Special Education 255 Pico Avenue, Suite 250 San Marcos, CA 92069
T 760.752.1299 F 760.471.1898 www.smusd.org
Reverse Mainstream Preschool Program San Marcos Unified School District
(760)752-1238 Thank you for your interest in the Preschool Special Education Reverse Mainstream/Inclusion Program with San Marcos Unified School District. Our preschool program is currently accepting applications for reverse mainstreamers to join the 2015-2016 school year. A reverse mainstreamer is a child who would provide role model behaviors, which include age appropriate language and social skills, for preschool children with special needs. Requirements for Reverse Mainstreamers
• 3.5 or 4 by September 1, 2015*
• Appropriate speech language skills (i.e. makes verbal greetings, participates in conversations by asking questions or making comments with adults and peers, speech is clear and understandable by a stranger).
• Age appropriate play skills (i.e. initiates play and conversation, runs, jumps, throws a ball, pedals a tricycle, demonstrates partner play, and follows directions).
• Age appropriate cognitive skills (i.e. independent in self-help skills, follows a classroom routine with minimal prompting, able to help peers with tasks, follows through with a plan).
• Able to take and follow directions from a variety of adults. • Toilet trained • Resides in San Marcos (school district boundaries)
Program Hours
• Morning (8:25-11:25) • Afternoon (12:10-3:10) • Days: Monday, Tuesday, Thursday, Friday (A child must be available for all four days.)
Selection to participate in the program will be based entirely upon a child’s role model abilities; social interactions, language skills, and behavior skills. Potential candidates will be identified through a demonstration of these skills during a simulated preschool program. We follow a traditional preschool model for expectations and it’s imperative that we ensure personalities blend well and that all children benefit from the program. I further understand that acceptance is for one school year only, and your child may be removed from the program if it is determined it is not a good fit or behavior becomes a concern. Families have the option of reapplying for a second year if their child meets the age eligibility. *Children who are not eligible for the SMUSD Transitional Kindergarten Program.
Special Education 255 Pico Avenue, Suite 250 San Marcos, CA 92069
T 760.752.1299 F 760.471.1898 www.smusd.org
Application for Reverse Mainstream Preschool Program
San Marcos Unified School District
CHILD’S NAME: PARENT(S) NAMES: ADDRESS: PHONE: EMAIL: CHILD’S DATE OF BIRTH: TELL US ABOUT YOUR CHILD:
• Rides tricycle using pedals YES NO • Steers tricycle around obstacles YES NO • Washes and dries own hands YES NO • Puts jacket or t-shirt on independently YES NO • Uses potty on own and indicates need to go YES NO • Feeds self/ eats independently YES NO • Understands waiting and taking turns YES NO • Follows two-step directions YES NO • Chews objects/sucks thumb YES NO • Bites or hits out of frustration YES NO • Initiates play on own YES NO • Separates from parents easily YES NO • Accepts disappointment appropriately YES NO • Has attended school/group activities YES NO • Enjoys socializing with other kids YES NO • Verbally communicates appropriately YES NO (ex. Would a stranger understand your child) • Enjoys pretend play YES NO • Can drink out of a cup or juice box YES NO • Enjoys physical exercise YES NO • Sits in a chair for longer than five minutes YES NO • Expresses feelings appropriately YES NO • Can count to 10, count 5 objects YES NO • Can recite the Alphabet YES NO • Knows shapes/colors YES NO • Can play for at least 10 mins in small group YES NO • My child is speaking in: (circle one)
1-2 word sentences 3-4 word sentences 5 or more word sentences
Special Education 255 Pico Avenue, Suite 250 San Marcos, CA 92069
T 760.752.1299 F 760.471.1898 www.smusd.org
HEALTH: Does your child have any special health concerns? YES NO If “yes”, please explain?
Is your child allergic to anything? YES NO If so, to what?
PREVIOUS SCHOOL/GROUP EXPERIENCES: What school or group experience has your child had? This can include preschool, daycare,
playgroups, church groups, etc… How long has your child been participating?
Describe your child’s favorite toys or play themes:
FAMILY: Tell us with whom your child lives and who they may talk about at school. Please list siblings and their ages?
YOUR COMMENTS: What else would you like for the preschool staff to know about your child? Our family lives in the school area of: _______________________________________________________ My child has siblings attending school at:___________________________________________________
Special Education 255 Pico Avenue, Suite 250 San Marcos, CA 92069
T 760.752.1299 F 760.471.1898 www.smusd.org
List preferences of preschool sites (#1 first choice, #2 second choice, and #3 third choice) Preschool sites currently available in the San Marcos Unified School District are: Alvin Dunn Elementary School _____ Richland Elementary School _____ Carillo Elementary School _____ Twin Oaks Elementary School ______ La Costa Elementary School ______ I prefer my child to attend the: ______AM Session (8:25 am – 11:25 am) ______PM Session (12:10 pm – 3:10 pm) Picture ______I have enclosed a picture of my child. ______I give permission for the SMUSD to take a picture of my child to be used only for the purpose of identifying my child for the Reverse Mainstream Program. . The SMUSD Preschool Coordinator will notify you via mail/email once your child has been selected for the program. At that time, you will be informed of the school site, classroom assignment, as well as morning or afternoon program. Parents will be required to register their child at the school site which requires a copy of a birth certificate, immunizations, and proof of residency. I further understand that acceptance is for one school year only, and my child may be removed from the program if it is determined it is not a good fit or behavior becomes a concern, or if my child has been found eligible for special education services. Please sign below indicating that you agree with and understand the requirements listed above. ______________________________________________ _____________________________ Parent Signature Date
