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Instructions
Master Student Table
Name
BIRTHDATE
Age
Grade Number
EL
EL Type
Primary Contact
Contact Name
Contact Phone
Contact Email
Next IEP
Next EVAL
DISABILIT1
DISABILIT2
accomm
Goal Area of Need
All Providers
1
Smith, Bill
4/30/2005
15
10
N
EO
Karen And Chris
3344 Bill Dr
San Jose, CA 95124
4081234567
Sally@kaaren.com
1/12/2022
1/14/2023
Other Health Impairment
None
Organization/Study Skills: Graphic organizer on written assignments
Organization/Study Skills: Study guides or sheets provided before test/quizzes
Organization/Study Skills: Note-taking assistance
Organization/Study Skills: Provide books in audio format (e.g. Bookshare), as available
Organization/Study Skills: Allow verbal responses for quizzes/tests as needed
Organization/Study Skills: Text-to-speech for text-based materials
Setting/Schedule: Extended time on tests, up to 100%
Setting/Schedule: Preferential Seating
Setting/Schedule: Alternate setting for quizzes/tests
Student Response: Speech-to-text application
Teacher Directions: Simplified directions
Teacher Directions: Frequent checks for understanding
Academic- Math
Transition - Training
Academic- Reading
Case Manager: Scott
2
Water, Bob
3/16/2004
17
11
N
RFEP
Maria
1585 Sally Hill Rd #unit L2
San Jose, CA 95118
Maria
4081234568
mariamom@mom.com
11/3/2021
11/6/2021
Specific Learning Disability
Speech or Language Impairment
Organization/Study Skills: Note-taking assistance
Organization/Study Skills: Assistance with recording assignments
Organization/Study Skills: Late assignments accepted up to 1 week without penalty
Organization/Study Skills: Study guides or sheets
Setting/Schedule: Seat near teacher
Setting/Schedule: Extended time on tests (100%)
Setting/Schedule: Extended time to complete assignments (100%)
Setting/Schedule: Student to check in with teacher 1x/week
Student Response: No penalty for spelling except on spelling task
Student Response: Use of notes on tests or quizzes
Student Response: No penalty for grammar unless a grammar task
Teacher Directions: Shorten directions and/or repeat directions
Teacher Directions: Written directions to supplement auditory instructions
Communication
Communication
Academic- Study Skills
Transition - Employment
Academic- Writing
Academic- Math
Academic- Reading
Case Manager: Scott
Speech-Language Pathologist: Nicole
3
Jam, Joe
8/23/2005
15
10
N
EO
Cynthia
3245 Cynthia Way
Santa Cruz, CA 95124
Cynthia
4081233567
sweir@cuhsd.org
10/28/2021
10/29/2021
Specific Learning Disability
None
Organization/Study Skills: Graphic organizer
Organization/Study Skills: Allowed to retake tests without penalty (alternate version)
Setting/Schedule: Seat at front of room / closer to teacher
Setting/Schedule: Test in resource room (when requested)
Setting/Schedule: Extended time to complete assignments/tests by request (150%)
Setting/Schedule: Check In with school counselor (as needed)
Student Response: Increased verbal response time
Student Response: text to speech options (when available)
Student Response: access to grammar check applications
Student Response: Test questions read aloud upon request.
Teacher Directions: Directions given in a variety of ways
Teacher Directions: Directions given in small chunks (oral and written)
Teacher Directions: Frequent checks for understanding
Transition - Employment
Academic Study Skills
Case Manager: Scott
4
Sandwhich, Sam
3/28/2003
18
12
N
IFEP
Jessica
432 Meridian Avenue
San Jose, CA 95118
Jessica Sand
4082062403
example@gmail.com
12/9/2021
12/12/2022
Other Health Impairment
None
Organization/Study Skills: Note-taking assistance- copy of teacher notes, when needed
Organization/Study Skills: Graphic organizer- writing assignments
Setting/Schedule: Seat away from distractions/noise
Setting/Schedule: Seat at front of room
Setting/Schedule: Extended time on tests (100%)
Setting/Schedule: Extended time to complete assignments (50%)
Teacher Directions: Frequent checks for understanding
Teacher Directions: Allow extra classroom movement
Teacher Directions: Allow extra class time for testing
Functional Academics
Transition - Training
Case Manager: Scott
5
Sand, Smith
5/2/2006
14
9
N
EO
Julie Sanwhich
1780 Marina Wy
San Jose, CA 95125
Julie Sandwhich
(408)1234567
Julie@mom.mom
10/14/2021
10/17/2022
Other Health Impairment
None
Organization/Study Skills: Extra set of books at home
Organization/Study Skills: Note-taking assistance/Copy of classroom notes
Organization/Study Skills: Assistance with recording assignments
Organization/Study Skills: Provision of study guides prior to test with main topics to be covered
Organization/Study Skills: Late assignments accepted with agreed upon timeframe
Organization/Study Skills: Speech to text
Sensory Needs: Fidget object
Sensory Needs: Frequent breaks
Sensory Needs: Multiple attempts on quiz/test (if technical difficulties)
Setting/Schedule: Seat at front of room / Seat near teacher
Setting/Schedule: Extended time on tests (100%)
Setting/Schedule: Seat away from distractions/noise
Setting/Schedule: Designated seat at table
Setting/Schedule: Visual barriers
Setting/Schedule: Supervised breaks within a test period
Student Response: Word processing software with tools turned off
Student Response: Use of equation notes on tests/quizzes for math
Student Response: Dictate responses (oral or sign)
Student Response: Alternative ways to demonstrate knowledge-Verbally
Student Response: Use of graphic organizer for written assignments.
Student Response: No scantron answer sheets
Teacher Directions: Directions given in a variety of ways
Teacher Directions: Directions given through visual cues
Teacher Directions: Textbook on tape or CD
Teacher Directions: Short answer tests
Teacher Directions: Fewer items on a page
Study Skills
College and Career Awareness
Case Manager: Scott
6
Tree, Linden
10/13/2005
15
9
N
EO
Tamia Tree
4567 Calle de Arbol
San Jose, CA 95118
Tamia Tree
40812345677
Thisisme@gmail.con
10/21/2021
10/22/2022
Other Health Impairment
Specific Learning Disability
Organization/Study Skills: Assistance with recording assignments
Organization/Study Skills: Study guides or sheets provided prior to tests
Organization/Study Skills: Access to Teacher Copy of Notes
Sensory Needs: Option to take breaks to refocus/ manage anxiety
Sensory Needs: No cold calls in class
Setting/Schedule: Extended time to complete assignments (100%)
Setting/Schedule: Test in alternate room
Setting/Schedule: Extended time on tests (100%)
Setting/Schedule: Preferential seating: front of room + away from distractions.
Student Response: Word processing software with grammar check/spell check
Student Response: Shortened assignments to show master of same standards.
Student Response: Reduced assignment to show mastery of Standard
Student Response: Use of calculator/multiplication chart except for calculation tests
Student Response: Option to type/access assignments via Chromebook
Student Response: Speech-to-Text option
Teacher Directions: Monitor Lindens's understanding of directions; reread/rephrase
College and Career awareness / Transition
Academic- Math
Academic- Writing
Case Manager: Scott Weir
Psychologist: Dennis
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