Kern County Consortium Special Education Local Plan Area CHARTER SCHOOL APPLICATION INFORMATION

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Kern County Consortium Special Education Local Plan Area CHARTER SCHOOL APPLICATION INFORMATION Introduction Special education and related services shall be provided to all eligible individuals within the Kern County Consortium SELPA in accordance with the Local Plan. Students enrolled in charter schools chartered within the SELPA shall receive services in a manner similar to students enrolled in member districts with the SELPA. Funding for special education services, participation in the governance structure and responsibility for provision of services shall be based on the status of the individual charter school. A charter school may apply to participate as an LEA for the provision of special education services. A request to participate as an LEA in the SELPA may not be treated differently from a similar request by a school district. Application must be made to the SELPA by February 1 of the school year preceding the school year in which the charter school anticipates operating as an LEA within the SELPA. This date is in place to permit the review and potential modifications of assurances and the service delivery plan prior to the effective date of funding. The effective date of funding will be July 1. The Superintendents Executive Council will make the final determination whether the charter school has met all the requirements of an LEA. These requirements include: Provide a current operating budget in order to assure fiscal responsibility in accordance with Education Code 42130 and 42131; if it is a new charter school requesting status as an LEA, the first year s budget and cash flow budget will be submitted as part of the fiscal review process; Provide assurances that students and staff will be instructed in a safe environment; Provide a copy of the original petition; Be responsible for any legal fees as it relates to the application and assurances process in becoming an LEA; Meet the terms of the assurances requirements in the Local Plan, including those regarding Identification, Screening, Referral, Assessment, Instructional Planning, Implementation and Review; Procedural Safeguards; and Regionalized Services. Funding Considerations Each district within the SELPA is assured an equitable share of federal and state special education funds available to the SELPA to provide special education services to residents of the districts. Services may be provided through funds allocated to the district of residence, another school district, a county office, or another SELPA.

Funds available for distribution are understood to be those allocated to the SELPA from the State Department of Education, less the funds received for Low Incidence equipment, Regionalized Services, specially designated pools, and infant and special education grant funds allocated by the State Department of Education for personnel development. Time Line for Applications: February 1st: March: April: June: July: Application for new LEA members must be submitted to the Kern County Consortium SELPA Application reviewed by SELPA Director and submitted for Consideration by the Superintendents Executive Council SELPA will prepare Local Plan Revision and submit to CDE Governing Board action; re: Local Plan Revision Charters will be notified by this date as to the status of their Applications Membership in the Kern County Consortium SELPA begins Application Procedure 1. Complete the attached application for membership in the Kern County Consortium SELPA. Incomplete applications will not be accepted. 2. In addition to the completed application form, Charters must submit the following: a. Most recently approved charter petition b. A copy of your audit report for the past two years (if applicable) c. Income/expense report for your special education program for the past two years (if applicable) d. API Scores for your school (if applicable) e. A copy of your School Accountability Report Card (if applicable) f. Copies of credentials for all certificated special education staff g. A signed copy of the SELPA Local Education Agency (LEA) Assurances (separate document) h. Proof of Liability Insurance 3. The application must be submitted in the following format: Two (2) copies of the application and supporting documentation must be submitted to the Kern County Consortium SELPA office (one copy for the SELPA office, one copy to be kept at CDE). The applications must be submitted in a view binder (with the charter school s name on the front cover and spine) with binder tabs identified and organized as follows: a. Application for membership in the Kern County Consortium SELPA b. Charter Petition c. Income/Expense Reports

d. API Scores e. SARC f. Credentials g. SELPA Local Education Agency (LEA) Assurances h. Liability Insurance Please mail the completed application binders to: Julianna L. Gaines, Executive Director Kern County Consortium SELPA 1300 17 th Street CITY CENTRE Bakersfield, CA 93301-4533 Submitted applications will be reviewed by the Kern County Consortium SELPA Director prior to consideration by the Superintendents Executive Council.

KERN COUNTY CONSORTIUM SELPA Application for Membership in the Kern County Consortium SELPA DATE: NAME OF APPLICANT: ADDRESS: TELEPHONE: E-MAIL: NAME OF CHARTER AUTHORIZER: NAME OF CHARTER CEO: NAME OF CHARTER SCHOOL DIRECTOR: FAX: NAME OF SPECIAL EDUCATION CONTACT: PUPIL COUNT INFORMATION. CBEDS DATA: Estimated students for 20-20 CASEMIS INFORMATION (attach data which provides the count by instructional setting, handicapping condition) Please complete the following in the space provided: I. Describe your rationale/reasons for applying to join the Kern County Consortium SELPA. II. Using the key below, please rank your current status in terms of each of the following special education mandates and place this rank in the box provided. Then please elaborate on your ranking by briefly describing this status in the space provided. KEY: 1 = COMPLIANT 2 = IN DEVELOPMENT PHASE 3 = NEED ASSISTANCE A special education program requires that you implement appropriate child find activities, provide general education program modifications, refer students for assessment, conduct assessments and develop Individual Education Plans (IEP) for identified students. Please describe your procedures for each of these areas. a. Child Find Activities:

b. General Education Program Modifications: c. Referral Process (including Student Study Team model): d. Assessment (include a description of personnel responsible for the assessment by name and title or agency providing the service as well as assessment tools used): e. Development of an appropriate IEP: III. Using the key below, please rank your current status in terms of providing each of the following special education services and place this rank in the box provided. Then please elaborate on your ranking by briefly describing your current special education services in the spaces provided. KEY: 1 = PROVIDING SERVICES 2 = CONTRACTING FOR SERVICES 3 = NEED ASSISTANCE IN OBTAINING OR PROVIDING SERVICES a. Resource Specialist Services: b. Designated Instruction and Services (e.g. Speech and Language therapy, Adaptive Physical Education, Occupational/Physical therapy, Counseling, Sign Language Interpreting, etc.): c. Non-severe Special Day Class (e.g. SDC for students with learning disabilities):

d. Severe Special Day Class (e.g. SDC for students with severe physical, medical, emotional disturbance and/or significant developmental delays requiring intensive services):. e. Inclusion Services (e.g. supported full time placement in general education classes for students with severe disabilities): f. Placement in a nonpublic school/agency (NPS/NPA) or residential facility: g. Transportation for students with special needs in order to access special education services: IV. Assurances a. Please review, sign and adopt through your governance structure the Special Education Local Plan Area Local Education Agency (LEA) Assurances (separate document). Note: This Assurance Statement has been updated to reflect IDEA 04. b. Additional Assurances. Your signature on this application indicates your assurance that you agree to adhere to the following additional requirements: 1. Utilize Kern County Consortium SELPA approved forms and documents, including the Special Education Support Program (SESP) and all computer hardware necessary; 2. Attend meetings in person as required; 3. Adopt and implement the Kern County Consortium SELPA Policies and Procedures Handbook; 4. Expend all State and Federal special education funds as required by law and defined in the Kern County Consortium SELPA Allocation Plan; 5. Ensure that students will be instructed in a safe environment; 6. Assume the legal and financial responsibilities to provide a free and appropriate public education to students with special needs.

Financial responsibility may include, but is not limited to, instruction, related services, transportation, NPA/NPS placements, intra-selpa placements, due process hearing proceedings and attorney fees; 7. Hold harmless, indemnify and defend the Kern County Consortium SELPA Director and his officers, agents and employees from any and all liabilities, claims, costs, expenses and damages arising from or connected with the services to be performed under this agreement. 8. Submit all reports within required time lines (CASEMIS, budget, Maintenance of Effort, etc.); 9. Comply with the requirements of Section 504 of the Rehabilitation Act and develop appropriate plans for students as needed; 10. Ensure facility access compliant with the Americans with Disabilities Act (ADA) or appropriate plans for future implementation; 11. Follow all Federal and State Laws regarding discipline and change of placement for students identified with special needs; 12. Participate in staff development activities as needed to ensure staff understanding of special education laws and regulations. Date of Board Approval for Application and Assurances Signature of Applicant CEO/Director Name Date