REEVALUATION REPORT

REEVALUATION REPORT (RR)

School Age

Student Name:

Date of Report (mm/dd/yy):

Date Report Provided to Parent/Guardian/Surrogate:

Student Birth Date:

Age:

Grade:

Local Education Agency (LEA):

School Student is Attending:

Current Educational Program:

County of Residence:

Phone (Home):

Name and Address of Parent/Guardian/Surrogate:

Phone (Work):

Other Information:

Date IEP Team Reviewed Existing Evaluation Data:

The IEP team must decide if it has enough data to determine: the student’s educational needs; the present levels of academic achievement and related developmental needs of the student; whether any additions or modifications to the special education and related services are needed to enable the student

to meet the measurable annual goals in the IEP and to

participate as appropriate in the general education

curriculum; and whether the student continues to

need special education and related services.

I. SUMMARIZE INFORMATION REVIEWED

Complete items 1-7 for all students.

1. Physical condition, social, or cultural background, and adaptive behavior relevant to the student’s disability and need for special education:

2.Evaluations and information provided by the parent (or documentation of LEA’s attempts to obtain parental input):

3.Aptitude and achievement tests:

4.Current classroom based assessments and local and/or state assessments:

5.Observations by teacher(s) and related services provider(s), when appropriate:

6.Teacher recommendations:

7.Determining factors: A student must not be found to be eligible for special education and related services if the determining factor for the student’s suspected disability is any of those listed below.

Respond Yes or No to, and provide evidence for, each determining factor below.

Lack of appropriate instruction in reading, including the essential components of reading instruction. Provide evidence:

Yes

No

Lack of appropriate instruction in math. Provide evidence:

Yes

No

Limited English proficiency. Provide evidence:

Yes

No

II. DETERMINATION OF NEED FOR ADDITIONAL DATA, SUMMARY AND CONCLUSIONS

Based on all evaluation data reviewed, complete item 1 or item 2.

1. The IEP team determined that additional data are not needed.

Reason(s) additional data are not needed:

Conclusion: Complete section A or B or C.

A. The student has a disability AND continues to need specially designed instruction.

i. Disability Category

Primary disability category:

Secondary disability category(s), if any:

ii. Summary of Findings

Student’s educational strengths and needs: Present levels of academic achievement and related developmental needs, including transition needs as appropriate:

Recommendations for consideration by the IEP team regarding any additions or modifications to the special education and related services needed to enable the student to meet the measurable annual goals in the IEP and to participate as appropriate in the general education curriculum (including special considerations the IEP team must consider before developing the IEP, measurable annual goals, specially designed instruction, and supplementary aids and services):

OR

B.

The student does not have a disability and no longer is eligible for special education. (The parent may request an assessment to determine whether the student continues to be a student with a disability.)

OR

C.

The student has a disability but no longer needs specially designed instruction, and no longer is eligible for special education. (The parent /guardian/surrogate may request an assessment to determine whether the student continues to be a student with a disability.)

2. The IEP team determined that there is a need for additional data.

The LEA must issue the Permission to Reevaluate – Consent Form and administer tests and other evaluation materials as may be needed to produce the data below.

NOTE: IF REEVALUATING THE STUDENT TO DETERMINE SPECIFIC LEARNING DISABILITY, COMPLETE THE

DETERMINATION OF SPECIFIC LEARNING DISABILITY

COMPONENT AT THE END OF THIS DOCUMENT BEFORE COMPLETING THE SECTION BELOW.

Interpretation of additional data:

Conclusion: Complete section A or B or C.

A. The student has a disability AND continues to need specially designed instruction.

i. Disability Category

Primary disability category:

Secondary disability category(s), if any: