Draft Approved Amended. Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: 12/01/2015

Transcription

1 Draft Approved Amended Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: First Name: Ashley Middle Name: Nicole Last Name: Corbin Address : 1519 ARGYLE AVE # City: Baltimore State: MD Zip Code: Grade: Grade 10 Unique Student Identification Number (State): Student Identification Number (local): Date of Birth: 03/18/1999 Age: 16 Gender: Female Race Code: Black or African American Student identified as Limited English Proficient: No Student's native language: English Residence County: Baltimore City Residence School: Carver Vocational-Technical High Service County: Baltimore City Service School: Carver Vocational-Technical High Which jurisdiction is financially responsible? Baltimore City Is the student currently under the care and custody of a state agency? If yes, name of state agency: Does the student require a parent surrogate? Parent Surrogate Name: Surrogate Phone: PARENT/GUARDIAN 1: First Name: MI: Last Name: Home Phone: Cell Phone: Parent native language, if not English: Interpreter needed? PARENT/GUARDIAN 2: First Name: MI: Last Name: Home Phone: Cell Phone: Parent native language, if not English: Interpreter needed? Case Manager:J. Donaldson IEP Team meeting date(s):, IEP Annual Review date: Parent was provided a copy of the Procedural Safeguards and Parental Rights document The parents were provided a verbal and written explanation of the parents' rights and responsibilities in the IEP team process. Parents were provided verbal and written information about access to habilitative services, including a copy of the Maryland Insurance Administration's Parents' Guide to Habilitative Services. Projected Annual Review Date: 11/30/2016 Most Recent Evaluation Date: 12/12/2013 Projected Evaluation Date: 12/11/2016 Primary Disability: SPECIFIC LEARNING DISABILITY Areas affected by disability: Academic - Math Problem Solving Student: Ashley Corbin Parent: Keshia Corbin Special Education Teacher: Oren Franklin General Education Teacher: Jeff Bailey Parent/Guardian: James Corbin Special Education Teacher: John Donaldson Guidance Counselor: Paul Kucan Principal/Designee: Alethea Turner Page 1 of 22

2 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Specify the area(s) identified for reevaluation: The team identified the areas of reading comprehension, math problem solving, and written language for review. Discussion to support decision: Based on teacher's progress reports, current level of performance, data gathered from classroom assessments and record review the team decided that Ashley continues to make steady progress in all academic areas. The team agrees that based on current informal assessments, classroom assessments, and teacher consult, Ashley no longer requires specialized service in the form of goals and objectives in reading comprehension and written language. These areas will therefore be dismiss from her IEP services. She continues to require services in math problem solving inside the general education environment. Evaluation Date: 12/12/2013 (This is the most recent date on which the IEP team completed a full and comprehensive review of all assessment materials.) Does the student continue to have a disability and such educational needs that require the continued provision of special education and related services? Yes Are any additions or modifications to special education and related services needed to enable the student to meet the measurable annual goals set out in the student's IEP and to participate, as appropriate, in the general education curriculum? No Eligible as a student with a disability? Yes Document basis for decision(s): Based on review of teacher input, record review, IEP quarterly report cards, and progress reports Ashley continues to be eligible for services as a student with a Specific Learning disability. Indicate Primary Disability: SPECIFIC LEARNING DISABILITY Page 2 of 22

3 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: PLAN FOR PARTICIPATION IN ASSESSMENTS TO BE ADMINISTERED DURING THE TERM OF THE CURRENT IEP* PERFORMANCE SUMMARY Is the student limited English proficient? No State graduation requirements can be found at Also record any additional local school system graduation requirements: The local school system does not require any additional requirements for graduation. The team discussed graduation requirements, transcript, community service learning hours, and attendance. According to her transcript Ashley has earned 5 credits toward her diploma. She has taken, but not passed the Government (368) HSA. She will be required to take and pass the English Language Arts/Literacy, Algebra I, Geometry, and Algebra II PARCC Assessment for high school and the Biology Maryland High School Assessment. She currently has 25 student service learning hours. Will the student participate in an alternate assessment based on alternate academic achievement standards in reading, math and science in assessed grade? Graduation requirements explained to parents? Yes Student is pursuing a: Maryland High School Diploma Will the student participate in the Maryland School Assessment aligned with grade level academic achievement standards in assessed grade? (MSA-Grades 5&8) Science: What was the student's performance on the Assessing Comprehension and Communication in English State-to-State for English Language Learners (ACCESS FOR ELLS)? Assessment Date: Overall Composite Proficiency Level: - What was the student's performance on the Alternate Assessing Comprehension and Communication in English State-to-State for English Language Learners (Alternate ACCESS FOR ELLS)? Assessment Date: Overall Composite Proficiency Level: - What was the student's performance on MSA as of 03/16/2013? MSA Assessments Reading Math Science Most Current Proficiency Levels Proficient Basic Current Scale Last Year's Scale What was the student's performance, if applicable, on alternate assessments as of? Alt-MSA Assessments % of Mastery Objectives Reading Math Science Will the student participate in the Maryland High School Assessment aligned with Maryland College and Career-Ready Standards in assessed course? Algebra/Data Analysis: Biology: Yes English: Government: Yes Will the student participate in the Maryland High School Assessment aligned with Maryland College and Modified achievement standards in assessed course? (Only available to second time test takers and only available through August 2015) Algebra/Data Analysis: Biology: English: Government: Will the student participate in PARCC Assessments for grades 3-8? What was the student's performance, if applicable, on HSA as of? HSA Assessments Algebra/Data Analysis Biology English Government Passing Student's 1st Student's 2nd Student's Highest Meet Standard No Bridge Plan Participant Mod-HSA+ Participant Page 3 of 22

4 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: English Language Arts/Literacy: Mathematics: Will the student participate in PARCC Assessments for high school? English Language Arts: Yes Algebra I: Yes Geometry: Algebra II: Yes Combined with Gov't Combined w/out Gov't Document basis for assessment decision(s): What was the student's performance, if applicable, on PARCC Assessments? PARCC Performance-Based Assessments (PBA) End of Year Assessments (EOY) Based on review of teacher progress reports, record review, and PARCC/HSA criteria, Ashley will be required to take and pass the English Language Arts/Literacy, Algebra I, Geometry, Algebra II PARCC Assessment for high school and the Biology and Government Maryland High School Assessment, with testing accommodations in order to meet the requirements to obtain his High School Diploma. English Language Arts/Literacy Mathematics Algebra I Geometry Grade Grade Grade Grade *A student may be asked to participate in national or international assessments. Only Algebra II Grade allowable accommodations on national/international assessments are permitted. Complete for high school seniors that may be eligible for an HSA waiver: IEP team has discussed the criteria of the waiver decision-making process for the student and supports an HSA waiver recommendation to the local superintendent Page 4 of 22

5 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Reading Comprehension Source(s): Brigance Inventory of Basic Skills Instructional Grade Level Performance: 9.0 G.E. (Consider private, state, local school system, and classroom based assessments, as applicable.) Summary of Assessment Findings (including dates of administration): Based on the Brigance Inventory of Basic Skills administered on 11/01/2015, Ashley will no longer need the services of an IEP Reading Goal. She is currently reading at the 9th grade level according to the Brigance Informal Assessment. That is a one and a half year increase from last year. She is performing within one year of her grade level expectancy. According to Ashley's first quarter report card, she has received an 87 in her English class, which is consistent with her performance from 9th grade where her average was a 90%. Conferences with her General Education English teacher revealed that she is performing at a level that is higher than her general education peers. He says that her reading comprehension is strong and she does not require any of the supplemental services that she received last year. Ashley can cite evidence from the text. Ashley can find the definitions of unfamiliar words based on context clues. She is able to summarize a text given at her current grade level. It is for this reason that Ashley's goal for Reading Comprehension will be dismissed. She is performing at a level that suggests mastery of this goal. Does this area impact the student's academic achievement and/or functional performance? No Math Problem Solving Source(s): Brigance Inventory of Basic Skills Instructional Grade Level Performance: 4.5 G.E. (Consider private, state, local school system, and classroom based assessments, as applicable.) Summary of Assessment Findings (including dates of administration): Based on the Brigance Inventory of Basic Skills conducted on 11/01/2015, Ashley is currently performing at the 4.5 G.E. in math problem solving. Ashley is able to complete problems that require basic addition and subtraction. These problems usually entail single step word problems. However as the steps become more complex and require multiple steps Ashley does not fair as well. It appears as if she becomes confused with the steps. She may perform the wrong operation. It seems as though Ashley may needs a way to separate out each step in the problem (unpacking the prompt). then she must decipher what is being asked of her. Ashley's General Education Math teacher says that she is currently performing at a acceptable level in his class. The teacher says that Ashley is able to perform computation problems with ease. He says that she needs to continue to work on solving equations, and graphing. He Page 5 of 22

6 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: notes that she confuses the axis's when she is graphing coordinates. The teacher states that Ashley will attend coach class as needed. He says that she is a good student and has no problems with his academics. As an accommodation, she requires highlighters in order to highlight information that is needed. These will help Ashley to unlock and address the demands of the prompt. Does this area impact the student's academic achievement and/or functional performance? Yes Written Language Expression Source(s): Brigance Inventory of Basic Skills Instructional Grade Level Performance: 7.0 G.E. (Consider private, state, local school system, and classroom based assessments, as applicable.) Summary of Assessment Findings (including dates of administration): Based on the Brigance informal assessment, Ashley is performing at a level that suggest that she does not require goals for writing at this time. She is performing at the 7.0 grade level in written language expression. Ashley was at a 6.0 last year on this same goal. She has made 1 years growth in this area. She is performing at a level that indicates that the written language goal is no longer required. Ashley is able to create a writing sample and control for audience. She is able to support her claims using the appropriate evidence. Ashley does need to continue to work on her grammar when writing. The teacher notes that he grammatical errors do not force her to lose meaning in the essay. Ashley is being considered for placement in the AP course at this time. It was noted by her teacher that she does not require services in the area of writing. Her IEP writing goal will be dismissed. Does this area impact the student's academic achievement and/or functional performance? No Page 6 of 22

7 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: What is the parental input regarding the student's educational program? The purpose of this meeting is to review Ashley's IEP and to determine if the IEP requires revision or modifications that will allow her maximum support to assist her with obtaining her diploma. The draft IEP was mailed to the parent. Parent and student were invited to the meeting. The parent received copies of the parent rights booklet and the transition guide. Both parents signed for the booklets. Mr. and Mrs. Corbin and Ashley participated in the meeting. Mother shared that she wanted to make sure that Ashley has her accommodations and supplemental services available to her. Ashley has been attending coach class for her one on one assistance and to ask questions to check her understanding. Ashley has requested Honors English; however, she is in Honors Biology at the same time. The guidance counselor offered to tutor her in the morning for math. The math teacher shared that Ashley is doing well in his class. She actively engaged and seem to be able learn the material. She attends his coach class whenever she has questions. The team discussed graduation requirements, transcript, community service learning hours, and attendance. According to her transcript Ashley has earned 5 credits toward her diploma. She has passed all her credit thus far. She has taken, but not passed the Government (368) HSA. She will take it again in May, She may be required to take the English Language Arts/Literacy, Algebra I, Geometry, and Algebra II PARCC Assessment for high school and the Biology Maryland High School Assessment. She sat for the Algebra I PARCC last year. She will sit for the English PARCC this year. She currently has 25 student service learning hours. Based on teacher's progress reports, current level of performance, data gathered from classroom assessments and record review the team decided that Ashley continues to make steady progress in all academic areas. The team agrees that based on current informal assessments, classroom assessments, and teacher consult, Ashley no longer requires specialized service in the form of goals and objectives in reading comprehension and written language. These areas will therefore be dismiss from her IEP services. She continues to require services in math problem solving inside the general education environment. What are the student's strengths, interest areas, significant personal attributes, and personal accomplishments? (Include preferences and interests for post-school outcomes, if appropriate.) Ashley is a tenth grade African American female at Carver Vocational Technical High School. Ashley is capable of completing assignments independently. She seems to be motivated to attend college after high school. She makes good decisions academically and is in line to graduate on time with the appropriate course work to attend the college of her choosing. She is able to make friends in the school building. She is able to articulate her needs and desires to teachers and other authority figures. Ashley seems to like to be involved in activities around the building that will allow her to learn more about college and her trade (the Culinary Arts). How does the student's disability affect his/her involvement in the general education curriculum? Ashley s Specific Learning Disability has an impact on her involvement in the general education curriculum. She sometimes can be distracted and miss instruction and directions. She can be disorganized, which leads to missed work, missing information, and missed assignments. Also, Ashley can misread symbols or write the wrong information. It can cause Ashley to fail to complete longer assignments that require longer periods of concentration. She may not follow directions that are given in class. She may omit operations that are needed to complete the assignment. She may miss key information while reading a prompt that can cause an incorrect response. Page 7 of 22

8 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Does the student have special communication needs? No (If yes, describe the specific needs.) Consider AT device(s) and service(s) that are needed to increase, maintain or improve functional capabilities of a student with a disability. The student needs an AT device(s): No If yes, AT device(s) will be addressed through: The student needs an AT service(s): No If yes, AT service(s) will be addressed through: Document basis for decision(s): The team agreed that Ashley does not require AT services or devices at this time. PRESENTATION ACCOMMODATIONS: ('I' covers all instruction/intervention including Bridge Plan) 1 For State assessments, tactile graphics are provided with the braille tests. 2 Use of the verbatim reading accommodation is permitted on all assessments as a standard accommodation, with the exception of the Maryland School Assessment (MSA) in reading, grade 3 ONLY, which assesses a student s ability to decode printed language. Students in grade 3 receiving this accommodation on the assessment will receive a score based on standards 2 and 3 (comprehension of informational and literary reading material) but will not receive a subscore for standard 1, general reading processes. 3 Any text-to-speech software may be used for instruction, but the only text-to-speech software currently allowed and supported by the State for assessment is the Kurzweil Please note that the human reader and text-to-speech accommodations are not allowable accommodations for Selected Sections of the PARCC assessments. Document basis for decision: " RESPONSE ACCOMMODATIONS: ('I' covers all instruction/intervention including Bridge Plan) Materials or Devices Used to Solve or Organize Responses 2-J: Mathematics Tools and Calculation Devices* 2-M: Graphic Organizer Conditions for Use In Instruction and Assessment I, A I, A 5 Spelling and grammar devices are not permitted to be used on the English High School Assessment. Page 8 of 22

9 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: 6 Photocopying of secure test materials requires approval by the MSDE and must be done under the supervision of the Local Accountability Coordinator (LAC). Photocopied materials must be securely destroyed under the supervision of the LAC. Use of highlighters may be limited on certain machine-scored test forms, as highlighting may obscure test responses. Check with the LAC before allowing the use of highlighters on any State assessment. Document basis for decision: Based on the assessment, Ashley will require the services of the calculator and a graphic organizer to complete math word problems. These accommodations will be required for the formal and informal assessments. This will exclude the PARCC assessment because it is a state assessment that does not allow for the use of the calculation device. * Provide specific description stating the type of accommodation and how the accommodation will be administered: Based on the assessment, Ashley will require the services of the calculator and a graphic organizer to complete math word problems. These accommodations will be required for the formal and informal assessments. This will exclude the PARCC assessment because it is a state assessment that does not allow for the use of the calculation device. TIMING AND SCHEDULING ACCOMMODATIONS: ('I' covers all instruction/intervention including Bridge Plan) Document basis for decision: SETTING ACCOMMODATIONS: ('I' covers all instruction/intervention including Bridge Plan) Document basis for decision: Page 9 of 22

10 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Instructional Support(s) Nature of Service Frequency Begin Date End Date Provider(s): (P)=Primary, (O)=Other Instructional Support(s) - Paraphrase questions & instruction Anticipated Frequency Daily 12/01/2016 (P) General Education Teacher Duration: 36 Weeks (O) Special Education Classroom Teacher Clarify location and manner: Based on the assessment results, Ashley may have trouble understanding what a word problem is asking and therefore the teacher should paraphrase what is being asked of her in these prompts. Nature of Service Frequency Begin Date End Date Provider(s): (P)=Primary, (O)=Other Instructional Support(s) - Check for understanding Anticipated Frequency Daily 12/01/2016 (P) General Education Teacher Duration: 36 Weeks (O) Special Education Classroom Teacher Clarify location and manner: Based on observation, Ashley will need a staff member to check on her understanding daily. She may not ask questions that will lead to understanding of the material. A professional should check her understanding of the material. Nature of Service Frequency Begin Date End Date Provider(s): (P)=Primary, (O)=Other Instructional Support(s) - Allow use of highlighters during instruction and assignments Anticipated Frequency Daily 12/01/2016 (P) General Education Teacher Duration: 36 Weeks (O) Special Education Classroom Teacher Page 10 of 22

11 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Clarify location and manner: Based on the assessment, Ashley will require this supplementary service in order to meet with success in the general education environment. She will use it to pay attention to important information that is required to complete the service. Documentation to Support Decision: Based on the assessment, Ashley is performing at a level in math problems solving that will require her to use supplementary services. These services will help her address her needs in the inclusion math environment. Supplementary Aids, Services, Program Modifications and Supports were considered and none are required at this time. No Discussion to support decision(s): Page 11 of 22

12 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: The IEP Team should determine if any of the factors below will significantly jeopardize the student's ability to receive some benefit from the student's educational program during the regular school year, if the student does not receive ESY services. ESY services are the individualized extension of specific special education and related services that are provided beyond the normal school year of the public agency, in accordance with the IEP, at no cost to the parents. When considering ESY, answer YES or NO and document the decision: 1. Does the student's IEP include annual goals related to critical life skills? No Discussion to support decision: Based on IEP content, IEP quarterly report cards, and progress reports, Ashley s IEP does not include annual goals related to critical life skills 1a. Is there a likely chance of substantial regression of critical life skills caused by the normal school break and a failure to recover those lost skills in a reasonable time? No Discussion to support decision: Based on IEP content, IEP quarterly report cards, and progress reports, there is not a likely chance of substantial regression of critical life skills caused by the normal school break and a failure to recover those lost skills in a reasonable time, due to no critical life skills being addressed as annual goals on the IEP. 1b. Is the student demonstrating a degree of progress toward mastery of IEP goals related to critical life skills? No Discussion to support decision: Based on IEP content, IEP quarterly report cards, and progress reports, Ashley is not demonstrating a degree of progress toward mastery of IEP goals related to critical life skills. 2. Is there a presence of emerging skills or breakthrough opportunities? No Discussion to support decision: After reviewing the IEP objectives, the team determined that there are no skills at a breakthrough point and the interruption of instruction on these objectives caused by the school break are not likely to prevent Ashley from receiving some benefit from the educational program during the next school year without ESY services. Page 12 of 22

13 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: 3. Are there significant interfering behaviors? No Discussion to support decision: Based on the IEP content, IEP quarterly report cards, and progress reports, the team has determined that there are no interfering behaviors targeted by the IEP objectives that have prevented Ashley from receiving some benefit from the educational program during the previous school year without ESY services and there were no interruptions in the program that addresses the interfering behaviors that are likely to prevent Ashley from receiving some benefit from the educational program during the next school year without ESY services. 4. Does the nature and severity of the disability warrant ESY? No Discussion to support decision: Based on the IEP content, IEP quarterly report cards, and progress reports, the nature and severity of the disability is not likely to prevent Ashley from receiving some benefit from the educational program during the regular school year. 5. Are there other special circumstances that require ESY? No Discussion to support decision: Based on review of records, IEP quarterly report cards, and progress reports, there are no other special circumstances that are likely to prevent Ashley from receiving some benefit from the educational program during the regular school year. After considering the above questions, will the benefits that the student receives from his/her educational program during the regular school year be significantly jeopardized if the student is not provided ESY? NO, student is not eligible for ESY service Document basis for decision(s): Based on review of records, IEP quarterly report cards, and progress reports, the benefits that Ashley receives from his educational program during the regular school year will not be significantly jeopardized if she is not provided ESY. Page 13 of 22

14 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: STUDENT PREFERENCES AND INTERESTS: The post secondary goal(s) are to be based on the student's interests,preferences and age appropriate transition assessment(s). Date of Annual Student Interview: 11/13/2015 Discussion of student's interests, preferences and age appropriate transition assessment(s): Based on the Student Interview 11/13/2015 and the TPI 11/11/2015, Ashley wants to attend culinary school. She wants to own her own business, but work with a professional chef to learn the trade. She is not sure if she wants to have children. She has standards that someone will have to meet before she entertains having children and getting married. Currently she is in her 1 st year of her culinary arts trade at Carver Vo. Tech High School. She wants to move to California because she believes there are more opportunities for culinary arts jobs. She plan s to enroll in Stratford upon graduation. She plans to research the school so that she can glean a better understanding of what is available. Ashley is a great candidate for the Bridges Program, because they may be able to place her in a hotel kitchen at the Marriott. She wanted to share that she is Type 2 Diabetic and will require her medication to be with her on the job at all times. POSTSECONDARY GOALS (Outcomes): Postsecondary goal(s) are to be recorded here.at least one goal must be indicated for training and/or education. Employment (required): Upon graduation, Ashley will work as a chef in a five star restaurant under a master chef. Training: Education: Upon graduation, Ashley will enroll in Stanford University to study culinary arts. Independent Living (if appropriate): Based on the TPI, student interview, teacher consult, and past IEP's, Ashley does not have any independent living concerns at this time. COURSE OF STUDY: The course of study is to support the stated postsecondary goal(s) Human Consumer Services, Hospitality & Tourism Student is enrolled in the following Functional and Skill Development Activities: Page 14 of 22

15 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Discussion to support decision: Ashley is pursuing a high school diploma. She is currently enrolled in Spanish. PROJECTED CATEGORY OF EXIT: The student is projected to exit with: Maryland High School Diploma: (with 2 credits of Foreign Language, with 4 credits of Career and Technology Program) PROJECTED DATE OF EXIT: The student is participating in a 4 year program and is projected to exit/graduate school Jun 01, 2018 (month, day, year) Have the student and parents been informed that rights under IDEA do not transfer to students with disabilities on reaching age of majority, except under limited circumstances. as described in Education Article , Annotated Code of Maryland? Yes TRANSITION SERVICES/ACTIVITIES Transition services are a coordinated set of activities for a student with a disability that is designed within a results oriented process that will facilitate the student's movement from school to postsecondary activities. Academic: 1. Register for Naviance 2. Register and take the SAT 3. Write a resume and cover letter Responsible Party: 1. College Board Representative 2. Guidance Counselor 3. English Teacher Employment Training: Page 15 of 22

16 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: 1. Research possible careers in culinary arts 2. Complete a mock application. 3. Attend a Transition Fair through the Office of Special Education. Responsible Party: 1. Case Manager 2. Case Manager 3. Case Manager Annual date student and parent were provided a copy of the Transition Planning Guide: AGENCY LINKAGE *The student has been referred to: *Agency Representatives were invited to the IEP Team Meeting: Anticipated Services for Transition: Division of Rehabilitation Services (DORS) No Yes Yes Developmental Disabilities Administration (DDA) No N/A No Behavioral Health Administration (BHA) No N/A No *If no or N/A, document basis for decision: The student will be referred to DORS when she in the 11th grade. She does not require the services of DDA or MHA at this time. Discussion to support decision: She does not require the services of DDA or MHA at this time Page 16 of 22

17 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Goal: Academic - Math Problem Solving By December 2016 Ashley, will use variables to represent quantities in a real-world or mathematical problem, and construct simple equations and inequalities to solve problems to the beginning 6 grade level as measured by classroom based assessments with 80% accuracy. By: 12/01/2016 Evaluation Method: Classroom Based Assessment With: 80 % Accuracy ESY goal? No Objective 1 : By the beginning of the year, Ashely will graph points in the first quadrant of the coordinate plane, Objective 3 : By the middle of the year, Ashely will understand that solving an equation or inequality is a process of answering a question: Objective 2 : By the middle of the year, Ashely will write expressions that record operations with numbers and with letters standing for numbers. Objective 4 : By the end of the year, Ashely will solve systems of equations numerically or by graphing. How will the parent be notified of the student's progress toward the IEP goals? IEP Report Card How often? Quarterly Page 17 of 22

18 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: SPECIAL EDUCATION Service Nature Location Service Description Begin Date End Date Provider(s): (P)=Primary, (O)=Other Summary of Service Classroom Instruction (Identifying the number of sessions for Classroom Instruction is optional) In General Education Number of Sessions: 2 Length of Time: 1 Hrs.30 Min. Frequency: Weekly 12/01/2016 Duration: 36 Weeks (P) General Education Teacher Total service time: Weekly 3 Hrs. 0 Min. Discussion of service(s) delivery including description of Transportation services if provided: Special Education - Classroom Instruction: Service should be provided in the inclusion setting with a general educator using supplementary aids and services and testing accommodations for at least three hours a week for math, depending upon the school schedule. Discussion of ESY service(s) delivery including description of Transportation services if provided: Page 18 of 22

19 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: What placement options did the IEP team consider? The team considered and identified Ashley's present services inside of the general education environment for all her classes and discussed her level of success in her current placement. The team will provide math services in the general education environment, with the additional support of coach class. If removed from the regular early childhood program/general education environment, explain reasons why services cannot be provided in that setting with the use of supplementary aids and services: Ashley will not be removed from the general education environment, because services can be provided in the general education environment with the use of supplementary aids and services. Document basis for decision(s): The team based its decision on record reviews of teachers' progress reports, comments, informal assessments, work samples, and present levels of performance. Special education placement (ages 3-5): Special education placement (ages 6-21): Average 100%/day - INSIDE GENERAL EDUCATION (80% or more) Total time in school week: 34 hrs. 00 minutes/week Total time in General Education: 34 hrs. 00 minutes/week Total time outside of General Education: 00 hrs. 00 minutes/week In selecting the LRE, are there any potential harmful effects on the student or quality of services he or she needs? No If yes, document basis for decision(s): Are the services in the student's home school (the school the student would attend if not disabled)? Yes If no, document basis for decision(s): If no, is placement as close as possible to the student's home? If no, document basis for decision(s): Consideration of Transportation Needs: Is the Related Service Transportation needed based on the unique needs of the student or to allow student access to special education services? No If Yes, consider: Is specialized equipment needed to assist the student during transportation? If yes, explain: Are personnel needed to accommodate the student during transportation? If yes, list type(s) of personnel: Are other supports needed to assist the student during transportation? If yes, explain: Document basis for decision(s) (including consideration of the amount of time and distance involved in travel): Provide an explanation to the extent, if any, the student will not participate with non-disabled peers in academic, non-academic, and extracurricular activities? Page 19 of 22

20 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Ashley will participate with her non-disabled peers in all academic, non-academic, and extracurricular activities, and therefore, will not be exclude from participating with her non-disabled peers during academic electives, non-academic and/or extracurricular activities. SSIS Resident County: Baltimore City SSIS Service County: Baltimore City SSIS Resident School: Carver Vocational-Technical High SSIS Service School: Carver Vocational-Technical High (1)Eligible student with a disability served in a public or placed in a nonpublic school by the public agency to receive FAPE Page 20 of 22

21 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Page 21 of 22

22 Name: Ashley Nicole Corbin Agency: Baltimore City IEP Team Meeting Date: Parental consent must be obtained before the provider agency discloses, for billing purposes, their child's personally identifiable information to the Maryland Department of Health and Mental Hygiene (DHMH), the State agency responsible for the administration of the Medical Assistance Program, consistent with the Family Educational Rights and Privacy Act (FERPA) and the Individuals with Disabilities Education Act (IDEA). By providing consent, you understand and agree in writing that the public agency may access your child's Medicaid to pay for services provided to your child. In order to provide a free appropriate public education (FAPE) to your child, the provider agency may not: Require you to sign up for or enroll in State's Medical Assistance in order for your child to receive FAPE under IDEA, Require you to incur an out-of-pocket expense such as the payment of a deductible or co-pay amount incurred in filing a claim for services, Use your child's benefits under Medical Assistance if that use would: Decrease available lifetime coverage or any other insured benefit; Result in your family paying for services that would otherwise be covered by Medical Assistance and that are required for your child outside of the time your child is in school; Increase premiums or lead to the discontinuation of benefits or insurance; or Risk loss of eligibility for home and community-based waivers, based on aggregate health-related expenditures. You have the right to withdraw your consent to disclosure of personally identifiable information to State's Medical Assistance Program at any time. If you withdraw consent for the provider agency to disclose your child's personally identifiable information it does not relieve the provider agency of its responsibility to ensure that all required services are provided to your child at no cost to you. Is the student eligible for MA? Yes MA Number I agree to Service Coordination for Children with Disabilities and that the Service Coordinator(s) identified on this IEP may be appointed as MA Service Coordinator(s). (COMAR ) I understand that I am free to choose an MA Service Coordinator for my child. At this time, I accept the following Service Coordinator(s). MA Service Coordinator Name: J. Donaldson MA Service Coordinator Name: O. Franklin I understand that if I wish to change the MA Service Coordinator in the future, I can call the school to make a change. I understand that the purpose of this service is to assist in gaining access to needed medical, social, educational, and other services. I give my consent for the provider agency to disclose my child's personally identifiable information to the State's Medical Assistance Program in order to access Medical Assistance Benefits. I give permission to the provider agency to recover costs from Medicaid for service coordination, as well as health-related services, related to the implementation of my child's IEP goals. I understand that if I refuse to allow the provider agency access to MA funds, it does not relieve the public agency of its responsibility to ensure that all required services are provided to my child at no cost to parent. I understand that this service does not restrict or otherwise affect my child's eligibility for other Medical Assistance benefits. I also understand that my child may not receive a similar type of case management service under Medical Assistance if he/she qualifies for more than one type. Parent Signature: Date: Page 22 of 22