CASA OF PHILADELPHIA COUNTY

EDUCATIONAL DECISION-MAKER (EDM) PROGRAM

EDUCATIONAL ACTION PLAN: QUARTERLY ASSESSMENT

This form is to be used by the assigned EDM volunteer as aguide to help obtain information about the child’s educational services and progress towards maintaining school stability, achieving positive academic achievement and engaging in school-based activities. The EDM supervisor will meet with the volunteer quarterly to monitor actions and required follow-up efforts in order to ensure consistent advocacy efforts and decision-making actions.

School Year: 2017/2018

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Made possible by the generous support of Impact100 Philadelphia.

CASA OF PHILADELPHIA COUNTY

EDUCATIONAL DECISION-MAKER (EDM) PROGRAM

EDUCATIONAL ACTION PLAN: QUARTERLY ASSESSMENT

Volunteer:

Child:

Group Home/Institution/Foster Home:

Provider Worker:

DHS Worker:

Name of School:

Teacher:

Guidance Counselor:

Beginning of School (Due Oct 1st)
Qtr1 (Due Dec. 1st)
Qtr2 (Due March 1st)
Qtr3 (Due May 1st)
Qtr4 (Due July 1st )

D.O.B:

Address:

Phone #:

Phone #:

Address:

Phone #:

Phone#:

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Made possible by the generous support of Impact100 Philadelphia.

CASA OF PHILADELPHIA COUNTY

EDUCATIONAL DECISION-MAKER (EDM) PROGRAM

EDUCATIONAL ACTION PLAN: QUARTERLY ASSESSMENT

Current Education Status

  1. Is the child enrolled in school? yes or no
  2. If no, why?
  1. Is the child receiving on-grounds educational services? yes or no
  2. If yes, who is responsible for providing educational materials?
  3. Who teaches them?
  4. How frequently are educational sessions taking place?
  5. What is the duration of each session?
  1. How long has the child been attending his/her current school?
  1. What grade is the child currently enrolled?
  1. Is the child in Regular or Special Education?
  1. Does the child have an Individualized Education Plan (IEP)? yes or no
  2. Date of last IEP update:
  3. Is this plan meeting the child’s needs?
  1. Does this child have a Section 504 Plan? yes or no
  2. Date of last 504 Plan update:
  3. Is this plan meeting the child’s needs? yes or no
  1. If currently not enrolled in a school setting, what educational services are the child receiving and from whom?

SCHOOL STABILITY

  1. How many school moves has the child made in the last two years?
  2. How many moves because of a foster care placement change?
  3. Did the child miss school as a result? yes or no
  4. How many days?
  5. How many moves because of behavioral problems?
  6. How many moves because of academic needs?
  1. Date(s) of moves:
  1. Has the child ever repeated a grade in school? yes or no
  2. Which grades?
  1. List school(s) attended:

School Name / Start and End Dates / In the best interest of the child? Y or N

(To add rows: go to “Table” then “Insert” then “Add Row Below.)

  1. List placements/foster home(s):

Facility / Household Name / Start and End Dates / In the best interest of the child? Y or N

(To add rows: go to “Table” then “Insert” then “Add Row Below.)

  1. What efforts have been made to maintain the child’s placement?
  1. What pitfalls in maintaining school placement have been encountered?

Attendance:

  1. Is the child regularly attending school? yes or no
  1. How many days present so far this school year?
  1. How many days marked late?
  1. How many excused absences? (court, doctor, sick day, etc.)
  1. How many unexcused absences?
  1. Has the child received any truancies and, if so, for how many days?
  1. Has the child been expelled, suspended or excluded from school this year? yes or no
  2. If yes, how many times?
  1. Have proper due process procedures been followed for the expulsions, suspensions or exclusions from school?
  1. What was the nature/reason for the child’s recent expulsion, suspension or exclusion from school?
  1. How many days of school will be missed as a result of being expelled, suspended or excluded from school?

Performance Level

  1. At which grade level is this child performing?
  1. Is the child academically on target? yes or no
  1. Is this the appropriate grade level for this child? yes or no
  2. If no, what is the appropriate grade level for this child?
  1. What is the child’s current grade point average?
  2. If below average, what efforts are being made to address this issue?
  1. Is the child receiving any tutoring or other academic supportive services? yes or no
  2. If yes, in which subjects and who are they taught by:
  3. If yes, how often are the sessions and for what duration?

ACADEMIC ASSESSMENT SERVICES

  1. When did the child last receive an educational evaluation or assessment?
  1. How comprehensive is this assessment?
  1. Is there a plan in place to help the child reach the appropriate grade level? yes or no
  1. Does the child need an education evaluation or assessment? yes or no

Health Factors Impacting Education

Physical Health

  1. Does the child have any physical issues that impair his or her ability to learn interact appropriately, or attend school regularly? (e.g. hearing impairment, visual impairment?) yes or no
  1. If yes: What is the physical issue?
  1. How is the physical issue impacting the child’s educational experience?
  1. How is the need being addressed?

Mental Health

  1. Does the child have any mental health issues that impair his or her ability to learn, interact appropriately, or attend school regularly? yes or no
  1. If yes: What is the mental health issue?
  1. How is the need being addressed?
  1. Which, if any, psychotropic medications have been prescribed?
  1. Has the need to be taking this medication been clearly explained to the child? yes or no
  1. How will this medication affect the child’s educational experience?

Emotional Issues

  1. Does the child have any emotional issues that impair his or her ability to learn, interact appropriately, or attend school regularly? yes or no
  1. Has the child’s educational decision-maker been informed of all information in the assessmentand does that individual understand the results? yes or no
  1. Is the child being provided with information and assistance in applying for financial aid, including federally funded Education and Training Vouchers?
  1. If the child has an IEP, does it address transition issues? yes or no
  1. If yes: What does this transition plan entail?
  2. Did the child participate in developing the transition plan? yes or no
  3. Is transition plan coordinated with the child independent living plan? yes or no

Social Factors Impacting Education

  1. Is the child experiencing difficulty interacting with other children at school? yes or no
  1. Is the child experiencing difficulty interacting with teachers/school faculty? yes or no

SCHOOL ENGAGEMENT

  1. What are some identifiable areas in which the child is excelling at school?
  1. Is this child involved in any extracurricular activities? yes or no
  2. If yes, what are they, and when are they scheduled?
  1. Have any of the child’s talents/interests been identified?
  2. If so, what are they?

Provision of Supplies

  1. Does the child have appropriate clothing to attend school? yes or no
  1. Does the child have the necessary supplies and equipment (e.g. pens, notebooks, musical instrument) to be successful in school? yes or no
  1. If no, what does the child need?

Transportation

  1. How is the child getting to and from school?
  1. What entity (e.g. school, foster care agency) is responsible for providing transportation?

EDUCATIONAL DECISION-MAKING ACTIONS:

Please list the activities completed on behalf of the child:

DATE / EDM ACTION TYPE
(Phone calls, meetings, etc. based on any barriers re: academic; attendance; health; school stability; social; school engagement; transportation; special services; other) / OBJECTIVE / OUTCOME/NEXT STEPS

EDM SUPERVISOR REMARKS

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Made possible by the generous support of Impact100 Philadelphia.