Directive to Administrators (Specify which administrators)

All Site Administrators

WAD (Wednesday) Publication Date

September 17, 2014

WAD Notice Number No. of Page

1 of 12

WAD Title

Vision and Hearing Screenings

Date Due (if applicable)

N/A Not Applicable After

May 31, 2014 From

Kim Coates

(Cabinet member or approved by one below)

Title

Executive Director, School Health Programs, SFCSD

Signature

Telephone

242-2615

Inform

( x ) Certificated Staff ( x ) Classified Staff ( x ) Parents ( x ) Post on Bulletin Board ( x ) Other: As Needed

Administrative Directive WHO: All Site Administrators and Teachers

WHAT: Vision and Hearing Screening for school age children is required by state law (CA Ed

Code, Section 49452). The following children in SFUSD are to receive vision and hearing screening during the 2014-2015 school year:

Students in grades 1 and 4; Referrals from other elementary, middle and high school grade levels; Students being referred for initial psycho-educational testing; Students with IEPs with upcoming Triennial Reviews.

WHEN: 2014-2015 School Year

WHY: Poor vision and hearing in children can interfere with coordination, acquisition of skills, achievement

of developmental milestones, and the ability to learn properly. Early detection of vision and hearing loss can provide the opportunity to correct the problem earlier, and with less interference to learning.

HOW: Responsibilities of Site Administrator

Enter screening dates on master calendar. o Please do not schedule field trips that include students being screened on screening

date. Please contact Kim Levine at 242-2615 at School Health Programs ASAP for any screening dates requiring rescheduling.

Notify staff of screening dates and procedures. o Screening instructions and materials will be mailed to your school site two weeks prior

to screening. If you do not receive your materials, please contact Kim Levine at 242-2615.

Review and implement instructions provided in this WAD. o Students must be supervised by certificated staff at all times. Any student arriving to

the screening without the presence of certificated staff will be turned away. o Within two weeks after screening, SFCSD Health Workers will record screening results

in students’ cum folders. Referrals for students who did not pass the screening will be prepared and given to Site Administrator for mailing. Please make cum folders, envelopes, and workspace available for Health Workers.

Middle Schools- please create your own screening schedule that includes the teacher name and room number. See sample screening instructions and sample referral forms. Vision and hearing screenings occur on the same day for Middle Schools.

High Schools – vision and hearing screenings are usually conducted by School District Nurses assigned to the site.

Screening Results - For all high school screenings and all screenings done on dates other

than the designated screening dates (see attached vision and hearing screening schedule), a designated employee at the site needs to add the screening results into the students’ cum folder and into Synergy.

Attached, please find the following documents related to SFUSD’s vision screening:

o Vision Screening Instructions o Vision Screening Site Information Request o Principal Letter and Vision Screening Procedure o Vision and Hearing Screening – Teacher Referral Forms o Hearing Screening –Site Information Request Form o Hearing Screening Instructions and Information o Middle School Screening Instructions for Vision and Hearing o Middle School Hearing and Vision Screening Teacher Referral Form o Hearing and Vision screening protocol for Special Education students o Vision and Hearing screening schedules

Responsibilities of Student, Family, and Community Support Department

Notify Site Administrator of screening dates (see attached screening dates) Provide screening instructions and materials to school sites (see attachments). Schedule, coordinate, and orient qualified screeners as necessary. On elementary and middle school designated screening dates (see attached vision and

hearing screening schedule), SFCSD Health Workers will record screening results in the student’s cum folder and into Synergy. A list of students that do not pass the screening, and next steps will be provided to the Site Administrator at this time.

Provide on-going consultation to school sites/screening teams Provide school sites with updated referral information.

If you have any questions, please contact the Nurse of the Day at 242-2615.

September 2 0 1 4 December 2 0 1 5 February 2 0 1 522 Sheridan 1 Alamo 2 Alice fong Yu23 B. Vista/Horace Mann K-5 2 Argonne 3 Miraloma24 Marshall 3 Lawton 4 Dianne Feinstein25 Sanchez 4 SF. Community 5 Jefferson26 WM. Cobb 4 James Lick MS 6 Glen Park29 Lakeshore 5 Alvarado 9 George Moscone30 J. Serra 8 JY Chin 10 Longfellow

9 Clarendon 11 GarfieldOctober 2 0 1 4 10 Monroe 12 Vis. Valley ES

16 Marina MS 11 Rosa Parks 13 McCoppin21 Bessie Carmichael 6-8 15 Hillcrest 17 FS Key22 Tenderloin 16 Redding 18 McKinley23 Bryant 17 SunseT 24 Rooftop 5-8 MS23 Presidio MS24 GW Carver January 2015 March 2 0 1527 Chavez 6 Lafayette 4 Jose Ortega28 Malcolm X 7 Sunnyside 4 ER Taylor29 LR Flynn 8 Comm. Sloat 5 Mission Education Center30 Bret Harte 9 Harvey Milk 6 Jean Parker

12 Yick Wo 9 SutroNovember 2 0 14 13 RL Stevenson 10 Chinese Education Center

3 Fairmount 13 Buena Vista/Horace Mann 6-8 11 Lilienthal- Scott 3-84 D. Webster 14 Grattan 11 Lilienthal- Madison K-24 Vis. Valley MS 15 Guadalupe 12 SF Montessori5 El Dorado 16 Spring Valley 13 Sherman 6 George Peabody 20 Everett MS 16 Gordon J Lau6 Roosevelt MS 22 Aptos MS 17 Gordon J Lau7 Cleveland 26 New Traditions 18 Charles Drew10 Chinese Immersion 27 AP. Giannini MS12 Paul Revere 27 Bessie Carmichael K-513 Starr King 28 Ulloa13 James Denman MS 29 Rooftop K-4 ML. King MS -TBD14 John Muir 30 West Portal17 Franciso MS18 Francisco MS20 ISA 8-12

SFUSD's HEARING SCREENING SCHEDULE 2014- 2015

October 2 0 1 4 December 2 0 1 4 February 2 0 15

6 Sheridan 1 Redding 2 Sunset7 Buena Vista/Horace Mann 2 Charles Drew 3 C Lilienthal 3-8 (Scott)9 Fairmount 4 Vis Valley ES 5 Clarendon 10 WM Cobb 4 James Lick MS 6 C. Lilienthal- Mad. K-214 J Serra 5 Moscone 9 George Peabody16 LR Flynn 8 Comm Sloat 10 Jose Ortega16 Marina MS 9 Paul Revere 12 ER Taylor17 Cleveland 11 Ulloa 13 Mc Coppin20 Bryant 12 SF Community 17 Glen Park21 Cesar Chavez 15 Sutro 23 G. J Lau Site 121 Bessie C. MS. 6-8 16 Garfield 24 G.J. Lau Site 223 Hillcrest 24 Rooftop 5-823 Presidio MS January 2 0 15 26 Lakeshore24 El Dorado 6 Grattan 27 West Portal ( 2 Doctors)27 Marshall 8 Bessie C. K-5 March 2 0 1 5

28 Hoover MS9 San Francisco Montessori 2 Chinese Edu. Center

28 Sanchez 12 JY Chin 3 Alvarado30 Longfellow 13 Sherman 5 Guadalupe

13 Buena Vista/Horace 6-8 6 Mission Ed CenterNovember 2 0 1 4 15 Lawton 9 New Traditions

3 McKinley 16 Rosa Parks 10 Argonne4 GW Carver 20 Yick Wo 12 Rooftop K-44 Vis Valley MS 20 Everrett MS 19 RL Stevenson6 Chinese Immersion 22 Alamo 26 Jefferson6 Roosevelt MS 22 Aptos MS 13, 16, 17, 20 Open7 Tenderloin 23 Spring Valley10 Sunnyside 26 Miraloma April 2 0 1 5 13 Monroe 27 Lafayette 2 Alice Fong Yu13 James Denman MS 27 AP Giannini MS14 Malcolm X 29 Dianne Feinstein17 Harvey Milk 30 Jean Parker17 Francisco MS18 John Muir18 Francisco MS ML King MS - date TBD20 Francis S Key20 ISA MS 8-1221 Starr King24 Daniel Webster25 Bret Harte

SFUSD's VISION SCREENING SCHEDULE 2014 - 2015