Transcript Paw Template - University of South Florida

Individual behavior plan designed for students who require
additional intervention beyond School Wide PBS
– Externalizing/Internalizing Behavior
– Check In/Check Out (externalizing)
– Guidance Intervention
– Outside Agencies
Lake Park Elementary
1295 14th Street
Naples, Florida 34102
(239) 377-7200 Fax (239)377-7201
To the parent/guardian of: _____________________________,
We would like to include your child in our Pawsome Daily CheckIn/Check-Out program. This is a program designed to help students
meet our school-wide expectations in a positive manner. Your child
will be assigned a coordinator (usually a guidance counselor, an
administrator, or a teacher) and will be responsible for checking-in
with that person each morning and checkout again at the end of the
day.
A report will be filled out daily by the teacher(s) and the coordinator
will review the report at check-in/out time. You will also review and
sign the daily report each night. The student will earn incentives and
rewards for appropriate behavior. As parents, you are responsible for
making sure your child arrives on time each day for check-in and that
you review and sign the daily progress report. Together, we can make
this a positive experience for your child.
We appreciate your cooperation in this program and look forward to
working for your student. Please contact the Assistant Principal,
Ronna Smith, if you have any questions. We may be reached at 239377-7200.
________ I do give consent for my child to participate.
________ I do not give consent for my child to participate.
______________________________
Parent/Guardian
_______________
Date
Pawsome Check-In/Check-Out Contract
Goal: To assist __________ in his behavioral and academic progress so that he can be more
successful in school.
Expectations for Responsible Student Behavior:
1. Show respect
2. Be Responsible
3. Ready to Learn
This plan is designed to help you become a better self-manager of your behavior.
In order to assist you, a Behavior Progress Report will be used to remind and support your
efforts to meet the school-wide expectations for behavior.
Student Responsibilities:
• Check-in with Mr. McFadden every morning between 8:00 and 8:20 a.m. to go over your daily goals.
• Bring the progress report to class and have your teacher fill it out by the end of the day.
• Check-out with Mr. McFadden at 2:30 every day AND bring your progress report with you for review.
• Have your progress report signed every night by your parent/guardian.
Parent Responsibilities:
• Review the contract with your child and sign it.
• Discuss the goals with your child and support them in their efforts.
• Sign the progress report nightly.
• Accept the evaluations of the teachers and staff participating.
• Reward your child as he meets their goals.
Teacher Responsibilities:
• Complete the Teacher Referral Information Sheet.
• Evaluate the student’s progress toward meeting their goals on the progress report.
• Provide the student with positive feedback when they demonstrate the desired behaviors.
CICO Liaison Responsibilities:
• Facilitate Check-in/Check-out.
• Provide student with positive and constructive feedback.
• Inform the student ahead of time (if possible) if you are going to be absent.
I have read and understood the expectations of the contract. By signing this contract, I accept
my responsibilities of a team member of the Pawsome Check in/ Check-out program.
Student’s signature: _____________________
Date: ___________
Parent’s signature: ______________________
Date: ___________
Teacher’s signature: _____________________
Date: ___________
CICO Officer’s signature: _________________
Date: ___________
Check In- Check Out Liaison Procedures and Responsibilities
Each morning:
 Greet students between 8:00 and 8:20
o If student does not show up then  Follow up in morning holding area or visit classroom after morning
announcements
 Students need cards right away in the morning even if a classroom visit is
necessary – unless absent a student should get their card in the morning
 Set procedures for morning routine…
 What to do if CICO Liaison is absent?
 What to do if CICO Liaison is in a meeting?
 How long to wait?
 Review expectations with students for day
o This might include:
 Positives from the day before
 Areas to improve upon
 Check homework – all done?
 Ways to improve day
 File returned card – if not returned call parent…
Each Afternoon:
 Be on time in the guidance office to meet students.
 At 2:35, if a student has not arrived please call room to remind.
 Review students Behavior Report Card
o Total points
o Discuss high points of the day
o Discuss areas for improvement, be specific - have students give examples that would
be the right things to do in an area that they scored low
o How close are they to their goal?
o Does the student have their homework?
 Actually look at their planner or class notebook to see they are organized
 Do they need to clean out their backpack?
 If student has earned reward, help them get it
 If the student has extra time continually, ask them to come later or send them back to class if
there is no reward
 Let students know of the next day’s morning schedule… Making student aware of the schedule
will help them be responsible for morning check in
Anthony
Date:
Announcements
/M orning Work
3
2
Lang. Arts
Core / Guided Reading
1
3
2
1
3
2
Math
1
3
2
Lunch / Recess
1
3
2
1
Related Arts
3
2
1
Science/S.Studies DEA R/Read-A lo ud
3
2
1
3
Com plete all classw ork
assigned (Respect)
Use appropriate
language and gestures
(Respect)
Keep hands, body and
feet to self (Respect)
Great Job!
Watch Out,
Stay Focused!
You Need to Try
Harder
Parent Signature:
Did Anthony arrive on time in morning? Y N
Teacher Comments:
Parent Comments:
Did Anthony complete homework and turn in? Y N
2
1