LAREDO INDEPENDENT SCHOOL DISTRICT by lRD56Jli

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									EXPULSION PACKET
                                                        LAREDO INDEPENDENT SCHOOL DISTRICT
                                                                   Expulsion Packet
                                                                 Administrator Checklist

Campus:
Student:                                                                                     ID#:
DOB:                                                                                         Grade:
Administrative Forms:
                   Principal’s Due Process Conference Form
                   All Pertinent Data

                   □    Police Report                                                        □      Immunization Record
                   □    Voluntary Statement                                                  □      Pictures
                        o    Administrator’s                                                 □      Under the influence checklist
                        o    Student’s                                                       □      Incident/Accident report

Student Files:
                  Student Discipline Action Form
                   Student Information
                   Detailed Attendance Report by Period – Entire Year
                   Copy of Transcript (High School Only)
                   Courses Needed Form (High School Only)
                   Home Language Survey
                   Individual Student Assessment Participation Form
                   Student's Withdrawal/Record Transfer Form (Current Grades and Student Schedule)
                   PRC Academic History and Current Report Card
                   TAKS/SDAA Confidential Student Report
                   Sp. Ed. Record
                   Counseling Referral Form (Required for Discretionary JJAEP Expulsions)
                   Discipline Intervention Documentation Form (Required for Discretionary JJAEP Expulsions)
Special Education:
                   Complete ARD packet including the following:
                   (must have been held within 10 school days of expulsion order)
                    Manifestation Determination page (Place at beginning of ARD packet)
                    FBA (Functional Behavioral Assessment) Manifestation Determination Review
                     Meeting (MDR) for this offense
                    BIP (Behavior Intervention Plan) – from Manifestation Determination Review
                    Schedule of services (only courses that are offered at F.S. Lara Academy)
                    IEP
Special 504:
                   Manifestation Determination
                   Copy of Individual Accommodation Plan
                   Individual Behavior Management Plan
Note:          Three copies (original plus 2 copies of packet) must be delivered to the Hearing Officer. The parents must receive our letter
               within 72 hours prior to the hearing. We MUST receive your packet no later than 24 hours following the Expulsion Due Process.
*** All packets must be completed and properly signed and/or documented to be accepted. ***
Prepared by                                                                           Date

LISD Official Form 735-03
   Last Updated July 2010
                   LAREDO INDEPENDENT SCHOOL DISTRICT
                                Principal’s Due Process Conference

Campus:                                          * Conference Date w/student:

                                                 * Conference Date w/parent:

Student:                                         I.D. #:                     Grade:

D.O.B.:

         Student Status:
                  Regular Ed                         Special Ed                   ESL
                  Previously Placed in AEP           504                          LEP Mainstream

Parents/Legal Guardian:

Address:                                                      Zip Code:

Work Phone:                                                   Home Phone:

Parents were notified of Conference on                                by
                                                      Date                         Administrator

Offense:



Proposed Disciplinary Action:



Comments:



                              Conference was conducted in     English  Spanish

* I certify that the Principal’s Conference was conducted in compliance with state and local policy and that
  all safeguards for the student’s due process rights were extended. (Notified parents within 24 hours of
  time of incident or offense and 72 hours to complete Due Process.)




Parents/Legal Guardian Signature              Date     Administrator‘s Signature                Date


Student’s Signature                           Date     Interpreter’s Signature                  Date


LISD Official Form 735-04
  Last Updated October 2009
                                LAREDO INDEPENDENT SCHOOL DISTRICT
                                      VOLUNTARY STATEMENT


I,                                                     , agree to making this statement at
     (Last Name)                 (First Name)
as a □ reporting party □ victim □ witness, on a voluntary basis before
on this                        day of                          20        at                    o’clock in Laredo, Webb
County of Texas.
My name is                                                                                                      .


My address is                                           in
                                (City)                                  (County)              (State)
my date of birth is                                     and my present age is           my home telephone number is


(         )                                                         .
I’m employed by                                                                                in the capacity of

                                                business phone number is (          )                          .

This statement is in reference to




                                                       Details of Statement




LISD Official Form 735-10
   Last Updated October 2009
Signature   Date
          STUDENT FILE




          LAREDO INDEPENDENT SCHOOL DISTRICT
Campus:     STUDENT DISCIPLINE ACTION FORM  □ Regular Ed □ Special Ed   □ 504
Student:                                                                ID#:                      Grade:                            DOB:
Parent/Guardian:                                                                                Address:
Home Phone:                                                                       Work Phone:
INCIDENT :                                                                                                 PEIMS:
        PEIMS Number                        Date                  Time         Location                                     Reason                Action
                                                                                                                          Table (C165)         Table (C164)

              *** PEIMS Codes must be entered in the 425 Report prior to submitting paperwork. ***
□ Excessive Absences/Tardies

LEVEL I - MINOR OFFENSES                                                          LEVEL IV—EXPELLABLE OFFENSES
□   Cheating/Lying/Deceitfulness                                                  □   Using/Exhibiting/Possessing                  □ Firearm              □ Illegal Knife
□   Excessive Absences/Tardiness                                                  □   Aggravated assault against a school district employee/volunteer
□   Classroom/Campus/Bus Misbehavior                                              □   Aggravated assault against someone other than a school district employee/volunteer
□   Disrespectful/Impolite                                                        □   Sexual assault or aggravated sexual assault against a school district employee/
□   Leaving Class/Campus/School Activity Without Permission                             volunteer
□   Inappropriate Verbal/Physical Conduct                                         □   Sexual assault or aggravated sexual assault against someone other than a school
□   Possession/Smoking/Using Matches/Lighter/Tobacco                                    district employee/volunteer
□   Violating Dress/Grooming Code                                                 □   Arson
□   Using Electronic Device (Pager/Cellular Phone)                                □   Murder, capital murder, criminal attempt to commit murder or capital murder
□   Other                                                                         □   Indecency with a Child
                                                                                  □   Aggravated kidnapping
                                                                                  □   Aggravated robbery
                                                                                  □   Manslaughter
                                                                                  □   Criminally negligent homicide
    FOLLOWED DISCIPLINE PLAN                          yes            no           □   Felony controlled substance violation (delivery of marijuana ≥ 2 oz.)
    Teacher’s Comments:                                                           □   Felony alcohol violation
                                                                                  □   Criminal mischief
                                                                                  □   Other



LEVEL II - SERIOUS OFFENSES
□   Vandalism On         □ School Property        □ Student Property
□   Stealing/Theft
□   Insubordination
□   Disrespect/Profanity/Vulgar Language/Gestures Towards School Employee
□   Fighting
□   Falsifying Documents/Records
□   Possession/or conspiracy to Possess any Explosive Device
□   Making/Assisting in Making Threats        (Individual)
□   Placing a Prohibited Substance in Another Person’s Food/Drink
    and/or other possessions
□   Possessing/Selling Drug Paraphernalia/Look-A-Like Drugs                       ACTION TAKEN (TABLE 1096)                      (Administrator Use Only)
□   Participating in Gang-Related Activities
□   Misuse of Computer/Software/Internet                                          □ Verbal Reprimand
□   Other                                                                         □ Teacher Conf. W/Student/Parent
LEVEL III – DISCIPLINARY ALTERNATIVE EDUCATION PROG.                              □ Counselor Conf. W/Student/Parent
□   False alarm/false report                                                               □ Administrator Conf. W/Student Parent
□   Making/Assisting in Making Threats/Terroristic Threats                                 □ Telephone Call or Note to Parent
□   Felony on Campus                                                              □ Detention     AM PM        Lunch          Saturday
□   Assault against someone other than a school district employee/volunteer       □ Withdrawal of Privileges
□   Assault against a school district employee or volunteer                       □ ISS 1 2 3 Day(s) in School Suspension                                     AP1
□   Selling/Giving/Delivering (less than 2 oz.)/Possessing/Using                  □ Suspension from School 1 2 3 Day(s)
    □ look alike drug     □ marijuana            □ other                          □ Assignment to Off-Campus AEP                       Days                   AP2
□   Selling/Giving/Delivering/Possessing/Using Alcohol                            □ Other
□   Abuse of a volatile chemical                                                  □ PD Citation Case No.
□   Engaging in Public Lewdness/Indecent Exposure
□   Retaliation Against a School Employee                                         Administrator’s Comments:
□   Title 5 Penal Code Felony
□   Criminal Mischief
□   Other
                                                                                  NOTE:       Students assigned to In-School Suspension shall serve the
                                                                                              prescribed day(s). Absence(s) shall not exclude student from
                                                                                              In-School Suspension Placement.




                      Originator                                  Date                                    Administrator                                Date


                       Student                                    Date                                 Parent/Guardian                                 Date
LISD Official Form 735-12
  Last Updated October 2009
                                          LAREDO INDEPENDENT SCHOOL DISTRICT
                                               INDIVIDUAL STUDENT
                                            ASSESSMENT PARTICIPATION

CAMPUS NAME & NUMBER:                                                               DATE:

* KEEP ORIGINAL AT YOUR CAMPUS
* TURN IN COPY TO F.S. LARA OR ALTERNATIVE ED.

                                                                                       Assessment Decision
                                                                    (Mark E for Eng TAKS, S for Span TAKS, TAKS A, TAKS M ,
                                                                                              TAKS Alt                         R
                                   REG.   BIL/   SP.   SEC.   LAS                                                              P
                                   ED.    ESL    ED.   504                                     include
                                                                     level, L for LEP Exemption & X for ARD Exemption, P for   T
                                                                                previously passed, R for TAKS retest)          E
STUDENT
                                                                    ELA         R         W         M        SC        SS
NAME:
D.O.B.:
I.D.
PEIMS:
GRADE:
COMMENTS:
IF APPLICABLE, MODIFICATIONS
EX: large print, oral adm., Etc.
ENGLISH LANGUAGE ARTS
READING
WRITING
MATH
SCIENCE
SOCIAL STUDIES




Counselor’s Signature:
LISD Official Form 735-13
  Last Updated October 2009
                              LAREDO INDEPENDENT SCHOOL DISTRICT


                               Courses Needed - High School
                               Only
Campus:                                                      Grade:

Student:                                                     ID#:

DOB:


                                             STUDENT STATUS

  Regular Ed                            Special Ed          SL                LEP Parent Denial
  Previously Placed in AEP              504                 LEP Mainstream    LEP Exit Date

                                          GRADUATION PROGRAM

  Minimum                                 Recommended                  Distinguished Achievement

                                TAKS MASTERY EXIT LEVEL (11th & 12th graders)

ELA                   Social Studies               Mathematics           Science              Writing


                    Date                             Date                          Date


                Course                              * Fall                         * Spring




* Must include Fall and Spring ½ credit courses.




Counselor’s Signature                                                    Date



LISD Official Form 735-14
  Last Updated October 2009
                                                                                                    Priority Level
                                                                                                    Low
                                                                                                    Moderate
                                                                                                    High
                                              Counseling Referral Form

Student                                                               I.D. #                     Grade
Counselor                                                             Date
Homeroom Teacher (Elementary Only)
 Reason for referral:
       Poor peer relationships                                Family changes (death, divorce, re-marriage, moving, etc.)
           Behavioral problems                                Aggressiveness/Bullying
           Academic problems                                  Sudden changes in mood, attitude, or behavior
           In need of Social Services                         PEP (Parenting Ed. Program)
                                             Other (Please Specify)


Services provided to student by School Counselor:

Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)




Date:
**********************************************************************************************************************
Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)




Date:
**********************************************************************************************************************
Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)




Date:
**********************************************************************************************************************
Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)




Date:
**********************************************************************************************************************


                   Date                                                        Counselor’s Signature


 LISD Official Form 735-15
   Last Updated October 2009
                       LAREDO INDEPENDENT SCHOOL DISTRICT
                    DISCIPLINE INTERVENTION DOCUMENTATION FORM
                           FOR DISCRETIONARY PLACEMENTS
Student Name:                                 D.O.B.:                    I.D.#:           Date Submitted:
Campus:                                       Teacher’s Name:                                      Grade:
Administrator/Teacher name:                                     Administrator/Teacher Signature:
 Regular Ed.          Special Ed      504            Signature of responsible person:


Behavior Concern(s): (REQUIRED)




Description                             Signature of responsible person

Interventions Implemented (i.e., Campus Support Team, Counseling, Parent                 Intervention       Outcome
Conferences, Truancy Court, Gang Activity, Behavior Specialist, ISS, OSS,                    Dates
Schedule change, Substance Abuse Counselor Session(s) etc.): Preferential
setting, lunch detention, after school detention, Saturday Detention/work program,
early bird detention, parental shadowing, etc …




  LISD Official Form 735-16
    Last Updated July 2010
SPECIAL EDUCATION
SECTION 504
 STUDENTS
                         Laredo Independent School District

                                  Manifestation Determination


Student:                                            ARD Date:

Behavior subject to disciplinary action:




Disabilities:

      The ARD Committee has reviewed all relevant information, including evaluation
and diagnostic results, observations of the child, the current IEP and placement, and other
relevant information supplied by the parents. Based on this review, the ARD Committee
has made the following determinations:

      37.       In relationship to the behavior subject to discipline, the IEP and
                placement were appropriate and the special education services,
                supplementary aids and services and behavior interventions strategies
                were provided consistent with IEP and placement.

                YES                 NO

      38.       The child’s disability/ies did not impair the ability of the child to
                Understand the impact and consequences of the behavior subject to
                Discipline.

                YES                 NO

      39.       The child’s disability/ies did not impair the ability of the child to control
                The behavior subject to discipline,

                YES                 NO

NOTE:    IF ANY OF THE THREE DETERMINATIONS ARE ANSWERED “NO”
THEN THE BEHAVIOR MUST BE CONSIDERED TO BE A MANIFESTION OF THE
STUDENTS DISABILITY, IN THAT EVENT, THE STUDENT CANNOT BE
EXPELLED OR PLACED IN THE DISTRICT’S AEP BEYOND 10 SCHOOL DAYS.

								
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