Tucson Unified School District

Individualized Education Program

Phone:
Fax:

Student Name: Rodriquez, Katelynn Home Phone: Date: 02/21/2017

Date Of Birth: 10/01/2006 Home Address: 2510 N Winstel Bl
Student No.: 1301241221 Tucson, AZ 85716

Age Gender Grade Home School Attending School

10 Female 04 Wright Elementary
Ethnicity Primary Language Home Language
Hispanic English
Parent/Guardian
Name Home Phone Name Home Phone
Angela Rodriquez James Limburg
Address Work Phone Address Work Phone

Emergency Phone Emergency Phone

641-638-1836 520-882-4840

IEP Review Due Date : 02/20/2018 Re-evaluation Due Date: 02/20/2020

Interpreter Needed: Y N
Documentation of efforts to schedule the IEP Meeting:
Date Description
02/20/2017 We contacted the parent and she agreed the best time to meet would be on Tuesday,
February 21st at 2:40pm. Meeting was confirmed by phone.

School Age Eligibility: Specific Learning Disability

The student and parents have been informed of his/her rights under IDEA. These rights will transfer from the parents to the student at age
18. Parent Initial________ Student Initial ________.
IEP TEAM MEMBERS

Please Sign below and indicate time in and out.

The following were in attendance:

Indicate Parent
Names Position Agreement Signature Date
Rodriquez, Katelynn Present
Rodriquez, Angela Present Mother
Peterson, Maria Present Case Carrier
Peterson, Maria Present District
Representative
Peterson, Maria Present Evaluation
Representative
Guenther, Patty Present General
Education
Teacher
Klimke, Joy Present General
Education
Teacher
Tucson Unified School District - Individualized Education Page 1 of 9
Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017
Education
Teacher
Brown, Jessica Consulted School Nurse
(Nurse Only)
Peterson, Maria Present Special
Education
Teacher
Shibuya, Peter Present
Kanefield, Lily Present Student
Teacher

Tucson Unified School District - Individualized Education Page 2 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017

C. PERTINENT MEDICAL INFORMATION

Transportation - Seizure Management Y N
Transportation - Diabetic Y N
Transportation - Oxygen Y N
Transportation - Bus Aide Required - Medically necessary Y N
Transportation - Air-Conditioned Bus Required - Medically Y N
Necessary
Transportation - Medically Fragile (include Remarks in Y N
Description)
Health Issues:
Ehlers-Danlos syndrome-may have joint pains, please contact the health office. Please allow her to use the restroom as
needed.
2/21/17 Hearing R-pass L-pass
2/21/17 Vision R-20/20 L-20/20 Both-20/20 with glasses
J. Brown, RN
Additional medical information is on file in the nurse's office and in the teacher's file. Y N

D. SUMMARY OF PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

ASSESSMENT RESULTS INCLUDING AGE-APPROPRIATE TRANSITION-BASED ASSESSMENTS

Summary of Current Assessments

SUMMARY OF PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE

Strengths of Student (Academic, Behavioral, Learning Characteristics)
Academic
Reading: Katelynn accurately reads 94/100 of the first 100 sight words; 89/100 of the second 100 words; and 81/100 of
the third 100 words.

Writing: Katelynn enjoys creative story writing.

Math: Katelynn can add two and three digit numbers.

Social / Emotional
Katelynn's social/emotional skills are within normal limits. She entered school mid-semester (February 6th) and has
adjusted nicely and has made many friends.
Communication
Katelynn's communication skills are within normal limits. She expresses herself very well, communicates with peers and
adults appropriately and advocates for herself.
Motor
Her motor skills are age appropriate. Katelynn has very neat and legible handwriting.
Self Help / Daily Living
Her self help/daily living skills are age appropriate. Katelynn is very independent and does not need assistance with daily
living skills.

Weakness
Academic
Reading: Katelynn needs to improve her phonics skills and fluency rate.

Writing: Katelynn needs to work on conventions (capitalization, punctuation, and spelling).

Math: Katelynn needs help in adding with and without regrouping and subtracting with and without borrowing.

Tucson Unified School District - Individualized Education Page 3 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017
Social / Emotional
Katelynn's social/emotional skills are within normal limits.
Communication
Katelynn's communication skills are within normal limits.

Motor
Her motor skills are age appropriate.

Self Help / Daily Living

Her self help/daily living skills are age appropriate.

Effect of disability on Progress in the General Curriculum and Needs of Student to Access the General Curriculum
Due to Katelynn's specific learning disability in reading, writing, and math, she needs daily resource support in order
to be successful in the general education curriculum. This is due to her difficulty in decoding skills, spelling and
conventions, and her difficulty to maintain and master new math concepts.

Parent Input for Enhancing Child's Education

Katelynn's parents are supportive in helping her with her school work and homework.

Performance in General Education

Additional Information:
Since February 6th, Katelynn has adjusted well starting new school. She completes her work and works well in the classroom.

Progress on IEP Goals:

The team excepted the transfer IEP and is developing a new IEP in addition to an MET.
Explanation for Lack of Progress:
The student is making appropriate progress on IEP Goals: Yes No N/A
N/A
E. SPECIAL CONSIDERATIONS
Assistive Technology
The team considered the student's need for Assistive Technology and determined it is not necessary.

Behavioral Needs
The team considered the student's need for positive behavioral interventions, supports and strategies to address
behaviors that impede learning of self or others and determined these are not necessary.

English Language Learner (For the child who is limited English proficient.)
It has been determined that this student is not an English Language Learner.

Blind/Visually Impaired
The team considered if the student has a visual impairment that requires Braille services in order to function at a level
consistent with expected achievement and determined are not needed.

Deaf/Hearing Impaired
The team considered if the student has communication needs that require educational communication in an alternate
mode preferred by the student and determined is not necessary.

Communication
The team considered the student's needs for other communication services, supports and goals and determined are not

Tucson Unified School District - Individualized Education Page 4 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017
necessary.

Tucson Unified School District - Individualized Education Page 5 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017

F. ANNUAL GOALS AND BENCHMARKS OR SHORT TERM OBJECTIVES

Progress Report Frequency:

Progress reports on goals will be sent home in accordance with the grading periods.
Progress Period 1
Progress Period 2
Progress Period 3
Progress Period 4
Close Out

Annual Goal(s)
Category: Reading - Elementary
Katelynn will decode words using knowledge of phonics, syllabication and word parts when given a list of words at the 3rd and 4th grade
level scoring 90 out of 100 as measured by The Fry's High Frequency Word List. (AZ Standard R01-S1C3, R02-S1C3, R03-S1C3)
Start Date 02/20/2017
Score First Grade 94/100; Second Grade 89/100; Third Grade 81/100.

Annual Goal(s)
Category: Writing - Elementary
Katelynn will write and/or draw on self-selected topics using the six writing elements (ideas and content, organization, voice, word
choice, sentence fluency, conventions) at grade level standardswhen given writing process activities and writing and/or drawing
materials, scoring 18 out of 30 points, as measured by the Writing Traits for Beginning Writers-Scoring Continuum. (AZ WRiting
Standards, Grades 1-2, Strand 1 Concepts 1-5 and Strand 2 Concepts 1-6)
Start Date 02/20/2017
Score Katelynn has great ideas and voice in her writing, however, she needs to focus on conventions of capitalization,
punctuation, and spelling.

Annual Goal(s)
Category: Math - Elementary
Katelynn will demonstrate application of computation skills by adding whole numbers with/without renamings when given 10 addition
problems, scoring 8 out of 10 as measured by Brigance Comprehensive Inventory of Basic Skills. (AZ Math Standards Strand 1,
Concept 2, Grade 1 P04, Grade 2 P04, 6, Grade 3 P02, 4, Grade 4 P01)
Start Date 02/20/2017
Score She can add two digit numbers without renamings. Current score: 3/10.

Katelynn will demonstrate application of computation skills by subtracting whole numbers with/without renamings when given 10
subtraction problems, scoring 8 out of 10 as measured by Brigance Comprehensive Inventory of Basic Skills. (AZ Math Standards
Strand 1, Concept 2, Grade 1 P05, Grade 2 P05, Grade 3 P03, Grade 4 P02)
Start Date 02/20/2017
Score She can subtract two digit numbers without renamings. Current score: 3/10.

Tucson Unified School District - Individualized Education Page 6 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017

G. STATEMENT OF SPECIAL EDUCATION/RELATED SERVICES

Specially Designed Provider Location Amount of Time Date of Duration of
Instruction Initiation Service
Minutes Frequency On/About
Writing Process Special Ed Teacher Resource Room 240 Monthly 02/21/2017 02/20/2018

Reading Decoding Special Ed Teacher Resource Room 240 Monthly 02/21/2017 02/20/2018

Math Calculation Special Ed Teacher Resource Room 240 Monthly 02/21/2017 02/20/2018

Related Service
The team considered the need for related services and determined that the student is not in need of related services.

Transportation:
Y N Sensory need/Physical need/Limited endurance (medically necessary).
Indicate, in detail below, the significance of the Sensory need/Physical need/Limited endurance (medically
necessary) that justify the need for specialized transportation.
Y N Significantly reduced intellectual development and/or problem-solving skills and/or behavioral issues.
Indicate, in detail below, the significance of the reduced intellectual development, problem solving skills, and
or behavior issues that justify the need for specialized transportation.
H. SUPPLEMENTARY AIDS AND SERVICES (ACCOMMODATIONS AND MODIFICATIONS)
Supplemental Aids and Services
The team considered the need for supplemental aids and services and determined that they are not needed.

Program Modifications and/or Supports for School Personnel

Programs supports and modifications were considered but not needed for the child to advance appropriately toward
attaining annual goals.

Accommodations
No accommodations are necessary.
The following accommodations are necessary for this student to benefit from instruction in the general
education classroom:
Read aloud or sign directions that students read on their own
Familiar test administrator administer the test
Extend time for assignments; For State Tests: Extended testing time (same day)
More breaks
Several shorter sessions
Small group administration
Limit amount of required reading
Lengthy Assignments will be divided into shorter segments
Reduced/Modified assignment
May be assigned alternative assignments
Use cooperative learning
Open note tests
Recap or summarize the main points of the lecture
Allow student to retake test
Use graphic organizers
Provide a table of math facts for reference
Use graph paper to keep numbers in proper columns

Tucson Unified School District - Individualized Education Page 7 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017
I. EXTENDED SCHOOL YEAR (ESY)

The team considered the need for ESY Considered/Not Needed The student is able to maintain skills needed to support
the IEP goals and objectives, as designated by an (E).

J. TESTING

Assessments
The student will participate in assessments without accommodations.
The student will participate in assessments with the following accommodations:

Student meets eligibility for alternate or alternative assessment? No

The Alternate Assessment Eligibility Form must be completed for students being considered for alternate assessments.

State assessment will be taken at grade level.

Tucson Unified School District - Individualized Education Page 8 of 9

Name Date of Birth Student Number Document Date
Rodriquez, Katelynn 10/01/2006 1301241221 02/21/2017

K. LEAST RESTRICTIVE ENVIRONMENT (LRE)

A - Inside Regular Class 80% or more of the day

Rationale for LRE selection:

a. Progress in the general curriculum is impacted by the disability?
Progress in the general curriculum is impacted by the disability due to significant weaknesses/deficits in reading
decoding skills
Progress in the general curriculum is impacted by the disability due to significant weaknesses/deficits in math
computationProgress in the general curriculum is impacted by the disability due to significant weaknesses/deficits in
writing mechanics
Are services to be provided at the neighborhood school?
Yes

b. Potential harmful effects of the placement:

Katelynn's participation in special education classes may stigmatize her.
Katelynn may receive reduced opportunities for interaction with general education peers
c. Explain to what extent the student will not participate with non-disabled peers in academic and
non-academic environments
Katelynn will not participate with non-disabled peers in academic and non-academic environments to the following
extent: she will be attending resource support during computer lab time.

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