Present Levels of Academic Achievement and Functional Performance

Name   IEP Date
 

 
  Strengths/Preferences/Interests
 
 
  Concerns of parent/adult student relevant to educational progress
 
 

 
  Academic/Pre-academic/Functional Skills
 
 
  Adaptive/Daily Living Skills
 
 
  Cognitive Development
 
 
  Communication Development
 
 
  Gross/Fine Motor Development
 
 
 
Health ( Hearing Hearing   Vision Vision ) N/A
 
 
  Social/Emotional/Behavioral
 
 
  Vocational/Career and Transition
 
 
  Other
 
 

 
  CA Standards Test English/Language Arts
 
    Mathematics
 
 
  CAT-6 English Language Arts   Mathematics   Hist/Soc Sci   Science  
 
  CAPA English Language Arts   Mathematics   Science   Other  
 
  CELDT Listening   Speaking   Reading   Writing  
 
  Other Assessment Data (e.g., curriculum assessment, other district assessment)