Springville Comm School District

check school menus · students · families · and the community. Springville Community School District 400 Academy St. Springville · IA 52336 Contact (319) 854-6197 Contact Us Students · parents · color · national origin · gender · sexual orientation · gender identity · socioeconomic status · disability · religion · creed · age (except for permitting/ prohibiting students to engage in certain activities) · political party affiliation · marital status · or genetic information in admission or access to · or treatment in · its educational programs and activities · Secondary School Counselor · 400 Academy Street · Springville · Iowa 52336 · or (319) 854-6196 from 7:45 a.m. to 3:45 p.m. · please contact us for assistance. Annual Notices · Springville Community School District · Protocol for Managing Students with Food Allergies · Purpose of protocol:

Diet Modification Request Form · Modifications are required by The United States Department of Agriculture (USDA) to accommodate a disability. Under Section 504 · the · ADA · and Departmental Regulations of 7 CFR part 15b define a person with disability as any person who has a physical or mental · impairment which substantially limits one or more major life activities · has a record of such impairment · or is regarded as having such an · impairment. “Major life activities” are broadly defined and include · but are not limited to · caring for oneself · performing manual · tasks · seeing · hearing · eating · sleeping · walking · standing · lifting · bending · speaking · breathing · learning · reading · concentrating · thinking · communicating · and working. “Major life activities” also include operation of a major bodily function · including but not limited to

HOW TO APPLY FOR FREE AND REDUCED PRICE SCHOOL MEALS · Please use these instructions to help you fill out the application for free or reduced price school meals/milk. You · only need to submit one application per household · even if your children attend more than one school in · Springville. Please follow these instructions in order. Each step of the instructions is the same as the steps on · your application. The application must be filled out completely to certify your children for free or reduced price · school meals. Completed applications should be mailed or returned to Springville CSD 400 Academy · Street · Springville · Iowa 52336. If at any time you are not sure what to do next · please contact Springville CSD · Michele McCoy · [email protected] or any office. · PLEASE USE A PEN (NOT A PENCIL) WHEN FILLING OUT THE APPLICATION AND DO YOUR BEST TO PRINT CLEARLY. · Tell us how many infants · children and school students live in your household. They do NOT have to be related to · you to be a part of your household. · A) List each child’s name and date of birth. Print each child’s first name · middle initial · last name and date of · birth (optional). Use one line of the application for each child. If there are more children present than lines on · the application · attach a Supplemental Worksheet · which can be obtained from the school · with all required · information for the additional children. · B) Is the child a student? Mark ‘Yes’ or ‘No’ under the column titled “student” to tell us which children attend · Springville. If you marked ‘Yes’ write where the child attends school and write the grade level of the student in · the “Grade” column to the right. · C) Do you have any foster children? If any children listed are foster children

A) Report total household size. Enter the total number of household members in the field “Total Household · Members (Children and Adults).” This number MUST be equal to the number of household members listed in · STEP 1 and STEP 3. If there are any members of your household that you have not listed on the application · go back and add them. It is very important to list all household members · as the size of your household affects · your eligibility for free and reduced price meals. · B) Provide the last four digits of your Social Security Number. An adult household member must enter the · last four digits of their Social Security Number in the space provided. · C) You are eligible to apply for benefits even if you do not have a Social Security Number. If no adult · Report all amounts in GROSS INCOME ONLY. Report all income in whole dollars. Do · household members have a Social security Number · Grossleave · incomethisisspace blank · the total and mark · income the box · received to the · before right · taxes. · labeled “Check if no SSN.” · STEP 3: REPORT INCOME FOR ALL HOUSEHOLD MEMBERS · Many people think of income as the amount they “take home” and not the to · FOR EACH ADULT HOUSEHOLD MEMBER: · D) List all adult household member’s name. Make sure · Print thethat · nametheofincome you report member · each household on this application · in the boxeshasmarked · NOT been reduced to · insurance premiums or any other amounts taken · “Names of Adult Household Members (First and Last).” Do not list any household members you listed infrom your pay.

income is received from child support or alimony · only report court-ordered payments. Informal but regular · payments should be reported as “other” income in the next part. · Report income from pensions/retirement/all other income. Refer to Table 2 below titled “Sources of · Income for Adults” and report all income that applies in the “Pensions/Retirement/All Other Income” field on the · application. · Table 1. Sources of Income for Adults · Earnings from Work Public Assistance/ Pensions/Retirement/All Other · Alimony/Child Support Income · ● Salary · wages · cash bonuses ● Unemployment benefits ● Social Security (including · ● Net income from self- ● Worker’s compensation railroad retirement and black · employment (farm or ● Supplemental Security lung benefits) · business) Income (SSI) ● Private Pensions or disability · ● Cash assistance from State benefits · or local government ● Regular Income from trusts or · If you are in the U.S. Military: ● Alimony payments estates · ● Basic pay and cash bonuses · ● Child support payments ● Annuities · (do NOT include combat pay · ● Veteran’s benefits Investment Income · FSSA or privatized housing · ● Strike benefits ● Earned interest · allowances) · ● Rental income · ● Allowances for off-base ● Regular cash payments from · housing · food and clothing outside household · E) Report all income earned or received by children. Refer to the table below titled “Sources of Income for

the back of the application. · A) Provide your contact information. Write your current address in the fields provided if this information is · available. If you have no permanent address · this does not make your children ineligible for free or · reduced price school meals. Sharing a phone number · email address · or both is optional · but helps us reach · you quickly if we need to contact you. · B) Print and sign your name and write today’s date. Print the name of the adult signing the application and · sign in the box labeled “Signature of adult completing the form.” · C) Mail or return completed form to: Springville CSD · 400 Academy Stree · Springville · Iowa 52336. Please · do not mail completed form to the Department of Agriculture as this will delay processing. · D) Decline having your information released to Hawki. If you do not want your household information shared · with Hawki · print · sign and date in the box provided. · E) Obtaining translated applications. If you need a translated application with instructions · they can be found in · 49 languages at: https://www.fns.usda.gov/school-meals/translated-applications. · Agriculture (USDA) civil rights regulations and policies · this institution is prohibited from discriminating on the · basis of race · color · national origin · sex (including gender identity and sexual orientation) · disability

How do you know if your children are · ready for school? Check their smiles. · All Iowa children enrolling for the first time in Kindergarten · or 9th grade must have a dental screening. It’s required! · Screening Rules · Kindergarten Students · Screening must occur no earlier than age 3 and no later than · 4 months after enrollment · Screenings can be performed by: dentists · dental hygienists · physicians · registered nurses · or physician assistants · 9th Grade Students · Screening must occur no earlier than 1 year before enrollment · and no later than 4 months after enrollment · Screenings can only be performed by: dentists or dental hygienists · √ Get an official Certificate of Dental Screening form from your school nurse or · local I-Smile™ Coordinator. · √ Make an appointment for your child to get a dental screening. · √ Return the completed form to the school. · Need help getting a dental screening? Your local I-Smile™ Coordinator can assist you! · Call 1-866-528-4020 for contact information or visit: · www.idph.state.ia.us/webmap/default.asp?map=ismile · You can also find forms and additional information on the dental screening requirement at: · http://www.idph.state.ia.us/ohds/OralHealth.aspx?prog=OHC&pg=Screenings · www.ismiledentalhome.iowa.gov September 2012 · ¿Cómo sabe si sus hijos están listos · para la escuela? Examine sus sonrisas. · Todos los niños de Iowa que se inscriben por primera vez en el jardín de

PARENT/GUARDIAN INFORMATION LETTER FOR FREE MEAL APPLICATIONS · Frequently Asked Questions About Free and Reduced Price School Meals · Dear Parent/Guardian: · Children need healthy meals to learn. Springville Community School offers healthy meals every school day. Breakfast · costs $2.00; lunch costs elementary · $2.90 · middle school · $3.00 and high school · $3.05. Your children may qualify for free · meals/milk or for reduced price meals. Reduced price is .30 for breakfast and .40 for lunch. Please visit our website to · complete an application at: http://www.lisbon.k12.ia.us. · Below are some common questions and answers to help you with the application process. · 1. WHO CAN GET FREE OR REDUCED PRICE MEALS? · ● All children in households receiving benefits from the Supplemental Nutrition Assistance Program (SNAP) · the · Family Investment Program (FIP) or a few specific Medicaid programs are eligible for free or reduced price meals. · ● Foster children that are under the legal responsibility of a foster care agency or court are eligible for free meals. · ● Children participating in their school’s Head Start program are eligible for free meals. · ● Children who meet the definition of homeless · runaway · or migrant are eligible for free meals. · ● Children may receive free or reduced price meals if your household’s income is at or below the limits on the · Federal Income Eligibility Guidelines below and apply for free and reduced price meals/milk. · FEDERAL INCOME ELIGIBILITY GUIDELINES for SCHOOL YEAR 2025-2026 · Household Yearly Monthly Twice per Month Every Two Weeks Weekly · Size · 1 28 · 953 2 · 413 1 · 207 1

5. DO I NEED TO FILL OUT AN APPLICATION FOR EACH CHILD? No · complete the applications for free and reduced · price school meals for all the students in your household. We cannot approve an application unless complete eligibility · information is submitted · so be sure to complete all required information. · 6. MY CHILD’S APPLICATION WAS APPROVED LAST YEAR. DO I NEED TO FILL OUT A NEW ONE? Yes · your · child’s application is only good for that school year and for the first few days of this school year · through October 6 · 2025. You must complete a new application unless the school told you that your child is eligible for the new school · year. When the carryover period ends · unless you are notified that your children will receive free meals or you submit · an application that is approved · the children must pay full price for school meals. The school is not required to send a · reminder or a notice of expired eligibility. · 7. I GET WIC. CAN MY CHILDREN GET FREE MEALS? Children in households participating in WIC may be eligible for · free or reduced price meals. Please complete and send in an application. · 8. MAY I APPLY IF SOMEONE IN MY HOUSEHOLD IS NOT A U.S. CITIZEN? Yes · you · your children or other · household members do not have to be U.S. citizens to apply for free or reduced price meals. · 9. WILL THE INFORMATION I GIVE BE CHECKED? Yes · we may also ask you to send written proof of the household · income you report. You are not required to provide proof with your application. · 10. IF I DON’T QUALIFY NOW · MAY I APPLY LATER? Yes · you may apply at any time during the school year. For · example · children with a parent or guardian who becomes unemployed may become eligible for free or reduced price · meals if the household income drops below the income limit

19. CAN CHILDREN WITH DISABILITIES GET FOOD SUBSTITUTIONS? If a child has a disability · as determined by a · licensed medical professional · and the disability prevents the child from eating the regular school meal · the school will · make substitutions prescribed by the licensed medical professional. If a substitution is needed · there will be no extra · charge for the meal. Please note · however · that the school is not required to make a substitution for a food allergy · unless it meets the definition of disability. Please call the school for further information. · 20. DO I NEED TO REPORT MY RACE AND ETHNICITY? It is optional to complete the racial/ethnic portion of the · application · however · if you do not select race or ethnicity · one will be selected for you based on visual observation. · 21. Translated applications are available at: http://www.fns.usda.gov/school-meals/translated-applications. · If you have other questions or need help · email Michele McCoy at [email protected]. · Sincerely · Michele McCoy · civil rights regulations and policies · this institution is prohibited from discriminating on the basis of race · color · national origin · sex (including gender identity and sexual orientation) · disability · age · or reprisal or retaliation for prior civil rights activity. · Program information may be made available in languages other than English. Persons with disabilities who require

SPRINGVILLE SCHOOL DISTRICT · HEAD LICE MANAGEMENT PLAN · Springville Community School District will support families by emphasizing prevention · early detection · and education as the best method in controlling head lice. · Pediculosis (head lice) represents a common childhood condition an acknowledged “problem · ” with · raising and caring for children. Community involvement is very important · and families must actively · participate at home in the treatment and prevention of head lice. The plan established by Springville · Community School District is designed to be family friendly and sensitive to individual needs. Our goal is · to support families and keep kids where they need to be…in school. This plan was developed following · the recommendations of the Linn County Public Health Department · Iowa Department of Public Health · National Association of School Nurses · American Academy of Pediatrics and Harvard School of Public · Health. · The School’s Role in Head Lice Parent/Caregiver Role in Head Lice · Management Management · General classroom screening is not • Check children at home for head lice as · recommended. Regular screening for live needed · lice has not been proven to have a • Check household contacts and treat those · significant effect on the incidence of head that have been identified with live head lice · lice in a school community overtime or nits within ¼ inch from scalp · (Rollins · 2010) • Notify others who have had close contact · Students with signs and symptoms of head with the child in the past 2-3 weeks · lice will be referred to the school nurse for • Call the school to report head lice and/or · evaluation and recommendations for nits found on child · treatment. All attempts will be made to • Contact your healthcare provider if two

QUESTIONS AND ANSWERS ABOUT LICE · 1. What are head lice? · Head lice are insects that live and feed on the human scalp and lay between 50-90 eggs by attaching · them firmly with a glue like substance to the hair shaft. The adult is about the size of a sesame seed and · is brown to reddish brown. They move quickly away from light but cannot fly (they have no wings) or · jump. Lice die within 24 hours off the head. The eggs hatch in seven days and grow to adulthood in · about 2 weeks. They are most commonly found around the ears and along the neckline at the back of · the head. · 2. Where do lice come from? · Head lice are insects that date back many centuries. They do not carry disease. · 3. How does a person get head lice? · Lice can be spread during direct hair-to-hair contact with a person who has lice. Sharing pillows · brushes · combs · hats or clothes recently used by someone with head lice can also spread lice. Pets do not · spread head lice. It is estimated that 95% of cases are spread through person-to-person contact while · only 5% comes from indirect contact. · 4. What are the symptoms of head lice? · Often · the first sign is itching at the back of the head and around the ears. Not everyone will experience · itching. If you notice your child repeatedly scratching his or her head · you should examine the head for · nits or bugs. Also · irritability and difficulty sleeping can be signs of head lice as they are most active in · the dark. Sores on the head caused by scratching can also be a sign and symptom of head lice · which can · lead to infections from bacteria on the skin. · 5. How long does it take for a person to develop symptoms? · It can take up to 2-3 weeks for symptoms to appear. Some people may never develop symptoms. · 6. Should I treat everyone in the family when my child has lice?

ths · 12 months plus a 1 month grace period. · ●​ Concussion acknowledgement form for any sports participation · this includes dance and cheer. · Code 507.2E1 · Springville Community Schools · Authorization: Asthma or Other Airway Constricting Medication · Self-Administration Consent Form · Student’s Name Grade Birth Date · In order for a student to self-administer asthma or medication for an 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 · or 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 state 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