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Spreadsheet---Pennsylvania-Department-of-Education

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					Alternative Education for Disruptive Youth Private Provider Site Information
# of slots for AEDY Brief Description of each facility that students provides AEDY services this site only (Application III. #4)
(Application III. #5)

Site Name
(Application III. #4)

Address
(Application III. #4)

Geographic area served
(Application III. #6)

Note: although this information is compiled by site, all sites should be submitted with the Provider’s main application and not separately.

Alternative Education for Disruptive Youth Private Provider Staff Information
Private Provider/Site Name (Please list staff working with AEDY students whether Full-time or Part-time) Classification (i.e. Staff Member Name Job Title
administrator, counselor, teacher, support staff)

Highest Degree Held

% of time assigned to this specific site

Responsibilities

Note: although this information is compiled by site, all sites should be submitted with the Provider’s main application and not separately.

Alternative Education for Disruptive Youth Private Provider Staff Information
Private Provider/Site Name (Please list staff working with AEDY students whether Full-time or Part-time) If Yes, Certification Area/Type Child Abuse Criminal Clearance History Record Provided with Provided Applic √ with Applic √

Staff Member Name

Certification Y/N

License Y/N

If Yes, License Area/Type

Note: although this information is compiled by site, all sites should be submitted with the Provider’s main application and not separately.

AEDY Program Evaluation Data Collection Sheet
I. # of students in B. who transferred to another program without having met behavioral or academic goals. (were not successful) M. # of students in B. who passed all 4 core content subjects (science, math, science, social studies) while in your program

A. Grade Level 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade **If you do not have data or don't know the answer to enter into a field/cell, DO NOT enter zero. Use zero ONLY IF your answer to that column is "zero students meet this criteria." Ex: if you didn't collect data on the # of core courses passed, don't enter zero. Instead, enter n/a for "not available"

B. Total # of AEDY Students Served

D. # of E. students in # of C. column B. students Average who met in B. who Daily behavioral met Attendance goals on provider's for AEDY their stated student behavior academic population plan goals

F. # of students in B. promoted to following grade 7th 11th) or graduated 12th)

G. Total # of students in B. who transitioned to regular school setting due to success in meeting goals

H.. # of students in B. who dropped out and did not re-enroll in any educational program (sending school or other)

J. # of total suspensi ons from your program for the students in B. during this school year

K. # of total expulsions from your program for the students in B. during this school year

L. # of times police interventi on, of any type, was required for students in B.

EACH PROVIDER MUST COMPLETE ONE COMPLETE SPREADSHEET (A - AJ) FOR EACH OF THE PAST 3 YEARS. B. Total # of AEDY students served at each grade level. C. Average Daily Attendance for AEDY student population at every grade level. D. Of number of students in column B, how many at every grade level met behavioral goals on their behavior plan as defined in the application? E. Of the number of students in column B, how many at every grade level met academic goals as determined by Periodic Review Team? F. Of the number of students in column B, how many were promoted to the following grade (for grades 7 through 11)? How many graduated from grade 12? G. Of the number of students in column B, how many students at every grade level transitioned to regular school setting due to success in meeting goals? H. Of the number of students in column B, how many at every grade level dropped out and did not re-enroll in any educational program (sending school or other)? I. Of the number of students in column B, how many at every grade level transferred to another program without having met their behavioral or academic goals (i.e. were not successful)? J. Number of total student suspensions for the students in B.at every grade level during this school year. K. Number of total expulsions for the students in B. at every grade level during this school year. L. Number of times police intervention, of any type, was required for students in column B at every grade level. M. Of the number of students in column B, how many at every grade level passed all 4 core content subjects (science, math, English, and social studies) while in your program?

Provider Name____________________________________________

4

School Year ____________________

AEDY Program Evaluation Data Collection Sheet
N. # of students in B. who passed at least 3 of 4 core content O. S. subjects # of P. Q. R. # of T. X. (science, students in # of # of # of students in # of U. V. # of math, B. who students in students in students in B. who students in # of # of W. students in english, participated B. who B. who B. who scored B. who students in students in # of students B. who social in a career scored scored scored Below scored B. who B. who in B. who scored studies) prep Advanced Proficient in Basic in Basic in Advanced scored scored scored Below Advanced while in training in PSSA PSSA PSSA PSSA in PSSA Proficient in Basic in Basic in in PSSA your program Reading Reading Reading Reading Math PSSA Math PSSA Math PSSA Math Writing

A. Grade Level 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade

**If you do not have data or don't know the answer to enter into a field/cell, DO NOT enter zero. Use zero How many graduated ONLY IF your answer to that column is "zero students meet this criteria." Ex: if you didn't collect data on the # of core courses passed, don't enter zero. Instead, enter n/a for "not available"

N. Of number of students in column B, how many at every grade level passed at least 3 of 4 core content subjects (science, math, English, and social studies) while in your program? O. Of number of students in column B, how many at every grade level participated in a career prep training program. (This includes but is not limited to: work-based learning, work-study, Career and Technical Education, job-coaching)? P-AA. Of number of students in column B, how many at every grade level scored advanced, proficient, basic, and below basic on the PSSA in reading, mathematics and writing?

Provider Name____________________________________________

5

School Year ____________________

AEDY Program Evaluation Data Collection Sheet

A. Grade Level 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade
**If you do not have data or don't know the answer to enter into a field/cell, DO NOT enter zero. Use zero ONLY IF your answer to that column is "zero students meet this criteria." Ex: if you didn't collect data on the # of core courses passed, don't enter zero. Instead, enter n/a for "not available"

AC. # of students in B. who AA. entered Y. Z. # of your # of # of students in program students in students in B. who AB. already B. who B. who scored # of identified as scored scored Below students in a student Proficient in Basic in Basic in B. who with special PSSA PSSA PSSA have an needs (had Writing Writing Writing IEP an IEP)

AD. # of students in B. who were identified as a student with special needs while in your program

AE. Of the # of students in B., how many were in this placemen t 0-6 mos

AF. Of the # of students in B., how many werein this placemen t 7-9 mos

AG. Of the # of students in B., how many werein this placemen t 10-12 mos

AH. Of the # of students in B., how many werein this placemen t 13-18 mos

AI. Of the # of students in B., how many werein this placemen t 19-24 mos

AJ. Of the # of students in B., how many were in this placemen t greater than 24 mos.

P-AA. Of number of students in column B, how many at every grade level scored advanced, proficient, basic, and below basic on the PSSA in reading, mathematics and writing? AB. Of number of students in column B, how many at every grade level have an IEP? AC. Of number of students in column B, how many at every grade level entered your program already identified as a student with an IEP? AD. Of number of students in column B, how many at every grade level were identified as needing special education services (as defined by IDEA) while in your program? AE. Of number of students in column B, how many at every grade level have been in your AEDY placement 0-6 mos? AF. Of number of students in column B, how many at every grade level have been in your AEDY placement 7-9 mos? AG. Of number of students in column B, how many at every grade level have been in your AEDY placement 10-12 mos? AH. Of number of students in column B, how many at every grade level have been in your AEDY placement 13-18 mos? AI. Of number of students in column B, how many at every grade level have been in your AEDY placement 19-24 mos? AJ. Of number of students in column B, how many at every grade level have been in your AEDY placement greater than 24 mos?

Provider Name____________________________________________

6

School Year ____________________


				
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