Parent Consent for CA Healthy Kids Survey (CHKS) - 5th Grade
Dear Parent or Guardian:

Your child is being asked to be a part of our school’s California Healthy Kids Survey (CHKS), sponsored by the California Department of Education. This is a very important survey that will help promote better health and well-being among our youth, improve the school learning environment, and combat problems such as drug abuse and violence. Your child does not have to take the survey. Participation is voluntary and requires your permission.

Survey Content: The survey gathers information on developmental supports provided to youth; school connectedness and barriers to learning; behaviors such as physical activity and nutritional habits; alcohol, tobacco, and other drug use; and school safety.  You can see our questionnaire from 2019-2020 on the district, Student Services Department website at https://mdusd-ca.schoolloop.com/studentservices

The results from this survey are compiled into district- and county-level CHKS Reports. To view a copy of your district’s report, go to https://calschls.org/reports-data/search-lea-reports and type in the district name.

It is Voluntary: Students who, with your permission, agree to participate do not have to answer any questions they do not want to answer, and may stop taking the survey at any time.

It is Anonymous: No names are recorded or attached to the survey forms or data. The results will be made available for analysis only under strict confidentiality controls.

Administration: The survey will only be administered to 5th graders.  Students will take the survey online during the school day once testing window dates are established.

Potential Risks: There are no known risks of physical harm to your child. Risks of psychological or social harm are very small. None have been reported in 20 years of survey administration. In rare instances, some discomfort might be experienced from the questions. The school’s counseling services will be available to answer any personal questions that may materialize.

For more information contact Linda Pete; Assistant Director, Student Services at 925-682-8000, ext. 4061.

Thank you so much,

Miss Pappas

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