Present Levels of Academic Achievement and Functional Performance

(This form can generate more than one printed page)
Name   IEP Date

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

Preacademic/Academic/Functional Skills Preacademic/Academic/Functional Skills
   Reading Reading
   Written Expression Written Expression
   Mathematics Mathematics

Communication Development Communication Development
 
Gross/Fine Motor Development Gross/Fine Motor Development
 
Social/Emotional/Behavioral Social/Emotional/Behavioral
Health Health
( Hearing Hearing   Vision Vision )
 
Pre-vocational/Vocational Pre-vocational/Vocational
 
Adaptive/Daily Living Skills Adaptive/Daily Living Skills

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