Health & Safety Agreement for In-Person Learning

  • As part of our communications to families as detailed in our COVID-19 Safety Plan for In-Person Instrtuction, parents and guardians were provided an agreement to review and acknowledge important health and safety protocols if their students are returning to campus for in-person learning.

    Once the following information has been reviewed, please sign the agreement electronically (Spanish).

    Only one signed agreement is needed per family.

    The Parent/Guardian Health & Safety Agreement for In-Person Learning

    1. COVID-19 Safety Plan: I have received and reviewed the LVJUSD COVID-19 Safety Plan for In-Person Instruction (Spanish).
    2. Spring 2021 Handbook: I have received and reviewed the LVJUSD Spring 2021 Handbook with my child.
    3. Daily Home Health Screenings: I agree to complete the Student Daily Health Screening each day before taking my child to school for in-person learning. Students should not complete a screening when distance learning.
    4. Masks: I understand and agree that my child will wear a face mask while on campus. Masks must cover nose and mouth; no bandanas or gaiters; those wearing face shields must also wear a cloth that can be tucked into their shirt or a mask. Non-compliance may lead to students being transitioned back to distance learning. (Although face coverings are a requirement, the California Department of Public Health has indicated that some may be exempt from this requirement if they have a medical condition or disability that prevents the person from wearing a face covering.)
    5. Exhibiting Symptoms at School: I understand that if my child exhibits signs or symptoms of COVID-19 while at school, a parent/guardian will be called to pick up that child from school as soon as reasonably possible but no later than within 30 minutes of being notified by the school. When the parent/guardian arrives at school, they will call the school office and remain in their vehicle.
    6. Positive COVID-19 Test Disclosure: I agree to notify my child’s school in the event my child tests positive for COVID-19, as the District is required to notify the Alameda County Public Health Department (ACPHD). This information is also critical to the contact tracing process to help mitigate the spread of the virus. Outside of the County notification, all medical information will remain confidential.
    7. Responsibility to Quarantine: I understand that the District may direct my child to quarantine either because my child is suspected of having COVID-19 or has been in close contact with someone suspected of having COVID-19. Students who are required to quarantine but are well enough to participate in learning will be asked to attend class through distance learning.Students who are required to quarantine may not return to in-person learning until permitted to do so under the guidance set forth by the California Department of Public Health (pages 34-35).
    8. Visitors: I understand that school offices must adhere to physical distancing protocols and may ask that I make an appointment for non-emergencies. Parents and visitors are not permitted beyond the front gate of the school.
    9. Tip Line: LVJUSD’s Tip Line now includes a COVID-19 Safety Concern classification as a means of communicating information by name (for follow-up) or anonymously.
    10. Nondiscrimination: LVJUSD prohibits discrimination against any student who has been diagnosed with COVID-19, whose family member has been diagnosed with COVID-19, or who is perceived to be a COVID-19 risk. If you feel your child is being discriminated against as a result of COVID-19, please notify the District immediately.

    Parent/Guardian Health & Safety Agreement for In-Person Instruction (Spanish)