Read Short-term Suspension Analysis Worksheet 9-09.xls text version

September 2009

Short-term Suspension Analysis Worksheet

For Students with Individual Accommodation Plans (IAP) OR Individualized Education Programs (IEP)

Use for students with cumulative suspensions of 10 days in a school year and for each additional period of suspension after the 10 days. Student's Name: School: Date of Determination Decision: 1. Indicate members of determination team (names and roles) Name Role (Position) Administrator Special Education Teacher/504 Coordinator General Education Teacher 2. Suspension Data Indicate on the lines below the dates of OUT OF SCHOOL SUSPENSIONS (OSS) (including bus suspension if transportation is included in the IEP) at this point in the school year and the length of each removal. Number of Days of This Describe Behavior Beginning Date of OSS Ending Date of OSS Out of School Suspension (# of OSS days) Suspensions (including bus Resulting in OSS Suspension 1 Suspension 2 Suspension 3 Suspension 4 Suspension 5 Total Days of Out of School Suspension Indicate on the lines below the dates of IN SCHOOL SUSPENSIONS (ISS) at this point in the school year and the length of each removal. Beginning Date of ISS Ending Date of ISS Number of Days of This In School Suspensions Describe Behavior Suspension (# of ISS days) that resulted in Student Resulting in ISS NOT receiving services, including access to the general curriculum Suspension 1 Suspension 2 Suspension 3 Suspension 4 Suspension 5 Total Days of In School Suspension Overall Total of Out of School and In School Suspensions 3. Data Analysis: a. Behavior is substantially similar in the incidents and constitutes a pattern of disciplinary removal. b. The length of each removal constitutes a pattern of disciplinary removal. c. The total amount of time that the student is removed constitutes a pattern of removal. d. The proximity of removals to one another constitutes a pattern of disciplinary removal. e. Based on the factors considered, did the series of short-term suspensions constitute a pattern of removal? State the reasons supporting the decision. Yes______ No ______ Yes ______ No ______ Yes ______ No ______ Yes ______ No ______ Yes ______ No ______ Grade: DOB: Disability: Age:

If removal constitutes a pattern, conduct a Manifestation Determination.

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Short-term Suspension Analysis Worksheet 9-09.xls

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