Edgefield County School District Office of Exceptional Children

Action Steps for 504 Process

Who qualifies……
· A student must have a disability documented by a qualified professional…..AND
· Have a disability that impairs a major life activity at school…..AND
· Have a disability that substantially limits the students ability to perform this major life activity
Definition of a major life activity……
*Caring for oneself *Performing manual tasks *Walking *Seeing *Hearing *Speaking *Breathing *Major bodily functions *Learning *Working *Sleeping *Standing *Lifting *Interacting with others *Bending *Reading *Thinking *Concentrating *Communicating
There is no automatic eligibility, and a student who is not IDEA eligible is not automatically eligible for a 504
CHECK WHEN COMPLETE / STEP / ACTION / TIMELINE / PERSON RESPONSIBLE
1. / School receives a request for a student to be considered for 504 / 504 School Coordinator
2. / Fill out Form A. (Intake for Parent Request for Assistance) This is an interview and needs to be done in person or over the telephone with the parent. / Within one week. All efforts to contact parent must be documented / 504 School Coordinator
3. / Fill out Form B (Intake for Teacher/Administrator Request for Assistance) with the teacher and administrator. This form can be completed by the adult. / Within one week / 504 School Coordinator
4. / The decision rendered at the completion of these forms guides you to the next step:
1. 504 referral
2. Intervention by regular classroom teacher
3. Special Education evaluation / Schedule a 504 meeting
Give information to the teacher(Teacher Interview Form)
Give to school psychologist and Sp. Ed. Coordinator
IMMEDIATELY. / 504 School Coordinator
504 School Coordinator
504 School Coordinator
5. / Initial 504 Eligibility Meeting
Form A & B are completed and Form C is done (504 Referral). / 504 School Coordinator
6. / Determine who needs to attend the meeting:
Medical issues? - Invite the nurse
Grade issues? - Invite teachers
Discipline issues? – Invite administrator
Considering eval? - Invite psychologist. / 2 weeks before the meeting / 504 School Coordinator
7. / Parent is invited to the meeting. Phone parent to set an agreeable date and time, but a formal invitation must be sent. Send forms C, E, F, G, H, I, J, K, L and M. / Needs to be done so meeting occurs within 30 days of request for 504 consideration / 504 School Coordinator –Inform the parent that the following forms must be returned prior to meeting - G, H, I, J, K and L
8. / Begin to gather data on the student
-Grades, MAP, PASS, HSAP
- Discipline
- Attendance
- Nurse info if relevant
- Distribute form X (Student Observation) / 2 weeks before the meeting
Make sure that the Student Observation Forms (Form X) are reviewed CAREFULLY several days prior to the meeting
At least 2 should be completed. / 504 school Coordinator
9. / Review Discipline.
Is a behavior plan needed? If yes, distribute behavior forms to teachers (Forms P & Q). / 10 days before meeting / 504 School Coordinator
10. / Talk to teachers/analyze all information you have gathered. Look for trends. / 5-7 days before meeting / 504 School Coordinator
11. / Remind parent of meeting (Send another invite via mail or speak or email them). Document on form J that the second contact is made. / 3-5 days prior to meeting / 504 School Coordinator
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12. / Gather all forms for the meeting and put in a folder. Fill out as much information prior to the meeting.
Remind staff members of the meeting date and time. / 3 days prior to meeting
Day of meeting / 504 School Coordinator
At the 504 Meeting
13. / Complete Form N to determine eligibility / During the meeting / 504 School Coordinator
14. / If the student qualifies, complete form O / During the meeting / 504 School Coordinator
15. / Complete the Meeting Summary Form / During the Meeting / 504 School Coordinator
16. / Complete Form R (Parental Consent) / During the Meeting / 504 School Coordinator
17. / If the parent does not attend, send Form T (Follow up letter), Form R (Parental consent for 504 Services) and Parental Handbook home / After the meeting / 504 School Coordinator
18. / Send all ORIGINAL paperwork and supporting documentation to the 504 District Coordinator. Make a copy for your school file. / Within 5 days of meeting / 504 School Coordinator
List of Forms / Form Name
Form A / Intake for Parent Request for Assistance
Form B / Intake for Teacher/Administrator Request for Assistance
Form C / Initial Section 504 Referral
Form E / District 504 Policy for Parents
Form F / Procedural Safeguards
Form G / Receipt of Rights
Form H / Parental Permission to Assess
Form I / Parental Authorization for Release of Information
Form J / Section 504 Letter of Invitation
Forms K / Parent Invitation Response
Form L / Medical Report
Form M / Developmental History
Form N / 504 Eligibility Team Review
Form O / Section 504 Accommodation Plan
Form P / FBA – Competing Behavior Pathway
Form Q / Behavior Intervention Plan
Form R / Parental Consent for 504 Services
Form T / Section 504 Follow up Notice of Conference Results
Form X / Student Observation Record
Staffing Summary / Review Summary
Parental Handbook
Other Forms Available for Use if Needed
List of Forms / Form Name
Form D / Assessment Checklist
Form U / Section 504 Termination Form
Form V / Section 504 / BIP Distribution Form
Form W / Documentation of ISS as an Intervention
Notice for Student Record Folder
Discipline Handbook
Classroom Intervention Plan

September 2012