Humboldt State University



March 3, 2014

|Learning Site Agreement (LSA) in Place - “Approved” Community Partners |

| |

|Message for Faculty: |

|Please contact Stacy Becker x4963 if you have any questions regarding whether an agency or program is “approved”; some community programs may be covered by |

|currently “approved” agencies with the Learning Site Agreement (LSA) and Learning Site Self-Assessment (SSA) already in place. |

|This is a resource list for faculty use only; it is not designed to be directly distributed to students. |

| |

|Risk Management paperwork required of students at ALL organizations – on campus (HSU Direct Programs) and off campus: |

|The Learning Plan, Participation Guidelines, Student Time Log, and Release of Liability forms are required of HSU students for Service Learning and Academic |

|Internship placements for academic credit. |

|For more information and direct links to required forms, please see our website at: |

|Additionally, specific agencies may have their own required documents. |

|For these forms and further assistance, please contact Stacy Becker at the |

|Center for Service Learning & Academic Internships, 122 Gist Hall, 826-4963, or email spb1@humboldt.edu |

| |

|Community-Based Organizations, Schools & Businesses covered by LSA – “Approved”: |

1. Access Humboldt

2. Adult Day Health Care of Mad River

3. Alcohol / Drug Care Services, Inc.: Serenity Inn

4. Alder Grove Charter School

5. Arcata Animal Hospital

6. Arcata Christian School

7. Arcata Economic Development Corporation

8. Arcata House Partnership

9. Arcata Playhouse

10. Area 1 Agency on Aging

11. Baroni DBA Plaza Home

12. Baroni Designs

13. Bear River Band of Rohnerville Rancheria / Bear River Casino

14. Big Brothers Big Sisters of the North Coast

15. Bird Ally X [inc. Humboldt Wildlife Care Center]

16. Blue Lake Family Resource Center

17. Bonanza Ranch

18. Boys and Girls Club of the Redwoods [inc. Club Houses, Teen Center, Teen Court]

19. Bureau of Land Management – Arcata Field Office

20. California Conservation Corps: Watershed Stewards Project

21. CarStations, Inc.

22. Catholic Charities of the Diocese of Santa Rosa [inc. Betty Kwan Chinn Homeless Foundation; and Betty Chinn Day Center in Eureka]

23. Cher-Ae Heights Indian Community of the Trinidad Rancheria

24. Children of the Redwoods Infant & Toddler Center

25. City of Arcata An additional City of Arcata Volunteer Packet, including livescan/background check, is required of all students serving with the City in ongoing volunteer positions; this packet will be distributed as needed by the City staff overseeing the student. Please inform the HSU Center for Service Learning & Academic Internships (CSLAI) about ANY placements with City programs, as these need to be reported to the City Personnel Director, Danette Demello. At the Arcata Marsh, "Interpretive/Marsh tours" work ONLY is covered by the City of Arcata LSA. For more info, please contact the CSLAI at x 4963.

26. City of Blue Lake

27. City of Billings, Montana: Environmental Affairs Division; Water Treatment Plant Lab; Planning Division

28. City of Eureka

29. Clarke Museum

30. Coastal Grove Charter School

31. Coast Central Credit Union

32. College of the Redwoods

33. Commercial Fishermen's Wives of Humboldt

34. Community Alliance with Family Farmers [inc. Farm to School Docent Program-at Redwood Roots Farm; and Harvest of the Month programs]

35. Consumer Credit Counseling Service of the North Coast

36. County of Humboldt [all departments; inc. Headwaters Fund] Please inform the HSU Center for Service Learning & Academic Internships (x 4963) about any placements with County program), as these need to be reported to the Deputy County Administrative Officer, Amy Nilsen.

37. Court Appointed Special Advocate of Humboldt (CASA)

38. Dick Taylor Craft Chocolate

39. Discovery Museum [inc. Discovery Camp]

40. Dominique Lascaud Production

41. East Bay Regional Park District

42. Emma Center

43. Environmental Protection Information Center (EPIC)

44. EPT Rehabilitation for HSU Kinesiology Dept. Academic Interns

45. Fire and Light

46. Food for People [Humboldt County Food Bank]

47. Friends of the Dunes

48. Fuente Nueva Charter School

49. Girl Scouts of Northern California

50. Gracelyn Home Care

51. Green Diamond Resource Company

52. Greenway Partners

53. Growing Tree Family Child Care for HSU Child Development Dept. placements

54. Headlands Center for the Arts

55. HealthSPORT for HSU Kinesiology Dept. Academic Interns

56. Holly Yashi

57. Humboldt Area Foundation [inc. Redwood Coast Rural Action, Humboldt Made]

58. HSU Bookstore

59. Humboldt Arts Council [inc. Morris Graves Museum]

60. Humboldt Bay Harbor District

61. Humboldt Baykeeper

62. Humboldt Community Access and Resource Center (HCAR) [inc. The Studio and Cheri Blackerby Gallery]

63. Humboldt Community Breast Health Project

64. Humboldt County Central Democratic Committee

65. Humboldt County Historical Society

66. Humboldt County Office of Education: Programs [SSAs Received: Court & Community Schools—Student Assistance Center.]

67. Humboldt County Office of Education: Afterschool Consortium [SSAS received: Blue Lake Union School, Bridgeville School, Peninsula School, Redway School, Scotia School, So. Fortuna Elem, Toddy Thomas, Trinidad Union School]

68. Humboldt County Resource Conservation District

69. Humboldt Domestic Violence Services

70. Humboldt Folklife Society

71. Humboldt Hotsauce

72. Humboldt Light Opera Company

73. Humboldt Physical Therapy, Inc. for HSU Kinesiology Dept. Academic Interns

74. Humboldt Regeneration

75. Humboldt Senior Resource Center [Arcata Senior Lunch Site]

76. Humboldt Trails Council [inc. Volunteer Trail Stewards]

77. Hydesville Elementary School District

78. Ink People Center for the Arts [inc. all sponsored programs]

79. , LLC

80. Jacoby Creek Land Trust

81. Jessicurl

82. Kokatat

83. KRCR - TV Channel 7 [Redding, CA]

84. LatinoNet

85. Little Learners Preschool for HSU Child Development Dept. placements.

86. Little Redwoods Preschool HSU Child Development Dept. placements

87. Los Angeles County Superior Court [expires 6/9/14]

88. Los Bagels

89. Lost Coast Brewery & Café

90. Lost Coast Communications, Inc. [inc. KHUM, KSLG, KWPT, KXGO, LOCO-Lost Coast Outpost]

91. Mad River Brewing Company

92. Mad River Montessori Preschool

93. Mad River Radio [special LSA expires 10/2/14]

94. Marimba One

95. Martial Athletics for HSU Kinesiology Dept. Academic Interns

96. Mattole Unified School District [inc. North Coast Learning Academy, Mattole Valley Charter School, etc.]

97. McKinleyville Community Services District [inc. First Five Playgroup hosted by MCSD Parks & Rec]

98. Miranda’s Rescue

99. National Center for Youth Law

100. National Park Service: Redwood National Park

101. Natural Decadence

102. NBC Universal Bravo Network [Burbank, CA]

103. Northcoast Children’s Services [inc. the following 16 Head Start or State Preschool locations: Alice Birney; Crescent City; Fortuna; Jefferson; McKinleyville; Orleans; Pine Grove; Rio Dell; Smith River; Sonoma Street; Toddy Thomas Head Start - Preschool; Willow Creek; Winzler; Worthington; Children of the Redwoods Infant Toddler Center; Children of the Redwoods Head Start.]

104. North Coast Co-op

105. North Coast Rape Crisis Team

106. North Coast Veterans Resource Center

107. North Coast Veterinary Hospital [Arcata, Fortuna]

108. Northcoast Environmental Center

109. Northern California Indian Development Council

110. Northern California Small Business Development Network/Office for Economic, Community & Business Development

111. Northern Redwood Federal Credit Union

112. Office of Assemblyman Wesley Chesbro

113. Ohana Organics

114. Ohlone College [Fremont, CA]

115. Open Door Community Health Centers

116. Planwest Partners

117. Q Center [Portland, OR]

118. Redwood Acres – 9th District Agricultural Association

119. Redwood Alliance [inc. Zero Waste Humboldt; Hope Coalition]

120. Redwood Capitol Bank

121. Redwood Coast Energy Authority

122. Redwood Community Action Agency (RCAA) [inc. Youth Services Bureau- RAVEN Project; Family Services Division-Multiple Assistance Center (MAC); Natural Resources Division; etc.]

123. Redwood Community Radio – KMUD

124. Redwood Empire Public Television, Inc. –KEET TV

125. Redwood Region Economic Development Commission

126. Redwoods and Rivers [Big Bar, CA]

127. Regents of the University of California, on behalf of University of California Cooperative Extension Humboldt-Del Norte Counties [inc. 4-H Youth Programs] for HSU Kinesiology Dept. Academic Interns

128. Rehabilitation and Wellness Centers (LP) [inc. Granada, Seaview, Pacific, Eureka, Fortuna sites]

129. Rohnerville School District

130. Sainte Partners II, L.P. [for KVIQ-Channel 6, Eureka, CA]

131. Salvation Army: Silvercrest Residences

132. Sanctuary Forest

133. Santa Cruz Museum of Art and History

134. Sewell Gallery

135. Seventh Generation Fund for Indian Development

136. Six Rivers Planned Parenthood

137. Southern Humboldt Community Park

138. St. Bernard’s Catholic School

139. St. Joseph Hospital System [inc. Santa Rosa Memorial Hospital, SRM Alliance Hospital Services dba Petaluma Valley Hospital, Queen of the Valley Medical Center, St. Joseph Hospital in Eureka and Redwood Memorial Hospital. This is a “Clinical and non-clinical training Affiliation Agreement.”] for HSU Kinesiology Dept. Academic Interns

140. State of California - California Department of Corrections and Rehabilitation - Division of Adult Parole Operations [expires 1/15/15]

141. StreamGuys, Inc.

142. Streamline Planning Consultants

143. The Mill Yard

144. The Watershed Center [inc. Indian Valley Summer Camp]

145. Timber Ridge [McKinleyville & Eureka sites]

146. Tri-County Independent Living

147. Trikone [San Francisco]

148. Trillium Charter School

149. Trinidad Museum

150. Trumpet Behavioral Health

151. U.S. Coast Guard [Marine Safety Detachment Unit - Humboldt Bay]

152. U.S. Fish and Wildlife – Humboldt Bay National Wildlife Refuge

153. Union Street Charter School

154. United Indian Health Services [inc. Potawot Community Health Garden]

155. United Way

156. United States Servas

157. University of California, Office of the President

158. Vector Rehabilitation for HSU Kinesiology Dept. Academic Interns

159. Westside Community Improvement Association [Jefferson Community Center]

160. Williamson Financial Group

161. Wing Inflatables

162. Wiyot Tribe

163. Wool Tree Mill

164. Yurok Tribe: All Programs except Head Start

165. Yurok Tribal Head Start

|Additional “Approved” Community Partners |

|Hum. Co. Schools/Districts |HSU – Related Programs |

|Covered by Teacher Education Agreements 2013-14 |(No LSA required) |

|(The Teacher Ed Agreements in place with the following entities have been | |

|approved by the HSU Risk Manager as sufficient to cover both Service Learning and| |

|Academic Internship placements, as well as Teacher Ed students): | |

| | |

|Arcata School District |HSU Programs/Departments |

|Blue Lake Union School District |(No LSA required) |

|Bridgeville School |The Learning Plan, Participation Guidelines, Student Time Log, and Release of |

|Columbia Elementary School District |Liability forms are required of HSU students serving with HSU programs for |

|Cotati-Rohnert Park Unified S.D. of Sonoma Co. |academic credit (see examples below). Please note: students serving in HSU |

|Cuddeback Union School District |Programs MUST be supervised by professional (non-student) staff. |

|Cupertino Union School District | |

|Cutten Elementary School District |Examples: |

|Del Norte County School District |Advancement Foundation |

|Eureka Unified School District |Associated Students |

|Evergreen Union S.D. of Shasta Co. |CA Center for Rural Policy |

|Ferndale Unified School District |HSU Academic Departments |

|Fieldbrook School District |HSU Center for International Programs |

|Fortuna Union Elem School District |HSU Children’s Center [reserved for Child Dev. Classes] |

|Fortuna Union High School District |HSU: Marketing and Communications (Marcom) |

|Freshwater School District |HSU Natural History Museum |

|Garfield School District |HSU: Student Health Center |

|Green Point School District |HSU: The Studio School |

|Humboldt County Office of Education |HSU: Marine Lab |

|Jacoby Creek Charter School District |Indian Tribal Education & Personnel Program (ITEPP) |

|Junction Elementary School District |KHSU |

|Klamath-Trinity Joint Unified School District |MultiCultural Center |

|Kneeland Elementary School |Schatz Energy Research Center |

|Lake Elsinore Unified School District |Sponsored Programs Foundation |

|Lakeport Unified School District |University Center |

|Los Angeles Unified School District |Y.E.S. Programs [different risk mgt paperwork may be required] |

|Los Gatos – Saratoga UHSD | |

|McKinleyville Union School District |The following HSU programs are NOT available as Learning Sites, due to no |

|Mendocino Unified School District |professional (non-student) staff available for supervision: |

|Newport-Mesa Unified School District |Campus Center Appropriate Technology |

|Northern Humboldt Union High School District |Eric Rofes Queer Resource Center |

|Orick School District |Graduation Pledge Alliance |

|Pacheco Union SD |Student Access Gallery |

|Pacific Union School District |Women's Resource Center |

|Peninsula Union School District |[pic] |

|Rio Dell School District | |

|Rohnerville School District |HSU “OTHER OUTSIDE” Programs (LSA required): |

|San Lorenzo Valley Unified School District |In addition to the Learning Plan, Participation Guidelines, Student Time Log, |

|Scotia School District |and Release of Liability forms, each of the following programs may have its own |

|Sonoma County Office of Education |agency-specific volunteer forms naming the student a volunteer of its own |

|South Bay Union School District |program. These sites include: |

|Sweetwater Union High School District |HSU Bookstore [LSA in place] |

|Temecula Valley Unified SD |Northern California Small Business Development Network/ Office for Economic, |

|Trinidad Union School District |Community, & Business Development: [LSA in place] |

|Trinity Alps Unified School District | |

|Yreka Union High School District | |

| | |

|Kinesiology / Recreation Administration -- Academic Internship “Approved” Sites |

| |

|Message for Faculty: |

|Please contact Stacy Becker x4963 if you have any questions regarding whether an agency or program is “approved”; some community programs may be covered by |

|currently “approved” agencies with the LSA already in place. |

|This is a resource list for faculty use only; it was not designed to be directly distributed to students. |

| | |

|“Approved” Agencies covered by LSA |“Approved” Agencies covered by “Clinical Agreements” |

|[grey highlights =local/available for other HSU departments] |Updated 7/3/13 |

| | |

|24 Hour Fitness Super Sport [Lakewood, CA] |St. Joseph Hospital System [inc. Santa Rosa Memorial Hospital, SRM Alliance |

|Accelerate Sports Performance [San Francisco, CA] |Hospital Services dba Petaluma Valley Hospital, Queen of the Valley Medical |

|Apple Wellness |Center, St. Joseph Hospital in Eureka and Redwood Memorial Hospital. This is a |

|Body Kinetics [Novato & Mill Valley Sites] |“Clinical and non-clinical training Affiliation Agreement.”] |

|Delaware North Company (DNC) – Wellness Center [Yosemite, CA] |Alderete Chiropractic |

|Department of Veteran's Affairs San Diego Medical Center [San Diego, CA] |Athletic Evolution |

|ept Rehabilitation [Eureka, CA] |Carmichael Training Systems |

|HealthSPORT |Cressey Performance, LLC |

|Humboldt Physical Therapy, Inc [Arcata, CA] |Duke University Health System, Inc. (annual auto renewal) |

|Iconic Innovations, Inc. [Studio City, CA] |Elemental Training Center |

|Jill B. Nimble/Nimble Training [Santa Rosa, CA] |Enloe Medical Center |

|Kern County Public Health Services Department |Fit Stop Human Performance Lab |

|Martial Athletics [Arcata, CA] |Green Mountain at Fox Run |

|Philippi Sports Institute [Las Vegas, NV] |Health Solutions, Inc. |

|Plus One Holdings, Inc. [inc. San Jose CA Cisco Systems] |L & T Health & Fitness |

|Rawmana Fitness [San Diego, CA] |Mad River Hospital - Pre-Physical Therapy and Exercise Science |

|Regents of the University of California, on behalf of University of California |Mustang Soccer League |

|Cooperative Extension Humboldt-Del Norte Counties [inc. 4-H Youth Programs] |Notre Dame |

|Shasta Family YMCA [Redding, CA] |Orange County Fire Authority |

|St. Joseph Hospital System [inc. Santa Rosa Memorial Hospital, SRM Alliance |Physiotherapy Associates |

|Hospital Services dba Petaluma Valley Hospital, Queen of the Valley Medical |Plus One Health Management, Inc. (Marathon Energy Club) |

|Center, St. Joseph Hospital in Eureka and Redwood Memorial Hospital. This is a |Providence Health & Services Alaska |

|“Clinical and non-clinical training Affiliation Agreement.”] |ReActive Gym |

|The Oaks at Ojai |Redwoods Community College District |

|University of Colorado at Boulder |Renown Health |

|University of Southern California - Recreational Sports |Saint Joseph Hospital- Santa Rosa Mem, Petaluma, Queen of the Valley |

|Vector Rehabilitation |Saint Joseph Hospital Child Dev. - SEE LSA |

| |Scripps Hospital |

| |South Side Strength & Fitness |

| |TJ's Gym |

| |University of Pittsburgh |

| |Velocity Sports, Dublin |

| |Yosemite Community College District - Columbia |

LSAs in Progress – NOT yet “Approved”

1. CA Department of Fish & Wildlife

2. CA State Parks

3. Companion Animal Foundation

4. Gala Events and Weddings

5. Harkness Center for Dance Injury, NYU Langone Medical Center [New York, NY] - For KINS dept. only [Clinical]

6. Heald College

7. Humboldt Bay Tourism Center

8. Humboldt County Republican Central Committee

9. IMPAQ International

10. Los Angeles Valley College

11. Mad River Alliance

12. National Marine Fisheries Service

13. National Park Service [at national level- beyond Redwood Natl. Parks]

14. North Coast Laboratories

15. Redwood Jazz Alliance

16. Santa Ana Community College/Centennial Education Center

17. Six Rivers National Forest - Supervisor's Office

18. Sonoma County Water Agency

19. State of California - Superior Court of California

20. Sun Valley Group

21. U.S. Fish & Wildlife Service: Arcata Office

22. U.S. Navy Marine Mammal Program [San Diego, CA] - On Hold: this entity will not consider the LSA paperwork until an HSU student is clearly identified and accepted into their Internship program.

23. U.S.D.A. Forest Service

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