34 CFR 300.306 6. Were the vision and hearing screenings completed within one year of testing for the student? Yes No Vision Screening Date passed:_____ Hearing Screening Date passed:_____ 7. Did the evaluation team use a variety of assessment tools to gather relevant academic, functional and developmental information about the student to determine eligibility? Yes No N/A Psychological Report SST Records Eligibility Report 8. Were the assessments and other evaluation materials selected to assess all needs and not merely those that are designed to provide a single general intelligence quotient? Yes No N/A Psychological Report Eligibility Report 9. Did the Eligibility Report include appropriate prereferral interventions and results (includes SST)? Yes No N/A SST records Eligibility Report C. Cont’d ELIGIBILITY OR REDETERMINATION 34 CFR 300.306 Initial Eligibility Date ________ Possible Evidence Comment based
10. Did the evaluation team consider progress monitoring data reflecting student progress over time? Yes No N/A SST Records Eligibility Reports 11. Was parent input included during the eligibility determination discussion? Yes No N/A Eligibility Report 12. Did the team consider exclusionary factors to determining eligibility? Yes No Eligibility Report 13. Were all eligibility requirements met? If eligibility requirements were not met did the IEP team list the reasons on the Eligibility Report? Yes No N/A Eligibility Report D. PROCESS 34 CFR 300.303 34 CFR 300.306 Current Reeval Date ________ Previous Reeval Date________ Possible Evidence Comment 14a. Was the reevaluation/redetermination process completed? Yes No N/A Yes No N/A IEP Reevaluation/ Redetermination checklist
Date completed: ___________ 14b. Were several sources of data reviewed to consider eligibility? Yes No N/A Yes No N/A Eligibility Report Reevaluation/ Redetermination checklist 14c. Were additional data needed to determine reevaluation? Some additional data was needed No additional Ad data was needed N/A Some additional data was needed No additional data was needed N/A Reevalution/ Redetermination checklist D. Cont’d PROCESS 34 CFR 300.303 34 CFR 300.306 Current Reeval Date ________ Previous Reeval Date________ Possible Evidence Comment 14d. Does the student continue to meet eligibility? Yes No N/A Yes No N/A Eligibility Report Reevaluation/ Redetermination checklist 14e. Were supports and/or interventions identified for the student if no longer eligible? Yes No N/A Yes No N/A SST minutes 504 plan
qualified to interpret instructional implications of test results Other agency personnel, if appropriate (VR, DBHDD, Private Evaluators, Social Workers, etc) Excusal letter, if applicable Transition and agency personnel invited as appropriate with written parental consent G. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE 34 CFR 300.320 34 CFR 300.324 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 17a. Does the Present Levels of Academic Achievement and Functional Performance (PLAAFP) include information regarding results of the initial and/or most recent evaluation of the student? Yes No Yes No IEP Date(s) of testing Explanation describing what the test scores mean? 17b. Does the present include recent state and/ or district assessments results? Yes No N/A Yes No N/A Assessment(s) Name(s): Date:
20. Were parental concerns regarding their student’s education stated on the IEP? Yes No Yes No IEP H CONSIDERATION OF SPECIAL FACTORS 34 CFR 300.324 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 21. Did the IEP team consider all special factors that may influence the student’s educational programs? Yes No N/A Yes No N/A If Applicable: Limited English Proficiency (LEP) Blind or visually impaired Behavior Communication Deaf/hard of hearing needs Assistive Technology devices or services Alternative formats for instructional materials 22a. Did the IEP team develop plans (i.e., AT plan, BIP etc.) to address special factors to provide educational benefit to the student? Yes No N/A Yes No N/A Documentation of special factors. For example, AT plan and/or Functional Behavior Assessment (FBA)
Behavior Intervention Plan (BIP) H Cont’d CONSIDERATION OF SPECIAL FACTORS 34 CFR 300.324 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 22b. Does the Behavior Intervention plan include target behavior and positive behavior interventions and supports? Yes No N/A Yes No N/A BIP 22c. Did the student make progress on targeted behaviors after implementation of positive behavior interventions and supports? Yes No N/A Yes No N/A BIP IEP I. TRANSITION SERVICES PLAN 34 CFR 300.320 34 CFR 300.43 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 23. Was the transition plan developed by age 16 or 9th (whichever comes first)? Yes No N/A Yes No N/A Transition plan 24. Does the transition plan reflect steps toward desired post secondary outcomes? Yes No N/A Yes No N/A
24a. Postsecondary outcome goals for Education/Training Yes No N/A Yes No N/A I. TRANSITION SERVICES PLAN 34 CFR 300.320 34 CFR 300.43 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 24b. Postsecondary outcome goal for Employment Yes No N/A Yes No N/A 24c. Postsecondary outcome goal for Independent Living (if appropriate) Yes No N/A Yes No N/A 24d. Transition IEP Measurable Goals to meet postsecondary goals, at least one for each education/ training. Yes No N/A Yes No N/A 24e. Transition IEP Measureable Goals to meet postsecondary goals, at least one for employment. Yes No N/A Yes No N/A 24f. Postsecondary goals on transition assessments Yes No N/A Yes No N/A 24g. Transition services and/or activities to facilitate movement to postsecondary outcomes Yes No N/A Yes No N/A
24h. Course of study to facilitate movement to post-school Yes No N/A Yes No N/A I. Cont’d TRANSITION SERVICES PLAN 34 CFR 300.320 34 CFR 300.43 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 24i. Were student’s post-secondary goals aligned with the outcome of the transition assessment? Yes No N/A Yes No N/A Transition assessment Transition plan Individual Graduation Plan 24j. Were the students informed of the transfer of all due process rights to student at age 17? Yes No N/A Yes No N/A IEP 24k. Were all due process rights transferred to the student at age 18? Yes No N/A Yes No N/A IEP J. MEASURABLE ANNUAL AND/OR SHORT-TERM OBJECTIVES 34 CFR 300.320 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 25a. Does the student’s annual goals and short-term objectives align with the needs section of the PLAAFP? Yes No Yes No IEP goals Criteria for mastery Evaluation method (s)
J. (cont’d) MEASURABLE ANNUAL GOALS AND/OR SHORT-TERM OBJECTIVES 34 CFR 300.320 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 25b. Does the IEP have measurable goals to address areas of deficits that help the student make progress towards general education curriculu Yes No Yes No IEP 25c. Has the student made progress toward his/her goals and objectives? Yes No Yes No IEP Progress reports Data sheets 26. Has the IEP team revised the IEP to address any lack of expected progress toward annual goals? Yes No N/A Yes No N/A IEP amendments 27. Are IEP annual goals identified to support the student’s Transition Plan if appropriate? Yes No N/A Yes No N/A IEP 28. Does the IEP contain a statement regarding when progress on IEP goals is reported to parents? Yes No Yes No IEP Progress reports K. STUDENT SUPPORTS FOR ACADEMIC AND NONACADEMIC ACTIVITIES 34 CFR 300.320 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment
29a. Does the IEP include instructional accommodations? Yes No N/A Yes No N/A IEP 29b. Did the accommodations with the students needs stated in the PLAAFP? Yes No N/A Yes No N/A IEP 30. Do the accommodations enable the student to make progress in the general education curriculum? Yes No N/A Yes No N/A IEP Progress reports Report Card 31. Does the IEP include accommodations that are necessary for the student to participate in classroom assessments? Yes No N/A Yes No N/A IEP 32a. Does the IEP include a statement of the special education and related services and supplementary aids and services to be provided to the student? Yes No N/A Yes No N/A IEP K. (con’t) STUDENT SUPPORTS FOR ACADEMIC AND NONACADEMIC ACTIVITIES 34 CFR 300.320 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment
32b. Do the supplementary aids and services enable the student to attain his/her goals AND make progress in the general education curriculum? Yes No N/A Yes No N/A IEP Progress Reports Report Card 33. Does the IEP include supports for school personnel in order to enable student to make progress within the general education curriculum? Yes No N/A Yes No N/A IEP Progress Reports Report Card L. PARTICIPATION IN ASSESSMENTS/ACCOMMODATIONS 34 CFR 300.320 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment 34. Does the IEP have appropriate accommodations listed by subtest that enable the student to participate in district and state assessments (GAA, EOC, Milestones)? Yes No N/A Yes No N/A IEP State and district tests specific to each subtest and test State and district tests aligned with needs section of the PLAAFP State and district test accommodations used as instructional accommodation GAA: Statement explaning why student cannot participate in general education assessment M. SPECIAL EDUCATION/RELATED SERVICES 34 CFR 300.34 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment
34 CFR 300.116 34 CFR 300.320 35a. Did the IEP team consider placement options for the student? Yes No Yes No IEP 35b. Did the IEP team select options of services for the student? Yes No Yes No IEP Frequency of services (hours, minutes, segments per day, week, or month indicated) Dates for initiation and duration of services (month/day/year) Special education location of services General education location of services 35c. Is the student making progress in the current placement? Yes No N/A Yes No N/A IEP Progress report Report Card M. Cont’d SPECIAL EDUCATION/RELATED SERVICES 34 CFR 300.34 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment
34 CFR 300.116 34 CFR 300.320 36. Are the appropriate services identified to support progress toward all goals including: progress in the general curriculum, participation in extracurricular activities, and other nonacademic areas? Yes No N/A Yes No N/A IEP Placement discussion Progress Reports Report Card 37. Were services and supports documented for all of need? Yes No Yes No IEP 38. Did the IEP include an explanation of the extent, if any, to which the student will not participate with peers without disabilities in the regular class and/or in nonacademic and extracurricular activities? Yes No N/A Yes No N/A IEP N. EXTENDED SCHOOL YEAR 34 CFR 300.106 Current IEP Date_______ Previous IEP Date_______ Possible Evidence Comment