Tier 1/Universal PBS: Specific Action Plan

School-Wide Positive Behavior Support:

Action Planning Guide

Date:______District:______District Contact:______

School:______Address: ______

Phone: ______

Fax: ______Team Leader: ______

Principal: ______E-mail: ______

Asst. Principal: ______E-mail: ______

Coach(es) working with team: ______

Our Team Meetings are Regularly Scheduled on:

Day of week ______Time of day ______

Location ______Length of meeting ______

Establish a Team Goal, Purpose or Mission:

Team Agreements/Norms:

1.

2.

3.

4.

5.

Team Members

Names Role Phone Email

Part B

Tier 1/Universal PBIS: Specific Action Plan

Critical Element / Step 1:
What is the problem/issue/task to be addressed? / Step 2:
Why is it occurring? / Step 3:
What are we going to do about it? / To-Do List / Persons Responsible / Follow-Up or Completion Date / Step 4: How will we know when we’ve been successful?
PBS Team / 1.
2.
3.
4.
5.
Faculty Commitment / 1.
2.
3.
4.
5.
Discipline Procedure / 1.
2.
3.
4.
5.
Data Entry & Analysis / 1.
2.
3.
4.
5.

Tier 1/Universal PBIS: Specific Action Plan

Critical Element / Step 1:
What is the problem/issue/task to be addressed? / Step 2:
Why is it occurring? / Step 3:
What are we going to do about it? / To-Do List / Persons Responsible / Follow-Up or Completion Date / Step 4: How will we know when we’ve been successful?
Expectations & Rules / 1.
2.
3.
4.
5.
Acknowledge System / 1.
2.
3.
4.
5.
Lesson Plans & Teaching / 1.
2.
3.
4.
5.
Implementation Plan / 1.
2.
3.
4.
5.

Tier 1/Universal PBIS: Specific Action Plan

Critical Element / Step 1:
What is the problem/issue/task to be addressed? / Step 2:
Why is it occurring? / Step 3:
What are we going to do about it? / To-Do List / Persons Responsible / Follow-Up or Completion Date / Step 4: How will we know when we’ve been successful?
Classroom Systems / 1.
2.
3.
4.
5.
Evaluation / 1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.