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Sample Forms Letter of Recommendation by mll93156

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									Check In/Check Out Program

             Hawthorne Elementary
Bridget Bradham [counselor]
Aneila Rouse [2nd grade teacher]
Ann Stuckey [teacher mentor]
Kim Myers [3rd grade teacher]
Background Information
                  PBIS school
Positive           since 2005
                   -   Code of Conduct
Behavioral         -   Paws
                   -   School Store
                   -   Cafeteria Program
Interventions &    -   Mentoring Program
                   -   Office Referral System

Supports          Became PBIS Plus
                   in 2007
        What is PBISPlus?
                                                        ~5%

                                                       ~15%




Grant support:
 A grant to Johns Hopkins from the U.S.
                                                  ~80% of Students
  Department of Education
It aims to:
 Address needs of yellow and red zone students
 Increase use of research-based interventions
 Reduce behavior problems in schools and improve student
  achievement
What is the strategy?
 Support SSTs by providing additional training and on-site
  technical assistance regarding:
   – Effective teamwork and collaborative problem-solving
   – Behavior support planning
   – Research-based interventions
   – Simplified functional behavioral assessment
Key Aspect of PBIS Plus
Alternative Check In/Check Out Program


                 Coordinator

                 Teachers and Staff
                  mentored Students
Student Selection Process
 Red and Yellow Zone Students
  from the Previous Year

 Teacher Recommendation

 An invitation to participate in
  CICO program was sent home
Mentor Selection Process
Faculty and Staff were asked to
 volunteer
 - No New Teachers

Letter outlining duties of CICO
 mentors was distributed
               Good Morning Everyone,


                    I will be the Check In – Check Out (formerly the Mentoring Program)
              contact person this year. Check In – Check Out (CICO) is an intervention program
              for our yellow and red zone students (students with persistent or increasing

Coordinator   behavior issues). The purpose of CICO is to build a positive relationship between a
              staff member and a student in order to help the student have successful days, both


and Program   academically and behaviorally.
                    Teachers, administrators and resource teachers, with the exception of first


   Letter
              year teachers, can volunteer to be a mentor for one student. If you choose to
              volunteer, your role as the mentor will be as follows:
                           Check in with the student before school (between 8:45 and 9:00) to
                            make sure that he or she is ready for the day.
                           Check out the student at the end of school (between 3:15 and 3:25)
                            to find out how his or her day was, make sure that he or she has the
                            homework for the night, and review behavior chart.
                           Keep a daily record of your check in - check out data. (more
                            information will follow)
                    At this time, send names of students who you believe would benefit from
              participating in this program. In addition, if you would like to volunteer to be a
              mentor, send me an email. Please consider that the number of staff volunteers we
              have will determine the number of students we can service.


                                                                        Sincerely,
                                                                  Coordinator’s Name
                             Hawthorne Elementary School
                                        125 Kingston Road      Baltimore, MD 21220




  Sample
                    Date

             Dear Parent(s)/Guardian(s) of         Name of Student ,



 Student
             Your child, Name of Student , has been selected to participate in our Check In – Check
             out Program (formerly the Mentoring Program) this year! This is the second year that we will
             have this program at Hawthorne Elementary School. The purpose of this program is to build a
             positive relationship between a staff member and a student in order to help the student have


Invitation
             successful days both academically and behaviorally. By participating in the Check In – Check
             Out (CICO) program, your child will gain goal setting and organizational skills, and build a
             supportive relationship with a teacher, administrator, or resource person in addition to his or her
             homeroom teacher. The student will stop by his or her mentor’s classroom/office every morning
             and at dismissal for a quick meeting. Behavior and academic review will be discussed as well as


  Letter
             praise and encouragement. This is a simple, yet effective way to keep your child motivated.
             Your child will come home every day with a behavior calendar in order for you to see how they
             are progressing.

             If you are interested in having your child participate in this exciting program, please fill out the
             permission slip below and return it to your child’s homeroom teacher. If you have any questions,
             feel free to contact    Program Coordinator’s Contact Information                             .


                                                                                  Sincerely,

                                                                                  The PBIS Committee




             ___ Yes, I would like my child, ________________________________, to participate in the
             Check In – Check Out Program.

             ___ No, I would prefer that my child, ____________________________, not be assigned a
             Mentor.

             _________________________________                            ________________________
                              Parent Signature                                             Date
Matching Mentors & Students
Mentor Preference Sheet
 distributed listing participating
 students

Welcome letter sent to
 students & mentors
             Mentors,

                   I am in the process of matching mentors to students. Below are the



  Mentor
             names of students who have been recommended for the CICO program.
             Please let me know if you have a preference for who you would like to mentor.
             Place a check next to all of the names that you are willing to mentor. I will do
             my best to match mentors to students according to preferences.



Preference   Thank you.

             Coordinator’s Name




   Sheet                               Students                      I am willing to mentor…




                                  I have no preference
                               Check In – Check Out
                                Mentoring Program
         Dear Mentor,

              Thank you for choosing to be a mentor. The student that you will

         mentor this year is    Student’s Name . He is in

Mentor
                                                             Teacher’s Name

         homeroom class.

              Today, your student was sent a welcome letter instructing him/her


Letter   to meet you Day and Date      in your classroom between Time . This is

         the time for you to explain your expectations.     (Bring signed behavior

         chart and completed homework in the morning. Show me your behavior

         chart and homework assignments in the afternoon.)

              For those of you who have an afternoon or morning duty, the

         student can meet you at your post. Please make them aware of where you

         will be so that they can find you each day.

              I have also sent a reminder to your student’s homeroom teacher to

         remind the student to visit you in the mornings and to dismiss them to

         meet with you in the afternoon.

              If you have any questions, please let me know.



         Thanks,



         Coordinator’s Name
                                Check In – Check Out
                                 Mentoring Program
 Teacher        Dear Teacher,


& Student       Name.
                      Student’s Name
                Program on
                                                   will begin the CICO Mentoring
                                Day and Date . His mentor is Mentor’s
                           In addition to this letter I have placed an invitation

Welcome         for him to meet his mentor on Day . Please make sure that you
                send Student’s Name
                behavior chart to check out with
                                                   in the afternoon with his
                                                         Mentor’s Name . If you

 letters        have any questions, let me know.

                Thanks,

                     Coordinator’s Name




                                 Congratulations
                                        Student’s Name

            You have been selected and approved to participate in the Check
            In – Check Out program. Please meet your mentor Mentor’s
            Name      on Day ,     Date      in room Room Number
            between Time         . Remember to meet with your mentor
            everyday before school between Check In Time         and after
            school between    Check Out Time .
                  Tracking
Mentors given a log
Students given behavior chart
  [if one did not exist]
Daily CICO procedures
 -Students check in before 9:00
 -Students check out before 3:30
Spreadsheet created to track CICO
Mentors turned in log bi-weekly
Grid created to analyze data each month
               Welcome to the Check In – Check Out
                        Mentoring Program



    Log
                                Instructions

               1. Check in your student every morning. Remember

Instructions
                  to check for homework, a signed behavior chart,
                  and have a brief chat about your student’s
                  night and morning.
               2. Complete the check in – check out log for the
                  morning. Add any notes that are pertinent.
               3. Check your student out in the afternoon.
                  Remember to check for copied homework
                  assignments, a completed behavior chart. Have a
                  brief chat about your student’s day. Reward
                  your student for positive behavior.
               4. Complete the check in – check out log for the
                  afternoon. Add any notes that are pertinent.
               5. At the end of each two week period, please send
                  the folder to room ______ by 12:00 pm to input
                  the data. I will return the folder to you
                  before the end of the day. A list of dates to
                  turn in the folder is below.
            Date:                                      Date:

            Check In
            
                                Check Out           Check In
                                                       
                                                                          Check Out     
            Notes: ______________________              Notes: ______________________
            _____________________________              _____________________________
            _____________________________              _____________________________



  Check     Date:

            Check In            Check Out     
                                                       Date:

                                                       Check In           Check Out     

In/Check
                                                      

            Notes: ______________________              Notes: ______________________
            _____________________________              _____________________________
            _____________________________              _____________________________




 Out Log    Date:

            Check In
            
                                Check Out     
                                                       Date:

                                                       Check In
                                                       
                                                                          Check Out     
            Notes: ______________________              Notes: ______________________
            _____________________________              _____________________________
            _____________________________              _____________________________



            Date:                                      Date:

            Check In
            
                                Check Out           Check In
                                                       
                                                                          Check Out     
            Notes: ______________________              Notes: ______________________
            _____________________________              _____________________________
            _____________________________              _____________________________



            Date:                                      Date:

            Check In
            
                                Check Out           Check In
                                                       
                                                                          Check Out     
            Notes: ______________________              Notes: ______________________
            _____________________________              _____________________________
            _____________________________              _____________________________


           Mentor Signature: _______________________   Mentor Signature: _______________________
                                            Check In – Check Out
                                             Monthly Data Sheet

                 Start   September               October           November               December                 January
          Name   Date                                      Check                                                            Check
                         Check In   Check Out   Check In           Check In   Check Out   Check In   Check Out   Check In


Monthly
                                                            Out                                                              Out




 Grid
                Data
Behavior Chart Data Analysis

Analyzed by coordinator and PBIS
 committee monthly

Shared at SST & IEP meetings

Used to evaluate & refine program
PBIS Triangle 2005-2008
CICO Data Collection
              CICO 2007-2008 Data
                                                                                Referrals    Add. referrals
                                                                   Referrals                                Referrals to
                                                Start   Behavior               since start    since 30 day
 Mentors      Students     Grade    Teacher
                                                Date     chart
                                                                    before
                                                                                date +30     benchmark to
                                                                                                            date 2007- Suspensions
                                                                    CICO                       end of year     2008
                                                                                  days

  Rouse       Student 1     1       Ellinger    1/14       N          0            0              0            0           0
                                                                                                            5 Majors,
  Klocko      Student 2     2        Rouse       1/3       Y          8            0             18        21minors        1
                                                                                                            1 Major,
 Newton       Student 3     3        Morin      11/15      N          0            0              3         2 minors       0
                                                                                                            2 Majors,
 Bradham      Student 4     3      Buckingham   11/15      Y          6            2              1         7 minors       1
                                                                                                           10 Majors,
  Ellinger    Student 5     3       K. Myers    11/20      Y          10           5              2         7 minors       0
                                                                                                            5 Majors,
  Allison     Student 6     3       K. Myers    12/14      Y          2            2              9         8 minors       0
                                                                                                            2 Majors,
 Bradham      Student 7     4       Barsotti    12/10      Y          1            1              2         2 minors       0
                                                                                                            1 Major,
 Stuckey      Student 8     4       Barsotti    11/15      Y          0            1              1          1 minor       0
                                                                                                            3 Majors,
 Beilman      Student 9     4       Barsotti    11/28      Y          3            0             11        11 minors       0
                                                                                                            6 Majors,
Pederson      Student 10    4       Barsotti    11/26      Y          1            1              7         3 minors       1
                                                                                                            2 Majors,
 DeRoso       Student 11    4       Barsotti    11/30      Y          2            0              6         6 minors       0

  Baker       Student 12    5       J. Myers    11/15      N          0            0              0            0           0

  Taylor      Student 13    5       J. Myers    11/15      Y          0            0              2        2 minors        0
                                                                                                            1 Major,
  Klocko      Student 14    5        Sexton     12/4       N          0            1              1         1 minor        0

 DePetris     Student 15    5        Sexton     11/15      Y          1            0              1        2 Majors        0
                                                                                                           4 Majors,
Lorraine W.   Student 16    5       DeRoso      11/15      Y          0            0              7        3 minors        0
                                                                                                           5 Majors,
 LaPorta      Student 17    5       DeRoso      11/26      Y          2            0              8        5 minors        1
                                                                                                           2 Majors,
  Klocko      Student 18    5       DeRoso      1/14       Y          1            0              3        2 minors        0
       Student 5’s Behavior Chart Data                       Student 5's Behavior Data
                                                                 February-08


                                                                                                                                                                          **Can
Date     Goal 1: Hands & feet to self           Goal 2: Stay in seat.               Goal 3: Respect others.                        Homework                             earn 72
                                                                                                                                                                       pts. Goal
                                                                                                                                                                         is 60**
                                                                                                                                                         Not            Daily
        MW RG LA SP      L   M   RC SS MW RG LA SP            L    M   RC SS MW RG LA SP          L   M   RC SS    C o m ple t e   Inc o m ple t e
                                                                                                                                                     C o m ple t e d    Total

  2/1    3   3   3   3   3   3    3     3   3   3   3    3     3   3    3   3   3     3   3   3   3   1    3   3        X                                                    70
  2/4    3   3   3   3   3   3    3     3   3   1   2    3     3   3    3   3   3     3   3   3   3   2    3   2        X                                                    67
  2/5    3   3   3   3   3   3    3     3   3   3   3    3     3   3    3   3   3     2   2   3   3   3    3   1        X                                                    68
  2/6    3   3   3   3   3   3    3     3   3   2   2    3     3   1    3   3   3     3   3   2   3   3    3   2        X                                                    66
  2/7    3   3   3   3   3   3    3     3   3   1   3    2     3   3    3   3   3     1   3   3   3   3    2   3        X                                                    66
  2/8    3   3   3   3   3   3    3     3   3   3   3    1     3   3    3   3   3     3   3   2   3   3    3   2        X                                                    68
 2/11    3   3   3   3   3   3    3     3   3   1   3    3     3   2    3   3   3     3   3   3   3   3    3   3        X                                                    69
 2/13
 2/14    3   3   3   3   3   3    3     3   3   3   3    3     3   3    3   3   3     2   3   3   3   3    2   2        X                                                    69
 2/15    3   3   3   2   3   3    3     3   3   1   3    2     3   3    3   3   3     3   3   2   3   3    3   3        X                                                    67
 2/19    3   3   3   3   3   3    3     3   3   2   3    3     3   3    3   2   3     1   2   3   3   3    3   3        X                                                    67
 2/20    3   3   1   3   3   3    3     3   3   1   3    3     3   2    3   3   3     3   3   3   3   3    3   3        X                                                    67
 2/21    3   3   3   3   3   3    3     1   3   3   3    3     3   2    3   1   3     3   3   2   3   3    3   1        X                                                    64
 2/22
 2/25    3   2   2   3   3   3    3     3   3   3   3    3     3   3    3   3   3     2   2   3   3   3    3   2        X                                                    67
 2/26    3   3   3   3   3   2    3     3   3   3   3    3     3   3    3   3   3     1   3   3   3   3    3   2        X                                                    68
 2/27    3   2   2   3   2   3    3     3   3   1   3    3     3   2    3   3   3     2   3   3   3   3    1   3        X                                                    63
     Ideas For Next Year…
Came from End of Year Recommendation Form

 -Training for mentors
 -Announcement reminders
 -Monthly incentives
    Platinum paw, lunch w/mentor, invite a
    friend, pizza party…
 -Daily rewards
 -Possible script for mentors
 -Recording sheet for CICO students
 -Exit criteria
                                      Check In – Check Out Program
                Dear Administrators, Teachers and Staff,

                      In order to begin the Check In – Check Out program earlier next year, I am asking for


 End of Year
                your help at the end of this year. Below, spaces are provided for you to recommend
                students for the CICO program, recommend students for a possible homework club, provide
                feedback for this year’s CICO program, and sign up as a mentor for next year.




Recommendatio
                Thank you,

                Coordinator’s Name
                                      Check In – Check Out Recommendations


    n form                     Name                   Grade
                                                                     Reason for Recommending Student

                                                               Behavior
                                                                           (circle all that apply)
                                                                          Attendance   Homework   Extra Support
                                                               Behavior   Attendance   Homework   Extra Support
                                                               Behavior   Attendance   Homework   Extra Support
                                                               Behavior   Attendance   Homework   Extra Support
                                                               Behavior   Attendance   Homework   Extra Support

                                         Homework Club Recommendations

                1.                                             2.
                3.                                             4.
                5.                                             6.
                7.                                             8.

                1. Would you like to be a mentor for the CICO program next year?           Yes           No

                2. Would you like to work with the homework club?                          Yes           No

                3. How can the CICO program be improved next year? ___________________________________

                __________________________________________________________________________________________

                __________________________________________________________________________________________

                Name: _________________________________
Question and Answer
         Contact Information
Hawthorne Elementary
Phone #: 410.887.0138
Email:   Bridget Bradham
         Bbradham@bcps.org
         Aneila Rouse
         arouse@bcps.org
         Ann Stuckey
         astuckey@bcps.org
         Kim Myers
         kmyers3@bcps.org

								
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