Vision:

Ford Blvd. Elementary is an urban school committed to a rigorous curriculum that promotes social responsibility and integrity.

Table of Contents
1. SCHOOL INFORMATION a. Faculty and Support Staff Roster b. Administrative Duties & Responsibilities c. Leadership Duties & Responsibilities d. Campus Map/ Room Assignment e. First Day of School Procedures f. School Schedules g. Substitute Protocol h. Inclement Weather Procedures i. Lunch Pavilion & Yard Standards j. Playground Play Areas k. Recess Schedules l. Bell Procedures m. Discipline Policy (Needs LLSC approval) 2. PROCEDURES a. Child Abuse Reporting Procedures b. Important Reminders/ Appropriate Behaviors c. Staff Attendance Procedures d. Attendance Card Procedures e. Supply/ Copy Request Form f. Library Parent Form g. Field Trip Procedures Letter h. Field Trip Arrangements Organizer i. Procedures for Handling Discipline Problems j. 100 Classroom Discipline Suggestions 3. EMERGENCY PROCEDURES a. School Emergency Operations Chart (SEOC) b. Emergency Assembly Area

c. d. e. f. g. h.

Evacuation Map SEOC Responsibilities Emergency Drills and Procedures (REF- 1314) Campus Protection Conducting Emergency Drills Operation Blue Jay Procedures

4. SCHOOL POLICY a. Curriculum Guidelines b. CA Standards for the Teaching Profession (CSTP) c. Parent Compact (TITLE I) d. OCR Assessment Dates e. OCR/ Foro Abierto Fluency Norms f. Foro Abierto Assessment Dates g. Math Assessment Dates h. (4/5) Science Assessment Dates i. IEP: Students Present Level of Performance j. IEP Meeting Notification k. Initial Request for SST Mtg. 5. DISTRICT POLICY a. Ethics Policy Statement b. Code of Conduct c. Sexual Harassment Policy- Employees d. Banked Time Schedule e. Non-Discrimination Statement f. Williams Notice g. Homework and Make-Up Assignments K-12 h. Title IX Policy i. Uniform Complaint Procedures j. Abolition of Corporal Punishment k. Anti-bullying Policy l. Computer Software Policy (Bul. 716) m. Hate-Crimes & Hate Motivated Crimes n. Dates for Required Progress Reports o. Acceptable Use Policy of the Internet (BUL-999) p. Guidelines for Audiovisual Media q. Employee Discrimination Complaint Procedures (S-27) r. Visitors to School Campuses s. Student and Employee Security (BUL. N-10) t. ITD Helpdesk Info u. Use of Cellular Telephones Memo 6. WEEKLY BULLETIN a. Insert bulletins as given throughout the year!

Ford Blvd. Elementary School Matrix

Agustin Gonzalez, Principal Armando Torres, Assistant Principal & Sylvester Harris, AP- Special Education
Updated 8/29/2011

Rm. PreK 32 31 9 58 Kindergarten 56 13 51 49 11 50 17 10 1st grade 53 52 15 55 54 26 21 2nd grade 16 14 27 20 22 65 12 66 64 62

Teacher Velia Dorado Irma Nuez Olga Oliande Veronica Torres Linda Marquez Angela Cardenas Veronica Chavez Soraya Perez Geni Garcia Connie Salas Priscilla Garcia Rosie Magana Nancy Serrano Giovanna Prieto Liz Munguia Pablo Guerrero Laura Valles- Salas Martha Castaeda Bertha Gallego Luis Gonzalez
Melissa Garcia

Prg

TA

Rm. 18 35 3rd grade

Teacher Sharon Sherman Margie Ramos- Lotter Rebecca Shahriary Griselda Lancaster Bertha Salcedo Minerva Padilla Lynn McEntire
Adrian Jimenez

Prg ME DL

TA

Patty Soto

DL DL

33 19 34 28

ME
25 36 4th Grade 34 43 29 ME 5 46 44 DL DL DL 6th Grade 7 3 4 8 Omar Zaragoza Rosita Tolentino Maria Tapia Delia Gonzalez
M/S ELA M/S ELA

Sarah Manning Tania Bearce Virginia Salcido George Flores Henry Castellanos Veronica Garcia Elizabeth Ravelo Vanessa Zedan Hoa Truong
M/S

DL

DL
ELA ELA M/S

5th Grade

45 48 47

DL
ME

Maria Perez Monica Hurtado Cynthia Roland Ileana Ceragioli John Esparza R. Cagungun E. Rodriguez

Special Education
RSP RSP SLD SLD 4SL D5 59 30 60 61 Lorraine Nepomuceno Yolanda Casas Cesar Correa M. Odain PSM EE AUT AUT

SUPPORT STAFF
Support Personnel
Lupe Carrandi Bridge Coordinator Veronica Martinez-Lopez CPA Julissa Ibarra Instructional Coach An Nguyen- Intervention Support Coordinator Psychologist Susan Xu Nurse

Office Staff
Lino Lizarraga, SAA Frances Aguilera Cristina Banderas

Custodial Staff
Steven Ramirez, Day B & G

Cleaning Crew
Educational Aides
Ricardo Oropeza- Equipment Denise Tiscareo- Nurse

Cafeteria
Darlene Escobar, Caf Mgr. Eva Domnguez Oralia Flores Mary Velzquez Miriam Martin Yeni Vasquez

Intervention Teachers
Sandra Cruz- Room 37 Adriana Madrid- Room 38 Minerva Leal- Room 39

Noon Aides Norma Canal Deanna Park Maria Santana Ana Trujillo Yolanda Pelayo Claudia Guzman YDPLuz Avila Sup.

Itinerant Staff PROGRAMS: DL= Dual Language ME= Mainstream (EO/ IFEP/ RFEP/ ELDs 4-5) SEI= Structured English Inmersion (ELDs 1-4)

Parent Community Rep. Lizbeth Orozco Jenny Velazquez Ernestina Cardenas

Ramon Ramos Humberto Carmona

1st Day of School Procedures TO: FROM: SUBJECT: Faculty and Staff Administration FIRST DAY OF SCHOOL PROCEDURES DATE: September 2011

The following provides information that will guide our activities in the first day of school. Please review the items carefully and contact the office staff regarding any concerns. 1. 2. School Hours are 8:15- 2:40 pm for Kst-6th students. Teacher Hours are now 7:55-2:49 p.m. (k-6), SRLDP 7:30-2:25 p.m., Pre-School 7:50-2:45 p.m. Students may be expected to arrive for breakfast beginning at 7:20 A.M. Yard supervisors will be present to assist in the lunch pavilion and near the entry of each building. After students are done eating they will be directed to the yard. Breakfast is from 7:35-8:05 a.m. First through sixth grade students will be directed to stand in the assembly area designated for their classroom. (Kindergarten students will line-up in front of the Lunch Pavilion) Class rosters have been posted throughout the campus. Adult monitors will carry master lists and circulate to assist families as needed. Please take the class roster and colored sign showing your room number to the line-up area as you prepare to meet your students. Instruction begins at 8:15. 4. Every child in your class should be officially enrolled. You may verify this by accessing ISIS. The office will provide a class roster for your own personal verification. For the first day please follow the usual procedure in taking attendance in ISIS. All no-shows should be marked by an absence. Please submit your attendance by 9:00 am. After 3 consecutive days of absences a student will be removed from the class list, per the district. No-shows will receive a phone call to check on enrollment status. Any student not appearing in your class list please send the student to the office. Students will line up after recess and lunch in front of the Lunch Pavilion. Please review with them the line-up procedures. Escort students to the lunch line. Students will sit in the order that they arrive. For the SAFETY of all students it is vital that you escort students directly to the lunch lines. Also, make sure you pick up your students on time when the lunch period ends. Please walk students at dismissal time to the various dismissal gates. Do not dismiss students directly from classrooms.

3.

5. 6. 7.

8.

If there are unfilled subs, late subs or late teachers the following will cover classes until personnel arrives or students are dispersed:

Coordinators Veronica Martinez- Lopez An Nguyen If Coordinators are Unavailable: Lupe Carrandi

Minerva Leal Coaches Adriana Madrid Possible SUBS (If the rest are unavailable): 1 Ileana Ceragioli (RST)/Cynthia Roland 2.SRLDP teachers: Nunez & Dorado (Friday ONLY) 3.PSM Teacher: Ms.Nepomuceno (Friday Only) Sandra Cruz

Ford Boulevard Elementary School

Bulldog Schedules for 2011-2012

Office Hours: Breakfast: School Hours: 2nd Chance: (10 minutes long @ start of Recess) Teacher Hours SRLDP Faculty: Pre-School Mixed Faculty: Kinder- 6th Grade Faculty: Student Hours SRLDP A.M.: SRLDP P.M.: Pre-School Mixed (PSM) AM: Pre-School Mixed (PSM) PM: Kindergarten- 6th Grade: Banked Time Tuesdays: Minimum Day Schedule
(Brunch Schedule; Lunch during Recess)

7:00am- 4:30pm 7:35am- 8:05am 8:15am- 2:40pm Recess 7:30 a.m. - 2:25 p.m. 7:50 a.m. - 2:45 p.m. 7:55 a.m. - 2:49 p.m.

8:00am- 10:20pm 11:20am- 1:40pm 8:20am- 10:40am 11:40am- 2:00pm 8:15am- 2:40pm 8:15am- 1:39pm 8:15am- 1:05pm 8:15am- 1:59pm Recess and Lunch Schedules

Shortened Day Dismissal

Class SRLDP AM & PM PSM Room 59 Kinder & 3rd Grade 1st & 4th + two 6th Grade Classes (Rooms 3 & 7): 2nd & 5th + two 6th Grade Classes (Rooms 4 & 8):

Recess
See classroom schedule See classroom schedule

Lunch 10:20 a.m.

In the classroom

9:45am 10:05am 10:10am-10:30am 10:35am 10:55am

11:20- 12:05am 12:05pm- 12:50pm 12:50pm 1:35pm

Ford Blvd. Elementary School INCLEMENT WEATHER Schedule

In order to facilitate the distribution of lunches during inclement weather please adhere to the following: Teachers will have a 30-minute lunch period during inclement weather. Please pick up your students promptly from the Auditorium or Lunch Pavilion at the end of Lunch Period. SEATING ARRANGEMENTS: (Please also refer to the diagram below.) Kinder, 1st, 2nd, and 5th Grade Teachers: Please line up your class on the yellow line leading up to Window #2 (right side of the lunch pavilion); your class will eat lunch inside of the Auditorium. 3rd & 4th, 6th Grade Teachers: Please line-up your class in the center aisle of the Lunch Pavilion leading up to Window #1; your class will eat lunch seated on the right side of the Lunch Pavilion.

Rainy Day Lunch Schedule Kinder: 11:15-11:45 *1/4/6: 12:00-12:30 *2/5/6 12:45-1:15 *includes( 2) 6th grade classes

Cafeteria

SEATING: Kinder: Aud. st, 2nd, 5th: *1 Aud. *3rd, 4th:, 6th Pavilion *Includes (2) 6th grade classes

LEFT SIDE

RIGHT SIDE

Auditorium

Lunch

Lunch

Ford Blvd. Elementary School Lunch Pavilion and Yard Standards Lunch Pavilion Standards: Teachers and all supervisory staff are responsible for the enforcement of these standards: Be Safe Walk Keep your hands and feet to yourself Be Respectful Use whisper voices Stay in assigned line and table Be Responsible Keep your food, on your tray Clean your space Eat food in lunch pavilio School Yard Standards Teachers play a vital role in the number and kinds of problems avoided or encountered on the yard by their commitment to do the following: Please be certain all students know where they play at RECESS and LUNCH. Follow the schedules provided. They should know the game rules (TEACH and Practice during P.E.) Escort children to and from RECESS and LUNCH play area in orderly, quiet lines. Remind students to WALK at all times. PRAISE students for following pavilion and yard standards. Remind students of yard standards often and DISCIPLINE accordingly when necessary. Support the supervisory staff, noon aides, and teacher assistants in their efforts to make the yard a safe place. Follow up on yard standard violations and other problems as soon as possible with the student(s) involved. Please stress using the restroom at appropriate times: o BEFORE & AFTER school o RECESS o LUNCH

Verona Street

29 4 3 Kickball 2 31 32 33 Kickball 134 2 35

22 23 24 25

21 19

20 18

9 10

16 26 27
Court

17

11 12

Duncan Ave.

Ford Blvd.

Bungalows Bungalows

Dodgeball 40

B-Ball15

JBuilding

Parking Lot

Bungalows Bungalows
Gate

52

45 36 37 38

Garage

Bungalows Main Building

Cafeteria

Olympic Blvd.

Kindergarten/3rd Grade Recess 9:45-10:05/Lunch 11:20-12:05

Revised Sept. 2011

Based on weekly Rotation

10/24 3/19 10/31 3/26 11/07 4/09 11/14 4/16 11/21 4/23 11/28 4/30 12/05 5/07 12/12 5/14 1/09 5/21 1/16 5/28 1/23 6/04

WEEK

9/07 1/30

9/12 2/06

9/19 2/13

9/26 2/20

10/03 2/27

10/10 3/05

10/17 3/12

AREA/GAMES
Kickball 2,(kicking skills) Tetherball 4,29 Dodge ball 40 A, Tetherball 1 Jump Rope Area 5 Kinder Area /*Foursquare 26 & 27 Foursquare 35,36 Handball 20, Tetherball 9 Kinder Yard / *Volley ball 16 & Foursquare 25 Dodge ball 40 B Handball 21/ Basketball22 Handball 18, Tetherball 10 Kickball 1, Tetherball 2, 3 Dodge ball 45, 52 Foursquare 37, Hopscotch C/D Foursquare 38, Hopscotch A/B 9 13 58 56 49 51 11 33 35 34 19 18 28 64 13 58 56 49 51 11 33 35 34 19 18 28 64 9 58 56 49 51 11 33 35 34 19 18 28 64 9 13 56 49 51 11 33 35 34 19 18 28 64 9 13 58 49 51 11 33 35 34 19 18 28 64 9 13 58 56 51 11 33 35 34 19 18 28 64 9 13 58 56 49 11 33 35 34 19 18 28 64 9 13 58 56 49 51 33 35 34 19 18 28 64 9 13 58 56 49 51 11 35 34 19 18 28 64 9 13 58 56 49 51 11 33 34 19 18 28 64 9 13 58 56 49 51 11 33 35 19 18 28 64 9 13 58 56 49 51 11 33 35 34 18 28 64 9 13 58 56 49 51 11 33 35 34 19 28 64 9 13 58 56 49 51 11 33 35 34 19 18 64 9 13 58 56 49 51 11 33 35 34 19 18 28 9 13 58 56 49 51 11 33 35 34 19 18 28 64 13 58 56 49 51 11 33 35 34 19 18 28 64 9 58 56 49 51 11 33 35 34 19 18 28 64 9 13 58 56 49 51 11 33 35 34 19 18 28 64 9 13

REVISED September, 2011

1st , 4th & 6th Grade Recess And Lunch Game Schedule
10:10-10:30 am Lunch 12:05-12:50pm
REVISED Sept. 2011

Based on Weekly Rotation

10/31 3/19 55 5 25 29 34 36 43 62 3 7 10 15 17 50 52 53 54 11/07 3/26 5 25 29 34 36 43 62 3 7 10 15 17 50 52 53 54 55 11/15 4/09 25 29 34 36 43 62 3 7 15 17 50 52 53 54 55 5 25 11./14 4/16 29 34 36 43 62 3 7 10 15 17 50 52 53 54 55 5 25 11/21 4/23 34 36 43 62 3 7 10 15 17 50 52 53 54 55 5 25 29 11/28 4/30 36 43 62 3 7 10 15 17 50 52 53 54 55 5 25 29 34 12/05 5/07 43 62 3 7 10 15 17 50 52 53 54 55 5 25 29 34 36 12/12 5/14 62 3 7 10 15 17 50 52 53 54 55 5 25 29 34 36 43 1/09 5/21 3 7 10 15 17 50 52 53 54 55 5 25 29 34 36 43 62 1/16 5/28 7 10 15 17 50 52 53 54 55 5 25 29 34 36 43 62 3 1/23 6/4 10 15 17 50 52 53 54 55 5 25 29 34 36 43 62 3 7

WEEK

9/07 1/30

9/12 2/06 15 17 50 52 53 54 55 5 25 29 34 36 43 62 3 7 10

9/26 2/13 17 50 52 53 54 55 5 25 29 34 36 43 62 3 7 10 15

10/03 2/20 50 52 52 54 55 5 25 29 34 36 43 62 3 7 10 15 52

10/10 2/27 52 53 54 55 5 25 29 34 36 43 62 3 7 10 15 52 53

10/17 3/05 53 54 55 5 25 29 34 36 43 62 3 7 10 15 52 53 54

10/24 3/12 54 55 5 25 29 34 36 43 62 3 7 10 15 17 50 52 53

AREA/GAMES
Handball 21, Foursquare 25 Dodge ball 40, Tetherball 4 Handball 19, Foursquare 26 Dodge ball 45 Basketball 15, Jump Rope 5 Handball 18, Tetherball 10 Dodge ball 52, Hopscotch C/D Kickball 2, Tetherball 29 Basketball 23, Foursquare 24 Volleyball 16 Foursquare 27 Handball 20, Tetherball 9 Kickball 1, Tetherball 3 Basketball 22, Jump Rope 5A Foursquare 35, 36 & 37 Tetherball 1 & 2 Hopscotch A&B, Foursquare 38 10 15 17 50 52 53 54 55 5 25 29 34 36 43 62 3 7

*6t3h Grade rooms 3 & 7

2nd, 5th & 6th Grade Recess and Lunch Schedule

Revised September 2011

Based on Weekly rotation

9/26 2/13 20 21 22 26 27 66 44 45 46 47 48 4 8 14 16 10/03 2/20 21 22 26 27 66 44 45 46 47 48 4 8 14 16 20 10/10 2/27 22 26 27 66 44 45 46 47 48 4 8 14 16 20 21 10/17 3/05 26 27 66 44 45 46 47 48 4 8 14 16 20 21 22 10/24 3/12 27 66 44 45 46 47 48 4 8 14 16 20 21 22 26 10/31 3/19 66 44 45 46 47 48 4 8 14 16 20 21 22 26 27 11/07 3/26 44 45 46 47 48 4 8 14 16 20 21 22 26 27 66 11/15 4/09 45 46 47 48 4 8 14 16 20 21 22 26 27 66 44 11./14 4/16 46 47 48 4 8 14 16 20 21 22 26 27 66 44 45 11/21 4/23 47 48 4 8 14 16 20 21 22 26 27 66 44 45 46 11/28 4/30 48 4 8 14 16 20 21 22 26 27 66 44 45 46 47 12/05 5/07 4 8 14 16 20 21 22 26 27 66 44 45 46 47 48 12/12 5/14 8 14 16 20 21 22 26 27 66 44 45 46 47 48 4 1/09 5/21 14 16 20 21 22 26 27 66 44 45 46 47 48 4 8 1/16 5/28 16 20 21 22 26 27 66 44 45 46 47 48 4 8 14 1/23 6/4 20 21 22 26 27 66 44 45 46 47 48 4 8 14 16

WEEK

9/07 1/30

9/12 2/06 16 20 21 22 26 27 66 44 45 46 47 48 4 8 14

AREA/GAMES
KICKBALL 1 & Teacher ball 1 Basketball 15 & Foursquare 27 FOURSQUARE 25 & 26 VOLLEYBALL16 Basketball 22 HANDBALL 18, Tetherball 10 BASKETBALL 23, Foursquare 24 KICKBALL 2, Tetherball 4 & 29 HANDBALL 20, Tetherball 9 DODGEBALL 40 A & Foursquare 25 VOLLEYBALL 17 & Tetherball 12 HANDBALL 21, Tetherball 11 Foursquare 35 & 36 HANDBALL 19 Dodge Ball 45 & 52 Dodge Ball 40 B & Jump Rope 5 14 16 20 21 22 26 27 66 44 45 46 47 48 4 8

Revised September 2011

Ford Boulevard Elementary School Bell Procedure

Ford Boulevard Elementary School

Ford Boulevard Elementary School Ford Boulevard Elementary School

Ford Boulevard Elementary Discipline Policy

Student Discipline Policy

The entire staff at Ford Blvd.

We need to encourage the following behavior: 1. 2. 3. 4. 5. 6. Follow School Wide Rules Be Safe Be Respectful Be Responsible Respect School Property Wear School Uniform

Teachers will follow these procedures in maintaining student discipline: 1. Support and reward appropriate behavior. Establish, post and maintain a Positive Classroom Behavior Support Plan 2. Conference with student 3. Maintain contact with parent/guardian 4. Schedule a parent/student/teacher conference at school when necessary. Parent support is crucial. 5. Schedule Principal/student/parent/teacher conference. LAUSD District Policy considers the following infractions serious and may lead to suspension 1. Possessed or sold any firearm, knife, explosive or any other dangerous weapon. 2. Possessed, used, or sold any type of drug or alcoholic substance. 3. Possessed or used tobacco on the school premises 4. Caused, attempted or threatened to cause injury to another person; i.e. fighting 5. Stolen or attempted to steal school or private property 6. Committed any type of obscene or profane act. 7. Disrupted school activities or willfully defied authority or school personnel.

Ford Boulevard Elementary School Child Abuse Reporting

1.

A staff member has suspicion of child abuse which may include one or more of the following: physical abuse, sexual abuse, neglect or life endangerment. (See Teacher Handbook for definitions) The staff member is mandated under Section 11166. of the California Penal Code to report all cases of suspected child abuse. 2. If child complains of pain or shows you a physical injury, send the student to the nurse for first aid. The office referral to the nurse should state what the first aid needs are. Do not write on the referral that you suspect child abuse. The report is made in two partsa telephone report and a written report.

3. Telephone Report- Immediately upon suspicion, or as soon as practically possible, report by telephone the child abuse to 1-800-540-4000. You m also call the hotline to consult or ask questions regarding the incident. Moderate to severe abuse is reported to the local law enforcement (ELA Sheriffs Dept.) at 1-323-264-4151. You may call DCFS for further guidance and they will either take the report or direct you to call law enforcement. Gather all pertinent information prior to making the telephone report: Childs name, home address, telephone number, date of birth, parents name(s), names of siblings, prior reports (if known), special needs of child, hom language, description of injury, statement of what led the reporter to suspect child abuse, present location of the child, time child is dismissed from school, etc During the telephone report: 1. Document date and time call is made. 2. Record agency contact persons name, title/position, and ID no. 3. Apprise the contact person of the time school is dismissed and how the child goes home. 4. Inquire and record the agencys plan regarding what action will be taken and when. 5. Clarify and record the agencys directive as to what the school should/should not do regarding the reported incident/victim/perpetrator. 6. Have the contact person read back the report information verbatim. 7. Verify the address to which the written report will be sent to. Report to nurse the name of agency telephoned and agency contact persons name, title/position, and ID/badge no. It is the nurses responsibility to l in the information in the schools Confidential School Log. If law enforcement is called and they will be picking up child for further investigation, the nurse and/or administrator should be notified to direct law enforcement when they arrive. The nurse and/or administrator will notify the visitors table and office of procedures when law enforcement arrives. A reminder that this may affect a child and we always want to act in a manner that keeps the emotional well-being of the child at a priority. If the child is expected to be returned after dismissal, then it is the responsibility of law enforcement to return the child to the home. 4. Written Report- Complete and send the appropriate state reporting form (Form SS 8572) within 36 hours of receiving information. The nurse can provide assistance in filling out the report and meeting your reporting responsibilities. If assistance is needed, the staff member suspecting child abus still mandated to fill-out the report. Class coverage, when needed, is available so you may comply with state law timelines. The report is sent to the agency to which the telephone report was made: DCS Child Abuse Hot line 3075 Wilshire Blvd., 5th floor Los Angeles, CA 90010 OR ELA Sheriffs Dept. 5019 E. 3rd St. Los Angeles, CA 90022

At any time, no employee is to verify the suspicion or prove that abuse has occurred. Investigation (questioning witnesses, obtaining writt statements) as well as notification (family, alleged perpetrator), counseling, and or family intervention are the responsibility of the child protective agency.

Important Reminders/ Appropriate Behavior

Ford Boulevard Elementary School

You are reminded to be mindful of the fine line drawn between being sensitive to and supportive of students and a possible or perceived breach of responsible, ethical behavior. While the District encourages the cultivation of positive relationships with students, employees should be cautioned to use good judgment and avoid the following situations: Meeting individual with a student behind closed doors Remaining on campus with student(s) after the last administrator leaves the site Taking student(s) off campus for other than District approved curricular trips Transporting student(s) in a personal vehicle without proper authorization forms on file Providing selected student(s) with a personal telephone number Meeting with student(s) off campus without proper parent authorization forms on file Even though the intent of the employee may be purely professional, those who engage in the above behaviors are exposing themselves to the possible perception of impropriety. If warranted, disciplinary action may be taken when allegations of inappropriate behavior are made.

Ford Boulevard Elementary School

Staff Attendance Procedures

TO: FROM: SUBJECT:

All Staff Administrators/ SAA STAFF ATTENDANCE PROCEDURES

With the inception of the Districts Absence Management Program and data from last years staff attendance, there is a need for improved attendance. Excessive absences have a negative impact on our ability to serve students. Thus, in order to provide our students with a consistent instructional program, the following guidelines should be followed in the event of an absence: 1. If you become ill or do not anticipate an absence, it is up to you to call the sub desk at (877) 528-7378). You should try to keep a copy of the Ford Preferred Sub List with you and try to select from these subs first. Remember that you still have to input information for the selected sub in the Sub Finder system. The Sub Finder is available 24 hours a day, 7 days a week. Please use the same procedure if you know you will be out the following day 2. To report an absence, you should notify the school at least 1 hour before the start of the day. You should call the school office to let them know when you will return to work. Notify the school no later than 2:00 p.m the day prior to your return. If you do not notify the office by the indicated time, the sub will be held over for the following day. Remember that a sub is entitled to the assignment even if the teacher reports to work in this situation. If absent please fill out the Certification of Absence Form and return to Lino. 3. Please update you information on the Sub Finder System, e.g. contact number, school, current grade level etc. 4. Remember to sign-in and out on a daily basis. It is critical that we know who is here for accounting purposes. This is also important for the payroll process. We want to avoid making adjustments on the payroll system. 5. In addition to regular attendance, it is important that all staff be punctual. In case of unforeseen emergencies and you anticipate being late, please call the school office to inform us. This will help with assigning supervision with students until you can get to school. Teacher hours are as follows: SRLDP 7:30 a.m.-2:25 p.m. Pre-School 7:50 a.m.-2:45 p.m. K-6 7:55 a.m.-2:49 p.m. By following these procedures we will not only make the absence management process run smoother, but we will also serve as good role models for our students. Thank you for your cooperation.

Supply/Copy Request Procedure Supply Request Procedure Supplies are delivered on a weekly basis. Supply request forms are located in the attendance office by the teacher sign-in. Forms must be turned in by noon on the specified date for your grade level for the materials to be delivered in a timely manner. Grade Level Pre- K, Kinder 1st Grade 2nd Grade 3rd Grade, Resource Teachers 4th, 5th, and 6th Grade Supply Delivery Day Monday Tuesday Wednesday Thursday Friday Request Form Due to Office Thursday Friday Monday Tuesday Wednesday

Ford Boulevard Elementary School

Copy Request Procedure Ford Blvd. offers two options for making copies: 1. Self- service 2. Put copy requests in the Attendance Office box. There will be a 2 week turnaround Teachers may utilize both options. A DUPLO machine is also available for large copy orders (self-service). Paper Allocation Amount K-3 4-6 3 reams per month 6 reams per month 1500 copies 3000 copies

Revised September 2011

Ford Boulevard Elementary School

Library Parent Form

Dear Parents, We are encouraging all our students to do more pleasure reading because we know this increases their ability to READ and LEARN. We would like our students to be able to take home the books they check out from the school library. However, we want the children to be responsible for bringing the books back promptly and in good condition. We are encouraging all parents to sign the permission slip for their child to be able to take home library books promptly and in good condition and, if lost or damaged, you will be responsible for paying for them. If you give your permission, please sign and return to your childs teacher. We thank you for your cooperation. Sincerely, Agustin Gonzalez, Principal

___________________________________ Childs Name

_________ Room

_________ Grade

I give my child permission to bring home library books from the school library. I will see that they are returned promptly and in good condition and will pay for any that are lost. I understand that if my child loses or damages the books, I will be responsible for the cost of the book or damages. I have discussed this with my child. Parents Signature _________________________ Date_______

Field Trip Procedures Letter

Field Trip Arrangements

Complete Student Trip/Excursion Approval Form. Submit to Mr. Gonzalez for approval

Arrange field trip destination

Mr. Gonzalez will forward form to Mrs. Martinez-Lopez

15 days in advance Mrs. MartinezLopez requests date with the transportation department
Pick up lunch form & and parent permission slip from coordinators office

Bus arrives! Have Fun!

Lunch request due two weeks prior to field trip

Procedures for Handling Discipline Problems

TO: FROM: SUBJECT: All Teachers Administrators PROCEDURES FOR HANDLING DISCIPLINE PROBLEMS

In order to make our school discipline plan function more effectively, here are a few suggestions. In general, most discipline cases are of the once in awhile type and can be dealt with by the classroom teacher. Try to determine whether the behavior can be changed through a different management technique, seating arrangement, or curricular challenge. Establish, post and maintain the Positive Classroom Management Plan Our goal in discipline is two-fold. We want to ensure that all children are able to learn without being disrupted, and that children who need to learn appropriate social skills are taught these skills. Personal responsibility and self discipline need to be viewed as a subject to be taught. Children need repeated opportunities to identify and demonstrate good behavior. Therefore, every teacher must utilize a Positive Classroom Management Plan to maintain an effective room environment. Teachers should adhere to classroom and playground standards, which are positively stated and are aligned to the school discipline policy. Only after students clearly understand classroom rules and have not followed them on a consistent basis or exhibit severe behaviors, should students be sent to the office. Please use the following procedures to refer a child to an administrator:
1) Use only the standard referral form and clearly describe the childs actions. 2) For serious infractions, such as major fights, vandalism, weapons, etc. you may send student directly to office for possible suspension or other appropriate consequences. Remember that out of school suspensions can only be carried out by an administrator. 3) Reminder. Please refer to the UTLA contract for in-house suspensions 4) For safety reasons, a child should never be left alone inside or outside the classroom. Students should also not be isolated where they cannot receive instruction as a form of punishment.

The Safety Committee is currently in the process of developing specific recommendations that will be presented to the staff. The Positive Behavior Support Plan will be discussed and implemented school wide. This is a work in progress. You will be informed of the changes that will occur this year. (September 2011)

School Emergency Operations Chart (SEOC) 2008-2009

Public Information Officers

Ford Boulevard Elementary School

Incident Command Center

Location: Garage Area Command Leader: Jeanette Rodriguez-Chien Documentation: Lino Lizarraga Communication: Myrna Romo

Backup Command Leaders 1. Victoria Monteleone 2. Myrna Romo Communications Jeanette Rodriguez-Chien

1. Jeanette Rodriguez-Chien 2. Victoria Monteleone 3. Myrna Romo Assembly Area Team

Location: Playground

Leader: Frances Aguilera

Alt.:

Mnica Mndez

1. Celina Mndez Request Gate Location: Ford Blvd. (East Gate) Leader: Michelle Garcia Alt: Ana Trujillo 1. Veronica Hernandez 2. Inez Gonzalez 3. Vanesa Pelayo

First Aid/Morgue Location: Garage Area Leader: Susan Xu Alt.: Denise Tiscareno 1. Laura Madrid 2. Maria Cervantez 3. Mayra Cruz

Reunion Gate
Location: Duncan Ave. (North Gate)

Fire Suppression/ HazMat Team Leader: Nancy Serrano Alt.: Julissa Ibarra 1. Luz Azpeitia 2. Bertha Castellon

Leader: Hilda Vargas Alt: Virginia Garcia

1. Martina Guerrero 2. Humberto Carmona

Search & Rescue Location: Garage Area Coordinator: Manuel Mabra Alternate: Veronica MartinezLopez Team 1 1. Luis Gonzalez (Captain) 2. Veronica Garcia 3. Leonard Domnguez 4. Irma Nunez Team 2 1. Henry Castellanos (Captain) 2. Rebecca Shahriary 3. Laura DuMond-Kerr 4. Rene Cardona Team 3 1. Diana Gonzlez (Captain) 2. George Flores 3. L. Valles-Salas 4. Francisco Gil Team 4 1. John Esparza (Captain) 2. Pablo Guerrero 3. Mnica Hurtado 4. Adrian Jimenez Security/Utilities Team Leader: Margarita Benavides Alt.: Steven Ramirez 1. Pete Maravilla 2. Luis Contreras

Supply/Equipment Team Leader: Celia Mata Alt: Ricardo Oropeza 1. Daniel Navarro 2. Doreen Santos

Mental Health Crisis Team Leader: Dalila Ontiveros Alt: 1. Sandra Cardenas 2. Silvia Valladares

Verona Street
20 43 44 45 46 47 48 36
19 8 7 6 5 4 3 69 68 67 66 65 64 63 62 61 60

Portn de Reunion

Reunion Gate

21 18 23 25 26 33 34 35 9 13 17 12A 30 14 15 31 12B 16 32 59

22 27 28 29 39 10 11 49 50 51 52 53 54 55 56

Portn de Presentacin

Request Gate

B-Ball

Duncan Ave.

Ford Blvd.

Basketball Court

Bungalows

J-Building

9 17 16 15 14 13 30 31

First Aid Command Center Psych. First Aid/ Cafeteria Garage

Gate

32

Main Building

Olympic Blvd.

Ford Boulevard Elementary School

EMERGENCY ASSEMBLY AREA & Morning Line-Up

Staff Parking Lot 45 48 Auditorium J. Bldg. 39

Staff Parking Lot

Library

44

47

Cafeteria
Emergency Operations Area

38

57

58

59 34 31 24A Psych 23 30 12B A2A

43

Restroom

37

August 21, 2007

46

Emergency Assembly Area

Restroom

36

49

50

51

52

3 8
Fire Extinguisher (1 every 8 ft.)
(2 in every hallway) Gas Valves (5)

4 7

5 6

5a

Lounge

9 16

10 15

11 14

RR 13

17

68 & 69 Bungalows

66 & 67 Bungalows

64 & 65 Bungalows

62 & 63 Bungalows

60 & 61 Bungalows

Office Nurse

AP1 Main

AP2

MPR
Coor. Office

18 29

19 28

20 27

21 26

22 25

Electrical Shut OFF= A Building Basement

Ford Boulevard Elementary School EMERGENCY Evacuation Plan & Exit Map

35

56

55

54

53

33

32

Ford Boulevard Elementary School SEOC Responsibilities

Please read this document thoroughly and become familiar with the emergency procedures for Ford Blvd. Elementary School. Knowing what to do during a school wide emergency will help you and your students prepared in any major crisis situation. OVERVIEW OF RESPONSIBILITIES OF PERSONNEL AND EMERGENCY TEAMS Principal or Administrative Designee 1. Identify problem/event and determine the degree of impact on school. 2. Determine if additional support is needed. If necessary request appropriate assistance and additional support from district/outside agencies. 3. Activate appropriate plans/teams and brief teams of important facts of current situation. 4. Develop a factual sheet of information to be communicated to parents and/or community. 5. Be visible- roam halls, playground, and lunchroom; be accessible. 6. Prioritize needs. 7. Plan follow-up actions. 8. Plan debriefing meeting with staff members. Office Manager and/or Office Staff
1. 2. 3. 4. 5. 6. 7. Contact District and keep records of all offices contacted. Receive directive from Principal. Factual sheet to be developed (English & Spanish) and communicated with any telephone call received or parent/community questions. Set-up REQUEST & REUNION GATES if needed. Bring out alpha lists, emergency cards, master keys, and extra walkie-talkies, set up the REQUEST & REUNION centers. Designate runners. The office staff will coordinate the retrieval system with the runners. Provide access to rooms.

Classroom Teachers During an emergency, teachers are responsible for the supervision of students in their charge. In discharging this responsibility, they will be governed by the specific directives or guidelines issued by the superintendent of designee and/or principal/site administrator of their school. 1. Respond to the specific emergency as prescribed and direct students in appropriate safety procedures. 2. Remain with the students until relieved by authority of school principal/site administrator. 3. Take roll call if class relocates as soon as conditions permit such action. 4. Report missing students to principal/ site administrator. 5. Send students in need of first aid to school nurse of first aid station 6. Help to restore order and assist other teachers and student, as needed. 7. Use planned activities during periods of confinement to lessen possible tension and hysteria of a disaster situation. 8. If not on classroom duty with students, report at once to pre-assigned station or to principal /site administrator. Supervise students at your designated area. Check to see if any of your students are injured or in shock. Notify the first- aid station if a child is in need of help. Make sure that you have an accurate attendance count. Your list of missing student will assist the search and rescue teams efforts. A runner will notify you when a student is to be released from your room. The runner will take the student to the reunion gate where they will be reunited with a parent or guardian.

Support Personnel Report to Principal or command center for directive. Assure that any students under your supervision are safely return to their classroom or Teacher. Teacher Assistants

Provide assistance to the teacher; keep the students calm as possible. Supervise students if teacher is called on any assignment. You may be called upon to serve on any of the above mentioned assignments. Resource Personnel Support and Itinerant teachers are to report to the command center to be given instructions to where their services can be utilized. Plant Manager and Staff 1. Shut off utilities as may be necessary. (Utilities should not be turned off unless absolutely necessary, i.e., broken gas lines, broken gas lines, broken water mains, downed electrical wires.) 2. Conduct rescue operations as required and to extent of capabilities. 3. Survey and report damage to school principal/site administrator. 4. Follow damage control procedures. 5. Safeguard all potable water within building (water heater, in cooking kettles, etc.) 6. Plant Manager and custodians should follow pre-determined emergency procedures of their supervisors. Check the gas, and water mainlines, electrical panels and look for any hazardous conditions on campus. They are to be equipped with a fire extinguisher to suppress any small fire that may exist. They will report to the command center after examining the school grounds. Assist in setting up outdoor restroom facilities. Campus Aides Please report to the command center for assignment. Cafeteria Staff 1. Secure utility outlets. 2. Cover and preserve all usable food and water. 3. Direct the rationing, use, and preparation of cafeteria stock and water supply, whenever the feeding of students becomes necessary. 4. Unlock and pull out the emergency supplies from the bin and set them out next to the command center. Assist in distributing water and food. Carry medical supplies and equipment to the first-aid center. Nurse Set-up first-aid station and morgue. Members of the first-aid team will be under the supervision of the nurse. A medical triage system will be put into place. The space behind the bottom bungalows is the first choice for the morgue. If it is determined that it is unsafe, another building/ area will be selected. Emergency Supplies All emergency supplies are located in the emergency storage bin located on the upper yard. This includes first-aid kits, water and search & rescue team equipment. Restroom Facilities Toiletry accommodations will be set-up if the bathrooms are unavailable. Privacy shelters will be raised with portable toilets inside.

School Emergency Operation Chart Responsibilities

Incident Command Center- Outside of Workshed or Principals Office. (Depending on Emergency.) Public Information Officers- Jeanette Rodriguez- Chien (Command Center); Myrna Romo (Playground) Assembly Area- Playground. Classroom Report Forms to be submitted. Verify all students are accounted for. All staff members are to report to the assembly area. Request Gate- The office staff will establish a REQUEST gate on EAST GATE of the playground if the office is not available for use. Only one entrance will be open. All other entrances will be secured. Parents/relatives wishing to pick-up their children will request their children at the REQUEST gate. Office personnel are to check the Emergency card and I.D. of person picking up student. Once verified, the Permit for Release Form is filled out and a runner is sent to the classroom for child pick-up. The Teacher is given the original of the Parent Release Form and the copy is taken to the REUNION gate with the student. Teacher is keeping Permit for Release Form with Emergency roster to keep track of students released. Reunion Gate- The reunion gate will be at the NORTH gate of the playground. The runner brings the student and the copy of the Permit for Release Form to office personnel at the REUNION gate. The person picking up the student is to sign-in and write relationship. Office personnel are to verify same signature and I.D. Student is released to person once identity is verified. Office personnel keep Permit for Release Form and sign-in. Security/Utilities Team- Lock all gates. Stand guard at gates if needed. Report to Assembly Area for assignment. First Aid/Morgue- (Nurses office, Cafeteria or Pre-K yard) First Aid assesses all injuries and determines priority. All personnel are to stay in the First Aid Area. Fire Suppression/ Hazardous Material Team- Check all buildings and areas. Determine safety of campus. Standby to assist Search and Rescue. Mental Health/Crisis Team- Determine immediate and/or on-going need for counseling. Visit classes as need for student counseling. Identify rooms to be used. Develop referral process. Search and Rescue Teams- All S & R Team members are to report to the Assembly Area. Teams are made up of at least four people, whose prime responsibility is to check each room, looking for missing students and/or staff and injured people. They are to report to the command center via walkie-talkie if they experience any hazardous conditions. The search and rescue teams are to chalk each room checked with a large X if all is clear. Each team will be supplied with hard hats, flashlights, gloves, a hooligan bar, walkie-talkie, and a stretcher. Team #1 will search the Cafeteria, Auditorium, C-building, and Bungalows (53-59)C Team #2 will search Main and B Buildings. Team #3 will search the Bungalows (49-52), Federal (D) Building Team #4 will search the Bungalows (60-69).

1. 2. 3. 4.

POST-DISASTER PROCEDURES 1. 2. 3. 4. Parent Letter to be developed & sent home of situation or emergency that occurred. Staff Meeting to be held for debriefing at the end of the day or the following Tuesday. Memo to Teachers to factual events and information. Post-Counseling procedures to be established by Psychologist and/or PSA Counselor. Memo to Teachers for Teachers to refer students that need additional counseling. Counseling Team to visit designated classrooms for student debriefing. Rooms to be selected of counseling to take place. (Auditorium, RSP rooms, library, etc) PERSONAL EARTHQUAKE PREPAREDNESS You should have an emergency plan in place for your family in case you are at work when an earthquake/disaster occurs. A well thought out plan will put you more at ease if such a situation ever arises

Things to Consider 1. Water, food, first-aid kit, portable radio/batteries, flashlight, fire extinguisher 2. Location of gas, electrical, water shut off valves 3. Does your childs school or childcare facility have a detailed plan for earthquakes and disasters? Do they have the necessary supplies? 4. Who will pick-up your child? 5. Do you have an emergency backpack in your vehicle with comfortable shoes, water, first-aid kit, and a flashlight? 6. Method of communication Please understand that you may not be able to call loved ones if the phone system is down or jammed with incoming calls. Cellular phones may not be operational. Even if you are released from your classroom duties to go home, please consider the possibilities that: The freeway overpasses may be down making the freeways impassable. Surface streets may have signal lights that are not functioning. By having an Earthquake/Safety Procedures, Ford Blvd. hopes to be prepared for any emergency. Please remember to practice with your students periodically in case of any emergency.

Ford Boulevard Elementary School Campus Protection

In case of a drive-by shooting or any kind of weapon being fired from surrounding neighborhood during school hours, please follow these procedures: 1. Students outside/on the playground are directed to DROP FLAT. Adults who hear or see the incident need to shout the command to children who may be outdoors. 2. In addition to the oral directions, use your hands to signal the position for their bodies. 3. Everyone outside drops flat on the ground remains in that position until further notice. 4. Immediately-notify the office. 5. Office will do the following: A. Notify an administrator B. Call 911 C. Use PA system to direct all classes that are inside to follow Campus Protection Procedures and REMAIN INSIDE. D. Discontinue all school bells. 6. When it has been established that it is safe, everyone who is outdoors is to be directed to walk quickly into the nearest building and stay in the hallway. Move away from any window or door openings as much as possible. 7. Classes that are indoors should stay in position until notified to get out from cover. 8. Any regular or special activity held in a location other than the classroom is postponed and/or canceled until safe conditions are maintained.

1. 2. 3. 4. 5. 6. 7. 8. 9.

10.

11. 12. 13. 14.

15.

Ford Boulevard Elementary School Curriculum Guidelines A standards-based instructional program is expected in all grades. Utilize State frameworks and California Content Standards for planning of instruction. Long-term planning should include: lesson objectives, direct instruction activities, activities to develop student background knowledge and skills, student outcomes, and methods of evaluation (including OCR & Envision assessments and writing rubrics). Standards being addressed should be made clear to students through discussion and posting of standard. There must be evidence of short and long term planning. Plans must be in the classroom and accessible at all times. Grades 1-5 will implement the Open Court Reading Program for the 2 hour instructional time block mandated by the District. Kinder will implement the program for the required 2 hour block. In addition, the State framework calls for 30 minutes of Intervention / IWT to the language arts block. Grades K-5 will implement the Envision Math Program for at least 50 minutes a day. An additional 15 minutes of Intervention is also to be dedicated to this time block. ELD Instruction should occur on a daily basis for all English Language Learners. Instruction should take place from 30-45 minutes/ day. Physical Education, Art, Music are part of the District curriculum. Students must be provided opportunities to develop skills in these areas. These areas can be taught throughout the week and can be integrated with the core content areas. Science and Social Science are also required content areas to be taught. These areas should not be solely integrated into language arts and math, but should be taught as independent content areas based on standards. These areas can be addressed on a flexible schedule. The Science skills/concepts in grades 4-5 for each strand do need to be taught. All teachers will teach the same science strand to facilitate assessment administration. All students should receive grade level instruction and materials. Students who are in Special Education should be provided instruction based on the students IEP goals. Students who are achieving above grade level, including GATE students, should be provided appropriate differentiated instruction. a. Students needing intervention should be referred to intervention programs or SST when appropriate. Planned lessons should include opportunities for language development, student interaction, and accountable talk. Students should have opportunities to write daily. Students should be engaged in the writing process as part of the language arts curriculum. Teachers should model appropriate reading, writing, and speaking skills for students. Teachers must administer all required OCR, Harcourt Math, Harcourt Science and any other mandated assessments. These assessments must be submitted by established deadlines. Teachers should also develop any diagnostic assessments they deem necessary to evaluate student performance. GATE: Identified students are clustered in designated rooms. Teachers providing instruction to GATE students should emphasize the development of higher level thinking and communication skills. Teachers are required to complete annual GATE and ongoing reports for these students as mandated by the District.

a. GATE teachers are required to remain current in GATE instructional methodology to promote high level thinking skills, content based projects, inquiry based learning and progressive pedagogy. b. Potential GATE students should be referred for assessment as soon as you identify the possibility for identification. 16. Do not complete registers, cumulative records, lesson plans, etc. during instructional time. Utilize teacher preparation time before and after school, lunch period as well as periodic release time. Remember contract obligations state that the workday of a full-time employee requires no less than 8 hours on-site and off-site work. 17. Cell Phone Use in the Classrooms: Cell phones cannot be used during instructional time. If a parent needs to communicate with you, please remind them to call the main office. If you have an emergency, please notify the office and someone will cover your class. Contact parents before school, after school, during recess and lunch if needed. a. These are some basic guidelines for implementing your instructional program. Depending on your grade level and specific student needs, there are several other considerations that you may have to address. We can work together to determine and address any needs that may arise.

18.

Ford Boulevard Elementary School Parent Compact (Title I) The Students Pledge I understand that education is important to me. I am the one responsible for my own success. 1. 2. 3. 4. 5. AS A STUDENT, I WILL: Come to school on time and be prepared to do my best. Respect the rights of others and myself. Follow all school and classroom rules. Complete class assignments and homeworks on time. Spend time at home reading. The Teachers Pledge I understand the importance of a quality education for every student and my role as an educator and positive role model. AS A TEACHER, I WILL: Create a safe, positive, and healthy learning environment. Provide a challenging, instructional program, which addresses the individual needs of all students. Communicate with parents on a regular basis. Assign appropriate homework with clear instructions. Encourage students to read daily at school and at home. Participate in professional growth activities. The Parents Pledge I understand that my participation in my childs education will help his/her achievement and attitude. AS A PARENT, I WILL: Listen to or read with my child every day. Provide a quiet place and materials for completing all homework. Support the schools homework, discipline, and attendance policies. Participate in school events. Read all home-school communications and contact the school when I have questions or concerns. Make sure that my child gets adequate sleep and has a healthy diet.

1. 2. 3. 4. 5. 6.

1. 2. 3. 4. 5. 6.

_________________
Students Signature _______________________________ Teachers Signature

__________________
Parents Signature

LOS ANGELES UNIFIED SCHOOL DISTRICT Memorandum INTER-OFFICE CORRESPONDENCE

TO: FROM: SUBJECT: DUE:

Staff Member Sylvester Harris , APEIS Students Present Level of Performance/IEP Five school days before IEP

DATE:

__________________________________ IEP will be on ______________________ at _______________________________ and to prepare for this meeting the students strengths and weakness in each one of these academic areas is needed. Your input is greatly appreciated. READING: Strength WRITING: Strength MATH: Strength Weakness

Weakness

Weakness

Open Court
Comprehension Checking Skills Spelling Vocabulary Fluency Average Writing

Unit 1 _______ _______ _______ _______ _______ _______

Unit 2

Unit 3 _______ _______ _______ _______ _______ _______

Unit 4 ______ ______ ______ ______ ______ ______

Unit 5 ______ ______ ______ ______ ______ ______

______ ______ ______ ______ ______ ______

Math Assessments: Quarter 1 Quarter 2 __________ __________

Quarter 3 __________

Quarter 4 __________

If you have any questions, please see me. Thank you!

Ford Boulevard Elementary School

INTER-OFFICE CORRESPONDENCE
To: From: Date: America

An IEP Meeting has been scheduled for: Student: Date: Location: DOB: Time:

Initial

Annual

2nd Annual

3-YR

30 day (parent request)

30 day (transfer)

Re-Eval

Other

The following IEP Team members will be in attendance: Administrator Nurse Psychologist Gen.Ed Teacher Sp. Ed Teacher LAS PKIT DHH PT APE AAA OT Other

PLEASE SIGN AND RETURN THIS NOTIFICATION TO Mr Harris

Ford Blvd. Elementary School

REQUEST FOR STUDENT SUCCESS TEAM MEETING

Return to Mr. Carreno Box

Student: ____________________________________ Grade: ______ ______ Room: ______ ____ Parents Name: ______________________________
Reason for referral (Check as many items below as apply): ___ inadequate academic progress in: decoding reading fluency phonemic awareness writing math ___ Inadequate progress in ELD (Please attach copy of ELD Portfolio) ___ Attendance (Please attach attendance record) ___ Behavior ___ Speech: Articulation Language

Birthdate:___________________ Teacher: ___________________ Phone #:_____________________

reading comprehension other: ____________

___ Level of Concentration (If yes, approximate minutes student is able to remain focused: ___) ___ Memory (If yes, explain:____________________________________________________) ___ Sensory Motor: fine motor gross motor ___ Oral Expression/Comprehension ___ Omissions, reversals in written work Attendance: Days Absent _____ Unexcused _____ Tardies _____

Physical / Health Problems: ____ Yes ____ No If yes, explain: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ Student wears glasses: ____ Yes ____ No Student wears a hearing device: ____ Yes ____ No Consistently: ____

Language Proficiency: _____ LEP (ELD Level ___) ____ RFEP ____ IFEP ____EO Language Program: _____ WB ____ Structured Eng. Immersion ____ EO Instruction Language Appraisal Team (LAT) should address students needs? ____ Yes ____ No Academic Achievement: OCR Unit ____ : Fluency ____ WPM (Kinder: __ uppercase/ __ lowercase letters) *Please attach SOAR history data for student* Math Quarter ___ Assessment: _____% Classroom / Playground Behavior (answer yes or no) 1. Good peer social interaction ____ 5. Group participation ____ 2. Good adult social interaction ____ 6. Attention seeking behavior ____ 3. Completes in-class assignments ____ 7. Lacks motivation ____ 4. Completes homework ____ 8. Follows rules ____ Comments _______________________________________________________________________

Does the student participate in any special education programs? ____ Yes ____ No If yes, indicate areas serviced: ________________________________________________________ Has the student participated in any intervention classes? ____ Yes ____ No If yes, list: ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ What classroom modifications have you made to alleviate students problem? 1. Modification: ___________________________ Date: ______________ Outcome: ___________________________________________________ 2. Modification: ___________________________ Date: ______________ Outcome: ___________________________________________________ 3. Modification: ___________________________ Date: ______________ Outcome: ___________________________________________________

Classroom Interventions already in place: Target Behavior: Date Initiated Interventions Implemented Outcomes

Frequency: Target Behavior: Date Initiated Interventions Implemented Outcomes

Frequency:
Please indicate contacts with parent and outcomes: Date Person Contacted Comment / Results 1. _____ ________________ ____________________________________ 2. _____ ________________ 3. _____ ________________ ____________________________________ ____________________________________

Are there other external factors that may be affecting childs academic progress or behavior? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ What would you like to see happen for this student as a result of this meeting? ________________________________________________________________________________________________________ _______________________________________________________________________________________________________
Teachers Please Attach any Documentation of Additional Areas of Concerns