Page 1 CONFIDENTIAL DOCUMENT

Page 1 CONFIDENTIAL DOCUMENT

ST. LANDRY PARISH

REEVALUATION REPORT

Student’s Name / School
Case# / Teacher
State ID # / Parent(s)
DOB / Address
Age / Grade
Race / Gender / Phone
REASON FOR REEVALUATION: / DOCUMENTATION:
New Concerns / Re-evaluation Notification Date
Significant Change of Placement / Re-evaluation Meeting Date(s)
Declassification
Developmental Delay / Dissemination Date
Hearing Impairment
Traumatic Brain Injury / Extension of Timelines -
Visual Impairment / Reason:
Other - Specify / Number of Days:
REVIEW OF INFORMATION RELATIVE TO: (Check if applicable)All documentation will be maintained by PAC.
Information provided by Parents and / or Student (Evaluations, etc.)
Educational History (Previous Evaluations, Standardized Tests, Grades, Pupil Progression, etc.)
Progress Monitoring Data - provided by teacher(s) and/or related service provider(s)
Observations – conducted by teacher(s) and/or related service provider(s)
Transition Needs (for students 15 years and older)
Additional Information (See page 2)

REEVALUATION DETERMINATIONS

A. Is there sufficient data to determine whether the student continues to have the existing exceptionality? YES NO

B. Is there sufficient data to determine the student’s present levels of academic achievement and educational needs? YES NO

C. Is there sufficient data to determine student’s related developmental needs? YES NO NA

D. Is there sufficient data to determine whether the student continues to need special education and related services? YES NO

E. Is there sufficient data to determine whether any additions or modifications to the education program and related services are needed to enable the student to meet the measurable annual goals set out in his/her Individualized Education Program (IEP)/Services Plan and to participate, as appropriate, in the general curriculum? YES NO

NOTE: If all of the answers above are YES, proceed to Section F. * If any of the answers above are NO, additional data will be presented on page 2.
Reconvene Reevaluation Team after additional data is collected. This meeting must be scheduled so as not to exceed the due date for this reevaluation.
Parents must be notified of this determination and the reasons for it; and of the right to request an assessment to determine whether, for the purposes of services, their child continues to be a student with a disability.
F. / EXCEPTIONALITY -
Impairment or Condition -
Additional / Related Services Needed -

We have reviewed the information and agree with the findings in this report:

Name/Signature

/

Position

/

Date

/

Approved:

Special Ed. Teacher /

Mary R. Doucet

Administrator of Special Education

Regular Ed. Teacher
Parent
Student
S. Nacoste/ / Coordinator

Page 2CONFIDENTIAL DOCUMENT

ST. LANDRY PARISH

REEVALUATION REPORT

Student
Case #
ADDITIONAL DATA:

The following are the “Additional Data” referred to in the new 1508 reeval criteria. They are just here to serve as reminders. Use what is appropriate.

Reevaluation requirements for:

Developmental Delay

Hearing Impairment

Traumatic Brain Injury

Visual Impairment

Additional Assessment/Evaluations

Documentation of Scientifically research-based interventions for “New concerns”

Documentation of Additional Data that addresses concerns

Initial criteria and procedures if different exceptionality is suspected

Systematic observation

Separate signed dissenting opinion – states the disagreement and provides supporting data and conclusions

Student: School: Sped. Teacher:

Notice of Upcoming Reevaluation

Date:

To:

This letter serves as notification of the upcoming reevaluation being conducted on this student for the following reason:

Your participation and input is appreciated and mandated by LA Bulletin 1508 in order to complete this process.

Thank you,

Coordinator

Notice of Reevaluation Meeting

Date:

To:

You are invited to attend a reevaluation meeting for this student. If you will not be in attendance, pleaseinform the Special Education Teacher as soon as possible.

Thank you,

Coordinator

Meeting Date: Time: Location:

ST. LANDRY PARISH

PUPIL APPRAISAL CENTER

FOLLOW-UP REPORT

NAME OF STUDENT

/ CASE NO.

SCHOOL

DATE OF INTERPRETATION

DATE OF DISSEMINATION

EXCEPTIONALITY

CASE INTERPRETED TO (Check the one appropriate):

Principal / SBLC Chairperson
Teacher / Guidance Counselor
Other

A complete evaluation report was interpreted and discussed with school personnel. Recommendations as set forth by the Pupil Appraisal team were accepted.

*Initial IEP due on or before:

*Updated IEP for new exceptionality due on or before:

Copy of this follow-up given to:

Teacher/Therapist and IEP Specialist (If new exceptionality)

SIGNED:

Principal / Teacher
Guidance Counselor / Pupil Appraisal Staff Member
SBLC Chairperson / Other
COMMENTS:
STUDENT NAME: CASE # SSN#

Section VI:PUPIL APPRAISAL EVALUATION INFORMATION

Type of Evaluation: 1 - Initial Evaluation

2 - Reevaluation

Determination of Eligibility: Dissemination Date:

Exceptionality:

- Autism- Multiple Disabilities

- Visual Impairment – Blindness - Autism

- Visual Impairment – Partially Seeing- Visual Impairment - Blindness

- Hearing Impairment – Deafness- Hearing Impairment - Deafness

– Hearing Impairment – Hard of Hearing- Emotional Disturbance

- Deaf-Blindness- Mental Disability - Moderate

- Emotional Disturbance- Mental Disability - Severe

- Developmental Delay - Mental Disability - Profound

- Specific Learning Disability- Orthopedic Impairment

- Basic Reading Skills- Other Health Impairment

- Reading Comprehension - Traumatic Brain Injury

- Reading Fluency- Orthopedic Impairment (Medical Diagnosis Required)

- Mathematics Reasoning - Other Health Impairment (Medical DiagnosisRequired)

- Mathematics Calculation - No Exceptionality

- Oral Expression - Traumatic Brain Injury (Medical Diagnosis Required)

- Written Expression - Gifted

- Listening Comprehension - Speech or Language Impairment

- Mental Disability – Mild- Articulation

- Mental Disability – Moderate- Fluency

- Mental Disability – Severe- Language

- Voice

- Talented

- Music

- Theater

- Visual Arts

- Unable to Complete Evaluation Process

Medical Diagnosis (Medical Diagnosis is required for Orthopedic Impairment, Other Health Impairment and Traumatic Brain Injury)

AmputationSickle Cell AnemiaSevere AllergiesTourette’s dDisorder

Arthogryposis EpilepsySpina BifidaNarcolepsy

Asthma HydrocephalusOther Spinal DisabilityExternal Physical Force to theBrain

Cancer LeukemiaUsher’s SyndromePost-Traumatic StressSyndrome

Cerebral Palsy Multiple SclerosisADDOther

Congenital Heart Defect Muscular DystrophyADHD Osteogenesis Imperfecta

Diabetes

Participants in Evaluation:

AudiologistOrthopedistSchool Nurse

Educ. DiagnosticianOther Medical SpecialistPhysical Therapist

Educ. ConsultantCertified School PsychologistOccupational Therapist

PsychiatristSocial WorkerAdapted P.E. Teacher

Optometrist/Speech/Language PathologistParent

OphthalmologistTeacher (Current) Neurologist

PediatricianSchool CounselorOther

Coordinator:

St. Landry Parish

Teacher / Related Service Provider Reevaluation Worksheet

Student Case # Teacher Date

Progress Monitoring Data– Provide Documentation

Charting and/or Graphing of Performance (Utilize data banks such as “Teacher Ease”, “Chart Dog”, or other graphing tools).

Provide intervention data used to address lack of progress.

Student Observation Data - Based upon observations, briefly describe the following:

Overall Reading Skills –

Overall Math Skills -

Level of Cooperation –

Time on Task –

Self-Confidence –

Response to Difficult Tasks –

Classroom Participation –

Completion of Assignments –

Peer Interaction –

Overall Behavior –

Attendance –

Comments:

LETTER FOR PRIOR NOTICE OF PROPOSED ACTION BY ST. LANDRY PARISH SCHOOLS FOR STUDENTS WITH DISABILITIES/IMPAIRMENTS

Date: / Coordinator/Teacher:
School: / Case #:
To: / and/or

(Student’s Name)(Parent(s) / Guardian(s) Name)

Mailing Address:
City, State, Zip Code:

Student and/or Parent(s) of a child with a disability have legal rights called procedural safeguards, which are part of the Regulations for Implementation of the Children with Exceptionalities Act. The procedural safeguards are found in the enclosed copy of Louisiana’s Educational Rights of Children with Disabilities.

If you are a person with a disability or speak another language, these rights can be given to you in a different format or language (e.g., Larger print, Braille, on CD, DVD or tape, or translated into another language). The Individuals with Disabilities Education Act recognizes that it is important that families be fully informed so that they can participate equally in making decisions about their child’s special education.

The following arrangements have been made for the meeting:

Date:
Time:
Location:

At this meeting we will:

Discuss the results of the evaluation and documentation of the determination of eligibility.

Develop, review, or amend an individualized education program (IEP) and determine placement (i.e., services and support, not the building or classroom) for your child. The development of the IEP will be based on information from a variety of sources, including the strengths of the child, the concerns of the parents for enhancing the education of their child, the results of the initial or most recent evaluation of the child, the academic, developmental, and functional needs of the child, and any other special factors. At this meeting we will have a draft copy of the IEP for the team to review. In all cases, the IEP team, of which you will be an equal participant, must review each section of the IEP to assure agreement. Any section of the IEP can be revised by the team before the IEP is finalized.

Consider your child’s transitional services needs. Transitional services are designed to promote movement from school to post-school activities including post-secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation.

Beginning not later than the first IEP to be in effect when the child turns 16, (or younger if deemed appropriate by the IEP team), and updated annually, thereafter, the IEP will include a statement of transitional service needs including a statement of the interagency responsibilities or any needed linkages.

At the IEP Team meeting, discuss your child’s possible eligibility for participation in LEAP Alternate Assessment, Level 1 (LAA 1) or Level 2 (LAA 2) rather than all aspects of the LEAP.

If my child participates in LEAP Alternate Assessment, Level 1 (LAA1), he/she will work toward a Certificate of Achievement (instead of the standard high school diploma). My child may earn Carnegie Units when appropriate.

If my child participates in LEAP Alternate Assessment, Level 2 (LAA2) rather than all aspects of the LEAP:

He/She can work towards a standard high school diploma. By taking the LAA2 and meeting graduation requirements *for the standard high school diploma, my child will be eligible for a high school diploma.

*Graduation requirements include: (1) earning required Carnegie units, (2) passing the required components of LAA2 (ELA, Math, and either Science or Social Studies) or passing by use of the LAA2 waiver, and (3) meeting attendance requirements.

Or he/she can work towards a Certificate of Achievement (instead of the standard high school diploma).

If my child does not meet the graduation requirements, he/she will be eligible to exit high school with a Certificate of Achievement.

The implications of alternate assessment have been explained to me and will be reviewed at least annually.

Discuss at the IEP Team meeting your child’s possible eligibility for entering the Options (Pre-GED/Skills) program. Your child must be 16 years of age or turn 16 during the year he/she is to enroll in the program and meet eligibility criteria. In the Optionsprogram, your child will be working toward a Louisiana Equivalency Diploma and/or aSkills Certificate, and not the standard Louisiana High School diploma.

Consider disciplinary action.

Reevaluate your child’s continued need for special education and related services. Your permission is requestedfor the reevaluation. The evaluation procedures we plan to use include the following:

A review of existing evaluation data, including evaluations and information provided by you.

A review of your child’s progress toward meeting the measureable annual goals.

A review of current classroom-based local or state assessments and classroom –based observations

A review of age-appropriate transition assessments related to training, education, employment and where appropriate, independent living skills, vocational and transition needs for an IEP in effect when the child turns 16 years old (or younger, if deemed appropriate by the IEP team).

Other tests and evaluation procedures that the IEP team and pupil appraisal staff decide are necessary.

Your child will be invited to participate in the IEP Team meeting unless you disagree (if your child is under age of majority, 18). We also need your permission to invite the selected representatives of adult transitional services listed below.

You may also bring other person(s) with you to assist in planning the IEP.

The following persons listed below will be invited to attend this meeting:

School System Personnel:

Officially Designated Representative Regular Education Teacher

Evaluation Representative Special Education Teacher

Other Representative Agency

Other Representative Agency

EXCUSAL REQUEST

We are asking permission to excuse the following persons from the meeting:

(Name and Position) (Name and Position)

(Name and Position) (Name and Position)

(Name and Position) (Name and Position)

This member’s area of curriculum or related services is not being discussed at the meeting.

This member’s area of curriculum or related services will be discussed at the meeting. Included is the member’s input to the general student information, academic and functional performance levelsand goal(s), amount of services, and any other recommendations for your child.

Please return the attached sheet to indicate whether you plan to attend the IEP Team meeting as scheduled. If this date, time, or location is not convenient for you, please indicate when you can attend.

Student’s Name: / Case No:
Coordinator / Teacher:

PLEASE CHECK THE APPROPRIATE SPACES, SIGN, AND RETURN WITHIN THREE (3) DAYS:

I have received a copy of Louisiana’s Educational Rights of Children with Disabilities.

Note: Parent(s) / guardian(s) of a child with a disability should receive a copy annually, as well as (1) the first time the child is referred for evaluation; (2) the first time acomplaint is filed; (3) whenever a parent asks.

Meeting for evaluation results or permission for reevaluation:

I plan to attend the meeting to discuss the evaluation results at the time and place indicated in the notification letter. I plan to bring additional person(s) with me.

I am unable to attend the meeting to discuss the evaluation results at the time and place indicated in the notification letter. The best day and time for me are .

I am unable to attend the meeting to discuss the evaluation results scheduled, in person, but I would still like to participate by telephone conference. Please call me at ( ) - to schedule telephone conference.

I give permission for you to conduct the reevaluation and any additional tests that may be needed.

Meeting for IEP:

I plan to attend the IEP Team meeting at the time and place indicated in the notification letter. I plan to bring additional person(s) with me.

I am unable to attend the IEP Team meeting at the time and place indicated in the notification letter. The best day and time for me are .

I am unable to attend the IEP Team meeting scheduled, in person, but I would still like to participate by telephone conference. Please call me at ( ) - to schedule telephone conference.

I give permission for you to invite the adult service agency (ies) listed on page 2 because they may be responsible for providing or paying for transition services.

I give permission for you to excuse the attendance of the IEP participants as noted on page 2.

I revoke my consent for special education and related services to be provided to my child.

If you have any special needs, please indicate them here: / .
X
PARENT(S) / GUARDIAN(S) SIGNATURE / DATE

RETURN WITHIN THREE (3) DAYS TO:

 / 
(Teacher) / (Contact Person)
(School Name) / OR / St. Landry Parish Pupil Appraisal Center
(School Address) / 127 Blair Street
(City, State, Zip) / Opelousas, Louisiana 70570
(School Telephone Number) / (337) 948-3646

Copies to: Parent, Teacher, Evaluation File, Service Provider(s) St. Landry Parish - Revised Sept. 2016