Transcript Completing the Referral Form

Office Referral Form
Boot Camp
SIERRA HIGH SCHOOL
February 12, 2014
Classified PLC
2:45 p.m. – 3:30 p.m.
SBCUSD Office
Referral Form
Excerpt from SBCUSD Progressive
Discipline Matrix (p 14)
When to Write an Office Referral
 Chronic Minor Offenses
When a student has failed to respond to interventions
as documented on the Low Level Referral form
(5th Minor Offense)
OR
 Major Infractions
When a student has violated the California Education
Code
Note: Office Referral forms must be completed by the staff member who
witnessed the misbehavior.
Level of
Severity
Minor
Offenses
Chronic
Misbehaviors
Major
Infractions
Definition
Failure to
demonstrate
an expectation
or social skill
A failure to respond
despite the presence of
systematic environmental
modifications and
interventions
Violation of the
Education Code
(EC 48900 & 48915)
Addressed
by
Witnessing
staff
Collaborative effort:
teacher, team, admin
Collaborative effort:
admin, support staff
Discuss the
Difference:
Minor Offenses
vs. Major Infractions
Excerpt from SBCUSD Progressive
Discipline Matrix (p 12)
Small Group Activity
Distinguish Between Minor and Major
When Do Minor Offenses
Go to the Office?
Minor Offenses are considered “chronic”
when a student’s misbehavior continues
despite the presence of low level
interventions as documented on the Low
Level Referral (LLR) form. LLR
documentation must be attached
to the Office Referral form.
Low Level
Referral:
Attach to Office
Referral on 5th
Incident
Excerpt from SBCUSD Progressive
Discipline Matrix (p 13)
Office Referral Form:
Data Fields
Understanding how to accurately collect and record
behavioral data for the purpose of problem-solving
is critical. This presentation will focus on how to
complete the following data fields:
 Location
 Problem Behavior
 Environmental Factors
 Possible Function
 Administrative Action Taken
Remember to
CHECK ONLY
ONE Option.
WHERE did the misbehavior occur?
Remember to
CHECK ONLY
ONE Option.
WHAT was the misbehavior?
If you select “other” on the Office Referral form, specify the
PROBLEM BEHAVIOR using one of the codes below:
Remember to
CHECK ONLY
ONE Option.
What was occurring at the time of the misbehavior?
Who Cares About
Environmental Factors?
Environmental variables contribute to human behavior
– both positively & negatively – we must be able
to identify and modify these factors for the purpose
of supporting behavioral success.
Remember to
CHECK ONLY
ONE Option.
What purpose did the misbehavior serve?
Functional Factors
It’s WHY We Do What We Do
Avoid Something
Gain Something
Who Cares About
Functional Factors?
 All behaviors (even misbehaviors)
serve a purpose (function)
 People continue to use certain
behaviors for one simple reason –
they “work”
 It is difficult to change a behavior
if we do not understand WHY
it’s happening
NOTE: Some of us will have to become skilled detectives
Administrator
Interventions
Refer to the SBCUSD Progressive
Discipline Matrix for further information.
ACTIVITY:
Practice Completing an Office Referral Form
The class was in the process of walking to an assembly
when Tina stepped out of line. Ms. Peters stopped the
class and asked Tina to please step back in line with the
class. Tina looked at Ms. Peters, rolled her eyes and said,
“Seriously lady?” Ms. Peters reminded Tina of the Hallway
Expectation to Be Safe which means to walk with the class
in a single file line. Tina responded by saying, “Get off my
back, b*t*h!”
Activity:
Complete an Office Referral Form
Tina
10 15
11/22/12
Ms. Peters
4th/B
Tina
10 15
11/22/11
Ms. Peters
4th/B




When the class was walking to assembly,
Tina stepped out of line. Tina was directed to follow Hallway
Expectations – walk in a single file line with the class. Tina refused to
get back in line stating, “Get off my back, bitch!”
“Just the Facts, Ma’am”
Office Referral forms are legal documents which parents
have the right to review. Therefore, record only the facts
as they pertain to THIS student in THIS situation.
Avoid:
 rehashing the student’s history
of misbehaviors
 identifying other students
by name or by ID#
 inserting editorial or emotional
comments regarding the student
or the family
Data-Based Decision Making
The Office Referral form was designed to
collect specific behavioral data for the purpose
of implementing school-wide, group, and
individual interventions.
Sample Office Referral Reports:
 Average Referrals per Day
 Referral by Location (PB)
 Referral by Environment (PB)
 Referral by Function (PB)
 Referral by Grade and Gender
 Referral by Student
 Referral by Team