Educational Setting (5B)
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Name
IEP Date
Physical Education
Physical Education
Physical Education
(if other, specify type)
District of Service
District of Service
District of Service
School of Attendance
School of Attendance
School of Attendance
If you cannot find the school of attendance listed in the drop-down list, you can try entering the school code and/or name here:
(select)
School Type
School Type
School Type
Federal Setting
Federal Setting
Federal Setting
Federal Presch. Setting
Federal Presch. Setting
Federal Presch. Setting
All special education services provided at the student's school of residence?
All special education services provided at the student's school of residence?
Yes
No (rationale)
Yes
No (rationale)
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Justificación...
% of time student is OUTSIDE the regular class & extracurricular & non-academic activities
% of time student is OUTSIDE the regular class & extracurricular & non-academic activities
Estimate
% of time student is IN the regular class & extracurricular & non-academic activities
% of time student is IN the regular class & extracurricular & non-academic activities
Student will not participate in the regular class and/or extracurricular and/or non-academic activities
Student will not participate in the regular class and/or extracurricular and/or non-academic activities
Student will not participate in the regular class and/or extracurricular and/or non-academic activities
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El estudiante no participará en la clase regular y / o extracurriculares y / o actividades no académicas
because
because
because
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porque
Other Agency Services
California Children's Services (CCS)
California Children's Services (CCS)
Regional Center
Regional Center
Probation
Probation
Department of Rehabilitation
Department of Rehabilitation
Department of Social Services (DSS)
Department of Social Services (DSS)
Other agency services (specify):
County Mental Health (CMH)
County Mental Health (CMH)
Promotion Criteria?
Promotion Criteria?
Promotion Criteria?
Parents will be informed of progress
Parents will be informed of progress
Parents will be informed of progress
How?
How?
How?
Activities to Support Transition
(e.g. preschool to kindergarten, special education and/or NPS to general education class, 7th-9th grade)
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Actividades de Apoyo a la Transición
Graduation Plan
(Grade 7 and Higher)
Projected graduation date and/or secondary completion date
Projected graduation date and/or secondary completion date
Plan type
Plan type
Plan type
To participate in a functional/life skills curriculum leading to a Certificate of Completion
To participate in a functional/life skills curriculum leading to a Certificate of Completion
NOTE: The state forms committee removed the following items (7.2011), and they no longer print:
Student Eligible for Mental Health Services under Chapter 26.5?
Yes
No
Yes
No
Mental Health Services Language included on the IEP?
Yes
No
Yes
No