Vaccinations and Records
I understand that only vaccinated adults may enter the HSDC building for the health and safety of our community.
I understand that my child will not be permitted to attend school until I have submitted all required paperwork documenting vaccinations.
COVID-19 Parent Agreement
ROSEN FAMILY PRESCHOOL
COVID-19 INFORMATION AND PARENTAL AGREEMENT
This form must be returned by parents in each household before their children are permitted to return to school.
PARENT AND CAREGIVER RESPONSIBILITY
It is the responsibility of parents and caregivers to assess their children on a daily basis before sending them to school. Additionally, parents must have a person available to pick up their child right away, should they become sick during school. Please read the following guidelines, then sign the agreement below. Further guidance is provided on the Washington State Coronavirus Response webpage found here: https://coronavirus.wa.gov.
GUIDELINES FOR DETERMINING WHETHER A CHILD SHOULD REMAIN AT HOME:
All students and staff must be free of symptoms of common cold, influenza, COVID-19, or other infectious respiratory disease before coming to school.
If children display symptoms, they are asked to remain home and not return to school until they have been assessed by a physician or nurse practitioner.
Additionally, parents can contact the King County COVID-19 Call Center at 1-206-477-3977 to seek further input, or contact a family physician or nurse practitioner to be assessed for COVID-19 and other infectious respiratory diseases.
If a student or staff member is assessed by their family physician or nurse practitioner and it is determined that they do NOT have COVID-19, they may return to school once symptoms resolve.
I have read and agree to the guidelines above.
I will ensure that myself or an authorized person is available to pick up my child(ren) immediately should they become sick while at school.
PLAYGROUND / MOTOR AREA RELEASE
Portions of HSDC activities may be spent either on our outdoor play deck or in our sensory motor room. Each area requires close staff supervision in order to participate, and special precautions may be posted in these areas which must be followed. Siblings are not allowed on any of the equipment without staff consent. I have read the above and I agree that any injuries obtained through use of this equipment during activities shall not be the responsibility of the Hearing, Speech & Deaf Center (HSDC).
PHOTO / PUBLICATIONS RELEASE
I give HSDC or its legal representative the absolute right and permission to include our family's name in articles about us, and to copyright and/or publish photographic portraits, pictures, or videotape of us and to use our photos in conjunction with a fictitious name for art, health, education, marketing, or any other lawful purpose. I waive my right to inspect and/or approve the finished product or the use to which it may be applied. I release, discharge and agree to hold harmless HSDC or its legal representatives from any liability by virtue of any blurring, alteration, optical illusion or use in composite form whether intentional or otherwise, that may occur or be produced in the taking of said pictures or any processing tending towards the completion of the product.
I understand that I may opt out of this release by sending a letter or email to email@example.com stating my preference.
WALKING FIELD TRIP RELEASE
Activities may include walking field trips in the surrounding neighborhood or area around HSDC. A separate release form will be provided for any field trip that involves travel by motor vehicle (bus, car, etc.) I signify that I consent to the child's participation in walking field trips. I am aware and understand that such trips represent a risk of personal injury, and I freely assume all such risks. I further release HSDC, its volunteers and employees from any and all claims, causes of action, and/or liabilities which I may suffer as a result of my child's participation in walking field trips.
Pesticide Policy Acknowledgement
I am aware that I can review Rosen Preschool's pesticide policy at any time, located in the Childcare Center Policies binder.
Health Policy Acknowledgement
I am aware that I can review Rosen Preschool's health policy at any time, which is located in the Childcare Center Policies binder.
I will provide the preschool with a plan to respond to any chronic or life-threatening illnesses as needed using the form found here: https://www.dcyf.wa.gov/sites/default/files/forms/15-970.pdf
Pet Policy Acknowledgement
I have reviewed and accepted the pet policy:
Animal and Pet Policy
Caring for and interacting with pets can be a special part of our preschool curriculum. It gives the teachers an opportunity to talk about life cycle issues including death. Children learn to care respectfully for creatures and are given the opportunity to nurture other living beings.
Classroom pets and visiting animals need to be in good health.
Pets and/or visiting animals must have documentation from a veterinarian or an animal shelter to show that the animals are fully immunized (if the animal should be so protected).
Teaching staff supervise all interactions between children and animals and instruct children on safe behavior when in close proximity to animals. Parents must submit information about any pet allergies a child might have.
Staff makes sure that any child who is allergic to a type of animal is not exposed to that animal.
Reptiles are not allowed as classroom pets because of the risk of salmonella infection.
Student Progress Acknowledgement
I understand how I will be kept informed of my child's progress and issues related to my child's care as well as any individualized supports for his/her needs.
Family Participation Acknowledgement
I recognize that I am encouraged to participate in preschool activities as they meet my family's needs.
Disaster Plan Acknowledgement
I understand Rosen Preschool's disaster plan and procedures.
Necessary and immediate steps will be taken in the event of an emergency, and a call to the emergency contact person listed on the emergency form of the enrollment packet will be made. It is critical that you keep Rosen Preschool updated with current emergency numbers. Inform the education office immediately of any changes.
If an emergency situation arises that compromises local communication lines, Rosen Preschool's out-of-area contact is Washington State's Center for Deaf and Hard of Hearing Youth (360) 418-4292. We will also post our emergency information to local radio station KPLU 88.5 FM as soon as possible.
Rosen Preschool Exit Path:
From the west (non-HSDC hall) door, take a right and out the door to Madison St. Walk east down Madison and cross to Mt. Zion Church parking lot. Teachers take care that group crosses safely together.
Take a left, walk down the main hall, then take a right at the corner. Walk through the HSDC lobby to the emergency stairs exit. Take the stairs down to the courtyard away from the building and cross to Mt. Zion Church parking lot.
EXTENDED EVACUATION FROM PRESCHOOL
If the cause of an emergency evacuation prevents people from reentering the building and parents are unable to pick their student(s) up immediately, the students and staff will relocate to the basement of the Madison Non Profit Center (MNC) Building, located behind HSDC at 1620 18th Ave, Seattle, WA 98122. Every effort will be made to keep families updated and in constant communication.
If there is a fire, Rosen Preschool staff and students will follow the Rosen Preschool Exit Path. We will wait in the parking lot of the Mt. Zion Baptist church until the building has been inspected and deemed safe.
Upon the first indication of an earthquake, teachers will direct students to duck, cover and hold. When the shaking stops, Rosen Preschool staff and students will follow the Rosen Preschool Exit Path. We will wait in the parking lot of the Mt. Zion Baptist church until the building has been inspected and deemed safe.
• Duck, cover and hold:
o If inside:
Drop to the floor
Get under the desk and remain facing away from windows
o If outside:
Move away from buildings and other collapsible objects
Drop to your knees on the ground
Bend over at the waist bringing your head between your knees
Cover your head with arms and hands
ACT OF VIOLENCE OR OTHER THREAT:
The Rosen Preschool staff will turn off the lights and the students will be directed to duck, cover and hold. All doors will be locked and door windows will be covered. The staff and students will remain in the Rosen Preschool classroom on lockdown until the building has been inspected and deemed safe.
This action is used after a decision is made that being indoors would provide a greater level of protection to students and staff than being outdoors. If any event occurs that requires this, students and staff will stay in Rosen Preschool. Rosen Preschool staff will take precautions to make the room a safe shelter-in-place. Rosen Preschool staff and students will remain here until conditions become safe.
If any Rosen Preschool staff or student shows signs and symptoms of a pandemic flu, such as the H1N1 flu, and needs to be quarantined until further notice, the Rosen Preschool classroom will convert into the quarantine area, and the other healthy students will leave the classroom and move to a different classroom.
During the school year, we prepare staff and students for emergencies by incorporating drills into the schedule. Each year we will conduct nine fire drills (monthly), two earthquake drills, one lockdown drill and one shelter-in-place drill.
If there is ever a situation in which we need to evacuate the Rosen Preschool classroom, staff will bring our Emergency Information notebook with us. If we are unable to be contacted in the HSDC building, we will contact you according to the information provided on the Annual Enrollment & Emergency Contact Form. If we are in the building during an emergency situation, you can contact the HSDC main line: (206) 323-5770.
I have read and understood the classroom language plan and I agree to uphold it. I agree to promote a fully accessible environment for all staff and students.
Family Handbook - Policies and Procedures
I acknowledge that HSDC's policies and procedures have been explained to me in the family handbook as well as its philosophy, program, and facilities. (This will satisfy the Family Handbook Signature Page)
I hereby voluntarily consent to the rendering of such care, including diagnostic procedures, surgical and medical treatment and blood transfusions, by medical doctors, hospitals or their authorized designees, as may in their professional judgment be necessary to provide for the medical, surgical, or emergency care of my dependent.
I further give my consent to HSDC (caregiver) to arrange for routine or emergency medical and/or dental care and treatment necessary to preserve the health of my dependent. In the event that my dependent is injured or ill while under the care of the caregiver, I hereby give permission to the caregiver to provide first aid for said dependent and to take the appropriate measures, including contacting the Emergency Medical Service (EMS) system and arranging for transportation to the nearest emergency medical facility.
In making medical decisions on my behalf for the behalf of my dependent, I direct that the caregiver attempt to contact me. However, if medical care becomes essential, I give permission to the caregiver to make such decisions regarding such treatment as deemed appropriate by the medical doctor, hospital, or their authorized designee. In furtherance of any treatment decisions to be made by the caregiver on my behalf for the benefit of my dependent, I authorize the caregiver to request, obtain, review and inspect any and all information bearing upon my dependent's health and relevant to any such decisions to be made respecting such treatment.
I acknowledge that no guarantees have been made to me as to the effect of such examinations or treatment on the condition of my dependent and that I am responsible for all reasonable charges in connection with the care and treatment rendered to my dependent during this period.
I understand that payment is due in full on the 1st of every month. If hardship or unexpected circumstances prevent me from paying this tuition, I agree to inform the program director and work out an alternative plan. If tuition assistance is needed, I can request information. I understand that I can apply for DCYF subsidies at https://www.dcyf.wa.gov/services/earlylearning-childcare/getting-help/wccc, and that HSDC will accept such subsidies.
I understand that I am responsible to stay up to date with any enrollment documentation required by the third-party agency responsible for my tuition. Disenrollment or disqualification by the funding agency makes tuition my responsibility. Students may not attend school until all enrollment paperwork is completed.