individual learning plan - Events [PDF]

INDIVIDUAL LEARNING PLAN SCHOOL Student Name: _______________(initial) __________ Homeroom Teacher: __________(initial)__________ Homeroom Teacher II: _________(initial)_________ Previous School: ____________________________ Parish of Previous school: _____________________

JIRMS#:__________ DOB: ___/___/___

Facility Entry Date: ___/___/___ Age: _____

Grade Completed: _____ School Year Last Attended: _____ ILP Date: ___/___/___ Release Date: ___/___/___

SCHOOL PROGRAM(S): Basic Skills I □ Basic Skills II □ Pre-GED □ GED □ Carnegie Credits □ Special Education □ Vocational □

EDUCATIONAL NEEDS: Check any which apply ____ Academy/ Cognitive ____ Behavior ____ Motor ____ Self-Help ____Vocational ____ Communication ____ Social ____ Other

MEDICAL CONCERNS: Check any which apply ____ Respiratory ____ Visual ____ Auditory ____ Medication ____ Other

STUDENT MULTI-REFFERENCED REPORT – TABE RESULTS st

STUDENT MULTI-REFFERENCED REPORT – TABE RESULTS nd

1 Test Date: __________ Reading: _____________ E M D A Total Math: ________ E M D A Language: _________ E M D A

2 Test Date: __________ Reading: ___________ E M D A Total Math: __________ E M D A Language: ______________ E M D A

Use the following codes to indicate mastery level of the skill Date Mastered = Mastery P = Partially Mastered – = Not Mastered NT = Not Tested at This Level READING SKILLS _____ Construct Meaning _____ Interpret Graphics _____ Evaluate/Extend _____ Words in Context _____ Recall Information Meaning

Use the following codes to indicate mastery level of the skill Date Mastered = Mastery P = Partially Mastered – = Not Mastered NT = Not Tested at This Level READING SKILLS _____ Construct Meaning _____ Interpret Graphics _____ Evaluate/Extend _____ Words in Context _____ Recall Information Meaning

MATH SKILLS _____ Add Whole Numbers _____ Numeration _____ Number Theory _____ Subtract Whole _____ Data Interpretation Numbers _____ Pre-Algebra/Algebra _____ Multiply Whole _____ Measurement Numbers _____ Geometry _____ Divide Whole _____ Computation in Numbers Context _____ Decimals _____ Fractions _____ Integers _____ Percents _____ Algebraic Operation LANGUAGE SKILLS _____ Usage _____ Capitalization _____ Punctuation _____ Sentence Formation _____ Paragraph _____ Writing Conventions Development

MATH SKILLS _____ Numeration _____ Add Whole Numbers _____ Number Theory _____ Subtract Whole _____ Data Interpretation Numbers _____ Pre-Algebra/Algebra _____ Multiply Whole _____ Measurement Numbers _____ Geometry _____ Divide Whole _____ Computation in Numbers Context _____ Decimals _____ Fractions _____ Integers _____ Percents _____ Algebraic Operation LANGUAGE SKILLS _____ Usage _____ Capitalization _____ Punctuation _____ Sentence Formation _____ Paragraph _____ Writing Conventions Development

Homeroom Teacher 3: ________________ (initial) ________ Homeroom Teacher 4: ________________ (initial) ________

Homeroom Teacher 5: ________________ (initial) _______ Homeroom Teacher 6: ________________ (initial) ________

ILP-1 (To be completed by homeroom teacher within four (4) calendar days)

INDIVIDUAL LEARNING PLAN SCHOOL Student Name: _______________(initial) __________ Homeroom Teacher: __________(initial)__________ Homeroom Teacher II: _________(initial)_________ Previous School: ____________________________ Parish of Previous school: _____________________

JIRMS#:__________ Facility Entry Date: ___/___/___ DOB: ___/___/___ Age: _____ Grade Completed: _____ Facility Entry School Year Last Attended: _____ Date: ___/___/___ Release Date: ___/___/___

SCHOOL PROGRAM(S): Basic Skills I □ Basic Skills II □ Pre-GED □ GED □ Carnegie Credits □ Special Education □ Vocational □

EDUCATIONAL NEEDS: Check any which apply ____ Academy/ Cognitive ____ Behavior ____ Motor ____ Self-Help ____Vocational ____ Communication ____ Social ____ Other

MEDICAL CONCERNS: Check any which apply ____ Respiratory ____ Visual ____ Auditory ____ Medication ____ Other

STUDENT MULTI-REFFERENCED REPORT TABE RESULTS Test Date: _______ Reading: ______ E M D A

Total Math: ______ E D M A

Language: _____ E M D A

READING SKILLS NOT MASTERED _____________________________________________________

PARTIALLY MASTERED ___________________________________________________

_____________________________________________________

___________________________________________________

_____________________________________________________

___________________________________________________

MATH SKILLS NOT MASTERED _____________________________________________________

PARTIALLY MASTERED ___________________________________________________

_____________________________________________________

___________________________________________________

_____________________________________________________

___________________________________________________

LANGUAGE SKILLS NOT MASTERED _____________________________________________________

PARTIALLY MASTERED ___________________________________________________

_____________________________________________________

___________________________________________________

_____________________________________________________

___________________________________________________

STUDENT’S STRENGHTS: (Based on TABE Results) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

ILP-1 (To be completed by homeroom teacher within four (4) calendar days)

DATE DUE: ___/___/___

Student Name: ______________________

INDIVIDUAL LEARNING PLAN

Facility Entry Date: ___/___/___

Teacher: _______________________ Homeroom Teacher: _____________

READING GOAL: ______________________________________________________________________________________________ ____________________________________________________________________________________________________________ TARGETED READING INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ STRATEGIES FOR MODIFICATION/RESOURCES: (Use Modification Checklist for Assistance) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ CLASSROOM BEHAVIOR/MODIFICATION: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ REVISIONS TO ILP DUE TO RE-TESTING: TARGETED READING INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

DATE: ___/___/___ MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ILP-2R (To be completed by reading teacher within seven (7) calendar days)

DATE DUE: ___/___/___

Student Name: ______________________

INDIVIDUAL LEARNING PLAN

Facility Entry Date: ___/___/___

Teacher: _______________________ Homeroom Teacher: _____________

MATH GOAL: _________________________________________________________________________________________________ ____________________________________________________________________________________________________________ TARGETED MATH INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ STRATEGIES FOR MODIFICATION/RESOURCES: (Use Modification Checklist for Assistance) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ CLASSROOM BEHAVIOR/MODIFICATION: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ REVISIONS TO ILP DUE TO RE-TESTING: TARGETED MATH INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

DATE: ___/___/___ MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ILP-2M (To be completed by math teacher within seven (7) calendar days)

DATE DUE: ___/___/___

Student Name: ______________________

INDIVIDUAL LEARNING PLAN

Facility Entry Date: ___/___/___

Teacher: _______________________ Homeroom Teacher: _____________

LANGUAGE ARTS GOAL: ________________________________________________________________________________________ ____________________________________________________________________________________________________________ TARGETED LANGUAGE ARTS INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ STRATEGIES FOR MODIFICATION/RESOURCES: (Use Modification Checklist for Assistance) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ CLASSROOM BEHAVIOR/MODIFICATION: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ REVISIONS TO ILP DUE TO RE-TESTING: TARGETED LANGUAGE ARTS INSTRUCTIONAL SKILLS ________________________________ ________________________________ ________________________________ ________________________________

DATE: ___/___/___ MASTERY DATE: (BASED ON TABE SCORES) _______________________ _______________________ _______________________ _______________________

BENCHMARKS: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ILP-2LA (To be completed by language arts teacher within seven (7) calendar days)

DATE DUE: ___/___/___

Student Name: ______________________

PROGRAM: ________________________

INDIVIDUAL LEARNING PLAN

Facility Entry Date: ___/___/___

Teacher: _______________________ Homeroom Teacher: _____________

VOCATIONAL GOAL: ___________________________________________________________________________________________ ____________________________________________________________________________________________________________

TARGETED VOCATIONAL INSTRUCTIONAL SKILLS:

MASTERY DATE

(Based on Student Competency Record and Curriculum Guide)

________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________

_______________________ _______________________ _______________________ _______________________ _______________________ _______________________

STRATEGIES FOR MODIFICATION/RESOURCES: (Use Modification Checklist for Assistance) ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ CLASSROOM BEHAVIOR/MODIFICATION: ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________

REVISIONS TO ILP DUE TO MASTERY: TARGETED VOCATIONAL INSTRUCTIONAL SKILLS:

DATE: ___/___/___ MASTERY DATE

(Based on Student Competency Record and Curriculum Guide)

________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________

ILP-2V (To be completed by vocational teacher within seven (7) days)

_______________________ _______________________ _______________________ _______________________ _______________________ _______________________

INDIVIDUAL LEARNING PLAN PROGRESS REPORT SUBJECT __________________ SCHOOL YEAR ________ Student _______________________ Riverside □ Scenic

□

Southside

□

Westside □

Homeroom Teacher

Subject Teacher

___________________ ___________________ ___________________ ___________________ ___________________

___________________ ___________________ ___________________ ___________________ ___________________

ACHIEVEMENT CODES:

Date Achieved – Mastery

N – Not Yet Addressed

O – Ongoing

PERFORMANCE CODES:

A –Above Satisfactory

S – Satisfactory

U – Unsatisfactory

Date

Benchmark Numbers (found on ILP 2)

FOCUS of Benchmark (found on ILP 2)

Achievement/Date 1st

2nd

3rd

4th

Performance S

1st

2nd

3rd

4th

S

Comments:________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________

Attach to report card