Date of Amendment: | Amendment of the IEP dated: |
| Student Name: | Student ID: |
Riser IEP Amendment
This IEP amendment revises or modifies: (Check all that apply)
| [ ] Present levels of educational achievement and functional performance.
[ ] Instructional goals and objectives. [X] Frequency, location, and/or duration of special education services provided. [ ] Related services. [ ] Supplementary aids/services, accommodations, and/or transportation. [ ] State and/or district assessment participation and/or testing accommodations. [ ] Transition services. | |
| [X] Other: | Riser paperwork for the 2020_2021 School Year |
Description of the Proposed Revision(s) (attach revised goal pages or other IEP pages as may be appropriate)
[ ] The IEP is being amended to change student’s Preschool placement to [ ] AM or [ ] PM
[ ] The IEP is being amended to change the student’s placement to reflect change from Preschool to Developmental DK.
[ ] The IEP is being amended to reflect the natural transition from Elementary school to Middle School
[ ] The IEP is being amended to reflect the natural transition from Middle school to High School
[ ] The IEP is being amended to reflect minute and program change to
[ ] The IEP is being amended to reflect the natural transition to Goal or Strive
[ ] Other:
Description:
Student Name:
Service
| Initiation Date
| Frequency
| Location of Service
| Duration
| Staff Responsible for Delivering Service
|
| Special Education (specially designed instruction): | |||||
| [ ] Cognitive Functioning | 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Reading
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Written Expression
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Math
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Vocational
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Personal Social Behavioral
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Adaptive/Self-Help
| 09/05/2020
| Special Education/SDI
| Special Education Teacher
| ||
[ ]
Communication Skills
| 09/05/2020
| Special Education/SDI
| Speech Language Pathologist
| ||
[ ]
Gross/Fine Motor
| 09/05/2020
| Special Education/SDI
| Occupational / Physical Therapist
| ||
[ ] Other
| 09/05/2020
| Special Education/SDI
| |||
[ ] Other
| 09/05/2020
| Special Education/SDI
| |||
| Related Services (i.e. – speech, motor, counseling, vision/hearing, transportation, interpreting services, orientation/mobility, parent training, etc.): | |||||
| [ ] Transportation | 09/05/2020
| To School
| Bus
| To home
| Bus Driver
|
[ ]
OT/PT related services
| 09/05/2020
| Occupational / Physical Therapist
| |||
[ ]
Communication Related
| 09/05/2020
| Speech Language Pathologist
| |||
[ ]
Shared Para
| 09/05/2020
| Shared Para
| |||
[ ]
1:1 Para
| 09/05/2020
| 1:1 Para
| |||
[ ]
2 Shared Para
| 09/05/2020
| 2 Shared Para
| |||
[ ]
1:1 Nurse
| 09/05/2020
| 1:1 Nurse
| |||
[ ]
1:1 Interpreter
| 09/05/2020
| 1:1 Interpreter
| |||
[ ]
Other
| 09/05/2020
| ||||
Parent/Guardian____________________________________ Parent/Guardian ___________________________
Student _____________________________________________ Special Education Staff__________________________
Special Education Staff_____________________________ Special Education Staff__________________________