“Kids Our Kids” Respite Program For Special Families
Policies and Procedures
I. Definitions 6. A parent or legal guardian is required to
1. The participants for the Kids Our Kids sign each child in and out at any K.O.K.
Respite Program (K.O.K.) are: program, leaving an emergency contact
a. Volunteers from the Melissa Rotary name and phone number.
Club and any other outside service 7. A parent or legal guardian is required to
clubs that the Melissa Rotary sign a “general consent” for each child
partners with to assist in staffing at each K.O.K. program or event, unless
the K.O.K. event prior arrangements have been made
b. Participants who are families that with the K.O.K. volunteer director.
have a special needs child and who 8. No fee will be charged for a
voluntarily participate in the K.O.K. participating family who uses the K.O.K.
respite program program or any events associated with
2. The K.O.K. volunteer director is the K.O.K.
responsible for oversight of 9. Only service animals are permitted to
programming, budgeting, planning, attend the K.O.K. program or events
special events and K.O.K. volunteer with the prior approval of the volunteer
management. director.
3. The K.O.K. volunteers are responsible 10. No volunteer, family or child shall bring
for interacting with the child assigned any pet to any K.O.K. program or event.
to them during the course of the Note: K.O.K. events and/or programs
evening in a positive and caring may involve animals which have been
manner. approved and arranged by the K.O.K.
II. General volunteer director (ie. Petting zoo,
1. The K.O.K. does not endorse other SPCA).
programs, individuals, professionals, 11. Any participant (child, sibling,
products or organizations. volunteer, etc…) in any K.O.K. program
2. Providing a resource does not or event must be free from signs and
constitute an endorsement by the symptoms of communicable disease
Melissa Rotary Club or the hosting and free of fever for 24 hours prior to
business Mudpies and Lullabies. such K.O.K. program or event.
3. A family may apply for participation in III. Children
the K.O.K. by completing a K.O.K. 1. General
Program Application, which is updated A. Children between the ages of 3
annually. months to 13 years of age are
4. Upon receipt of the K.O.K. Program eligible for the K.O.K. program.
Application , the K.O.K. volunteers may When a child reaches the age of
accept or decline the child, children 13 years, the child is no longer
and/or family at its sole discretion. eligible for the K.O.K. program.
5. A parent or legal guardian shall pick-up B. If a child requires medication
and drop-off his or her child or children and/or any special procedures
at any K.O.K. program event, unless during any K.O.K. program, the
prior arrangements for an alternate parent shall follw the
responsible party have been made in procedures and policies under
writing with the K.O.K. volunteer “Medication/Special
director. Procedure” (Section VI).
“Kids Our Kids” Respite Program For Special Families
Policies and Procedures
C. The K.O.K. reserves the right to absences without notification will
take photos and fashion press be removed from the standing list.
releases with any participant in Upon loss of the standing
the K.O.K. program unless reservation, the family will then be
specifically requested by a required to call prior to the next
parent otherwise for their scheduled K.O.K. at least 3 weeks
child(ren). prior for reservations.
2. Special needs 6. A parent is required to notify the
A. Children are eligible for the K.O.K. volunteer director if they are
K.O.K. program if they have a unable to keep their standing
physical and/or mental reservation.
disability including complex V. Volunteers
developmental disabilities that 1. A volunteer must be at least eighteen
affect the child’s ability to years of age.
communicate and interact with 2. Application/eligibility to volunteer- each
others. volunteer must complete an
B. Acceptance into the program application, provide references and
will be based on the complexity consent to a criminal background check.
of health care needs of the child The K.O.K. volunteer director will make
determined by the volunteer the final determination on eligibility for
director. volunteers.
3. Siblings 3. Volunteers suspected of alcohol/drug
A. Siblings between the ages of 3 abuse before or during a K.O.K. event
months to 13 years are eligible will be asked to leave immediately.
to attend the K.O.K. program 4. Volunteers may not bring their children
with their special needs sibling. to K.O.K. programs or events as we are
IV. Families to be focused on the children in our
1. The family list is confidential and care.
NOT available for release to other 5. The volunteer list is confidential and not
programs. available for release to other programs.
2. Participation in the K.O.K. program 6. Guests/visitors-guests and visitors are
is not contingent upon membership required to sign in at the registration
in Melissa Rotary or any other table and receive a nametag. Tours of
volunteer group associated with the program are given by a K.O.K.
K.O.K. including the facility host. volunteer. Prior notification of the visit
3. K.O.K. encourages all families to be is preferred.
considerate of the needs of other 7. Outside contact-outside contact
families when seeking respite care. including but not limited to babysitting,
4. Families are served by the K.O.K. on dining out, taking children special
a first come first serve basis until places, visiting children in their homes,
the program capacity is met. As friend-ing on social networking sites
time goes on the K.O.K. will be with K.O.K. children must be discussed
expanded as needed when able. with the K.O.K. volunteer director..
5. Families who have standing These activities are discouraged
reservations, but have frequent because they cannot be provided for
“Kids Our Kids” Respite Program For Special Families
Policies and Procedures
every child in K.O.K. and outside 4. K.O.K. volunteers may decline any special
activities are not within the K.O.K. procedure and will discuss this decision
mission of providing respite. with the parent.
8. A volunteer shall be knowledge and VII. Operational procedures (volunteers)
adhere to the K.O.K. Operational 1. K.O.K. is a 5:30 to 10 p.m. time commitment
Procedures as attached. for our volunteers. Please phone 972-254-
9. A volunteer must treat each child’s 2011 as soon as possible if you will be late
personal and medical information as or need to cancel.
confidential. Please respect the privacy 2. Children and adults must stay within the
of each K.O.K. family. designated areas approved for K.O.K..
10. Volunteers will arrive 30 minutes before Changes will be reported in the 5:30 p.m.
any K.O.K. event or program for the meeting.
pre-event meeting where updates, 3. A volunteer nurse or the volunteer director
notices, assignments and changes to will oversee the administration of all
any policies and procedures will be medication and medical procedures. All
reviewed. parents who have medications for their
11. Volunteers will have their backgrounds child or who need to report any changes in
checked prior to being able to work in medical conditions must speak to the nurse
the K.O.K. program for their own or director before leaving their child.
protection and the protection of the 4. Please notify the volunteer director or
children in the program. Your volunteer nurse of any unusual incidents,
information will be collected in this accidents or changes in behavior or
form and be held in strict and safe conditions that occur during the course of
confidence. the evening. The volunteer nurse or
VI. Medication/special procedures volunteer director should be notified for
1. If a child requires medication and/or a any emergency. The appropriate parties
special procedure during any K.O.K. will be contacted for emergencies by the
program, the parent will: volunteer director or nurse.
a. Bring medication in a prescription 5. Do not put yourself in a position where you
bottle clearly labeled with the name are alone with one or more children. There
of the child, the name of the should always be at least two aduls present
medicine, the required dosage and in secluded situations (such as the
the time to be given. restroom). This is for the volunteer’s
b. Sign in the medication and/or protection as well as all children.
review the special procedure with 6. Anyone associated with K.O.K. must have a
the K.O.K. volunteer director or nametag. Please refer anyone in the K.O.K.
volunteer nurse area not identified by a nametag to the
2. Medicine is maintained and administered volunteer director.
by the volunteer director or the volunteer 7. Children will not be given any food except
nurse. what their parents provide. This is prevent
3. Routine medications and special procedures reaction to food allergies and/or
will not be administered during any event complications from eating swallowing
lasting less than (2) hours, unless prior disorders. Children should be assisted with
arrangements have been made and their meal or snacks in the area designated
approved by the K.O.K. volunteer director. for this purpose.
“Kids Our Kids” Respite Program For Special Families
Policies and Procedures
8. Please use good judgment and practice
appropriate touch. Examples of
appropriate touch are: arm around
shoulder, walking hand in hand, short side
hugs, handshakes and high fives. Examples
of inappropriate touch would be: touching a
child in anger or disgust, touching a child
anywhere a bathing suit would cover, child
over the age of 2 sitting in your lap, tickling
children, wrestling and piggy back rides.
Inappropriate touch will not be tolerated.
Family:_________________________________________________________________________
Child’s name(s):_____________________________________ Birthday:_____________________
_____________________________________ Birthday:_____________________
_____________________________________ Birthday:_____________________
_____________________________________ Birthday:_____________________
By signing below, I acknowledge that I have been given, have read and understand this policy and
procedure manual.
Parental signature:________________________________________________________________
Date:_____________________ Phone number:__________________________________
Volunteer:______________________________________________________________________
By signing below, I acknowledge that I have been given, have read and understand this policy and
procedure manual and agree to have my background checked.
Volunteer signature:_______________________________________________________________
Date:_____________________ Phone number:__________________________________
Social security number: _______-_____-_________ Dl#:_________________________ State:____