Ohio Evaluation Team Report Form Instructions and User Guide IEPPLUS

IEPPLUS: OH ETR Ohio Evaluation Team Report Form Instructions and User Guide IEPPLUS 1990-2013 SunGard Public Sector Inc. All rights reserved. No part of this publication may be reproduced without the prior written permission of SunGard Public Sector Inc., with the exception of copies made for your internal use. SunGard, the SunGard logo, PLUS 360, eschoolplus, IEPPLUS, PerformancePLUS, efinanceplus, and BusinessPLUS are trademarks or registered trademarks of SunGard Data Systems Inc. or its subsidiaries in the U.S. and other countries. All other trade names are trademarks or registered trademarks of their respective holders. Page 1 of 31

TABLE OF CONTENTS OVERVIEW... 3 FORM INSTRUCTIONS... 3 FORM CREATION... 3 Step 1 Select a Student... 3 Step 2 Create Form... 4 NAVIGATION/TOOLBAR... 5 FORM COMPLETION... 6 Cover Page... 6 Section 1. Individual Evaluator s Assessment... 7 Section 2. Team Summary... 7 Section 3. Documentation for the Existence of a SLD... 8 Section 4. Eligibility... 9 Section 5. Signatures... 11 Planning Forms... 11 EMIS Summary... 12 DATA MAPPING... 13 COVER PAGE... 13 SECTION 1. INDIVIDUAL EVALUATOR S ASSESSMENT... 16 SECTION 2. TEAM SUMMARY... 18 SECTION 3. DOCUMENTATION FOR THE EXISTENCE OF A SLD... 19 SECTION 4. ELIGIBILITY... 21 SECTION 5. SIGNATURES... 22 EVALUATION PLANNING FORM... 23 EMIS SUMMARY... 28 CODE TABLE SETUP... 29 REVISION HISTORY... 30 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 2 of 31

OVERVIEW An Evaluation Team Report (ETR) is completed to document the outcome of an evaluation or reevaluation needed to determine if a student has a disability and is in need of special education services. The ETR includes information and findings, concerning the student's educational needs and strengths, conclusions and recommendations for specially designed instruction. It serves as a foundation for completing the Individualized Education Plan (IEP) if the student is found to be in need of special education. Prior to beginning the ETR/evaluation process, a Consent for Evaluation form should be sent to the parents/guardians to obtain permission to conduct an evaluation. The district must receive signed permission from the student s parent/guardian before an evaluation can begin. Initial evaluations must be completed within 60 days of receipt of consent or 90 days of the referral date, whichever is shorter. Reevaluations must be completed within 3 years of the last ETR. The initial IEP must be completed within 30 days of completion of the ETR if the student is found to be eligible for special education services. FORM INSTRUCTIONS FORM CREATION The ETR/form creation process includes the following steps: STEP 1 SELECT A STUDENT 1. Click Student Management > Manage an Existing Student. 2. Use the Search window to find the student based on either, Last Name, First Name or Student ID. 3. Click Search. 4. Click the appropriate Name to select a student. Once a student has been selected, the student s Name, ID, Birth date and Age will display. The Forms that can be created for a student will be listed. Click on the ETR link. The ETR Summary screen will display, listing any prior ETR s for the student. The most recent form will display at the top of the list. To review an existing ETR, click the appropriate link. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 3 of 31

STEP 2 CREATE FORM 1. To create a new ETR, click the New icon illustrated in the above screenshot. 2. Select a Form Type: ETR School Aged or ETR Preschool (Alternate Code = ETR). 3. Select or create a Referral record (where Type is like Initial Evaluation or Reevaluation, Alternate Code = IR or RE respectively). 4. If a Meeting has been previously scheduled in IEPPLUS, select it from the drop down list. If not, enter a meeting date and select a Meeting Type (Alternate Code = ETR). 5. Select Evaluations to display on the ETR. Select ALL Evaluations/Tests will pull all evaluations a student has ever received and place them on the form. Select the LATEST of each type of Evaluation/Test will pull only the most recent of each type of evaluation. For example, if a student received two Social History evaluations, only the most recent would display. Enter a Date Range for the Evaluations. For example, to only include evaluations from the last three years, enter a Start Date three years prior to the meeting. Use the Meeting Date as the End Date. 6. Select the Letterhead for this report from the drop down list, and click on the Create Form link. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 4 of 31

NAVIGATION/TOOLBAR After the ETR has been created it will display to the screen. A toolbar will display on the left side of the screen, divided into the following areas: 1. Sections There is a separate link for each section of the form. Click on any link to move to that section. 2. Maintenance These options will maintain form information, such as Form Name, Date Ranges, Letterhead, etc. 3. Validation These options will change the status of the form (i.e., Locked, Ready for Review, Finalized). 4. File Attachments Click the plus icon (+) to add an attachment. Click the minus icon to delete an attachment. 5. Archives Archives are permanent PDF copies of the form. Click Finalize in the Validation section to create an Archived copy. The form should be finalized and archived only after it has been fully completed and a copy has been sent home to the student s parents or guardians. The following options will display at the top and bottom of the form (see screenshot below). Save Information from each section should be saved before moving to another section. Return Click the Return icon to return to the Form Summary screen. Print Preview Print Preview will display the form in Adobe Acrobat. Mouse over the bottom of the form preview to see the toolbar illustrated below. Select the Print icon or click the Save icon to save a copy of the form to your computer. The plus (+) icon will enlarge the preview for ease of viewing. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 5 of 31

FORM COMPLETION COVER PAGE The cover page includes general information about the child, the type of evaluation, dates relating to the special education timeline and the ETR form status by section. Most of the fields in this section will auto-populate. For more information on these fields or any other areas of the form, please refer to the Data Mapping section of this guide. Complete the cover page as follows. 1. District of Residence This field will populate based on the default Organization in System or User Options. The user can select another Organization from the drop down list. The selection will create/update an Associated Org record (Type = District of Residence) as of the form Start Date. To view or edit this record, return out of the form and navigate to Educational Information, Associated Organizations via the Student Toolbar. 2. District of Service Same as above (Associated Org Type = District of Service). 3. Type of Evaluation This field will populate based on the referral information entered when creating the form or linked in the Form Information section accessible through the Maintenance section of the Form Toolbar. Only Referral Types similar to Initial Evaluation or Reevaluation (Alternate Code = IR or RE respectively) will populate this field. To modify the existing or create new referral information, return out of the form and navigate to Educational Information, Referral via the Student Toolbar. 4. Date of Meeting This field will populate based on the meeting information entered when creating the form or linked in the Form Information section accessible through the Maintenance section of the Form Toolbar. Only Meeting Types with specific Alternate Codes (see table below) that have NOT been finalized on another form will display in the drop down. To create or edit a meeting record, return out of the form and navigate to Meetings via the Student Toolbar. Meeting Type similar to: Initial Evaluation Team Report Reevaluation Team Report Transfer Student ETR Preschool Transition Conference Alternate Code Type = EMIS Code and Description as follows: IETR RETR TETR PSTC 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 6 of 31

5. Date of Last ETR Click in the textbox to enter the date the student s last ETR was completed in MM/DD/YY format or click the calendar icon to select a date. Click the Not Available check box (typically indicates every effort was made to obtain a transferring student s ETR). 6. ETR Completion Date and Next ETR Due Date ETR Completion Date and Next ETR Due Date will calculate based on the meeting (same as Meeting Date and Meeting Date plus 3 years minus one day respectively). 7. ETR Form Status Checks are made in individual sections (Parts 1-5) upon their completion and will display on the cover page. 8. Choose a Planning Form This field will populate with the Planning form selected during ETR creation. To change from one form to the other (School Age or Preschool) click the drop down and make another selection. SECTION 1. INDIVIDUAL EVALUATOR S ASSESSMENT Use the Add Part 1 button to create evaluation sections for each evaluator. Upon completing each section, click the Update button to save the data. Update will enable the Add Part 1 button, allowing the addition of another section. Complete each section as follows. 1. Evaluator Name and Position Click in the text box to search for and select the evaluator s name. Position will auto-fill based on the name selected and is changeable. 2. Areas of Assessment Click the applicable check boxes indicating the areas the evaluator is assessing. 3. Evaluation Methods and Strategies Click the applicable check boxes indicating the methods used to conduct the evaluation. 4. Assessment Information Enter text describing the assessment results, educational needs and strengths, and implications for instructional accommodations/modifications and progress monitoring. SECTION 2. TEAM SUMMARY This section consists of summary statements describing the interventions tried prior to referral or during evaluation, reason for the evaluation, information obtained from parents, medical information, test scores, and other information related to academic performance and ability. 1. Interventions Summary Enter text describing interventions taken prior to referral or as part of the evaluation process. 2. Reason(s) for Evaluation 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 7 of 31

Enter text describing the reasons the student was referred for evaluation. Referral date, type and reason will display based on the referral information entered when creating the ETR or linked in Form Information in the Maintenance section of the Form Toolbar. 3. Information Provided by Parents Enter text describing any information provided by the child s parents. 4. Summary of Observations (Preschool or Specific Learning Disability only) Enter text describing the child s academic performance and behavior, including observations from the regular classroom setting (as appropriate). 5. Medical Information Enter text describing any medical history that influences the child s educational needs. 6. Assessment Results Summary Enter text summarizing the team s conclusions. Click the Add Evaluation or Add Test button to enter the student s evaluation results, achievement test scores or other assessment results. 7. Educational Needs Enter text describing the student s educational needs (behavioral, social, speech and language, medical, etc.). 8. Implications for Instruction and Progress Monitoring Enter text describing the supports, services, specially designed instruction, accommodations or modifications needed to address the student s educational needs. SECTION 3. DOCUMENTATION FOR THE EXISTENCE OF A SLD 1. Required Notification Use the Yes/No check boxes in this section to indicate if parents were notified (required only if child participated in a scientific research-based intervention). 2. Identified Areas Use the check boxes in this section to identify the specific areas in which the student is under achieving. 3. Response to Intervention If applicable, summarize the results of the scientific research-based interventions tried. Either this section or the next section must be completed for documenting SLD. 4. Strengths and Weaknesses If applicable, summarize the assessment results used to identify a pattern of strengths and weaknesses for this student. Either this section or the prior section must be completed for documenting SLD. 5. Exclusionary Factors Use the check boxes to identify areas that are NOT the primary cause of the student s poor performance. If all boxes are checked, the child may have a SLD. 6. Documentation that Underachievement is not due to Lack of Instruction In the first text box, summarize the team s findings relating to age or grade appropriate learning standards. In the second text box, document the assessment results provided to the child's parents. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 8 of 31

7. Observation of Academic Performance and Behavior Summarize the areas of concern based on observations of the child in a regular classroom setting (as appropriate). If this data was provided in Part 2 (Team Summary) just make a note it; there is no need to repeat the data here. 8. Medical Findings Summarize any medical history that may impact the child s educational needs. If this data was provided in Part 2 (Team Summary) just make a note it; there is no need to repeat the data here. SECTION 4. ELIGIBILITY This section consists of eligibility (Yes/No) check boxes and a text box used to describe the basis for the decision. Also provided is the ability to create/update the student s disability record or inactivate the student s special education enrollment. 1. Eligibility Click the Yes or No check box to indicate that the areas of concern are not due to lack of appropriate instruction or limited English proficiency. Click the Yes or No check box to indicate if the student meets the state criteria for having a disability. Click the Yes or No check box to indicate if the student demonstrates an educational need that requires specially designed instruction. 2. Eligibility Determination: a. No Responses Answering No to any of the 3 Yes/No Eligibility check boxes will activate the Inactivation Date and Reason fields. The user should indicate the date the student did not qualify and the reason. Upon finalizing the ETR form, the application will update the student s Enrollment record with the Exit Date and Reason indicated on the form. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 9 of 31

b. Yes Responses Answering Yes to all of the 3 Yes/No Eligibility check boxes will activate the Enrollment Start Date field. The user should indicate the date the student qualifies for Special Education. Upon finalizing the ETR form, the application will update the student s Enrollment record with the Enrollment Start Date thus activating the student in IEPPLUS. 3. Disability Yes answers to all of the three Eligibility questions mentioned above in #1 indicate the student is eligible for services under IDEA. Click the Add Disability link to identify the specific disability (e.g., Autism, Visual Impairment, etc.). This action will display the disability record. Within this record, indicate whether the disability is Primary (Priority = 1) or Secondary (Priority = 2). Clicking Add Disability displays the following screen: 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 10 of 31

Enter a Disability Start Date, leave the end date blank, indicate the Disability from the drop down menu, Determination if applicable and a Priority. Click the Disk icon to save the Disability record. Upon returning to section 4 of the ETR form, the following screen will display the disability record(s) as follows: Editing Disabilities: click on the Disability (blue link) to edit the disability (to change the disability or Start Date/End Date, Priority). 4. Basis for Eligibility Determination Enter text describing how the student meets or does not meet the eligibility criteria. SECTION 5. SIGNATURES This section provides the ability to populate the signatures page with the names and titles of the ETR team. Click the Add Meeting Attendee link to indicate the names and positions of the members of the ETR team invited to the meeting. A Search Box will open. Click in the Search Box, enter search and select from the displayed results. Select a Role from the drop down list, and click the Update link to complete this process. To edit or delete a contact, click the appropriate link. The signatures page includes Status (Agree/Disagree) check boxes for each evaluator to indicate their opinion regarding eligibility. To record a negative status, navigate to the meeting record via the Student Toolbar or through the EMIS Summary section of the ETR. Create a Meeting Note, Type = Disagree, with attendee Name, Position and reasons for disagreeing with the team s decision saved to the text box. PLANNING FORMS Use the appropriate form (Preschool or School Age) to identify the assessment areas the team will use to evaluate the child. For each area, determine if data is available or further evaluation needs to be done. Then indicate the team member responsible for the area. The Preschool planning form also includes a chart, identifying assessment 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 11 of 31

areas by disability category. To switch between forms (School Age or Preschool), navigate to the Cover Page, Choose a Planning Form field, and click the drop down list to make another selection. EMIS SUMMARY The EMIS Summary includes links to the Referral and Meeting information linked to the form. It also displays the Disability information maintained in the Eligibility section (Part 4) of the ETR. Click the Meeting link to update the meeting outcome. The EMIS Summary does not print with the ETR form. To print the EMIS Summary, please select Ohio ETR-EMIS Summary when printing the report. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 12 of 31

DATA MAPPING This section provides data source and destination information, where applicable, for all fields on the form. If source or destination data is missing or incorrect, follow the navigation indicated in this section to add or correct the data. Also included is a description of necessary Alternate Codes, if required. To add, edit or lookup a code, navigate to Maintenance > Manage Code Tables. Select the name of the table from the drop down list. Then click the Show Alternate Codes link at the top of the page to see the applicable codes (see section on Code Table Setup at the end of this document for more information). COVER PAGE OH ETR Cover Page A Letterhead Logo & Letterhead, maintained under Form Information. 1 Child s Name Student, Basic Information, Demographics (First, Middle, Last and Qualifier). 2 Birth Date Student, Basic Information, Demographics, DOB (in MM/DD/YYYY format). 3 Gender Student, Basic Information, Demographics, Gender. 4 Student ID Student, Basic Information, Demographics, Student ID 5 Student Home Address Student, Basic Information, Home Address. 6 Grade Student, Basic Information, Enrollment/Exit, Grade as of Meeting Date 7 District of Residence System Options, Organization (default Organization or the following if different) - Student, Educational Information, Associated Organizations, District of Residence, Alternate Code = RD. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 13 of 31

8 District of Service Student, Educational Information, Associated Organizations, District of Service, Alternate Code = SD. 9 Ward of the State Checkbox (Yes/No). If yes, text box will open to provide the name of the surrogate parent. If there is a Release/Waiver, Type = Ward of State a link to this record will display. The Release/Waiver provides the ability to keep track of custody dates and other notes. 10 Guardian Name Student, Basic Information, Contacts (Type = Parent/Guardian or Surrogate), Salutation, First, Last, Qualifier. Parent/Guardian Information will repeat as needed; Surrogate Parent will print first. 11 Home Address Student, Basic Information, Contacts, Home Address. 12 Communication Student, Basic Information, Contacts, Communication (where Type is like Home, Cell, Work or Email). 13 Type of Evaluation Student, Educational Information, Referral (where Type is like Initial Evaluation or Reevaluation, Alternate Code = IR or RE respectively). 14 Meeting Date This field automatically fills in based on the meeting selected when creating the form or linked through Form Information in the Maintenance section of the Form Toolbar. Only meeting records with Meeting Type, Alternate Code (Type = EMIS Code and Description = IETR, RETR or PSTC) that have NOT been finalized on another form will display in the drop down. To change the date, edit the meeting record accessible through the Student Tool Bar. Meeting Reason = Initial Evaluation or Reevaluation (Alternate Code = IR or RE respectively). 15 Date of Last ETR User fills in date of the student s last ETR form or Not Available check box. Date is stored on the form only, not reportable. Date also displays on the Signature page. 16 ETR Completion Date Create/Update Important Date = Date of Last ETR (or Imp. Date Description) with an Alternate Code = ETRC upon finalization of the form. The date used is the meeting associated to the ETR form (e.g. 5/27/13). 17 Next ETR Due Date Create Important Date = Next ETR Due Date (or Imp. Date Description) with an Alternate Code = ETRD upon finalization of the form. The date used is the meeting associated to the ETR form, adding 3 years less one day (e.g. 5/26/16). Does not create or will delete the Important Date if the meeting outcome has codes ETNE or ETEX upon finalizing the ETR form. This date does not print on report. 18 Referral Date Student, Educational Information, Referral (Type = IR or RE), Referral Date. 19 Date Parents Consent Student, Educational Information, Referral, Consent to Test Date. Received 20 ETR Form Status Read Only (Parts 1-5). Checks are made upon individual sections upon their completion. 21 Instructions Form instructions (text only). 22 Choose Planning Form Planning form selected during ETR creation. This field provides the ability to change the planning form from/to: ETR School Aged or ETR Preschool (Alternate Code = ETR). 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 14 of 31

1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 15 of 31

SECTION 1. INDIVIDUAL EVALUATOR S ASSESSMENT 23 Add Part 1, Update, Cancel buttons 24 Evaluator Name Position OH ETR Section 1. Individual Evaluator s Assessment Use the Add Part 1 button to create evaluation sections for each evaluator. Upon completing the section, click the Update button to save the data. Update will enable the Add Part 1 button, allowing the user to add another section. Click in the text box to search for and select the evaluator s name. Position will auto-fill based on the name selected and is changeable. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 16 of 31

25 Areas of Assessment Check Boxes used to indicate the areas that the evaluator assessed. The available selections will vary based upon the Form Type selected on the cover page: Form Type = School Aged ETR Information Provided By Parent General Intelligence Academic Skills Classroom Based Evaluations And Progress In The General Curriculum Data From Interventions Communicative Status Vision Hearing Social Emotional Status Physical Exam/General Health Gross Motor Fine Motor Vocational/Transition Background History Observations Behavior Assessment Braille Needs As Determined By Eye Care Specialist Audiological Needs As Determined By Certified/Licensed Audiologist Assistive Technology Needs Other: Text Box Check Boxes Form Type = Preschool ETR Background (Pr-04) Adaptive Behavior Cognition Communication Hearing Vision Pre Academic Skills Gross/Fine Motor Skills Social/Emotional Behavioral Medical/Health 26 Evaluation Methods & Strategies 27 Summary of Assessment Text Box Results 28 Description of Text Box Educational Needs 29 Implications for Text Box Instruction and Progress Monitoring 30 Evaluator s Signature Signature line will display. Date will default to today s date. and Date 31 Part 1 Complete Check Box - Marking this box will update section form status on Cover Page. Ensure that all evaluators have completed their information before marking the box completed. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 17 of 31

SECTION 2. TEAM SUMMARY OH ETR Section 2. Team Summary 32 Interventions Summary Text Box 33 Reasons for Evaluation Text Box - Form, Referral, Reason(s) 34 Summary of Parent Information Text Box 35 Observation Summary (ONLY FOR SLD) Text Box - Validation Rule: Data required if student s determined disability = SLD 36 Medical Information Text Box 37 Assessment Results Text Box - Ability to Add Evaluations/Test Scores with records WITHOUT an Alternate Coded type = EMIS. 38 Educational Needs Text Box 39 Instruction & Progress Monitoring Text Box 40 Part 2 Complete Check Box - Marking this box will update section form status on Cover Page. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 18 of 31

SECTION 3. DOCUMENTATION FOR THE EXISTENCE OF A SLD 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 19 of 31

OH ETR Section 3. Documentation for the Existence of a SLD 41 Required Notification Check Boxes (Yes/No) This section will not print if student does not have SLD. Text beneath Required Notification will print the following: Student not suspected as having a Specific Learning Disability so therefore SLD sections of the Evaluation Team Report intentionally not addressed and left blank. 42 Identified Areas Check Boxes (8) 43 Response to Intervention Text Box 44 Strengths & Weaknesses Text Box 45 Exclusionary Factors Check Boxes (6) 46 Documentation Underachievement Text Boxes (2) 47 Observation Text Box 48 Medical Findings Text Box 49 Part 3 Complete Check Box - Marking this box will update section form status on Cover Page. Validation Rule: If #4 Eligibility = SLD, this section must be completed. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 20 of 31

SECTION 4. ELIGIBILITY 50 Eligibility Determination OH ETR Section 4. Eligibility Check Boxes (Yes/No) Validation Rule: If any question = No, student cannot be identified as having a disability (EMIS Codes 01-16). 51 Student Not Eligible If any of the 3 No check boxes are checked, the Inactivation Date and Reason fields are activated for the user to edit. Upon finalizing the ETR form, the application will update the student s Enrollment record with the Exit Date and Reason indicated on the form. 52 Enrollment Start Date Based on User Security, Utilities, Student Inactivation settings, the user will have the ability to run the Inactivation Utility to end all records here. Answering Yes to all of the 3 Yes/No Eligibility check boxes will activate the Enrollment Start Date field. The user should indicate the date the student qualifies for Special Education. Upon finalizing the ETR form, the application will update the student s Enrollment record with the Enrollment Start Date thus activating the student in IEPPLUS. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 21 of 31

53 Disability User will click the Add Disability link to create disability record, using the ETR Meeting Date as the Start Date. If the disability changes, click the applicable Disability link, enter an End Date to the existing record and Save. Click the Add Disability to create a new disability record. 54 Basis for Disability Text Box Determination 55 Part 4 Complete Check Box - Marking this box will update section form status on Cover Page. SECTION 5. SIGNATURES OH ETR Section 5. Signatures 56 Date of Meeting Same as Mapping #14. Read Only. 57 Date of Last ER Same as Mapping #15. Read Only. 58 Referral Date Same as Mapping #18. Read Only. 59 Evaluation Team Signatures Boxes for Name, Title, Signature/Date and Status (Agree/Disagree). Name and title will populate based on form meeting attendees. For Status, create Meeting Note, Type = Disagree, with attendee Name and Position saved to text box. 60 Part 5 Complete Check Box - Marking this box will update section form status on Cover Page. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 22 of 31

EVALUATION PLANNING FORM Planning form selected during ETR creation or modified on the cover page (field # 22) will determine the content in this section: School Age or Preschool. School Age Evaluation Planning Form: 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 23 of 31

OH ETR School Age Evaluation Planning Form 61 Date of Plan Date Box 62 Plan Type Same as Mapping #13. 63 Team Chairperson Form Meeting, Attendee with Position like Chairperson. 64 Suspected Disability Check Boxes based on Disability (Maintenance > Manage Code Tables). 65 Team Members Text Box 66 Assessment Areas For each Assessment Area, there are 3 columns to describe the following: - Data Available (Yes/No/Not Applicable) - Further Testing Needed (Check Box) - Person(s) Responsible for Assessment & Report 67 Other Assessment Area(s) 68 Considerations Check Boxes (2) 69 Signatures Form, Meeting, Attendee, Positions - School District Representative - Regular Ed Teacher - Parents - Intervention Specialist Ability to add additional assessment areas - Text Box and 3 columns (same as above). 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 24 of 31

Preschool Evaluation Planning Form: 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 25 of 31

OH ETR Preschool Evaluation Planning Form 70 Date of Plan Date Box 71 Plan Type Same as Mapping #13. 72 Team Chairperson Form Meeting, Attendee with Position like Chairperson. 73 Suspected Disability Check Boxes based on Disability (Maintenance > Manage Code Tables). 74 Team Members Text Box 75 Assessment Areas For each Assessment Area, there are 7 columns: Check Boxes (2) - Existing Data Available and Additional Data Needed Text Boxes (5) - Structured Interview, Structured Observations, Standardized Norm-Referenced Assessments, Criterion-Referenced Curriculum-Based Assessments, and Data from Part C. 76 Considerations Check Boxes (2) 77 Signatures Form, Meeting, Attendee, Positions & Date Line - School District Representative - General Preschool/Regular Ed Teacher - Parents - Preschool Special Education Teacher 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 26 of 31

OH ETR Preschool Evaluation Planning Form Page 2 78 Suspected Disability Check Boxes based on Disability (Maintenance > Manage Code Tables). 79 Evaluation Planning Form chart and text. Areas 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 27 of 31

EMIS SUMMARY OH ETR EMIS Summary 80 Referral Referral information linked when creating the form or in Form Information. 81 Disability Disability maintained in section 4 (Eligibility) of the ETR. 82 Meeting Meeting linked when creating the form or in Form Information. Click the link to update the meeting outcome. Outcome selections are based on Meeting type: IETR Meeting Type will only display ET prefixed disabilities - ETDP, ETNE. The selection drop downs are controlled by Maintenance, Manage Code Tables, Meeting or Referral Result, Alternate Code Type = Result Code and indication of which type it should display for. For Example: 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 28 of 31

CODE TABLE SETUP 1. Navigate to Maintenance > Manage Code Tables. 2. Select the name of the table from the drop down list (e.g., Extension Reasons ). 3. To add a code: choose New from the top menu. 4. Enter the Code in the yellow box, click on Update and then Save the record. 5. To add or edit an Alternate Code, first click Show Alternate Codes at the top of the page. Then click Edit on the applicable Code record to open the record for changes. 6. Once the record is open, click the appropriate link to add a new Alt Code or Edit an existing one. Clicking delete will remove an existing Alternate Code. When finished with the changes, click the Save icon. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 29 of 31

REVISION HISTORY 12/2/2013: Modified the Eligibility section referring to a software change where the Enrollment record is updated upon finalization of the ETR form. Added new screenshots under "Section 4. Eligibility". Updated Data Mapping field #51 and #52. Added SunGard copyright information to the cover page and subsequent footer records. Updated the Table of Contents, header & footer records. 6/3/2013: Document updated with the new SunGard standard formatting, table of contents, sections, etc. 11/16/2011: Minor wording changes to the Preschool Evaluation Planning Form as per ODE. 7/19/2011: Only meeting records with EMIS Code = IETR, RETR, TETR not linked to a Finalized ETR will be displayed in the meeting drop down. 6/22/2011: EMIS section has enhanced to only allow selection of the appropriate outcomes based on the Meeting type. 6/20/2011: Cover Page: ETR Referral & Consent dates: Read only, message to go to EMIS screen to make any necessary changes. Team Summary Screen: Evaluations & Tests drop downs are now filtered by Alternate Code type = EMIS Codes (or not). EMIS Summary: Referral & Meeting code table filtering and EMIS link added. 3/3/2011: ETR Important Dates: The program will not overwrite Important Dates UNTIL a form is finalized. Creation of an ETR: o Important date records are automatically created based on the ETR meeting date BUT they are not automatically saved into the Important Date records upon form creation! o New dates are displayed in the appropriate fields of the ETR. o The existing finalized ETR dates are also displayed beside these fields for information. o Upon finalization of the form, the original dates will be overwritten with the new ETR dates and the informational dates are removed. (The program only displays additional dates when an Important Date record exists that is less than the current ETR.) o In the event you open a previous ETR, the program will display the 'current' finalized important date record. Upon re-finalization of this ETR, the important date will NOT change as there is a later ETR in effect. 5/3/2010: Updated Section 1 Assessment Area to be piped checkboxes Updated Planning Pages to be separate from Section 1 4/12/2010: Section 3 - SLD Section: Section will be suppressed if student does not have an SLD disability. Beneath Required Notification text the following will display: Student not suspected as having a Specific Learning 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 30 of 31

Disability so therefore SLD sections of the Evaluation Team Report intentionally not addressed and left blank. Evaluation Planning Form: Date of Plan is now a blank text box instead of meeting date. Planning Page: Team Members no longer linked to the Meeting Members. This is now a Text Box allowing Users to add Team Members independent of the attached Meeting. 4/5/2010: Date of Last ETR changed from an Important Date to a simple text box. Create Important Date record = Date of Last ETR (ETRC) based on the meeting date on the form upon saving of the form. Date is in view Only Mode. Create Important Date record = Next ETR Due Date (ETRD) based on the meeting date plus 3 years less 1 day upon saving of the form. Date is in view Only Mode. NOTE: Dates will change if the meeting date linked to the form is changed and the form saved. If an older form is unlocked and the meeting date is different than the current dates, the important date records will be updated with this ETR meeting date. 3/30/2010: ETR: Team Summary, Summary of Assessment Results section will only display/print evaluations/tests WITHOUT and alternate code. 10/10/2009: State Changes. Remove Building Name, Add Ward of the State, Minor wording to Instructions on Page 1 regarding Part 5. 7/21/2009: State Minor wording change to School Aged Planning Form, Braille area. 2/8/2009: Removed from Field 12, creation of Important Date upon finalization of form annotation as not programmed. Clarified: all latest Important Dates are pulled into the ETR Form based on their alt codes indicated. If no Important Date exists for that record, an Important Date is created. If an important date exists and the user modifies it, that date is then overwritten upon saving. 1990-2013 SunGard Public Sector Inc. All Rights Reserved. Page 31 of 31