parent and teacher spring conferences final evaluation · 2011-03-10 · standard expectations at...

Student ID LabelProvided by

Office Automation Technician

Lompoc Unified School District

InterventionDocuments

FolderK-12

FOLDER SHOULD INCLUDE: The Elementary School Intervention Document (ESID), PWPs, RWPs, and Intervention Focus Standards, Middle School Intervention Document (MSID), and the California High School Exit Exam (CAHSEE) Intervention Documentation Form.

Elementary & Middle School Intervention Documentation (ESID & MSID)Grades kindergarten, 1st and 2nd FBB are identified and placed on an ESID using academic assessments (HM Core and/or Results) and grade level matrices.Grades 3rd-5th FBB and BB are identified and placed on an ESID using the CST scores, academic assessments, and grade level matrices.Grades 6th- 8th FBB are identified and placed on a MSID using CST scores, core academic and other supporting assessments.ESID and MSID are monitored at each grading period.If a student is not improving, an SST should evaluate options for success. Transition Students: All transition students are Title I and require documentation when services are provided using an ESID or MSID.

Parent and Teacher Spring Conferences

Review the results of the PWP, ESID or MSID, site core assessments, and/or report card and matrices.PWP is updated and initialed by parent(s) and teacher(s).If, based on documentation, retention is recommended, a SST will be scheduled immediately to discuss intensive student intervention goals to occur by May 1st.The Retention Policy/Regulation is reviewed with the parent(s).

Revised 3/2007 smcd

NOTE: The LUSD K-12 Intervention Documents Folderis placed in envelope #1 in the cum file

Copyright 2007 – All Rights Reserved –For in-house use only. Copies by individuals or

institutions outside the LUSD are by permission only.

Final EvaluationOn or before May 1st, an SST follow-up evaluation will occur and a final promotion/retention decision will be made.If student’s progress is satisfactory, the student will be promoted and his/her PWP will be completed, and placed in their cum folder in the Intervention Documents Folder.Intervention Form Standards (FFS) are updated for FBB and Summer School students in grades 2-8.

Retention:All retention candidates shall be reviewed by the Superintendent or his/her designee before a final decision and conference takes place with the parent(s) on or before May 15th.If the student will be retained, a parent conference is scheduled and the PWP is completed and signed by teacher and parent(s).The appeals procedure will be reviewed with the parent(s).For kindergarten students who will continue kindergarten for another year, parent(s) shall sign an agreement (Form D-162b) for the student to complete not more than one school year at his/her present grade level.For grades 1-8 students who are being retained, a RWP (form RWP 915 and/or 915s) will be initiated by sending teacher. Parent(s) and teacher(s) signatures are obtained on the RWP and given to the site principal to be placed in the student’s cum folder in the Intervention Documents Folder.

RWP Information Filled in by Sending Teacher:Date of Plan (Initiated)/Parent Signature.Sending Teacher Signature.Check boxes that apply for sending teacher.Complete the Goal/Objective of the Intervention for Language Arts and/or Math.

Developing the RWPReceiving teacher reviews RWP with sending teacher(s).Receiving teacher completes RWP within 30 days.At the Teacher/Parent meeting, parent(s) will sign RWP where indicated no later than fall conferences.

Refer to the PWP and RWP Flow Chart for Timelines

Curr-950

Lompoc Unified School DistrictProtocol

Pass With a Plan (PWP), Retention With a Plan (RWP), Intervention

Pass With a Plan Guidelines – Far Below Basic (Below Basic at Teacher Discretion)

Producing a PWP – Grades K-2Grades K-2 PWPs are generated as follows:

Office staff generates a Zangle class list for each teacher.Teacher puts a star (*) by each FBB student. BB students may be starred at teacher’s discretion.Teacher gives list to principal for review.Principal then gives list to designated office staff to enter starred students into Zangle.Office staff then sends all the class lists to the Office Automation Technician (OAT) for imprinting.OAT sends the imprinted PWPs back to the principal.

Parent and Teacher Fall Conferences (August – October)

California Standards Test (CST) – BasicStudents who are making progress toward grade level standards need not be placed on a PWP. An ESID or a MSID is not required for students at basic level.

CST – Far Below Basic (FBB)Students whose progress is FBB are placed on a PWP and monitored using an ESID or a MSID. OAT will imprint a PWP for each FBB student.

Special EducationResource and Speech:

The IEP is the main document for the student’s intervention. If the student is at risk of being retained a PWP is required (see Flow Chart).

Special Day Class:No PWP needed.

English Learners: English Learners are to follow the EL Master Plan. If

the student is at risk of not meeting the ELD standard expectations at the their CELDT level, a PWP is required.

English Learners may be placed on a PWP for documentation purposes; however, Level 1 & 2 students may not be retained.

Expectations:CELDT levels 1-3 one level growth per year; and,CELDT levels 4-5 one level growth per two years.

Further Clarification for Identifying PWPs in Grades 3-8

Identifying and Producing PWPs – Grades 3-8

Developing a Pass With a Plan for Intensive Needs StudentsBased on the previous assessments and documentation, the teacher or grade level team will identify the specific focus and purpose for the intervention(s) to be used to increase student achievement, remembering that:

Instructional interventions supplement the District core curriculum.Intervention materials and activities should be specifically identified on the intervention document for: classroom support, instruction and monitoring (i.e. regrouping students for focused instruction, site interventions programs, home participation and responsibility and/or pre and post assessments).ELD services and instruction are mandated curriculum and instructional strategy used to assist the English Learner in their academic and language development. ELD cannot be listed as an intervention.The teacher will complete the PWP and ESID or MSID form, depending on grade level.

Meet with the parent(s) to review the assessment data, student needs and concerns. Review interventions and responsibilities of students, parent(s), and teacher(s).PWP is signed and dated by parent(s) and teacher(s); Home/Parent Agreement is signed by parent(s).A copy of the PWP will be distributed to the parent(s), teacher(s), and principal.Develop and agree on communication procedures to monitor student progress in intervention programs.

PWP Implementations and MonitoringEnroll student in extended day, Saturday, and/or other appropriate intervention programs.Monitor and evaluate the success of the PWP and review and update PWP and ESID or MSID each grading period. A more frequent review may be necessary. If interventions are unsuccessful, the SST/Intervention Team will need to make adjustments to the plan. Parents should be kept apprised of changes to the PWP.Send the mid-year letter to parent(s) by January 30 reporting student progress.SST will be scheduled and held for students as soon as it is apparent that the student may be retained, no later than the Spring parent teacher conferences.

Before the first conference the classroom teacher will review:Information from cumulative files about student’s academic history including ESID or Middle School Intervention Document (MSID), PWP, RWP, SST, report card and matrices.(FBB) District identifies students from CST scores, enters data into Zangle, imprints PWPs and sends to site principal.(BB) Office staff generates a Zangle Test History query for CST BB students and gives list(s) to teachers.Teacher puts star (*) on list(s) next to BB students needing a PWP and returns list to principal for review.Principal gives lists to designated office staff to enter (*) students into Zangle.Office staff then sends lists to Office Automation Technician (OAT) for imprinting. OAT sends the imprinted PWPs back to the principal to distribute to teachers.

CST – Below Basic (BB)Students whose progress toward grade level standards is BB may be placed on a PWP based on teacher discretion. An ESID will be used to monitor students programs and academic progress in grades 3-5.A MSID is not required.

Identifying Potential PWPs – Grade 2

Language Arts / Reading BenchmarksUnable to read from the 100 Word list.Unable to blend 2 to 4 phonemes.

Math BenchmarksUnable to read and write whole numbers.Does not know basic addition and subtraction facts.Unable to use place value.

Before the first conference the classroom teacher will review:Information from cumulative files about student’s academic history, including these documents: ESID, PWP, RWP, SST, Intervention Focus Standards for 1st grade, report card and matrices.Site second grade and/or core curriculum assessments to identify students Far Below Basic.Student is not mastering the Language Arts and Math benchmarks.

Language Arts / Reading BenchmarksRecognizes 10 or less letter names/sounds.Recognizes 5 or less words.Unable to blend sounds.Unable to write their own name.

Identifying Potential PWPs - Kindergarten

During the second trimester the classroom teacher will review:Site kindergarten and/or core curriculum assessments to identify students who are far below basic.Students who are not mastering the kindergarten Language Arts and Math benchmarks.

Math BenchmarksUnable to count to 20.Unable to identify numbers 1-10.Recognizes fewer than 3 shapes.

Identifying Potential PWPs – Grade 1

Language Arts / Reading BenchmarksRecognizes 20 or less letter names.Blend and segment 8 or less words.Unable to distinguish initial, medial, and final sounds.

Math BenchmarksUnable to count to 50.Unable to write numbers 1-30.Unable to make a variety of patterns.

Before the first conference the classroom teacher will review:Information from cumulative files about student’s academic history, including these documents: Elementary School Intervention Document (ESID), PWP, Kindergarten Continuation Form, Student Study Team (SST), kindergarten report card and matrices.Site first grade and/or core curriculum assessments to identify students who are Far Below Basic.Student is not mastering the 1st grade Language Arts and Math benchmarks.

Intervention Documents Folder K-12

Table of Contents

Document Name Number Where to Get It

Cover Letter

Flow Chart TRC Curriculum Specialist

Pass With a Plan - PWP Curr-919 Office Automation Technician

Pass With a Plan - Spanish Curr-919s Office Automation Technician

Retention With a Plan - RWP Curr-915 Office Automation Technician

Retention With a Plan - Spanish Curr-915s Office Automation Technician

Elementary School Intervention Document - ESID Curr-936 Printing Department or on-line

Middle School Intervention Document - MSID Curr-937a,b,c Printing Department or on-line

Mid year letter - English TRC Curriculum Specialist

Mid year letter - Spanish TRC Curriculum Specialist

Kindergarten continuation letter - English D-162 Printing Department or on-line

Kindergarten continuation letter - Spanish D-162s Printing Department or on-line

Retention cover sheet TRC Curriculum Specialist

CAHSEE Intervention D6146.2 Printing Department or on-line

Resources

Intervention Focus Standards Curr-ELA 933Math 944

On-line

Board Policy Procedures Education Center ServicesTechnician

Intervention Documentation Folder K-12(labels generated at school site - template availablefrom Curriculum Department)

Curr-950 Printing Department

ALL DOCUMENTS MAY BE FOUND ON THE LUSD WEBSITE

March 2007

March 2007

Subject: Lompoc Unified School District Promotion/Retention Policy

Dear Colleagues:

On January 1, 1999 assembly bill AB1626 became law. This law governs thepromotion and retention of students in California’s public schools. On April 13, 1999,the Board of Education approved Policy 7123 and regulations in support of AB1626.

The Intervention Documents Folder K-12 will follow students until they reach proficiencyin Language Arts and Math; their beginning grade level will vary. The folder containsmandatory guidelines for Intervention, PWP and RWP. It will house all documentationfor interventions for Basic and Below students, including the Intervention FocusStandards used for Far Below Basic and Summer School students.

The Promotion/Retention Flow Chart paces the PWP, RWP and the interventionprocess. It has been revised to unify, simplify, and clarify procedures so that all schoolshave clear and concise direction. The flowchart is in color to highlight the necessarytimelines for PWPs and RWPs.

We hope that you find the Intervention Documents Folder K-12 convenient to use. Revisions and updates, if necessary, will occur in January of each year. If you havesuggestions of information you feel should be included, please submit them in writing tomy office by January 15, 2008.

Sincerely,

Diane Burton, Ph.D.Director, Curriculum and Projects

Lompoc Unified School DistrictPass With a Plan & Retention With a Plan Flow Chart*

Parent Teacher Spring Conference

Results of ESID or MSID, site assessments, report card matrix (standards) reviewed and PWP updated and initialed by parent(s) and teacher(s)

Final Evaluation / Retention Conference

Final promotion / retention decision made by May 1Parent signs bottom of PWP indicating that student will be retainedAppeal procedure is explained to parentTeacher initiates the RWP and the parent signs it

Identifying Potential Pass With a Plan (PWP) and Retention With a Plan (RWP) Students

Develop PWPs

Cross/grade level meetings to develop PWP Initiate Intervention documentation form and attach to PWP

Special Education

IEP Team Consideration of retention at annual reviews

Year RoundTime Line

Traditional

July August

Year RoundTime Line

TraditionalAugust September

Paperwork Deadline

**This is a timeline overview to be used in conjunction with the information contained in the Intervention Documents Folder K-12

Site administration reviews Intervention, Promotion, Retention Packet with staffTeacher reviews cumsSite assessments givenPreliminary ranking of studentsSite discusses intervention plans for the year (School Plan)

Grades K-2Site stars on site-generated list the names of Far Below Basic (FBB) students needing PWP.Site enters BB student’s PWP data into Zangle.Send list to Office Automation Technician (OAT) for imprinted PWP

Grades 3-8District sends imprinted PWP for all CST Far Below Basic (FBB) students; OAT enters data into ZangleSite stars on site-generated list the names of Below Basic (BB) students needing PWPSite enters BB student’s PWP data into ZangleSend BB list to OAT for imprinted PWP forms; District sends imprinted PWPs back to site

Special Education

Special day classThe IEP will serve as the PWP

Resource / SpeechFollow regular PWP procedure

smcd 3/2007

Retention Candidates:Retention regulation reviewed and a copy given to parentSST scheduled

RWP Students (August):Receiving teacher reviews RWP with sending teacherReceiving teacher completes RWP within 30 days, by fall conferenceTeacher/Parent meeting: parent signs RWP

Color Key: Blue – Special Education; Green – PWP Information; Peach – RWP Information; Multi-Color – Transition from PWP to RWP

PWP / RWP Checklist

Review:Intervention Focus StandardsElementary or Middle School Intervention Documentation Form (ESID or MSID)SST recommendations Grade level matrixReport Card

English Learners

CELDT Levels 1-2 (K-5):EL students in CELDT levels 1-2 are not subject to retention proceduresELD progress must be documented with a pre and post ADEPT scoreAccess to the Core Curriculum must be ensured through primary language support

CELDT Levels 1-2 (6-8):EL students in 6-8 will be placed in High Point according to their DPI score, and will be tested when they are below 325 points in CST for ELAAccess to the core curriculum will be ensured through the use of SIOP techniques in SDAIE classes

Parent Teacher Fall Conference

Review PWP and InterventionsHome agreement is reviewed and checked; PWP is signedCopies of PWP provided to parent, principal and teacher

Year RoundTime Line

TraditionalAugust

through JuneSeptember

through June

PWP and RWP Implementation and MonitoringPWP/RWP implementation and monitoring at each report card periodUse most current assessments, report card matrix, Intervention Focus Standards (IFS), and Elementary and/or Middle School Intervention Document (ESID / MSID) to monitor student progressTeacher identifies possible retention candidatesMid-year letter sent by January 30 reporting student progress

Year Round

May 15 May 15

Traditional

CURR-919 Rev. 03/2006 White: Teacher/CUM Folder Yellow: Parent Pink: Office

LOMPOC UNIFIED SCHOOL DISTRICT PASS WITH A PLAN FOR INTERVENTION

Current Level: At Risk □ Possible Retention □

Academic Intervention Plan (Check [ ] all that apply)

School Support: □ Reading □ Math □ Intervention Documentation Form (*) □ Intervention Focus Standards (*) □ Tutor □ Extended Day

□ Other ________________________________________________________________________________ Additional Intervention Strategies: □ SST □ SARB □ Counseling □ Nurse/Health □ Progress Reports □ Behavior Support Plan □ Other ________________________________________________________________________________ *Please attach the Intervention Documentation Form and Intervention Focus Standards. Home/Parent Agreement – “In order to support my child’s progress during this year, I will…”

_____ Ensure that my child receives proper rest and nutrition. _____ Ensure that my child attends school daily and arrives on time. _____ Monitor my child’s homework completion; reading, writing and math at home. _____ Support intervention strategies as agreed to with the teacher. (Describe strategies) __________________________________________________________________________________________________________________________

□ Parent Signature above acknowledges intent to implement Parent Agreement.

□ Parent received a copy of the Promotion Retention Regulations.

□ Copy mailed home by return receipt on _____________________. Parent did not attend conference. Results – Academic Intervention Plan: Please check [ ] end-of-year achievement levels indicator:

1. □ Student is making progress towards grade level standards: promote without a PWP. 2. □ Student is making progress: promote and continue monitoring achievement with a PWP.

3. □ Retention Plan: student retained

4. □ The classroom teacher recommends retention because student has not made progress toward grade level standards based on the following assessments: ______________________________________________________________________

5. □ Student retained in __________________ □ Student promoted to __________________ Classroom Teacher Signature:__________________________________________________ Date:________________________ Parent Signature:____________________________________________________________ Date:_________________________

_______________________________ Date of Plan _________________________________ Teacher Signature _________________________________ Parent Signature Review Dates Parent Initials Teacher Initials _________ _________ _________ _________ _________ _________ _________ _________ _________ Review and initial this plan at each conference and SST.

DISTRITO ESCOLAR UNIFICADO DE LOMPOC PASAR CON UN PLAN PARA INTERVENCION

_________________________________ Fecha del Plan _________________________________ Firma del Maestro _________________________________ Firma del Padre Fechas de Revisión Iniciales del Padre Iniciales del Maestro _________ _________ _________ _________ _________ _________ _________ _________ _________ Favor de Revisar en las conferencias siguientes

Nivel Actual: En Riesgo □ Posible Retención □

Plan de Intervención Académico (Indique [ ] todo lo que aplique)

Programas de Apoyo Escolar: □ Lectura □ Matemáticas □ Documentación de Intervención □ Estándares de Intervención(*) □ Tutoría □ Día Extendido

□ Otro ________________________________________________________________________________ Estrategias de Intervención Adicionales: □ SST □ SARB □ Consejería □ Enfermera/Salud □ Reportes de Progreso □ Plan de Apoyo de Comportamiento □ Otro ________________________________________________________________________________ *Favor de añadir la forma de documentación de intervención y los estándares de Intervención Acuerdo de los Padres – “Para apoyar el progreso de mi estudiante durante este año, yo voy a…”

_____ Asegurarme que mi estudiante reciba el descanso y nutrición adecuada. _____ Asegurarme que mi estudiante sea puntual y asista a la escuela diariamente. _____ Monitorear que mi estudiante complete su tarea de casa; lectura, escritura y matemáticas. _____ Apoyar las estrategias como se acordaron con el maestro. (Describa las estrategias) __________________________________________________________________________________________________________________________

□ Al firmar, los padres se comprometen a implementar el Acuerdo de los Padres.

□ Los padres recibieron una copia de las Regulaciones de Promoción y Retención.

□ Se envió una copia al hogar en _____________________. Los padres no asistieron a la conferencia. Resultados – Plan de Intervención Académico: Favor de indicar [ ] los niveles de aprovechamiento a fin de año:

1. □ El estudiante esta progresando hacia los estándares de nivel de grado; promover sin un PWP. 2. □ El estudiante esta progresando; promover y continuar monitoreando el aprovechamiento con un PWP.

3. □ Plan de Retención; el estudiante sera reprobado

4. □ El maestro/a no recomienda la promoción en este momento debido a la falta de aprovechamiento del estudiante hacia el dominio de estándares académicos basado en las siguientes evaluaciones:

5. □ El estudiante es reprobado en __________________ □ El estudiante es promovido al __________________

Fecha del Maestro/a: ________________________________________ Fecha: ________________________

Firma del Padre: ___________________________________________ Fecha: _________________________

Curr-919s rev. 08/2005 White: Teacher/CUM Folder Yellow: Parent Pink: Office

CURR-915 Rev. 03/2006 White: Teacher/CUM Folder Yellow: Parent Pink: Office

LOMPOC UNIFIED SCHOOL DISTRICT RETENTION/CONTINUATION WITH A PLAN

Academic Intervention Plan (Check [ ] all that apply)

□ Intervention Documentation Form □ Intervention Focus Standards □ Extended Day (sending teacher) ----------------------------------------------------------------------------------------------------------------------------------------------- Additional Intervention Strategies: □ SST □ SARB □ Counseling (receiving teacher) □ Nurse/Health □ Progress Reports □ Behavior Support Plan □ Other ________________________________________________________________________________

Academic: (Intervention different than normal program delivery) Subject Area Language Arts Math

Goal/objective of intervention (sending teacher)

Curriculum/materials Organization & Delivery of Instruction

(Days, minutes, grouping, location) Responsible Staff

Assessment 1 2 3 4 1 2 3 4 Pre assessment (Date, name, score)

Post assessment (Date, name, score)

Other

Home/Parent Agreement – “In order to support my child’s progress during this year, I will…”

_____ Ensure that my child receives proper rest and nutrition. _____ Ensure that my child attends school daily and arrives on time. _____ Monitor my child’s homework completion; reading, writing and math at home. _____ Support intervention strategies as agreed to with the teacher. (Describe strategies) __________________________________________________________________________________________________________________________

□ Parent Signature above acknowledges intent to implement Parent Agreement.

□ Parent received a copy of the Promotion Retention Regulations.

□ Copy mailed home by return receipt on _____________________. Parent did not attend conference. Retention plan and goal is initiated by the sending teacher: due to principal May 15. Receiving teacher completes RWP with sending teacher: due to principal by end of fall conferences

_________________________________ Date of Plan (Initiated)/Parent Signature ____________________________________________ Sending Teacher Signature ____________________________________________ Date of Plan (Beginning)/Parent Signature ____________________________________________ Receiving Teacher Signature Review Dates Parent Initials Teacher Initials _________ _________ _________ _________ _________ _________ _________ _________ _________ Review and initial this plan at each conference and SST.

Site to request sticker from Office Automation Technician when state scores arrive at LUSD

CURR-915s Rev. 03/2006 White: Teacher/CUM Folder Yellow: Parent Pink: Office

DISTRITO ESCOLAR UNIFICADO DE LOMPOC RETENCION/CONTINUACIÓN CON UN PLAN

Plan de Intervención Académica (Marque [ ] todo lo que aplique)

□ Forma de Documentación de Intervención □ Intervención de Enfoque en Estándares □ Día Extendido (sending teacher) ----------------------------------------------------------------------------------------------------------------------------------------------- Estrategias de Intervención Adicional: □ SST □ SARB □ Consejería (receiving teacher) □ Enfermera/Salud □ Reportes de Progreso □ Plan de Apoyo al Comportamiento □ Otro ________________________________________________________________________________

Académica: (Intervención diferente al programa normal) Materia Inglés Matemáticas

Meta/objetivo de intervención (sending teacher)

Currículo/materiales Organización & Instrucción

(Días, minutos, grupo, lugar) Personal Responsable

Evaluación 1 2 3 4 1 2 3 4 Pre-Evaluación (Fecha, nombre, resultado)

Después de la Evaluación (Fecha, nombre, resultado)

Otro

Acuerdo de los Padres – “Para apoyar el progreso de mi estudiante durante este año, yo voy a…”

_____ Asegurarme que mi estudiante reciba el descanso y nutrición adecuada. _____ Asegurarme que mi estudiante asista a clases diariamente. _____ Monitorear que mi estudiante complete su tarea en el hogar; lectura, escritura y Matemáticas. _____ Apoyar las estrategias de intervención como se acordaron con el maestro. (Describa las estrategias). _____________________________________________________________________________________________________________________

□ La firma del padre se compromete a implementar el Acuerdo de los Padres.

□ Los padres recibieron una copia de las Regulaciones de Promoción y Retención

□ Se envió una copia al hogar en _______________________. Los padres no asistieron a la conferencia. Retention plan and goal is initiated by the sending teacher: due to principal May 15. Receiving teacher completes RWP with sending teacher: due to principal by end of fall conferences

_________________________________ Fecha del Plan (Inicial)/Firma del Padre ____________________________________________ Firma del Maestro (que lo esta reprobando) ____________________________________________ Fecha del Plan (empezando retención)/Firma del Padre ____________________________________________ Firma del Maestro (recibiendo al estudiante reprobado) Fechas de Revisión Iniciales del Padre Iniciales del Maestro _________ _________ _________ _________ _________ _________ _________ _________ _________ Review and initial this plan at each conference and SST.

Site to request sticker from Office Automation Technician when state scores arrive at LUSD

All students Below Basic (BB) and Far Below Basic (FBB) must have an ESID that is updated at each trimester and placed in the student’s Intervention Documents Folder in the Cum File at the end of the year.

Student Name____________________________________

Kindergarten District Intervention 1st Grade District Intervention

Teacher: _______________________________ 100/250 Word List_____ Phonics for Reading (Archer)_____ Reading Counts / Acc. Reader_____ Soar to Success_____ Read Naturally_____ Guided Reading_____ Accelerated Math_____ Math Masters_____ Math Steps _____ CD ROM_____ Other ______________________Criteria – Student has needs in:_____ Meeting Standards_____ Decoding_____ Fluency_____ Spelling_____ Addition/Subtraction facts

2nd Grade District Interventions

Teacher: ______________________________ 10/25 Word List_____ Math StepsCriteria – Student has needs in:_____ Meeting Standards_____ Writing name_____ Identifying letters_____ Identifying sounds_____ Numbers_____ Shapes_____ Sequencing_____ Other: ____________________

Teacher: ______________________________ 10/25/50/100 Word List_____ Phonics for Reading (Archer)_____ Read Naturally_____ Guided Reading_____ Math Masters_____ Math StepsCriteria – Student has needs in:_____ Meeting Standards_____ Decoding_____ Identify letters and sounds_____ Spelling_____ Numbers_____ Patterns_____ Blending/segmenting _____ Other:_____________________

_____ Title I – Transition_____ After School Program /

Before School Program_____ During School Assistance_____ Teacher_____ Certificated Tutor_____ Instructional Assistant_____ High School Aide_____ Volunteer_____ Peer Tutoring_____ Other

__________________________

When, What Programs and Who

Acceptable Site Programs

_____ Computer Software__________________________

_____ Lexia_____ Phonics and Friends_____ Lindamood-Bell_____ Words Their Way (Vocabulary)_____ TouchMath



__________________________




_____ Lexia_____ Rosetta Stone_____ Phonics and Friends_____ Lindamood-Bell_____ Project READ_____ HM Leveled Books_____ Accelerated Grammar_____ Words Their Way (Vocabulary)_____ TouchMath




__________________________



_____ Lexia_____ Sequoia_____ Rosetta Stone_____ Phonics and Friends_____ Lindamood-Bell_____ Project READ _____ HM Leveled Books_____ Accelerated Grammar_____ Words Their Way (Vocabulary)_____ TouchMath

Dates of ServiceReading MathEntry Date: ________ Entry Date: ________Exit Date: ________ Exit Date: ________Total Time/Hrs: ________ Total Time/Hrs: ________

Type/Title/Yr Trimester 1 Trimester 2 Trimester 3Pre Post PostPre PostPre

Assessments



Assessments AssessmentsType/Title/Yr Type/Title/YrTrimester 1 Trimester 2 Trimester 3 Trimester 1 Trimester 2 Trimester 3

Pre Pre PrePost Post Post PostPre Pre Post PostPre

CURR-936 Rev. 3/2007

Student Number___________________

Lompoc Unified School DistrictElementary School Intervention Document (ESID)

For Supplemental Programs – SIDE 1(Houghton Mifflin Universal Access is part of the core curriculum and is the first line of intervention.)

______________________________________________Teacher Signature and Date



smcd 3/2007

All students Below Basic (BB) and Far Below Basic (FBB) must have an ESID that is updated at each trimester and placed in the student’s Intervention Documents Folder in the Cum File at the end of the year.

4th Grade District Interventions 5th Grade Interventions

Teacher: ________________________________ 100/250/500 Word List_____ Phonics for Reading (Archer)_____ Reading Counts / Acc. Reader_____ Soar to Success_____ Read Naturally_____ Accelerated Math_____ Math Masters_____ Math Steps _____ CD ROM_____ Other ______________________Criteria – Student has needs in:_____ Results_____ Meeting Standards_____ CST_____ District Assessments_____ Report Card

_____ Title I - Transition_____ After School Program /


__________________________




_____ Lexia_____ Sequoia_____ Rosetta Stone_____ Wildcats_____ Lindamood-Bell_____ Project READ _____ HM Leveled Books_____ Accelerated Grammar_____ Words Their Way Vocabulary_____ TouchMath




__________________________



_____ Lexia_____ Sequoia_____ Rosetta Stone_____ Wildcats_____ Lindamood-Bell_____ Project READ _____ HM Leveled Books_____ Accelerated Grammar_____ Words Their Way Vocabulary_____ TouchMath

PostPre



Assessments AssessmentsType/Title/Yr Type/Title/YrTrimester 1 Trimester 2 Trimester 3 Trimester 1 Trimester 2 Trimester 3

Pre Pre PrePost Post Post PostPre Pre Post PostPre



Teacher: ________________________________ 100/250/500 Word List_____ Phonics for Reading (Archer)_____ Reading Counts / Acc. Reader_____ Soar to Success_____ Read Naturally_____ Accelerated Math_____ Math Masters_____ Math Steps _____ CD ROM_____ Other _______________________Criteria – Student has needs in:_____ Results_____ Meeting Standards_____ CST_____ District Assessments_____ Report Card

CURR-936 Rev. 3/2007 smcd 3/2007

Student Name____________________________________

Teacher: _______________________________ 100/250/500 Word List_____ Phonics for Reading (Archer)_____ Reading Counts / Acc. Reader_____ Soar to Success_____ Read Naturally_____ Guided Reading_____ Accelerated Math_____ Math Masters_____ Math Steps _____ CD ROM_____ Other ______________________Criteria – Student has needs in:_____ Results_____ Meeting Standards_____ CST_____ District Assessments_____ Report Card



__________________________




_____ Lexia_____ Sequoia_____ Rosetta Stone_____ Lindamood-Bell_____ Project READ_____ HM Leveled Books_____ Accelerated Grammar_____ Words Their Way Vocabulary_____ TouchMath


Type/Title/Yr Trimester 1 Trimester 2 Trimester 3Pre Post PostPre


Assessments

Student Number___________________

Lompoc Unified School DistrictElementary School Intervention Document (ESID)

For Supplemental Programs – SIDE 2(Houghton Mifflin Universal Access is part of the core curriculum and is the first line of intervention.)

3rd Grade District Intervention

Lompoc Unified School DistrictMiddle School Intervention Document (MSID)

For Supplemental Programs – Grade 6

Student Name____________________________________

The MSID must be attached to the PWP form. All students basic and below must have a MSID that is updated at each grading period and placed in the student’s cum file at the end of the year.

3rdHigh Point ELD – EL Assessments

2nd1stDPI

Test 1Star Reading

Test 2 Test 3 Test 4 Test 5

Math

Pre TestTest 1 Test 2 Test 3 Test 4 Test 5 Test 6

Post Test

Reading

Student Number_________________

District Curriculum is not listed on this form. Intervention programs supplement the regular curriculum. According to your Single Plan for Student Achievement, students qualify for Intervention by meeting two or more of the following criteria:

Yearly Assessments_____ CST – LA Score _____ CST – Math Score_____ District Reading _____ District Math_____ CELDT - RFEP _____

__________ Special Education ___________ CELDT Level

Grade 6 – Teacher Comments

Language Arts Teacher: ___________________ Date: __________Comments______________________________________________

______________________________________________________

______________________________________________________

Interventions Assessments

Student Recognition

Verification

Math Teacher: __________________________ Date: __________Comments______________________________________________

______________________________________________________

______________________________________________________


_____________________. _____ Used in Lab _____ Used in ClassroomComputer Programs Used: ______________________________________

_____ Smith Math Programs _____ SOAR to Success

Math Declined DeclinedSummer School Recommendations

Fall SpringParent Teacher Conferences Unattended Unattended

6th Grade – Both – Read - Math

Reading Counts

SRAIntensive Reading – Read 180 (FBB)Strategic Reading - Read 180Intensive English (FBB)Intensive Math (FBB)Strategic Math - SaxonAccelerated Math

Accelerated Reading

Academic Assistance (Self-Contained)

Date Parent Declined3rd2nd Program1st

_____ EL _____Volunteer _____Peer Tutoring

When, What Program and WhoDate Parent Declined

_____ Teacher _____Tutor _____Instructional Assistant

_____Extended Day (SHIP) ____ LA ____ Math_____Before/After School Assistance____ LA ____ Math

_____During School Assistance ____ LA ____ MathAttendance

Attendance Key: NS = No Show; P = Poor; G = Good; E = Excellent

Report Card – Semester 1

LA S1 M S1 2M S1 RD S1 LA S2 M S2 2M S2 RD S2


*DRP Pre Score

DRP Post Score

Lexile Level

PreSaxon

PostSaxon

*DRP = Degrees of Reading Power

_____ Below District Assessments _____Language Arts _____ Math

_____ Below 349 on the CST _____Language Arts _____ Math

_____ Title I _____Language Arts _____ Math

_____ Below Grade Level _____Language Arts _____ Math

CURR 937a 3/2007 smcd 3/2007

Lompoc Unified School DistrictMiddle School CAHSEE Intervention Document (MSID)


Student Name____________________________________



2nd1stDPI

Test 1Star Reading


Math


Post Test

Reading



Yearly Assessments_____ CST – LA Score _____ CST – Math Score_____ District Reading _____ District Math_____ CELDT - RFEP _____




______________________________________________________

______________________________________________________


Student Recognition

Verification


______________________________________________________

______________________________________________________







Reading Counts


Accelerated Reading












*DRP Pre Score

DRP Post Score

Lexile Level

PreSaxon

PostSaxon






CURR 937b 3/2007 smcd 3/2007

Lompoc Unified School DistrictMiddle School CAHSEE Intervention Document (MSID)


Student Name____________________________________



2nd1stDPI

Test 1Star Reading


Math


Post Test

Reading



Yearly Assessments_____ CST – LA Score _____ CST – Math Score_____ District Reading _____ District Math_____ CELDT - RFEP _____ Cal Poly Math Test




______________________________________________________

______________________________________________________


Student Recognition

Verification


______________________________________________________

______________________________________________________







Reading Counts


Accelerated Reading












*DRP Pre Score

DRP Post Score

Lexile Level

PreSaxon

PostSaxon






CURR 937c 3/2007 smcd 3/2007

Mid Year Letter Template

(Date)

Dear Parents of

SUBJECT: Pass-W ith-A-Plan (PW P)

__________________ School is deeply committed to the academic success of every

student. During the parent/teacher conference last fall, your student’s teacher contacted

you to discuss his/her performance. As a result of this conversation, you received a plan

for improved academic success (PW P).

After approximately five months of instruction it is our opinion that your student:

G is making positive progress and is approaching grade level standards.

G is making positive progress but is still below grade level and should

continue in after-school tutoring.

G is not making sufficient progress and is at risk of repeating his/her current

grade.

G is not making sufficient progress and is required to attend supplementary

tutoring program (after-school program)

During the remainder of this school year, the teacher will do everything possible to offer

academic help. At present, it appears that the lack of progress toward grade level is

occurring because of one or more of the following conditions:

G Classroom work is not being completed.

G Assigned homework is not being completed.

G Poor school attendance.

G Lack of effort to complete the intervention services noted in the PW P.

G Other

_________________________________________________________

The school will continue to implement the Pass-W ith-A-Plan for your student. W e will

have a chance to discuss this with you during parent conferences in March of this school

year.

If your student is still below grade level and identified as a student to be retained, you

will be notified and asked to attend a conference toward the latter part of this school

year. At that time, your student’s academic progress will be reviewed and a plan will be

established outlining the educational program and services for next year.

If you have questions related to your student’s academic progress, please contact your

student’s teacher.

Sincerely,

(Principal signature)

Mid Year Letter Template in Spanish

Date

TEMA: Pasar-con-un-Plan (PW P)

Estimados Padres de :

La Escuela ________________________ esta muy interesada en el éxito académico de cada alumno. Durante las

reuniones de padres de familia que se realizaron el otoño pasado, el maestro/a de su alumno se puso en contacto

con usted para hablar acerca de su rendimiento. Como resultado de esta conversación, Ud. recibió un plan para

mejorar el rendimiento académico de su alumno (PW P).

Después de aproximadamente cinco meses de instrucción, es nuestra opinión que su alumno:

£ Está logrando un progreso positivo.

£ Esta logrando un progreso positivo pero todavía esta bajo el nivel de grado y debe continuar en el

programa de tutoría después de clases.

£ No esta logrando un progreso positivo suficiente y esta en riesgo de repetir el presente grado actual.

£ No esta logrando un progreso positivo suficiente y se requiere que asista a un programa suplemental

de tutoría (programa después de clases).

Durante el resto de éste año escolar, el maestro/a hará todo lo posible para ofrecer ayuda académica a su alumno.

Actualmente, parece ser que la falta de progreso de su alumno de no estar al nivel de grado requerido es debido a

una o más de las siguientes razones:

£ No termina su trabajo en la clase.

£ No completa las tareas asignadas.

£ Falta de asistencia a la escuela.

£ No pone el esfuerzo suficiente en completar los servicios de intervención del PW P.

£ Otro

La escuela continuará con la implementación del PW P de su alumno. Tendremos la oportunidad de discutir este

asunto con usted durante las reuniones de padres de familia en el mes de marzo de este año escolar.

Si se cree que su alumno no está a nivel del grado y ha sido identificado como un alumno que será retenido, se le

notificará y se le pedirá que asista a una reunión a fines del año escolar. En ese momento, el progreso académico

de su alumno será revisado y se establecerá un plan para delinear el programa educativo y los servicios para el

próximo año.

Si tiene preguntas relacionadas al progreso académico de su alumno, por favor póngase en contacto con el

maestro/a de su alumno.

Sinceramente,

School Principal

March 2007

PARENTAL AGREEMENT FORM

Agreement for Pupil to Continue in Kindergarten(Reflects amendments to Education Code § 46300 and 48011, Effective January 1, 1992)

Name of Pupil: ________________________________________________________

Kindergarten Attendance Anniversary Date: __________________________________

Name of School Official Approving for District:_________________________________

Information for Parent or Guardian

California law provides that after a child has been lawfully admitted to a kindergartenand has attended for a year, the child shall be promoted to the first grade unless theschool district and the child’s parent/guardian agree to having the child continue toattend kindergarten for not longer than one additional year. This rule applies whether achild begins kindergarten at the beginning of a school year or at some later date, sothat a child who begins kindergarten in January, for example, shall be promoted thefollowing January unless there is formal agreement to have him or her continue inkindergarten. Because kindergarten-age children often do not develop at steady orpredictable rates, the California Department of Education recommends that approval fora child to continue not be given until near the anniversary of a child’s admittance tokindergarten.

I agree to having my child (named above) continue in kindergarten until:____________.(Date)**

**(May not be more than one year beyond anniversary)

Signature of Parent/Guardian: ________________________ Date: ________________

Printed/typed name of Parent/Guardian: _____________________________________

Address: _____________________________________________________________

Telephone: __________________________

D-162 (Revised 3/06)

ACUERDO DE LOS PADRES

ACUERDO DE CONTINUACIÓN DEL ALUMNO EN KINDER (Indica las enmiendas al Código Educativo Sección 46300 y 48011, Efectivas el 1 de enero de 1992)

Nombre del Estudiante ____________________________________________________________ Aniversario de Asistencia al Kinder __________________________________________________ Nombre del Oficial de la Escuela Autorizado por el Distrito _______________________________ INFORMACIÓN PARA LOS PADRES/APODERADOS LEGALES La Ley de California provee que después de que un estudiante ha sido admitido legalmente y ha asistido por un año a Kinder, debe de ser pasado/aprobado al primer grado, a menos que el Distrito Escolar y los Padres/Apoderados Legales del estudiante estén de acuerdo de que el estudiante continúe asistiendo a Kinder por no más de un año adicional. Esta regla se aplica aunque el estudiante comience en el grado Kinder al inicio del año escolar o tiempo después, por lo tanto; un estudiante que ingresa al grado Kinder en el mes de enero, por ejemplo, será pasado en enero del próximo año, a menos que exista un acuerdo formal de que continúe en el grado Kinder. Debido a que el desarrollo de estudiantes del grado Kinder no es tan gradual o predecible, el Departamento de Educación de California recomienda que la aprobación para que un estudiante continúe, no sea otorgada hasta poco antes del aniversario de su ingreso al grado Kinder. Estoy de acuerdo de que mi estudiante (nombrado arriba) continúe en Kinder hasta ____________ (date)** **(No puede ser por más de un año después del aniversario de ingreso) Firma del Padre/Apoderado Legal _______________________________ Fecha: ________________ Nombre impreso del Padre/Apoderado Legal _____________________________________________ Dirección _____________________________________________________________________ _____________________________________________________________________ Número de Teléfono ____________________________

Distrito Escolar Unificado de Lompoc D-162s (rev. 5/06)

Retention Cover Sheet

Name of student ______________________ School ________________ Grade _____

Please check off each bullet after completed. The district

designee will need to look at each of these completed

documents before the final retention conference. Highlighted

are the documentation papers to be sent to the District Office

by the last day of school.

Retention Cover Sheet

� Intervention Documentation Form - marked during the schoolyear to document the interventions and assessments

� Pass with a Plan (PWP) - completed and signed by parent(usually during first conference)

� PWP - completed in primary language

� January/February letter updating progress of student

� PWP - Second parent conference was held and parentinitialed

� SST - with interventions suggested and implemented

� PWP - att the bottom “Retention Plan - student retained” ismarked and signed by the parent

� Retention with a Plan (RWP) is initiated

� After final decision the school office personnel will check the“retained” box with the current school year on Zangle

March 2007

CAHSEE INTERVENTION DOCUMENTATION FORMLOMPOC UNIFIED SCHOOL DISTRICT

Exhibit 6146.21

INTERVENTIONS Offered AttemptedBrief Description of Instruction

(Materials-Amount of Time)

Student Attendance in Intervention

(Good/Fair/Poor)

Date Intervention Completed

Specialized Instruction ELA

Specialized Instruction Math

Specialized Materials ELA

Specialized Materials Math

Targeted CAHSEE Instruction ELA

Targeted CAHSEE Instruction Math

After School Instruction ELA

After School Instruction Math

Lunchtime Instruction

Summer School

Student Name:Student ID #:

CAHSEE Scale ScoreDate taken ELA MATH

Grade 10Grade 11

Grade 12Projected Date of Graduation:Special Ed Student:English Learner Student:

Student/Parent Contact (Seniors Only)

Parent Notification of Testing Opportunities: Parent Notification of Interventions: CAHSEE Study Guide Provided:

Grades 9th _________ 10th _________ 11th _________ 12th _________

CAHSEE PASSELA MATH

No Yes No YesPass Date/Score Pass Date/Score

No YesNo Yes

Grades 9th _________ 10th _________ 11th _________ 12th _________Grades 9th _________ 10th _________ 11th _________ 12th _________

School: Year:

Birthdate:

To be updated annually by counselor and registrar or Special Education teacher and registrar. This form to be entered in student cum file.Rev. 3/15/07trm

D6146.2