Click on the uploaded file below to access the form.

____________________________________________________________        ___/___/___         

Student's Name (Last), (First), (Middle)                            Birthday

 

___________________________________________________________    ___/___/___

School                                                    Date

 

School medications and health services are administered following these guidelines:

 

• Parent has provided a signed, dated authorization to administer medication, an epinephrine auto-injector, and/or provide the health service.

• The medication is in the original, labeled container as dispensed or the manufacturer's labeled container.

• The medication label contains the student’s name, name of the medication, directions for use, and date.

• Authorization is renewed annually and as soon as practical  when the parent notifies the school that changes are necessary.

 

                                                     

Medication/Health Care    Dosage            Route            Time at School

 

                                                

 

                                                

Administration instructions

 

                                                

 

                                                

Special Directives, Signs to Observe and Side Effects

 

    /    /    

Discontinue/Re-Evaluate/Follow-up Date

 

                                /    /    

Prescriber’s Signature (if prescription medication)    Date

 

                                            

Prescriber's Address                    Emergency Phone

 

I request the above named student carry medication at school and school activities, according to the prescription, or other medication administration instructions, and a written record kept. Special considerations are noted above. The information is confidential except as provided by the Family Educational Rights and Privacy Act (FERPA) and any other applicable law.  I agree to coordinate and work with school personnel and prescriber (if any) when questions arise. I agree to provide safe delivery of medication and equipment to and from school and to pick up remaining medication and equipment. Procedures for medication disposal shall be in accordance with federal and state law.

 

 

                                    /    /    

Parent's Signature                        Date

 

                                                    

Parent's Address                        Home Phone

 

                                                    

Additional Information                        Business Phone

                                                

        

                                                

 

                                                

Authorization Form

                                                                                    /      /                                                            /     /     .

 Student’s Name (Last), (First), Middle                 Birthday                          School                     Date

 

In order for a student to self-administer medication for asthma or any airway constricting disease:

 

• Parent/guardian provides signed, dated authorization for student medication self-administration.

 

• Physician (person licensed under chapter 148, 150, or 150A, physician, physician’s assistant, advanced registered nurse practitioner, other person licensed or registered to distribute or dispense a prescription drug or device in the course of professional practice in Iowa in accordance with section 147.107, or a person licensed by another state in a health field in which, under Iowa law, licensees in this stat may legally prescribe drugs provides written authorization containing:

 

• purpose of the medication,

• prescribed dosage,

• times or;

• special circumstances under which the medication is to be administered

 

• The medication is in the original, labeled container as dispensed or the manufacturer’s labeled container containing the student name, name of the medication, directions for use, and date.

 

• Authorization is renewed annually.  If any changes occur in the medication, dosage or time of administration, the parent is to notify school officials immediately.  The authorization shall be reviewed as soon as practical.

 

Provided the above requirements are fulfilled, a student with asthma or other airway constricting disease may possess and use the student’s medication while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property.  If the student abuses the self-administration policy, the ability to self-administer may be imposed.

 

Pursuant to state law, the school district or accredited nonpublic school and its employees are to incur no liability, except for gross negligence, as a result of any injury arising from self-administration of medication by the student.  The parent or guardian of the student shall sign a statement acknowledging that the school district or nonpublic school is to incur no liability, except for gross negligence, as a result of self-administration of medication by the student as establishing by Iowa Code 280.16.

 

                                                                                                                                                          .

          Medication                                        Dosage                     Route                        Time

 

                                                                                                                                                          .

Purpose of Medication & Administration/Instructions

 

                                                                                                                                                          .

Special Circumstances

 

Code No.  507.2E3

    Page 2 of 2

 

AUTHORIZATION-ASTHMA OR AIRWAY CONSTRICTING MEDICATION SELF-ADMINISTRATION CONSENT FORM

 

Discontinue/Re-Evaluate           /        /        .

 

Follow-up Date           /        /        .

 

                                                                                                                                                          .

Prescriber’s Signature                                                                                              Date

 

                                                                                                                                                          .

Prescriber’s Address                                                                                      Emergency Phone

 

I request the above named student possess and self-administer asthma or other airway constricting disease medication(s) at school and in school activities according to the authorization and instructions.

 

I understand the school district and its employees acting reasonably and in good faith shall incur no liability for any improper use of medication or for supervision, monitoring, or interfering with a student’s self-administration of medication.

 

I agree to coordinate and work with school personnel and notify them when questions arise or relevant conditions change.

 

I agree to provided safe delivery of medication and equipment to and from school and to pick up remaining medication and equipment.

 

I agree the information is shared with school personnel in accordance with the Family Education Rights and Privacy Act (FERPA).

 

I agree to provide the school with back-up medication approved in this form.

 

Student maintains self-administration record.

 

                                                                                                                                                          .

Parent/Guardian Signature (agrees to above statement)                                         Date

 

                                                                                                                                                          .

Parent/Guardian Address                                                                                   Home Phone

 

                                        .

Business Phone

 

Self-Administration Authorization Additional Information                                                              .

 

Code No.  507.2E2

 

PARENTAL AUTHORIZATION AND RELEASE FORM FOR THE

ADMINISTRATION OF PRESCRIPTION MEDICATION TO STUDENTS

 

                                                                                    /      /                                                            /     /     .

 Student’s Name (Last), (First), Middle                 Birthday                          School                     Date

 

School medications and health services are administered following these guidelines:

• Parent has provided a signed, dated authorization to administer medication and/or provide the health service.

• The medication is in the original, labeled container as dispenses or the manufacturer’s labeled container.

• The medication label contains the student’s name, name of the medication, directions for use, and date.

• Authorization is renewed annually and immediately when the parent notifies the school that changes are necessary.

 

                                                                                                                                                          .

          Medication                                        Dosage                     Route                        Time

 

Administration instructions:

                                                                                                                                                          .

                                                                                                                                                          .

Special Directives Signs to observe and Side Effects:

                                                                                                                                                          .

                                                                                                                                                          .

Discontinue/Re-Evaluate           /        /        .

Follow-up Date           /        /        .

 

                                                                                                                                                          .

Prescriber’s Signature                                                                                              Date

 

                                                                                                                                                          .

Prescriber’s Address                                                                                      Emergency Phone

 

I request the above named student carry medication at school and school activities, according to the prescription, instructions, and a written record kept.  Special considerations are noted above.  The information is confidential except as provided to the Family Education Rights and Privacy Act (FERPA).  I agree to coordinate and work with school personnel and prescriber when questions arise.  I agree to provide safe delivery of medication and equipment to and from school and to pick up remaining medication and equipment.

 

                                                                                                                                                          .

Parent/Guardian Signature (agrees to above statement)                                         Date

 

                                                                                                                                                          .

Parent/Guardian Address                                                                                   Home Phone

 

                                                                                                                                                          .

Additional Information                                                                                    Business Phone

CONCISE DESCRIPTIONS AND RECOMMENDATIONS FOR EXCLUSION OF CASES FROM SCHOOL

 

Readmission to School – It is advisable that school authorities require written permission from the health officer, school physician or attending physician before any pupil is readmitted to class following any disease which requires exclusion, not mere absence, from school.

    Board Policy East Buchanan Community Schools

While the school district is not responsible for reporting, the following infectious diseases are required to be reported to the state and local public health offices:

Acquired Immune    Leprosy    Rubella (German

 Deficiency Syndrome    Leptospirosis      measles)

 (AIDS)    Lyme disease    Rubeola (measles)

Amebiasis    Malaria    Salmonellosis

Anthrax    Meningitis    Shigellosis

Botulism      (bacterial or viral)    Tetanus

Brucellosis    Mumps    Toxic Shock Syndrome

Campylobacteriosis    Parvovirus B 19    Trichinosis

Chlamydia trachomatis      infection (fifth    Tuberculosis

Cholera      disease and other    Tularemia

Diphtheria      complications)    Typhoid fever

E. Coli 0157:h7    Pertussis    Typhus fever

Encephalitis      (whooping cough)    Venereal disease

Giardiasis    Plague      Chancroid

Hepatitis, viral    Poliomyelitis      Gonorrhea

 (A,B, Non A-    Psittacosis      Granuloma Inguinale

 Non-B, Unspecified)    Rabies      Lymphogranuloma

Histoplasmosis    Reye's Syndrome         Venereum

Human Immunodeficiency    Rheumatic fever      Syphilis

 Virus (HIV) infection    Rocky Mountain    Yellow fever

 other than AIDS      spotted fever

Influenza    Rubella (congenital

Legionellosis      syndrome)

 

Any other disease which is unusual in incidence, occurs in unusual numbers of circumstances, or appears to be of public health concern, e.g., epidemic diarrhea, food or waterborne outbreaks, acute respiratory illness.

NOTE:  Be sure to mail the appropriate copies to both the state and local public health offices.  School districts must submit a report weekly if there are cases of mumps, chicken pox, erythema infectiosum, gastroenteritis, influenza-like illnesses and if the number is greater than 10 percent of the school district's enrollment.

Board Policy East Buchanan Community Schools

Source:  Iowa Department of Public Health (1997).

REPORT THE FOLLOWING DISEASES IMMEDIATELY BY TELEPHONE (1-800-362-2736)

 

Reporting Physician, Hospital, or Other Authorized Person

 

Board Policy East Buchanan Community Schools

Some students who require special education need special health services in order to participate in the educational program.  These students will receive special health services in accordance with their individualized educational program.

A.    Definitions

"Assignment and delegation" - occurs when licensed health personnel, in collaboration with the education team, determine the special health services to be provided and the qualifications of individuals performing the health services.  Primary consideration is given to the recommendation of the licensed health personnel.  Each designation considers the student's special health service.  The rationale for the designation is documented.  If the designation decision of the team differs from the licensed health professional, team members may file a dissenting opinion.

"Co-administration" - the eligible student's participation in the planning, management and implementation of the student's special health service and demonstration of proficiency to licensed health personnel.

"Educational program" - includes all school curricular programs and activities both on and off school grounds.

"Education team" - may include the eligible student, the student's parent, administrator, teacher, licensed health personnel, and others involved in the student's educational program.

"Health assessment" - health data collection, observation, analysis, and interpretation relating to the eligible student's educational program.

"Health instruction" - education by licensed health personnel to prepare qualified designated personnel to deliver and perform special health services contained in the eligible student's health plan.  Documentation of education and periodic updates are on file at school.

"Individual health plan" - the confidential, written, preplanned and ongoing special health service in the educational program.  It includes assessment, planning, implementation, documentation, evaluation and a plan for emergencies.  The plan is updated as needed and at least annually.  Licensed health personnel develop this written plan with the education team.

"Licensed health personnel" - includes licensed registered nurse, licensed physician, and other licensed health personnel legally authorized to provide special health services and medications.

"Prescriber" - licensed health personnel legally authorized to prescribe special health services and medications.

"Qualified designated personnel" - persons instructed, supervised and competent in implementing the eligible student's health plan.

"Special health services" - includes, but is not limited to, services for eligible students whose health status (stable or unstable) requires:

        ∙    Interpretation or intervention,

        ∙    Administration of health procedures and health care, or

        ∙    Use of a health device to compensate for the reduction or loss of a body function.

"Supervision" - the assessment, delegation, evaluation and documentation of special health services by licensed health personnel.  Levels of supervision include situations in which licensed health personnel are:

        ∙    physically present.

        ∙    available at the same site.

        ∙    available on call.

1. Licensed health personnel will provide special health services under the auspices of the school.  Duties of the licensed personnel include the duty to:

    ∙    Participate as a member of the education team.

    ∙    Provide the health assessment.

    ∙    Plan, implement and evaluate the written individual health plan.

    ∙    Plan, implement and evaluate special emergency health services.

    ∙    Serve as liaison and encourage participation and communication with health service agencies and individuals providing health care.

    ∙    Provide health consultation, counseling and instruction with the eligible student, the student's parent and the staff in cooperation and conjunction with the prescriber.

    ∙    Maintain a record of special health services.  The documentation includes the eligible student's name, special health service, prescriber or person authorizing, date and time, signature and title of the person providing the special health service and any unusual circumstances in the provision of such services.

    ∙    Report unusual circumstances to the parent, school administration, and prescriber.

    ∙    Assign and delegate to, instruct, provide technical assistance and supervise qualified designated personnel.

    ∙    Update knowledge and skills to meet special health service needs.

2. Prior to the provision of special health services the following will be on file:

    ∙    Written statement by the prescriber detailing the specific method and schedule of the special health service, when indicated.

    ∙    Written statement by the student's parent requesting the provision of the special health service.

    ∙    Written report of the preplanning staffing or meeting of the education team.

    ∙    Written individual health plan available in the health record and integrated into the IEP or IFSP.

3. Licensed health personnel, in collaboration with the education team, will determine the special health services to be provided and the qualifications of individuals performing the special health services.  The documented rationale will include the following:

    ∙    Analysis and interpretation of the special health service needs, health status stability, complexity of the service, predictability of the service outcome and risk of improperly performed service.

    ∙    Determination that the special health service, task, procedure or function is part of the person's job description.

    ∙    Determination of the assignment and delegation based on the student's needs.

    ∙    Review of the designated person's competency.

    ∙    Determination of initial and ongoing level of supervision required to ensure quality services.

E.    Licensed health personnel will supervise the special health services, define the level of supervision and document the supervision.

 

F.    Licensed health personnel will instruct qualified designated personnel to deliver and perform special health services contained in the eligible individual health plan.  Documentation of instruction and periodic updates are on file at school.

G.    Parents will provide the usual equipment, supplies and necessary maintenance for such.  The equipment is stored in a secure area.  The personnel responsible for the equipment are designated in the individual health plan.  The individual health plan will designate the role of the school, parents, and others in the provision, supply, storage and maintenance of necessary equipment.

Board Policy East Buchanan Community Schools

WELLNESS POLICY - ADMINISTRATIVE GUIDELINES APPENDIX

The board promotes healthy students by supporting wellness, good nutrition and regular physical activity as a part of the total learning environment. The school district supports a healthy environment where students learn and participate in positive dietary and lifestyle practices.  By facilitating learning through the support and promotion of good nutrition and physical activity, schools contribute to the basic health status of students.  Improved health optimizes student performance potential.

The school district provides a comprehensive learning environment for developing and practicing lifelong wellness behaviors.  The entire school environment, not just the classroom, shall be aligned with healthy school district goals to positively influence a student’s understanding, beliefs and habits as they relate to good nutrition and regular physical activity.

The school district supports and promotes proper dietary habits contributing to students’ health status and academic performance.  All foods available on school grounds and at school-sponsored activities during the instructional day should meet or exceed the school district nutrition standards and be in compliance with state and federal law. Foods should be served with consideration toward nutritional integrity, variety, appeal, taste, safety and packaging to ensure high-quality meals.  ( See the DE guidance on Healthy Kids Act) .

The school district will make every effort to eliminate any social stigma attached to and prevent the overt identification of students who are eligible for free and reduced meals.  Toward this end, the school district may utilize electronic identification and payment systems; provide meals at no charge to all children, regardless of income; and promote the availability of meals to all students.

The school district will develop a local wellness policy committee composed of parents, students, and representatives of the school food authority, the school board, school administrators and the public, physical education teachers, and school health professionals.  The local wellness policy committee will develop a plan to implement the local wellness policy and review and update the policy every three years.  The committee will designate an individual to monitor implementation and evaluation of the implementation of the policy.  The committee will report annually to the board and community regarding the content and effectiveness of this policy and recommend updates if needed.  When monitoring implementation, schools will be evaluated individually with reports prepared by the school district.  The report will include if the school is in compliance with this policy, the extent to which this policy compares to the model Wellness policies and describe the progress made in achieving the goals of this policy.

 

SPECIFIC GOALS

• SPECIFIC GOALS FOR NUTRITION EDUCATION AND PROMOTION (SEE APPENDIX A)
• PHYSICAL ACTIVITY (SEE APPENDIX B)
• OTHER SCHOOL-BASED ACTIVITIES THAT ARE DESIGNED TO PROMOTE    STUDENT    WELLNESS ( SEE APPENDIX C)

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APPENDIX A - NUTRITION EDUCATION AND PROMOTION

The school district will provide nutrition education and engage in nutrition promotion that:

• is offered at Pre, K,1,2,3,4 ,5,8 & Food and Consumer Science as part of a comprehensive program throughout a students educational career; elementary teachers will teach units reinforcing proper nutrition; high school health classes will each review the essentials and the importance of proper nutrition.
• includes enjoyable, developmentally appropriate, culturally relevant participatory activities such as contests, promotions, taste-testing, farm visits and work on getting a school garden started.
• promotes fruits, vegetables, whole-grain products, low-fat and fat-free dairy products, healthy food preparation methods and health-enhancing nutrition practices;

---

Appendix B - PHYSICAL ACTIVITY GUIDELINES

DAILY PHYSICAL EDUCATION

The school district will provide physical education classes that:

• are taught by a certified physical education teacher;
• are for all students in grades K-12 for the entire school year, grades 9-12 for 2 trimesters, and can only have a waiver for one trimester for sport involvement and academic schedule. If a waiver is signed, the parent is responsible for making sure the time in physical activity is completed by the student.
• includes students with disabilities, students with special health-care needs may be provided in alternative educational settings;
• engage students in moderate to vigorous activity during at least 50 percent of physical education class time, examines possible fitness options for secondary students, (i.e. Pilates, yoga, tae chi, aerobic exercise), and encourages personal recordkeeping of fitness endeavors;

(The Center for Disease Control and Prevention recommends at least 150 minutes a week for elementary students and 225 minutes for middle and high school students);

Daily Recess:

Elementary schools should provide recess for students that:

• is at least 20 minutes a day;
• is preferably outdoors and if weather prohibits will be physically active in the classroom or other facilities within the building;
• encourages moderate to vigorous physical activity verbally and through the provision of space and equipment; recess monitors shall engage themselves with inactive students.
• discourages extended periods (i.e., periods of two or more hours) of inactivity.

When activities, such as mandatory school wide testing, make it necessary for students to remain indoors for long periods of time, schools should give students periodic breaks during which they are encouraged to stand and be moderately active.

Physical Activity and Punishment

Employees should not use physical activity( e.g. running laps, pushups) or withhold opportunities for physical activity ( e.g. recess, physical education) for punishment.

Note- Iowa law now requires elementary students, k-5, to have 30 minutes of physical activity, not physical education, per day.  This requirement can be met through a combination of PE, recess, classroom and other activities. Middle and high school students must have at least 120 minutes of physical activity per week. Again this is not just physical education but can be met with a combination of
PE, school and non-school sponsored athletics and other activities where the body is exerted.  Should a student wish to meet the requirements outside of school, the student and the school district must have an agreement detailing the outside activity.  A physical activity sample agreement may be found at East Buchanan Physical Activity Contract

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Appendix C - OTHER SCHOOL-BASED ACTIVITIES THAT PROMOTE STUDENT WELLNESS                                                                          

Integrating Physical Activity into Classroom Settings

For students to receive the nationally recommended amount of daily physical activity and for students to fully embrace regular physical activity as personal behavior, students need opportunities for physical activity beyond the physical education class. To ward that end, the school district will:

.   encourage classroom teachers to provide short physical activity breaks between lessons or classes, as appropriate.

 

OPTIONAL ISSUES

 

COMMUNICATION WITH PARENTS

The school district will support parents’ efforts to provide a healthy diet and daily physical activity for their children. The school district will:

.     provide nutrient analyses of school menus;

.     encourage parents to pack healthy lunches and to refrain from including beverages and foods that do not meet the established nutrition standards for individual foods and beverages or are larger than 20 ounces. (e.g. no pop or juice containing less than 50% fruit juice for cold lunches and field trips).

 

Food Marketing in Schools

School-based marketing will be consistent with nutrition education and health promotion. The school district will:

.      limit food and beverage marketing to the promotion of foods and beverages that meet the nutrition standards for meals or for foods and beverages sold individually;

.     promote healthy foods, including fruits, vegetables, whole grains and low fat dairy products.

 

Staff Wellness

The school district values the health and well-being of every staff member and will plan and implement activities and policies that support efforts by staff to maintain a healthy lifestyle:

.     establish and maintain a staff wellness committee composed of staff members, school nurse, students, physical education teacher, students, food service, administration, parents, school board members and community members.

---

Appendix D - NUTRITION GUIDELINES FOR ALL FOODS AVAILABLE ON CAMPUS

School Meals

Meals served through the National School Lunch and Breakfast Programs will:

• be appealing and attractive to children
• be served in a clean and pleasant setting
• meet, at a minimum, nutrition requirements established by local, state and federal law
• offer a variety of fruits and vegetables, legumes and whole grains;
• serve only low-fat (1%) and fat-free milk and nutritionally equivalent non-dairy alternatives (as defined by the USDA)
• have nutritional substitutes (salads or salad bar) for the main entrée .

Schools should:

• engage students and parents, through taste-tests of new entrée and surveys ( establish Taste-Test Ambassadors from student council and each elementary classroom), in selecting foods offered through the meal programs in order to identify new, healthful and appealing food choices: and,
• share information about the nutritional content of meals with parents and students. Enlist a student cadet to help food service publish the nutritional content on the school website and menu board.

Breakfast

To ensure that all children have breakfast, either at home or at school, in order to meet their nutritional needs and enhance their ability to learn the school will:

• operate the breakfast program, to the extent possible;
• arrange bus schedules and utilize methods to serve breakfasts that encourage participation,

 

Free and Reduced-Priced Meals

The school district will make every effort to eliminate any social stigma attached to, and prevent the overt identification of, students who are eligible for free and reduced-price meals. Toward this end the school district may:

• utilize electronic identification and payment systems;
• provide meals at no charge to all children, regardless of income; and,
• promote the availability of meals to all students.

 

Meal Times and Scheduling

The school district:

• will provide students with at least 10 minutes to eat after sitting down for breakfast and 20 minutes after sitting down for lunch
• should schedule meal periods at appropriate times, e.g. lunch should be scheduled between 11 a.m. and 1 p.m.: should not schedule tutoring, club or organizational meetings or activities during mealtimes, unless students may eat during such activities;
• will attempt to schedule lunch periods to follow recess periods (in elementary schools)
• will provide students access to hand washing or hand sanitizing before they eat meals or snacks
• take reasonable steps to accommodate students with special oral health needs (e.g., orthodontia or high tooth decay risk).

 

Qualification of Food Service Staff

Qualified nutrition professionals will administer the meal programs.  As part of the school district’s responsibility to operate a food service program, the school district will

• provide continuing professional development for all nutrition professionals; and,

 

• provide staff development programs that include appropriate certification and/or training programs for cafeteria workers according to their levels of responsibility.

 

• hire a part time dietician or other food service specialist to help food service staff develop and serve healthy attractive complete meals that meet federal guidelines.

 

Sharing of Foods

The school district discourages students from sharing their foods or beverages, except from the sharing table, with one another during meal or snack times, given concerns about allergies and some children’s diet restrictions.

 

Foods Sold Outside the Meal (e.g. vending, a la carte, sales)

All foods and beverages sold individually outside the reimbursable meal programs( including those sold through a la carte lines, vending machines, student stores or fundraising activities) during the school day, or through programs for students after the school day will meet nutrition standards as required by state and federal law.

 

Fundraising Activities

There are two types of fundraising-regulated and other. Regulated fundraisers are those that offer the sale of foods or beverages on school property and that are targeted primarily to PK-12 students by or through other PK-12 students, student groups, school organizations or through on-campus school stores. Regulated fundraising activities must comply with the state nutritional guidelines.  All other fundraising activities are encouraged, but not required, to comply with the state nutritional guidelines if the activities involve foods and beverages.

The school district encourages fundraising activities that promote physical activity.

Snacks

Snacks served during the school day will make a positive contribution to children’s diets and health. With an emphasis on serving fruits and vegetables as the primary snack, a fruit or a vegetable will be offered for elementary snacks on Tuesday and Thursday. The wellness committee will look into applying for a fruit and vegetable grant for the upcoming years. Schools will assess if and when to offer snacks based on timing of meals, children’s nutritional needs, children’s ages and other considerations.  Snacks offered at school will come from the cafeteria.

 

Rewards

The school district will not use foods or beverages, especially those that do not meet the nutrition standards for foods and beverages sold individually, as rewards for academic performance or good behavior, and will not withhold food or beverages (including food served through meals) as a punishment.

Celebrations

Schools should evaluate their celebrations/birthday practices that involve food during the school day.
 

School-Sponsored Events

Foods and beverages offered or sold at school-sponsored events outside the school day are encouraged to comply with nutrition standards for meals or for foods and beverages sold individually.
 

 

Food Safety

All foods made available on campus comply with the state and local food safety and security guidelines.

• All foods made available on campus comply with state and local food safety and sanitation regulations.  Hazard Analysis and Critical Control Points (HACCP) plans and guidelines are implemented to prevent food illness in schools.
• For the safety and security of food and facility, access to the food service operations are limited to food service staff and authorized personnel.

MONITORING GUIDELINES

The superintendent will ensure compliance with established school district-wide nutrition and physical activity wellness policies.

In each school:

• the principal will ensure compliance with those policies in the school and will report on the schools compliance to the superintendent; and
• food service staff will ensure compliance with nutrition policies within food service areas and will report on this matter to the superintendent or principal.

In the school district:

• The school district will report on the most recent USDA School Meals Initiative (SMI) review findings and any resulting changes.  If the school district has not received a SMI review from the state agency within the past five years, the school district will request from the state agency that a SMI review be scheduled as soon as possible;
• the superintendent will develop a summary report every three years on school district-wide compliance with the school district’s established nutrition and physical activity, wellness policies; based on input from schools within the district’ and
• The report will be provided to the school board and also distributed to all school wellness committee, principals and health service personnel in the school district.

POLICY REVIEW

To help with the initial development of the school district’s wellness policies, each building in the school district will conduct a baseline assessment of the school’s existing nutrition and physical activity environments and practices.  The results of those assessments will be compiled at the school district level to identify and prioritize needs.

Assessments will be repeated every year to help review policy compliance, assess progress and determine areas in need of improvement.  As part of that review, the school district will review the nutrition and physical activity policies and practices and the provision of an environment that supports healthy eating and physical activity.  The school district will revise the wellness policies and develop work plans to facilitate their implementation.

Approved  September 13, 2023                         

Reviewed___September 13, 2023_______