1. Comprehensive Academic Assessment & Other Forms
Presented by
Los Angeles Unified School District
Los Angeles Unified School District

2. Comprehensive Academic Assessment
Overview of Forms and Sample Documents

3. Step 1: Comprehensive Academic Assessment
Kindergarten – 12th Grade
As Needed
Case Management Tool
Secondary Supplementary Form (11th and 12th Grade)
Birth - Kindergarten
Early Childhood Education Form
Step 3: Treatment Plan

4. Tool Kit: Forms & Templates (Tab 3) Comprehensive Academic Assessment

5. Comprehensive Academic Assessment
For all current LAUSD students and newly enrolling students on your assigned caseload, complete assessment as promptly as possible.
Provides background information on the student, including:
Student biographical information
School information
Caregiver information
School history
Contact information
Services (student is receiving)
Student health
Documents
Sources of Information:
Contacts-Youth, caregiver, Educational Rights Holder (ERH), social worker/probation officer, minor’s attorney/public defender, therapist, and/or school nurse
Document sources-MiSiS, MyData, CalPADS, Student’s Cumulative Records

6. Tool Kit: Forms & Templates (Tab 3) Case Management Tool

7. Case Management Tool
Allows counselors to make appropriate referrals for services to address a variety of academic, attendance, social-emotional, and behavioral concerns.
As needed, complete this form for all LAUSD students on a counselor’s caseload by the end of the school year. Note that caseloads will change depending on the enrollment and disenrollment of foster youth students.
Factors to consider when prioritizing students:
Off track to graduate
Less than 2.0 GPA (middle and high school) or majority of 1s/2s (elementary)
Basic or Far Below Basic attendance (< 92% attendance)
Below average statewide testing or did not pass the CAHSEE
School instability
Disciplinary actions, referrals, suspensions, placement in continuation school

8. Components
School Enrollment: Provides information regarding school enrollment and disenrollment for the current school year, and reasons for school transfers.
Academic Achievement: Summarizes the academic progress of the student, including grades and credits.
Previous Interventions: Helps the counselor avoid making previously ineffective referrals when the counselor completes the “Noted Concerns, Referrals, and Outcomes” section.
Noted Concerns, Referrals, and Outcomes: Three subsections work together to help counselors identify areas of concern for the student, make appropriate referrals to address the concern, and monitor the impact of these services on the student’s education progress.

9. Noted Concerns, Referrals, Outcomes
Noted Concerns: Review the Educational Assessment and the completed sections of the Case Management Tool, and indicate whether there are concerns in the following areas:
Education Rights Holder
Alternative School Placement
Social-emotional
Behavioral
School Stability/Enrollment
Attendance
High School Graduation
Academics
A-G requirements
Referrals: In order to determine appropriate referrals review student’s records, previous interventions and referrals. Assessing the effectiveness of previous interventions may help you decide what referrals are needed.
Outcomes: As needed, follow up with youth, caregiver, ERH, social worker, and school officials to determine whether the referred intervention occurred and if the concern was resolved. Use Summary of Services log to monitor interventions.

10. Tool Kit: Forms & Templates (Tab 3) Early Childhood Education Supplemental Form

11. EARLY CHILDHOOD EDUCATION SUPPLEMENTAL FORM (Ages 0-5 years old)
Should be completed for all students up until they enroll in Kindergarten.
Information can be collected from the caregiver, education rights holder, social worker, Minor’s Attorney, therapist, school nurse and/or primary physician.
Components:
Student Health
Document any health concerns the student has, including whether the student was born prematurely, has any medical and mental health diagnoses, or if there are any caregiver concerns.
Indicate whether the student has been “asked to leave” a Pre-K program.
Early Care and Education History
List all Pre-K programs the student has attended, and indicate the type of pre-k or early education program.

12. Assessments/Screenings: Work with the student’s early education provider to gather and/or conduct appropriate assessments/screenings.
Types of Screenings:
Providers:
PEDS
Regional Center
ASQ
Child Care/Pre-School Program
M-CHAT
DCFS MAT
DRDP
211 LA County
Areas of Concern: Based on the results of the assessments/screenings and caregiver input, indicate whether there are concerns in any of the listed developmental areas.
Referrals: Appropriate referrals will depend on the student’s age:
Younger than 3: Refer to Regional Center Early Start, Early Childhood Mental Health, or Special Education Infant Program.
3 years old-K enrollment: Refer to Special Education or Early Childhood Mental Health.

13. Secondary Supplemental Form
Helps the counselor assist students in identifying and preparing for post-high school opportunities.
Only completed for 11th and 12th graders.
Components
Transitional Plans
Goals: Indicate whether the student’s goal is a 4 year university, community college, military, employment or another identified goal.
College Information: Ensure that the student takes all necessary steps to apply to college or university.
Financial Aid: Ensure that the student accesses necessary support to apply for scholarships and complete the FAFSA.
Independent Living Program: Follow up with DCFS/ILP Coordinator regarding the student’s TILP Conference (should be held 6 months before their 18th birthday).

14. Tool Kit: Forms & Templates (Tab 3) Secondary Supplementary Form

15. Tool Kit: Forms & Templates (Tab 3) Treatment Plan

16. Treatment Plan
Helps counselors establish a strategy to address academic, attendance, social-emotional and behavior concerns identified by the student, caregiver, ERH or other stakeholders.
Before completing, set up a meeting with the student, caregiver, ERH and other stakeholders to discuss the Treatment Plan so that all members collaboratively establish the student’s goals and referrals.
Follow up as needed to monitor progress towards short and long term goals.
Reconvene meeting with student, caregiver, and ERH as needed to review progress towards long term goals, and modify goals as appropriate.

17. Goal-setting Long Term Goals
Should focus on improving students’ school stability, academic progress, behavior, and attendance so that they meet the requirements for promotion or high school graduation.
Gather input from student, caregiver, ERH and/or Case Management Tool to identify the student’s weaknesses that are affecting their educational progress.
Develop long term goals for each of the student’s areas of concern/weaknesses.
Short Term Goals
Should be aligned to the long term goals to allow the student to make incremental progress towards achieving the long term goals.

18. Outcomes
Monitor outcomes of short and long term goals and follow up as needed to determine whether progress was made.
Indicate on Treatment Plan the date of follow up using “Y” for “Yes” and “N” for “No” to represent whether progress was made. If a goal was achieved, write “achieved.”
If goals not achieved within specific time frame, reconvene with stakeholders and revise Treatment Plan which may include additional goals and/or referrals.
Review the Case Management Tool and Treatment Plan and indicate whether outcomes were achieved on both forms.

19. Thank you!