DO MBG Compliance If you are human, leave this field blank.District Office Mandate Block Grant Compliance FormInstructionsPlease use this form to submit your Department Mandated Block Grant Compliance Form to us electronically. The following section entitled \”Your Information\” is required before you may continue. Definitions of Yes, No and N/AYes=Someone at your site performed the activity associated with the mandate. No=Your site is NOT in compliance with the mandate. N/A=This Mandate/Activity is not applicable to (1) your department or (2) the activity related to this mandate, or the mandate itself did not take place this school year. Your InformationName *Department Designee? *Please check Yes if you are the Department Designee and you are reporting on all mandates for your department. Please check No if you are reporting for yourself only.YesNoTitleDistrict *Department *Email * MandatesInstructionsIndicate whether or not you performed ANY or All of the activities listed under each mandate by clicking \”Yes\”, \”No\”, or \” N/A\” (not applicable). See the definition of N/A above. Agency Fee Arrangements-Program 269Reimbursable Activities Under the MBG - Deducted the classified employee\'s fair-share-service fee from their wages & paid it to the employee organization. Provided the exclusive representative with the home address of each member of a bargaining unit, Provided an alphabetical list of the names and job titles/classifications of those employed in the unit as described in the petition as of the last date of the payroll period immediately preceding the date the petition was filed.YesNoN/AAIDS Instruction and AIDS Prevention Instruction (Grades 7-12)-Program 250Reimbursable Activities Under the MBG - Provide in-service training to instructors of the program. Provide instruction to students by non-classroom assigned teachers. Hiring consultants to provide AIDS instruction. Selection of instructional material. Provide written notification of the program to parents/guardians that the program is offered and of any assemblies being held by guest speakers.YesNoN/ACalifornia Assessment of Student Performance and Progress-Program 369Reimbursable Activities Under the MBG - Provide computing devices and/or internet services as needed; assess the current technology for compliance as needed; notify parents about CAASPP; score & transmit the tests to CDE as needed; identify pupils unable to access the computer-based test as needed; report to CDE of any pupil in grade 2 that was administered a diagnostic assessment in language arts and math as needed; review videos and the Smarter Balance Online Test Manual as needed; and ensure all designated supports, accommodations and individualized aids are entered in the registration system.YesNoN/ACalifornia State Teacherts\' Retirement System (CalSTRS)-Program 286Reimbursable Activities Under the MBG - Make available criteria for membership & optional membership. Inform part-time & substitute employees that they elect membership at any time. Maintained written acknowledgment by the employee regarding information provided about the Defined Benefit Program in employer files on a form provided by CalSTRS. Inform the employee of their right to make an election to CalStrs/CalPERS. Certify the number of unused excess sick leave days to CalSTRS for retiring members. Upon request from the CalSTRS board, submitted sick leave records of past years for audit purposes. Provided information to CalSTRS regarding the reemployment of a member who is subject to federal law regarding the reemployment of military service personnel.YesNoN/ACaregiver Affidavits (CA) to Establish Residence for School Attendance-Program 172Reimbursable Activities Under the MBG - Accept & review for completeness the CA form submitted by the caregiver. Performed administrative tasks associated with enrollment and transfer of students under the caregiver affidavit program. Conducted and/or attended training regarding the requirements of the subject mandate.YesNoN/ACharter Schools I, II, & III-Program 278Reimbursable Activities Under the MBG - Respond to information requests. Evaluate petitions. Public hearings. Review of renewal petitions. Notification of violation of EC § 47607. Findings on denial of petitions. Monitor the Charter. Transfer funds in lieu of taxes.YesNoN/ACharter Schools IV-Program 337Reimbursable Activities Under the MBG - Review Charter School petition. Make a written factual finding if the CBOE denies the charter petition. Consider proposed material revisions. File Charter School annual statement. Receive annual statement. Verify and transmit annual statement with the county superintendent of schools.YesNoN/AChild Abuse and Neglect Reporting-Program 309Reimbursable Activities Under the MBG - Report to the CDE the reasons why training is NOT provided in the duties of a mandated reporter under the child abuse reporting laws. Inform a selected member of the staff of requirements prior to an interview of a suspected victim of child abuse or neglect.YesNoN/ACollective Bargaining-Program 11Reimbursable Activities Under the MBG - Determination of Bargaining Units and exclusive representation. Election of unit representation. Cost of negotiations. Impasse proceedings. Collective bargaining agreement disclosure. Contract administration including grievances and interpretation of the contract with an employee. Unfair labor practice charges.YesNoN/AComprehensive School Safety Plans (CSSP) I & II-Program 313Reimbursable Activities Under the MBG - Develop, write, and adopt the CSSP for any new school established on or after July 2009. Annually update the CSSP.YesNoN/AConsolidation of Annual Parent Notification/Schoolsite Discipline Rules/Alternative Schools - Program 272Reimbursable Activities Under the MBG - Annually notify parents/guardians of the following: Pupil attendance alternatives, alternative schools, staff development days, grade reduction & text, advanced placement fees, Schoolsite discipline rules, & prospectus of curriculum.YesNoN/AConsolidation of Notification to Teachers: Pupils Subject to Suspension or Expulsion I & II, and Pupil Discipline Records - Program 292Reimbursable Activities Under the MBG - For receiving district request from the school district in which the pupil was last enrolled any records from a law enforcement agency regarding acts committed by the transferring pupil that resulted in his/her suspension or expulsion. Provide the same information to a district any pupil who is transferring to. Notify the school and staff upon receipt of any information related to a suspension or expulsion of a student transferring in from another district.YesNoN/AConsolidated Suspension, Expulsions, & Expulsion Appeals - Program 330Reimbursable Activities Under the MBG - Adopt policies and procedures. Recommendation for expulsion. Expulsion hearing procedures. Expulsion hearing procedures for sexual assault or sexual battery allegations. Post-expulsion hearing procedures. Refer expelled pupil to different school site rehabilitation plan, and alternative educational program. Readmission to the district. Expelled pupil\'s request to attend a new district. Expulsion appeal hearings. School district data collection and reporting. Training staff on suspension and expulsion procedures and policies (one-time per employee).YesNoN/ACriminal Background Checks I (CBC) - Program 183Process a CBC for certificated employees hired. Process a CBC for certificated employees applying for a temporary certificate/clearance. Process a CBC for contractor employees. Cost of electronic fingerprinting equipment. Preparation of policies, procedures, guidelines, and training.YesNoN/ACriminal Background Checks II (CBC) - Program 251Reimbursable Activities Under the MBG - Communicate with the DOJ. Storage of DOJs documents. Destruction of the DOJs information. Fingerprint card requests to FBI. Maintain a list of the number of current employees. Subsequent arrest service requests. Precautions dealing with construction contractors.YesNoN/ADeveloper Fees - Program 333Reimbursable Activities Under the MBG - Notify local government if conditions of overcrowding exist in one or more of the attendance areas. Submit the schedule of fees to the local government. Make a recommendation of the fee amount to be assessed due to overcrowding. Cost of fund accounting as follows: (1) Maintained a separate account (2) Filed a report by 10/15 of each year with the city council or county board of supervisors which specifies; (a) balanced in the account at the end of the previous year; (b) the facilities leased, purchased, or constructed; (c) the dedication of land during the previous fiscal year; and (d) which attendance areas will continue to be overcrowded when the fall term begins and where conditions of overcrowding will no longer exist.YesNoN/ADifferential Pay and Reemployment - Program 253Reimbursable Activities Under the MBG - One-Time Activity-Change the process for calculating the five-month differential pay period and establish a reemployment list. On-going activities to maintain a reemployment list and process the reemployment paperwork.YesNoN/AExpulsion of Pupils: Transcript Cost of Appeals - Program 91Reimbursable Activities Under the MBG - Provide a transcript of the initial hearing to the parents/guardians of an expelled student if the parents/guardians have limited income.YesNoN/AFinancial and Compliance Audits - Program 192Reimbursable Activities Under the MBG - Boilerplate language (One-time cost)-changing the contract language to require access to audit working papers and delineate payment terms, payment withholds, and the provision to void multi-year contracts. Ongoing costs of processing multiple payments to the auditor. Costs associated with changes to the audit put forth by the State. Resolving audit exceptions. Adjusting future local property tax requirements to correct any audit exceptions. Responding to, consulting with, and providing access to audit working papers to the SDE and/or COE. Placing a review of the annual audit on the agenda for a public meeting of the governing board.YesNoN/AGraduation Requirements (Grades 9-12) - Program 297Reimbursable Activities Under the MBG - Acquired additional space due to and increase in units of science course enrollments. Acquired additional equipment & furniture for the new courses. Remodel existing space. Increased cost for staffing new science classes. Increased costs for textbooks & supplies.YesNoN/AHabitual Truants - Program 166Reimbursable Activities Under the MBG - Verify prior truancies. Make an effort to schedule a parent conference. Hold a parent conference. Reclassify pupil as truant.YesNoN/AImmunization Records - Program 32Reimbursable Activities Under the MBG - The governing authority of the school maintained immunization records on each student and filed a written report on the immunization status of new entrants to the school with the State Department of Health Services at times and on forms prescribed by the DepartmentYesNoN/AImmunization Records-Mumps, Rubella, & Hepatitis B - Program 368Reimbursable Activities Under the MBG - Request & review exemption or proof of immunization. Record immunization or exemption in the student\'s permanent record. Request & review exemption of Hepatitis B. Conditionally admit any pupil not yet immunized. Periodically review the pupil\'s immunization record until it is fully up to date. Document vaccine doses on the pupil\'s immunization record as they are administered. Notify parents/guardians of all requirements & refer them to a health practitioner. Exclude those pupils when written evidence of immunization is not presented within 10 days of notification. Collect data and prepare the required reports for DHS.YesNoN/AImmunization Records-Pertussis (7TH GRADE ONLY) - Program 357Reimbursable Activities Under the MBG - Unconditionally admit students who are fully immunized against pertussis, Conditionally admit students who are not fully immunized against pertussis. Notify parents of their obligations. Exclude students who have not provided the proper documentation from attending school within 10 days of notifying the parent/guardian.YesNoN/AInterdistrict Attendance Permits - Program 148Reimbursable Activities Under the MBG - Evaluate the application giving consideration to child care needs of the pupil. Prepare & present the transfer application for child care purposes to the governing board. Provide a written explanation of the reasons for denial to the parent/guardian. Notify the parent/guardian of their appeal rights.YesNoN/AIntradistrict Attendance - Program 153Reimbursable Activities Under the MBG - Prepare & adopt rules & regulations to establish a policy of open enrollment. Establish and operate a random selection process in excess of school site capacity. Enrollment projections. Evaluate each request for its impact on district racial & ethnic balances.YesNoN/AJuvenile Court Notices II - Program 155Reimbursable Activities Under the MBG - Juvenile court notices are kept in a separate confidential file at the school of attendance until the minor graduates from high school, is released from juvenile court jurisdiction, or turns 18.YesNoN/ANotification of Truancy - Program 48Reimbursable Activities Under the MBG - To be in complete compliance with this mandate the notification of truancy must be made when there are 3 unexcused days or 3rd thirty minute tardy or a combination of both. The notification MUST include the following: The pupil is truant. The parent is obligated to compel the attendance of the pupil. The parents may be subject to prosecution. That alternative education is available. That the parent has the right to meet with school personnel to discuss solutions. That the pupil may be subject to prosecution. That the pupil may be subject to suspension, restriction, or delay of their driving privileges. That it is recommended the parent accompany the student to school and attend class with the pupil for one day.YesNoN/APhysical Performance Tests (Grades 5, 7, 9) - Program 173Reimbursable Activities Under the MBG - Acquisition of supplies and equipment. Training staff responsible for testing. Conducting the tests. Process & analyze score data. Respond to requests by the CDE.YesNoN/APublic School Restrooms Feminine Hygiene Products (Grades 6-12) - Program 374Reimbursable Activities Under the MBG - Stocked 50% of the school's restrooms with feminine hygiene products at all times at no cost to pupils. Purchased and installed a sufficient number of suitable dispensers for feminine hygiene products in 50% of the school's restrooms. Repaired or retrofitted a sufficient number of suitable dispensers for feminine hygiene products in 50% of the school's restrooms.YesNoN/APrevailing Wage Rate - Program 304Reimbursable Activities Under the MBG - Upon request made to the awarding vendor perform the following: (1)Obtain certified payroll records. (2)Send acknowledgement to requestor. (3)Provide copies of records to requestor. (4)Retain copies of payroll records. Withhold penalties from contractor progress payments for noncompliance. Insert stipulations regarding contractor\'s & subcontractor\'s requirements.YesNoN/APublic Contracts (K-14) - Program 335Reimbursable Activities Under the MBG - Specify classification of contractor\'s license. Include clause in public works contract. Set provisions in plans of public-work. Respond to claims, schedule and engage in a meet and confer conference. Review payment requests. Include provisions in invitation for bid. Before awarding, verify license. Before first payment verify license.YesNoN/APupil Health Screenings - Program 261Reimbursable Activities Under the MBG - Notify the parents/guardians enrolling kindergarten students of the availability of CHDPP services; notify parents or guardians of kindergarten & 1st grade pupils of their obligation to obtain a pupil health screening certificate. Follow-up with those parents who have not complied either with the certificate or exemption. Exclude those pupils from attendance for up to 5 days beginning the 91st calendar day after entrance to the first grade.YesNoN/APupil Safety Notices - Program 280Reimbursable Activities Under the MBG - Within 60 days of the completion of testing a Schoolsite for lead in the water, the department shall notify the principal of the school or director of the schoolsite of the survey results. Within 45 days of receiving the survey results, the principal or director, as the case may be, shall notify the teachers and other school personnel and parents of the survey results. (Ed. Code, § 32242, subd. (c).)YesNoN/APupil Safety Notices - Program 280Reimbursable Activities Under the MBG - Child Abuse Complaint Process: Disseminate guidelines to parents/guardians of minors which he or she can follow in filing a complaint of child abuse by a school employee or other person committed against a pupil at a school site. (Ed. Code, § 48987.)YesNoN/APupil Safety Notices - Program 280Reimbursable Activities Under the MBG - Child Abuse Complaint Process: Provide an interpreter for a parent or guardian, whose primary language is other than English, in the case of any communications concerning the guidelines and procedures for filing child abuse complaints committed against a pupil at a school site. (Ed. Code, § 48987.)YesNoN/ARace to the Top - Program 362Reimbursable Activities Under the MBG - This mandate is for school-districts persistently low-achieving. Hold 2 public hearings for each school to seek input for options suitable for the school. Governing board selects one of the four intervention models. Implement the intervention model. Under the parent empowerment act implement the intervention model requested by parents. Notify the SPI and SBE of any alternative option selected. Under the open enrollment act notify parents/guardians of their option to transfer to another school district. Conduct a lottery. If transfer is rejected state the reasons why in writing.YesNoN/ASchool Accountability Report Cards (SARC) - Program 171Reimbursable Activities Under the MBG - Compilation, analysis, and reporting of data. Annual posting of SARCs on the internet.YesNoN/ASchool District Fiscal Accountability Reporting & Employee Benefits Disclosure (Consolidation) - Program 258Reimbursable Activities Under the MBG - Annual statement of receipts & expenditures. Revise annual budget. Negative fund or cash balances. Disapproved budget. Certification of ability to meet fiscal year obligations. Qualified & negative certifications. Neglect or refusal to make a budget. Collective bargaining budget revisions. Training (one-time activity).YesNoN/ASchool District Reorganization - Program 228Reimbursable Activities Under the MBG - Transmitting reorganization petitions. Preparing a description of the petition. Post or make the petition description available. Report to SBE.YesNoN/AStudent Records - Program 308Reimbursable Activities Under the MBG - Provide access to records of current or former pupils to foster family agencies. Transfer the foster child\'s educational & health record to new educational agencies. Release of identity and location information to designated peace officer.YesNoN/AThreats Against Peace Officers - Program 162Reimbursable Activities Under the MBG - Receive notification of a \"credible threat\". Approve relocation plans, and if necessary, verify residency of immediate family member. Review and approve claims for actual and necessary relation expenses incurred. Payment of approved claims.YesNoN/ATraining for School Employee Mandated Reporters-Program 367Reimbursable Activities Under the MBG - Providing annual training to all employees for the detection of child abuse and neglect, the proper action that school personnel should take, and information that failure to report is a misdemeanor punishable by up to six month in jail and/or up to a fine of one thousand dollars.YesNoN/AUniform Complaint Procedures - Program 346Reimbursable Activities Under the MBG - Antidiscrimination laws & notices regarding civil remedies: Provide written assurance, submit timely, complete, & accurate compliance reports, advice complainant, publication of civil remedies. Refer complainant to appropriate entities. Activities for non-employment discrimination and specific educational programs complaints include: (1) Adoption of policies & procedures (one-time only). (2) Notification of complaint procedures, investigation & disposition of complaints. (3) Forward the information to the SPI.YesNoN/AWilliams Case Implementation I, II, & III - Program 351Reimbursable Activities Under the MBG - Report information on the SARC. Comply with the Williams Complaint Process. Verifications in the annual compliance audits. Provide copies of reports to the COE.YesNoN/A SignatureElectronic Signature *I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct based upon personal knowledge. *** By signing your name in the Electronic Signature field, you are signing the MBG Compliance form electronically. You agree that your electronic signature is the legal equivalent of your handwritten signature.Reset SignatureSignature is required.NameCaptcha *reCAPTCHA is required.Submit