Hillside Public Schools · Agenda Regular Meeting October 15, 2015 CALL TO ORDER: PM FLAG SALUTE...

Agenda Regular Meeting October 15, 2015

CALL TO ORDER: PM

FLAG SALUTE

NOTICE OF MEETING:

Pursuant to the Open Public Meetings Act, adequate notice of this meeting has been provided as follows: By having the time, date and place of the meeting posted on the bulletin board In the Administration Building February 24, 2015;

By sending a copy of the meeting notice to the Star Ledger Newspaper and the Union County Local Source Newspaper on February 24, 2015;

By filing a copy with the Township on February 24, 2015.

ROLLCALL:

Chiles-Bass Sileem Cook Watson James Lofton McKnight Deo Menza Weinheimer Mondella Lattiboudere

Public Comments - Agenda Items

Executive Session

Announcements and Reminders

Middle States Presentation - Lt. Col. Ron Richard, Internal Coordinator, Mrs. Christine Sidwa, Principal

Superintendent's Report

Business Administrator's Report Presentation on recently completed facility work

Committee reports:

Finance: Mr. James Buildings and Grounds: Ms. Watson Education: Mr. Cook Community Relations: Mr. James

Public Comments - Agenda Items

Board Action

Public Comments - Agenda and Non-Agenda Items

If anyone in the Public would like to speak on an AGENDA OR NON-AGENDA item ONLY, please come forward at the designated time. Please begin your comments by stating your name, address, and writing same in the log provided. Individuals are invited to speak on one topic at a time, and no individual will speak more than once, until all individuals so desiring have spoken once. Please limit your comments to three minutes on one item at a time.

The time allotted, as set in board policy is three minutes per person and fifteen minutes in total per each comment period. (Note that this policy may be suspended by specific board action.)

1 10/15/2015

Agenda Regular Meeting - October 15, 2015

Organization Items

1. Motion to approve the following as Tax Shelter Annuity Companies (403(b) and 457) and College Savings Plans (529):

Motion to approve the following as a vendor for income protection plans (as employee deductions):

AFLAC (expanding from HAA and non-affiliated to include HEA)

Motion: Second:

Chiles-Sass Mondella

Cook Sileem James Watson McKnight Lofton Menza

10/15/2015 2 UnderlininQ indicates additions since reviewed in committee.


FINANCE - McKnight/Mondelia

1. Motion to approve the minutes of the regular meeting held on September 17,2015.

2. Motion to approve line item transfers. (FI#1-10/15)

3. Motion to approve the following line item transfer for the 2014-15 year:

From: 11-000-240-105-09-00, Salaries of Principal's Secretary - HHS = $19,500 To: 11-000-230-890-01-00, Supt. Office Miscellaneous Expense = $19,500

4. Motion to approve the payment of bills subject to the availability of funds.

5. Motion to approve the Board Secretary's Report for the month of September 2015.

6. Motion to approve the Treasurer's Report for the month of September 2015.

7. Motion to ratify and approve the award of the proposal for lease purchase financing, Option .!2 submitted by TD Equipment Finance, Inc. at an interest rate per annum of 1.7219% prepayable at the option of the Board in whole or in part at any time and with semiannual principal and interest payments and otherwise in accordance with the Request for Proposals issued on behalf of the Board of Education on September 23, 2015 for the lease purchase financing of a portion of the cost of the George Washington School Project in the principal amount not to exceed $6,750,000, subject to approval of the lease purchase financing by the Department of Education as required by law. (FI#2-10/15)

Motion:

10/15/2015

Second:

Chiles-Bass Cook James McKnight Menza

TD Bank* JP Morgan US Bank Bank of AmericalML M&T Bank PNC Bank

Mandella Sileem Watson Lofton

3 Underlining indicates additions since reviewed in committee.


BUILDINGS & GROUNDS - Watson

1. Motion to approve for submission to the New Jersey Department of Education the following:

a. Comprehensive Maintenance Plan (CMP) covering the periods 2013-14 through 2016-17. (BG#1-10/15)

b. Form M-1 Annual Maintenance Budget amount worksheet along with detailed expenditures. (BG#2-10/15)

c. Health and Safety Evaluation of School Buildings. (BG#3-10/15)

2. Motion to approve the attached Humanitarian meal service procedure for the 2015-16 school year. (BG#4-10/15)

Motion: Second:

Chiles-Bass Mondella

Cook Sileem James Watson McKnight Lofton Menza

4 10/15/2015 Underlining indicates additions since reviewed in committee.


EDUCATION - COOKIMENZA

1. Motion to accept the recommendation of the Superintendent of Schools and approve the Training and Seminars, Conventions and Conferences for the district. The board has determined that the travel is directly related to and within the scope of the employees' duties or responsibilities; that participation in the program or event is critical to the instructional needs of the district or furthers the efficient operation of the district; and that the travel is in compliance with the district policy on travel. (Attachment ED#1-1 0/15)

2. Motion to accept the Superintendent's Report of Harassment, Intimidation and Bullying (HIB): 4 case for September 17, 2015 through October 15,2015.

3. Motion to accept the recommendation of the Superintendent of Schools and approve the Agreement for Participation in Amistad Workshops on November 19, 2015, December 3, 2015 and February 4, 2016 between Hillside and the Board of Education of the city of Rahway at a cost of $900.00 per participant not to exceed $4,500.00 effective October 1, 2015 for the 2015 -16 school year. The following teachers will be trained:

a. Jason Jaco - WOK b. Elfrieda Eubanks - APMECC c. Grace Laspata - CC d. Kimley Davis - HL e. Jessica Rozewski - GW

4. Motion to accept the recommendation of the Superintendent of Schools and approve the Memorandum of Agreement between Education and Law Enforcement Officials, as adopted annually by the Board of Education, the Hillside Police Department, and the office of the Union County Prosecutor for the 2015-16 school year.

5. Motion to accept the recommendation of the Superintendent of Schools to approve the revised Title I District-Wide Parental Involvement Policy for the 2015-2016 school year. (Attachment ED#2-10/15)

6. Motion to approve one hundred HHS seniors to visit Pine Grove Dude Ranch in Kerhonkson, NY from June 9-11,2016. This is the annual Senior Class Trip. (Attachment ED#3-10/15)

7. Motion to approve fifty HHS students in grades 9-12 to visit Dorney Park in Allentown, PA on October 30, 2015. The purpose of the trip is for students in the FBLA club- Business classes to build connections between classroom instruction and meaningful on-site experiences. (Attachment ED#4-10/15)

8. Motion to approve fifty HHS students in grades 9-12 to visit Dorney Park in Allentown, PA on June 18, 2016. The purpose of the trip is for students in the FBLA club- Business classes to build connections between classroom instruction and meaningful on-site experiences. (Attachment ED#5-10/15)

9. Motion to accept the recommendation of the Superintendent of Schools and approve the revised school calendar for the 2015-16 school year. (Attachment ED#6-10/15)

5

10/15/15 Underlining indicates additions since reviewed in committee.


EDUCATION - COOKIMENZA (continued)

10. Motion to approve the submission of the SOA for the New Jersey Quality Single Accountability Continuum (NJQSAC) for the 2015-16 School Year to the New Jersey Department of Education. (Attachment ED#7 -10/15 )

11. Motion to accept the recommendation of the Superintendent of Schools and approve the Special Education request for Related Services/Out-of-District Placements as attached. (Attachment ED#8-10/15)

12. Motion to approve a settlement agreement for the provision of educational services for student ID #9322954467 commencing September 1, 2015.

13. Motion to approve the attached list of destinations for in-state field trips for the 2015-2016 school year. (Attachment ED# 9-10/15)

14. Motion to accept the recommendation of the Superintendent of Schools and approve the following Science Curriculum for Grades K- 8.

15. Motion to approve twenty-five Hillside High School students in grades 9-12 to visit HVO Orienteering @ Blue Mountain Park in Peekskill, NY on November 21, 2015. The purpose of the trip is for students to participate in the JROTC drill and fitness competition. (Attachment ED#10 -10/15)

16. Motion to accept the recommendation of the Superintendent of Schools and approve the New Jersey Non-Public Security Aid Program Agreement for the 2015-16 school year between the Union County Educational Services Commission and the Hillside Board of Education. (Attachment ED#11-10/15)

17. Motion to accept the recommendation of the Superintendent of Schools and approve the 2015-2016 Nursing Services Plan. (Attachment ED#12-1 0/15)

18. Motion to approve a contract with Delta-T Group for the provision of interim professional services for the 2015-16 school year effective September 10, 2015, subject to final verification of all terms and conditions. (Attachment ED#13-1 0/15)

19. Motion to approve a contract with Preferred Home Health Care & Nursing Services, Inc. for the provision of LPN services at a cost of $49 per hour and RN services at a cost of $52 per hour for the 2015-16 fiscal year effective July 1, 2015, subject to final verification of all terms and conditions .. (Attachment ED#14-1 0/15)

20. Motion to approve a contract with Epic Health Services, Inc. and Loving Care Agency, Inc. for the provision of private duty nursing services for the 2015-16 fiscal year effective July 1, 2015, subject to final verification of all terms and conditions. (Attachment ED#15-1 0/15)

6



EDUCATION - COOKIMENZA (continued)

21. Motion to approve a contract with Sayada Home Health Care for the provision of LPN services at a cost of $44.50 per hour and RN services at a cost of $54.50 per hour for the 2015-16 fiscal year effective July 1, 2015, subject to final verification of all terms and conditions .. (Attachment ED#16-1 0/15)

Motion: Second:

Chiles-Sass Mondella

Cook Sileem

James Watson

McKnight Lofton

Menza

7



POLICY - Committee of the Whole

1. Motion to adopt upon the second reading the following policies/regulations (Attachment PO#1-1 0/15)

a) Regulation 7444 Use of Metal Detectors

Motion: Second:

Chiles-Bass Mondella Cook Sileem James Watson McKnight Lofton

Menza

8 10/15/2015

.J.. .-Transfers by Account Code Hillside Board of Education Page 1 of 8

10/15/1516:40 Start date 7/1/2015 Period date 9/1/2015 End date 9/1/2015 Expenditure

Original amt Prior xfer Period xfer Adjusted amt % Chg FUND 11 GENERAL CURRENT EXPENSE

11-000-100-562-11-00 TUIT OTH LEA STATE-SPEC $1,587,600.00 $86,288.00 $96,588.00 $1,770,476.00 12% 115896 : 11-000-100-566-11-00 SEPT TRANS 09/01/15 $96,588.00

11-000-100-563-12-00 TUITION - COUNTY VOCATIONAL PR $319,500.00 $0.00 $61,000.00 $380,500.00 19% 11589~ 11-000-100-566-11-00 SEPT TRANS 09/01/15 $61,000.00

11-000-100-566-11-00 TUIT PVT SCH HANDIC. $834,234.03 ($62,461.00) ($157,588.00) $614,185.03 -26% 1158961 11-000-100-562-11-00 SEPT TRANS 09/01/15 ($96,588.00)

1158961 11-000-100-563-12-00 SEPT TRANS 09/01/15 ($61,000.00)

11-000-217 -106-11-00 OTHER SALARIES EXTRAORD SVC $339,000.00 $0.00 $1,108.00 $340,108.00 0% : 15897 i 11-000-217-106-55-00 SEPT TRANS 09/01/15 $1,108.00

11-000-217 -106-55-00 OTHER SAL EXTRAORD SERV ESY $33,500.00 $0.00 ($1,108.00) $32,392.00 -3% 1158971 11-000-217 -106-11-00 SEPT TRANS 09/01/15 ($1,108.00)

11-000-218-104-55-00 SALARIES - SUMMER GUIDANCE COU $16,700.00 $1,300.00 $1,131.00 $19,131.00 15% 1158981 11-000-219-104-11-00 SEPT TRANS 09/01/15 $1,131.00

11-000-219-104-11-00 SALARIES SPECIAL SERVICES CHIL $971,511.00 $0.00 ($105,734.00) $865,777.00 -11% 115898 ! 11-000-218-104-55-00 SEPT TRANS 09/01/15 ($1,131.00) i 15899 i 11-000-219-104-55-00 SEPT TRANS 09/01/15 ($7,210.00) 1158991 11-000-222-177-01-00 SEPT TRANS 09/01/15 ($15,862.00)

1158991 11-000-222-177-56-00 SEPT TRANS 09/01/15 ($326.00)

1158991 11-000-252-100-01-00 SEPT TRANS 09/01/15 ($8,205.00)

1159231 11-000-266-110-09-00 SEPT TRANS 09/01/15 ($2,059.00) 115923 ! 11-120-100-101-01-03 SEPT TRANS 09/01/15 ($70,941.00)

11-000-219-104-55-00 SUMMER SALARIES CHILD STUDY TE $21,000.00 $599.00 $7,210.00 $28,809.00 37% 1158991 11-000-219-104-11-00 SEPT TRANS 09/01/15 $7,210.00

11-000-221-102-01-00 SUPERVISORS OF INSTRUCTION $744,756.00 ($2,254.00) ($55,000.00) $687,502.00 -8% 1159011 11-000-223-580-01-00 SEPT TRANS 09/01/15 ($9,000.00)

1159241 11-120-100-101-01-03 SEPT TRANS 09/01/15 ($46,000.00)

11-000-222-177 -01-00 TECHNOLOGY COORDINATORS $205,506.56 $0.00 $47,862.00 $253,368.56 23% : 15899 ! 11-000-219-104-11-00 SEPT TRANS 09/01/15 $15,862.00 .15900 i 11-000-252-340-01-00 SEPT TRANS 09/01/15 $5,760.00 115900 I 11-190-100-590-01-00 SEPT TRANS 09/01/15 $26,240.00

11-000-222-177 -56-00 TECHNOLOGY COORD ASST SUMMER $5,500.00 $700.00 $326.00 $6,526.00 19% 1158991 11-000-219-104-11-00 SEPT TRANS 09/01/15 $326.00

11-000-223-320-07 -00 STAFF DEVELOPMENT PRESENTORS A $100.00 $0.00 $1,700.00 $1,800.00 1700% 1158671 11-190-100-610-07 -00 SEPT TRANS 09/01/15 $1,700.00

11-000-223-580-01-00 TRAVEL FOR STAFF TRAINING $0.00 $0.00 $9,000.00 $9,000.00 0% I 15901 I 11-000-221-102-01-00 SEPT TRANS 09/01/15 $9,000.00

11-000-230-104-01-00 SALARIES SUPT AND CERTIFIED ST $182,500.00 ($5,799.00) ($2,096.00) $174,605.00 -4% 1159021 11-000-230-105-01-00 SEPT TRANS 09/01/15 ($1,471.00) [15847J 11-000-251-890-21-00 SEPT TRANS 09/01/15 ($625.00)

11-000-230-105-01-00 SALARIES SUPT. SECRETARIAL & C $213,906.00 $0.00 $1,471.00 $215,377 .00 1% 1159021 11-000-230-104-01-00 SEPT TRANS 09/01/15 $1,471.00

Transfers by Account Code Hillside Board of Education

Start date 7/1/2015 Period date 9/1/2015 End date 9/1/2015

FUND 11 GENERAL CURRENT EXPENSE

11-000-240-103-02-00 SALARIES PRINCIPAL! ASST PRINC 115903 I 11-000-240-103-03-00 SEPT TRANS

11-000-240-103-03-00 SALARIES PRINCIPALS/ASST. PRIN 1159031

11-000-240-103-04-00 1159041 : 15904:

11-000-240-103-05-00 1159041

11-000-240-103-07 -00 1159041

11-000-240-104-01-00 ! 159251 i 159251

11-000-240-105-04-00 1159051

11-000-240-105-05-01 115905 i

11-000-240-610-07 -00 115871 !

11-000-251-580-01-00 1159061

11-000-251-610-01-00 115906 i

11-000-251-890-21-00 1158471

11-000-252-100-01-00 1158991

11-000-252-340-01-00 1159001

11-000-261-420-04-00 I 15883J

11-000-261-420-09-00 i 15907!

11-000-261-590-01-00 115907 !

11-000-261-610-01-00 1158831

11-000-240-103-02-00 SEPT TRANS

SALARIES-PRINCIPALS/ASST. PRIN 11-000-240-103-05-00 SEPT TRANS 11-000-240-103-07-00 SEPT TRANS

SALARIES-PRINCIPALS/ASST. PRIN 11-000-240-103-04-00 SEPT TRANS

SALARIES-PRINCIPALS/ASST. PRIN 11-000-240-103-04-00 SEPT TRANS

SALARIES OTHER PROF STAFFfDlRE 11-120-100-101-01-03 SEPT TRANS 11-140-100-101-01-00 SEPT TRANS

SALARIES PRINCIPAL'S SEC'Y STA 11-000-240-105-05-01 SEPT TRANS

SALARIES OVERTIME PRINCP SECYS 11-000-240-105-04-00 SEPT TRANS

PRINCIPALS SUPPLIES & MAT GW 11-190-100-610-07-00 SEPT TRANS

BUS OFFICE TRAVEL 11-000-251-610-01-00 SEPT TRANS

BUS OFFICE SUPPLIES & MATERIAL 11-000-251-580-01-00 SEPT TRANS

HUMAN RESOURCES MISC 11-000-230-104-01-00 SEPT TRANS

TECHNOLOGY SALARIES 11-000-219-104-11-00 SEPT TRANS

TECH PURCHASED TECH SERVICES 11-000-222-177-01-00 SEPT TRANS

REO BLDG MAINT WOK 11-000-261-610-01-00 SEPT TRANS

REO BLDG MAINT HHS 11-000-261-590-01-00 SEPT TRANS

REO BLDG MAl NT PURCH TECH SERV 11-000-261-420-09-00 SEPT TRANS

REO BLDG MAINT SUPPLIES 11-000-261-420-04-00 SEPT TRANS

Expenditure

Original amt

$124,726.00

$139,121.00

$371,166.00

$87,908.00

$128,362.00

$388,413.00

$124,368.00

$0.00

$2,500.00

$400.00

$8,500.00

$0.00

$30,795.36

$11,520.00

$82,963.00

$204,306.00

$0.00

$58,000.00

Prior xfer

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15 09/01/15

$0.00 09/01/15

$0.00 09/01/15

($12,547.00) 09/01/15 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$256.44 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$35,942.00 09/01/15

$149,924.20 09/01/15

$0.00 09/01/15

$14,008.74 09/01/15

Page 2 of 8

10/15/1516:40

Period xfer Adjusted amt % Chg

($957.00) ($957.00)

$957.00 $957.00

($3,987.OO) ($604.00)

($3,383.00)

$604.00 $604.00

$3,383.00 $3,383.00

($25,000.00) ($18,872.00) ($6,128.00)

($1,000.00) ($1,000.00)

$1,000.00 $1,000.00

$1,100.00 $1,100.00

$21.00 $21.00

($21 ($21.00)

$625.00 $625.00

$8,205.00 $8,205.00

($5,76()'00) ($5,760.00)

($6,000.00) ($6,000.00)

($3,500.00) ($3,500.00)

$3,500.00 $3,500.00

$6,000.00 $6,000.00

$123,769.00 -1%

$140,078.00 1%

$367,179.00 -1%

$88,512.00 1%

$131,745.00 3%

$350,866.00 -10%

$123,368.00 -1%

$1,000.00 0%

$3,600.00 44%

$421.00 5%

$8,735.44 3%

$625.00 0%

$39,000.36 27%

$5,760.00 -50%

$112,905.00 36%

$350,730.20 72%

$3,500.00 0%

$78,008.74 34%

Transfers by Account Code Hillside Board of Education Page 3 of 8


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I


11-000-262-110-01-00 SALARIES CERT ED FACILITIES MG $103,700.00 $0.00 $699.00 $104,399.00 1% 1159271 11-000-262-340-02-00 SEPT TRANS 09/01/15 $699.00

11-000-262-110-57 -00 SUMMER SALARIES CUSTODIAL $23,000.00 $0.00 $699.00 $23,699.00 3% 1 159m 11-000-262-340-02-00 SEPT TRANS 09/01/15 $699.00

11-000-262-340-01-00 PURCH TECHNICAL SERVICES $0.00 $0.00 $1,800.00 $1,800.00 0% 1158821 11-000-262-340-02-00 SEPT TRANS 09/01/15 $1,800.00

11-000-262-340-02-00 PURCHASED TECHNICAL SERVICES C $23,500.00 ($4,504.00) ($3,1'98.00) $15,798.00 -33% 1159271 11-000-262-110-01-00 SEPT TRANS 09/01/15 ($699.00) 1159271 11-000-262-110-57 -00 SEPT TRANS 09/01/15 ($699.00) 1158821 11-000-262-340-01-00 SEPT TRANS 09/01/15 ($1,800.00)

11-000-266-110-06-00 SALARIES SECURITY - SAY $16,920.40 $0.00 ($16,920.40) $0.00 -100% i 159081 11-000-266-110-09-00 SEPT TRANS 09/01/15 ($16,920.40)

11-000-266-110-09-00 SALA~ESSECU~TYHHS $248,323.60 $0.00 $18,979.40 $267,303.00 8% 1159231 11-000-219-104-11-00 SEPT TRANS 09/01/15 $2,059.00

1159081 11-000-266-110-06-00 SEPT TRANS 09/01/15 $16,920.40

11-000-266-590-01-00 SECURITY-PURCHASED SERVICES $1,000.00 $0.00 ($97.DO) $903.00 -10% : 159091 11-000-266-610-01-00 SEPT TRANS 09/01/15 ($97.00)

11-000-266-610-01-00 SECURITY - SUPPLIES $3,500.00 $946.00 $97.00 $4,543.00 30% i 159091 11-000-266-590-01-00 SEPT TRANS 09/01/15 $97.00

11-000-270-160-01-01 SALARIES TRANS COORD REG ED $15,506.00 $0.00 $107.00 $15,613.00 1% 1 15910J 11-000-270-350-01-00 SEPT TRANS 09/01/15 $107.00

11-000-270-161-01-01 SALARIES TRAN COORD S.E. $15,506.00 $0.00 $107.00 $15,613.00 1% 1159101 11-000-270-350-01-00 SEPT TRANS 09/01/15 $107.00

11-000-270-162-01-01 SAL TRANS OTH HOME/SCG COORD $7,753.00 $0.00 $53.00 $7,806.00 1% 115910 i 11-000-270-350-01-00 SEPT TRANS 09/01/15 $53.00

11-000-270-350-01-00 MANAGEMENT FEES-ESC/CTSA $27,750.00 $0.00 ($267.00) $27,483.00 -1% 1159101 11-000-270-160-01-01 SEPT TRANS 09/01/15 ($107.00)

1159101 11-000-270-161-01-01 SEPT TRANS 09/01/15 ($107.00) 1159101 11-000-270-162-01-01 SEPT TRANS 09/01/15 ($53.00)

11-110-100-101-01-00 SALARIES TEACHERS (KINDERGARTE $595,681.00 $0.00 $26,374.00 $622,055.00 4% 1159111 11-120-100-101-01-02 SEPT TRANS 09/01/15 $26,374.00

11-110-100-106-01-00 OTHER SAL FOR INSTRUCTION $55,133.00 $0.00 $323.00 $55,456.00 1% 115912] 11-120-100-101-01-02 SEPT TRANS 09/01/15 $323.00

11-120-100-101-01-02 SALARIES TEACHERS GR 1-5 CC $949,850.60 $0.00 ($26,697.00) $923,153.60 -3% ! 159111 11-110-100-101-01-00 SEPT TRANS 09/01/15 ($26,374.00) . 15912: 11-110-100-106-01-00 SEPT TRANS 09/01/15 ($323.00)

11-120-100-101-01-03 SALARIES TEACHERS GR 1-5 HL $1,837,809.00 $0.00 $158,511.00 $1,996,320.00 9% 1159231 11-000-219-104-11-00 SEPT TRANS 09/01/15 $70,941.00

1159241 11-000-221-102-01-00 SEPT TRANS 09/01/15 $46,000.00

1159251 11-000-240-104-01-00 SEPT TRANS 09/01/15 $18,872.00




11-120-100-101-01-03 SALARIES TEACHERS GR 1-5 HL $1,837,809.00 $0.00 $158,511.00 $1,996,320.00 9% 1159131 11-120-100-101-01-05 SEPT TRANS 09/01/15 $22,698.00

11-120-100-101-01-05 SALARIES TEACHERS GR 1-5 APM $1,288,887.40 $0.00 ($22,698.00) $1,266,189.40 -2% 1159131 11-120-100-101-01-03 SEPT TRANS 09/01/15 ($22,698.00)

11-120-100-101-01-07 SALARIES TEACHERS GR 1-5 GW $915,948.40 $0.00 $27,011.00 $942,959.40 3% 1159291 11-212-100-101-56-00 SEPT TRANS 09/01/15 $7,000.00 1159291 11-214-100-101-56-00 SEPT TRANS 09/01/15 $4,000.00 1159291 11-422-100-101-04-00 SEPT TRANS 09/01/15 $11,000.00

1159291 11-422-100-101-07-00 SEPT TRANS 09/01/15 $5,011.00

11-140-100-101-01-00 SALARIES TEACHERS (GRADE 9-12) $4,974,533.00 ($3,259.00) $6,354.00 $4,977 ,628.00 0% 1159251 11-000-240-104-01-00 SEPT TRANS 09/01/15 $6,128.00 ! 159261 11-212-100-101-56-00 SEPT TRANS 09/01/15 $226.00

11-190-100-320-Z9-00 PURCH PROFIEDUC SERV HHS $34,000.00 $0.00 ($34,000.00) $0.00 -100% 'i5928 I 11-190-100-610-09-00 SEPT TRANS 09/01/15 ($34,000.00)

11-190-100-590-01-00 OTHER PURCHASED SERVICES $252,549.50 $3,554.70 ($26,240.00) $229,864.20 -9% i 159001 11-000-222-177-01-00 SEPT TRANS 09/01/15 ($26,240.00)

11-190-100-610-07 -00 TEACHING SUPPLIES & MAT GW $37,115.00 $16,924.20 ($2,800.00) $51,239.20 38% i 15867 I 11-000-223-320-07-00 SEPT TRANS 09/01/15 ($1,700.00) : 15871 ' 11-000-240-610-07-00 SEPT TRANS 09/01/15 ($1,100.00)

11-190-100-610-09-00 TEACHING SUPPLIES & MAT HHS $126,116.46 $6,874.85 $34,000.00 $166,991.31 32% 15928 I 11-190-100-320-Z9-00 SEPT TRANS 09/01/15 $34,000.00

11-201-100-101-11-00 SALARIES OF TEACHERS - CI-MILD $54,156.00 ($13,357.00) ($40,799.00) $0.00 -100% 1159141 11-204-100-101-11-00 SEPT TRANS 09/01/15 ($13,210.00) 1159141 11-213-100-101-11-00 SEPT TRANS 09/01/15 ($27,589.00)

11-204-100-101-11-00 SALARIES TEACHERS LEARNING DIS $108,312.00 $0.00 $13,210.00 $121,522.00 12% 1159141 11-201-100-101-11-00 SEPT TRANS 09/01/15 $13,210.00

11-204-100-106-11-00 SALARIES AIDES LANGUAGE & LEAR $0.00 $0.00 $48,136.00 $48,136.00 0% 1159151 11-212-100-106-11-00 SEPT TRANS 09/01/15 $23,639.00 1159151 11-213-100-106-11-00 SEPT TRANS 09/01/15 $23,085.00 1159151 11-216-100-106-11-00 SEPT TRANS 09/01/15 $1,412.00

11-204-100-610-11-00 LANGUAGE & LEARNING DISABLED S $800.00 $0.00 $159.00 $959.00 20% 1158701 11-214-100-610-11-00 SEPT TRANS 09/01/15 ($100.00)

1158791 11-214-100-610-11-00 SEPT TRANS 09/01/15 $259.00

11-212-100-101-56-00 SAL OF TEACH MD - ESY $37,620.00 $0.00 ($7,226.00) $30,394.00 -19% 1159291 11-120-100-101-01-07 SEPT TRANS 09/01/15 ($7,000.00)

I 15926J 11-140-100-101-01-00 SEPT TRANS 09/01/15 ($226.00)

11-212-100-106-11-00 SALARIES AIDES MULTIPLE DISABI $77,432.00 $0.00 ($23,639.00) $53,793.00 -31% 1159151 11-204-100-106-11-00 SEPT TRANS 09/01/15 ($23,639.00)

11-212-100-610-11-00 SUPPLIES & MATERIALS MULTIPLE $2,800.00 $0.00 ($1,054.00) $1,746.00 -38% I 158iOJ 11-214-100-610-11-00 SEPT TRANS 09/01/15 ($1,400.00) 1158791 11-214-100-610-11-00 SEPT TRANS 09/01/15 $346.00

- ~--- -----


Start date 7/1/2015 Period date 9/1/2015 End date 9/1/2015

FUND 11 GENERAL CURRENT EXPENSE 11-213-100-101-11-00

1159141 1159161

11-213-100-101-56-00 1159171

11-213-100-106-11-00 1159151

11-214-100-101-11-00 1159161

11-214-100-101-56-00 1159291 1159171

11-214-100-610-11-00 1158791 1158701 i 158701 i 1~82hl i 158791

11-216-100-101-11-00 • 15918 I

11-216-100-106-11-00 15915 i .15918 1

i 159181 !15919:

11-216-100-106-56-00 1159181

11-216-100-610-11-00 .15879 !

11-240-100-101-01-00 : 15919 i

11-402-100-101-53-00 i 15920 1

11-402-100-390-14-00 15920 i

11-402-100-420-14-00 1159321

11-402-100-440-14-00 1159321 1158441

SALARIES TEACHERS RESOURCE ROO 11-201-100-101-11-00 SEPT TRANS 11-214-100-101-11-00 SEPT TRANS

SAL OF TEACH RESOURCE - ESY 11-214-100-101-56-00 SEPT TRANS

SALARIES AIDES RESOURCE ROOMIR 11-204-100-106-11-00 SEPT TRANS

SALARIES OF TEACHERS AUTISTIC 11-213-100-101-11-00 SEPT TRANS

SAL OF TEACH AUTISTIC - ESY 11-120-100-101-01-07 SEPT TRANS 11-213-100-101-56-00 SEPT TRANS

SUPPLIES & MATERIALS AUTISTIC 11-204-100-610-11-00 SEPT TRANS 11-204-100-610-11-00 SEPT TRANS 11-212-100-610-11-00 SEPT TRANS 11-212-100-610-11-00 SEPT TRANS 11-216-100-610-11-00 SEPT TRANS

SALARIES TEACHERS PRE-SCHOOL D 11-216-100-106-11-00 SEPT TRANS

SALARIES AIDES PRE-SCHOOL DISA 11-204-100-106-11-00 11-216-100-101-11-00 11-216-100-106-56-00 11-240-100-101-01-00

SAL AIDES PSD - ESY

SEPT TRANS SEPT TRANS SEPT TRANS SEPT TRANS

11-216-100-106-11-00 SEPT TRANS

SUPPLIES & MATERIALS PRE-SCHOO 11-214-100-610-11-00 SEPT TRANS

SALARIES TEACHERS BILINGUAL 11-216-100-106-11-00 SEPT TRANS

SUMMER SALARIES ATHLETICS TEAC 11-402-100-390-14-00 SEPT TRANS

ATHLETICS PURCH PROF SERVICES-11-402-100-101-53-00 SEPT TRANS

CLEANING REPAIR RECONDITIONING 11-402-100-440-14-00 SEPT TRANS

RENTALS - ATHLETICS 11-402-100-420-14-00 SEPT TRANS 11-402-100-610-14-00 SEPT TRANS

Expenditure

Original amt

$2,152,548.00

$3,250.00

$143,425.00

$278,050.00

$36,220.00

$2,000.00

$108,519.00

$71,711.00

$6,880.00

$1,200.00

$494,790.00

$9,200.00

$35,000.00

$16,500.00

$250.00

Prior xfer

$0.00 09/01/15 09/01/15

$13,357.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15 09/01/15

$0.00 09/01/15 09/01/15 09/01/15 09/01/15 09/01/15

$0.00 09/01/15

($1,208.00) 09/01/15 09/01/15 09/01/15 09/01/15

$1,208.00 09/01/15

$388.50 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$0.00 09/01/15

$540.70 09/01/15

$0.00 09/01/15 09/01/15

Page 5 of 8

10/15/1516:40

Period xfer Adjusted amt % Chg

$32,452.00 $27,589.00 $4,863.00

$393.00 $393.00

($23,085.00) ($23,085.00)

($4,863.00) ($4,863.00)

($4,393.00) ($4,000.00)

($393.00)

$697.00 ($259.00)

$100.00 $1,400.00 ($346.00) ($198.00)

$5,737.00 $5,737.00

($16,393.00) ($1,412.00) ($5,737.00)

($500.00) ($8,744.00)

$500.00 $500.00

$198.00 $198.00

$8,744.00 $8,744.00

($2,780.1)0) ($2,780.00)

$2,780.00 $2,780.00

($470.00) ($470.00)

$601.31 $470.00 $131.31

$2,185,000.00 2%

$17,000.00 423%

$120,340.00 -16%

$273,187.00 -2%

$31,827.00 -12%

$2,697.00 35%

$114,256.00 5%

$54,110.00 -25%

$8,588.00 25%

$1,786.50 49%

$503,534.00 2%

$6,420.00 -30%

$37,780.00 8%

$16,570.70 0%

$851.31 241%


Start date 71112015 Period date 91112015 End date 91112015 Expenditure

Original amt Prior xfer FUND 11 GENERAL CURRENT EXPENSE

11-402-100-610-14-00 ATHLETIC SUPPLIES HHS $58,000.00 $399.18 i 15844 i 11-402-100-440-14-00 SEPT TRANS 09/01/15

11-422-100-101-04-00 SAL OF TEACHERS SUMMER SCH WOK $15,000.00 $0.00 1159291 11-120-100-101-01-07 SEPT TRANS 09/01/15

11-422-100-101-07 -00 SAL OF TEACHERS SUMMER SCH GW $12,100.00 $0.00 1159291 11-120-100-101-01-07 SEPT TRANS 09/01/15

Total for Just Accounts Listed $22,518,207.31 $227,822.51

Period xfer

($131.31) ($131.31 )

($11,000.00) ($11,000.00)

($5,011.00) ($5,011.00)

$0.00

Page 6 of 8

1011511516:40

Adjusted amt % Chg

$58,267.87 0%

$4,000.00 -73%

$7,089.00 -41%

$22,746,029.82 1%


Start date 7/1/2015 Period date 9/1/2015 End date 9/1/2015 Expenditure

Original amt Prior xfer FUND 12 CAPITAL OUTLAY

12-000-100-730-01-00 EQUIPMENT UNDIST EDUCATIONAL $144,098.50 ($307.00) 1159221 12-000-230-730-01-00 SEPT TRANS 09/01/15

12-000-230-730-01-00 GENERAL ADMIN EQUIPMENT $0.00 $3,185.00 115922] 12-000-100-730-01-00 SEPT TRANS 09/01/15

12-000-400-334-07 -00 ARCHITECTURAL/ENGINEERING GW $20,000.00 ! 159211 12-000-400-334-09-00 SEPT TRANS 09/01/15

12-000-400-334-09-00 ARCHITECTURAL/ENGINEERING HHS $138,622.00 $0.00 1159211 12-000-400-334-07-00 SEPT TRANS 09/01/15

Total for Just Accounts Listed $302,720.50 ($17,122.00)

Period xfer

($2,152.00) ($2,152.00)

$2,152.00 $2,152.00

$6,200.00 $6,200.00

($6,200.00) ($6,200.00)

$0.00

Page 7 of 8

10/15/1516:40

Adjusted amt % Chg

$141,639.50 -2%

$5,337.00 0%

$6,200.00 -69%

$132,422.00 -4%

$285,598.50 -6%



Original amt Prior xfer Period xfer Adjusted amt % Chg FUND 20 SPECIAL REVENUE FUNDS

20-218-100-101-05-00 PSEA SALARIES OF TEACHERS $763,793.00 $0.00 $5,251.00 $769,044.00 1% 1158651 20-218-100-610-05-00 SEPT TRANS 09/01/15 $2,144.00 115@1j 20-218-200-102-05-00 SEPT TRANS 09/01/15 $1,163.00 1158631 20-218-200-103-05-00 SEPT TRANS 09/01/15 $1,944.00

20-218-100-106-05-00 PSEA OTHER SALARIES FOR INSTR $262,940.00 $0.00 $1,953.00 $264,893.00 1% ! 15863 i 20-218-200-103-05-00 SEPT TRANS 09/01/15 $1,953.00

20-218-100-610-05-00 PSEA SUPPLIES & MATERIALS $15,000.00 $3,295.53 ($2,144.00) $16,151.53 8% i 158651 20-218-100-101-05-00 SEPT TRANS 09/01/15 ($2,144.00)

20-218-200-102-05-00 PSEA SAL SUPV OF INSTRUCT $29,243.00 $0.00 ($1,163.(0) $28,080.00 -4% 1158641 20-218-100-101-05-00 SEPT TRANS 09/01/15 ($1,163.00)

20-218-200-103-05-00 PSEA SAL OF PRINC/ASST/PRG DIR $62,883.00 $0.00 ($3,897.00) $58,986.00 -6% 1158631 20-218-100-101-05-00 SEPT TRANS 09/01/15 ($1,944.00) 1158631 20-218-100-106-05-00 SEPT TRANS 09/01/15 ($1,953.00)

20-271-200-104-01-00 TITLE IIA 2015-16 SAL OTH PROF $0.00 $7,000.00 $500.00 $7,500.00 0% i 15890 1 20-271-200-110-01-00 SEPT TRANS 09/01/15 $500.00

20-271-200-110-01-00 TITLE IIA 2015-16 OTHER SAL $0.00 $22,000.00 ($500.00) $21,500.00 0% 1158901 20-271-200-104-01-00 SEPT TRANS 09/01/15 ($500.00)

Total for Just Accounts Listed $1,133,859.00 $32,295.53 $0.00 $1,166,154.53 3%

Hillside Board of Education, Hillside, New Jersey Proposal Sheet

SECTION f. INTEREST RA TES}) AND PREPA YMENT PROVISIONS

Proposal to:

With Copies to:

Kenneth Weinheimer, Business AdministralorlBoard Secretary 1530 Leslie Street Hillside. New Jersey 07205 908-352-7664, ext. 6429

DIanna Geist, NW Financial Group, LLC 3000 Atrium Way. Suite 240 Mount Laurel, Nel'{ Jersey Telephone 856-273-6926

Andrea Kahn, McManimon, Scotland & Baumann, LLC 75 Livingston A venue Roseland, New Jersey 07068 Telephone 973-622-5171

FI#2-10/15

Name of Proposer: ''I'D tQvl IA-1 ~\.J't luvJ\~!,..:P-:'C.._ .. ___ .. _._._ .. _o._

Address of Proposer: . . ll:!f?ff &:f1.f!::~~.f!p_1Otllj~~7kLL!5'fI/UJ ar~tI Con tact Person: ..... If: 6 c:.c.'="_."._~~?:2.. __ .. _. ____ ...... '. _. ""_"'_~_~"_'_ Contact Phone:.73.Z:=~5_::..J5tl_. __ 0. • • __ ••••• __ •• _ ••• _ •• ___ ....

Contact Facsimile: .~.13?~ S'Lt1.!i"-,I,-O",---~

Contact E-Mail: 12iJG g,VLT,. <;; ftJ!.f::PJ@. I'() ·.~.vVI,_",._."_"""",,,_~_o_"' __ ""'.'. __ '--r __ '

to, £) p~ l..l A L"()l~ a) Interest Rate Per Annum Proposed for term: /ti

() PntvtJ i1: i. 7:l-11(J/4 h) Are there Addilimwl Cnsls associafed \\illl this financing oilter than escnm fees'?

-~ ~NO

I f "yes" please siale the amoun! of additional charges

Please al1ach a separate page detailing sLlch initial or anflual charges if any.

e; I'rcpaymcu! Penal I} e~.srcssf.'d as ;, pcn:f.'!I!agf.' of ullpaid principal:

~ Proposal Submitted by:

Authorized Signature of Proposer Date

OPrU.lAJ .l\ '" r{{~lA) ~W/( ".';, OmaN e.: JJo fl..lltr(~T~

~N,l'r r /1t»f1 j fh ~"&Ji /)~ Printed Name Title

Attach Amortization Schedule

dale

Nov-06-1S Muy-Ol-!6

Nov-OI-16 M!1y-{H-17

Nov-OI-!7 May-0l-18

Nov-OI-fS lv!ay-01-19

Nov-OI-19 May-01 .. 20

Nov-01-20

TOTAL

A ;110 It T I Z,\ T ION S eli E!l r L E Aggregllie or Lending LOllJlS

Parameler filename . ., . . ., . Hillside aOE $6.75MM ground lease open 10.05.15 Pnramelcr path c:\users\rc!iircCliQlI\shullirxloocuments\documenIS slllJllis\my documcnlslivoly\pr Aggregate average lire (fending) ... , ....................•.............. ,. J.035 years Rale •........... , ..•..............•.....• " ....•..............•.. 1.72190000%

starling debt remaining baillilce lukedowns service haeresl principal ba(llilce

000 6,750,000.00 0.00 000 0.00 6.750,000.00 6,750,000.00 0.00 56,499.84 56,499,34 0.00 6,750.000.00

6,750,000.00 000 ! ,343,11 4.!3 58.114. ]J 1.285,000.00 5,465,000.00 5,465,000.00 0.00 47,050.')2 47.050.92 0.00 SA6S,OOO.0f}

5,465,000.00 0.00 1,362.050.92 47,050,92 ! .315,000.00 4,150,000.00 4,150,000.00 0.00 35,72943 35,72943 (l00 4,150.000.00

4,150,00000 0.00 1,385,729AJ 35.72943 1.350,000.00 2,800,000.00 2,800,000.00 000 24.106.60 24,106.60 0.00 2.800,000.00

2,800,00000 000 1,409,106.60 24,106.60 1.385,00000 1.4IS.000.00 1,415,000.00 O.()O 12,I82A4 12,182,114 0,00 1,415,00000

fA!5,OO(l.OO 0.00 1,427,182,44 12,18244 1,415,000,00 0.00

6.750,000.00 7J02.75U4 352,75V4 6.750,00000 :.;;.;;:.:.-;-:;::::;:::::::;::"":":"

10. Structure

11. Municipal lease Purchase

12 Tax Status

13. legal Opinion

14. Costs & Expenses

15. Insurance

16. Warranties

17. Lease Documents

Confidential

This Lease shall be a Lease intended as a secured transaction, to the extent allowable by law. Titles, if any, shafllist lessee as owner and lessor as lienholder. The lease shall be subject to, and contain a non-appropriation clause; and, the Lessor will require bona fide best efforts by Lessee to indude aU payments under this master "lease "purchase in all its budget requests during each Lease term in accordance with the terms of the Lease"

This lease shall be considered a "Municipal lease Purchase" by all parties. The Lessee wHl represent and warrant that it is a state or a political sub-division thereof, within the meaning of Section 103(c} of the Internal Revenue Code of 1986, as amended (the "Code") and that the Lease will constitute a Tax Exempt Obligation of the Lessee as described in Section 103{a) of the Code. Following any default or event of non-appropriation under the Lease, Lessee will return the Equipment to lessor (if requested by Lessor) as required under the lease and at Lessee's sale cost and expense.

This agreement is a qualified tax exempt obligation under Section 265 (b) (3) of the Internal Revenue Code of 1986, The interest portion of the payments under this Lease will not be includable In the gross income of the Lessor for federal income taxation purposes. The lessee will supply at closing a tax opinIon confirming the tax status discussed in this section from qualified bond counsel.

This transaction is subject to a legal opinion which must include a statement that the lease represents a valid and binding obligation of the lessee.

$0,00

Lessee shan bear all risk of loss, damage and liability to the Equipment and Lessee shall be responsible to keep the Equipment insured or self-insured in an amount and in a form acceptable to Lessor.

Lessor shall Lease the Equipment to Lessee without representation or warranty on an "AS IS BASIS". However, Lessor shall assign to lessee ail warranties, guarantees and services provided by the manufacturer(s) and/or vendor(s) to the extent that they can be assigned, LESSOR SHAll NOT BE RESPONSIBLE FOR PROVIDING ANY OF THE FOREGOING,

AU legal matters, and ail documents to be executed in connection herewith. shall be in satisfactory form and substance to Lessor, or Lessor's counsel, as may be the case, in its sale discretion. lessor shall verify the Equipment specifications including, but not limlted to, model number, number of units, installation costs, year of manufacturing and maintenance contracts; and approve the final Equipment configuration, and acceptance of the finanCing.

Hillside Board of Education Hillside, New Jersey Proposal Sheet

SECTION II. -ESCROW(/) Proposal To:

Kenneth Weinheimer, Business Administrator/Board Secretary 1530 Leslie Street, Hillside, New Jersey 07205 Telephone: 908-352-7664, ext. 6429

With copies to:

Cc: Dianna Geist, NW Financial Group, LLC 3000 Atrium Way, Suite 240 Mount Loure!, New Jersey Telephone: 908-439-4280, extA51 0

Cc: Andrea L. Kahn, Esq. McManimon, Scotland & Baumann, LLC 75 Livingston A venue Roseland, NJ 07068 Telephone: 973-622-5171

Name of Escrow Agent: _~_ TO .'~ i(.../~l:?~~ A. Address of Escrow Agent: jC(X, t\S12ltft'\J~~tJOlt-C:1tt&&~ d]l:<-/, ,Lt[~fOs-¥~_,,_~ Coniaci person:i1at ~ /J:.~l ttr~ ___ ",_ ... ____ , ____ ,, ____ .... __ ... __ .. __ . __ ._._......_ Contact Phone:

Contact Facsimile: Ii;>

Contact E-Mlli!: Jt~~(}Jt .l1i" .. ,f'lW&:-:12:!!::~ il) Escrow Agent Fee: ~/A- _'~,;, h) Arc there nny miditi()!lll! costs associated with the escrow?

tiona! charges S Mit

Proposal Submitted by:

(I) iNSTRUCTIONS TO PROPOSERS

!leh lnitia.! or annual charges if any.

U ~S'A0-Title

All propOs~l$ mus, be submitted on IhlS form and must mdmle the a!lached dUCl!m~nl.!iOll {executed) and n sample DIlIOO1Wlnon .d,.d"k fmhm~ 10 foHow thesc ,,,.Iruchon. will be {!lOjmds for "JeCI'OI; Fa,lufC!O ,h.d"se any of lhe mformanon requesled /n;lY Ix: ltfO,mds fOl rejecllOn, The Board or Ed"c~Mn w!!1 accopi nu SlluShtu!l(lnS for 11t1. propOs", sheet Propo .. r< "eed "01 proVide e,croW se~'ic".

SECTION l. Provide;ill inicresl mle ano nddltional charges for rhe Leale 11$ requ •• lcd Ul !he Req"cSl For PlOpO>ai Inl","51 Raj. must b~ i;dd fll! JD days I,om proposal opening ami ndjunmcnls "ller 30 days wif) 100M 10 Ihe specdkallOn5 proqded In the Reqllesl For I'lOpO.11

SECTION U' If .-.::q"m"n "scH)w ",rVlees for Ihe Lea,e proceed;, please furmsn lh. aoow ;llfOffilim<m If e$C'O\; StrV,ces art "01 m.pmeU. fWe "None Pwpns<d" nad exeeUie ihe (unll The !.loard or EducaliQH resemosli>e righr!O Ii"",ll". depOsil ""d Inv"stment oflhe Lense proceeds

Hillside Board of Education Hillside, New Jersey

\'{i)( '''flO/DU':.) ST-IIE,\/L\T

In accordance with New Jersey Statutes Title 52:25-24.2. all corporate and partnership Proposers for State, county,

municipal or Board of Education contracts are required to submit a list of the names and addresses of all

stockholders owning 10% or more of their stock or 10% or more of the stock of their corporate stockholders or in

the case of u purtnership. the names and addresses ofthose partners owning a 10% or greater interest therein.

NAME ADDRESS

t I

Signature

10 tQU(PI1f(jtJ] hvA;lJCJt ..... . .. . "._-'-'-' --~.~~ ...

Company

Date

AMERiCANS WITH mSABILlTIES ACT

Equal Opportunity For Individuals With Disabilities

The Proposer and the Hillside Board of Education (the "Board of Education") do hereby agree that the provisions of Title 11 afthe Americans With Disabilities Act of 1990 (the "Act") (42 U.S.C. Sl2101 et seq.), which prohibits discrimination on the basis of disability by public entities in all services, programs, and activities provided or made available by public entities, and the rules and regulations promulgated pursuant thereunto, are made a part of this contract In providing an aid, benefit, or service on behalf of the Board of Education pursuant to this Contract, the Proposer agrees that the performance shall be ill strict compliance with the Act. In the event that the Proposer, its agents, servants, employees, or subcontractors violate or are alleged to have violated the Act during the performance of this Contract, the Proposer shall defend the Board of Education in any action or administrative proceedings commended pursuant 10 this Act. The Proposer shaH indemnify. protect, nnd save harmless the Board of Education, its agents, servants, and employees rrom and against any and all suits. claims. 'osses, demands or damages of whatever kind or nature arising out of or claimed to arise out of the alleged violation. The Proposer shall, at its own expense, appear, defend and pay any and all charges for legal services and any and all costs and other expenses arising from such action Or ildministrative proceeding or incurred in connection therewith. In any and all complaints brought pursuant to the Board of Education's grievance procedure, the Proposer agrees to a proposal by any decision of Ihe Board of Education which is rendered pursuant to said grievance procedure. If any action or administrative proceedings results in an award of damage against the Board of Education or if the Board of Education incurs any expense to cure a violation of the Act which has been brought pursuant to its grievance procedure, the Proposer shat! satisfY and discharge the same at its own expense.

The Board of Education shaH, as soon as practicable after u claim has been made against it, give written notice thereof 10 the Proposer along with full and complete particulars of the claim. ! f any action or administrative proceedings is brought against the Board of Education or any of ils agents, servants and/or employees, the Board of Education shaH expeditiously forward or have forwarded 10 the Proposer every demand, complaint, notice, summons, pleading or other process received by the Board of Education or its representatives<

It is expressly agreed and understood that any approval by the Board of Education of the services provided by the Proposer pursuant to this contract will not relieve the Proposer ofthe obligation 10 comply with lhe Act and to defend, indemnifY, protect and save harmless the Board of Education pursuant to t.his paragraph.

It is further agreed and understood that the Board of Educ ion assumes no obligation to indemnify or save harmless the Proposer, its agents, servants, employees lInd subcon a tors for any claim which may arise out oftheir performance of this Agreement. FUl1.hermore, the Proposer understands and agrees that the provisions of this indemnification clause shall in no way limit the Propose opligations as d in this Agreement, nor shall they be construed to relive the Proposer from any liability, no !jfedude the =-Education from taking any other actions available to it under any other provisions of this ag eement or {] eat iaw,

EXHllJlT B

NEW JERSEY BUSINESS REGISTRATIQN REQUIREMENTS

The contractor shall provide written notice to its suoconlrnctors of the responsibility to submit proof of business registration to the contractor.

All Proposers must be registered with the State of New Jersey and the Board of Educalion must either have a copy, or 'the Proposer must include a New Jersey Business Registration Certi ocate with the Proposer's submission, or the successful Proposer must supply a copy of the New Jersey Business Registration Certificate prior to the award by the Board of Education. If a Proposer submits a proposal and the Board of Education does not have a copy of the Proposer's certificate on file, or a copy is not included in Ihe proposal submission package, or the Proposer does not supply the certificate prior to the award, the submitted proposal will not be considered for award.

for the term of the contract, the contractor and each of its affiliates and a subcontractor and each of its affiliates N.J.S.A. 52:32-44(g)(J)1 shall collect and remit to the Director, New Jersey Division of Taxation, the use tax due pursuant to the Sales and Use Tax Act on all sales oftllngihle persona! property delivered into this State, regardfess of whether the tangible personal property is intended for a contract with a contracting agency.

A business organization that fails to provide a copy of a business registration as required pursuant to section i of P.L.200!, c.l34 (C.52:32-44 ~ ill or subsection e. or f. of section 92 of P.L.l977, c.110 (C.5:12-92), or that provides false business registration information under the requirements of either of those sections, shall be liabl~ for a penalty of $25 for each day of violation, not to exceed $50,000 for each business registration copy not properly provided under a contract with a contracting agency."

J'l.J. ueparrmem or 1 reasmy - UIVISlOn or l'<.evenue, un-LIne mqlllry lage 1 01 I

STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE

Tnxpayer Name:

Trade Name:

Address:

Certificate Number:

Effective Date:

Date of Issuance:

For Office Usc Only;

20081126091551189

TO EQUIPMENT FINANCE, INC.

5 COMMERCE PARK NORTH BEDFORD, NH 03110

1058051

April 18. 2004

November 26. 2008

15

Equipment Finance

trhe Board of Education of the Township of Hillside in the County of Union, New Jersey 1530 Leslie Stree~ Hillside, New Jersey 07205

1. Lessor

2. Lessee

3. Equipment Description

4. Equipment Cost/Lease Amount

5. Tax-exempt Interest Rate

6. Term

7. Payment

8. Index

9. Purchase Option

10. Structure

TD Equipment Finance, Inc., its successors and assigns

The Board of Education of the Township of Hillside in the County of Union, New Jersey

To provide funds for the construction of an addition and renovations to the George Washington School consisting of four classrooms, a gymnasium and additional rooms and space, including acquisition and installation of furnishings and equipment, financing and other incidental or related costs Hereinafter referred to as the "Equipment".

$6,750,000

1.7219% - Bank Qualified Tax-Exempt Rate See bid sheet attached hereto and made a part hereof.

• Base Lease Commencement Date: November 6, 2015

• Lease Term: Not to exceed five (5) years. • Payment Amount: See amortization schedule attached

hereto and made a part hereof

• •

Payments Due: Semi-annually beginning May1, 2016

Prepayment: No prepayment penalty. The Lease may be prepaid at any time.

Interest Rate will include a thirty (30) day rate lock commitment from the date of bid opening. In the event that the lease does not close within thirty (30) days, the Interest Rate will be indexed as outlined below.

Upon expiration of the thirty (30) day rate lock commitment, the Interest Rate and the corresponding Base Lease Rental Payments outlined in the attached Amortization Schedule will be indexed as described in the RFP. The Interest Rate and corresponding Base Lease Rental Payments will be adjusted on or about the Base Lease Commencement Date to reflect any movement in the Reference Yield.

iLessee will purchase all, but not less than all, of the Equipment for $1.00:

This Lease shall be a Lease intended as a secured transaction, to the extent allowable by law. Titles, if any, shall list Lessee as owner and Lessor as lienholder. The Lease shall be subject to, and contain a non-appropriation clause; and, the Lessor will require bona fide best efforts by Lessee to include all payments under this master "Lease "purchase in all its budget requests during each Lease term in accordance with the terms of the Lease .. \

11. Municipal Lease Purchase

12. Tax Status

13. Legal Opinion

14. Costs & Expenses

15. Insurance

16. Warranties

17. Lease Documents

Confidential

This Lease shall be considered a "Municipal Lease Purchase" by all parties. The Lessee will represent and warrant that it is a state or a

political sub-division thereof, within the meaning of Section 103(c)

of the Internal Revenue Code of 1986, as amended (the "Code")

and that the Lease will constitute a Tax Exempt Obligation of the Lessee as described in Section 103(a) of the Code. Following any

default or event of non-appropriation under the Lease, Lessee will return the Equipment to Lessor (if requested by Lessor) as required

under the Lease and at Lessee's sole cost and expense.

This agreement is a qualified tax exempt obligation under Section

265 (b) (3) of the Internal Revenue Code of 1986. The interest portion of the payments under this Lease will not be includable in

the gross income of the Lessor for federal income taxation purposes. The Lessee will supply at closing a tax opinion confirming

the tax status discussed in this section from qualified bond counsel.

This transaction is subject to a legal opinion which must include a

statement that the Lease represents a valid and binding obligation of the Lessee.

$0.00

Lessee shall bear all risk of loss, damage and liability to the

Equipment and Lessee shall be responsible to keep the Equipment

insured or self-insured in an amount and in a form acceptable to

Lessor.

Lessor shall Lease the Equipment to Lessee without representation

or warranty on an "AS IS BASIS". However, Lessor shall assign to

Lessee all warranties, guarantees and services provided by the

manufacturer(s) and/or vendor(s) to the extent that they can be

assigned. LESSOR SHALL NOT BE RESPONSIBLE FOR

PROVIDING ANY OF THE FOREGOING.

All legal matters, and all documents to be executed in connection herewith, shall be in satisfactory form and substance to Lessor, or

Lessor's counsel, as may be the case, in its sole discretion. Lessor

shall verify the Equipment specifications including, but not limited

to, model number, number of units, installation costs, year of

manufacturing and maintenance contracts; and approve the final

Equipment configuration, and acceptance of the financing.

Equipment Finance

18. Lessor's Proposal/Financial and Additional Information:

19. Authorization

20. General

21. Expiration

22. Collateral

Confidential

This Lease Proposal is subject to final credit review, and not, nor should it be construed as, a commitment by Lessor or any affiliate to enter into the proposed Lease transaction. In order to complete its credit due diligence, Lessee shall provide Lessor with the following: I-Three years most current audited annual financial statements, and shall be furnished annually thereafter, if not otherwise published on the Lessee's website -Copy of meeting minutes -Copy of budget -Statement of essential use -Other supporting data as may be requestedi I

Lessee acknowledges and agrees that Lessor may furnish all Lessee-presented information, financials, analysis, and related credit and review materials to its employees, counsel and agents, as well as its participants and/or assigns. Lessee authorizes Lessor to contact TO Bank, NA and other references of Lessee, and to order any and all credit checks and investigative reports, all as Lessor deems necessary in connection with the evaluation of the transaction.

The Lease will be a "Triple Net Lease" in which the Lessee will be responsible for all expenses relating to the Equipment including, but not limited to, Equipment maintenance, insurance coverage, and all taxes (e.g. sales, use and personal property). Lessor expects to be indemnified under for all acts and omission of the Lessor and for any liability or claims related to and arising with respect to the Equipment and under the Lease; however, the parties reserve the right to discuss and negotiate any indemnification provisions to be contained in the final and definitive Lease Documents, which shall in all respects be in full compliance with all applicable laws. The Lessee will carry any and all insurance coverage required by Lessor in accordance with the Lease.

TO Equipment Finance, Inc. complies with Section 326 of the USA Patriot Act. This Act mandates that we verify certain information about the Lessee while processing any Lease request.

This Lease Proposal shall expire in 30 days from bid response due date if not accepted by a qualified official.

• First priority recorded ground lease • Lessor will file a UCC-1 financing statement and fixture

filing on all Equipment to be financed.

Equipment Finance

AMORTIZATION SCHEDULE Aggregate Of Lending Loans

Aggregate average life (lending) ................................. 3.219 years Rate ............................................................. 1.72190000%

starting debt date balance takedowns service

Nov-06-15 0.00 6,750,000.00 0.00 May-01-16 6,750,000.00 0.00 56,499.84

Nov-01-16 6,750,000.00 May-01-17 6,095,000.00

Nov-01-17 5,445,000.00 May-01-18 4,785,000.00

Nov-01-18 4,120,000.00 May-01-19 3,445,000.00

Nov-01-19 2,770,000.00 May-01-20 2,085,000.00

0.00 0.00

0.00 0.00

0.00 0.00

0.00 0.00

713,114.13 702,474.90

706,878.73 706,196.46

710,471.14 704,659.73

708,848.32 702,950.81

remaining interest principal balance

0.00 0.00 6,750,000.00 56,499.84 0.00 6,750,000.00

58,114.13 52,474.90

46,878.73 41,196.46

35,471.14 29,659.73

23,848.32 17,950.81

655,000.00 6,095,000.00 650,000.00 5,445,000.00

660,000.00 4,785,000.00 665,000.00 4,120,000.00

675,000.00 3,445,000.00 675,000.00 2,770,000.00

685,000.00 2,085,000.00 685,000.00 1,400,000.00

Nov-01-20 1,400,000.00 0.00 1,412,053.30 12,053.30 1,400,000.00 0.00

TOTAL 6,750,000.00 7,124,147.35 374,147.35 6,750,000.00 ============= ============= ============= =============

SuperTRUMP 9.50 financial model Page 1 . Ivory Consulting Corporation

Confidential

Equipment Finance

BG#1-10/15

SCHOOL NAME 13-14 ACTUAL EXPENDITURES 14-15 ACTUAL EXPENDITURES 15-16 BUDGETED 16-17 PLANNED Administration Building $41,707 $45,448 $15,884 $16,202

21901000 lCocaTlzea repairs, salanes ana Localized repairs, salaries and Localized repairs, salaries and supplies. Annual service, Localized repairs, salaries and supplies. Annual service, supplies. Annual service, inspection of boilers, fire alarm supplies. Annual service, inspection of boilers, fire alarm inspection of boilers, fire alarm and security. Water treatment inspection of boilers, fire alarm and security. Water treatment and security. Water treatment and boiler treatment. O&M repairs and security. Water treatment and and boiler treatment. O&M and boiler treatment. O&M repairs to AHERA report.Sidewalk boiler treatment. O&M repairs to repairs to AHERA report. to AHERA report.Sidewalk repairs. Replace shades. AHERA report Replace shades. Masonry repairs. Replace repairs. Replace shades. Replaces window alc units. Replaces window alc units. shades. Replace window alc Replaces window alc units. Replace carpeting. Carpet Replace carpeting. Carpet units. Replace carpeting. cleaning. cleaning.

Hillside High School $597,536 $375,046 $595,611 $607,523 21901050 L-V ,4.v,", "1-'''''' "', "'".",., ,'-'" 0"'"'

supplies. Annual service, inspection of boilers, fire alarm Localized repairs, salaries and

Localized repairs, salaries and Localized repairs, salaries and and security. Water treatment supplies. Annual service, supplies. Annual service, supplies. Annual service, and boiler treatment. O&M repairs inspection of boilers, fire alarm inspection of boilers, fire alarm inspection of boilers, fire alarm to AHERA report. Masonry and security. Water treatment and and security. Water treatment and security. Water treatment repairs. Refinish stage floor and boiler treatment. O&M repairs to and boiler treatment. O&M and boiler treatment. O&M repairs paint. Replace shades. Replace AHERA report. Masonry repairs. repairs to AHERA report. to AHERA report. Masonry clocks. Replace window alc units. Replace shades. Replace clocks. Replace certain exterior doors. repairs. Refinish (screen) gym Replace certain windows. Replace window alc units. Masonry repairs. floor. Replace shades. Replace Replacement of sidewalks. Paint Replace certain windows. Refinish(screen) gym floor. clock system. Replace window dance studio. Carpet Replacement of sidewalks. Replace lockers. Replace floor alc units. Replace certain cleaning. Replace smoke Carpet cleaning. Replace smoke tile. Replace window alc units. windows. Replacement of detectors. Replace detectors. Replace flooring. Replace certain windows. sidewalks. Refinish library floor. flooring. Replace certain interior Replace certain interior Replacement of sidewalks. Paint library. doors. Install drop ceilings. doors.lnstall drop celings.

Calvin Coolidge Elementary $113,374 $109,038 $112,896 $115,154 21901060

Localized repairs, salaries and supplies. Annual service,

Localized repairs, salaries and inspection of boilers, fire alarm supplies. Annual service, Localized repairs, salaries and and security. Water treatment inspection of boilers, fire alarm supplies. Annual service, and boiler treatment. O&M repairs and security. Water treatment inspection of boilers, fire alarm to AHERA report. Masonry Localized repairs, salaries and and boiler treatment. O&M and security. Water treatment repairs. Refinish classroom supplies. Annual service, repairs to AHERA report. and boiler treatment. O&M repairs floors. Refinish (screen) gym floor. inspection of boilers, fire alarm Replace certain exterior doors. to.AHERA report. Masonry Replace sidewalks. Replace and security. Water treatment and Masonry repairs. repairs. Refinish classroom windowalc units. Replace boiler treatment. O&M repairs to Refinish(screen) gym floor. floors. Replace sidewalks. fencing. Replace window AHERA report. Masonry repairs. Replace certain windows. Replace window alc units. shades. Replace smoke Refinish classroom floors. Replace Replaces window alc units. Replace fencing. Install detectors. Replace flooring. windowalc units. Replace Repaint gym. rubberized play surface. Replace certain interior doors. fencing. Replace smoke detectors

Hurden Looker Elementary $181,466 $153,765 $413,898 $422,176 21901080

Localized repairs, salaries and Localized repairs, salaries and Localized repairs, salaries and supplies. Annual service, supplies. Annual service,

Localized repairs, salaries and supplies. Annual service, inspection of boilers, fire alarm inspection of boilers, fire alarm supplies. Annual service, inspection of boilers, fire alarm and security. Water treatment and security. Water treatment and inspection of boilers, fire alarm and security. Water treatment and boiler treatment. O&M repairs boiler treatment. O&M repairs to and security. Water treatment and boiler treatment. O&M repairs to AHERA report. Replace AHERA report. Replace certain and boiler treatment. O&M to AHERA report. Replace certain windows. Refinish windows. Refinish classroom repairs to AHERA report. certain windows. Replacement of (screen) gym floor. Replace floors. Replace certain interior Replace certain exterior and rear sidewalks. Refinish (screen) certain interior doors. Replace doors. Replace shades. Install interior doors. Replace certain gym floor. Replace certain shades. Install drop ceilings rear drop ceilings rear of building.

I windows. Replacement of interior doors. Replace shades. of building. Replace fencing. Replace smoke sidewalks. Replace fire alarm Install drop ceilings rear of Carpet cleaning. Replace smoke detectors. Replace fencing. Carpet panel. building. Replace fencing. detectors. replace flooring. cleaning.

Walter O. Krumbiegel Middle 21901085

A.P. Morris-ECC Elementary 21901090

Saybrook Annex Elementary 21901090

$219,612

Localized repairs, salaries and supplies. Annual service, inspection of boilers, fire alarm and security. Water treatment and boiler treatment. O&M repairs to AHERA report. Replace certain exterior doors. Masonry repairs. New clock system. Replace certain exterior and interior classroom doors. Replace shades. Replace windowalc units.

$233,758 $242,767 $247,622

Localized repairs, salaries and Localized repairs, salaries and Localized repairs, salaries and supplies. Annual service, supplies. Annual service, supplies. Annual service, inspection of boilers, fire alarm inspection of boilers, fire alarm inspection of boilers, fire alarm and security. Water treatment and security. Watertreatment and security. Water treatment and and boiler treatment. O&M repairs and boiler treatment. O&M repairs boiler treatment. O&M repairs to to AHERA report. Replace certain to AHERA report. Replace carpet. AHERA report. Replace certain exterior doors. Masonry repairs. Masonry repairs. Repave small exterior doors. Masonry repairs. Repave small lot. Replace certain lot. Replace interior classroom Repave small lot. Replace interior exterior and interior classroom doors. Replace shades. Replace classroom doors. Replace doors. Replace shades. Replace window alc units. Replace shades. Replace window alc windowalc units. Replace fencing. Carpet cleaning. replace units. Replace sidewalks. Carpet sidewalks. flooring. cleaning. Replace carpeting.

$336,0051 $330,6361 $351,8031 $358,839

Localized repairs, salaries and supplies. Annual service, inspection of boilers, fire alarm and security. Water treatment and boiler treatment. O&M repairs to AHERA report. Replace gym floor. Replaces window alc units.

Localized repairs, salaries and Localized repairs, salaries and Localized repairs, salaries and supplies. Annual service, supplies. Annual service, supplies. Annual service, inspection of boilers, fire alarm inspection of boilers, fire alarm inspection of boilers, fire alarm and security. Water treatment and security. Water treatment and and security. Water treatment and boiler treatment. O&M repairs boiler treatment. O&M repairs to and boiler treatment. O&M repairs to AHERA report. Paint exterior of AHERA report. Paint gym. to AHERA report. Paint gym. the gym. Replaces window alc Replaces window alc units. Replaces window alc units. units. Replace shades. Replace Replace shades. Replace certain Replace shades. Replace certain certain windows. Replace windows. Replace certain exterior windows. Replace certain exterior sidewlalk sections. Refinish doors. Replace areas of doors. Install rubberized play classroom floors. Replace smoke sidewalk. Replace smoke surface. detectors detectors.

$21,1731 $38,3601 $25,294 $25,800

Localized repairs, salaries and supplies. Annual service, inspection of boilers, fire alarm and security. Water treatment and boiler treatment. O&M repairs to AHERA report. Refinish classroom floors. Replace shades.

Localized repairs, salaries and Localized repairs, salaries and supplies. Annual service, supplies. Annual service,

Localized repairs, salaries and inspection of boilers, fire alarm inspection of boilers, fire alarm supplies. Annual service, and security. Water treatment and security. Water treatment and inspection of boilers, fire alarm and boiler treatment. O&M repairs boiler treatment. O&M repairs to and security. Water treatment to AHERA report. Replace AHERA report. Replace and boiler treatment. O&M repairs shades. Install carpet. Carpet shades. Carpet cleaning. Refinish to AHERA report. Replace cleaning. Replace smoke wood floors. Replace smoke shades. Install carpet. detectors detectors

George Washington Elementary $138,310 $186,612 $144,527 $147,418 2190/110

~t"'~ ~,~~.~ •. ~~ _. , Localized repairs, salaries and supplies. Annual service, supplies. Annual service, supplies. Annual service, inspection of boilers, fire alarm inspection of boilers, fire alarm Localized repairs, salaries and inspection of boilers, fire alarm and security. Water treatment and security. Water treatment supplies. Annual service, and security. Water treatment and boiler treatment. O&M repairs and boiler treatment. O&M repairs inspection of boilers, fire alarm and boiler treatment. O&M to AHERA report. Replace certain to AHERA report. Replace certain and security. Water treatment and repairs to AHERA report. windows. Replace shades. windows. Replace boiler treatment. O&M repairs to Replace certain windows. Replace fire alarm panel. shades. Replace smoke detectors AHERA report. Replace certain Replace shades. Repair of Replace clock system. Replace Replace window alc units. windows. Replace shades. plaster in classrooms. Replace windowalc units. Refinish Refinish classroom floors. Replace smoke detectors. Replace windowalc units. Refinish gym classroom floors. Refinish Refinish gym floor. Carpet window alc units. Refinish floor. (screen) gym floor. cleaning .. classroom floors. Carpet cleaning.

Woodfield Stadium $4,336 $164,711 $46,420 $47,348 2190 rllt::: t:::Jl.LIIIYUI::'IIt:::1 II II::'.

Maintaining of playing field, Fire extinguisher inspections. supplies, equipment and salaries. Maintaining of playing field, Fire extinguisher inspections.

Fire extinguisher inspections. Repair of bleachers. Replace supplies, equipment and salaries. Maintaining of playing field, Maintaining of playing field, deck and roof on press box. Repair of bleachers. Replace supplies, equipment and salaries. supplies, equipment and salaries. Repainting of all team rooms and sidewalk. Repainting of all team Repainting of all team rooms and Replacement of fencing. Replace bathrooms. Replace sections of rooms and bathrooms. Replace bathrooms. Replace sections of deck and roof on press box. fence. Replace hot water heater. sections of fence. fence. Repave certain areas.

TOTAL ALL FACILITIES $1,653,519 $1,637,374 $1,949,100 $1,988,082

District

NJ DS::PARTMENT OF EDUCATION BG#2-10/15 SCHOOL FACILITIES

Form M-I

County IUnion

District Name I Hillside

District Number I Filing Date 1

Prepared by:

District School Business Administrator

Final

Annual Mainteuance

Budget Amount Worl{sheet

Per N.J.A.C. 6A:26A

Current Area Cost Allowance per SF 1 $ 143.00 1

21901

1

District contact name 1 Kenneth R Weinheimer 1

District contact phone 1908-352-7664, ext. 6428 1

District contact e-mail [email protected] 1

Max. Maintenance Reserve Amount (4% of column D) Current District Maintenance Reserve Amount

G

Print ~. e~.einfie·

Sign :::::,:.~~::::~=:. =.:==::"::::::=::::= Date 10/15/2015 ----

10/9/201511:47 AM October 20, 2011 Board approval

New Jersey Department of Education BG#3-10/15

Health and Safety Evaluation Of School Buildings Checklist

COUNTY: Union DISTRICT: Hillside SCHOOL YEAR: 2015-2016 (check one) [ ] Leased !XXI Owned SCHOOL BUILDING:_H_l-'-°1_l-.::s:...:..i:...:..d--=e ____ H_i-=!g_h_<_G_r_-_9_-_1_2_) __ _ COMPLETED BY: David DeFluri DATE = 10- R~/s-____ -L~~~~~ ________ __

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluationjs for the health and safotv or students and staff even in the absence ora specific Statute or Code. The items fisted are not mutuaIlv exclusive o{other findings a monitorlinspector_may_srre. See "Facility Instructions and Guidance" for additional information.

SECTION A: 1 00% Items 100%COMPL.IANCE. ' . ,,": . .. . ; . ~ , .

. ' . ' . . ...... . ~ ;

CURRENT LICENSES AND CERTIFICATES YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

/ has been issued by the local or State fITe official/inspector within the year and posted ill a conspICUOUS location. (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, y/.J'" cafeteria, pool, etco) is available.

3. A 3 year asbestos management plan, as required by AH.E.R.A, is available including current 6 month surveillance V letters. If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of V Environmental Protection for the operation ofa sewage

treatment plant, where applicable, is available.

5. Current boiler inspection certificate(s) posted at site of boiler V 6. Current licensees) for high and low pressure boiler operators, as V required by code, are properly posted. 7. Current drinking water supply inspection reports are available

!/ to comply with the Safe Water Drinking Act. (N.IAC 58: 12A-1) (6A:26-12.4)

8. One flre drill and one school security drill are held each month;

V [See"Checklist Instructions" for Certificate of Assurance] 18A:4l-l

9. Right To Know requirements are properly posted and MSDS V reporting materials on flle for review. 10. District has defibrillators identified with appropriate

slgnage, is placed and made available in an unlocked location on school property, which is accessible during the V school day and any other time in which a school-sponsored athletic event or team practice, in which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Pagel 0/6 Revised: 0612612015

11. Exterior switches and receptacles are covered by securely fastened weather-proof plates and :fixtures are securely mounted / with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a. Fire escapes and/or exterior stairs can be safely negotiated. ~ b. Panic hardware is provided on exit doors of all spaces with

an occupanc load/capacity greater than 50. ~:~mQ~·~1t~~~~~:~ ~~~~lf~:~~~~:~}t]j~~?~f~tf~~?~r~~~jf;~~f~tr~;:;~·~~~~<~KE,\1~:·~ttt.;~~-~~i}t~ 13. All electrical outlets; switciies, receptacles and Junction i:>oxes;

electric wires; fuses and/or oircuit breaker panels; etc. are V. properly covered and/or secured and/or protected.

14. Sufficient access and working space is provided and maintained around all electrical spaces. Items, especially combustibles, are • / a minimum of 36 inches from electrical power sources or V equipment; i.e.: circuit breaker panels, fuse boxes, transformers.

15. Instructional areas are free of all unapproved construction; e.g.: walls; partitions; doors and stairs; etc.

16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, thumb-turn locks, hasps dead bolts, slide bolts or similar types oflocking devices shall not be permitted. 6A:26-8.1 (i2)

17. Unobstructed vision panels with code approved glass are installed in doors opening into corridors. Interior glazing shall be safety glazing. 6A:26-8.1 (i3)

18. Kindergarten and Pre-K toilet requirements are met. 19.Distrlct approves· as needed: Duai Use, Change of Use,

Alternate Toilet, Temporary sites (TCU or rented faculties). Required DOE approvals in place.

20. Dangerous chemicals (i.e.: liquefied petroleum gas/propane) and/or explosive materials (i.e.: gunpowder; picric acid) are NOT stored/present in the building. If needed, flammable and combustible materials are properly stored/maintained (i.e.: in properly rated cabinets; NOT in boiler roomlhazardous areas).

21. Power machinery and equipment, as well as science labs, have appropriate safety features in place, including as applicable: a. Appropriate placement on the floor and required p~int of

operation guards to protect users from injury due to moving parts.

v ~

t/"

,V

b. Clearly visible and accessible push-type emergency cut-out / switche's at appropriate locations within shops to de- V energize electrical supply to nonportable machinery.

c. Non-portable machinery provided with magnetic type switches to prevent automatic restart upon restoration of power after an electrical failure or reactivation of the emergency cut-off switch.

d. Key-operated electric solenoid shut-off valves on natural gas lines in science laboratories and shops constructed after 1979. On all other gas lines there is an emergency shut off valve which is clearly marked and accessible.

" V

/'

Page 2 of 6 Revised: 06/26/2015

100% COMPLIANCE·. ;'. . ....

VOCATIONALILABORATORIES continued YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 BC rated flre extinguisher is provided V/

in each laboratory and vocational area. 23. Adequate eye and body protection is provided, including:

a. Eye protection devices (glasses, goggles) for students and faculty in each laboratory and shop area, including appropriate provision for their sanitation. V b. Emergency eyewash device(s), with 15 minutes \ continuous flow, where caustic or corrosive materials are used.

c. An emergency cold-water shower for chemistry laboratory if constructed after October 1985. ( 6A:26-12.5)

24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities, as ap'plicable: \

a. For science activities (i.e.: via fume hoods)

( b. For welding operations. c. For paint spraying operations:

1 Auto: should have separate exhaust system. 2 Art: proper ventilation for spray/ paint with

., fumes d. Art: Safe designated space/room for kilns with proper

ventilation e. For dust generating operations, such as wood working,

(i.e.: a dust collecting system which should be either single or multi-use vacuum packs or a central dust collection system

;;100% ITEMS TOTAL> ........

~C) (0 ,if

Section B: 80% Items ;80% COMPLiANo: .. '

EXITSIEXTERIOR YES NO N/A VIOLATION LOCATION 1. No evidence of major exterior building structural damage.

Ss'oQf\.e CCf\oCks Exarnple(s) would include: a. Exterior walls appear free of structural cracks, loose / So!'<''€. I\\"'\"~~

masonry and crumbling parapets; lintels appear free of rust and flaking. ®~ \\~e\s

b. Gutters and downspouts appear to be in good condition and are secured to the building; runoff does not appear to be obstructed or create drainage or soil erosion.

2. All exterior receptacles are GFI protected in accordance with V code.

3. All school grounds, including general purpose play areas and athletic fields, are free of holes; glass; stumps, roots; rocks and t/' other hazardous obstacles. Fences are maintained and are free of holes. The outside physical education area for students shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix '-

Page30f6 Revised: 0612612015

~~$O;*~~Gclt\x£r;W(;:+J.tlJ~;1\}~;'jWgE'iJt?~j:ii,):~'s1f.!;}~':C;{[;~q[j:~iif~kj~:~i;~n~!~;;yt2;iPK:i;j~;;fr;!:t,:~fi '''','i~:,c:~:;''~,: '?~+:~(~~; ··j{:\1S~" ::::!j:'.'<';;j'.(';:'; >:,{:', ,.·····;}'~·i:\~' 'j/. ,';f:'·.::,: ~)t~$Otn:E.mQ;~/~·9.~ij~1i~~!,~:j:/::::::::?:}ti:::::::::::::::'::/il'),::f;::f;'I:t:t:j,:@:::t::/:i;:'::·::::t:S,::::ii::':;:::1 YES NO NI A VIOLATION LOCATION 4. Playground area and equipment appear to be in safe operating

condition and in compliance with code and district maintains documentation of compliance and regular inspections.

5. All interior exits and corridors are in good condition; readily accessible; and free of obstructions andlor excessive materials ~ which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible I ./

height and standard location in all areas. 6A:26-8.1 (i4) V 7. Doors leading to interior courtyards are clearly marked: "Not an

Exit" 8. Handrails on both sides of interior stairways, guardrails, and

interior stair treads are free of surface features which may cause injury and/or are properly secured. Interior stair treads do not ~ show evidence of extensive wear and are generally in good repair

9. Stage curtains are flame proof or flame retardant and V. certificates are on file.

10. All education spaces shall be equipped with a communication devise/system connected to the main V office and capable of emergency communication to local authorities or 9-1-1. 6A:26-8.I (i6)

11. Electric outlets andlor wiring appear appropriate, including: a. GFI protection for receptacle( s) within 6 ft of water in /

accordance with code. V h. Electrical extension cords and surge protectors used

appropriately, with extension cor~s o:oJy. used for temporary need(s). " " '

c. Sufficient electrical duplex outlets shall be provided to satisfy the program needs as provided in N.J.A.C. 6A:26-6.3 6A:26-8.1{vii2)

12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the V performance of the duties required under State law and the rules by health services personneL (6A:26-l2.3)

13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth inN.JA.C. 6A:26-6.3 and the Dec. 6A:26-8.l (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, as measured with a light meter, comply with code and ~ lampslbulbs are covered with a lens cover or equivalent protection.6A:26-8.I(vi)

15. Instructional areas have no unauthorized and/or potentially t/ hazardous materials/equipment in rooms. 6A:26-8.I (il)

16. A chalkboard or whiteboard, andlor display board is provided in each instructional space and is free of cracks and jagged edges. 6A:26-8.1 (viiI)

Page 4 of6

IUdf trll u/fJ/fs

Revised: 06/2612015

80% COMPLIANCE ...

. INTERIOR 17. Ceilings, walls and floors are free of holes, sags, and evidence

of water damage. The average ceiling height shall be at least 8' feet for instructional spaces in temporary facilities ill an existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites.6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working order and covered with appropriate plates; unused (abandoned) waste lines (drains) are sealed off and capped.

19. Floors throughout the school are clean and free of trash, as well as appear free of slipping, tripping; and/or other hazards. Any concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering. 6A:26-8.1 (is)

20. Supplies and materials are neatly and appropriately stored: a. Storage racks/shelving over 6 feet in height are properly

secured from tipping. h. In general, there is no storage within 24 inches of a ceiling.

In buildings with sprinkler systems, storage is at least a minimum of 18 inches below sprinkler head deflectors.

c. Storage is organized to allow safe access through space. 21. Provision shall be made for storage of students' clothing in

other than a corridor or exitway. Student lockers are usable; i.e.: doors, handles and locks are operable. 6A:26-8.1 (i7)

22. Drinking fountains are provided with sufficient water pressure or access to water coolers is readily available. (6A:26-12.4) Potable water shall be available and drinking fountains. shall be provided for students ill cafeterias, preschool and kindergarten programs in accordance with N.J.A.C. 5:23-7; 6A:26-8.1 (v)

23. Toilet facilities shall meet existing DCC requirements for the E D se Group as determined by the construction official. Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.1 (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home economics rooms & cafeteria are stored sCQarately

25. Non-instructional areas are free of all unapproved construction; e.g.: walls,2artitions, doors and stairs.

26. Furniture and equipment that is in good condition and suitable for the age and size of the students and purposes of instruction shall be provided; 6A:26-8.l(vii)

27. Corrosives, toxic and other hazardous substances are stored in proper corrosive storage cabinets and are properly labeled.

28. Required space is available for the safe operation of machinery 29. Mechanical and hydraulic automotive lifts have locking devices

to hold them in the extended (open) position. 30. Floor(s) and aisles in all shops are free of slipping and tripping

hazards.

YES NO N/A

31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. V

VIOLATION LOCATION

50 m ~ ~~<'~e",~

~ ~~"O'" i~\ ('(\ e 5~, b ~. yV\ H"'4\l ~, It-L,~c!l( -\-O{ ~ LA~ .

VOCATIONALiLABo;RATom8. YES NO N/A VIOLATION LOCATION

PageS of6 Revised: 0612612015

32. The following additional safety measures are ill

welding operations are on-going: a. Welding curtains are provided and are painted with a Imish

of low reflectivity. h. Personal protective equipment (goggles, aprons, etc.) are

33. Pressurized gas cylinders are secured (chain and eye hooks to and valve . are in

34. Oxygen cylinders in storage are separated from fuel gas cylinders (acetylene) or combustible materials a minimum distance of 20 feet

SCORING SECTIONS 100% Section A

Maximum # of Compliant Questions: 24

80% Section B

34

# of NO responses in section A U [X 1 COMPLIANT (No exceptions) [ 1 NONCOMPLIANT

f--_b_. #_o_fN_O_r_es...::p_o_ns_e_s _____ -+-_--:::-'7=?_---l [ 'X ] COMPLIANT Line a is equal to or greater than Line #d c. Subtotal [(a)+(b)] 2,,0

a.# of YES responses 'Z.::S

-·-d.-M-ultiply [(c) x 80%] dO,:!! ] NONCOMPLIANT Line a'is'lessthan Line #d

Title Date

Date

/0/4r5 Date

All indicators denoted with 6A:26-8.1 also represent codified Temporary Facility Standards.

Page 6of6 Revised: 0612612015

New Jersey Department of Education Health and Safety Evaluation Of School Buildings Checklist

COUNTY: Union DISTRICT: Hillside SCHOOL YEAR: 2015-2016

(check one) [ 1 Leased [xl Owned SCHOOL BUILDING: w.o. Krumbiegel Middle (Gr. 6-8)

COMPLETED BY: David DeFluri DATE: 10 -,f- /~

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluationjs for the health and safetv orstudents and statfeven in the absence ora specific Statute or Code. The items listed are not mutuallv exclusive orother findings a monitoriinspector_mayAle. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COMP~IANCE • . . .. : .. ..;. . , .

.. . ,

CURRENT LICENSES AND CERTIFICATES· YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State fire official/inspector V within the year and posted III a conspicuous location. (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, V cafeteria, pool, etc.) is available. 3. A 3 year asbestos management plan, as required by

A.H.E.R-A., is available including current 6 month surveillance letters. If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of Environniental Protection for the operation of a sewage V treatment plant, where applicable, is available.

5. Current boiler inspection certificate(s) posted at site of boiler V 6. Current licensees) for high and low pressure boiler operators, as V required by code, are properly posted. 7. Current drinking water supply inspection reports are available / to comply with the Safe Water Drinking Act. (N.J.A.C 58: 12A-

1) (6A:26-12.4) 8. One fire drill and one school security drill are held each month; V [See"Checklist Instructions" for Certificate of

Assurance] 18A:41-1 9. Right To Know requirements are properly posted and MSDS ~ reporting materials on file for review.

10. District has defibrillators identified with appropriate signage, is placed and made available in an unlocked

/ location on school property, which is accessible during the school day and any other time in which a school-sponsored athletic event or team practice, in which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Pagel 0/6 Revised: 06/2612015

11. Exterior switches and receptacles are covered by securely /' fastened weather-proof plates and fixtures are securely mounted V with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a. Fire escapes and/or exterior stairs can be safely negotiated. V h. Panic hardware is provided on exit doors of all spaces with

an occupancy load/capacity greater than 5 O.

13. All electrical outlets; switches, receptacles and junction boxes; electric wires; fuses and/or circuit breaker panels; etc. are

.£foperly covered and/or secured and/or protected. 14. Sufficient access and working space is provided and maintained

around all electrical spaces. Items, especially combustibles, are a minimum of 36 inches from electrical power sources or equipment; i.e.: circuit breaker panels, fuse boxes, transformers.


16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key--operated locks, thumb-turn locks, hasps dead bolts, slide bolts or similar types oflocking devices shall not be permitted. 6A:26-8.1 (i2)


18. Kindergarten and Pre-K toilet requirements are met.

19. District approves as needed: Dual Use, Change of Use, Alternate Toilet, Temporary sites (TCU or rented faculties). Required DOE approvals in place.




h. Clearly visible and accessible push-type emergency cut-out switches at appropriate locations within shops to deenergize electrical supply to nonportable machinery.

c. Non,-portable machinery provided with magnetic type switches to prevent automatic restart upon restoration of power after an electrical failure or reactivation of the emergency cut-off switch.


Page2of6 Revised: 06/2612015

100% CO:MPLIANCE. .

VOCATIONALILABORATORIES continued YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 Be rated fIre extinguisher is provided

V in each laboratory and vocational area. 23. Adequate eye and body protection is provided, including:

a. Eye protection devices (glasses, goggles) for students and faculty in each laboratory and shop area, including y/ appropriate provision for their sanitation.

b. Emergency eyewash device(s), with 15 minutes continuous flow, where caustic or corrosive materials are used.

c. An emergency cold-water shower for chemistry laboratory if constructed after October 1985. (6A:26-12.5)

24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities;as ap'plicable: a. For science activities (i.e.: via fume hoods) b. For welding operations. c. For paint spraying operations:

I 1 Auto: should have separate exhaust system. 2 Art: proper ventilation for spray/ paint with fumes

d. Art: Safe designated space/room for kilns with proper ventilation

e. For dust generating operations, such as wood working, (i.e.: a dust collecting system which should be either single or multi-use vacuum packs or a central dust collection system

,;100% ITE.MsTOTA,:L: ..... ,. /g () UJ Section B· 80% Items

'80% COMPLIANCE· .' '." ...

EXITSIEXTERIOR YES NO N/A VIOLATION LOCATION 1. No evidence of major exterior building structural damage.

~f'<"--e v\eAe( lO(~A-e ~ Example(s) would include: a. Exterior walls appear free of structural cracks, loose ( h'~ff:,l5

masonry and crumbling parapets; lintels appear free of rust and flaking.


2. All exterior receptacles are GFI protected in accordance with t/ code. 3. All school grounds, including general purpose play areas and

athletic fIelds, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free of holes. The outside physical education area for students I shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix

Page 3 of6 Revised: 0612612015

i.~}3Qi~~::i:;(}0~t.~(j:Jt;{;;;Wf)\{~:::?;f~'1Hs;;~~V~>}i\%~¥i~Ni~j;~~!:~1fJ2::iUi,gr~;{:;;ii;?:i:,~i;;\;~~#i:}":;i:,:2:';~> P~;~i~:,(':;I;;i;ti:ii7. Ph:,,:: ':';:;c;; .. :.:<~;: ;:~?~':F "\,;:,'), :~:,;, ?»~§i~~ttitm<it{\~;;~#;ri~i.,4:a;:}::i~::):ti:rg:::::::!::;:?::t${{J~;}::?~:;;:r:!::{i,::ft::::::t1,::}i:!::;ii::: YES NO NI A VIOLATION LOCATION 4. Playground area and equipment appear to be in safe operating


5. All interior exits and corridors are in good condition; readily accessible; and free of obstructions and/or excessive materials which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible height and standard location in all areas. 6A:26-8.1 (i4)

7. Doors leading to interior courtyards are clearly marked: liN ot an Exit"

8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause injury and/or are 'properly secured. Interior stair treads do not V show evidence of extensive wear and are generally in good npair

9. Stage curtains are flame proof or flame retardant and certificates are On file.

10. All education spaces shall be equipped with a communication devise/system connected to the main office and capable of emergency communication to local authorities or 9-1-1. 6A:26-8.1 (i6)

11. Electric outlets and/or wiring appear appropriate, including: a. GFI protection for receptacle( s) within 6 ft of water in

accordance with code. b. Electrical extension cords and surge protectors used ~

" appropri(iteJy, "With extension cords . only used for temporary need( s).

c. Sufficient electrical duplex outlets shall be provided to satisfy the program needs as provided in N.J.A.C. 6A:26-6.3 6A:26-8.1(vii2)

12. Nurse's Office: District boards of education shall provide the . / necessary facilities, equipment and supplies for the V perfonnance of the duties required under State law and the rules by health services personnel. (6A:26-12.3)

13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the UCC. 6A:26-8.1 (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, as measured with a light meter, comply with code and V lamps/bulbs are covered with a lens cover or equivalent protection.6A:26-8.1(vi)

15. Instructional areas have no unauthorized and/or potentially hazardous materials/equipment in rooms. 6A:26-8.1 (il)

16. A chalkboard or whiteboard, and/or display board is provided in each instructional space and is free of cracks and jagged edges. 6A:26-8.1 (viiI)

Page 4 of6

/

It/of frJ/ ulvif5 OfdPJf / (J;;/fi~ I

Revised: 0612612015

80% COMPLIANCE ' .

INTERIOR ..... .. YES NO N/A VIOLATION LOCATION 17. Ceilings, walls and floors are free of holes, sags, and evidence .

of water damage. The average ceiling height shall be at least 8'

V feet for instructional spaces in temporary facilities in an existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites.6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working order and covered with appropriate plates; unused (abandoned) waste lines (drains) are sealed off and capped.

19. Floors throughout the school are clean and free of trash, as well v// as appear free of slipping, tripping; andlor other hazards. Any concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering. 6A:26-8.1 (is)


~ secured from tipping. h. In general, there is no storage within 24 inches of a ceiling.


c. Storage is organized to allow safe access through space. 21. Provision shall be made for storage of students' clothing in V other than a corridor or exitway. Student lockers are usable; i.e.:

doors, handles and locks are operable. 6A:26-8.1 (i7) 22. Drinking fountains are provided with sufficient water pressure

or access to water coolers is readily available. (6A:26-12.4) / Potable water shall be available and drinking fountains. shall be provided for students in cafeterias, preschool and kindergarten programs in accordance with N.J.A.C. 5:23-7; 6A:26-8.l(v)

23. Toilet facilities shall meet existing UCC requirements for the E Use Group as determined by the construction official. / Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.1 (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home ~ economics rooms & cafeteria are stored separately 25. Non-instructional areas are free of all unapproved V-

construction; e.g.: walls, partitions, doors and stairs. 26. Furniture and equipment that is in good condition and V suitable for the age and size of the students and purposes of

instruction shall be provided; 6A:26-8.l(vii) "VOCATIoNALiLABORATORlES '?:,':.,:.":.,.,.,,, .. . ':','" '. ,

:' :~: '

27. Corrosives, toxic and other hazardous substances are stored in V proper corrosive storage cabinets and are properly labeled. 28. Required space is available for the safe operation of machinery V 29. Mechanical and hydraulic automotive lifts have locking devices -/ to hold them in the extended (open) position. /'

30. Floor(s) and aisles in all shops are free of slipping and tripping / hazards.

31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. V V'OCATIONALftABdRAtoRIES' ........ YES NO N/A VIOLATION LOCATION

Page 50f6 Revised: 0612612015

, Ye j\JO

32. The following additional safety measures are in place if welding operations are on-going: a. Welding curtains are provided and are painted with a fmish

of low reflectivity. b. Personal protective equipment (goggles, aprons, etc.) are

rovided. 33. Pressurized gas cylinders are secured (chain and eye hooks to

welding cart, etc.) and valve rotection ca s are in lace. 34. Oxygen cylinders in storage are separated from fuel gas

cylinders ( acetylene) or combustible materials a IDillilllUm distance of 20 feet.



80% Section B

34

# of NO responses in section A o [1<.] COMPLIANT (No exceptions) [ ] NONCOMPLIANT

a. # of YES responses ;;>-3 b. # of NO responses 2- [ XJ ] COMPLIANT Line a is equal to or greater than Line #d

r--c.-S-ub-t-ot-~-[-(a~)+-~-)-]----------T--~~3-'~~-~

d.Multiply[(c)x80%] 2{:;:) ] NONCOMPLIANT Line a is less than Line #d

Title Date

ifapp~ Certified E ~cational Facilities Manger

~ ..' Date

Chie Sc 00 Adnimistrator I ' -

Date


Page6of6 Revised: 0612612015



(check one) [ ] Leased [x ] Owned SCHOOL BUILDING: George Washington (Gr. 5)

COMPLETED BY: David DeFluri DATE: /O:.-.f-IS-

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluationjs for the health and safotv or students and staf(even in the absence ora specific Statute or Code. The items listed are not mutuallv exclusive orothel' findings a monitorlinspector_may_srre. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COl\1:P:LIANCE : " . ,' .

" . ~ : • t"

CURRENT LICENSES AND CERTIFICATES' YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State fire official/inspector ~ within the year and posted ill a conspicuous location.

(or current abatement inspection is available) 2. A current inspection report of the local health official (kitchen, t.,./""

cafeteria, pool, etc.) is available. 3. A 3 year asbestos management plan, as required by

AH.E.R.A, is available including current 6 month surveillance /r

letters. If constructed without asbestos, a letter of certification V

from the architect is available. 4. An annual , inspection report of the Department of

Environmental Protection for the operation of a sewage V treatment plant, where applicable, is available.

5. Current boiler inspection certificate(s) posted at site of boiler J-" L. ...

6. Current licensee s) for high and low pressure boiler operators, as tl.,,-e"'/'

required by code, are properly posted. 7. Current drinking water supply inspection reports are available

/ .

to comply with the Safe Water Drinking Act (N.J.Ae 58:I2A- I.

1) (6A:26-I2.4) 8. One fire drill and one school security drill are held each month;

[See"Checklist Instructions" for Certificate of ~ Assurance] 18A:41-1

9. Right To Know requirements are properly posted and MSDS V reporting materials on file for review. 10. District has defibrillators identified with appropriate

signage, is placed and made available in an unlocked location on school property, which is accessible during the school day and any other time in which a school-sponsored V athletic event or team practice, in which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Pagel 0/6 Revised: f)6126120l5

. I

I ,

~;ib,Q%'/Q(?lj~%!t0~~'~H~-~f~:~:Ms"~~W0!;ttlS~i.;!-~~~}1D«~~'~~jly:'~?{§.tl~w~irgi~~~~,~: ~1f}.~~:~~~~i:'~ ~;Si':t~,{(f. ;.;:: ;};.: :,,,,..:, ':~%;f.:;§~l;:'k~~f;{irk~L~;:t~X,;D~Fc~~;~:i; )Jtm$I.E~:EXUQI(t~;:i~i~;'~~\:/f1::::~f;!ii:~;:::~'i~:(/?;~:; icl:t,~;i/~>;Y;;:~~y;Wj·i.r\1;tt:'it YES NO NI A VIOLATION LO CATION 11. Exterior switches and receptacles are covered by securely

fastened weather-proof plates and fixtures are securely mounted with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a. Fire escapes and/or exterior stairs can be safely negotiated. h. Panic hardware is provided on exit doors of all spaces with

an occupancy load/capacity greater than 50.

13. All electrical outlets; switches, receptacles and junction boxes; electric wires; fuses and/or circuit breaker panels; etc. are properly covered and/or secured and/or protected.

14. Sufficient access and working space is provided and maintained around all electrical spaces. Items, especially combustibles, are a min:imum of 36 inches from electrical power sources or equipment; i.e.: circuit breaker panels, fuse boxes, transformers.

15. Instructional. areas are free of all unapproved construction;/ e.g.: walls; partitions; doors and stairs; etc.

16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, \;/ thumb-tum locks, hasps dead bolts, slide bolts or s:imilar types oflocking devices shall not be permitted. 6A:26-8.1 (i2)

17. Unobstructed vision panels with code approved glass are/ l/ installed in doors opening into corridors. Interior glazing shall

be safety glazing. 6A:26-8.1 (i3)

18. Kindergarten and Pre-K toilet requirements are met

19. District approves' as needed: Dual Use, Change of Use, / Alternate Toilet, Temporary sites (rCU or rented faculties). V Required DOE approvals in place.

20. Dangerous chemicals (i.e.: liquefied petroleum gas/propane) and/or explosive materials (i.e.: gunpowder; picric acid) are / NOT stored/present in the building. If needed, flammable and V combustible materials are properly stored/maintained (i.e.: in properly rated cabinets; NOT in boiler roomlhazardous areas).


operation guards to protect users from injury due to moving

p~. / h. Clearly visible and accessible push-type emergency cut-out \

switches at appropriate locations within shops to de-energize electrical supply to nonportable machinery.




i • i

, 100% COMPLIANCE , ,,"', .' ",

VOCATIONALILABORATORIES continued' YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 Be rated fire extinguisher is provided t-/


a. Eye protection devices (glasses, goggles) for students and faculty in each laboratory and shop area, including

~ appropriate provision for their sanitation. b. Emergency eyewash device(s), with 15 minutes

continuous flow, where caustic or corrosive materials are used.


24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities, as applicable: a. For science activities (i.e.: via fume hoods) b. For welding operations. ,....

c. For paint spraying operations: 1-/"/

1 Auto: should have separate exhaust system. 2 Art: proper ventilation for spray/ paint with fumes


e. For dust generating operations, such as wood working, (i.e.: a dust collecting system which should be either single or mnlti-use vacuum packs or a central dust collection system

,100%ITEMS TOTAl, . ' .. . 16 0 >?

Section B: 80% Items ~"80% COl\1PLiAN(JE . .-

'.~:.:'::' .. > .. ' c· . C:,'

EXITSIEXTERIOR YES .. NO N/A VIOLATION LOCATION 1. No evidence of major exterior building structural damage.

SOV'Y'-{L Example( s) would include: a. Exterior walls appear free of structural cracks, loose V 0\ eke, o(~\ec\.

masonry and crumbling parapets; lintels appear free of rust \;, ~\eJs and flaking.


2. All exterior receptacles are GFI protected in accordance with V' code.

3. All school grounds, including general purpose play areas and athletic fields, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free of holes. The outside physical education area for students / shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix


J;$Q,%!:;§.li~:L~9;m~;bt\~)~i:!~Zi:;{i~]fJ~kdli;:~(}~¥.:~i;~i'~!::{\~!{:j:{:f~g/:;~;~i();~i;j;'f~:;:r~i;i~~ii;;;;i~:,};:);;r:~2;·"iT;r:IT0t~··,· ~""~:',:,:;:;; ",::::>r3.'~:'.~,~~:.; .• ;~:VX·.· :jt$.Jt,t$/E.~itR!Qi.~/~~~1:iji~~4:;;:::::;;:;:::::):t::::::::·::::::::::::fi\::::::::::::J:5/::\::::::J:/i.{·:t~i::;1::;/:{::::it)!ES NO NI A VIOLATION LOCATION 4. Playground area and equipment appear to be in safe operating ,/,

condition and in compliance with code and district maintains V documentation of compliance and regular inspections.

5. All interior exits and corridors are in good conditibn; readily accessible; and free of obstructions and/or excessive materials which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible height and standard location in all areas. 6A:26-8.1 (i4)

7. Doors leading to interior courtyards are clearly marked: "Not an Exit"

8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause injury and/or are properly secured. Interior stair treads do not show evidence of extensive wear and are generally in good repair

9. Stage curtains are flame proof or flame retardant and certificates are on file.

10. All education spaces shall be equipped with a communication devise/system connected to the main office and capable of emergency communication to local authorities or 9-1-1. 6A:26-8.1 (i6)

11. Electric outlets and/or wiring appear appropriate, including: a. GFI protection for receptacle(s) within 6 ft of water in

accordance with code. h. Electrical extension cords and surge protectors used

appropriately, with extension cords only used for temporary need( s). .

c. Sufficient electrical duplex outlets shall be provided to satisfy the program needs as provided in N.J.A.C. 6A:26-6.36A:26-8.I{vii2)

12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the performance of the duties required under State law and the rules by health services personneL (6A:26-12.3)

13. Individual or central' mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the VCC. 6A:26-8.1 (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, as measured with a light meter, comply with code and lampslbulbs are covered with a lens cover or equivalent protection. 6A:26-8. I (vi)

15. Instructional areas have no unauthorized and/or potentially hazardous materials/equipment in rooms. 6A:26-8.1 (il)

16. A chalkboard or whiteboard, andlor display board is provided in each instructional space and is free of cracks and jagged edges. 6A:26-8.1 (viiI)

Page 4 of6

/

/

/ V

,/ IF

Revised: 0612612015

80%, COM:PLIANCE .. .

INTERIOR YES NO N/A VIOLATION LOCATION 17. Ceilings, walls and floors are free of holes, sags, and evidence

of water damage. The average ceiling height shall be at least 8' feet for instructional spaces in temporary facilities ill an V existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites.6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working L/'" order and covered with appropriate plates; unused (abandoned)

'waste lines (drains) are sealed off and capped. 19. Floors throughout the school are clean and free of trash, as well

as appear free of slipping, tripping; andlor other hazards. Any concrete floors in all instructional areas, except shops, shall be

v· covered with a resilient floor covering. 6A:26-8.1 (is)


secured from tipping. ~ h. In general, there is no storage within 24 inches of a ceiling.



t/ other than a corridor or exitway. Student lockers are usable; i.e.: doors, handles and locks are operable. 6A:26-8.1 (i7)

22. Drinking fountains are provided with sufficient water pressure or access to water coolers is readily available. (6A:26-12.4)

V Potable water shall be available and drinking fountains. shall be provided for students III cafeterias, preschool and kindergarten programs in accordance with N.J.A.C. 5:23-7; 6A:26-8.l(v)

23. Toilet facilities shall meet existing uee requirements for the E Use Group as determined by the construction official. V Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.1 (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home V· economics rooms & cafeteria are stored separately

25. Non-instructional areas are free of all unapproved V' construction; e.g.: walls, partitions, doors and stairs. 26. Furniture and equipment that is in good condition and t/.

suitable for the age and size of the students and purposes of instruction shall be provided; 6A:26-8.l(vii)

VOCATIONALILABORATORIES: . >c':;: . . .' .. . . .. ,., . '," , ;. ::.: .: .:, . .:.,: .. . >:,.

27. Corrosives, toxic and other hazardous substances are stored in V proper corrosive storage cabinets and are properly labeled.

28. Required space is available for the safe operation of machinery V 29. Mechanical and hydraulic automotive lifts have locking devices V·

to hold them in the extended (open) position. 30. Floor(s) and aisles in all shops are free of slipping and tripping V·<

hazards. 31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. V 'VOCATIONALrLA:BO;RATORIES ........ .. YES NO N/A VIOLATION LOCATION

Page 5 0/6 Revised: 0612612015

32. The following additional safety measures are in place if welding operations are on:"going: a. Welding curtains are provided and are painted with a fInish


rovided. 33. Pressurized gas cylinders are secured (chain and eye hooks to

weldin cart, etc.) and valve protection ca s are in lace. 34. Oxygen cylinders in storage are separated from fuel gas

cylinders (acetylene) or combustible materials a mllllIllUID distance of 20 feet.

[~tf~~r~AI~i~i., ~=~=



I

80% Section B

34

# of NO responses in section A o [Xl COlVIPLIANT (No exceptions) [ 1 NONCOMPLIANT

a. # of YES responses ;)if b. # of NO responses I [ X 1 COlVIPLIANT Line a is equal to or greater than Line #d

~--------~--------------~--~~~ c. Subtotal [(a)+(b)] .:A.5-d.Multiply [(e) x 80%} "00 ] NONCOMPLIANT Line a is less than Line #d .

Title Date

Date

Date !.

All indicators denoted with 6A:26-B.1 also represent codified Temporary Facility Standards.



COUNTY: __ U",-,n,-,,-,l...,' o~n",,--____ DISTRICT: Hillside SCHOOL YEAR: 2015-2016

(check one) [ 1 Leased [xl Owned SCHOOL BUILDING: __ H_u_r_d_e_n_L_o_o_k_e_r_(-,-G_r_"_3_-_"_14-,-) ___ _

COMPLETED BY: David DeFluri DATE: fa >c?-IS/

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluationjs for the health and safety or students and staff even in the absence ora specific Statute or Code. The items listed are not mutually exclusive orother findings a monitorlinspector_may_sjJe. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COMPL.IANCE •... ...

". . ., :

CURRENT LICENSES AND CERTIFICATES . YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State [lIe official/inspector ~ within the year and posted ill a conspICUOUS location, (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, V cafeteria, pool, etc.) is available.

3. A 3 year asbestos management plan, as required by AH.E.R.A, is available including current 6 month surveillance V letters, If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of Environmental Protection for the operation of a sewage y/ treatment plant, where applicable, is available.

/

5. Current boiler inspection certificate(s) posted at site of boiler / 6. Current licensees) for high and low pressure boiler operators, as 1-"'/

required by code, areproperlYjJ_osted. 7. Current drinking water supply inspection reports are available

V to comply with the Safe Water Drinking Act. (N.lAC 58: l2A-1) (6A:26-12.4)

8. One fire drill and one school security drill are held each month; /~ [See"Checklist Instructions" for Certificate of Assurance] 18A:41-1

9. Right To Know requirements are properly posted and MSDS ~ reporting materials on file for review.

10. District has defibrillators identified with appropriate signage, is placed and made available in an unlocked location on school property, which is accessible during the

/ """ school day and any other time in which a school-sponsored athletic event or team practice, in' which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Page10f6 Revised: 06126/2015

I

I

I'

; ~i:QQ%1'GQ.~j1~~~:HQ5}i~t~(J~%~~~i"~~;~J~~}}:i;~J~}/j·~?~f::M~;:§j;~;i~%i~~{§~;~~A'} sJMA~.~~ t(~t~~f;~lif;~t\~.rf~ :it!;?H~~7.~;~"':;:i\;";;:{f\S.;·:,;~j;:';;·,'W:0.'·~ i}i;~~? .. i. ·:;;;:¢:Xtt$fEx.:.:t:E:Rro.E:t:~;i~:i.~r~'Y·:::':~·~~:L;::}~;·;·;~:;;';:i~;:;!~~t;;;·,~/J·~:\;k\:~);-:0;?}r:(;;·Y~ YES NO NI A VIOLATION LO CATrON 11. Exterior switches and receptacles are covered by securely

fastened weather-proof plates and fixtures are securely mounted ~ with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: . /' a. Fire escapes and/or exterior stairs can be safely negotiated. V b. Panic hardware is provided on exit doors of all spaces with

an occupancy load/capaci eater than 50. ~~"""~~~~~~~~~-----r----T----+--------------------~

l:~mQ~T~~}~1~~?~~~~{:J~I~J~~~)~1~~~~~i::f:~~\. ~~~~~~~~};t,:·~~j~~~#.:t~~~1R~~~;~~~~~tlf~:~~~i~~·~J~~~~i.~~ ~~~~~~~~~~~~----~----~---+--------------------~

13. All electrical outlets; switches, receptacl<';s and Junction boxes; . /" electric wires; fuses and/or circuit breaker panels; etc. are V properly covered and/or secured and/or protected.

14. Sufficient access and working space is provided and maintained around all electrical spaces. Items, especially combustibles, are .~ a minimum of 36 inches from electrical power sources or equipment; i.e.: circuit breaker panels, fuse boxes, transformers.

15. Instructional areas are free of all unapproved construction; V e.g.: walls; partitions; doors and stairs; etc.

16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, ,./ thumb-turn locks, hasps dead bolts, slide boIts or similar types V oflocking devices shall not be permitted. 6A:26-8.l (i2)

17. Unobstructed vision panels with code approved glass are V installed in doors opening into corridors. Interior glaZing shall be safety glazing. 6A:26-8.l (i3)



20. Dangerous chemicals (i.e.: liquefied petroleum gas/propane) and/or explosive materials (i.e.: gunpowder; picric acid) are . ./' NOT stored/present in the building. If needed, flammable and V combustible materials are properly stored/maintained (i.e.: in properly rated cabinets; NOT in boiler roomlhazardous areas).

21. Power machinery and e,quipment, as well as science labs, have appropriate safety features in place, including as applicable: a. Appropriate placement on the floor and required p~int of


b. Clearly visible and accessible push-type emergency cut-out switch6s at appropriate locations within shops to deenergize electrical supply to nonportable machinery.



Page 2 of6 Revised: 06126/2015

100'Vo'COMPLIANCE ',:: -"

VOCATIONALILABORATORIES continued YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 BC rated fire extinguisher is provided /


a. Eye protection devices (glasses, goggles) for students and faculty in each laboratory and shop area, including appropriate provision for their sanitation. t/'



24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fu~es and/or odors, including for the following activities, as applicable: a. For science activities (i.e.: via fume hoods) b. For welding operations. /' c. For paint spraying operations:




,;lOO%ITEMSTOTAL: 10 0 <l

Section B: 80% Items "80%' COMPLIANCE " ''',' '

' " "",,: '

EXITSIEXTERIOR YES NO N/A VIOLATION LOCATION ..

1. No evidence of major exterior building structural damage. Sor~-~ CC(l\c.~s: Example(s) would include:

a. Exterior walls appear free of structural cracks, loose / masonry and crumbling parapets; lintels appear free of rust S:::>/fY\~ c\e..1-er\ 0 \' Dh ..

and flaking. I ()0"hL\S b. Gutters and downspouts appear to be in good condition and are secured to the building; runoff does not appear to be obstructed or create drainage or soil erosion.

2. All exterior receptacles are GFI protected in accordance with / code. 3. All school grounds, including general purpose play areas and

athletic fields, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free

/ of holes. The outside physical education area for students shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix

Page 3 0/6 Revised: 0612612015

· d~.Q/0,\G.Q~L~'0E·!t~iit~,;i~;·~[t~/[.;@};S;;~:~~~~i\~;U~~;l<;}{;();:Tl~i~;;l;:~.~~~;;;::&,~;i!§I~i?'i;~~~:if:~ :)(") I';j'{ :';,:,.: i'0£G .. \fi: ;:;>'~2S~ .. ~:: ·i:~~~~ii;::\~:':;~;!·i:;:.· :jtiP.X$I:iBXWjti.4Qi~r~·q#.ti;IiJ,~fi:i(~::~:{:::::::!'::'~:::·~;:::;t::::::::::\\:{:';;:::::::::}:{:{~:={i:::/:::::;}:{:;::;ii:i;:!it YES NO NI A VI OLATI ON LOCATION 4. Playground area and equipment appear to be in safe operating /


5. All interior exits and corridors are in good condition; readily/ accessible; and free of obstructions and/or excessive materials V which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible ~ height and standard location in all areas. 6A:26-8.I (i4)


8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause ./"" injury and/or are properly secured. Interior stair treads do not V show evidence of extensive wear and are gene:J."ally in good repair

9. Stage curtains are flame proof or flame retardant and t./ certificates are on file.

10. All education spaces shall be equipped with a communication devise/system connected to the main V office and capable of emergency communication to local authorities or 9-1-1. 6A:26-8.1 (i6)



appropriately, . with extension cords only used for temporaiY need(s). '. '" .... . .'

c. Sufficient electrical duplex outlets shall be provided to satisfy the program needs as provided in N.J.A.C. 6A:26-6.3 6A:26-8.1 (vii2)

12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the / performance of the duties required under State law and the rules by health services personnel. (6A:26-12.3)

13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and /'" toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the DCC. 6A:26-8.1 (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, as measured with a light meter, comply with code and v/' lampslbulbs are covered with a lens cover or equivalent protection.6A:26-8.l(vi)

15. Instructional areas have no unauthorized and/or potentially V hazardous materials/equipment in rooms. 6A:26-8.l (il)

16. A chalkboard or whiteboard, and/or display board is provided in each instructional space and is free of cracks and jagged l~ edges. 6A:26-8.l (viiI)


'80% COMPLIANCE .'

·lNTERIOR YES NO N/A VIOLATION LOCATION 17. Ceilings, walls and floors are free of holes, sags, and evidence

~V rde)v c. e .. of water damage. The average ceiling height shall be at least 8' V 04-

feet for instructional spaces in temporary facilities in an W \\A-e \' 6 f\.{'{\ ~ q e existing public school, in a district owned facility and in rented

or leased buildings not on school district owned sites.6A:26-8.1 M~\~J ~\\ (ii)

18. Area and floor drains, where provided,_ appear to be in working order and covered with appropriate plates; unused (abandoned) ~ waste lines (drains) are sealed off and capped.

19. Floors throughout the school are clean and free of trash, as well t/ as appear free of slipping, tripping; and/or other hazards. Any

concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering. 6A:26-8.1 (is)


secured from tipping. h. In general, there is no storage within 24 inches of a ceiling.



other than a corridor or exitway. Student lockers are usable; i.e.: doors, handles and locks are operable. 6A:26-8.1 (i7)


~ Potable water shall be available and drinking fountains.shall be provided for students m cafeterias, preschool and kindergarten programs in accordance with N.lA.C. 5:23-7; 6A:26-8.l(v)

23. Toilet facilities shall meet existing UCC requirements for the E Use Group as determined by the construction official.

~ Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.l (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home V economics rooms & cafeteria are stored separately 25. Non-instructional areas are free of all unapproved ~'

construction; e.g.: walls, partitions, doors and stairs. 26. Furniture and equipment that is in good condition and V' suitable for the age and size of the students and purposes of

instruction shall be provided; 6A:26-8.1(vii) ,'VOCATIONALlLABo1iA:rOIUES

. '.' . . ,: .... , .. "j.' , .. ",: ..... . ,<c.

27. Corrosives, toxic and other hazardous substances are stored in / proper corrosive storage cabinets and are properly labeled.

-"

28. Required space is available for the safe operation of machinery V 29. Mechanical and hydraulic automotive lifts have locking devices ~.

to hold them in the extended (open) position. 30. Floor(s) and aisles in all shops are free of slipping and tripping /

hazards. 31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. \,/"

VOCATIONALII.ABOAATORIES YES NO N/A VIOLATION LOCATION


32. The following additional safety welding operations are on-going: a. Welding curtains are provided and are painted with a fInish

of low reflectivity. b. Personal protective equipment (goggles: aprons, etc.) are

33. Pressurized gas cylinders are secured (chain and eye hooks to and valve . are in

34. Oxygen cylinders in storage are separated from fuel gas cylinders (acetylene) or combustible materials a minimum distance of 20 feet.



v

80% Section B

34

# of NO responses in section A 0 [X J COMPLIANT (No exceptions) [ J NONCOMPLIANT

a. # of YES responses h~

b. # of NO responses .3 [ X J COMPLIANT Line a is equal to or greater than Line #d ~-c.-S-ub-t-ot-ill-[-(a~)+-(-b)-]----------~~~~5~--=-~

d.Multiply [(c) x80%] 8-6 ] NONCOMPLIANT Linea is less than Line #d

Title Date

ifapp\icah\e, Certified Educational Facilities Manger Date

j Date



New Jersey Department o/Education Health and Safety Evaluation Of School Buildings Checklist


(check one) [ ] Leased [xl Owned SCHOOL BUILDING: Calvin Coolidge (Gr. 2)

COMPLETED BY: David DeFluri DATE: I cJ -- fJ- 15----

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaiuationjs for the health and safotv of students and staff even in the absence ora specific Statute or Code. The items listed are not mutuallv exclusive orothe,. findings a 11l0nitoriinspector_mayAle. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COMPLIANCE - -.,-,','.;." ,-: .

; :.,'

CURRENT LICENSES AND CERTIFICATES YES NO L A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State fire official/inspector _ ./ within the year and posted III a conspicuous location. V (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, V cafeteria, pool, etc.) is available.

3. A 3 year asbestos management plan, as required by AH.E.R.A., is available including current 6 month surveillance V letters. If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of Environmental Protection for the operation of a sewage treatment plant, where applicable, is available.

5. Current boiler inspection certificate(s) posted at site of boiler t,./ 6. Current licensees) for high and low pressure boiler operators, as

required by code, are properly posted. 7. Current drinking water supply inspection reports are available

to comply with the Safe Water Drinking Act. (N.J.A.C 58:12A-1) (6A:26-12.4)

8. One fire drill and one school security drill are held each month; ,,,,/ [See"Checklist Instructions" for Certificate of V

Assurance] 18A:4l-l 9. Right To Know requirements are properly posted and MSDS ~

reporting materials on file for review. 10. District has defibrillators identified with appropriate

signage, is placed and made available in an unlocked location on school property, which is accessible during the /' " school day and any other time in which a school-sponsored V athletic event or team practice, in which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Page 1 0/6

N/A VIOLATION LOCATION

Revised: 0612612015

:~iQP)~~\·'0Q'ME.;P~~~f::l;tH~~~!~WJi1~%~~gi¥i~::~~;j;~~i~']i.~~~;:;;~{:iia!;$~~j;1~;g!~i; ~'fiWAj;f;ff,¥:ti}f,ffl;l;i{?ii,i~:~~j~;r;i;;l~~}F'~i(;;:·'~;J·it;~t.}jiD;:1':?tJt;'J;;:;}(~·~~:)' ,:, i/:$WSIE~JtRrQR.;J~~~·{':;;(?:;i'::::;~·;;~~:~::~;~~~::~;~:'::].'i::U~:i;f:~i;~~::lF;,;t~)J~?(::;:(Y~Jf YES NO NI A VIOLATION LO CATl 0 N 11- Exterior switches and receptacles are covered by securely

fastened weather-proof plates and fixtures are securely mounted with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a.. Fire escapes and/or exterior stairs can be safely negotiated. b. Panic hardware is provided on exit doors of all spaces with

an occupancy load/capacity greater than 50.

13. All electrical outlets; switches, r~ceptacl~s and junction boxes; electric wires; fuses and/or circuit breaker panels; etc. are properly covered and/or secured and/or protected.

14. Sufficient access and working space is provided and maintained around all electrical spaces. Items, especially combustibles, are a minimum of 36 inches from electrical power sources or equipment; i.e.: circuit breaker panels, fuse boxes, transformers.


16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, thumb-tum locks, hasps dead bolts, slide bolts or similar types oflocking devices shall not be permitted. 6A:26-8.1 (12)


18. Kindergarten and Pre-K toilet requirements are met


20. Dangerous chemicals (i.e.: liquefied petroleum gas/propane) and/or explosive materials (i.e.: gunpowder; picric acid) are ./ NOT stored/present in the building. If needed, flammable and V combustible materials are properly stored/maintained (i.e.: in properly rated cabinets; NOT in boiler roorolhazardous areas).

21. Power machinery and equipment, as well as science labs, have appropriate safety features in place, including as applicable: a.. Appropriate placement on the floor and required p~int of



c. Non--portable machinery provided with magnetic type switches to prevent automatic restart upon restoration of power after an electrical failure or reactivation of the emergency cut-off switch.



100% COMPLIANCE .' '.

VOCATIONALILABQRATORIES continued YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 Be rated fIre extinguisher is provided V"'



r appropriate provision for their sanitation. ~ b. Emergency eyewash device(s), with 15 minutes



24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities, as applicable: a. For science activities (i.e.: via fume hoods) b. For welding operations. (/' c. For paint spraying operations:




,;100% ITEMS TOTAL:. .' :' IJ CJ If Section B: 80% Items

'80% COIVIPLiA.No: ' ' '.' . "'.: ,'" :.

. .. .>.:: .... ,'., . : ... ,:,: EXITSIEXTERIOR YES NO N/A VIOLATION LOCATION 1. No evidence of major exterior building structural damage.

Example(s) would include: a. Exterior walls appear free of structural cracks, loose V masonry and crumbling parapets; lintels appear free of rust

and flaking. b. Gutters and downspouts appear to be in good condition and

are secured to the building; runoff does not appear to be obstructed or create drainage or soil erosion.

2. All exterior receptacles are GFI protected in accordance with ~ code. 3. All school grounds, including general purpose play areas and

athletic fields, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free .~ of holes. The outside physical education area for students shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix


i~d,%:;:',GQNtf\t~0.1b.tg0::'i;!ii,;!t:,~~Mi@~~:if,,;;:i:~~~);;;:(:~;~~}i~i~~n~~;,j};,;i:~iti:Ji!}~~gf'i&£!:~!;,;~:\:':!:i,:;'< I··.(~,;·.·,;)l~ li;~;~;f;:.;';i: 1.(.':;;::.. ::':}/)':' ': ';·i/~, •. ':}:~i~{";Y';;:~:·; ~ii;;{: :j~;jQ;X$.iJtX\t;E~bj:~Xi:p~ij#ii~~li::,:;:.;;:::=;:;:::.):;::i:~;;i::·:::i(:r{:\:ii::;:?:::::t:::;::·::::;::::i::::::;:f::{:;:;;:~:/:i.i:;It: YES NO NI A VIO LATION LOCATION 4. Playground area and equipment appear to be in safe operating

condition and in compliance with code and district maintains V documentation of compliance and regular inspections.

5. All interior exits and corridors are in good condition; readily accessible; and free of obstructions and/or excessive materials V which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible V height and standard location in all areas. 6A:26-8.l (i4)

7. Doors leading to interior courtyards are clearly marked: "Not an //"-Exit"

8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause ,," injury and/or are properly secured. Interior stair treads do not ·V show evidence of extensive wear and are generally in good repair

9. Stage curtains are flame proof or flame retardant and I /'"

certificates are on file, V

10. All education spaces shall be equipped with a communication devise/system connected to the main V· office and capable of emergency communication to local authorities or 9-1-1. 6A:26-8.l (i6)



appropriately, with extension cords only used for temporary need(s). '. ,

c. Sufficient electrical duplex outlets shall be provided to satisfY the program needs as provided in N.J.A.C. 6A:26-6.36A:26-8.1(vii2)

12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the ~ performance of the duties required under State law and the rules by health services personnel. (6A:26-I2.3)

13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and t./ toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the DCC. 6A:26-8.I (iii)

14. Lighting levels in all instructional areas at least 50 foot candles" /' as measured with a light meter, comply with code and l/'

lamps/bulhs are covered with a lens cover or equivalent protection.6A:26-8.l(vi)

15. Instructional areas have no unauthorized and/or potentially ~ hazardous materials/equipment in rooms. 6A:26-8.l (il)

16. A chalkboard or whiteboard, and/or display board is provided in each instructional space and is free of cracks and jagged . /'"

V edges. 6A:26-8.I (viiI)


80% COMPLIANCE .... . INTERIOR YES NO N/A VIOLATION LOCATION

17. Ceilings, walls and floors are free of holes, sags, and evidence of water damage. The average ceiling height shall be at least 8'

V feet for instructional spaces in temporary facilities III an existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites.6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working v/ order and covered with appropriate plates; unused (abandoned)

waste lines (drains) are sealed off and capped. 19. Floors throughout the school are clean and free of trash, as well

V as appear free of slipping, tripping; andlor other hazards. Any concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering. 6A:26-8.1 (is)


secured from tipping. ~ b. In general, there is no storage within 24 inches of a ceiling. In buildings with sprinkler systems, storage is at least a minimum of 18 inches below sprinkler head deflectors.

c. Storage is organized to allow safe access through space. 21. Provision shall be made for storage of students' clothing in V' other than a corridor or exitway. Student lockers are usable; i.e.:

doors, handles and locks are operable. 6A:26-8.1 (i7) 22. Drinking fountains are provided with sufficient water pressure

or access to water coolers is readily available. (6A:26-12.4) V/ Potable water shall be available and drinking fountains. shall be provided for students III cafeterias, preschool and kindergarten programs in accordance with N.J.A.C. 5:23-7; . .

6A:26-8.l(v) 23. Toilet facilities shall meet existing UCC requirements for the

E Use Group as determined by the construction official. Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.l (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home V economics rooms & cafeteria are stored separately 25. Non-instructional areas are free of all unapproved V

construction; e.g.: walls, partitions, doors and stairs. 26. Furniture and equipment that is in good condition and

V suitable for the age and size of the students and purposes of instruction shall be provided; 6A:26-8.l(vii)

:VOCAUQNALIL;ABORATQRmS . . '; :: ... . ' ...•. : < ..... ,::; ..

27. Corrosives, toxic and other hazardous substances are stored in / proper corrosive storage cabinets and are properly labeled. .

28. Required space is available for the safe operation of machinery ,,/

29. Mechanical and hydraulic automotive lifts have locking devices t/' to hold them in the extended (open) position. 30. Floor(s) and aisles in all shops are free of slipping and tripping V'.

hazards. 31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. \/' VOCATIONALtLAB6RA:roRIES .' YES NO N/A VIOLATION LOCATION

Page 50[6 Revised: 0612612015

following additional safety welding operations are on-going: a. Welding curtains are provided and are painted with a :fmish


33. Pressurized gas cylinders are secured (chain and eye hooks to cart, and valve . are in


~=~



80% Section B

34

# of NO responses in section A o [)G] COMPLIANT (No exceptions) [ ] NONCOMPLIANT

a. # of YES responses 1--:::-b. # of NO responses CJ [ V ] COMPLIANT

r. __ c_._S_u_bt_oW~[~~~)+_~~)] __________ +-~~~ .. ~~-~ (~ a.o .[ Line a is equal to or greater than Line #d

d.Multiply [(c) x 80%] ] NONCOMPLIANT· Line a is less than Line #d

Title Date

ifapplic Ie, Certified Educational Facilities Manger Date

-~~--+-----;-;~b-<~"-------. __ /O/mS Date i '




COUNTY: Union DISTRICT: Hillside SCHOOL YEAR: 201 5-201 6

(checkone) [ ] Leased [zkOwned SCHOOL BUILDING: A. P. Morris/ECC (PreK-gr _ 1 )

COMPLETED BY: David DeFluri DATE: /u:-Z~/5

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluationjs for the health and sq[etv of students and staff even in the absence ora specific Statute or Code. The items listed are not l11utuallv exclusive orother findings a monitorlinspector_may_sfte. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COMPr,IANCE '"

' , ! .' , .

--, , . :. '::.:' . , , '.,: .

CURRENT LICENSES AND CERTIFICATES " YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State fire official/inspector ./ within the year and posted ill a conspICUOUS location. (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, ./ cafeteria, pool, etc.) is available.

3. A 3 year asbestos management plan, as required by AH.E.RA, is available including current 6 month surveillance \/'" letters. If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of Environmental Protection for the operation of a sewage te'/ treatment plant, where applicable, is available.

5. Current boiler inspection certificate(s) posted at site of boiler ~ 6. Current licensees) for high and low pressure boiler operators, as /

required by code, are properly posted. 7. Current drinking water supply inspection reports' are available

~ to comply with the Safe Water Drinking Act. (N.J.AC 58: 12A-1) (6A:26-12.4)

8. One fire drill and one school security drill are held each month; ~ [See"Checklist Instructions" for Certificate of

Assurance]18A:41-1 9. Right To Know requirements are properly posted and MSDS \/' reporting materials on file for review.

10. District has defibrillators identified with appropriate signage, is placed and made available in an unlocked location on school property, which is accessible during the school day and any other time in which a school-sponsored

V athletic event or team practice, in which pupils of the district are participating, is taking place and is within reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

Page 10/6 Revised: 0612612015

\~~ .Jt~S~:ElUQn.:f,;~~\l.f;~:;):;:::~<1~~:}~;;;~~;;'/;i·j:'h];:1\~;i(~.~~:L:'~i<~:;';i'}d-¥·i.~:~:;:~?!::·;:< YES NO N/ A VIO LATI 0 N LO CATION 11. Exterior switches and receptacles are covered by securely

fastened weather-proof plates and fixtures are securely mounted V WIth no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a. Fire escapes and/or exterior stairs can be safely negotiated. ~ b. Panic hardware is provided on exit doors of all spaces with

anoccupancyload/~~gr~e~a~t~er~th~an~5~07'~~~~~~~ __ ~L-__ -r __ L-+-____________________ ~ ~~{~mQ)t{~?t~~~)~~~l~L~~{i~:7~~~~~tt~~¥~1f.~:!~i~~~~~~:~~t~#:l~~~~;~~:1~~t#·~~~~{0;t~t~~~~tt~J.%~l~l;:~~ 13. AIl electrical outlets; switches, receptach~s and junction boxes; /'"

electric wires; fuses and/or circuit breaker panels; etc. are V properly covered and/or secured and/orprotected.

14. Sufficient access and working space is provided and maintained

aro~~ all elecftri

3cal

6 ~pahces. fr1tems, elsPtrie~ialllY combustibles, are .' /

a rmrumum 0 mc es om e ec ca power sources or V equipment; i.e.: circuit breaker panels, fuse boxes, transformers.


16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, thumb-tum locks, hasps dead bolts, slide bolts or similar types of locking devices shall not be permitted. 6A:26-8.1 (12)

17. Unobstructed vision panels with code approved glass are installed in doors opening into corridors. Interior glazing shall be safety glazing. 6A:26-8.1 (13)


19. District approves as needed:'· Dual Use, Change of Use, Alternate Toilet, Temporary sites (TCD or rented faculties). Required DOE approvals inplace.

20. Dangerous chemicals (i.e.: liquefied petroleum gas/propane) and/or explosive materials (i.e.: gunpowder; picric acid) are NOT stored/present in the building. If needed, flammable and combustible materials are properly stored/maintained (i.e.: in ~ro~erly rated cabinets; NOT in boiler roomlhazardous areas).

21. Power machinery and equipment, as well as science labs, have appropriate safety features in place, including as applicable: a. Appropriate placement on the floor and required po.int of






100% COMPLIANCE . ,. ....

VOCATIONALILABORATORIES continued YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 Be rated flre extinguisher is provided v/ in each laboratory and vocational area. 23. Adequate eye and body protection is provided, including:


V appropriate provision for their sanitation. b. Emergency eyewash device(s), with 15 minutes



24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities, as applicable: a. For science activities (Le.: via fume hoods) b. For welding operations. / c. For paint spraying operations:




.)OO%ITEMS.TOTAL •. . . "

17 0 7 .'.

Section B: 80% Items .'80%COMPLiA;NCE . '.' . '. '.;:. . .. < ...... EXITSIEXTERIOR YES NO N/A VIOLATION LOCATION 1- No evidence of major exterior building structural damage.

Example(s) would include: a. Exterior walls appear free of structural cracks, loose

masonry and crumbling parapets; lintels appear free of rust ~ and flaking. b. Gutters and downspouts appear to be in good condition and

are secured to the building; runoff does not appear to be obstructed or create drainage or soil erosion.

2. All exterior receptacles are GFI protected in accordance with V code. 3. All school grounds, including general purpose play areas and

athletic fields, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free

( of holes. The outside physical education area for students shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.1ix


t,$0,,%:!:G.OMEL~~E.Mj;gka;~!;l~J~1;:5;\~f\Ii:'~;'~iN~~;;;~\;;;;}~~~;'~\~~;;;:&;;,:\;'~D£St~:iN;:if;~:~':1;:ft~~:i:,?l(?':~<, )}: ' .. )\ I;,;)~t::':;=- .'. ::}!;:::);9}:;F.·.·~i:;:, ,';::.;:~;'{\ :.,:' ",j;" > ,}, !'~:itX.1X'${:itXt;itw.Qg:'~~l.itiA~~:¥~::~.\'{::::::::l::::~:~:::::::::::/i:;);::::,d;r::r::::,:~d;::i}:,'::;:'(:::::(::':::{;:::::}:{:: YES NON/A VI 0 LATIO N LO CATION 4. Playground area and equipment appear to be in safe operating /

condition and in compliance with code and district maintains V documentation of compliance and regular inspections_

5. All interior exits and corridors are in good condition; readily accessible; and free of obstructions andlor excessive materials which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible height and standard location in all areas. 6A:26-S_I (i4)


8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause injury andlor are properly secured. Interior stair treads do not show evidence of extensive wear and are generally in good repair


10. All education spaces shall be equipped with a communication devise/system connected to the main office and capable of emergency communication to local authorities or 9-1-1. 6A:26-S.I (i6)


accordance with code. b. Electrical extension cords and surge protectors used

appropriately, with extension cords only used for temporary need( s). . .


12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the performance of the duties required under State law and the rules by health services personneL (6A:26-I2.3)

13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the UCC. 6A:26-S.I (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, as measured with a light meter, comply with code and lampslbulbs are covered with a lens cover or equivalent protection.6A:26-S.I(vi)

15. Instructional areas have no unauthorized andlor 'potentially hazardous materials/equipment in rooms. 6A:26-S.I (iI)

16. A chalkboard or whiteboard, andlor display board is provided in each instructional space and is free of cracks and jagged edges. 6A:26-S.1 (viiI)

Page 4 of6

,.\1

I

/ V

I

Revised: 0612612015

80% COMPLIANCE INTERIOR YES NO N/A VIOLATION LOCATION

17. Ceilings, walls and floors are free of holes, sags, and evidence of water damage. The average ceiling height shall be at least 8' feet for instructional spaces in temporary facilities ill an \./ existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites.6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working t/ order and covered with appropriate plates; unused (abandoned) waste lines (drains) are sealed off and capped.

19. Floors throughout the school are clean and free of trash, as well

~ as appear free of slipping, tripping; and/or other hazards. Any concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering. 6A:26-8.1 (is)


secured from tipping. 'v/ h. In general, there is no storage within 24 inches of a ceiling.


c. Storage is organized to allow safe access through space. 21. Provision shall be made for storage of students' clothing in /,F

other than a corridor or exitway. Student lockers are usable; i.e.: 1/ doors, handles and locks are operable. 6A:26-8.1 (i7)

22. Drinking fountains are provided with sufficient water pressure or access to water coolers is readily available. (6A:26-12.4) Potable water shall be available and drinking fountains, shall V be provided for students III cafeterias, preschool and kindergarten programs in accordance with NJ.A.C. 5:23-7; 6A:26-8.l(v)

23. Toilet facilities shall meet existing vee requirements for the E Use Group as determined by the construction official.

V Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.1 (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home / economics rooms & cafeteria are stored separately 25. Non-instructional areas are free of all unapproved ~ construction; e.g.: walls, partitions, doors and stairs. 26. Furniture and equipment that is in good condition and / suitable for the age and size of the students and purposes of

instruction shall be provided; 6A:26-8.l(vii) ,NOOATIONAL~6RATQRIES, ,::., .. ', ,:-::,,:-"," " '~:: ,

":,,',,,,',': " ;.- ,

27. Corrosives, toxic and other hazardous substances are stored in / ...£roper corrosive storage cabinets and are properly labeled. 28. Required space is available for the safe operation of machinery ......./

29. Mechanical and hydraulic automotive lifts have locking devices / to hold them in the extended (open) position. -

30. Floor(s) and aisles in all shops are free of slipping and tripping / hazards.

31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. V-VOCATIONALiliABORATORIES: " YES NO N/A VIOLATION LOCATION Page 5of6 Revised: 0612612015

32. The following additional safety measures are in place if . welding operations are on-going:

a. Welding curtains are provided and are painted with a fmish of low reflectivity.

b. Personal protective equipment (goggles, aprons, etc.) are

33. Pressurized gas cylinders are secured (chain and eye hooks to . and valve . are in


~~~



80% Section B

34

# of NO responses in section A [)<] COMPLIANT (No exceptions) [ ] NONCOMPLIANT

a. # of YES responses 2-~ b. # of NO responses I x, ] COMPLIANT Line a is equal to or greater than Line #d

c. Subtotal [(a)+(b)]

d.Multiply [(c) x 80%] ] NONCOMPLIANT Line a is less than Line #d

Title Date

/0- j-I) if"P'':Z Certified E,tiOnal Facilities Manger Date

Chiefi, chool Admmi



New Jersey Department o/Education Health and Safety Evaluation Of School Buildings Checklist

COUNTY: Union DISTRICT: Hillside SCHOOL YEAR: 2015-201 6

(checkone) [ 1 Leased [xl Owned SCHOOL BUILDING:_-=-S=a ....... yb=-=..ro.:::..o.:::..k __ --=-(_o_f_f_i_c_e'-s..:....) ___ _ COMPLETED BY: David DeFluri DATE :_~/'--u_-:.-"~"---'/'-.:5=----____ _

This form shall be used for the evaluation of school buildings including: Traditional Public School Districts (owned or leased), Private Schools for the Disabled, Charter Schools, Renaissance School Projects and any other school settings. This evaluation checklist shall be completed annually by appropriate district personnel and kept on file for inspection or other legal issues. These indicators cover regulations issued by NJDOE, NJDCA, NJUCC, OSHA. The emphasis of this evaluation)s for the health and safetv orstudents and staff even in the absence ora specific Statute or Code. The items fisted are not mutuallv exclusive orother findings a monitoriinspector_mayAle. See "Facility Instructions and Guidance" for additional information.

SECTION A: 100% Items 100% COMP~IANCE ... ' . . .. . '. .. . . . , ~

'.' ' . " .

CURRENT LICENSES AND CERTIFICATES' YES NO N/A VIOLATION LOCATION 1. A current certificate of compliance with the Uniform Fire Code

has been issued by the local or State fire official/inspector within the year and posted ill a conspICUOUS location. (or current abatement inspection is available)

2. A current inspection report of the local health official (kitchen, / cafeteria, pool, etc.) is available.

3. A 3 year asbestos management plan, as required by /. A.H.E.RA., is available including current 6 month surveillance letters. If constructed without asbestos, a letter of certification from the architect is available.

4. An annual inspection report of the Department of ,/,. Environmental Protection for the operation of a sewage treatment plant, where applicable, is available. .'

5. Current boiler inspection certificate(s) posted at site of boiler \/ . 6. Current licensee s) for high and low pressure boiler operators, as /

required by code, are 2ro~erly posted. 7. Current drinking water supply inspection reports are available / to comply with the Safe Water Drinking Act. (N.IA.C 58:12A-

1) (6A:26-12.4) 8. One flre drill and one school security drill are held each month; , .

I

[See"Checklist Instructions" for Certificate of V Assurance] 18A:41-1

9. Right To Know requirements are properly posted and MSDS V reporting materials on me for review. 10. District has defibrillators identified with appropriate

slgnage, is placed and made available in an unlocked location on school property, which is accessible during the

~ school day and any other time in which a school-sponsored athletic event or team practice, in which pupils of the district are participating, is taking place and is within -

reasonable proximity of the school athletic field or gymnasium, as applicable (Janet's Law18A:40 41a-41c)

~

"

Page 10/6 Revised: 0612612015

11. Exterior switches and receptacles are covered by securely / fastened weather-proof plates and fixtures are securely mounted V with no exposed wires.

12. All exterior exits are in good condition; readily accessible and free of obstructions for use in an emergency; including: a. Fire escapes and/or exterior stairs can be safely negotiated. h. l?anic hardware is provided on exit doors of all spaces with

an occupancy load/capacity greater than50.

13. All electrical outlets; switciies, receptacles and Junction box~s; / electric wires; fuses and/or circuit breaker panels; etc. are V properly covered and/or secured and/or protected.

14. Sufficient access and working space is provided and maintained around all electrical spaces. Items, especially combustibles, are . / a minimum of 36 inches from electrical power sources or V. equipment; i.e.: circuit breaker panels, :fuse boxes, transformers.


16. The hardware on doors of any space occupied by students shall permit egress from the room at all times. Key-operated locks, thumb-turn locks, hasps dead bolts, slide bolts or similar types of locking devices shall not be permitted. 6A:26-8.1 (i2)

17. Unobstructed vision panels with code approved glass are installed in doors opening into corridors. Interior glazing shall be safety glazing. 6A:26-8.1 (D)









Page2of6 Revised: 06126/2015

100% COMPLIANCE .,;; ,';

VOCATIONALILABORATORIES c,ontinued' YES NO N/A VIOLATION LOCATION 22. At a minimum, one # 20 BC rated fire extinguisher is provided

'/ in each laboratory and vocational area. 23. Adequate eye and body protection is provided, including:

a. Eye protection devices (glasses, goggles) for students and faculty in each laboratory and shop area, including t/" appropriate provision for their sanitation.



24. Room provides for proper local or general ventilation and/or exhaustion of toxic and/or dangerous fumes and/or odors, including for the following activities, as applicable: a. For science activities (i.e.: via fume hoods)

/ b. For welding operations. c. For paint spraying operations:


d. Art:· Safe designated space/room for kilns with proper ventilation


,;100% ITEMS TOTAt C"'. ' :. /3 C) II Section B: 80% Items

"80%COMPLJANCE" ',. ... ' ..... , ..•... ; .. ? . - ..

EXITS/EXTERIOR YES NO N/A VIOLATION LOCATION 1. No evidence of major exterior building structural damage. Sc::> (Yl'C:. U ~c..ks Example(s) would include:

a. Exterior walls appear free of structural cracks, loose V ~('{\. --E!_ ~,S.ts:.'·\n( 't-J "-masonry and crumbling parapets; lintels appear free of rust

. and flaking. t!)~';" \ \ w-\els ' -:'


2. . All exterior receptacles are GFI protected in accordance with / code. 3. All school grounds, including general purpose play areas and

athletic fields, are free of holes; glass; stumps, roots; rocks and other hazardous obstacles. Fences are maintained and are free // of holes. The outside physical education area for students shall include, but not be limited to, sufficient space, equipment, and safe surfaces for the temporary facility enrollment and program needs and be protected from hazards or traffic conditions.6A:26-8.lix

Page 3 0/6 Revised: 06/2612015

. i:$Jji~4t;'0QW.~J3~0jf:K;~~\~::I:;~'fm);J;~;f;~;':tI;~:;;~{;{t;:~i:X;:s-i;l~t;\~~s5:'I~.:~i~;):;;ri::!~f!lt;I;~~\%:!~~I:;'··.:~;?/S(L~t,\:;;/;I):J:::{;n::·:+ ·;:::.::·}~~<S .;-i:':?:',i;,i;;';~:;C(,:i;'·;::;:,' ::::'.' . ,.',:, ~'E.i9.tt$jE~:¢.w.Qi~;\2p'#ijfi~~~~i::~:::::{:;;:::~)\~:;.;:::;:::::::::}:;:::\:;/?:/::;f:;:;;:q::'i'::;::::::::t:::,:;t:;:::}:{::::it YES NO NI A VIO LATION LOCATION 4. Playground area and equipment appear to be in safe operating


5. All interior exits and conidors are in good conditibn; readily accessible; and free of obstructions andlor excessive materials which would hinder exiting.

6. Emergency evacuation egress procedures are posted at a visible height and standard location in all areas. 6A:26-S.1 (i4)


8. Handrails on both sides of interior stairways, guardrails, and interior stair treads are free of surface features which may cause . /""-injury andlor are properly secured. Interior stair treads do not l/'

'show evidence of extensive wear and are generally in good repair


10. All education spaces shall be equipped with a communication devise/system connected to the main office and capable of emergency communication to local authorities or 9-1-1. 6A:26-S.1 (i6)

11. Electric outlets andlor wiring appear appropriate, including: a. GFI protection for receptacle(s) within 6 ft of water in

accordance with code. /. " h. Electrical extension cords and surge protectors used

appropriately, with extension cords only used for temporaly ne6d(s). -'. _. . .. , . ,


12. Nurse's Office: District boards of education shall provide the necessary facilities, equipment and supplies for the performance of the duties required under State law and the rules by health services personneL (6A:26-12.3)

_. 13. Individual or central mechanical ventilation unites) are operating in all student and staff occupied rooms/areas and toilet facilities; air conditioners are operational in windowless interior areas. Heating and ventilation requirements shall be as set forth in N.J.A.C. 6A:26-6.3 and the DCC. 6A:26-S.1 (iii)

14. Lighting levels in all instructional areas at least 50 foot candles, I ,/

as measured with a light meter, comply with code and v lamps/bulbs are covered with a lens cover or equivalent protection.6A:26-8.1(vi)

15. Instructional areas have no unauthorized andlor potentially hazardous materials/equipment in rooms. 6A:26-S.l (il)

16. A chalkboard or whiteboard, andlor display board is provided in each instructional space and is free of cracks and jagged edges. 6A:26-S.1 (viiI)

Page 4 of6

1'/ :/

Revised: 0612612015

"

80% COMPLIANCE INTERIOR YES NO N/A VIOLATION LOCATION

17. Ceilings, walls and floors are free of holes, sags, and evidence of water damage. The average ceiling height shall be at least 8'

V feet for instructional spaces in temporary facilities ill an existing public school, in a district owned facility and in rented or leased buildings not on school district owned sites_6A:26-8.1 (ii)

18. Area and floor drains, where provided, appear to be in working 1// order and covered with appropriate plates; unused (abandoned) waste lines (drains) are sealed off and capped_

19. Floors throughout the school are clean and free of trash, as well ~' as appear free of slipping, tripping; and/or other hazards. Any

concrete floors in all instructional areas, except shops, shall be covered with a resilient floor covering_ 6A:26-8_1 (is)


secured from tipping_ V b. In general, there is no storage within 24 inches of a ceiling.


c. Storage is organized to allow safe access through space. 21. Provision shall be made for storage of students' clothing in t/c

other than a corridor or exitway. Student lockers are usable; i.e.: doors, handles and locks are operable. 6A:26-8_1 (i7)


/" Potable water shall be available and drinking fountains,shall be provided for students III cafeterias, preschool and kindergarten programs in accordance with N.lA.C. 5:23-7; 6A:26-8. I (v)

23. Toilet facilities shall meet existing VCC requirements for the E Use Group as determined by the construction official.

V'" Toilet facilities shall be available within a reasonable distance not more than one floor away, and shall be equipped with an exterior operable window sash or mechanical exhaust ventilation. 6A:26-8.1 (iv)

24. Food and nonfood items (i.e.: cleaning products, etc.) in home v'"''' economics rooms & cafeteria are stored separately

25. Non-instructional areas are free of all unapproved / construction; e.g.: walls, partitions, doors and stairs. V

26. Furniture and equipment that IS in good condition and t,./

-suitable for the age and size of the students and purposes of instruction shall be provided; 6A:26-8.l(vii)

'VOCATIONALtLABORAtoJiIEs ,','.": :;;, .".':',,'," ;'1::':' ," ,,", ' " ','" ,', .. " ,",," ' .. , "",:',,

27. Corrosives, toxic and other hazardous substances are stored in V-proper corrosive storage cabinets and are properly labeled.

28. Required space is available for the safe operation of machinery V 29. Mechanical and hydraulic automotive lifts have locking devices t.. ..•. /

to hold them in the extended (open) position. 30. Floor(s) and aisles in all shops are free of slipping and tripping V~

hazards. 31. "Eye Hazard Area-Wear Your Eye Protection" signs are posted. V VOCATIONALfLABO:RATORIE$, '

; . , .. YES NO N/A VIOLATION LOCATION ','

Page 50f6 Revised: 0612612015

following additional safety welding operations are on-going: a. Welding curtains are provided and are painted with a flnish

of low reflectivity. b. Personal protective equipment (goggles, aprons, etc.) are

33. Pressurized gas cylinders are secured (chain and eye hooks to . and valve . s are in

34. Oxygen cylinders in storage are separated from fuel gas cylinders (acetylene) or combustible materials a m1ll1ill.Uffi distance of 20 feet.



80% Section B

34

# of NO responses in section A ] COMPLIANT (No exceptions) [ ] NONCOMPLIANT

a. # of YES responses

b. # of NO responses [ ~--------~--------------~------~

c. Subtotal [(a)+(b)].

d.Multiply((c) x 80%]

comple~fi-D

if"PPli,4wfied Educational Facilities Manger

] COMPLIANT Line a is equal to or greater than Line #d

] NONCOMPLIANT Line ais less than Line #d

Title

Date

'f~ )0 it;J5

Date



BG#4-10/15

Humanitarian (Charged) Meal Service Procedures

The Hillside Board of Education will process humanitarian (charged) meals in accordance with

the following procedures:

As of October 16, 2015, all individual student charged account balances will be written off

(zeroed out) by charging the general fund budget for the losses in the food service program.

Notice regarding the humanitarian meal procedures will be given to all parents/guardians.

Notice regarding meal charges in the 2015-16 school year

Parents/Guardians of any student who accumulates a charge balance of at least $13 will be

sent a notice from the Hillside Board of Education indicating there is an outstanding balance.

Elementary and Middle School Students

For elementary and middle school students, 15 days after the first notice, and for each 15 day

period thereafter, if the student's charged account balance remains at least $13, they will

receive another notice that their account remains in arrears. Fifteen days after the second

notice the student will be served an alternate meal service of a cheese sandwich or its

equivalent, and a milk until their account is cleared.

High School Students

For high school students, 15 days after the first notice, if the student's charged account balance

remains at least $13, they will receive a second notice concerning the outstanding balance.

Seven days after the date of the second notice, the student will not be able to charge a meal for

the remainder of the current school year.

Approved: Hillside Board of Education, October 15, 2015

Number Attending Conference Title

Hillside Public Schools Board Approval for Training and Seminars, Conventions and Conferences

Board Meeting: October 15, 2015

Dates Anticipated Purpose+ Location Reimbursement*

(Source)

* Expenses may exceed state and federal reimbursement guidelines + How will this activity promote the delivery of instruction, improvement of curriculum, or further district goals?

R. Williams NJASL Fall November 15-17, Registration $241.00 NJASL Fall conference Conference 2015 Transportation $27.90 provides workshops and

Ocean Place Resort Meals $88.50 keynote speakers and Long Branch, NJ Other $202.00 presentations all designed to

Total cost $559.40 promote and showcase successful school library

20-271-200-580-01-00 media programs.

S. Allen- Williams NJASLFall November 16-17, Registration $241.00 NJASL Fall conference Conference 2015 Meals $88.50 provides workshops and

Ocean Place Resort Total cost $329.50 keynote speakers and Long Branch, NJ presentations all designed to

20-271-200-580-01-00 promote and showcase successful schoollibrary media programs.

S. Festante TEACHNJ: October 27,2015 Registration $150.00 Workshop will provide New Paradigm! Foundation for Transportation $5.00 participants with concrete

Corrective Educational strategies & templates to use in Action Plans & Administration Total Cost $155.00 addressing staff members

progressive Monroe, NJ proactively through Supervision 11-000-240-580-07-00 progressive supervision, in

order to reduce the need of improvement.

T. Ellis NJEA January 29-31,2016 Transportation $60.00 Workshop will provide Professional One Ocean participants with concrete Development Boulevard 11-000-223-590-04-00 strategies on Succeeding with

workshop Long Branch, NJ Difficult students.

Attachment ED#1-10/15

Date of Date of Report Request Board (due

Approval within 30 days)

9/29/15 10/15/15

9/29/15 10/15/15

9/30/15 10/15/15

9/30115 10/15115

Hillside Public Schools Board Approval for Training and Seminars, Conventions and Conferences

Board Meetin!!: October 15.2015 S?

Attachment ED#1-10/lS

Number Attending Conference Dates Anticipated Purpose+ Date of Date of Report Title Location Reimbursement* Request Board (due

(Source) Approval within 30 days)

* Expenses may exceed state and federal reimbursement guidelines + How will this activity promote the delivery of instruction, improvement of curriculum, or further district goals?

L. Bohm Growing December 1, 2015 Registration $100.00 per Implement close reading 10/2/15 10115/15 E. Dougherty Thoughtful person one free strategies with fictions and

I. Fairman Readers through Holiday Inn administrator informational text. Adapt close R. Masterson Close Reading Clark, NJ reading strategies to meet the

S. Vigdor and Navigating Total $500.00 needs of ELL learners, student T. Westervelt Informational with special needs, and

Text 20-271-200-580-01-00 struggling learners. Utilize simple procedures for monitoring student progress.

L. Bohm Growing December 2, 2015 Registration $100.00 per Implement close reading 10/2115 10/15/15 R. Graham Thoughtful person three administrators strategies with fictions and T. Wolff Readers through Holiday Inn free informational text. Adapt close

M. Araujo Close Reading Clark, NJ reading strategies to meet the E. Dougherty and Navigating Total $700.00 needs of ELL learners, student

I. Fairman Informational with special needs, and M. Gerber Text 20-271-200-580-01-00 struggling learners. Utilize

V. Hamilton simple procedures for A.Mee monitoring student progress.

J. Wicklund

D. Singleton Meeting the October 16, 2015 Registration $230.00 per The goal of this presentation is 10/6/15 10115/15 Educational and person to assist students in their

R. Torres Emotional Somerset Double academic work. Time Needs of Tree Hotel Total $460.00 management will be discussed

Students with along with reading, note-Dyslexia and Somerset, NJ 20-271-200-590-01-00 taking, test taking and studying other Reading strategies.

Disabilities 11-402-100-610-14-04

~-

Attachrrut ED/I=2-10/15

Hillside Public Schools

Title I District- Wide Parental Involvement Policy

Section 1118 of the Elementary and Secondary Education Act (ESEA) requires each school district to establish expectations for parental involvement. The Hillside Board of Education and its public school recognize the important role parents have in the education of their child. The Hillside Public School District agrees to implement the following statutory requirements of the Federal No Child Left Behind Act (NCLB) as its Title I Parent Involvement Policy:

PART I. DISTRICT EXPECTATIONS

• The school district will put into operation programs, activities and procedures for the involvement of parents in all of its schools with Title I, Part A programs, consistent with section 1118 of the Elementary and Secondary Education Act (ESEA). Those programs, activities and procedures will be planned and operated with meaningful consultation with parents of participating children.

• Consistent with section 1118, the school district will work with its schools to ensure that the required school-level parental involvement policies meet the requirements of section 1118(b} of the ESEA, and each include, as a component, a school-parent compact consistent with section 1118(d} ofthe ESEA.

• The school district will incorporate this district wide parental involvement policy into its LEA plan developed under section 1112 of the ESEA.

• In carrying out the Title I, Part A parental involvement requirements, to the extent practicable, the school district and its schools will provide full opportunities for the participation of parents with limited English proficiency, parents with disabilities, and parents of migratory children, including providing information and school reports required under section 1111 of the ESEA in an understandable and uniform format and, including alternative formats upon request, and, to the extent practicable, in a language parents understand.

• If the LEA plan for Title I, Part A, developed under section 1112 of the ESEA, is not satisfactory to the parents of participating children, the school district will submit any parent comments with the plan when the school district submits the plan to the State Department of Education.

• The school district will involve the parents of children served in Title I, Part A schools in decisions about how the 1 percent of Title I, Part A funds reserved for parental involvement is spent, and will ensure that not less than 95 percent of the one percent reserved goes directly to the schools.

• The school district will be governed by the following statutory definition of parental involvement, and expects that its Title I schools will carry out programs, activities and procedures in accordance with this definition:

Parental involvement means the participation of parents in regular, two-way, and meaningful communication involving student academic learning and other school activities, including ensuring-

(A) that parents play an integral role in assisting their child's learning;

(8) that parents are encouraged to be actively involved in their child's education at school;

(C) that parents are full partners in their child's education and are included, as appropriate, in decision-making and on advisory committees to assist in the education of their child;

(0) the carrying out of other activities, such as those described in section 1118 of the ESEA.

PART II. DESCRIPTION OF HOW DISTRICT WILL IMPLEMENT REQUIRED DISTRICT WIDE PARENTAL INVOLVEMENT POLICY COMPONENTS

1. The Hillside Public School District will take the following actions to involve parents in the joint development of its district wide parental involvement plan under section 1112 of the ESEA:

The school district will hold an annual Title I parent meeting where parents will assist in the development, agreement, and implementation of the district parent involvement policy.

The school district will invite parents whose children receive Title I services to participate in the development of the district Title I plan. Parents will proVide suggestions for increased parent involvement.

2. The Hillside Public School District will take the following actions to involve parents in the process of school review and improvement under section 1116 of the ESEA:

The school district will share goals, assessment, and achievement data with parents.

The school district will invite parents to participate in school review and improvement activities.

The school district will work to ensure that documents are sent to parents in timely and practical manner in a language parents understand.

The school district will survey parents on school review and improvement. The survey data will inform plans for school improvement and parent-school engagement.

The school district will hold an annual Title I parent meeting to discuss the Title I plan parental involvement activities, and solicit suggestions for school improvement.

3. The Hillside Public School District will provide the following necessary coordination, technical assistance, and other support to assist Title I, Part A schools in planning and implementing effective parental involvement activities to improve student academic achievement and school performance:

The school district will collaborate with meet with administrators to enhance the coordination of activities and use resources to improve student achievement .and school performance.

The district staff will provide annual training to Title I school administrators and staff on effective parental involvement strategies.

4. The Hillside Public School District will coordinate and integrate parental involvement strategies in Part A with parental involvement strategies under the following other programs: [Insert programs, such as: Head Start, Reading First, Early Reading First, Even Start, Parents As Teachers, Home Instruction Program for Preschool Youngsters, and State-operated preschool programs], by:

N/A

5. The Hillside Public School District will take the following actions to conduct, with the involvement of parents, an annual evaluation of the content and effectiveness of this parental involvement policy in improving the quality of its Title I, Part A schools. The evaluation will include identifying barriers to greater participation by parents in parental involvement activities (with particular attention to parents who are economically disadvantaged, are disabled, have limited English proficiency, have limited literacy, or are of any racial or ethnic minority background). The school district will use the findings of the evaluation about its parental involvement policy and activities to design strategies for more effective parental involvement, and to revise, if necessary (and with the involvement of parents) its parental involvement policies.

The school district will hold an Annual Title I Parent Advisory Council Meeting to solicit feedback as a part of the program evaluation of the content and effectiveness of the parental involvement policy. The district will communicate with parents regarding this evaluation in a timely and practical manner in a language that they understand. The school district will use surveys to determine the effectiveness of parental involvement policy and programs.

1. The Hillside Public School District will build the schools' and parent's capacity for strong parental involvement, in order to ensure effective involvement of parents and to support a partnership among the school involved, parents, and the community to improve student academic achievement, through the following activities specifically described below:

A. The school district will, with the assistance of its Title I, Part A schools, provide assistance to parents of children served by the school district or school, as appropriate, in understanding topics such as the following, by undertaking the actions described in this paragraph --

!

I

• the State's academic content standards,

• the State's student academic achievement standards,

• the State and local academic assessments including alternate assessments,

• the requirements of Part A,

• how to monitor their child's progress, and

• how to work with educators:

The school district will offer parental involvement workshops for parents throughout the year in collaboration with schools and the PTA. Monthly newsletters and the district website will provide parents with strategies and for monitoring their child's homework and academic progress.

B. The school district will, with the assistance of its schools, provide materials and training to help parents work with their children to improve their children's academic achievement, such as literacy training, and using technology, as appropriate, to foster parental involvement, by:

Offering PARCC Information for Parents Sessions, Effective Parenting Workshops and Family Technology Workshops.

The district and its Title I schools will provide parents with a copy of the Home-School Compact.

The district and its Title I schools will provide parents with activities and support during Open-House/Back-to-School-Night.

The district and its Title I schools will provide parents with suggestions for improvement and increasing student achievement.

The district and its Title I schools will provide workshops and training for parents regarding topics such as:

Home-School Connection Effective Parenting Strategies Math and Language Arts Skill Builders Effective ESL Strategies for Parents

C. The school district will, with the assistance of its schools and parents, educate its teachers, pupil services personnel, principals and other staff, in how to reach out to, communicate with, and work with parents as equal partners, in the value and utility of contributions of parents,

and in how to implement and coordinate parent programs and build ties between parents and

schools, by:

Providing district personnel with policies, materials and training on effective meaningful, twoway communication with parents.

Working with all administrators, support personnel and teachers to effectively communicate with parents in a clear format and understandable format.

Utilize Back-to-School Night as a means of implementing effective and meaningful, two-way communication.

Utilize the Genesis parent portal as a means for parent to monitor their child's academic progress and communicate with classroom teachers.

D. The school district will, to the extent feasible and appropriate, coordinate and integrate parental involvement programs and activities with Head Start, Reading First, Early Reading First, Even Start, Home Instruction Programs for Preschool Youngsters, the Parents as Teachers Program, and public preschool and other programs, and conduct other activities, such as parent resource centers, that encourage and support parents in more fully participating in the education of their children, by:

N/A

E. The school district will take the following actions to ensure that information related to the school and parent- programs, meetings, and other activities, is sent to the parents of participating children in an understandable and uniform format, including alternative formats upon request, and, to the extent practicable, in a language the parents can understand:

The district will disseminate information to Title I parents in a manner that is both timely and meaningful in a language they understand via:

Flyers The District Website/School Webpage Global Connect (by phone/text) Parent Letters Local Television Station Communication will be translated

PART III. DISCRETIONARY DISTRICT WIDE PARENTAL INVOLVEMENT POLICY COMPONENTS

NOTE: The District wide Parental Involvement Policy may include additional paragraphs listing and describing other discretionary activities that the school district, in consultation with its parents, chooses to undertake to build parents' capacity for involvement in the school and school system to support their children's academic achievement, such as the following discretionary activities listed under section 1118(e) of the ESEA:

• involving parents in the development of training for teachers, principals, and other educators to improve the effectiveness of that training;

• providing necessary literacy training for parents from Title I, Part A funds, if the school district has exhausted all other reasonably available sources of funding for that training;

• paying reasonable and necessary expenses associated with parental involvement activities, including transportation and child care costs, to enable parents to participate in school-related meetings and training sessions;

• training parents to enhance the involvement of other parents;

• in order to maximize parental involvement and participation in their children's education, arranging school meetings at a variety of times, or conducting in-home conferences between teachers or other educators, who work directly with participating children, with parents who are unable to attend those conferences at school;

• adopting and implementing model approaches to improving parental involvement;

• establishing a district wide parent advisory council to provide advice on all matters related to parental involvement in Title I, Part A programs;

• developing appropriate roles for community-based organizations and businesses, including faith-based organizations, in parental involvement activities; and

• providing other reasonable support for parental involvement activities under section 1118 as parents may request.]

* * * * *

PART IV. ADOPTION

This District wide Parental Involvement Policy has been developed jOintly with, and agreed on with, parents of children participating in Title I, Part A programs, as evidenced by the agenda from Title I Parent Meeting.

This policy was adopted by the Hillside Public School District on _October 15, 2015 and will be in effect for the period of _5 years __ . The school district will distribute this policy to all parents of participating Title I, Part A children on or before _November. 1, 2015_.

(Signature of Authorized Official)

(Date)

Att:aclm::nt ED#~-10/15 ··-DEC.' 3.2010 10:31AM . NO. 6900 P. 1

BlLT"SI1)E PUBLIC SCHOOLS ffillside~ New Jersey

"School Bl,lSiness" will be autom.atically recorded fOr teachers in charge, chaperones listed below. <-tR uest for Absence" not ry u1red. .

DootI)1atlon.:ToWn/State K.E '/100 k"so N J ·~ity/A.tlraction B n{,:., ~("'DoJ~ D 0...clQ:_ . I

_])~~.of~ppli~~2A ... q . \ I t" \ IS; .... Pate oiTrip . /) \.," "'le., q! ( 0 I '*" 1 l ~ - -_ •••. -.------._------- ---'.--'-'-' .-_ .. _-- . ,-+ "._-- --- .--.-•• --" •. - .. _-.• _-

Purpose ofrriplInilicate Educati Value ofTrl.p (attach additional sheet(s) jfnecessflIY) ---r~------~ ,

School . \.\ vi \1\. i>c: 1 ;tOO L Grade~--,',--2~-:-_~ NuntberofStllde1J.~.j· 100 Means of Transporlation '" "11Atl ; ~tA $ Co • Describ~ how studsnts are selected to pLlrticipate in tr, ~ I'!! " IT t j ~ f

. . ~O I \dJ S~N.[~~ C ~.~ ·,(1

TbneofbepartUre 10: OO~ Expected!imeofRetum 3: 00 ~ Teacher(s) ill Ch<ltgl;) (i('C1hQ. M . List chaperoneS who wilL aoorppanystude.nts M~. ~ \ dw ~ ,Ms LA1N \~, 0 t"h z.. ~ SEk\.\«.,.\. ~ - '11 )<t10wl rA~~, PcYlo\A VI tL, ~ \G&.-\~ Y\J " /' '. ·

Nam~ mEns Company. ' VI I J o.n I (Company must l:\n current,fproved list oftransp.crtation eon:tmy) c:=" :Price l?er Bus 0(:1R3l. -- . ToJal Cost for buses_Q ___ 2=-~ ___ =-_

Cost ofTransportntio.o. Per Student :z ~ Paid By _Ed of Ed ~School Fund ~tudent PIA

Admission Fees EerStudent ~ -- ErdBy EdoiEd ~SchoolFund ""dent -PTA

Ltm~h Expens~ ger Student S.1ld_d By. Bd oiEd _$chool Fund V'S-tudent ~PTA "'-==="';;ijlf-~~E-.....- ,Paid By_B.d of Ed _SchooiFund ~tudent ~PTA

(WItep. paid by srodentlZparent) / .------Approved by Pdnoip . ~ Date 1, 1-:)-( (S . . Out~fwStllt~Trip Requ1ring Board ApprbY _(Cht$Ck by Sltperinte1?rient)

Date BUl1dings & GtoundslLRPF CQmmittee willllevlew (fol' Out-of-StatQ Trips) ~~ __

Date of Board of Education Meetfug to Take Action on Out-o£.Siate Trips _~_~

Approved by Board_

Rejected by Boatd_

SuperiP.tendent~s Signature Date ----(Revised: January 2.005~ Octob~ 2006, Msy 2007)

_Other

_·Other

_Other

_Other

2015-09-16 16:54 Vi llani Bus Co. 9084748058 » Villani nus Company 811 Ell~t Linden Avenue Linden, NJ 07036

P1/1

Charter Confirmation

Phone: 908-862-3333 Fax: 908-474-8058 Website: www.vlllanibus.com [email protected]

Confinned: Charter No. :

09116/15 56335

... - .-------~------ -- -+---.-~-- .. ~----~-.--~- .. ---.--------~-----------.-- .-+.~. --.-- _._- .. " ---,._. --.-~"~-- ... __ .---._-----_.---.... ---CJirlstineGraham Hillside High School 1085 Uberty Avenue Hillside, NJ 07205 USA

Phone: Pax:

908-892~S932

908-352-4246 Order Date 09/15/15

SalesRep; Mr'.Shabazz

Thank you for selecting Villani Bus Company for your upcoming trip. We are committed to providing you with the very

best service possible. and! am sure that you will be ple!lSed with the quality of our equipment and drivers. This Confirmation

serves as ~our contract for your transportation needs shown below. We must receive your deposit along with one signed and .

dated copy ofthis letter by the due date of the deposit shown below. Please review the following infOr(Otltion to confirm Our

understanding of the services we will provide.

Group Name: Pine Grove Dude Ranch Group Group Leader: Christine (;raham

Destination: Kerhonkson, New York

Leave Date: Thursday, June 09, 2016

Spot Time: 9:45 am Leave Time:

Pickup Location:

10:00 am

Hillside High SChool 1085 LIberty Avenue HilIslde.NJ

Description

Single Day Motorcoach Trip local Transportation rate does not include gratuity UNSIGNED CONFIRMATION WILL VOID RESERVATION

# Coaches: 1 8quipment: 1-55 Motorcoach

Return Date: Thursday, June 09, 2016

Rctn\Drop Time: 3:00 pm

Destination Pine Grove Dude Ranch Details: 30 Cherry town Road

Kerhonkson, New York 800.230.4134

# Coaches Qty Rate Charge

1 1.00 $1,150.00 1 1.00 $0.00 1 lOa $0.00

Transport Charge: Amount Paid

$1,150.00 $0.00 $0.00

$1,150.00

$0.00

,

Dw;: Da(c~

09{29/15 05/,?Gf16

Description

Signed Contract Final Paymont $1,150.00 8alance Due $1,150.00

If you have not already done so. please remember to send us an itinerary complete with addresses to insure the success

of your trip. Plcaso call me if you have any questions.

Sincerely.

Chartor Party Authorized Signature

--2015-09-15 14:56 Vi llani Bus Co.


9084748058 » Villani Bus Company 811 East Linden Avenue Linden, N.I 07036 Phone: 908~862-3333 Fax: 908-474-8058 Website: www.villanibus.com E:mail: [email protected]

C(!nfil'llicd: Charter No. :

09/15/15 56336

P 4/4

---

Christine Graham Hillside High School 1085 Liberty Avenue

Hillside, NJ 07205 USA

Phone: Fax: Order Pate Salc~Rep;

908-892-6932 908w~524246

09115/15

Mr.Shabazz

Thank you for selecting Villani Bus Company for your upcoming trip. We nre committed to providing you with the very

best service possible. and I mn sure that you will be pleased with tho quality of our cql!ipment and driv.ers. This Confirmation

-'serves as your contract for your trLlllsportation needs shown below. We must receive your deposit along with one signed nnd

dated copy ofthis letter by the due date of the deposit shown below. Please roviQw the following information to confirm our

under:;tanding of the services we will ptovide.

Group Name: Pine Grove Dude ~anch Group

Group Leader: Ctlristine Graham

Dt;stinntion: Hillside, New York

Leave Pate: Saturday, June 11, 2016 Spot Time: 10:45 am Leave Time: 11:00 am Pickup Location:

Pine Grove Dude Ranch 30 ChetrytOWr'l Road Kerhonkson, New York

Ocscription ~

Single Day Motorcoach Trip local • Transportation rate does not include gratuity UNSIGNED CONFIRMATION WILL VOID RESERVAT!ON

Dnc Dnt~

09/29/15 05/28/16

Siglioo Contract Final Payment $1,350.00

# Coaches: 1 Equipment: 1-55 Motorcoach

Return Date: Saturday, June 11, 2016

Retn\Drop rime: 3:00 pm

Destination Hillside High School Details: 1085 Liberty Avenue

Hillside NJ

# Conches Qty Rate

1 1.00 $1,350.00 1 1.00 $0.00 1 1.00 $0.00

Transport Charge:

Amount Paid

Balance Due

Ch:trge

$1,350.00 $0.00 $0.00

$1.350.00 $0.00

$1,350.00

If you have not already done so, please remember to send us an itinerary complete with addresses to insure the success of youI' trip. Please call mo if you have any qucstions.

Sincerely.

Ch:lrtcr Party Authori:ted Signature Date

Ml'.Shuba7);

PINEGROVE FAMILY DUDE RANCH· P.o. Box 209, 30 Cherrytown Rd. Kerhonkson, New York 12446

845~626~7345 800-3464626 pinegroveranch.com E-mail: [email protected] Page 1

Quote Date:

09115/2015 HILLSIDE HIGH SCHOOL ATTN: CHRISTINE GRAHAM 1085 LIBERTY AVE HILLSIDE, NJ 07205

'* * '* Group Quote ***

Arriving: Thursday 06/09/2016 for 2 nights Departure: Saturday 0611112016 by 02:00 PM

Room Type: Run of the House Number of Rooms: 22 Arriving by: Bus ETA: 02:00 PM

Contact Person: Group Name: HILLSIDE HIGH SCHOOL

Reservationist Betsy

Inclusions: Nights:

Breakfasts: Lunches: Dinners: Coketail:

2 2 2 2 2

Additional Charges: Taxes Yes

Rooming List Due By: 0512612016

Binder due: 10/15/2015 Per person deposit due by: 03/1112016.

I Payment History

Guest Type

Single:

Number of Guests o

Price per Guest/Night

$ 150.00 Twins: Triples: Quads:

Quintple: Comp.:

o o o

100 J..Q 110

WELCOME TO PINEGROVE . SEE PAGE 2 FOR CONTRACT DETAilS

Contract

$ 125.00 $ 115.00 $ 110.00 $ 105.00 $ 0.00

. Binder: An initial deposit of $500.00 is required 30 days from the receipt of this quote. Then a $100.00 per person deposit is required 90 days prior to arrival or the rooms are subject to release. This per person deposit will confirin the exact number of rooms to be held. Please sign this contract and retUrn italong with your group's Binder Deposit

DATED:,~-+---¥---,-_.

DATED: ____ SIGNED:,_--::: __ --:--:-:-----:-::::----::-_--::-____ _ Group Representative I Tour Operator

See Next Page for Terms and Conditions

PINEGROVE FAMILY DUDE RANCH P.O. Box 209, 30 Cherrytown Rd. Kerhonkson, New York 12446

845-626-7345 800-346-4626 pinegroveranch.com

HILLSIDE HIGH SCHOOL ATTN: CHRISTINE GRAHAM 1085 LIBERTY AVE

E-mail: [email protected]

* * * Group Quote

Page 2

Quote Date: 09115/2015

*** _t!lh_,=§1 D I;L~J _Q?~Q§ ________ . --Quote-#;---tt5864--Guest '#~--- 530117- -------

without notification. Please Note: All Final Payments paid by Credit Card will be subject to a 3% Service Charge. In order to eliminate NYS Sales and Occupancy Taxes. we must receive a valid NYS Exempt Form in advance of your arrival. The fiqal bill is based on the rooming list 14 days prior to arrival, there are no refunds for reduction in counts on arrival. .

Riding Plan: Rides may be purchased at the price of $20.00 per person, per ride. Please specify numqer of riders two weeks prior to arrival.

Arrival Times: Thursday arrival begins after 2pm. Rooms are usually ready between 2-4 pm.

Meals: 6 Meal package includes: Thursday dinner, Friday breakfast/lunch/dinner, Saturday breakfast/lunch.

Snackbar: Open from 11 am to 11 pm daily.

Bottomless Cup: We offer a souvenir bottomless cup for $5.00 each. Includes unlimited Soda, Ice Tea, Lemonade, and Fruit Punch for your entire stay. .

-Entertainment:-Uve D.J. Dance Party-on Thursday-and Friday nights included.

Complimentary Stays: 1 complimentary Chaperone per every 10 paying students. All Complimentary guests are considered NON-RIDERS. Riding tickets can be purchased at the non-rider rates.

Registration Forms: Waivers are included in packet. Please copy and have each guest attending trip fill out entire form prior to arrival REGARDLESS IF THEY ARE RfDING OR NOT.

Cancellation Policy: For Entire Group Cancellation: Written cancellation notice must be received 90 days prior to arrival for Full Refund. Entire Group Cancellations after 90 Day cut off will be "Held" for a future stay. No Exceptions. Individual cancellations within the group received 14 days prior to arrival will receive their money back minus their deposit of $100.00 per person. Individual cancellations received after 14 days prior to arrival will be responsible for the cost of the entire stay.

Please sign one copy of contract and remit with Deposit Any questions please feel free to call Group Sales at 800-346-4626.

DATED: q (( (\7 U I~GNED\+-~'---\:---'""::~ ___ --=--=-\ l AU. ales

DATED: ____ SIGNED: _____ -:----:-::::-----=-_--:-____ _

Group Representative I Tour Operator

~DEC, 3. 2010 10:31AM

Att:acJ.-m:nt FJ'J#:4-10/15

BlLLSIDE PUBLIC SCHOOLS Hillside, New Jersey

_ NO, 6900 p,

"Sohool B~iness" will be. autom.atically recorded fOr teachers in charge, chaperOIies listed below. ttRe uest for Abs,*oo" notr() ired.

~-------.----~~~====~~~~~--------------~

DestfusUon: ToWnlStne A 1 \<. N'1'bw, -1~ Ilacilltyl A.ttraction 1) 0 t(. tV e j 1'1\ r: Ie Dateo~Application 9 I If... \ ,S" DateofTrlp' Dc. f. 30.2.0,5 l'urpose ofTriplIndicate Educational Value ofTrlp (attach additional sheet(s) jfuecessary) __________ ~_

7",11'11 BVIL,'I>JA16,

School I 1:1:. ~ ", Nuwher of Studen:ts - £0

Grade Cf. -12-MearwofTransporiation V i L~ AN; B (,C.J'

De!?cribe how students are selected to participate in tdp 6 ~ ~ I 0 "- c" I A-\ S. 2...0 Ib'·f:8L8 CLub - 13Y~;NES~ C1AJJE~

Time ofbepartttre~" 0 QJ'M Expected Time ofRettlrnJll 01)1'M Teacher(s) In CIw~ a fZ. A ,..,. trr::1 ListchBperonesw~owillaccOl}lPFYs11ldents. /(oovJ/de IV I A odiNO I Ske 1./-0 tV

VPt'l111'r .s I L-e'?Y t..s 7' · ,

Nam~o£BusCompany . \/' LL AN,e :au J CO. (Company must be on current approved list of transpOrtation. ~on.tmeto:rs) 'price Per Bus '1/50- -Total Cost for buses. _____ _

CostofTranspommo~Per.Student ;1,3 PaidBy_-BdofEd _School Fund ~ Student _PTA _Other

Admission Fees Ear Student Ol J :Paid By_Bd of Ed School Fund ~Stu.dent _PTA ~.Other Lt1n~h ExpenSe:> Fer Student .", Paid BY.~Bd of Ed ~School Fund _Student _PTA _Other

Other:&;:pense~PerStudent ,,/ Paid By_BdofEd $c.h.oolFuod _Student ~PTA _Other

.Total Assessment fer SWdellt f:z D -- (When paid by student/parent)

Approved by :Principal lJa:te_~ __

Out-Qf~Smte Trip Requiring Board Apprbval __ (Ch$Ck by Su:perin~dent)

Date BU11dings & GrolmdslLRPF Co:mmitt~ will Review (fo~ Out-of-State Trips) ~~ __

Date orBoard ofEdnca:tion Mee~g to Take Action on Out-of-State Trips ____ _

Approved by 13oard_

Rejected by Bo.atd_

SupetintendenFs Signature Date -----(Revised: JaaWU)' 2005) Ootob(,';T 2006, Msy 2007)

2015~09-15 14:55 Vi llani Bus Co.


Christine Graham Hillsido High School 1085 Liborty Avenue HillsIde, NJ 07205 USA

9084748058 »

VilInni Bus Company 811 East Linden Avenue Linden, N.T 07036 Phone: 908-862-3333 Fax: 908-474-8058 Website: www.villanibus.com Email: [email protected]

Confirnlod: 09/15115 Charter No, : 56334

Phone: 908-692-6932 Fax: 908-352-4246 Order Date 09/15/15

SalesRcp: Mr.Shabazz

P 3/4

Thank you for selecting Villani Bus Company for your upcoming trip. We are committed to providing you with the velY

best service possible. and I am $urc that you will be pleased with the quality of our equipmeI1t and drivers. This Confirmation

serves !IS your contrnct fol' yOUI' transportation needs shown bolow, We must receive yout deposit along with one signed and

dated copy of this lettel' by the due date of the deposit shown below. Please review the following information to con finn our

understanding of the services we will provide.

Group Name: Dorney Park Group Group Leader: Christine Graham

Destination: Allentown, Pa.

!"cave Date: Friday, October 30, :2015 Spot Time: 3:30 pm Leave Time!

Pickup i...oc;:ution:

4:00 pm

Hillside High School 1 O.8I:LLiberty'Avcnue. Hillside NJ

Description

Single Day Motorcoach Trip local Transportation rate does not include gratuity UNSIGNED CONFI~MATION WILL VOID RESERVATION

/I Coaches: 1 Equipment: 1-55 Motorcoach

Return Date: Friday, October' 30, 2015

Retn\Drop Time: 11 :00 pm

Destination Dorney Park Details: Rto78W Off 222 N

Allentown, PA

# Coaches Qty Rate

1 1.00 $1,150.00 1 1.00 $0.00 1 1.00 $0.00

Char~c

$1,150.00 $0.00 $0.00

Due DUlQ;;

09/:Z9/15 10(16115

Dc;;criI21io.!l

Signod Contract Final Payment

Amount DOlI} Received Transport ChMgC: $1.150.00 $0.00 Amount Paid

$1,150.00 Balance Due $1,150.00

If you have;: not already done so, please remember to send us an itincl'itI)' complete with addresses to insure the success

ofyollr trip. Please call me if you have any questions.

Sincerely.

Charter Puny Authorized Signature Date

Mr.Shabazz

·':;::::l-~-:::::::~:::C:'::.~"::~_"":": . - .::;:~:S:fS:=';f::':":~ __ -::.:, .. ,;.' j .. c;.::,."..:,:',~"::: -:-::_' ___ c::~::=_::c-.:.)

Att:ac:hrent ED#5-10/15 .. -. --.----:-':-..: -~ -.... '--~

~-~--~---.-,

-DEC. 3.2010 10:31AM _ NO. 6900 P. 1

ElLLSIDE PUBLIC SCHOOLS HilIside~ New Jersey

"School Business" will be. autom.a:tica.lly recorded for teachers in charge, chaperones listed below. ~tRe uest for AbsMce" not re ired.

DesthlaUon: TownlStafe.A '-lutrOUl"l- R'h~ci1ityJA.ttraction '"00 tt.N E j rw Ie

Date of Application 9 I It. \ ,S" Pate of Trip . .:l\it1<... I 8 . 2.0' (p Purpose ofTrlpllndicate Educational Value of Trip (attach additional sheet(s) jfnecesSBIy)..--::-_~ ______ _

7EAM BUlI-blNtb

School ' 1:1=. ~ h Grade '1. -L '2.. NTInlber of Stlldetrfs ' £0 Means of'rr8l1Sl'oriation V iLL A tV; B f.,t. J'

Describe how students are selected to participate in. trip 6' ; N I 0 ~ wi A-\ S 2-0 I b '-,'::BL 8 CLub - :BY~;Ne$~ CIAJJE~

. TUne of Departure -.a : 0",_ A.... Expected Lune ofRetrm1!J ;." D"J?H Teacher(s)InCh~ge U:r2A Utrt1 ListCbaperonesw~owillacco1i1p~students. /(oovJ/deN+ AndiNO I Ske I+oN

Veut'} Aj ,~ Le~t..s~ , Nameof~l$Company ,\I, LL AN" 'Hi). J CO. (Company must be on current approved list of transportation ~ontractors) 'price Per Bus " 150 - ' Total Cost for buses~ ____ _

Cost ofTransportatio.o. Per Student 2.3 Paid By_, Ed of Ed ~School Fund ~ Student _PTA _Other

Admission Fees ;per Student 011 Paid By_Bd oiEd ~Sch.ool Food X Stud~nt ~PTA _,Other

Lun~h Expcl:J.Se:; J;'er Student ..- Paid By _Bd oiEd ~Scbool Fund _Swdent _PTA _Other

Otherfupenses.PerStudent ,. , Paid By_Bd of Ed _$choolFU'l)d ~Student

,ToW.Assessment F,er StJ,IdW f, 0 -' (WIlen paid by student/parent)

~PTA _Other

Approved by Prinoipal Date._~~_

Out-of-State Trip Reqllrmg :Soard Approva1 __ (Ch~k by SU:p~~dent)

Date BUl1dings &. GrolmdsILRPF Commi.~ will :Rev!ew (for Out-of-StatQ Trips) ~~ __

Date of Board. ofEdnca:tion Meetmg to Take Action on Out-of-State Trips ___ _

Approved by Board_

Rejected by Boatd_

~uperintendentts Signature Date.~ __ _

(Rev.ised: Jan])a:!)' 2005~ Octob~ 2006, MBy 2007)

2015-09-15 14:55 Villani Bus Co.


Christine Graham Hillside High School 10851..iberty Avenue

Hillside, NJ 07205 USA

9084748058 » Villani Bus Company 811 Eust Linden AVClluc Linden, NJ 07036 Phone: 908-862-3333 Fax: 908.474-8058 Website: www.villanibus.com Email: [email protected]

Confirmed: 09/15/15 Charter No. : 56339

Phone: 908-892-6932 Frix: 908-352-4246 Order Date 09/15/15

Sa1csRcp: Mr.Shabazz

P 2/4

Thank you for selecting Villani Blis Company for your upcoming trip. We arc committed to providing you with tho very

best service possible. and I am sure that you will be pleascd with the quality of our equipment and drivers. This Confim1ation

serves as youI' contract for you,' transportation needs shown below. We must receive youI' depOSit along with one signed and dated copy of this letter by the due date of the depo~it shown below. Pleus!) review the following inlortnation to COl1timi our

understanding of the servicos we will provide.

Group Name: Dorney Park Group

Group Leader: Christine Graham

Destination: Allentown, Pa.

Leavc Date: Saturday, June 18, 2016

Spot Time! 7;45 am

Leave Time~ 8:00 am

Pickup Location:

Hillside High School 1085 Uberty Avonue Hillside NJ

Description

Single Day Motorcoach Trip local Transportation rate does not include gratuity UNSIGNED CONFIRMATION WILL VOID RESERVArlON

1)\11,1 !)j1tc~

09129/15 06/04/16

t~s;ri"lion

Signod Contract Final Payment $1,150.00

Ii Coaches: 1 Equipment: 1-55 Motorcoach

Return Date: Saturday, June 18, 2016

Rctn\Drop Time: 7:00 pm

Destina~ion Details:

Dorney Park Rte78W Off 222 N Allentown, PA

# COlu;hcs Qty Rate

1 1,00 $1,150.00 1 1.00 $0.00 1 1.00 $0.00

Trnllspol't Charge:

Amount Paid

Balance Duc

,

Charge

$1,150,00 $0,00 $0.00

$1,150.00

$0.00

$1,150.00

If you have not already done so, plca~e rernemb!)r to send us an itinerary complete with addresses to insure thC$uccess

of>,o~lr trip. Please call me if you have any questlons.

Sinccl'cly.

Charter Pmiy Authorized Signature Date

Mr.Shubazz

SEPTEMBER

S M T W T F S

1 2 3 4 5

6 7 8 9 10 11 12 I--

13 14 15 16 17 18 19 '---

22 [3I] 24 20 21 25 26

27 28 29 30

OCTOBER

S IMiTIWi TI F 1 S

1 2 3

4 5 6 7 8 9 10

11[gJ13 14 15 16 17

18 19 20 21 22 23 24

25 26 27 28 29 30 31

NOVEMBER

S I MIT WiT I F I S 1 2~4151617 8 9 (10) (11) (12) 13 14

15 16 17 18 (19) 20 21

22 23 24 (25)1 261 271 28 29 30

DECEMBER

S 1 MIT 1 W T F 1 S

1 2 3 4 5

6 7 8 9 10 11 12

13 14 15 16 17 18 19

20 21 22 (23) 24 25126

27 1 28 1 29 130 31

JANUARY

SIMITlwlT F S

1 2 -3 4 5 6 7 8 9

10 11 12 13 14 15 16

17~19 20 21 22 23

24 25 26 27 28 29 30

31

_~, '. ." ...AttachrEnt ED#6-10/15 HILLSIDE-PUatTt St'Fi'O'C1LS

Sept. 1,2,3

Sept. 4,7

Sept. 8

Sept. 14

Sept. 23

Oct. 12

Nov. 3

Nov. 5,6

Nov. 10,11,12

Nov. 19

Nov. 25

Nov. 26,27

Dec. 23

Dec. 24-Jan. 1

Jan. 18

Feb. 10

Feb. 12

Feb. 15

Feb. 25

March 25

March 28

April 11-15

May30

June 17,20,21

June 21

SCHOOL CALENDAR

2015-2016

Staff Development

District Closed

Schools Open

Rosh Hashanah-Closed

Yom Kippur/ld al Adha-Closed

Columbus Day-Closed

Staff Development-Closed

NJEA Conference-Closed

Parent Conferences-PreK-8

Early Dismissal

Parent Conferences-HS ONLY

Early Dismissal-HS ONLY

Early Dismissal

Thanksgiving Recess

Early Dismissal

Winter Recess

Martin Luther King Day-Closed

Parent Conferences-HS ONLY

Early Dismissal

Staff Development-Closed

President's Day-Closed

Parent Conferences-PreK-8

Early Dismissal

Good Friday-Closed

District Closed

Spring Recess

Memorial Day-Closed

Early Dismissal

Last Day of School

D =School Closed for Students

( ) =Single Session - Early Dismissal

Total - Student Days

Sept. - 15 Feb. - 19

Oct. - 21 Mar. - 21

Nov. -16 Apr. -16

Dec. -17 . May - 21

Jan. - 19 June -15

FEBRUARY

siMITIW1TIFis 1 2 3 4 5 6

7 8 9 (10) 11 [gJ 13

14 ~ 16 17 18 19 20

21 22 23 24 (25) 26 27

28 29

MARCH

SIMITlwlTIFI S

1 2 3 4 5

6 7 8 9 10 11 12

13 14 15 16 17 18 19

20 21 22 23 24 [ill 26

27 ["2A] 29 30 31

APRIL

siMITlW1TI Fis 1 2

3 4 5 6 7 8 9

10 111 112113 114115 116 17 18 19 20 21 22 23

24 25 26 27 28 29 30

MAY

SIMITlwlTI FI S 1 2 3 4 5 6 7

8 9 10 11 12 13 14

15 16 17 18 19 20 21

22 23 24 25 26 27 28

29.[3Ql31

JUNE

siMITIW1TJF1S 1 2 3 4

5 6 7 8 9 10 11

12 13 14 15 16 (17) 18

19 (20) (21) 22 23 24 25

26 27 28 29 30

In the event of inclement weather/emergency closings, the first five days will be added at the end of the year and any additional

days will be deducted from winter and/or spring vacations. Please be aware of these closing possibilities before planning

any activities.

If there are any emergency school closing days, they will be added to the calendar as follows: i-day on June 22, 2016; 2-days on

June 22, 2016 and June 23, 2016; 3-days on June 22, 23, 24, 2016; 4 days on June 22, 23, 24, 27, 2016 and S-days on June 22, 23,

24,27,28,2016. Any additional days will be taken away from the April break starting with Friday, April 15, 2016 and working

backwards towards Monday, April 11, 2016. REVISED: 10/15/15

Attacl:m:nt FD#7 -10/15 Hillside Township

NJ QUALITY SINGLE ACCOUNTABILITY CONTINUUM STATEMENT OF ASSURANCE - SCHOOL YEAR 2015-16

DECLARATION PAGE Hillside

Union County Hillside Township

By signing below, the Chief School Administrator and Board President are affirming the accuracy of this document.

POSITION NAME SIGNATURE

Chief School Administrator Ms. Zende Clark

Board of Education President Mr. Calvin Lofton

~ard Resolution Date: October 15,2015

NJQSAC: SOA Declaration Page 10fl Submit byll/15/2015 through NJ Homeroom

NJQSAC Statement of Assurance - School Year 2015-16

DistrictName:Hillside - --

Instruction and Program Yes orN/A = 1 Comments

No=O

1. Reports to the district board of education and the public on the Board of Education meeting performance of all students on the New Jersey standardized testing _ system 1 (N.J.A.C.6A:8-3.I).

2. Communicates district graduation requirements to all high school 1

Career Night - Hillside High School and Hillside students, their families, and the community annually (NJ.A.C. 6A:8-5.1). High School Back to School Night

3. Implements board-approved new and/or revised curricula that clearly and specifically align with the most recent State Board adopted version of the New Jersey Common Core Curriculum Standards (NJCCCS) and Common Core State Standards (CCSS) and with the time1ine for implementation of curriculum for each content standard (N.J.A.C. 6A:3-3.I). Content Area and Date Standards Were Adopted by the State Board of Yes or N/A = 1 In the boxes below, enter the district board Education: No=O adoption date for each content area. If the

content area has not been aligned to the standards, provide an explanation.

English Language Arts: (June 2010) Math (June 2010) Science (June 2009) Social Studies (September 2009)

1 World Languages (June 2009) Technology (June 2009) 21st Century Life and Careers (June 2009) Visual and Performing Arts (June 2009) Comprehensive Health and Ph~sical EducationQune 2009J

Instruction and Program Yes or N/A = 1 Comments

No=O

Page1of10


District Name: HiiIside 4. Aligns the approved career and technical education program with the State Plan for Career and Technical Education and evaluates the program annually, including the required safety and health program (NJA. C. 6A: 19 et seq .).

Page 2 of 10

1


])istrictN al11e:'fiil1side ,,/ '.' ... ' . .' .•. c ," .... , ..

. ....... . ' .. '., " c>: .... ". <'.

Instruction and Program Yes or N/A = 1 Comments No=O

5. Has a preschool program plan approved by NJDOE Div. of Early !

Childhood Education, as per NJA.C. 6A:13A-3.1 (if district receives State !

preschool education aid). For those school districts receiving full State 1 funding under the School Funding Reform Act (SFRA) funded per pupil

amount determined by the formula, the preschool Self-Assessment Validation System is complete, per NJA.C. 6A:13A-8.1.

Instruction & Program Subtotal 5 I

Fiscal Management Yes orN/A= 1 Comments

No=O The district: 1. Follows a budget calendar that was developed and shared with the board

1 I

annually and that reflects all applicable legal and management requirements. I

2. Bases the tuition estimate on an analysis of prior year expenditures and the I

current year schedule of out-of-district placements from existing contracts. 1 I

I

3. Bases appropriations for capital projects on the district's Long Range Facilities Plan (N.J.A.C. 6A:26-2.1) and the comprehensive maintenance 1 plan (N.J.A.C. 6A:26-20).

4. Supports other budget lines by a trend analysis of historical expenditures. 1 !

I

5. Includes only line-item transfers or appropriations of surplus for new The annual transfer report as of 6/30/15 exhibits !

,

programs and initiatives contained in the original budget certified for taxes 1

transfers outside the advertised budget lines. This is (excluding transfers for health and safety related items and awards of legal/permissible and should not be a performance additional state aid or grants for new purposes. measure. Weare (still) not sure what the point is

Page 3 of 10


Distf'ictNail1.e:Hillsid~ .. "

" . ..

" " ... ,

. ' .. " ....... .' .. ..... .'. .. .'

.. '

Fiscal Management Comments

6. Submits initial applications, revisions and [mal reports for all entitlement 1 and discretionary grants in a timely manner.

7. Maintains separate accounts and keeps records, by grant (IDEA, Title I, IDEA-ARRA, Education Jobs Funds, etc.) and location as required (Title I,

1 etc.), andlor consolidates accounts for approved school-wide programs as allowed in accordance with the approved budget.

8. Expends federal funds consistent with the approved indirect cost rate. 1 NI A The district does not use the indirect cost rate fo:

9. At a minimum, performs a semi-monthly review of the budget status 1 (budget to actual) to ensure that sufficient appropriations are available.

10. Approves purchase orders approved only by the purchasing agent and issued in advance of goods received or services rendered and encumbered for 1 the full contractual amount. There are no confirming orders. .

Fiscal Management Subtotal 10 Governance Yes or N/A = 1

Comments No=O

! The district: 1. Establishes policies and procedures for the provision of educational

1 programs and services to all students (N.l.A.C. 6A:7 et.seq).

2. Establishes a nepotism policy (N.l.A.C. 6A:23A-6.2) 1 3. Follows all requirements for the annual organization meeting (N.l.S.A.

1 18A:10-3 et seq. and 15-1 et seq.). ---- ------

Page 4 of 10


Disf:rict·Nall1e: ·I1il1side Governance Yes or N/A = 1

Comments No=O

4. Drafts minutes of all meetings, including executive sessions, that reflect all board actions and makes the minutes publicly available within two weeks or by the next board meeting (NJ.S.A. 18A:17-7). When appropriate, the board obtains public input and provides information to district staff as it 1 relates to community expectations. The board also implements the Open Public Records Act COPRA) pursuant to N.J.S.A. 47:1A-l et seq.).

5. Requires each board member and administrator to file a timely and properly completed financial and personal/relative disclosure statement each year (NJ.SA. 18A:12-26). Annually discusses the School Ethics Act and 1 has not been found in violation of the School Ethics Act (NJ.SA. 18A:12-22).

6. Establishes a travel and related expense reimbursement policy and ensures school board members and all employees operate in accordance with 1 that policy (NJSA. 18A:11-12 and NJA.C. 6A:23A-7).

7. Submits new, renegotiated, amended, altered or extended contracts for superintendents, deputy superintendents, assistant superintendents and school business administrators to the Executive County Superintendent (ECS) for review and approval. Takes no formal action to approve or 1 implement such contracts prior to ECS review and approval (NJSA. 18A:7-8, NJA.C. 6A:23A-3.1).

_ ... _---------- ---_ .. - .. _-- ----_ .. _-------_ .... _- ------_ .. _--

-~---

Page 5 of 10


DistfictNal11e:>HiIlside' ____ .. ;. ,' .

,.' .... , ..... ;

'. ;""" " ....... . ....' "'c' ."'.: "'. ", ... ';."'- -'

'.

Governance Yes or N/A = 1 Comments

No=O 8. Approves appointments and transfers, and removes or renews certificated and non-certificated officers and employees only by a roll call majority vote of the full membership of the board upon the recommendation of the Chief 1 School Administrator and acts within 60 days of the CSA's recommendation (NJS.A. 18A:27-4.l).

9. Approves the monthly board secretary's and treasurer's reports within The 2014-15 fiscal year was the first year the district 60 days ofmonth's end and certifies in the minutes that the major funds

0 did not have a treasurer and did not approve the

(general fund, special revenue and capital projects fund) have not been over- treasurer's reports for July through May until JUly. expended (NJA.C. 6A:23A-16.10).

10. Conducts a public hearing on the proposed budget and formally adopts !

the budget at a public meeting (NJA. C. 18A:22-7 et seq. and NJA. C. 1 23A:8-1) .

Governance Subtotal 9 I

I

Operations Yes or N/A = 1 Comments

I No=O The district:

I

I

1. Conducts all required trainings for school district employees (NJS.A. 1 I

18A and NJA. C. 6A). I

2. Submits all required NJSMART files by the due dates and has an error I

1 I rate ofless than 2% for each file. ! ,

3. Adopts and distributes to all school staff, students and parents a code of !

student conduct that contains all required elements (NJA. C. 6A: 16-7.1). 1 I

- -- -- - -

Page 6 of 10


~ ,~ ,~ '": ~ , , , ,.~~::, ", . ' ~ .' ~ ~ .- "

~ , ':

DistrictName: . Hillside ~. ,; ~', , .<' -';' , . "

Operations Yes orN/A= 1 Comments

No=O 4. Collects and reports annually, incidents of violence, vandalism, substance abuse and disruptive behavior to the NJDOE on the Electronic Violence and Vandalism Reporting System (EVVRS). Reports to the board all incidents 1 from the previous year, annually at a public hearing. Analyzes these incidents and identifies activities to address them (N.JA. C 6A: 16-5. 3).

5. Develops and implements policies and procedures prohibiting harassment, intimidation and bullying (RIB); distributes them to students,

1 parents and staff; and posts the policies and procedures on the district's website (NJS.A. 18A:37-14-18 and NJA.C 6A:16-7. 7).

6. Satisfies all requirements of the Gun-Free Schools Act, 20 USC 7151 and the Title IV Section 4141 ofNCLB (N.JS.A. 1BA:37-7-12 and NJA.C 1 6A: 16-5.5).

7. Provides for the safety and protection of students through the annual review, development and implementation of a memorandum of agreement (MOA) with law enforcement and implementation of board-approved 1 policies to facilitate cooperation between school staff and law enforcement (N.JA.C 6A:16-6.2)

8. Implements procedures to review and resolve transportation incidents to avoid safety violations and ensures the safety of children including but not limited to meeting Motor Vehicle Commission requirements for bus driver 1 inspections before loading and after drop-off and evacuation drills (N.JA. C 6A:27-11 and 12.1 (g).

Page 7 of 10


, ," , - " ", '" ',;" ",: ," ' . " " " , ,,' . ' , , I

DislfictName: ';;Hillside , .. ' I " ' ;.; ,

""" <>, ' ,', " -,,' .. ' -

Operations Yes or N/A = 1 Comments

No=O 9. Adopts and implements policies and procedures designed to report missing and abused children to law enforcement and child welfare authorities. Appoints and school district liaison and provides training to 1 district employees, volunteers and interns working in the school district (NJA.C 6A:16-11).

10. Provides school health services, screenings and examinations to identifY the need for medical services for public and nonpublic students. Maintains 1 student health records (NJA. C 6A: 16-2.1 et seq). 11. Implements the NJDOE-approved school health nursing services plan

1 (NJA.C 6A:16-2.1 (b)).

12. Implements a board-approved comprehensive guidance and academic 1 counseling program for all students (NJA.C 6A:8-3.2).

13. Coordinates a comprehensive career education and counseling program with transition services for students with disabilities beginning at age 14 or

1 younger as determined by the Individualized Education Program team (NJA.C 6A:14-3.7(e)11-13).

14. Ensures that each school building has a multidisciplinary team (such as Intervention and Referral Services Team, Pupil Assistance Team and School

1 Resource Committee) as part of its coordinated system for the planning and delivery of intervention and referral services (NJAC 6A: 16-8.

15. Provides educational services, either in school or out of school, within five days of the student's removal for disciplinary reasons or absence due to chronic or temporary illness (NJA. C 6A: 16-7. 2; 7.3 and 10).

1 If the district is a County Special Services School District, it develops and implements procedures for notifying resident district of disciplinary removals or absences due to chronic or temporary illness.

- _ .. - --- - -- -- --- .. _------_ .. _---

Page 8 of 10


-, '- ---,-- -,-,: -',-", - -- :' -' '- -: --:' - ,:

DisttictNanie: -Hillside -, - 'c:' ~ , ,- ,:--

- '- .' : .' "

Operations YesorN/A=l Comments

No=O 16. Forwards all student records, including disciplinary records, to the school district to which the student has transferred within 10 school days after the transfer has been verified by the requesting school district. Forwards 1 disciplinary records, with respect to suspensions and expulsions, to nonpublic schools (N.JA.C 6A:32-7.5(j)10iii and 6A:16-7.10).

17. Provides services and programs to nonpublic school students in accordance with Chapter 192 Auxiliary Services (N.JSA. 18A:46A-1 et seq.

1 and N JA. C 6A: 14-6.1 et seq) and Chapter 193 Remedial Services for the Handicapped (N.JSA. 18A:46-19.1 et seq and NJA.C 6A:14-6.1).

18. Disseminates information about and implements a comprehensive alcohol, tobacco and other drug abuse program. Adopts and disseminates to all school staff, students and parents policies and procedures for the

1 prevention, assessment, intervention, referral for evaluation referral for treatment, discipline for students using alcohol or other drugs and continuity of care (N.JSA. 18A:40A-B and NJA.C 6A:16-1.4(a)18; 6A:16-3-4). 19. Annually reviews, revises or develops, and implements safety and security plans, procedures and mechanisms in consultation with law

1 enforcement, health, social service and emergency management agencies and other community members, including parents (N.JA. C 6A: 16-5.1 et seq).

20. Implements the NJDOE-approved Comprehensive Equity Plan (CEP) designed to eliminate discrimination according to race, age, creed, color, national original, ancestry, marital status, affectional or sexual orientation, 1 gender, religion, disability, socioeconomic status, pregnancy or parenthood (N.JA.C 6A:7-1.4).

Operations Subtotal 20

Page 9 of 10


.' . . ... .'c > ·.c .< .. '

DistrictNitme:HilIside .. c·:> ·c· . ..... ,

,

Personnel Yes or N/A = 1 Comments

No=O The district: 1. Utilizes board-approved job descriptions and standards for appointment of each teaching staff member, substitute teacher and other staff including paraprofessional positions. Ensures that all staff are appropriately certified 1 and credentialed for their assignment (NJA. C. 6A:32-4 and NJA. C. 6A:9-6.5).

2. Confirms that new employees have a successful criminal history record check within three months of employment and that they have not been

1 disqualified for employment (NJS.A. 18A:6-7.1 et. seq., 18A:39-19.1 and 18A:6-4.13 et. seq .).

3. Adopts written policies and procedures for the physical examination of new and existing employees and maintains personnel health records in a 1 secure separate location from personnel files (NJA. C. 6A:32-6.2 and 6.3).

4. Adopts policies and procedures for the annual evaluation of all tenured and non-tenured teaching staff members by appropriately certified personnel. 1 Distributes the policies to all tenured teaching staff members, including administrators and supervisor, by October I (N.lA.C. 6A:l0). 5. Uses multiple data sources, (e.g., test scores, needs assessments, attendance data, violence reports) to address current and projected needs and priorities for all school/district staff when providing professional

1 development opportunities. Uses the data sources to analyze the alignment ofthe district's Professional Development Plan with teaching staff needs (NJA.C. 6A:9-15 et.seq .).

Personnel Subtotal 5 '--------_ .... __ .. _----------_ .. _ .. _---------_ ..... _-_. __ .---- -- ---- ----_ ....... --_ ... _--- ------ _ ... _-------- .. _-- .. _----- ----- ---- ...... _-_._----

Page 10 of 10

Special Education Request Related Services/OOD Placements

OlJ'r .OF DIS'l'RICT.PL.ACEl\ffiN1'REQQESl' .... .' c. .•.•. .•.••••.•.• .··;·,ii >< ....••.....••. ) •. : .. i";:""",,"(·:;· .>,.,.....: .• SchoollPlacement Student Tuition Term

The Deron School of New Jersey, Inc. 4316097286 $52,538.40 2015-2016 5798557031 $41,552.40 2015-2016

Morris-Union Jointure Commission 9846552205 $86,988.00 2015-2016 Union, NJ

The Newark Public Schools 9379330354 $49,388.00 2015-2016 Newark, NJ

ESY = Extended School Year (Summer) Hillside Board of Education Regular Meeting October 15, 2015

ED#8-10/15

~,': ""'; . ""'/<"/";""'!:';/;> Extraordinary Service

Page 1

FIELD TRIP SCHEDULING FORM Attachment ED#9-10/15

School: APMECC

Month: October

Submitted by: T.Kennedy Destination Ph~sical Location

Trip # Teacher Purpose (Name of) (Citv, State) DavofWeek Date of Trip # of Students Grade Students will gain a better understanding of what it means to be a Hillside Fire Oct. 20, 26,

1 firefighter Department Hiliside,NJ Tuesday 28,2015 168

2 Kennedy Pre-k

3 Nascimento Pre-k

4 Kildosher Pre-k

5 Mesavitz Pre-k

6 Ponce Pre-k I

7 Plus chaperones Pre-k

8

9

10 -- --- --

FIELD TRIP SCHEDULING FORM

School: HHS

Month: October

Submitted by: Morgenthal

Destination Ph~sical Location Trip # Teacher Purpose (Name of) (Citv, State) Dav of Week Date of Trip # of Students Grade

Practical English Jersey Garden 1 Morgenthal Exploration Mall Elizabeth, NJ Tuesday 10/27/15 13 12-Sep

2

3 I 4

Attachrent ED#10-10/15

HlLLSIDE PUBLIC SCHOOLS Hillsid.e, New Jersey

"School Business" will be automatically recorded for teachers in charge, chaperones listed below. "Re uest for Absence" not re uired.

School ___ ---"-·M..:.....::t...l/-V_S __ LI',- Id.-G.rnde ______ '~ ________ __

Number of Stud.ttllts,_-=dA:::..=o::::...--___ Means of Transportation (0 /Yl mJE{::CJ IJL e uS

Describe how students are selected to participate in trip _Vk_o_L_U_A.l_7f2_ff_lf..;,.e;::, ~ _____________ _

Time of Departure '::{--':: DO ytlIA. Expected Time of Return /;/. /00 f'rVL . Teacher(s) In Charge,_' _L-~...!.Y;-,c..-::::..-~!L=t~t=H-,-A....:.:ro,,-,= _______ _

List chaperones who will accompany students.~jU---,,->-=G:.,<_--,-j)_/_Il-,---,,"l~ ________________ _

Name of Bus Company :s )h {2£- V1JAJ:C (Company must be. on current.:yproved list of transportation contractors) Price Per Bus .?¥) &-£9 0 (£s:t ") Total Cost for buses, ______ _

Cost of Transportation Per Student I 0 Paid By _Bd of Ed _School Fund

'Admission Fees Per Student I U Paid By _Bd of Ed _School Fund

Lunch Expenses Per Student· Z--;aid By_Bd of Ed _School Fund

Other Expenses Per Student 7 Paid By _Bd of Ed _School Fund

Total Assessment Per Stu7t ~ 0 ~ (When paid by student/parent)

Approved by prinCipa1Z~L Date, ____ _

Out-of-State Trip Requiring Board Approval __ (Check by Superintendent)

D<.Student

~Student

_Student

_Student

Date Buildings & GroundsILRPF Committee will Review (for Out-of-State Trips) _____ _

Date of Board of Education Meeting to Take Action on Out-of-State Trips _~ __ _

Approved by Board_

Rejected by Board_

Superintendent's Signature-+-H~{,,4-#--J,;.H-_

(Revised: January 200S, Octo

Date

_PTA _Other

_PTA _Other

_PTA _Other

_PTA _Other

BOARD OF EDUCATION TOWNSHIP OF HILLSIDE 195 VIRGINIA STREET HILLSIDE, NEW JERSEY 07205 908-352-7664 ext. 6428

Kenneth R. Weinheimer Business Administrator/Board Secretary

2015-2016

ED#11-10/15

Telephone: 908-352-7664 Ext. 6428 Fax: 908-282-5830

Email: [email protected]

NEW JERSEY NON PUBLIC SECURITY AID PROGRAM AGREEMENT

THIS AGREEMENT made this first day of July 2015, between the Union County Educational Services Commission, having its principal office at 45 Cardinal Drive, in the Town of Westfield, County of Union, and State of New Jersey, hereinafter referred to as U.C.E.S.C., and the Hillside Board of Education having its principal office at 195 Virginia Street, Hillside, New Jersey, County of Union, and State of New Jersey hereinafter referred to as the Public School District.

WHEREAS, the U.C.E.S.C. by the authority of its Board of Directors, acting on approval of the State Board of Education, is capable of administering the Nonpublic School Security Aid Program; and

WHEREAS, the U.C.E.S.C. services are in accordance with the New Jersey Nonpublic School Security Aid Program, and the Rules and Regulations governing same to nonpublic schools; and

WHEREAS, the Public School District is under an obligation to provide said services to all eligible non public schools within its district to assure equal access to the specified New Jersey Nonpublic School Security Aid Program; and

WHEREAS, the Public School District has by Resolution of its Board agreed to contract with the U.C.E.S.C. to provide said services pursuant to said legislation and serve as the district designee:

NOW, THEREFORE, the parties hereto agree as follows:

I. The terms and conditions of this Agreement shall be in effect from July 1, 2015 through and including June 30, 2016.

II. The U.C.E.S.C. will fulfill the following responsibilities on behalf of the Public School District within the limitations of funds;

A. Confer with the nonpublic school administrator(s) to determine the security aid to be provided and the limit of funds available;

B. Provide the agreed upon security material which may include purchasing security services, equipment or technology pursuant to the Public School Contract law;

III. BE IT FURTHER UNDERSTOOD that the Hillside Board of Education pay a surcharge equal to 12% of the allocation for non public security aid to cover the Commission's costs for administering the program. The Commission will bill the district for services rendered throughout the 2015-2016 school year, not to exceed State aide for non public security aid. There will be a 12% surcharge on these invoices to be paid out of district current expense funds. Surcharge is not to be paid from non public school security aid entitlement.

IN WITNESS WHEREOF, the Board of Directors of the Union County Educational Services Commission and the Hillside Board of Education, have by Resolution directed their respective Presidents and Secretaries to set their signatures and affix their seals. A certified copy of the Public School Resolution is annexed hereto.

ACCEPTED AND APPROVED:

(Hillside Board of Education)

Calvin Lofton, Board President Date

Kenneth R. Weinheimer, Board Secretary Date

UNION COUNTY EDUCATIONAL SERVICES COMMISSION

Helen E. Kirsch, Board President Date

Robert A. Be hot, Ed.D, Board Secretary Date

Resolution for Nonpublic School Security Aid Program

WHEREAS P.L. 2015. C.63, requires the State and local community purchase nonpublic security aid program upon individual request to all students enrolled in grades Kindergarten through 12 in nonpublic schools located within the local school district. From the amount appropriated for Nonpublic Security Aid, the Commissioner of Education shall provide State aid to each school district in an amount to equal $25 multiplied by the number of nonpublic school students within the district identified by the district on or before November 5 for security services, equipment or technology to ensure a safe and secure school environment for nonpublic school students.

WHEREAS the Union County Educational Services Commission has agreed to handle the purchasing and processing of nonpublic school security aid program, security services, equipment or technology for local public school districts for the purpose of greater cost effectiveness through joint purchasing and centralized administration,

THEREFORE, BE IT RESOL VED that the Hillside Board of Education enter into an agreement with the Union County Educational Services Commission whereby the Commission will administer a nonpublic security aid program for those eligible students attending nonpublic schools located within Hillside for the 2015-2016 school year, in accordance with P.L. 2015. C.63; and

BE IT FURTHER RESOLVED that the Hillside Board of Education pay a surcharge equal to 12% of the allocation for nonpublic school security to cover the Commission's costs for administering the program. The Commission will bill the district for services rendered throughout the 2015-2016 school year. There will be a 12% surcharge on these invoices.

AttochrEnt EDf/:12-10/15

.HlllSI.DE SCHOOL DISTRICT . .. ;

Nursing Services Plan 2015·2016

A.P. Morris/Early Childhood Elementary School

Calvin Coolidge Elementary School

Hurden-Looker Elementary School

George Washington Elementary School

Walter O. Krumbiegel Middle School

Hillside High School

The Hillside School District consists of seven independent school complexes that serve the educational needs of regular and special education students that are registered in the Hillside School District.

The health offices of the Hillside School District serve the needs of students who require skilled nursing because of complex medical problems, or suffer from chronic illnesses requiring monitoring. Certified school nurses dispense daily or PRN medications, provide first-aid, and conduct assessments for illness complaints. Nurses also promote wellness and healthy lifestyles to enhance optimal academic performance.

The Certified School Nurses assure immunizations compliance with current state law, conduct required school health screenings, assist with doctors' medical examinations, serve on committees which assist Child Study Teams, attendance review and substance abuse COncerns. As advocates for children, school nurses act as liaison between the student, school and parent. School nurses complete monthly and annual reports as required by rules, regulations and policies.

Nurses attend courses, classes and seminars in continuing education. They also maintain CPR! AED certification. The nurses work in coordination with the Hillside Health Department and assist at health fairs and clinics.

In preparing the Nursing Services Plan, it is critical to review population size, the severity of health concerns and the time requirements necessary to meet each health concern.

The formulation of the School Nursing Services Plan, pursuant to NJAC 6A:30-1.4(a) 9., provides the vehicle for delivery of health services to our students by having a professional certified school nurse and/or provisionally certified school nurse assigned to each facility. The documented rationale for the school nursing service document is a collaborative effort of professional colleagues and the school physician. It reflects the increasing medical services required by the students being educated in our district, and exceeds the original educational mandate by the State.

Emergency Management (N.lA.C. 6A 16-2.1 (b) 2 (iii) The Hillside Board of Education provides for emergency services as follows:

A. Acute Care Management Plan: 1. Creation and maintenance of an Emergency Management Kit ("Go-box",

crash cart, etc.) for utilization in Crisis, Emergency Evacuations, or situations. 2. Cardiac or Respiratory Distress Action Plan

a. AED's (Automatic External Defibrillators) deployment and delegates trained

b. CPR trained school nurse (NJAC 6A:13.3) c. Universal Precautions trained staff d. CPR trained coaches/athletic trainers/teachers/staff

3. Concussion training for staff and Management or current in-service certificates for coaches, PE teachers, nurses.

B. IHP/Chronic Care Management Plans: 1. Epinephrine Auto-Inj ector/Anaphylaxis Action Plan 2. Asthma Action Plan 3. Asthma Nebulizer trained nurses 4. Diabetic Action Plan-Glucagon 5. Lock-Down Health Care Action Plan

C. District Crisis Management Plan: 1. Triage Action Plans are in the District Crisis Management Plan

D. Community Rescue Squad and Emergency Paramedic Services 1. Local rescue squad is available in the township. Daytime emergency services

and transport will be contacted when necessary.

Definitions:

School Complex: For the purposes of assigning school nurses, the District Board of Education shall determine whether two or more buildings constitute a school complex based on the following criteria:

Grade Levels General education emollment Special education emollment Number of children medically complex or medically fragile Distance between buildings Type of communication system in place

Certified and Non-Certified School Nurses: The certified nurse functions within the licenses of the Professional Registered Nurse and School Nurse Certification, and fulfill the duties stated in accordance with the Nursing Practice Act and the policies of the Board of Education School Health Policies, in ongoing efforts to ensure the well being of students. The certified school nurse uses the nursing process which includes assessment, planning and implementation, and follow-up of nursing care in a sequential manner. The certified school nurse develops individualized health care plans and emergency care plans for each student with acute or chronic health concerns.

Health Concerns: Students whose physical and/or social-emotional conditions is uncomplicated and predictable.

• Headaches (migraines) • Borderline hypertension • Allergies • Hyperventilation • Body prosthetics • Chronic conditions i.e., bronchitis • Laryngitis • Frequent complaints of body aches and pains, menstrual cramps • Injuries - post effects • Dental problems • Daily medication • Vaso vagus syndrome • Sinusitis • Stomach aches • Frequent nose bleeds • Hay fever • Skin disorders • Anemia • Ear aches/otitis media • Gastritis/urinary tract infection • Cysts • Upper respiratory disorders

Medically Fragile: Students with complex health care needs for whom life-threatening emergencies are possible and, therefore, require monitoring.

• Severe/serious asthmatics • Diabetics • Seizure disorders • Severe allergic reactions: bee stings, shell fish, peanuts, use of Epi Pen • Self catheterization with supervision • Gastro-intestinal feeding • Heart surgery • Multiple injuries • Depression • 504 multiple disorders

Medically Complex: Students with medically complex concerns have unstable physical and/or emotional conditions that require daily treatments or close monitoring. The potential for a life-threatening event may exist (e.g. severe asthma with inhaler/peak flow meter, adolescent pregnancy, complex, mental, or emotional disorders).

• Adolescent pregnancy with other medical problems • Legally blind-loss of hearing-other visual problems • Heart, kidney, blood disorders • Paralysis/muscle weakness with use of crutches • Scoliosis surgery/other spinal surgery • Fibrous dysplasia • Asthma • Major/serious surgical procedures • Sickle cell anemia • Lyme disease • Os good-Schlatter disease • Heart murmur • Cataracts

Nursing Dependent: Students needing skilled nursing for survival, twenty-four hours/day, frequently one-to-one (e.g. ventilator dependent).

Nurse Assigments: Hillside Schools AP Morris/Early Childhood Center Calvin Coolidge George Washington Hurden Looker Walter O. Krumbiegel Hillside High

Nurse Roseanna Bainbridge/Jen Lobo Norma Huber Patricia Stansfield Merril Strachan Ann Martinez/Julia Lyndt Patricia KozacheklLisa Dilts

SCHOOL: A.P. MorrislEarly Childhood Center Identified Needs Within the School

A. Grade Levels: Pre K 3 & 4, K_pt grade

B. Total student population, September 2015: 634 General Education Enrollment: 562 Special Education Enrollment: 72

C. Preschool Students: 178 Regular: 149 Special Education: 29

D. Students with Medical Involvement: 220 Health Concerns: 72 Medically Fragile: 85 Medically Complex: 63 Nursing Dependent: 0

E. Employees: Regular Board of Ed. Hired Faculty & Staff: 100 Employees with Health Concerns: 50

F. Additional Programs & Responsibilities: Medical secretarial duties, health alerts for staff, I&RS team member, BP monitoring for personnel with health issues, assist with health fair & clinics, annual reports (TB, State immunization, monthly nurses report, nursing services & OSHA Accident), Board of Education building, custodians & cafeteria staff care, student allergy lists for cafeteria, coverage for nurses if absent or when needed for emergencies, AED checks regularly x2 and check new staff and studentteachers for PPD's for state report. Coordinate and organize Janet's Law drills.

G. Teaching Responsibilities: Provide ongoing health & hygiene related information on topics for staff & students as mandated or requested i.e. blood borne pathogens topics and DYFS info.

H. Other non-nursing tasks: Call parents of children with toileting accidents. Working with PTA to present programs and speakers on relevant topics. Referral letters are sent regarding health exams, immunization compliance, hearing and vision throughout the year. Individual student health records are updated annually an as needed throughout the year. Letters are sent to parents regarding immunizations needed and as necessary throughout the year regarding important health issues.

1. Multiple Buildings & Travel Time: AP MorrislECC to other Hillside district schools where coverage is needed. At times it is a daily occurrence.

J. Nursing Staff: Two full time certified school nurses at AP MorrislECC.

Nurses in this building is CPR! AED certified

SCHOOL: Calvin Coolidge Identified Needs Within the School

A. Grade Levels: 2nd grade

B. Total student population, September 2015: 232 General Education Enrollment: 212 Special Education Enrollment: 20

C. Preschool Students: 0

D. Students with Medical Involvement: 104 Health Concerns: 61 Medically Fragile: 4 Medically Complex: 40 Nursing Dependent: 0 Epi-Pens ordered for students: 1

E. Employees: Regular Board of Ed. Hired Faculty & Staff: 30 Privately Contracted Staff: 2 Employees with Health Concerns: 12

F. Additional Programs & Responsibilities: Monthly and State reports are completed and sent to appropriate agencies. Other duties include by not limited to; AED checks regularly, information & counseling offered to I&RS team members as needed, assist with health fair '& clinics, allergy lists to cafeteria. Medical care, BP screenings, & medical alerts of staff, as needed. Check PPD' s of new staff & students when necessary. Participation in any other assigned committees such as the school safety team/monthly meetings.

G. Teaching Responsibilities: Provide ongoing health and hygiene related information on topics to staff & students. In services given to staff as mandated or requested on topics such as; blood borne pathogens, asthma, diabetes, seizure disorders, DCPP, and Epi-pen training.

H. Other non-nursing tasks: Secretarial functions - referrals letters are sent regarding; health exams, immunization compliance, dental and vision throughout the year. Individual student health records are updated annually and as needed throughout the year. Letters are sent to parents regarding immunizations needed and throughout the year regarding important health issues. Calling parents of children with toileting accidents and clothing repairs. Care & cleaning of blankets used on children when they are sick.

1. Multiple Buildings & Travel Time: Nurse provides coverage at other schools for emergencies if necessary.

J. Nursing Staff: One certified school nurse (RN/CSN). Nurse in this building is CPR! AED certified

SCHOOL: George Washington Identified Needs Within the School

A. Grade Levels: 5th grade

B. Total student population, October 2015: 230 General Education Enrollment: 182 Special Education Enrollment: 48

C. Preschool students: 0

D. Students with Medical Involvement: 126 Health Concerns: 64 Medically Fragile: 32 Medically Complex: 30 Nursing Dependent: 0 Epi-Pens ordered for students: 3

E. Employees: Regular Board of Ed. Hired Faculty & Staff: 44 Privately Contracted Staff: 2 Employees with Health Concerns: 16 Epi-Pens for faculty: 1 - Diabetic Insulin: 1

F. Additional Programs & Responsibilities: The nurse does all in-services and State reports. I&RS team member, Safety and HIB Team, Beautification and Safety, Community Involvement committees, monthly and state reports & counseling. Assist in annual Hillside Health Fair/clinics.

G. Teaching Responsibilities: • Family Life Program 5th grade. • Health EducationlWellness 5th grade as per collaborative assessments. • Asthma classes as needed. • Faculty in-services OSHA requirements, child abuse/neglect, Epi-pen

training, asthma, and as determined by needs of staff/students/district.

H. Other non-nursing tasks: As determined by administration (i.e. cover class in an emergency situation). Medical secretarial duties. Referral letters are sent regarding health exams and immunizations compliance.

1. Multiple Buildings & Travel Time: Nurse provides coverage at other schools when needed.

J. Nursing Staff: 1 certified school nurse.

Nurse in this building is CPR! AED certified

SCHOOL: Hurden Looker Identified Needs Within the School

A. Grade Levels: 3rd & 4th grades

B. Total student population, October 2015: 467 General Education Emollment: 412 Special Education Emollment: 55

C. Preschool students: 0

D. Students with Medical Involvement: 240 Health Concerns: 130 Medically Fragile: 40 Medically Complex: 70 Nursing Dependent: 0 Prescribed Epi-pens in building 6

E. Employees Regular Board of Ed. Hired Faculty & Staff: 72 Employees with Medical Involvement: 17

Health Concerns: 8 Medically Fragile: 3 Medically Complex: 6

F. Additional Programs & Responsibilities: Monthly and State reports. Crisis team member. I&RS team member & School Safety Team member.

G. Teaching Responsibilities: Family Life and Hygiene.

H. Other non-nursing tasks: Medical secretarial duties.

1. Multiple Buildings & Travel Time: Nurse provides coverage at other schools when nurse is absent.

J. Nursing Staff: One full-time certified school nurse.

Nurse in this building is CPR! AEP certified

SCHOOL: Walter O. Krumbiegel Middle School Identified Needs within the School

A. Grade Levels: 6th, 7th & 8th grade

B. Total student population, September 2015: 663 General Education Emollment: 573 Special Education Emollment: 90 IEP Students Emollment: 0



E. Employees Regular Board of Ed. Hired Faculty & Staff: 87 IEP/Privately Contracted Staff: 5 Employees with Health Concerns: 15

F. Additional Programs & Responsibilities: Monthly and State reports, crisis team member and I&RS team member.

G. Teaching Responsibilities: Staff in services, informal teaching and counseling.

H. Other non-nursing tasks: Medical secretarial duties.

1. Multiple Buildings & Travel Time: Nurse provides coverage at other schools when nurses are absent and for emergencies. Travel time depends on location.

J. Nursing Staff: 2 Nurses: One full-time certified school nurse and one Registered Nurse non- certified.

Nurses in this building are CPR! AED certified

SCHOOL: Hillside High School Identified Needs within the School

A. Grade Levels: 9th - 12th grade

B . Total student population, September 2015: 909 General Education Enrollment: 780 Special Education Enrollment: 129



E. Employees: Regular Board of Ed. Hired Faculty & Staff: 158 Employees with Health Concerns: 35

F. Additional Programs & Responsibilities: Coverage for absent nurses, immunization report, tuberculosis report, OSHA report, IR&S team, crisis team and monthly report. Perform preliminary screenings as well as assisting the physician with sports physicals. Communicating with parents regarding students not cleared by the school physician for sports. Communicate with Athletic Department regarding students cleared to participate along with health concerns. BP monitoring for personnel with health issues. Coordinate and organize Janet's Law drills.

G. Teaching Responsibilities: Individualized health teaching and counseling, faculty/staff presentations as determined by needs, Epinephrine delegation and diabetes training by certified school nurse.

H. Other non-nursing tasks: Secretarial functions: Collecting and reviewing sports packets prior to scheduling sports physicals and/or medical director clearance. Compiling sports rosters and updating them as needed. Referral letters are sent regarding health exams, immunization compliance, BP, scoliosis, hearing and vision throughout the year. Individual student health records are updated annually and as needed. Letters are sent to parents regarding immunizations needed and as necessary throughout the year regarding important health issues.

1. Multiple Buildings & Travel Time: Coverage for absent nurse as needed.

J. Nursing Staff: Two full-time certified school nurses-develop individualized health care and emergency care plans for each student with acute or chronic health concerns.

Nurses in this building is CPR! AED certified

Reviewed andvtr JiLv4 M1

/tl· / 'I-/r Date

Hillside Public Schools 195 Virginia Street Hillside, NJ, 07205

ED# 13-10 /15

September 10, 2015

This Letter Agreement outlines the terms under which Oelta-T Group North Jersey Inc. ("Oelta-1") will refer interim professionals to Hillside Public Schools ("Client"). This Agreement shall commence on the date first stated above and continue for an initial term of one (1) year or such shorter period in the event that the parties execute a more comprehensive agreement. This Agreement shall automatically renew for successive i-year terms. This Agreement may be terminated without cause by either party upon thirty (30) days written notice to the other party.

The professionals referred to Client through Oelta-T are Independent Contractors ("Contractor(s)"). OeltaT requires, as part of our arrangement with the Contractors, that each Contractor sign an operating agreement with Oelta-T before they are contracted out to a facility such as yours.

You must immediately notify Oelta-T of any and all job offers made to Contractors that were referred to you by Oelta-T. Oelta-1's Temp to Perm Policy is that from the time Client notifies Oelta-T of its intention to hire or contract directly with a Contractor, the Contractor must work seven hundred and fifty (750) hours through Oelta-T at a Client facility before the Contractor may accept a position with Client. Client may hire or contract with Contractor without meeting this 750-hour requirement by making payment to Oelta-T the sum of $7,500.00 or a sum equal to 1/3 of the total compensation package (including bonuses and fringe benefits) offered to Contractor, whichever sum is greater. This 750-hour requirement remains in effect for a period of six (6) months after the last date of a Contractor's assignment with Client.

All invoices for services are due net thirty (30) days and will be forwarded to your attention. Client shall notify Oelta-T of any disputed amounts within ten (10) business days of Client's receipt of invoice. Invoices or amounts not disputed within this time period shall be deemed accepted by Client. Client shall not withhold payment of any undisputed amounts. All outstanding balances are subject to statutory interest and a late charge. If payment is not made in accordance with these terms, Oelta-T will cease referring Contractors to Client and Contractors will not be released for referral until payment is received in full. Oelta-T shall be entitled to recover reasonable attorneys fees in the event legal action is necessary to enforce the terms of this Letter Agreement.

Thank you for choosing Oelta-T. We look forward to continuing our business relationship. If these terms are acceptable, please sign and return this to our office as soon as possible.

Respectfully,

Scott R. McAndrews

Scott R. McAndrews, EVP

By:~ ____ ~~ __ =-____ ~ __ __ Signature of Client Representative Oate

Print Name and Title

BEHAVIORAL HEALTH REFERRAL AGENCY

DELTA-T GROUP NORTHJERSE1~ INC.

ONE \'('OODBRIDGE CENTER • SUITE 225 • WOODBRIDGE, NJ 07095 • 800/426-0932 • PAX: 732/283-8804 • www.delta-tgroup.com

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r)frrA\~ nJ~1R()" 'UP lJl.:Il.:I_I~ . _, _ , ~1AI\lNG lin; EASIEH ~ F()F~ ;(12 SCHOOL',:.

Delta-T Group Education Rates 2015-2016 School Year

Delta-T Group specializes in referring intermittent professionals in the Education for long term ,short term and per diem needs. Our 24 hours a day 7 days a week availability and unique portfolio of services allow access to a strong network of professionals possessing a wide variety of experience and training. Delta-T Group is able to refer independent professionals with the appropriate Degree(s), Certification(s), Licensure and Experience to meet each organization's requirements.

Professional ABA Therapist ABA Aid Program Coordinator BCABA/BCBA RN LPN One to One Aides/ Paraprofessionals/Teachers Aid Bus Aid/Lunch Aid Teachers/Sub-Teachers -(day rate ) Special Education Teachers Home Instructor ESL Teachers Reading Specialist School Psychologist School Social Worker LDTC Guidance counselor

Per Evaluation Psychological Evaluations or Re-Evaluation Psychiatric Evaluations or re -Evaluations Functional Behavioral Assessment LDTC Evaluations IEP Meeting

• Teacher Aides • RN,LPN,CNA • Certified Teachers & Substitutes • 1:1 Nurses • 1: 1 Paraprofessiomils • Home Instruction • School Social Workers • Evaluation Services • School Psychologist • LDTC • Special Education Teachers • Board Certified Behavior Analyst • ABA Therapist

Thank You! Daniel M. Spalango, Jr.

Educational Sales Manager-New Jersey

Hourly Bill Rate $30 $23 $90 $41 $33 $18 $20 $120 $38 $38 $38 $38 $58 $34 $52 $32

$600 $600 $400 $400 $125

1 Office: 732.791.29781 Email: [email protected] 1 Fax 732.636.80241

BEHA VIORAL HEALTHCARE REFERRAL AGENCY

DELTA-T GROUP

www.delta-tgroup.com

ED#14-10/15

Horne Heollh Core & l'-1ursing Services

Preferred Home Health CaJ'e & Nursing Services, Inc.

SCHOOL STAFFING AGREEMENT Student: Jadie! Velesquez

This Agreement is entered into this 20 th day of April 2015, by and between Hillside Board of Education, located at 195 Virginia St. Hillside, NJ 07205, referred to in this Agreement as SCHOOL, and Preferred Home Healt!1 Care & Nursing Services, Inc. including its affiliates and subsidiaries, with an office located at 45 Main Street (Hig/may 35) E(ltOl/tOWIl, N1 07724 referred to in this Agreement as PREFERRED.

SCHOOL requires health care personnel to provide nursing services to SCHOOL students under the general supervision of the SCHOOL and wishes to engage PREFERRED to provide such personnel to supplement SCHOOL staff.

PREFERRED employs health care personnel and is willing to provide such personnel to SCHOOL.

Therefore, SCHOOL and PREFERRED agree to the following terms and conditions.

Section 1.01

Section 2.01

Section 2.02

Section 2.03

Section 2.04

ARTICLE 1. - TERM OF AGREEMENT

Term and Termination. This Agreement will be in effect for one (1) SCHOOL calendar year 711115 -- 6/30/16. Either party may terminate this Agreement at any time, with or without cause, by providing at least thirty (30) days advance written notice of the termination date to the other party. Such termination will have no effect upon the rights and obligations resulting fTom any transactions occurring prior to the effective date of the termination.

ARTICLE 2. - RESPONSIBIUTmS OF PREFERRED

Services. Subject to availability of qualified Personnel CHHAM, RN(s) and LPN(s), PREFERRED will, upon request by SCHOOL, provide one-on-one nursing services to physically and/or mentally challenged SCHOOL STUDENT(s). PREFERRED may also provide a SCHOOL nurse for sick days and vacation days for the regular/full-time SCHOOL nursing staff Services will be provided according to the SCHOOL calendar year, provided by SCHOOL and includes, but not limited to, traveling to and/or from SCHOOL on transportation provided by SCHOOL.

Personnel. PREFERRED will supply SCHOOL with personnel who meet the following criteria:

A. Possess current state license/registration and/or certification, as applicable and appropriate for the services provided to SCI-:IOOL, and possess CPR celtificatiol1, if required by applicable laws, regulations, or accreditation standards, to be presented to SCHOOL Administrator upon request.

B. Meet PREFERRED and SCHOOL conditions of employment regarding health clearance, provision of professional references and any other applicable hiring criteria such as a criminal background check, documentation of which will be kept in the employee file.

Nurse PooL PREFERRED will establish a back-up personnel pool to provide coverage in the event of personnel sickness, vacation or unexpected termination, while still allowing for consistency in STUDENT(s) care.

Insurance. PREFERRED will maintain (at its sole expense), or require the individuals it provides under this Agreement to maintain, a valid policy of insurance evidencing general and professional liability coverage of not less than $1,000,000 per occurrence and $3,000,000 in aggregate covering acts or omissions which may give rise to liability for services under this Agreement. PREFERRED

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Section 2.05

Section 2.06

SectiOJl 3.01

Section 3.02

Section 3.03

Section 3.04

Section 3.05

' .. ~p f d([1) i;·:::·::i: ... ·:. re "erre ..• -1··lome Health Care & Nursing Services

will provide a certificate of insurance evidencing such coverage upon request by SCHOOL.

Additional Insured Status and Certificate of Insurance. The SCHOOL(s), along with their respective officers, agents and employees, shall be named as Additional Insured's for Operations and Products I Completed Operations on the Contractors' Commercial General Liability Policy and the Contractor's Automobile Liability, which must be primary and noncontributory with respect to the Additional Insured's.

Employer Obligations. PREFERRED will follow its standard employment policies and procedures to verify that all personnel meet applicable licensing requirements. PREFERRED, or its subcontractors, if applicable, will maintain direct responsibility as employer for payment of wages and other compensation, and for any applicable mandatory withholdings and contributions such as federal, state, and local income taxes, social security taxes, workers compensation and unemployment insurance.

ARTICLE 3. - RESPONSIBILITIES OF SCHOOL

Responsibility for Student Care. SCHOOL retains full authority for STUDENT(s) care while using PREFERRED personnel.

Individual Education Programs (IEP). Services to be provided will be determined by the individual students IEP. SCHOOL will provide PREFERRED with STUDENT(s) IEP and all duties will be carried out on SCHOOL premises including, but not limited to, the school bus or other mode of trans pOl tat ion when indicated by the STUDENT(s) IEP. SCHOOL agrees and guarantees, through all reasonable and necessary means, that the IEP will not contradict any aspect of STUDENT(s) plan of care, as established by STUDENT(s) physician.

Right to Dismiss. If SCHOOL(s) Board or designee determines that anyone provided by PREFERRED is incompetent, has engaged in misconduct, or has been negligent, SCHOOL may require such personnel to leave the premises and will notify PREFERRED immediately. SCHOOL(s) obligation to compensate PREFERRED for such personnel services will be limited to the number of hours actually worked. PREFERRED will not reassign such personnel to SCHOOL without prior approval of the SCHOOL(s) Board or designee. PREFERRED has the right to cure such incompetence by replacing incompetent personnel with competent personnel.

Insurance. SCHOOL wiII maintain at its sole expense a valid professional liability policy of insurance covering acts or omissions which may give rise to liability for services under this Agreement in an amount generally considered standard in the SCHOOL industry. SCHOOL will forward a copy of its professional liability insurance certificate to PREFERRED prior to execution of this Agreement and will give prompt written notice of any material change in SCHOOL coverage.

Placement Fee. SCHOOL will take no steps to recruit or hire as its own employees those personnel provided by PREFERRED during the term ofthls Agreement. SCHOOL understands PREFERRED is not an employment agency and that personnel are assigned to the SCHOOL to render temporary service(s) and are not assigned to become full-time employees by the SCHOOL. The SCHOOL further acknowledges the substantial investment in business related costs incurred by PREFERRED to include advertisement, recruitment, interviewing, evaluation, reference, checks, training and supervising personnel. In the event that SCHOOL, or any affiliate, subsidiary, department, or division of SCHOOL hires personnel, SCHOOL will be in breach ofthis Agreement and SCHOOL agrees that damages would be too difficult to calculate. Accordingly, SCHOOL agrees that if SCHOOL recruits or hires Personnel who has been introduced to SCHOOL through this Agreement, SCHOOL agrees to give PREFERRED one hundred eighty (180) days notice of its intent to hire, continuing to staff personnel through PREFERRED for a minimum of thirty-six (36) hours per week through the one hundred eighty (180) days notice

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Section 4.01

Section 4.02

Section 5.01

Section 5.02

Section 5.03

Section 5.04

Section 5.05

Section 6.01

Section 6.02

period or SCHOOL agrees to pay PREFERRED liquidated damages ofthir!y thousand dollars ($30,000.00) or the sum ofthiIiy percent (30%) of such Personnel annual salary (calculated as Hourly Pay Rate x 2080 i-lours x 30%), whichever is greater.

ARTICLE 4. - MUTUAL RESPONSIBILITIES

Oricntation. PREFERRED will cooperate with SCHOOL to provide PREFERRED personnel with an adequate and timely orientation to SCHOOL. At a minimum, SCHOOL will orient PREFERRED personnel to its hazardous communication procedures and the SCHOOL - specific Exposure Control Plan as it pertains to OSHA requirements for blood borne pathogens.

Non-discrimination. Neither PREFERRED nor SCHOOL will discriminate on the basis of age, race, color, national origin, religion, sex, disability, being a qualified disabled veteran, being a qualified veteran of the Vietnam era or any other categOlY protected by law.

ARTICLE 5. - COMPENSATION

Rates PREFERRED will supply personnel under this Agreement at the rates listed in Attachment A.

Billing. PREFERRED will submit invoices to SCHOOL every week for personnel provided to SCHOOL. Invoices are to be sent to the following SCHOOL address:

Attcntion: Ken Weinheimer - Business Administrator Hillside Public Schools

195 Virginia st. Hillside, NJ 07205

Payment. All amounts due to PREFERRED are due and payable within thirty (45) days from date of invoice. SCHOOL will send all payment to the following address:

Preferred Home Health Cat·c & Nursing Services, Inc. 45 Main Street (Highway 35)

Eatontown, NJ 07724 (132) 443-8100

Late Payment. Invoices not paid within thirty (30) days from issue date will accumulate interest, until paid, at the rate of one and one-half percent (1.5%) per month on the unpaid balance, equating to an annual percentage rate of eighteen percent (18%) or the maximum rate permitted by applicable law, whichever is less.

Ratc Change. PREFERRED will give SCHOOL at least thiliy (30) days advance written notice of any change in billing/hourly rates.

ARTICLE 6. - GENERAL TERMS

Independent Contractors. The parties enter into this Agreement as independent contractors, and nothing contained in this Agreement will be construed to create a pminership, joint venture, agency or employment relationship between the parties.

Assignment. Neither party may assign this Agreement without the prior written consent ofthe other party, and such consent will not be unreasonably withheld. No such consent will be required for assignment to an entity owned by or under common control with assignor. In any event, the

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Section 6.03

Section 6.04

Section 6.05

Section 6.06

Section 6.07

Section 7.01

. ®

:::(::~\:'~Preferred ~ Home Health Care & Nursing Services

assigning party willl'emain fully responsible for compliance with all the terms of this Agreement.

Indemnification. Both parties, PREFERRED and SCHOOL, agree to indemnify and hold harmless each other, their respective directors, officers, employees and agents from and against any and all claims, actions or liabilities, which may be asserted against them by third pmties in connection with the negligent performance of either PREFERRED or SCHOOL, their respective directors, officers, employees or agents under this Agreement.

Headings. The headings of sections and subsections of this Agreement are for reference only and will not affect in any way the meaning or interpretation of this Agreement.

Entire Contract. This Agreement constitutes the entire contract between SCHOOL and PREFERRED regarding the services covered under this Agreement. Any agreements, promises, negotiations or representations not expressly set forth in this Agreement are of no force or effect. This Agreement may be executed in any number of counterparts, each of which will be deemed to be the original. No amendments to this Agreement will be effective unless made in writing and signed by both parties. This Agreement will be governed by and construed in accordance with the laws of the State of New Jersey.

Availability of Personnel. The parties agree that PREFERRED(s) duty to supply personnel 0))

request of SCHOOL is subject to the availability of qualified SCHOOL personnel. The failure of PREFERRED to provide personnel or the failure of SCHOOL to request personnel results in no penalty and does not constitute a breach of this Agreement.

Compliance with Laws. PREFERRED agrees that all services provided pursuant to this Agreement shall be performed in compliance with all applicable federal, state or local rules and regulations. If any law or regulation is enacted, modified or judicially interpreted so that any section ofthis Agreement would be found not to comply with such law or regulation, such section shall be deemed null and void and this Agreement shall be construed and continued in effect as if such section had never been contained herein.

ARTICLE 7. - CONFIDENTIALITY OF PROTECTED HEALTH INFORMATION

HIP AA Compliance. In instance where PREFERRED received Protected Health Information, (PHI), herein referred to as HlPAA from SCHOOL, PREFERRED agrees that it shall:

1) Comply with the applicable provisions ofthe Administrative simplification section of the Health Insurance POliability and Accountability Acts of 1996, as codified at 42 U.S.C. & J 320d through d-8 (HIPAA), and the requirements of any regulations promulgated there under.

2) No use or further disclosure of any PHI concerning a patient other than as permitted by this Agreement, the requirements ofHIPAA andlor applicable federal regulations. PREFERRED shall implement appropriate safeguards to prevent the use or disclosure of a patient(s) PHI other than as provided for by this Agreement.

3) Promptly report to SCHOOL any violations, use and/or disclosure of a patient(s) PHI not provided for by this Agreement as soon as practicable, upon becoming aware ofthe improper violation(s), use andlor disclosure.

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Home Health Care & Nursin!;) Services

SCHOOL and PREFERRED have acknowledged their understanding of and agreement to the mutual promises written above by executing this Agreement.

Hillside Board of Education Preferred Home Health Care & Nursing Services, Inc.

Signature

.0/7 Signature

.-.-.. ---.---------~ Printed Name and Title Printed Name and Title

Date Date

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I

I

Horne Health Care & Nursin(J Services

ATTACHMENT A PREFERRED flOME HEALTH CARE & NURSING SERVICES, INC.

SCHOOL STAFFING RATES

A school day consists of hours worked. (Eight (8) hours is the standard billing per day, but varies.)

If special needs one-an-one services are provided, charges will be based on a rate of$49 per hour for services rendered by a LPN.

If special needs one-an-One services are provided, charges will be based on a rate of $52 per hour for services rendered by a RN.

SCHOOL:

Signature

Printed Name and Title

Date

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ED#15-10/15

HEALTH CARE STAFFING AGREEMENT

This Health Care Staffmg Agreement ("Agreement") is entered into as of the 1st day of July, 2015, by and between Hillside Board of Education ("School District") Epic Health Services, Inc. and Loving Care Agency, Inc. d/b/a Epic Health Services ("Epic") to provide private duty nursing services to students of School District.

RECITALS

Whereas, the District is committed to providing a free public education to children with special.healthcare needs and disabilities (CSHN) to students residing within the district; and

Whereas, the District must ensure that students with CSHN are provided healthcare services in confonnance with an individualize educational plan (IEP) at no cost to the family; and that such studel1ts have all of the rights of a CSHN who is served directly by the district; and

Whereas, Epic assures that it is licensed and skilled in the provision of healthcare services for CSHN in compliance with all state and federal laws and regulations goveming the provision of healthcare services in an educational setting; and

Whereas, the District desires to engage Epic and Epic desires to be engaged by the District to furnish healthcare services for CSHN who are students of the District.

NOW THEREFORE, for and in consideration of the mutual promises of the parties, and for other good and valuable consideration, the receipt and sufficiency of which is hereby aclmow1edged, the undersigned agree as follows:

1. Staffing Services. Pursuant to the terms and conditions of this Agreement, Epic, agrees to provide nurses (RNs and LPNs) ("Personnel") to School District for private duty nursing services.

2. Qualification Requirements. The Personnel to be provided by Epic to School District under this Agreement must: a. Possess current state license/registration and/or certification, as applicable and appropriate for the

services provided to School District, and possess CPR certification, if required by applicable laws, regulations, or accreditation standards, to be presented to the Administrator for School District, upon request.

b. Meet Epic and School District conditions of employment regarding health clearance (to include proof of pre-employment physical and completed TB questionnaire), provision of professional references, and any other applicable hiring criteria, documentation of which will be leept in the Epic employee file.

3. Insurance. a. Epic will maintain (at its sole expense), 01' require the individuals it provides under this Agreement to

maintain, a valid policy of insurance evidencing general and professional1iability coverage of not less than $1,000,000 per occurrence and $3,000,000 in the aggregate, covering acts or omissions which may give rise to liability for services Ullder this Agreement. Epic will provide a certificate of insurance evidencing such coverage upon request by School District.

b. School District will maintain at its sole expense a valid policy of insurance covering acts or omissions which may give rise to liability for services under this Agreement in an amount generally considered standard in School District's industry. School District will provide to Epic a certificate of insurance evidencing such coverage prior to execution of this Agreement and will give prompt written notice to Epic of any material change in School District's coverage.

HEAL THCARE STAFFING AGREEMENT Page 1

4. Employer Obligations. Epic will follow its standard employment policies and procedures to verHy that all Personnel meet applicable licensing requirements. Epic will maintain direct responsibility as employer for payment of wages and other compensation, and for any applicable mandatory withholdings and contributions such as federal, state, and local income taxes, social security taxes, workers' compensation, and unemployment insurance.

5. Responsibility for Patient Care. School District retains fun authority for patient care while Students attend school. For each student receiving services under this Agreement the District shall provide Epic with a copy of the student's most current Individualized Education Program (IEP) and/or Individualized Healthcare Plan (llIP). Revisions to each student's IEP/IHP shall thereafter be the responsibility of the District's IEP team. Epic and its employees, at the invitation of the District and at the request of a student's IEP team, will be available for participation in the development of IDEA evaluation and reevaluation programs/plans. Applicable rates will apply and are listed in Addendum A.

6. Placement Fee. If School District recnuts or hires anyone provided by Epic who has been introduced to School District through this Agreement, School District will pay Epic a finder's fee of five thousand dollars ($5,000.00) or thhty percent (30%) of the employee's annualized salary, whichever is greater.

7. Right to Dismiss. If School District's director of nursing or designee detel1nines that anyone provided is incompetent, has engaged in misconduct, or has been negligent, School District may require the individual to leave the premises and will notifY Epic immediately. School District's obligation to compensate Epic for such individual's services wlll be limited to the number of hours actually worked. Epic will not reassign the individual to School District without prior approval of the director of nursing.

8. Orientation. Epic will cooperate with School District to provide Personnel with an adequate and timely orientation to School District. At a minimum, School District will orient Epic Personnel to its hazard communication procedures and School District-specific Exposure Control Plan as it pertains to OSHA requirements for bloodbome pathogens.

9. Non-discrimination. Neither Epic nor School District wlll discritninate on the basis of age, race, c010r, national origin, religion, sex, disability, being a qualified disabled veteran, being a qualified veteran of the Vietnam era, or any other category protected by law.

10. Rates. Epic will supply Personnel under this Agreement at the rates listed in Addendum A. Epic will give School District at least thirty (30) days' advance notice of any change in rates, to be mutually agreed upon in writing by both parties. If School District does not object to such rate revision, or otherwise tenninate this Agreement in accordance with its terms, prior to the effective date of such revision, then School District agrees to pay Epic according to such revised rates.

11. Billing. Epic will submit invoices to School District evelY week for Personnel provided to School District. Invoices shall be submitted to School District at School District's Notice Address (as defined in Section 15.a. below).

12. Payment. All amounts due to Epic are due and payable within fifteen (15) days from date of invoice. School District will send all payments to EPIC at the following address:

HEALTHCARE STAFFING AGREEMENT

If To: Loving Care Agency, Inc. d/b/a Epic Health Services Commercial Lock Box P.O. Box 12400 Newark, NJ 07101-3500

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If invoices are not paid within fifteen (15) days from their issue date, such unpaid balance shall accrue interest, and School District agrees to pay interest on such unpaid balance, at the lesser rate of: (a) eighteen percent (18%) pel' annum, and (b) the highest rate allowed by applicable law.

13. Term and Termination. This Agreement will be in effect for one (1) year and will be automatically renewed for an additional one (1) year period at the elld of the first year and each subsequent year unless tenninated. Either party may terminate this Agreement at any time, with or without cause. Such termination will have no effect upon the rights and obligations resulting from any transactions occurring prior to the effective date oftbe ternlination.

14. Indemnification. Epic agrees to indemnify, defend and hold ha11nless School District, its directors, officers, employees, and agents fl:om and against any and all claims, actions, or liabilities which may be asserted against them by third parties in connection with the negligent perfomlance of Epic, its directors, officers, employees, or agents under this Agreement. School District agrees to indemnify, defend and hold ha11l1less Epic, its directors, officers, employees, and agents from and against any and all claims, actions, or liabilities which may be asserted against them by third patiies in comlection with the negligent perfomlance of School District, its directors, officers, employees, or agents under this Agreement.

15. Notices. All notices, requests, consents and other cOlllinunications required or permitted under this Agreement shall be in writing and shall be deemed to have been given if delivered or sent by electronic media, upon receipt, or if sent by registered or certified mail, return receipt requested, upon the sooner of the date on which receipt is acknowledged or the expiration of five (5) days after deposit in United States post office facilities properly addressed with postage prepaid. All notices to a party will be sent to the addresses set forth below 01' to such other address as such party may designate by notice to the other party hereunder:

a. Hillside Board of Education Attn: Kenneth R. Weinheimer Business Administrator / Board Secretary 195 Virginia Street Hillside, NJ 07205 Phone: 908-352-7664 EXT. 6428

b. If To: Epic Health Services, Inc. 5220 Spring Valley Road Suite 400 Danas, TX 75254 P: 201-403-9314 C: 732-236-9831 E: J eanine.stawinski@epichealthservices,com

16. Miscellaneous.

If To: Loving Care Agency, Inc. d/b/a Epic Health Services Attn: Jeatline Stawinski 611 Route 46 West, Suite 200 Hasbrouck Heights, NJ 07604 P: 201-403-9314 c: 732-236-9831 E: Jeanine,[email protected]

a, All captions in this Agreement are intended solely for the convenience of the parties, and none shall affect the meaning or construction of any provision.

b. This Agreement, with the attached Addendum A (with may be amended from time to time pursuant to the terms hereof) constitutes the entire understanding between Epic and School District regarding the subject matter hereof. No prior or present agreements or representations regarding the subject matter hereof shall be binding upon any of the parties hereto unless incorporated in this Agreement. No modification or change in this Agreement shall be valid or binding upon the parties unless in writing and executed by the patiies to be bound thereby.

c. This Agreement may be executed in several counterparts, each of which will be deemed to be an original, and each of which alone and all of which together, shall constitute one and the same

HEALTH CARE STAFFING AGREEMENT Page 3

instrument, but in making proof of this Agreement it shall not be necessary to produce or account for each copy of any counterpatt other than the counterpart signed by the party against whom this Agreement is to be enforced. This Agreement may be transmitted by facsimile, and it is the intent of the parties for the facsimile (or a photocopy thereof) of any autograph printed by a receiving facsimile machine to be an original signature and for the facsimile (or a photocopy thereof) and any complete photocopy of the Agreement to be deemed an original counterpart.

d. This Agreement shall be construed in accordance with the laws of the State of Texas and applicable U.S. federal law and all claims andlor lawsuits in connection with this Agreement must be brought in Dallas County, Texas, wherein exclusive venue shall lie.

e. If a dispute arises out of or relates to this Agreement, or its breach, and if the dispute carnlot be settled through direct discussions, then the patties herein agree to first endeavor to settle the dispute in an amicable manner by mediation, under the applicable provisions of Section 154.001, et seq., TEXAS CIVIL PRACTICE & REMEDIES CODE, as supplemented by the rules of the Association of Att0l1ley Mediators, before having recourse to atlY other proceeding or forum. The parties agree to conduct such mediation in Dallas County, Texas. This provision shall not prevent any of the parties from seeking injunctive relief.

f. Epic agrees that all services provided pursuant to this Agreement shall be perfOlmed in compliance with all applicable federal, state, or local rules and regulations including but not limited to the Family Educational Rights and Privacy Act of 1974, 20 U.S.C. 1232(g), otherwise known as FERPA and; the Individuals with Disabilities Education Act (IDEA), as amended. Epic and District will take all measures necessary to ensure the confidentiality of any and all infonnation in its possession regarding the District's students who receive services from Epic pursuant to the Agreement. The District shall furnish Provider with copies of the District's TIlles, policies and regulations and procedures. If any law or regulation is enacted, modified, or judicially interpreted so that any section of tlus Agreement would be found not to comply with such law or regulation, such section shal1 be deemed null and void and this Agreement shall be construed and continued in effect as if such section had never been contained herein.

g. Except as may be otherwise provided herein and without limiting such other relief to which the prevailing litigant may be entitled under this Agreement and/or applicable law, in the event of litigation regarding this Agreement, the parties hereto agree that, in addition to such other relief to which the prevailing litigant may be entitled under this Agreement and/or applicable law, the prevailing litigant shall be allowed to recover the prevailing litigant's attOlneys' fees and expenses and costs of court from the losing litigant.

h. This Agreement shall bind and inure to the benefit of the parties and their successors and assigns; provided, however, that neither party may assign its rights under this Agreement, except with the prior written consent of the other party. Notwithstanding the preceding, approval shall be deemed given for the assignment of the rights and obligations of a party to an entity owned or controlled by such assigning party.

i. Nothing contained herein or any document executed in connection herewith shall be deemed or construed by the patties hereto, nor by any third party, as creating the relationship of principal and agent, employer and employee, partnership, or joint venture between the parties. The parties hereby declare and aclrnowledge that the relationship existing is one of independent contractor.

IN WITNESS WHEREOF, the pmties hereto have caused this Agreement to be executed as ofthe date set forth above by their duly authorized representatives.


By: Name: Title:

'-

Jeanine Stawinski Manager of School Contracting and Relations

HEALTHCARE STAFFING AGREEMENT

Hillside Board of Education

l By: Name: Kenneth R. Weinheimer Title: Bllsilless Administrator 195 Virginia Street Hillside, NJ 07205

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ADDENDUM A EPIC HEALTH SERVICES

HEALTHCARE STAFFING RATES

A school day consists of homs worked. Eight (8) hours is the typical billing per day, but varies. Hours are recorded in 14 hour increments (15 minutes).

1. For One-On-One nursing services provided on a school campus or otfsite for a school sponsored event; charges will be a based on the following: A. $50.00 per hour for services rendered by an RN. B. $40.00 per hour for services rendered by a LPN.

2. For a Substitute School Nurse service provided on a school campus or offsite for a school sponsored event; charges will be based on a rate of $55.00 per hour for services rendered by anRNorLPN.

3. Transp01tation Services: Nursing transportation services consist of a nurse riding in a school sponsored vehicle with a single special needs student to accompany the child to/from home and their school sponsored destination. No other nursing services are provided. Charges for this service will be based on a rate of $115.00 per trip for services rendered by an RN or LPN.

4. For Nurse Consulting Services to also include, but not limited to consultations with school staff, 504 Reviews, ARDI1EP attendance, and the like; charges will be based on the rate of $55.00 per hour rendered by an RN 01' LPN.

1. A. One-on-One: Registered Nurse (RN) $ 50.00 I hr.

1. B. One-an-One: Licensed Practical Nurse (LPN) $ 40.00 /hr.

2. Substitute School Nurse: Registered Nurse (RN) $ 55.00 /hr.

3. Transportation Services: Registered/ Licensed Practical Nurse (RN/LPN) $ 115.00 I trip

4. Consultations: Registered or Licensed Practical Nurse (RNILPN) $ 55.00 /h1'.


········ED#16;..;.·10/15

CONTRACT FOR "IN SCHOOL" NURSING SERVICES PERTAINING TO #373-33

This AGREEMENT is made and entered into this 3rd day of June, 2015, by BAYADA Home Health Care, Inc., with a service offices located at 6 Commerce Drive, Penthouse, Cranford, NJ 07016 (hereinafter referred to as BAYADA) and Hillside Board of Education, located at 195 Virginia Street, Hillside, New Jersey 07205 (hereinafter referred to as SCHOOL).

BAYADA is a home health care agency, engaged in the business of providing nursing services and SCHOOL has identified a need for in-school nursing care of its student, #373-33, (hereinafter referred to as STUDENT).

WHEREAS, it is the desire of both parties to make provision for on site, daily nursing care for STUDENT, in accordance with the terms of this Agreement.

THEREFORE, in consideration for the mutual covenants expressed herein, BAYADA and SCHOOL agree to the terms and conditions outlined herein:

I. RESPONSIBILITIES OF BAYADA

A. Qualifications of Personnel. The NUrse supplied by BAYADA will be a Registered Nurse (RN) or Licensed Practical Nurse (LPN) who will hold a current license, registration or certification to practice in the State of New Jersey, and will provide services pursuant to the applicable state laws. .

B. Personnel Records Inspection. BAYADA will make available for inspection, upon the request of SCHOOL, the personnel files of its nurses who are caring for STUDENT. The contents of such file must include:

1. Verification of current licensure or certification as applicable; and 2. Completed application for employment or resume; and 3. Verified references; and 4. Evidence of annual performance evaluation; and 5. A criminal record check, conducted upon hire, if required by state law; and 6. Evidence of at least one, annual in-service education or training in accordance with

applicable state regulations.

C. Service. BAYADA will provide an RN or LPN to care for STUDENT each day that said student attends SCHOOL. Nursing services will be provided subject to the availability of a qualified nurse. The services to be provided may include, escorting STUDENT to and from SCHOOL on the school bus and providing care to STUDENT during the school day. Upon execution of this Agreement, SCHOOL will provide BAY ADA with a schedule of the SCHOOL calendar including all scheduled days off.

D. Place of Performance. BAYADA will provide services primarily at schools located within SCHOOL's district or other specified location where STUDENT will be during the school day. SCHOOL acknowledges and understands that BAYADA cannot guarantee services. All services will be provided subject to the availability of a qualified nurse.

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Created on: 6/3/2015

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E. Insurance. All insurance requirements are contained in the attached Hillside Board of Education "Insurance and Indemnification Agreement", which is executed iri conjunction with this Agreement and made a part hereof.

F. Indemnification. All indemnification requirements are contained in the attached Hillside Board of Education "Insurance and Indemnification Agreement", which is executed in conjunction with this Agreement and made a part hereof.

G. Payment of Personnel. BAY ADA, as an employer, will remain responsible for the payment of wages and other compensation, reimbursement of expenses and compliance with Federal, State and local tax withholdings, Workers' Compensation, Social Security, employment and other insurance requirements for its personnel.

H. Equal Opportunity Employment. BAYADA agrees to comply with the New Jersey state requirements of N.J.S.A. 10:5-31 et seq., N.JAC. 17:27, and the Americans With Disabilities Act, where applicable, during the performance of this Agreement and will not discriminate against any employee or applicant for employment because of age, race, creed, color, national origin, ancestry, marital status, affedional or sexual orientation or sex. BAYADA will provide required reports as requested.

I. Policies and Procedures. BAYADA will follow the SCHOOL's policies and procedures while providing care in the SCHOOL setting.

II. RESPONSIBILITIES OF SCHOOL

A. Payment for Services. SCHOOL will remain responsible to compensate BAYADA for services rendered pursuant to' this Agreement. Section III hereunder shall govern billing terms and compensation.

B. Insurance. All insurance requirements are contained in the attached Hillside Board of Education "Insurance and Indemnification Agreement", which is executed in conjunction with this Agreement and made a part hereof.

C. Indemnification. All indemnification requirements are contained in the attached Hillside Board of Education "Insurance and Indemnification Agreement", which is executed in conjunction with this Agreement and made a part hereof.

D. Employment Status. SCHOOL understands and agrees that the RN/LPN is an employee of BAYADA and SCHOOL will not attempt to solicit the RN/LPN to work privately for SCHOOL, without written authorization from BAYADA, during the term of this Agreement and for one (1) year following its termination or expiration. SCHOOL recognizes the recruiting, training and retention expenses that BAY ADA encounters as an employer and acknowledges that BAYADA is not a placement or referral service. Should SCHOOL desire to hire one of BAYADA's employees, SCHOOL agrees to provide BAYADA with written notice and pay a liquidated damages fee equal to four (4) months of the specific employee's annual gross salary or $5,000.00 whichever is greater. This fee shall apply to any BAYADA employee SCHOOL wishes to hire.

E. New Jersey Department of Education Requirements. As required by the New Jersey Department of Education (NJDOE), SCHOOL agrees to sponsor those BAYADA employees who will be providing services within SCHOOL's district. Such sponsorship includes, but is

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not limited to, an NJDOE Criminal History Review. SCHOOL agrees to provide BAY ADA with all NJDOE forms and information necessary for BAYADA's employees to obtain the required Criminal History Review. BAYADA agrees to provide only employees that have been sponsored by SCHOOL and approved by the NJDOE.

F. Compliance Program. BAYADA values honesty and confidentiality in all business interactions. In order to assure adherence to these values, BAYADA maintains a corporate compliance program, designed to detect and prevent illegal and unethical activities, including breaches of confidentiality. SCHOOL agrees to abide by this program, and understands its obligation to report questionable activities involving BAYADA's employees to the local office Director named below or to the Compliance Hotline at 1-866-665-4295.

III. BILLING AND COMPENSATION

A. SCHOOL agrees to compensate BAYADA at a rate of $54.50/hour for RN services or $44.50/hour for LPN services provided under this Agreement. SCHOOL will also pay for all time the BAY ADA employee spends on the bus or otherwise transporting the client to and from SCHOOL.

B. BAY ADA will forward to SCHOOL an itemized bill on a weekly basis. Each weekly bill will itemize the name of the BAYADA employee providing care, the date of service, the type and length of service provided.

C. SCHOOL agrees to pay SUbmitted bills within sixty (60) days of receipt. Any bill not paid within the sixty (60) day period will be considered delinquent. BAY ADA reserves the right to . pursue any collection remedies in an attempt to resolve a delinquent account. SCHOOL agrees to reimburse BAY ADA for all collection costs, including attorneys' fees· and expenses.

IV. TERM AND TERMINATION

A. This Agreement will come into effect beginning on July 1, 2015 and will remain in effect through June 30, 2016. This Ag reement may be extended upon the written consent of each party outlining the terms and time for extension.

B. Either party may terminate this Agreement, for any reason, upon thirty (30) days prior written notice.

C. Either party may terminate this Agreement for cause due to the occurrence of one of the following events by giving ten (10) days prior written notice:

'1. Dissolution or bankruptcy of either BAY ADA or SCHOOL.

2. Failure of either BAY ADA or SCHOOL to maintain the insurance coverages required hereunder.

3. Breach by BAYADA or SCHOOL of any of the material provisions in this Agreement.

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v. ADDITIONAL TERMS

A. Governing Law. This Agreement will be construed and go.verned in all respects acco.rding to the laws of the State of New Jersey.

B. Relationship to Parties. The parties enter into this Agreement as independent contractors. Nothing contained in this Agreement will be co.nstrued to create a partnership, joint venture, agency or employment relationship between the parties.

C. Assignment". This Agreement may not be assigned by either party, in whole or in part.

D. Modification of Terms. No amendments or modifications to. the terms of this Agreement will be binding unless evidenced in writing and signed by an autho.rized representative of each party hereto.

E. Notices. Any Notice given in connection with this Agreement will be given in writing and will . be delivered either by hand or by certified mail, return receipt requested, to the other party, at the party's address stated below. Any party may change its address as stated herein by giving Notice of the change of address in acco.rdance with this Paragraph.

F. Confidentiality. Except for acknowledging the existence of this Agreement, the parties understand and agree that the terms of this Agreement, including all payment terms, shall be kept co.nfidential unless disclosure is required by law o.r the parties agree, in writing, to such dis~losure. All methods and mode of co.nduct of business for SCHOOL and BAY ADA are to be kept confidential by SCHOOL and F;3AYADA and not disclosed to any other party

·or used in part or whole without the permission of SCHOOL and/or BAYADA.

G. Entire Agreement. This writing evidences the entire Agreement between BAY ADA and SCHOOL; there are no prior written or oral promises or representations incorporated herein. Each Attachment, Fee Schedule, Exhibit or other documents referenced herein and/or attached to this Agreement are incorporated herein as if the same was set out in full in the text of this Agreement. This Agreement may be executed in two or more counterparts, each of which will be deemed an original, but all of which together will constitute one and the same instrument. Delivery of an executed signature page of this Agreement by facsimile or electronic (email) transmission shall be effective as delivery of a manually executed counterpart hereof.

Date: __ (p-+-.!--"¥+-I--=lS:::....~ __ _ Date:

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Ken Weinheimer Business Administrator Signing with authority for Hillside Board of Education

REGULATION

PO#l-lO/lS

HILLSIDE BOARD OF EDUCATION

Propeliy 7444/Page 1 of 1

USE OF METAL DETECTORS

7444 USE OF METAL DETECTORS

A. Metal detectors shall be used at school entrances and at activities and events as needed and detennined by the Superintendent or designee and may be either of a walk-through or hand-held design.

B. Security officers at all the schools shall be trained initially with the introduction of a metal detector into the school or district, on the upgrade or change in device type, or on initial hiring. One or more administrator(s) from the schools with the device(s) in their respective buildings should be trained or be familiar with the use of the device(s) used for screening.

C. The principal of each school shall advise the Superintendent or designee of the need for expanded training or re-training of personnel conducting metal detector screemng.

D. The principal of each school shall advise the Superintendent or designee of any recommended changes in the screening protocols to ensure the most effective use of the devices that ensures the safest learning and teaching environment possible.

E. The district shall work closely with the Hillside Police Department, as well as the device vendor(s), in the training on, use of and procedures for metal detector screemng.

F. Each building with device(s) in use, or available for use, shall maintain a record of training for all personnel.

G. The Hillside Public Schools Metal Detector Use and Search/Seizure Handbook shall be reviewed annually by the Superintendent or designee and updated, if needed. The Hillside Police Depmiment and/or legal counsel shall be consulted on an as needed basis for assistance in the review and updating of the handbook.

Issued: 15 October 2015 Revised:

Hillside Public Schools · Agenda Regular Meeting October 15, 2015 CALL TO ORDER: PM FLAG SALUTE...

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