Patterson Joint Unified School District

Patterson Joint Unified School District

Review of New Program/Grant Proposal - Checklist

(Attach Program Description)

Program Title: / Grant Period:
Submitted by:
Administrator: / Site:
Schedule of program operation (during the school day, after school, weekend)
Anticipated program start date:
Comments
ED SERVICES
Grade Level Involved ☐K-5☐6-8☐9-12☐K-12
Program meets District objectives as outlined in Strategic Plan? / ☐Yes / ☐No
Instructional services considerations reviewed? / ☐Yes / ☐No
Other similar programs (list) / ☐Yes / ☐No
Complements and supports the district’s instructional goals and programs? / ☐Yes / ☐No
Complements the District’s goal of providing comprehensive integrated pupil support programs as outlined in Strategic Plan? / ☐Yes / ☐No
Does the program impact delivery of Health Services/Special Education to students after the regular school day? If yes, how will this be addressed? / ☐Yes / ☐No
Signature/Date______/ Assistant Superintendent, Educational Services
HUMAN RESOURCES
Employment status reviewed, i.e. Short term, temporary, probationary or permanent, certificated or classified? / ☐Yes / ☐No
Budget salaries/fringe benefits compatible with salary schedules/job specification for particular positions required by or proposed for the project? / ☐Yes / ☐No
Collective bargaining considerations reviewed? / ☐Yes / ☐No
Other
Signature/Date______/ Assistant Superintendent, Human Resources
PLANNING AND FACILITIES SUPPORT
Requires classroom or additional space? / ☐Yes / ☐No
What type and how much space? (please list) / ☐Yes / ☐No
Requires remodel and/or tenant improvement to existing space? / ☐Yes / ☐No
Impact on site capacity or long-range plans? / ☐Yes / ☐No
Displaces existing programs? / ☐Yes / ☐No
Impacts enrollment at specific site? / ☐Yes / ☐No
Requires transportation? / ☐Yes / ☐No
New position checklist completed? / ☐Yes / ☐No
Requires financing for capital needs/funding for capital needs? / ☐Yes / ☐No
Cost estimate of needed facilities / ☐Yes / ☐No
Requires extension of utilities, sewer, water, gas, electrical and/or phone? / ☐Yes / ☐No
Is public access and security needed? / ☐Yes / ☐No
Other
Signature/Date______/ Coordinator, Maintenance and Operations
Signature/Date______
TECHNOLOGY
Requires engineering plan for network wiring / ☐Yes / ☐No
Requires LAN (Local Area Network) conduit / ☐Yes / ☐No
Requires switch/hub/router hardware? / ☐Yes / ☐No
Number of computers budgeted? / ☐Yes / ☐No
Any hardware required? / ☐Yes / ☐No
Number of computers
Number of printers
Number of other peripherals
What peripherals are required (storage devices, input devices, etc)?
Any software required? / ☐Yes / ☐No
Is the software a hosted service or server based? / ☐Yes / ☐No
Does this project require development of any in-house applications? / ☐Yes / ☐No
Does the project require and of the following:
New furniture for computers and associated equipment? / ☐Yes / ☐No
Information Systems support? / ☐Yes / ☐No
Data Evaluation? / ☐Yes / ☐No
Mandated Reporting? / ☐Yes / ☐No
Technology Training? / ☐Yes / ☐No
On-going Technology Support? / ☐Yes / ☐No
Computer Systems to complete the following:
What are the server requirements?
Are any additional network drops required? / ☐Yes / ☐No
How many new drops are needed?
Are ports available on MDF/IDF switch to support additions? / ☐Yes / ☐No
Is existing electrical available for equipment at the drop locations? / ☐Yes / ☐No
Is power sufficient for additional equipment? / ☐Yes / ☐No
Signature/Date______/ Technology Department
BUSINESS SERVICES
Requires matching funds or additional District funds? / ☐Yes / ☐No
Requires expenditures of District funds in future years? / ☐Yes / ☐No
District received reimbursement for direct administrative support? / ☐Yes / ☐No
District received reimbursement for indirect administrative support? / ☐Yes / ☐No
Relevant financial report requirements reviewed / ☐Yes / ☐No
In kind contribution required? / ☐Yes / ☐No
Timing of funding and impact on cash flow / ☐Yes / ☐No
Is funding for a limited time or diminishes over time? / ☐Yes / ☐No
Special insurance requirements? / ☐Yes / ☐No
Impacts on school meal program or cafeteria? / ☐Yes / ☐No
Other
Signature/Date______/ Assistant Superintendent, Business Services - Fiscal
SUPERINTENDENT DISTRICT
Final approval for submittal to Governing Board agency / ☐Yes / ☐No
Signature/Date______