Present Levels of Academic Achievement and Functional Performance (2)
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Name   IEP Date
 

 
  Strengths/Preferences/Interests Strengths/Preferences/Interests Strengths/Preferences/Interests  
   
 
 
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  Concerns of parent/adult student relevant to educational progress Concerns of parent/adult student relevant to educational progress Concerns of parent/adult student relevant to educational progress  
 
 
 
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CA Standards Tests English/Language Arts English/Language Arts
 
  Math Math
 
  Hist./Soc. Sciences Hist./Soc. Sciences
 
  Science Science

 
CMA English Language Arts   Mathematics   Science   Other
 

 
CAPA English/Language Arts English/Language Arts
 
  Math Math
 
  Science Science

 
 
CELDT Listening Speaking Reading Writing
 

 
Physical education testing Physical education testing Physical education testing  (grades 5, 7, & 9 only)
 
 
 
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Other Assessment Data Other Assessment Data Other Assessment Data  (e.g., curriculum assessment, other district assessment, etc.)
 
 
 
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Hearing Hearing ( ) Pass Other   Vision Vision ( ) Pass Other
 
(For the hearing and vision tests, to have the pass and fail boxes un-checked on the printed form, leave the test date field empty, or enter "N/A" in the associated "Other" box.)
 

 
  Preacademic/Academic/Functional Skills Preacademic/Academic/Functional Skills Preacademic/Academic/Functional Skills
 
 
 
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  Communication Development Communication Development Communication Development
 
 
 
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  Gross/Fine Motor Development Gross/Fine Motor Development Gross/Fine Motor Development
 
 
 
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  Social/Emotional/Behavioral Social/Emotional/Behavioral Social/Emotional/Behavioral
 
 
 
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  Vocational Vocational Vocational
 
 
 
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  Health Health Health
 
 
 
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