Procedure – Category 5000 (Students) AR 5005.4 – SELPA Referral Procedures
B. Referral Procedures Forward the following completed documents to the attention of the Area Director for San Bernardino County Superintendent of Schools (SBCSS), Desert/Mountain Operations (DMOPs). • DM 108 – Initial Request for Audiological Evaluation/Services • DM 66 – Assessment Plan • DM 63 – Authorization for Use and/or Disclosure of Information • IEP or IEP Addendum dated within one year of the referral for an audiological assessment. • LEA’s hearing screening form that documents a minimum of two repeated failures on threshold tests or previous audiological assessment reports and/or audiograms for students who have an identified hearing loss. NOTE: This does not apply to DMOPs. C. Timeline for Assessment The audiological assessment must occur within 60 calendar days from the date the Assessment Plan (DM 66) was received by the LEA. When the signed Assessment Plan is received by the LEA, it should be date stamped or the date entered in the field at the bottom of the Assessment Plan. An Audiology Assessment Calendar is published on an annual basis at the beginning of each school year. The calendar lists the scheduled assessment dates and referral due dates for each LEA within the SELPA that participates in the SELPA Audiological Program. The calendar can be found on the CAHELP website at www.cahelp.org. For students who require services outside of the regularly scheduled LEA visit, services may be coordinated between the SELPA and the LEA. Arrangements may be made for students to be served at the school site, at a nearby LEA, the Desert Mountain Children’s Center (DMCC), or at the service provider’s office, whichever is available and appropriate. Please contact the CAHELP Chief Executive Officer at the CAHELP for assistance. D. Timeline for Services
AR 5005.4 – SELPA Referral Procedures Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 8/9/22)
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