III. Needed Interventions And Outcome-Tracking For YY/YY Current Status Needed Interventions Outcomes Education Rights Holder Unable to identify ERH Contact the youth’s social worker Current ERH identified and contacted No contact information for current ERH and/or legal representative to (provide name/phone number): Attempts to contact ERH unsuccessful (specify obtain up-to-date ERH contact New ERH appointed, court documentation and methods of contact): information. received, and ERH contacted (provide ERH not available to meaningfully participate in Send ERH Appointment Request name/phone number): student’s education (specify): Letter to CSW. ERH not appointed, district surrogate ERH no longer has relationship with student Contact the court directly to appointed (provide name and phone (specify): express concern about ERH number): Other (specify): appropriateness. Other (specify): No Concern School of Origin Enrolled in current school within last 15 months Discuss youth’s school of origin Remained in/returned to school of origin because of a home placement change rights with ERH and current Transferred to new school per ERH decision Home placement change imminent caregiver No concern Identify school of origin options, including transportation funding availability Discuss pros and cons of options Identify ERH decision Academics Earning poor grades Refer for after county office of Grades improved Scored below average on state or district testing education tutoring Test scores improved Other signs of academic delays (specify): Refer for school based tutoring Other (specify): No concern Refer for SST for Special Education Assessment. Conduct 30-day IEP meeting. Refer for on campus after “Bridge school to Tomorrow” tutoring provided by local agency. Attendance
III. Needed Interventions And Outcome-Tracking For YY/YY Current Status Needed Interventions Outcomes Education Rights Holder Unable to identify ERH No contact information for current ERH Attempts to contact ERH unsuccessful (specify and methods of contact): ERH not available to meaningfully participate in student’s education (specify): ERH no longer has relationship with student (specify): Other (specify): No Concern Contact the youth’s social worker and/or legal representative to obtain up-to-date ERH contact information. Send ERH Appointment Request Letter to CSW. Contact the court directly to express concern about ERH appropriateness. Current ERH identified and contacted (provide name/phone number): New ERH appointed, court documentation received, and ERH contacted (provide name/phone number): ERH not appointed, district surrogate appointed (provide name and phone number): Other (specify): School of Origin Enrolled in current school within last 15 months because of a home placement change Home placement change imminent No concern Discuss youth’s school of origin rights with ERH and current caregiver Identify school of origin options, including transportation funding availability Discuss pros and cons of options Identify ERH decision Remained in/returned to school of origin Transferred to new school per ERH decision Academics Earning poor grades Scored below average on state or district testing Other signs of academic delays (specify): No concern Refer for after county office of education tutoring Refer for school based tutoring Refer for SST for Special Education Assessment. Conduct 30-day IEP meeting. Refer for on campus after school “Bridge to Tomorrow” tutoring provided by local agency. Grades improved Test scores improved Other (specify): Attendance
Sample-Education-Evaluation.docx