St. Michael the Archangel
Religious Education Program
Parent/Student
Forms & Information
2016-2017
PERMISSION TO ADMINISTER PRESCRIPTION MEDICATION
PRESCRIPTION MEDICINES ARE DEFINED AS MEDICINE PRESCRIBED BY A DOCTOR. IF A CHILD IS REQUIRED TO TAKE PRESCRIPTION MEDICATION DURING SCHOOL HOURS, AND A PARENT CANNOT BE AT SCHOOL TO ADMINISTER THE MEDICATION, THE FOLLOWING INFORMATION IS REQUIRED:
Child’s Name: ______
Name of Medication: ______
Purpose of Medication: ______
Time to be administered: ______
Dosage: ______
Possible side effects, if known: ______
Termination date for giving the medication: ______
______
Parent/Legal Guardian Signature Date
· The record of the administration of the medication will become a part of the student’s permanent file.
· Medication will be kept in the office and any unused medication will only be given to the parent.
· The parent assumes responsibility for informing the school of any change of medication or in the child’s health.
PERMISSION TO ADMINISTER NON-PRESCRIPTION MEDICATION
NON-PRESCRIPTION MEDICINES ARE DEFINED AS MEDICINE WHICH IS NOT PRESCRIBED BY A DOCTOR. IF A CHILD IS REQUIRED TO TAKE NON-PRESCRIPTION MEDICATION DURING SCHOOL HOURS, AND A PARENT CANNOT BE AT SCHOOL TO ADMINISTER THE MEDICATION, THE FOLLOWING INFORMATION IS REQUIRED:
Child’s Name: ______
Name of Medication: ______
Purpose of Medication: ______
Time to be administered: ______
Dosage: ______
Possible side effects, if known: ______
Termination date for giving the medication: ______
______
Parent/Legal Guardian Signature Date
· The record of the administration of the medication will become a part of the student’s permanent file.
· Medication will be kept in the office and any unused medication will only be given to the parent.
· The parent assumes responsibility for informing the school of any change of medication or in the child’s health.
PARENT/GUARDIAN NOTE TO RELIGIOUS EDUCATION DEPARTMENT FORM
THIS FORM MAY BE USED AS A CONVENIENT MEANS BY WHICH PARENTS/GUARDIANS CAN COMMUNICATE MISCELLANEOUS INFORMATION (UPCOMING VACATION DATES, STUDENT ABSENTEE INFORMATION, CONCERNS, COMMENTS, ETC.) TO THE DIRECTOR OF RELIGIOUS EDUCATION AND/OR CLASSROOM INSTRUCTOR.
DATE:______PARENT NAME:______
(PLEASE PRINT)
STUDENT NAME(S) ______
(PLEASE PRINT)
---MESSAGE---
______
PARENT/GUARDIAN SIGNATURE:
PROGRESS REPORT
CRITERIA AND SCALE
THE FOLLOWING INFORMATION CONTAINS THE CRITERIA AND DESCRIPTIVE SCALE USED TO MEASURE THE LEVEL OF SUCCESS THAT A STUDENT HAS ACHIEVED FOR A PARTICULAR SEMESTER. THE FOLLOWING INFORMATION PRESENTS THE CITERIA USED IN DETERMINING THE PROGRESS OF AN INDIVIDUAL CLASSROOM STUDENT.
OBSERVED STUDENT CRITERIA CATEGORIES
· COMES PREPARED FOR CLASS WITH NECESSARY CLASS MATERIALS
· WORKS THROUGH ASSIGNMENTS THOUGHTFULLY AND CAREFULLY; COMPLETES AND RETURNS HOMEWORK
· LISTENS ATTENTIVELY AND RESPECTS OTHERS
· BEHAVES SO THAT THERE IS LEARNING ATMOSPHERE BY OBSERVING CLASSROOM AND RELIGIOUS EDUCATION PROGRAM RULES
· PARTICIPATES DURING CLASSROOM ACTIIVITIES AND DISCUSSIONS
· RESPONSIBLY CARES FOR ROOM, BOOKS, AND MATERIALS
· IS WORKING AT AND KNOWS THE PRAYERS REQUIRED FOR THIS GRADE LEVEL
· STUDENT SHOWS GROWTH IN RELIOUS KNOWLEDGE AS PRESENT AT THIS LEVEL
SCALE USED TO DETERMINE STUDENT PROGRESS IN OBSERVED STUDENT CRITERIA CATEGORIES
· E = EXCELLENT
· VG=VERY GOOD
· G=GOOD
· NI=NEEDS INPROVEMENT
· L=LACK OF APPROPRIATE EFFORT
(NOTE: AN INSTRUCTOR “COMMENTS/SUGGESTIONS” SECTION IS ALSO INCLUDED.)
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DISMISSAL DIAGRAM
FOR THE SAFETY OF OUR STUDENTS AND PARENTS,
THE FIRST VEHICALS TO ARRIVE SHOULD PARK IN THE ALLEY IN ORDER TO BLOCK ANY INCOMING TRAFFIC. ONCE EVERYONE IS READY, THE VEHICLES IN THE ALLEY LEAVE FIRST. ALL OTHER VEHICLES FOLLOW: ROW 1, ROW 2, ETC.
ROW 1
ROW 2
ROW 3
ROW 4
ROW 5
ROW 6
NOTE: PARENTS MAY PARK IN THE CHURCH’S PARKING LOT. IF SO, THEY ARE STRONGLY ENCOURAGED TO MEET THEIR CHILDREN AT THE CROSSWALK OF LUNDY AND PARK STREET. FROM THERE, THEY ARE TO WALK THEM SAFELY TO THEIR VEHICLE.
C-400
P-CDOP
BACKGROUND CHECKS
All schools located and operating within the Catholic Diocese of Peoria must have a completed criminal background check for each full-time or part-time employee or volunteer working in the school. This background check must be completed for all personnel working in the schools and is a condition for employment. It is also required for all volunteers.
Catholic Diocese of Peoria Policy
Adopted: 2/94
Revised: 9/04; 9/07
C-400
AR-CDOP
BACKGROUND CHECKS
The background check consists of two separate procedures: a fingerprint-based criminal history records check as well as a background check done through the Illinois Department of Children and Family Services, known as the Child Abuse and Neglect Tracking System (CANTS).
The following adults are subject to the background check requirements:
· All employees (full and part-time), including personnel who work in the school under a contract with another business or organization (e.g. food service, janitorial service, etc.)
· Substitute teachers
· All coaches (head coach and assistants)
· All volunteers, even those who come to school for a one-time event
· All vendors/contractors who work consistently inside the school and/or for an extended period of time in the school must have background checks (see Policy C-403) Vendors who just deliver milk, food, mail, etc. do not have to go through a background check.
As long as the criminal history records check and CANTS check are in progress, an adult can begin working/volunteering in the school.
Effective July 1, 2007, all newly hired elementary and secondary school employees shall be fingerprinted electronically using Live Scan technology. The results of the electronic fingerprinting will be returned to the Office of Catholic Schools, and the school principal will be notified of the results. Ink-based fingerprinting will continue to be used for volunteers.
All student teachers should have a criminal background check from their college or university. If the college does not require a criminal background check, then the local school must have the student teacher submit to an electric fingerprint-based criminal history records check using Live Scan technology before he or she can begin teaching in the school. In such cases, the local school would be responsible for covering the expense of the background check.
Additionally, all student teachers are required to fill out a CANTS form when they begin working in the school.
All college and university employees who work in the Catholic schools of the diocese must also have a background check and CANTS check.
All Illinois public school districts are required under Illinois law to conduct criminal background checks for employees for certified and non-certified positions. Therefore, public school district employees who work in the Catholic schools of the diocese are only required to fill out a CANTS form before they begin working in the schools.
Special guest speakers are not required to have background checks. They should never be left alone with children. Classroom teachers should be with their class at all times.
All reports related to the CANTS and criminal history records checks are to be kept in a secure place that is other than the personnel files of the individuals. Reports will be kept in a separate file away from normal traffic. Only the principal, pastor, the Office of Catholic Schools, and other diocesan authorities shall have access to these files. Copies of all reports are to be retained at the individual school location as well as sent to the Office of Catholic Schools for review and retention.
All incidents of criminal conviction, or indicated incidents or pending investigations by DCFS must be fully addressed by the principal with the employee or volunteer. To determine whether such information prohibits employment with the school, the principal must consult with the Superintendent of Schools prior to meeting with the employee or volunteer.
Catholic Diocese of Peoria
Administrative Regulation
Issued: 9/07