Initial IEP Checklist
Student Name ________________________ Case Manager__________________
School ________________________ Date_________________________
Date of Referral_______________________
Date of Eligibility/Ineligibility____________
Date of IEP___________________________
_____ Initial IEP Checklist (this form)
_____ Student Intervention Team (SIT) Documentation (copies of all documentation of intervention and data collection during SIT process)
_____ Notice of IEP Team Meeting (check *Review existing information about your child, and *Decide if your child should be evaluated for special
education eligibility)
_____ Referral for Special Education (CORE team completes form)
_____ Prior Notice about Evaluation/Consent for Evaluation (CORE team completes form)
(ATTACH Assessment Summary Brochure with proposed evaluations checked)
_____ Procedural Safeguards given to parent
_____ Parent Non-Attendance at IEP Letter
_____ Attendance / Agenda sheet
_____ Summary of Meeting Notes
_____ Developmental History (completed by parent in English or Spanish)
_____ Cumulative File Review (form completed by a member of CORE team as assigned)
_____ Permission to Exchange Information (use the form(s) below if requesting information)
*Parental Permission to Exchange Information for non-medically related information
*HIPPA for medically related information
Note: After all evaluations have been completed, the following forms need to be completed:
_____ Prior Notice of IEP Team Meeting (Check on form: *Review existing information about your child, and
*Decide whether your child is eligible/ineligible
for special education
*Develop or review an IEP and placement of your
Child)
_____ Eligibility Form(s) - Include form(s) for all eligibilities considered as a part of the evaluation
_____ Prior Notice and Consent for Initial Provision of Special Education
_____ Individual Education Plan (IEP) draft 15 and younger or 16 and older
_____ Procedural Safeguards given to parent
_____ Parent Non-Attendance at IEP Letter
_____ Attendance / Agenda sheet
_____ Summary of Meeting Notes
_____ Prior Notice of Special Education Action
_____ Complete Child Find Census Report & Submit to JCESD
NOTE:
* Make corrections to the draft IEP in Tienet and send corrected copy to parent
* Send corrected original forms to ESD-Keep copy of all documents in your special education working file
** Contact Log – Please document all communications with parent on contact log (keep log in your sped file)
TIMELINES:
***60 school days from signed Prior Notice About Evaluation/Consent for Evaluation to eligibility meeting
***10 school days from date of IEP meeting to date send parent final corrected copy of IEP
***30 calendar days from date of initial eligibility to special education placement
JCESD August 2008