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LEA CAASPP Coordinator / 2016–17California Assessment of Student Performance and Progress
School/Test Site Data Collection Form / District and School Use Only
School Name / LEA CAASPP Test Site Coordinator Name (printed) / Telephone
School Code

This optional form may be used by local educational agencies (LEAs) to collect test-site information for use in verifying the accuracy of the California Assessment of Student Performance and Progress (CAASPP) Apportionment Information Report that the California Department of Education (CDE) will provide to LEAs in early January 2018. Return the completed form to your LEA CAASPP Coordinator. Do not return it to the CDE. Keep a copy for your records.

Description / Grade
2 / Grade
3 / Grade
4 / Grade
5 / Grade
6 / Grade
7 / Grade
8 / Grade
9 / Grade
10 / Grade
11 / Grade
12 / Total
A / Number of pupils enrolled on the last day of the CAASPP testing window for the LEA(do not use attendance figures)
Computer-based Assessments:
B / Number of pupils tested with any portion of the Smarter Balanced Summative Assessments
C / Number of pupils administered any portion ofthe California Science Test (CAST) and notadministered a Smarter Balanced Summative Assessment (reflected in Row B)
Computer-based Alternate Assessments:
D / Number of pupils with significant cognitive disabilities administered any portion of a California Alternate Assessment (CAA) (ELA and Math)
E / Number of pupils with significant cognitive disabilities assessed with the CAA for science and not administered a CAA for English-language arts or mathematics (reflected in Row D)
Pupils Without Scores (not included in rows B through E)
F / Number of pupils exempted from testing by written parent or guardian request (to be reported to the testing contractor through the Test Operations Management System)
G / Number of pupils, with demographic information only, who were not tested for any reason other than parent/guardian exemption
H / Total Number of Pupils (Rows B through G):
Optional Assessments (administered at the option of the LEA)
I / Number of English learner pupils administered the Standards-based Tests in Spanish (STS)for reading/language arts
J / Number of pupils administered a CDE-certified grade two diagnostic assessmentper California Education Code Section 60644
We hereby certify that the information provided in this report is complete and accurate.
Principal’s Name (printed) / Principal’s Signature / LEA CAASPP Test Site Coordinator’s Signature

California Department of Education January 2017

California Department of Education January 2017

Assessment Development and Administration Division

2016–17California Assessment of Student Performance and Progress
School/Test Site Data Collection Form

Directions

Complete only one form per school or test site. Year-round schools that tested in multiple administrations are to combine the information for all administrations on one form.

School Site Identification and Enrollment Data

  1. Print or type all information at the top of each form. Be sure to include the seven-digit school code.
  1. Row A: Number of pupils enrolled on the last day of the CAASPP testing window for the LEA. For each grade level served, enter the school/test site enrollment on the last day of the CAASPP testing window for the LEA, including both pupils present and absent. DO NOT use attendance figures.

Required LEA CAASPP School/Test Site Data

  1. Row B: Number of pupils administered any portion of the Smarter Balanced Summative Assessments. For each grade level served, enter the number of pupils in grades three through eight, inclusive, and grade eleven tested with any portion of the Smarter Balanced Summative Assessments, including any pupils administered apaper-pencil version due to technical barriers as identified by the LEA andapproved by the CDE prior to testing.
  1. Row C: Number of pupils administered any portion of the California Science Test (CAST)and not administered a Smarter Balanced Summative Assessment. For eachpupil in grade five, eight, ten, eleven, or twelve enter the number of pupils who took a CAST but did not also take a Smarter Balanced Summative Assessment as reflected in RowB.
  1. Row D: Number of pupils with significant cognitive disabilities administered any portion of a California Alternate Assessment (CAA) (ELA and Math)
  1. Row E: Number of pupils with significant cognitive disabilities administered any portion of a CAA. For each grade level served, enter the number of special education pupils assessed with the new CAA in grades five, eight and once in high school.
  1. Row F: Number of pupils exempted from testing by written parent or guardian request (to be reported to the testing contractor through the Test Operations Management System)LEAs are to report parent exemptions to the testing contractor through the Test Operations Management System.
  1. Row G: Number of pupils, with demographic information only, who were not tested for any reason other than parent/guardian exemption. For each grade level served, enter the number of pupils the LEA provided test registration information for who were not tested for any reason other than parent/guardian exemption.
  1. Row H: Total Number of Pupils. For each grade level served, enter the sum of Row B through Row G.

Optional Assessments

  1. Row I: Number of Spanish-speaking English learner pupils administered the STS for reading/language arts at the option of the LEA. For each grade level served, enter the number of Spanish-speaking English learnerpupils who were tested with any portion of the STS for reading/language arts in grades two through eleven, inclusive.
  1. Row J: Number of pupils administered a CDE-certified grade two diagnostic assessment per California Education Code Section 60644. For grade two, enter the number of pupils administered any portion of a CDE-certified grade two diagnostic assessmentat the option and cost of the LEA per California Education Code Section 60644. A pupil is to be reported only once. Do not report the number of times a student was administered the same assessmentor if the student was assessed withmultiple CDE-certified diagnostic assessments.

Certification Signatures

  1. Sign and return the completed form to your LEA CAASPP Coordinator. Keep a copy for your records. Do not submit the form to the CDE.