Education For Homeless Children

Exhibit 1 DISTRICT EXPLANATION OF DECISION RELATED TO ELIGIBILITY, SCHOOL SELECTION, OR ENROLLMENT Instructions: The following form provides notice and explanation to a student's parent/guardian or an unaccompanied youth regarding the district's decision related to student eligibility, school selection, or enrollment. Date: __________ Name of person completing form: ______________________________ Title: _________________________ Phone number: ______________________________ In accordance with the federal McKinney-Vento Homeless Assistance Act (42 USC 11431-11435), this notification is being provided to either: Name of parent(s)/guardian(s): _________________________________________________ Name of unaccompanied student: _______________________________________________ School requested: ___________________________________________________________ District's placement decision (name of school): ____________________________________ Action(s) proposed/refused by the district related to eligibility, school selection, or enrollment: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ The district's determination regarding eligibility, school selection, or enrollment was based upon the following evidence and for the following reasons: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Other options that the district considered, if any, included the following options which were rejected for the following reasons: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Factors relevant to the district's decision and information related to the eligibility or best interest determination including the facts, witnesses, and evidence relied upon and their sources, if any: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ You have the right to appeal this decision to the district Superintendent. To do so, contact the district's homeless liaison listed below within the next ______ days to request a Dispute Form. You may provide written or verbal documentation to support your position, and may also seek the assistance of social services, advocates, and/or service providers in the dispute process. The Superintendent or designee will review all the evidence and will notify you of their decision within ______ days. If you are not satisfied with the Superintendent's decision, you may appeal to the San Mateo County Office of Education. If you are not satisfied with the county office's decision, you may then appeal to the California Department of Education. The district's homeless liaison can assist you with this appeal. CONTACT INFORMATION: District Liaison: The district liaison is one of the primary contacts between homeless families and school or district staff. They are responsible for coordinating services to ensure that homeless students enroll in school and have the opportunity to succeed academically, and mediates enrollment disputes as needed. Name of district's homeless liaison: _____________________________________________ Address: __________________________________________________________________ Phone number: _____________________________________________________________ County Liaison: If you appeal the district's decision to the county office of education, the district liaison shall forward all written documentation and related paperwork to the homeless liaison at the county office. The county liaison will review the materials and determine the eligibility, school selection, or enrollment decision within five working days of receiving the materials. They will notify you of the decision. Name of County Office of Education homeless liaison: _____________________________ Address: __________________________________________________________________ Phone number: _____________________________________________________________ State Coordinator: If you appeal the county office's decision to the California Department of Education, the county homeless liaison shall forward all written documentation and related paperwork to the State Homeless Coordinator. The state coordinator will review the district, county office, and parent/guardian information and will notify you of the decision within ten working days of receiving the materials. Name of state homeless coordinator: ____________________________________________ Address: __________________________________________________________________ Phone number: _____________________________________________________________ RIGHTS: Pending the final resolution of this dispute, including the period of all appeals, the student has the right to immediately enroll in the school requested and to participate fully in school activities at that school.