HB 5 Community and Student Engagement Campus Report Rev. 9/15/14 Indicator: Wellness and Physical Education Campus: _________________ Principal: __________________ Campus Rating: __________________

Metric Campus Level Compliance Indicators Requirement Due By May 8, 2015Completed C_W1ALL Student Teacher Ratio Physical Education classes have a 45 to 1 ratio of students to teacher. C_W2ALLMVPA The campus has Moderate to Vigorous Physical Activity (MVPA) level for 50% of the class period in a minimum of 3 observations (1 per grade level). C_W3ALLFitnessgram The campus has Fitnessgram Assessment for all non-exempt students in PE grades 3rd- 12 grade C_W4 ECEC, ES, MS Program Implementation The campus has 135 minutes weekly of structured Physical Education. C_W5 ECEC, ES, MS Program Implementation The campus implements TEA and District approved Coordinated School Health Program (Bienestar, SPARK, Great Body Shop). C_W6HS Program Implementation The campus has 225 minutes weekly of structured Physical Education. Metric Campus Level Recognized/ Exemplary Indicators Requirement Due By May 8, 2015Completed RE_W1ALLWellness Journals The campus implements personal wellness journals in PE/Health class. RE_W2ALLWellness Clubs The campus implements wellness clubs such as student walking/running clubs, or PE3 clubs. RE_W3ECEC, ESRecessThe campus implements recess during school hours. RE_W4ALLCycling The campus holds a Bicycle Rodeo/Cycling Club/Field Day or participates as a team in Siclovia. RE_W5ALL Community Wellness Activities The campus participates in Kid's Rock/Go Kids Challenge/San Antonio Sports Activities/First Tee Golf/Bowling Teams/Jump Rope for Heart/Hoops for Heart. RE_W6ALLZumba The campus holds or participates in campus or District sponsored Zumba classes. RE_W7ALLWellness NewsletterThe campus publishes a wellness newsletter. RE_W8ALLWellness FairThe campus holds a wellness/health fair for students and parents. RE_W9ALLNutrition The campus holds nutrition classes/healthy cooking/recipes demonstrations for students and parents. RE_W10ALL District or SAISD Foundation Wellness Activities The campus participates as a team in local fitness activities such as the 4E Run (5k Walk/Run), Komen Race for the Cure, etc. RE_W11ALL Wellness Needs Analysis The campus completes the 'Let's Move Initiative' inventory or the School Health Index. Wellness and Physical Education Roger Rodriguez, Senior Coordinator, Health and Physical Education, HB 5 Community and Student Engagement Campus Report Campus Self Rating - Please Circle one: Exemplary Recognized Acceptable Unacceptable Not Rated Campus Coordinator/Department Chair Signature_________________________________________________ Date ____________________ Principal Signature__________________________________________________________________________ Date ____________________ Rev. 9/30/14 Verified by: ___________________________________________ Title _________________________________ Date ___________________ Rating Verification – Final Campus Rating: Exemplary Recognized Acceptable Unacceptable Not Rated For District Department Use Only Campus:_______________________ Principal: _______________________