Humboldt State University



May 30, 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 Core Pilates for HSU Kinesiology Dept. Academic Interns

8. Arcata Economic Development Corporation

9. Arcata House Partnership

10. Arcata Playhouse

11. Area 1 Agency on Aging

12. Baroni DBA Plaza Home

13. Baroni Designs

14. Bay Area Packaging [Lafayette, CA]

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

16. Big Brothers Big Sisters of the North Coast

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

18. Blue Lake Family Resource Center

19. Bonanza Ranch

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

21. Bureau of Land Management – Arcata Field Office

22. California Conservation Corps: Watershed Stewards Project

23. CarStations, Inc.

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

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

26. Children of the Redwoods Infant & Toddler Center

27. 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.

28. City of Blue Lake

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

30. City of Eureka

31. City of Fortuna [inc. Parks & Recreation; Planning Division; Riverlodge Conference Center; Finance Dept.]]

32. Clarke Museum

33. Coastal Grove Charter School

34. Coast Central Credit Union

35. College of the Redwoods

36. Commercial Fishermen's Wives of Humboldt

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

38. Consumer Credit Counseling Service of the North Coast

39. County of Humboldt [all departments; inc. Headwaters Fund, Coroner's Office…] 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.

40. Court Appointed Special Advocate of Humboldt (CASA)

41. Dell'Arte International

42. Dick Taylor Craft Chocolate

43. Discovery Museum [inc. Discovery Camp]

44. Dominique Lascaud Production [France]

45. East Bay Regional Park District [Oakland, CA]

46. Emma Center

47. Environmental Protection Information Center (EPIC)

48. EPT Rehabilitation for HSU Kinesiology Dept. Academic Interns

49. Fire and Light

50. Food for People [Humboldt County Food Bank]

51. Friends of the Dunes

52. Fuente Nueva Charter School

53. Gala Events and Weddings

54. Girl Scouts of Northern California

55. Gracelyn Home Care

56. Green Diamond Resource Company

57. Greenway Partners

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

59. Headlands Center for the Arts

60. Heald College [expires 6/1/14]

61. HealthSPORT for HSU Kinesiology Dept. Academic Interns

62. Holly Yashi

63. Hoopa Tribal Civilian Community Corps/AmeriCorps on Native Lands

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

65. HSU Bookstore

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

67. Humboldt Bay Harbor District

68. Humboldt Bay Municipal Water District

69. Humboldt Baykeeper

70. Humboldt Center for Constitutional Rights

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

72. Humboldt Community Breast Health Project

73. Humboldt County Central Democratic Committee

74. Humboldt County Historical Society

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

76. 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]

77. Humboldt County Resource Conservation District

78. Humboldt Crossfit

79. Humboldt Domestic Violence Services

80. Humboldt Folklife Society

81. Humboldt Hotsauce

82. Humboldt Light Opera Company

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

84. Humboldt Patient Resource Center

85. Humboldt Regeneration

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

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

88. Hydesville Elementary School District

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

90. , LLC [Internet based business]

91. Jacoby Creek Land Trust

92. Jessicurl

93. Kayak Zak's [inc. Big Lagoon Park Rd.; 115336 Hwy 101, Trinidad; Indian Beach, Trinidad]

94. Kokatat

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

96. LatinoNet

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

98. Little Redwoods Preschool for HSU Child Development Dept. placements

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

100. Los Angeles Valley College [Valley Glen, CA]

101. Los Bagels

102. Lost Coast Brewery & Café

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

104. Mad River Alliance [for OFF site (HSU self-directed) work only; expires 4/17/15]

105. Mad River Brewing Company

106. Mad River Montessori Preschool

107. Mad River Radio [expires 10/2/14]

108. Marimba One

109. Martial Athletics for HSU Kinesiology Dept. Academic Interns

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

111. McKeever Energy and Electric, Inc.

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

113. Medical Staffing Network

114. Miranda’s Rescue

115. National Center for Youth Law [Oakland, CA]

116. National Park Service: Redwood National Park

117. Natural Decadence

118. NBC Universal Bravo Network [Burbank, CA]

119. 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.]

120. North Coast Co-op

121. North Coast Rape Crisis Team

122. North Coast Veterans Resource Center

123. North Coast Veterinary Hospital [Arcata, Fortuna]

124. Northcoast Environmental Center

125. Northern California Indian Development Council

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

127. Northern Redwood Federal Credit Union

128. Office of Assemblyman Wesley Chesbro

129. Ohana Organics

130. Ohlone College [Fremont, CA]

131. Open Door Community Health Centers

132. Planwest Partners

133. Professional Climbers International Ops [Portland, OR]

134. Q Center [Portland, OR]

135. Rancho Santiago Community College District on behalf of Santa Ana Community College [1530 W. 17th St. Santa Ana, CA]

136. Redwood Acres – 9th District Agricultural Association

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

138. Redwood Capitol Bank

139. Redwood Coast Energy Authority

140. Redwood Coast Montessori

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

142. Redwood Community Radio – KMUD

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

144. Redwood Region Economic Development Commission

145. Redwoods and Rivers [Big Bar, CA]

146. Redwoods Rural Health Center

147. 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

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

149. Remote Control Productions [Santa Monica, CA]

150. Rohnerville School District

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

152. Salvation Army: Silvercrest Residences

153. Samoa Peninsula Fire District

154. Sanctuary Forest

155. Santa Cruz Museum of Art and History [Santa Cruz, CA]

156. Sewell Gallery

157. Seventh Generation Fund for Indian Development

158. Six Rivers Planned Parenthood

159. South Bay BMW [Torrance, CA]

160. Southern Humboldt Community Park

161. St. Bernard’s Catholic School

162. St. Joseph Hospital System [This is a “Clinical and non-clinical training Affiliation Agreement;” expires 5/2/17. Covers 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. No SSAs on file.] for HSU Kinesiology Dept. Academic Interns

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

164. StreamGuys, Inc.

165. Streamline Planning Consultants

166. Sun Valley Group [this agency may require HSU Intellectual Property Addendum, depending on internship work]

167. The Mill Yard

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

169. Timber Ridge [McKinleyville & Eureka sites]

170. Tri-County Independent Living

171. Trikone [San Francisco, CA]

172. Trillium Charter School

173. Trinidad Museum

174. Trumpet Behavioral Health

175. UPLIFT San Diego [San Diego, CA; covers multiple sites under this agency]

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

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

178. U.S.D.A. Six Rivers National Forest - Supervisor's Office [SSA for Bayshore Way Office]

179. Union Street Charter School

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

181. United Way of the Wind Country

182. United States Servas

183. University of California, Office of the President [Oakland, CA]

184. Vector Rehabilitation for HSU Kinesiology Dept. Academic Interns

185. Vixen Kitchen

186. Westside Community Improvement Association [Jefferson Community Center]

187. Williamson Financial Group

188. Wing Inflatables

189. Wiyot Tribe

190. Wool Tree Mill

191. Yurok Tribe: All Programs except Head Start

192. 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 [inc. TRiO Upward Bound] |

|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 [inc. Pacific Union Adult School] |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] |Alderete Chiropractic |

|Accelerate Sports Performance [San Francisco, CA] |Athletic Evolution |

|Apple Wellness [Austin, TX] |Carmichael Training Systems |

|Arcata Core Pilates |Cressey Performance, LLC |

|Body Kinetics [Novato & Mill Valley Sites] |Duke University Health System, Inc. (annual auto renewal) |

|Cornerstone Physical Therapy [Cottonwood, CA] |Elemental Training Center |

|Delaware North Company (DNC) – Wellness Center [Yosemite, CA; includes all areas,|Enloe Medical Center |

|Community Wellness Center, Pool, etc.] |Fit Stop Human Performance Lab |

|Department of Veteran's Affairs San Diego Medical Center [San Diego, CA] |Green Mountain at Fox Run |

|Diakadi Body [San Francisco] |Health Solutions, Inc. |

|ept Rehabilitation [Eureka, CA] |L & T Health & Fitness |

|HealthSPORT |Mad River Hospital - Pre-Physical Therapy and Exercise Science |

|Humboldt Physical Therapy, Inc [Arcata, CA] |Mustang Soccer League |

|Iconic Innovations, Inc. [Studio City, CA] |New York University- Hospital for Joint Diseases [inc. Harkness Center for Dance |

|Jill B. Nimble/Nimble Training [Santa Rosa, CA] |Injuries] |

|Kern County Public Health Services Department [Bakersfield, CA] |Notre Dame |

|Martial Athletics [Arcata, CA] |Orange County Fire Authority |

|NYU Hospital for Joint Diseases [inc. Harkness Center for Dance Injuries] |Physiotherapy Associates |

|Philippi Sports Institute [Las Vegas, NV] |Plus One Health Management, Inc. (Marathon Energy Club) |

|Plus One Holdings, Inc. [inc. San Jose CA Cisco Systems] |Providence Health & Services Alaska |

|POM Wonderful Fitness Center [Del Rey, CA] |ReActive Gym |

|Rawmana Fitness [San Diego, CA] |Redwoods Community College District |

|Regents of the University of California, on behalf of University of California |Renown Health [Expires 6/9/17] |

|Cooperative Extension Humboldt-Del Norte Counties [inc. 4-H Youth Programs] |St. Joseph Hospital System [This is a “Clinical and non-clinical training |

|Shasta Family YMCA [Redding, CA] |Affiliation Agreement;” expires 5/2/17. Covers Santa Rosa Memorial Hospital, SRM |

|St. Joseph Hospital [Expires 7/30/17. Covers Kinesiology Pre-Physical Therapy |Alliance Hospital Services dba Petaluma Valley Hospital, Queen of the Valley |

|Practica only- no “Hands on.” SSA on file for: St. Jo’s Physical Therapy Dept- |Medical Center, St. Joseph Hospital in Eureka and Redwood Memorial Hospital. No |

|2700 Dolbeer, Eka.] |SSAs on file.] |

|Tahoe Whitewater Tours [Truckee, CA] |Scripps Hospital |

|The Oaks at Ojai [Ojai, CA] |South Side Strength & Fitness |

|University of Colorado at Boulder |TJ's Gym |

|University of Southern California - Recreational Sports |University of Pittsburgh |

|Vector Rehabilitation |Velocity Sports, Dublin |

| |Yosemite Community College District - Columbia |

| | |

| | |

| | |

LSAs in Progress – NOT yet “Approved”

1. Adrenaline Performance Center [Montreal, Quebec] [For KINS dept. only]

2. California Department of Fish & Wildlife

3. California State Parks

4. Camp Gold Arrow [Clovis, CA] [Waiting on Burghart’s approval; sent 5/23/14]

5. Cardiovascular Associates of Marin [For KINS dept. only] [Waiting on Burghart’s approval; sent 5/23/14]

6. Companion Animal Foundation

7. Cumulus Media San Francisco [San Francisco, CA; Includes KFOG 104.5, KNBR 680, 107.7 The Bone, KGO 810, KSFO 560] [Waiting on Burghart’s approval; sent 5/28/14]

8. Disney World Wide Services, Inc.

9. Ebert Capital Management [5/23/14: HOLD-We can re-approach when there is a student definitely being considered for internship]

10. Fit Nor Cal

11. Good Samaritan Hospital/ Cardiac Rehabilitation [Los Angeles, CA] [For KINS dept. only] [Students serving at this site are required by this site to have their own health insurance; please be prepared to show proof.]

12. Heart Works Cardiac Rehab Center [Santa Rosa, CA] [5/29/14: We have signed LSA; we’re now waiting on new “BAA” Agreement required by agency to be approved by HSU Risk Management]

13. Humboldt County Republican Central Committee [Need Site Self-Assessment from agency; multiple requests have been made]

14. Humboldt Mediation Services

15. Humboldt Plan It Green

16. Kaiser Permanente [South Sacramento, CA] [For KINS dept. only]

17. Lima’s Pharmacy [Waiting on Burghart’s approval; sent 5/29/14]

18. Manila Community Services District [inc. Manila Community Resource Center] [Waiting on Burghart’s approval; sent 5/28/14]

19. National Marine Fisheries Service

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

21. Northtown Coffee [Waiting on Burghart’s approval; sent 5/29/14]

22. Om Shala Yoga LLC

23. Praxis Fitness, LLC [Waiting on Burghart’s approval; sent 5/28/14]

24. Scribe America for HSU Kinesiology Dept. Academic Interns

25. Scripps Research Institute [La Jolla, CA] [Waiting on Burghart’s approval; sent 5/30/14]

26. Sonoma County Water Agency [Santa Rosa, CA]

27. Sports Reaction Center [Bellevue, WA] [Waiting on Burghart’s approval; sent 5/28/14]

28. State of California - Superior Court of California [Eureka, CA]

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

30. 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.]

31. U.S.D.A. Forest Service [national]

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