financial Officer as to the availability of funds.

b. The amount of the District’s obligation hereunder shall not at any time exceed the amount herein stated.

c. The District has no obligation to renew this Agreement after expiration of its term. If funds are appropriated for a portion of a fiscal year, this Agreement will terminate, without penalty, at the end of the term for which funds are appropriated.

d. Contractor’s assumption of risk of possible non-appropriation is part of the consideration for this Agreement.

e. This section controls against any and all other provisions of this Agreement.

2. CONTRACT EVALUATION FEE

Where the services to be provided by Contractor under this Agreement have been designated as Evaluation Level IV on the Board Resolution, Contractor understands and agrees that a contract evaluation fee of up to 5% (five percent) of the total Agreement amount (including, but not limited to, payments for services and expenses) may be assessed by the District on this Agreement. The monies collected through this fee will be used to monitor and evaluate these Agreements to guarantee that the promised services are provided in a timely and effective manner. This evaluation fee shall apply only to those Agreements in excess of $2,500.00. The fee may be deducted from the District funds encumbered to pay Contractor at any time during or following the term of the Agreement and this section shall survive the termination or expiration of this Agreement. If the parties later amend this Agreement to increase payments to Contractor, those increases will also be subject to the 5% assessment.

3. DISALLOWANCE

a. If Contractor claims or receives payment from the District for a service, reimbursement for which is later disallowed by the State of California or United States Government, Contractor shall promptly refund the disallowed amount to the District upon the District’s request. At its option, the District may offset the amount disallowed from any payment due or to become due to Contractor under this Agreement or any other Agreement.

b. By executing this Agreement, Contractor certifies that Contractor is not suspended, debarred or otherwise excluded from participation in federal or state programs. Contractor acknowledges that this certification of eligibility to receive state or federal funds is a material term of this Agreement.

4. SUBMITTING FALSE CLAIMS; MONETARY PENALTIES

Pursuant to Government Code §12650 et. seq., any person, including a contractor, subcontractor or a consultant, who submits a false claim, shall be liable to the District for three times the amount of damages which the District sustains because of the false claim. A person who commits a false claim act shall also be liable to the District for the costs of a civil action brought to recover any of those penalties or damages, and may be liable to the District for a civil penalty of up to ten thousand dollars ($10,000) for each false claim. A person will be deemed to have submitted a false claim to the District if the person: a. knowingly presents or causes to be presented to an officer or employee of the District, a false

claim for payment or approval; b. knowingly makes, uses, or causes to be made or used a false record or statement to get a false

claim paid or approved by the District; c. conspires to defraud the District by getting a false claim allowed or paid by the District; d. has possession, custody, or control of public property or money used or to be used by the

District and knowingly delivers or causes to be delivered less property than the amount for which the person receives a certificate or receipt;


Page 11 of 19

e. is authorized to make or deliver a document certifying receipt of property used or to be used by the District and knowingly makes or delivers a receipt that falsely represents the property used or to be used;

f. knowingly buys, or receives as a pledge of an obligation or debt, public property from any person who lawfully may not sell or pledge the property;

g. knowingly makes, uses, or causes to be made or used a false record or statement to conceal, avoid, or decrease an obligation to pay or transmit money or property to the District; or

h. is a beneficiary of an inadvertent submission of a false claim to the District, subsequently discovers the falsity of the claim, and fails to disclose the false claim to the District within a reasonable time after discovery of the false claim.

5. PAYMENT DOES NOT IMPLY ACCEPTANCE OF WORK

No payment shall in any way lessen the liability of Contractor to remedy or replace unsatisfactory work, service, equipment, or materials, if the unsatisfactory character of such work, service, equipment or materials was not detected at the time of payment. Service, materials, equipment, components, or workmanship that do not conform to the requirements of this Agreement may be rejected by the District and in such case must be remedied or replaced by Contractor without delay at no additional cost to the District.

6. QUALIFIED PERSONNEL

Work under this Agreement shall be performed only by competent personnel under the supervision of and in the employment of Contractor. Contractor will comply with the District’s reasonable requests regarding assignment of personnel, but all personnel, including those assigned at the District’s request, must be supervised by Contractor. Contractor shall commit adequate resources to complete the project schedule specified in this Agreement.

7. RESPONSIBILITY FOR EQUIPMENT

The District shall not be responsible for any damages to persons or property as a result of the use, misuse or failure of any equipment used by Contractor, or by any of its employees, even though such equipment may be furnished, rented or loaned to Contractor by the District.

8. TAXES

Contractor shall pay all taxes levied in connection with this Agreement, or the services delivered pursuant hereto.

9. INDEPENDENT CONTRACTOR

a. Contractor or any agent or employee of Contractor shall be deemed at all times to be an independent contractor and not an employee of the District. Contractor shall be wholly responsible for the manner in which it performs the services required of it under this Agreement. Nothing contained in this Agreement shall be construed as creating an employment or agency relationship between the District and Contractor or its agents and employees.

b. Any terms in this Agreement referring to direction from the District shall be construed as providing for direction as to policy and the result of Contractor’s work only, and not as the means by which such a result is obtained. The District does not retain the right to control the means or the method by which Contractor performs work under this Agreement. Nothing contained in this Agreement shall be construed as creating an employment or agency relationship between the District and Contractor or its agents and employees.

c. If any governmental authority should, nevertheless, determine that Contractor is an employee, then the District’s payment obligations hereunder shall be reduced so that the aggregate amount of payments directly to Contractor and to the applicable governmental authority does not exceed the maximum amount specified in this Agreement under Section C., “Compensation”. Contractor shall refund any amounts necessary to effect such reduction.

d. Contractor shall also complete and file with the District the attached W-9 form.

10. INSURANCE


Page 12 of 19

a. Without in any way limiting Contractor’s liability pursuant to the “Indemnification” section of this Agreement, Contractor shall procure and maintain during the full term of this Agreement the following insurance amounts and coverage: 1) Commercial General Liability Insurance with limits not less than $1,000,000 (one million

dollars) each occurrence Combined Single Limit for Bodily Injury and Property Damage (including coverage for claims of sexual abuse and molestation).

2) Automobile Liability Insurance with limits not less than $1,000,000 (one million dollars) each occurrence Combined Single Limit for Bodily Injury and Property Damage, including Owned, Non-Owned and Hired auto coverage, as applicable

3) Workers’ Compensation Insurance, with Employer’s Liability limits not less than $1,000,000 (one million dollars) each accident.

4) Crime coverage for losses resulting from employee dishonesty naming the District as a loss payee with limits of no less than $100,000 per occurrence. Such coverage should be primary and noncontributory to any other coverage available to the District with respect to claims arising out of Contractor’s performance under this Agreement.

b. Commercial General Liability policy must provide the following: 1) Name as Additional Insured the San Francisco Unified School District, its Board,

officers and employees. 2) That such policy is primary insurance to any other insurance available to the Additional

Insured, with respect to any claims arising out of this Agreement and that such policies apply separately to each insured against who claim is made or suit is brought.

c. All policies shall provide thirty (30) days advance written notice to the District of cancellation, non-renewal or reduction in coverage to the following office:

Contracts Office 135 Van Ness Street, Room 102 San Francisco, CA 94102 d. If any policies are written on a claims-made form, Contractor agrees to maintain such coverage

continuously throughout the term of this Agreement and, without lapse, for a period of three years beyond the expiration of this Agreement, such that should occurrences during the Agreement term give rise to claims made after expiration of the Agreement, such claims shall be covered.

e. Should any of the required insurance be provided under a form of coverage that includes a general annual aggregate limit or provides that claims investigation or legal defense costs are included in such general annual aggregate limit, such annual aggregate limit shall be double the occurrence or claims limits specified above.

f. Should any required insurance lapse during the term of this Agreement, requests for payments originating after such lapse shall not be processed until the District receives satisfactory evidence of reinstated coverage as required by this Agreement, effective as of the lapse date. If insurance is not reinstated, the District may, at its sole option, terminate this Agreement effective on the date of such lapse of insurance.

g. Before commencing any operations under this Agreement, Contractor must provide the District with the certificates of insurance, and additional insured policy and with insurers satisfactory to the District, evidencing all coverages set forth above, and shall furnish complete copies of policies promptly upon the District's request. Contractor also understands and agrees that the District may withhold payment for services performed for any violations of the insurance provisions of this Agreement.

h. Approval of the insurance by the District shall not relieve or decrease the liability of Contractor hereunder.

11. INDEMNIFICATION

Contractor shall indemnify and hold harmless the District, its Board, officers, employees and agents from, and, if requested, shall defend them against any and all claims, demands, liabilities, obligations, losses, damages, judgments, costs or expenses (including legal fees and costs of investigation) (collectively “Claim”), whether actual or alleged, arising directly or indirectly from or in any way connected with the performance of this Agreement, including but not limited to any Claim for personal injury, death, property damage, loss of profits, infringement upon intellectual property rights, failure to comply with the criminal background check requirements of Education Code section 45125.1 and/or disclosure of confidential information which might be obtained by Contractor or Contractor’s agents or employees during the performance of this Agreement. Notwithstanding the foregoing, Contractor shall



19

Appendix IX: Student Forms

(injury, incident, field trip etc)

Page 1 of 4

**SAMPLE**

[CBO NAME HERE] ExCEL AFTER SCHOOL PROGRAMS

OVERNIGHT OR EXPERIENTIAL FIELD TRIP PERMISSION FORM ACKNOWLEDGEMENT AND ASSUMPTION OF RISK

AND WAIVER OF CLAIMS

Please read this document carefully before signing. It contains important information and advises of certain risks. Participant and family are asked to acknowledge and assume risks and waive claims they might have in the event of injury or other loss. This document must be signed by the Participant (student) and by at least one parent or legally appointed guardian. If the Participant (student) is over the age of 18, s/he can sign on behalf of him/her self. Name of Field Trip: Location(s) of Field Trip: Departure Date, Time and Location: Return Date, Time and Location: List Trip Activities: (ie) hiking, swimming, rafting, camping, climbing, etc.

No. of students expected to participate: Names of supervising teacher(s), program staff, chaperone(s):

Mode(s) of Transportation (List in detail transportation mode and description for each segment of the educational trip): If traveling by automobile, name(s) of approved driver(s):

*Volunteer drivers must complete [CBO Name] Agreement for Volunteer Drivers prior to trip (if applicable) What the Participant should bring for the trip:

Acknowledgements and Agreements of Participant and Parent

Page 2 of 4

I, Participant and Parent/Guardian (hereinafter “parent”) of minor Participant, for myself and

on behalf of a minor Participant for whom I sign acknowledge and agree as follows:

1. Participation is Voluntary. I acknowledge that this field trip is voluntary and attendance by the Participant is not required and that an alternative educational activity will be provided if the parent/guardian does not give permission for him/her to participate.

2. Acknowledgment of Risks. I acknowledge and understand that the activities

involved in this trip (as detailed in list of trip activities on page 1) may be dangerous and include risks which are inherent and cannot be reasonably avoided without changing the nature of the activity. I acknowledge that participation in the activities can cause personal injury, including emotional trauma and even death.

3. Assumption of Risks. I acknowledge and expressly assume all risks and

dangers associated with all field trip activities, whether described above, known or unknown, and inherent or otherwise. I take full responsibility for any injury or loss, including death, which Participant may suffer, arising in whole or in part from the enrollment and participation of the minor Participant for whom I sign, in the activities of the trip.

For Wilderness Trips: Trips in the wilderness will be without ready access to emergency rescue or medical aid. As on all wilderness trips, the terrain, the weather (including the possibility of unexpected storms), potential encounters with wildlife, and travel to and from the trailheads in motor vehicles all subject the participants to risk of accident, injury, and even death. While all trip activities will be supervised by qualified and experienced personnel, and while safety will be our primary concern, it is impossible to guarantee that accidents will not happen.

4. Participant Conduct and Capability to Participate: It is understood that the Participant will follow direction from the bus driver(s), teacher(s), chaperone(s) and, if applicable, adult sponsors, at all times. I acknowledge that the Participant is to abide by all rules and regulations governing conduct during the trip. I certify that the Participant is fully capable of participating in these activities, without causing harm to him/herself or others.

5. Dismissal of Participant. I acknowledge that the [CBO NAME] reserves the

right to dismiss any participant from a trip or program that staff believes, in their discretion, presents a safety concern or medical risk, is disruptive, and/or otherwise conducts him/herself in a manner detrimental to [CBO NAME]. Use of illegal drugs, tobacco products or alcohol, or disregarding instructions, rules or regulations are examples of conduct that [CBO NAME] considers detrimental to its program, and that can lead to early dismissal. If Participant is dismissed or departs for any reason, Participant (and his/her parent/guardian) are responsible for all costs of early departure, whether for medical reasons, dismissal, personal emergencies or otherwise. These costs include, but are not limited to, medical evacuation and costs, travel, and compensation and expenses for staff accompanying Participant.

6. Indemnification for Injury Caused by Participant. Parent of minor

Participant may be held liable and responsible for any injury or death to another person or injury to property of another caused by the minor Participant, as required by law. I hereby AGREE TO INDEMNIFY (meaning to defend, and to satisfy by payment or reimbursement, including costs and attorneys fees) AND HOLD HARMLESS [CBO NAME].

Page 3 of 4

7. Transportation. I acknowledge that each participant is required to go and

return from an excursion/field trip by means of the transportation provided, arranged or agreed to by [CBO NAME].

8. Medical Treatment/Emergencies. In the event that I, or other

parent/guardian, cannot be reached in an emergency, I give CBO staff the authority to obtain immediate medical attention for Participant. I do hereby consent to whatever x-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care are considered necessary in the best judgment of the attending physician, surgeon or dentist and performed by or under the supervision of the medical staff of the hospital or facility furnishing medical or dental services.

PARENT/GUARDIAN SECTION: MUST BE COMPLETED Parent/Guardian Phone Contact During Time of Trip: Name: Work Phone: Cell Phone: Home Phone: Name: Work Phone: Cell Phone: Home Phone: Other Emergency Contact: Name: Work Phone: Cell Phone: Home Phone: (Other emergency contact is not used to authorize medical treatment) Physician and Insurance Information: Name: Medical Insurance Type and Number: Phone: Student Medical Needs for Trip (Allergies/Medical Conditions/Physical Limitations/Medications): IF PARTICIPANT IS A MINOR: I acknowledge that I have carefully read this document and understand the information therein. I agree to each of the terms and acknowledgments above, and agree to permit my child to participate in the trip described above. _______________________________________________ Date:_________________ Signature of Participant (Student under age 18)

Page 4 of 4

_______________________________________________Date:_________________ Signature of Parent/Guardian (in individual capacity and on behalf of Participant) _______________________________________________ Parent/Guardian Name (Please Print) IF PARTICIPANT IS AN ADULT OVER 18: I acknowledge that I have carefully read this document and understand the information therein. I agree to each of the terms and acknowledgments above, and sign this document on behalf of myself, so that I may participate in the trip described above. _______________________________________________Date:_________________ Signature of Participant (Student over age 18)

Executive Director’s Approval

[CBO Name] School

Location of Incident

Date of Incident Time of Incident

Names of Persons Involved:

Victim(s) & Ethnicity Assailant(s) & Ethnicity Witness(es) & Ethnicity

V1 | A1 | W1 |

V2 | A2 | W2 |

V3 | A3 | W3 |

V4 | A4 | W4 |

CHECK ONE FROM THE FOLLOWING LIST: Alcohol/drug possession Battery Hate Violence Sexual Harassment Tobacco use/possession

Alcohol/drug use Burglary Property Damage Theft Weapon possession Arson Defiance/Disruption Robbery/Extortion Threats/Intimidation

Assault w/deadly weapon Graffiti Sex offense Other read below

Describe Circumstances of Incident

Describe the Action Taken

Administrator Notified (name/title) Date/Time

Caregiver notified Yes Prior to calling SFPD? No Telephone Name

Name/Title of Person Making Contact

If the caregiver was NOT contacted, explain

Police called No By whom (name/title)

SFPD Officer’s Name Star # SFPD Report #

Names of persons present during police interview of student(s)

SFUSD Student Injury Report Completed No Attach if “Yes”

Name/Signature of Person Completing Report

Title/Position Date/Time

Name/Signature of Administrator Reviewing Report

Title/Position Date/Time

FAX 1 COPY TO CBO OFFICE.

SEND 1 COPY TO YOUR ExCEL DISTRICT COORDINATOR BY THE CLOSE OF BUSINESS ON DATE OF

INCIDENT.

CO

NF

IDE

NT

IAL

**SAMPLE**

[CBO NAME]

EXCEL AFTER SCHOOL PROGRAMS

FIELD TRIP PERMISSION FORM AND WAIVER

Your child will participate in a field trip for the ExCEL After School Program administered by

[CBO NAME]. Such trips are always under the supervision of [CBO NAME] After School

Program staff and all precautions are taken to ensure each student’s welfare.

Student Name: _________________________________________________________________

Field Trip Location and Address: ___________________________________________________

The trip will depart from and return to: (school name) __________________________________

Field Trip Date: ________________________________________________________________

Trip Description. The field trip will involve the following activities: (Describe trip and

activities in detail. ______________________________________________________________

_____________________________________________________________________________

Class or group(s) attending: ____________ ___________Number of Students:___________

Items Student Should Bring (if any): ___________________________

Names of teacher(s), staff, coach(es), chaperone(s): __________________________________

_____________________________________________________________________________

Transportation. (Describe transportation (ie) walking, MUNI, BART, Caltrain, First Student

Bus, Chartered S.F. MUNI #1 and #44 bus lines

1. I understand this field trip is optional and attendance by my child is not required and that an

alternative activity at the After School Program will be provided if I do not give permission

for my child to participate.

2. I understand that all students going on this trip will be responsible in conduct to the bus

driver(s), to teachers, and, if applicable, adult sponsors at all times.

3. I understand that all field trips begin and end at the Program and that all students are required

to go and return from this event on the transportation provided, unless prior arrangements

have been made and agreed to in writing by the principal or Site Coordinator.

AUTHORIZATION TO TREAT MINOR: In the event that I, or other parent/guardian, cannot

be reached in an emergency, I hereby give permission to the school staff to secure proper

treatment for my child. I do hereby consent to whatever x-ray, examination, anesthetic, medical,

surgical or dental diagnosis or treatment and hospital care are considered necessary in the best

judgment of the attending physician, surgeon or dentist and performed by or under the

supervision of the medical staff of the hospital or facility furnishing medical or dental services.

PARENT/GUARDIAN SECTION: MUST BE COMPLETED

Print Name(s) of Parent/Guardian:

2

Parent/Guardian Work Phone:

Parent/Guardian Work Phone:

Emergency Contact Person:

Emergency Phone Number:

Pagers, cell phones, e-mail:

Physician/Health Insurance Name:

Policy Number:

Phone:

Student's Critical Medical Needs/Allergies/Conditions:

I acknowledge that I have carefully read this document and understand the information

therein. I agree to each of the terms and acknowledgments above, and agree to permit my

child to participate in the trip described above.

Date: ___________ Parent /Guardian Signature:

CHAPERONES: If agreement has been reached with the supervising teacher, and I chaperone

students on this trip, I will comply with all of [CBO NAME] requirements pertaining to the

chaperoning of students.

Print Name __________________________Signature__________________________

Executive Director’s Approval



20

Appendix X: Allowable Expenses



1 | P a g e A u g u s t 2 0 1 2

GENERAL GUIDANCE:

Expenses must supplement and not SUPPLANT school activities. Items purchased must be utilized

entirely for ExCEL student programming or multiple funding sources must be utilized i.e match funds.

Furlough days- NO on-site activities or programming for students taking place during SFUSD furlough

days may be billed.

School-wide expenses may not be funded solely using ExCEL grant funds. With pre-approval, a portion of

event, postage or other related expense may be allowable if directly related to the ExCEL program

students.

Please note: It is difficult to be all inclusive in a list of what is allowed. We cannot anticipate everything

so, when in doubt, please ASK your District Coordinator. We want to work with you and make the

invoicing process as simple as possible.

All ExCEL Approval forms must be submitted for review and pre-approval IN ADVANCE of any


ADMINISTRATIVE EXPENSES:

The following are examples of Administrative expenses, which are included in the allowable administrative

maximum of up to 7.5% of contract direct expenses per year. Such costs should NOT be submitted as itemized

DIRECT expenses on invoices. Examples include:

Copy machine rental

HR/Personnel related costs i.e. job posting, fingerprinting/ background checks, TB tests

Management salaries

Mileage/gas/muni pass for staff/parking

Rentals (excluding PD-related training space)

NON ALLOWABLE EXPENSES

Tips/optional gratuity for services is not an allowable expense using ExCEL Funds

Apps: “Apps” related application/monthly fees for electronic/computer devices are also NOT allowed.

Gift cards or purchases with gift cards

No “lost receipt” payments

Yearbooks are not allowable expenses.

Food for weekly meetings, refreshments for field trips, club meetings. A nutritious snack is required;

however refreshments are not allowed.

T-shirts for program staff

Any supplies for fundraising events or incentives– e.g. cooking supplies for bake sales, raffle tickets,

costume winner prize, carnival supplies, rewards for good behavior, etc.

Supplies for holiday enrichment activities – e.g.: materials for Lunar New Year, Valentine’s Day, St.

Patrick’s Day, Easter, Halloween, and Christmas.

Pizza



2 | P a g e A u g u s t 2 0 1 2

Any costs related to entertainment, amusement, social activities. Examples: Final party supplies, BBQ

supplies, Final Party Food, Lights On Dessert/table covers, YAC field trip ice cream, Hospitality

meetings, staff retreats, movie tickets, Great America, D.J.s, dances, jumpy houses.

Gifts for teachers, parents, students, etc . For example: flowers, birthday gift, get well cards

Any personal expenses including but not limited to medicine, staff parties, fundraisers, other

expenses not-related to ExCEL are NOT allowed.

EQUIPMENT: CBOs may not purchase EQUIPMENT valued at $500 or more per item. For ELECTRONICS,

*iPads or COMPUTERS, A Principal Expenditure Request Form and a quote from IT must be submitted to

your ExCEL District Coordinator for approval. These items may only be purchased through the SFUSD

Purchasing Department and tagged/inventoried according to SFUSD protocol.

ALLOWABLE EXPENSES FY 2013-2014


Americorps Non-school day portion to be paid by ExCEL only up to 50% of CBO cost

Invoice/General Ledger (GL)

Benefits If related to Direct Service staff position (ex. Site Coordinator)

GL

Direct Service Staff Site Coordinator/Assistant Coordinator and Program Leaders (Line Staff) are the only CBO staff positions to be funded using ExCEL funds

GL

Non Consumable Supplies ($100-$500 value per item)

Individual items which value $100-$500 and will be utilized for multiple years must be tagged and added to the ExCEL site inventory list upon receipt; Annual inventory must be submitted. Tagging: School site code/Year/month/item number i.e. XXX-YYYY-ZZ-00A Property of SFUSD ExCEL ASP.

Receipt/GL

Professional Development for Direct Service Staff

Training, conference registration etc. not to exceed $5000 per fiscal year using BASE grant

Invoice/GL

Supplies for Program <$1500 per order

"Consumable" items (i.e. glue, paper, cookies supplies, crayons, board games, books)

GL/receipts

Snacks/Food for students Must adhere to the SFUSD Wellness policy and grant required USDA guidelines (see attached). Additionally:

No sugar sweetened beverages

No foods with hydrogenated fat

No candy, cookies, cake, ice cream, gum, potato chips, pizza, etc.

Allowable: Pretzels, non-hydrogenated goldfish, rice cakes, bagel chips, air popped popcorn.

Receipts



3 | P a g e A u g u s t 2 0 1 2


PRE-APPROVAL REQUIRED

Supplies for Program >$1500 per order

Must submit CBO Expenditure Approval Form Expenditure Approval Form; GL/Receipts

Youth Stipends Allowable for HS ASSETS grants. Must submit CBP Expenditure Approval form


Off Site Program Activity Including Transportation*

Pre-approval is required. Submit the CBO Expenditure Approval Form. The program activity should be integral to the program summary and a lesson plan is required. The lesson plan must have specifically stated educational

objectives*

Invoice/GL; Off Expenditure approval form with lesson plan; sign in sheet, receipts

Subcontractor Must submit CBO Expenditure Approval Form for pre-approval and conform with SFUSD subcontracting requirements for insurance, TB, etc.

Invoice requires proof of payment, description and dates of services provided

Digital Media (DVDs, VHS, CDs)

Must submit CBO Expenditure Approval Form; with attached lesson plan and justification of use


Video/computer games and/or consoles

Must submit CBO Expenditure Approval Form with attached lesson plan and justification of use


Tshirts/sweatshirts/other custom printed materials* for participants

Must submit CBO Expenditure Approval Form. Tag line

required:

ExCEL After School Program Logo (on ExCEL website)

Name of School

SFUSD

Expense Approval Form, Receipts

School Wide Events

Must submit CBO Expenditure Approval form and

identify matching funds

Expenditure Approval form, Receipts



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Appendix XI: Snack FAQ

Updated June 20, 2013

SFUSD ExCEL After School Snack Program

What is a snack?

A snack is TWO COMPONENTS. It can be a protein, fruit or grain.

Students must take the TWO COMPONENTS to count as a reimbursable snack.

What are the requirements to receive snack?

School site must be at least 50% Free/Reduced status as designated by SFUSD

Turning in a completed snack application

You must post a “Justice For All” poster and snack menu at location of snack distribution.

When are the snack documents due?

o Snack Adjustments – (only if you want to change your current order): complete in EMS (Due every Friday

by 10am) See ExCEL calendar for more details.

Attendance and Snack Count - 5th

of each month- See ExCEL calendar for more details.

Who do I send paperwork to?

o Snack adjustments, Attendance and Snack Count

� Submit via: EMS

Snack Distribution

1. Snack should be distributed after school

2. Each site’s snack count MUST be reflected on the Number Sheet (each document should be

labeled clearly with your site’s name and dates of information reflected)

3. If a participant DOES NOT want one or both snack components, the participant should put the item(s)

in the SHARE BIN (a container where unwanted snacks are placed, and can be shared among the

participants)

4. Distributed and Undistributed snacks should be accounted for on EMS

5. Leftover snacks should be stored properly or DISCARDED the same day of distribution.

6. Students must physically take TWO COMPONENTS (snacks cannot be handed to students)

7. Students can not hand out snacks to other students.

TIPs

o On the first day of school, check in with cafeteria employee regarding where snacks will be located. Please do

this as early as you can as cafeteria employees usually leave after lunch.

o Email [email protected] and your District Coordinator on the days you do not receive snack by 2pm. (If you

let us know a week later, there is very little we can do.)

o Complete the snack report and attendance on time and accurately.

o For the first two weeks of school, under order snacks and purchase healthy snacks until you can determine (on

average) how many students will take a snack.

o This is what one site did to reduce the number of snacks wasted: At the beginning of the year, we understand

not every student take a snack each day so what we did was we monitored and tracked on average how many

students brought their own snacks. After two-three months, sites were able to average their number to 85-90.

We currently have 126 enrolled; however our ADA is 118-120. We have extra snacks on hand in case for those

days we fall short.



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Appendix XII: Equitable Access

All About ExCEL: ExCEL After School Program Manual

Documents