Minnesota Valley Area Learning Center ANNUAL CONTINUOUS LEARNING PLAN (CLP) FORM

To be completed by teacher and kept in cum folder for 3 years.

Student Name ______________________________________Grade Level______Home District ___________________Graduation Year__________ Current Status Goals Program/Activities Assessments
Targeted Services Referral 504 Plan in lace !"P in lace #t$er Social%emotional Tas& 'om letion Stud( S&ills #t$er Targeted Services )fter Sc$ool Summer Sc$ool

Formal Assessment(s) Standardi*ed District Tests District )ssessments Informal Assessments(s) Teac$er )ssessments '$ec&list of s&ill Develo ment

District Addendum: District credit and standard re+uirements are availa,le u on re+uest-

Current Status
__N/") _____3_____R_____/ __ST)R _____3_____R_____/ __3') _____3_____R_____/ __#t$er _____3_____R_____/ Descri,e ot$er __Social%"motional Status4 __Limited Relational S&ills __Limited Self5confidence%esteem __Poor Sc$ool )ttendance __Stud( S&ill Status4 __Limited #rgani*ational S&ills __Limited Stud( S&ill Strategies __Learning 3odalities #t$er4

Goals
__N/") _____3_____R_____/ __ST)R _____3_____R_____/ __3') _____3_____R_____/ __#t$er _____3_____R_____/ Descri,e ot$er __!m rove Social%"motional Status4 __Relational S&ills __Self5confidence%esteem __!m rove Sc$ool )ttendance __!m rove Stud( S&ills4 __#rgani*ational S&ills __Stud( Strategies #t$er4

Activities ./$at t(
rovided12

e of rogramming 0ill ,e

Assessments .enter after t$e

rogram is over2

__Direct !nstruction __Guided Practice __Hands 6 on "7 eriences __!ndividual Pro8ects __!ndividual Presentations __Grou Pro8ects __Grou Presentations __Simulations __Team 9uilding __Personal Gro0t$ )ctivities __Home5centered )ctivities __#t$er

__N/") _____3_____R_____/ __ST)R _____3_____R_____/ __3') _____3_____R_____/ __#t$er _____3_____R_____/ Descri,e ot$er __!m roved Social%"motional Status4 __Relational S&ills __Self5confidence%esteem __!m roved Sc$ool )ttendance __!m roved Stud( S&ills4 __#rgani*ational S&ills __Stud( Strategies #t$er4

Student Signature

Date

Parent Signature

Date

Teacher/Counselor Signature

Date

CONTINUOUS LEARNING PLAN (CLP) DIRECTIONS This exact form must be used. No substitutes are allowed. T$e 'ontinuous Learning Plan is to ,e com leted ,( t$e student:s classroom teac$er; t$e Targeted Services teac$er; t$e student; and t$eir arent.s2%guardian.s2- T$e 'LP 0ill ,e revie0ed eriodicall( during t$e sc$ool (ear and%or summer- !f a student is enrolled in summer session and t$en starts anot$er session during t$e sc$ool (ear; t$e 'LP needs to ,e u dated- ) new C P needs to ,e develo ed at t$e start of ever( sc$ool (ear t$at t$e student is enrolled in a Targeted Services rogram)t t$e to enter4 Student:s name; Grade level t$at t$e( are in t$is fall; Sc$ool District t$e student is from; and )ntici ated (ear of graduation from $ig$ sc$oolT$e Plan $as four .42 columns4 Column ! " Current status '$ec& all t$at a l(S&i District )ddendum !n t$e ,ottom ,o7 of column one enter an( data t$at (ou ma( $ave for4 N/") ST)R 3') #t$er Nort$0est "valuation )ssociation ST)R reading 3innesota 'om re$ensive )ssessments T$is 0ould ,e an( ot$er data t$at 0as used to lace t$e student in t$e rogram or t$at 0ill ,e used t$is fall- !dentif( t$e data source- "7am les mig$t ,e reading levels in Guided Reading Grou s; )R .)ccelerated Reading2 or mat$ level; !T9S or Stan< results3at$ Reading /riting

3 R /

You need to use some form of data as (our ,aseline for t$e 'urrent Status!n t$is same ,o7 (ou 0ill see items related to social%emotional issues- Targeted Services must focus on t$e 0$ole c$ild- Please c$ec& .=2 all t$ose t$at a l(!f t$ere is more information t$at 0ould ,e valua,le to t$e Targeted Services teac$er lease enter it in t$e #t$er area-

Column # " Goals T$is column is 0$ere (ou set t$e goals for t$is learner- T$e goals s$ould ,e set for one calendar (ear t$oug$ t$e data on t$is form 0ill ,e revie0ed eriodicall( including t$e end of t$e sc$ool (earSet goals for t$ose areas (ou &no0 (ou 0ill ,e 0or&ing onT$e Targeted Services rogram must include a social and emotional com onent- Please c$ec& .=2 t$ose t$at (ou 0ill 0or& onColumn $ " Program/Activities You are 0or&ing in a Targeted Services 5 )fter Sc$ool rogram or Summer Sc$oolT$is section s$ould give a ,rief overvie0 of t$e t( e of rogramming t$at (ou are roviding for t$is learner'$ec& .=2 0$ic$ t( e of activities (ou 0ill ,e using in teac$ing t$e after sc$ool rogram- 3D" re+uires t$at (ou do active and e7 eriential learning and teac$ing- Please give a ,rief descri tor in t$e ,lan&Column % " Assessments T$e goal of Targeted Services is to $ave t$e student ma&e t$e necessar( rogress sociall( and%or academicall( so t$at t$e( ma( remain in t$e regular educational sc$ool rogram- T$is > ost? data 0ill give t$e teac$er; arent and student information regarding t$e rogress t$at t$e( are ma&ing- !n t$is area (ou s$ould record t$e most current data (ou $ave for eac$ of t$e areas (ou assessed in t$e fall!t 0as t$e intention of t$e advisor( grou t$at develo ed t$e 3R@"D ro osal to t$e 3D"; t$at t$is form ,e com leted at a conference 0it$ t$e arent.s2; student; classroom teac$ers and Targeted Services teac$er- )t t$e end of t$e conference lease get t$e student and arent to sign t$e form- You sign t$e teac$er slotA co&' of t(is form must )e in t(e student*s cum folder !f (ou $ave an( +uestions related to t$is form and Targeted Services lease contact Aaren Baco,son; 3R@"D Director; CD05DE<5<D<F or &8aco,sonGmrved-net-