Desert Mountain Charter SELPA Policies and Procedures

Surrogate Parents in California: Appendix B (https://www.cde.ca.gov/sp/se/sr/documents/surrogateparents.pdf)

Sample Forms

Forms used in California in the Surrogate Parent program:

• Request for Surrogate Parent Volunteer: a sample form is made available online by the Los Angeles Unified School District at the link below. https://achieve.lausd.net/cms/lib08/CA01000043/Centricity/Domain/351/ Request%20for%20a%20Surrogate%20Parent%20Form.pdf • Sacramento County Special Education Local Plan Area Surrogate Parent Agreement: see page 56 • Sacramento County Special Education Local Plan Area Notification of Surrogate Parent Authorization: see page 58

Superior Court of California Surrogate Parent Appointment Forms:

• Order Designating Educational Rights Holder (JV-535) - https://www.courts.ca.gov/ documents/jv535.pdf • Local Educational Agency Response to JV-535 - Appointment of Surrogate Parent (JV- 536) - https://www.courts.ca.gov/documents/jv536.pdf

Chapter 4 – Procedural Safeguards, Charter SELPA

Page 98

As of 11/18/2016

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