Here is DS' 504 for his second year in MS. It changed every year a bit:
DS will be given permission to relocate in a designated area when food is being consumed.
DS will be given permission to wash his hands upon entering the building and at any time throughout the school day upon his request, as needed.
Food items will not be consumed in his classroom (any environment which he is in--in, around or outside the building)
The ingredient labels of any items (edible or consumable) used in class activities will be checked before the activity is conducted. Faculty must contact parents and 504C with the ingredients and manufacturer prior to the item being introduced to the class. Approval must be obtained from 504C before introduction and/or use. When an ingredient label is not available, the content of the item will be checked with the manufacturer by the parents. {this one is weird I know. The last year it was clarified and a two-week notice was specified.}
Phone access will be made available to supervising staff in the student's school environments including school-sponsored activities.
Staff will have a peanut free desk in each classroom. The desk is to be cleaned prior to students entering the classroom. {btw--this one is tot ally gone in our high school 504--as are others listed here. However, during DS' last year of middle school his first class was at the high school and then he was bused to the MS, and this desk cleaning item was in place in that one class at the high school.)
DS will use his discretion in determining participation in any clean-up activities involving food items other cleaning up his lunch and or approved snack. If deemed unsafe, DS will not be permitted to be involved in the clean-up activities. {This stemmed from an incident in ES where a custodian had him clean up other kids' trash. Also, in MS DS went on a LOT of field trips, many involving travel of 3+ hours where they got back after midnight. The kids weren't supposed to bring blatant PN on the bus, but this accommodation was used a few times when DS had picked up his own trash on the bus and other kids had left theirs. We simply took him home then.}
School lunch program - Substitutions to the regular meal will be provided upon request when the student is unable to eat the regular meal to to his identified disability as certified by a licensed physician.
The tables for DS' class will be cleaned before and after use in a manner to address the possibility of cross-contamination. During lunch, a school staff member who has received training will be in the cafeteria monitoring DS' class tables.
DS' parents will be notified of any special occasions/activities where the school will permit food items t be consumed so that can provide similar food item/s for DS. In emergency situation where extended stat at teh school is required, appropriate food items will be available and stored with the Crisis Kit in Principal's office for DS' consumption.
DS will have access to go to the school cafeteria to secure items his parents have made available for the special activity. When donation of food items is requested by th school, ie dances, the school will request donated items not include peanut products.
DS will have a desginated computer for his yues in each of the computer labs and it willb e wiped down prior to use.
Bus--DS can sit in the seat of his choice and he will be responsible for wiping the seat down. A trained bus aide will be provided. {The last year, DS did not have a bus aide. Also the last year the high school bus picked him up from home and he took that to the high school for a math class. A different bus/driver took him to his MS after that class. A third bus/driver drove him home on the days he didn't have an activity (he didn't ride the bus home many days). And on the days he rode the Activity Bus home (not many--it took forever to get home that way), a fourth bus/driver drove him home.
Transportation for after school activities will be provided with 48 hours notice by DS' parents.
The student is permitted to carry an EpiPen kit in the school and during school-sponsored activities.
EpiPen kits will be kept in the nurse's office, guidance office, gym and music office. The parents are responsible for providing all medications and EpiPens. {This was a HUGE school. DS was there a LOT after school and on the weekends for theatre and band things--and those teachers shared the music office. It was important to have meds that were accessible on the weekends and evenings.}
Staff members involved in DS' day-to-day activities, including extracurricular activities, will receive instruction about the potentially severe nature and proper treatment of a life threatening food allergy, recognition of anaphylaxis, and steps to be followed int eh event of an accidental ingestion. This training will be provided prior to the opening of school and updated if his physician provides the principal with updated information during the school year. Training occurred on XXX date.
The training session will include information on how to address age=appropriate awareness of life threatening food allergies and the necessary precautions DS must take to address his individual needs. The training will include that DS is not to be singled out.
DS will be encouraged to self-advocate by making statements to a supervising adult that he suspects a situation to be unsafe. This issue will be part of teacher training.
Substitute teachers assigned to DS' instructional program will receive appropriate training.
A planning meeting will be held with DS will be participating in field trips and new extracurricular experiences.
XXX School District will provide cleaning materials for cleaning the classroom and bus. {Of course, each year at every 504 meeting with all his teachers we provided a box of Kleenex and a tub of Clorox Wipes for each of his teachers--nice way to start the year.}
{The 504 plan included the allergy action plan, including the following--but I'm not typing the whole thing--just things that might be useful to consider in a 504.}
DS will be permitted to call his parents when he has any reaction. {We made it clear this was not the first step--but if he felt he needed to contact us, he could--this included on any field trip, any rehearsal, any exam, any time.}
If a reaction is suspected, DS will have adult supervision as he reports to the office/assigned area if he goes.
{We specified body systems and graded symptoms--we had given them the Anaphylaxis Grading Chart a couple of years before.}
The severity of symptoms can quickly change.
all above symptoms can potentially progress to a life-threatening situation.
MINOR ALLERGIC REACTION {listed what to do}
MAJOR ALLERGIC REACTION {listed what to do--Noteworthy inclusions:
If ingestion is suspected OR there is throat tightness OR there are two or more symptoms involving any of the body systems above, give EpiPen IMMEDIATELY. Visible hives and swelling are not necessary to administer the EpiPen. {I'm going to bold that, in light of the recent death. I'd forgotten that was in here this way.}
Unless he is vomiting, have DS lie down on his back with his feet elevated immediately after EpiPen injection. Keep him quiet and still. Avoid moving him until emergency transport arrives. Continue to monitor vital signs.
Then call 911 and instruct then to bring epinephrine.
AFter 5 minutes, if symptoms do not decrease give another EpiPen
Call parents DadName and MomName
Dadname Cell:
Dadname Work:
Dadname Home:
Momname Cell:
Momname Work Direct Line:
Momname Work Central Line:
Momname Home:
When Transport arrives, given expended auto-injectors to paramedics.