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PD-1/4 FORM CONTENTS: |
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THE STATE EDUCATION DEPARTMENT THE UNIVERSITY OF THE STATE OF NEW
YORK / ALBANY, NY 12234 |
To: |
Special Education Data Managers of Public School
Districts Superintendents of Public School Districts |
September 2006 |
From: | Inni
Barone |
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Subject: |
PD-1/4
– Public School District Report of Number of Students with
Disabilities Provided Special Education on December 1, 2006 and Number
of Students with Disabilities Provided Special Education in Regular
School-Based Programs and in Separate Settings.
Important: Due Date is Between December 1, 2006 and December 15, 2006. |
Attached is the PD-1/4 form for your use in recording child count and educational placement information for all students with disabilities (ages 3-21) who are the responsibility of your Committee on Preschool Special Education (CPSE) or Committee on Special Education (CSE) and receive special education programs and/or services on December 1, 2006. This form also requests the numbers of students with disabilities who are parentally placed in nonpublic elementary and secondary schools located in your school district. This count will be used by school districts to determine the minimum proportionate per-pupil amount of IDEA funds to be used for services for these students during the 2007-08 school year. Beginning in the 2006-07 school year, the Department will request data on the numbers of parentally placed students in elementary and secondary nonpublic schools located in your school district who are referred for special education services, the numbers of such students who are determined to be eligible for special education services and the numbers of such students who are provided special education services anytime during the entire school year. These data are required pursuant to sections 612 and 618 of Public Law 108-446.
The PD-1/4 data are to be submitted by all school districts by entering the data through the website at http://pd.nysed.gov or by using the File Transfer Protocol (FTP) process. Paper copies of this report are not accepted. The web-based PD data entry system provides immediate feedback on any data reporting errors and allows school districts to make any necessary corrections. A User ID and password to access the web-based system has been mailed to the latest contact person identified on the PD website. If your school district has a new contact person, or did not get this information, please contact my office. Please note: if your school district has the capability of submitting PD-1/4 data through the FTP process, the User Name and password for that process are different from the User ID and password that has been assigned to the contact person to submit PD data through the PD website. If your school district needs a User Name and password to submit data through the FTP process, please contact this office.
The due date for this report is between December 1, 2006 and December 15, 2006. Only the Certification and Assurance Form (page 1 of the PD-1/4 form), with an original ink signature, must be submitted through regular mail. Paper copies of this report will not be accepted. Your timely and accurate completion of this report is required in order to ensure full compliance with federal reporting requirements.
The data entered on the PD-1/4 form will provide the December 1, 2006 count of students with disabilities and will indicate the extent to which students with disabilities are removed from regular education and are placed in separate educational settings outside of regular school facilities or are educated in some other specific settings. This report requests data regarding the settings in which students receive regular and special education services and will not affect your State aid allocations in any way. (In contrast, the State Aid Management System (SAMS) Form A form set collects data for State aid purposes regarding the cumulative extent to which students receive special education programs and/or services.)
Data from the PD-1/4 form, child count data from Charter Schools on the PD-1C/4C form, program expansion information from Charter Schools, and information provided on the SEDCAR-1 forms, which will be sent to school districts by approved special education programs (ASEP), will establish the number of school-age and preschool-age students with disabilities to be included in local level calculations to determine the school district’s 2007-2008 federal fund allocation under IDEA sections 611 and 619. These data will also be useful in determining:
To be counted in this report, each student with a disability, must meet the following criteria as of December 1, 2006:
OR
AND, in addition to either one of the criteria described above:
Federal law and regulations require that State and local education
agencies ensure an unduplicated count of students with disabilities.
Before submitting the PD-1/4 report, please complete local verification
procedures to ensure that each student is counted only once. Such
verification procedures may include visual scans, computer scans or
other methods; and are especially important for school districts having
several school buildings and for students receiving multiple special
education programs and/or services.
The State Education Department will confirm the accuracy of information
included in this report as part of the program review process, or as is
otherwise indicated. To facilitate such review of your school district,
please maintain a list (hard copy or other readily retrievable format)
of all students included in this report until June 30, 2014. Upon
completing local verification procedures, if it is determined that one
or more counts are incorrect, a revised report (i.e., PD-1/4 form) must
be submitted to SED.
Compared to the PD-1/4 report for December 1, 2005, the December 1,
2006, PD-1/4 report is revised in the following ways in order to
accommodate changes in federal reporting requirements and data
management needs:
During 2006-2007, Strategic Evaluation Data Collection Analysis and
Reporting (SEDCAR) Unit personnel may be available to conduct a limited
number of regional training programs regarding the various special
education data forms (i.e., the PD forms). If you feel that such
training would be useful to the data managers in your area, please
contact your local Special Education Training and Resource Center (SETRC).
The data collected through the PD forms are used in the following
reports and activities:
If you have any questions or are in need of assistance in completing
this report, please contact the SEDCAR Unit by using the contact
information provided in the letterhead.
Thank you for your cooperation in submitting accurate and timely data.
Attachment
The
University of the State of New York
THE STATE EDUCATION DEPARTMENT
Office of Vocational and Educational Services for Individuals with
Disabilities (VESID)
Strategic Evaluation Data Collection, Analysis and Reporting (SEDCAR)
One Commerce Plaza – Room 1613
Albany, NY 12234
Instructions: |
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School District Information |
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(Enter 12-digit SED Code Below) |
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SCHOOL
DISTRICT NAME |
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ADDRESS
(include building name, room number , or mail stop information) |
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CITY | STATE | ZIP | |||||||||||||
Contact Person Information* |
Director of
Special Education
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NAME |
NAME | ||||||||||||||
TITLE |
TITLE | ||||||||||||||
TELEPHONE
(include Area Code) |
TELEPHONE (include Area Code) | ||||||||||||||
FAX NUMBER (include Area Code) |
FAX NUMBER (include Area Code) | ||||||||||||||
E-MAIL
ADDRESS |
E-MAIL ADDRESS |
*All correspondence from SEDCAR will be directed to the contact person identified in the PD web based data entry system at http://pd.nysed.gov. Please keep the contact information current, including the e-mail address as most communication will occur via e-mail. |
I have reviewed the PD-1/4 data that has been submitted
electronically to the State Education Department. I will also review any
modifications that may be made to these data and the final verification report
that will be issued to the school district by the State Education Department.
These data provide the number of students with disabilities provided special
education programs and/or services on December 1, 2006 and number of students
with disabilities provided special education in regular school-based programs
and in separate settings. I certify that this is a complete and accurate count
of students with disabilities served on December 1, 2006. I further certify that
the students reported were the responsibility of this school district’s CSE or
CPSE or were parentally placed in nonpublic schools located in this school
district, had a current Individualized Education Program, and received publicly
funded special education programs and/or services that met State standards.
I assure that IDEA funds will be sub-allocated, in a manner consistent with
State and federal laws and regulations, to Charter Schools in which resident
students with disabilities are enrolled and provided special education services
directly or indirectly by Charter Schools and to approved special education
programs. I also assure that students with disabilities who are parentally
placed in nonpublic schools located in this school district will be provided a
proportionate share of special education services supported with IDEA funds.
__________________________ |
___________________ |
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Superintendent Must Sign and Date on or after December 1, 2006 |
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- Resident students with disabilities in district operated educational programs;
- Resident students with disabilities in the New York State School for the Blind in Batavia and in the New York State School for the Deaf in Rome;
- Resident students with disabilities in Charter Schools;
- Students with disabilities who were residents of the school district at the time they were placed by the courts or State agencies in out-of-State approved residential schools;
- Resident students with disabilities in BOCES programs;
- Resident students with disabilities who are placed by the school district in Special Act School Districts;
- Resident students with disabilities who are placed by the school district in approved private schools for students with disabilities;
- Resident students with disabilities who are placed out-of-State as Emergency Interim Placements;
- Resident students with disabilities who are parentally placed in nonpublic elementary and secondary schools located in the school district and in nonpublic elementary and secondary schools located in other school districts.
This section contains three Tables. Table 1 requests placement information by age, gender and race/ethnicity category for all preschool students with disabilities, ages 3 to 4, who are the responsibility of the school district’s CPSE. These students must be receiving preschool special education programs and/or services, pursuant to Sections 4201 or 4410 of the Education Law, on December 1, 2006. This table also requests a subset of the number of preschool children who receive related services only. Table 2 requests the counts of preschool students with disabilities who are provided preschool special education services by five approved preschool special education providers (the County of Hamilton Preschool Program, the County of Niagara Preschool Program, the County of Otsego Preschool Program, the County of Suffolk Preschool Program, and the County of Westchester Preschool Program). These data will be used by the Department to calculate the minimum per-pupil federal sub-allocation, which school districts must provide to the approved special education providers. Table 3 is to report the count of preschool students with disabilities, age 2, who are receiving preschool special education services, pursuant to Sections 4201 or 4410 of the Education Law, on December 1, 2006.
Table 1 requests data on the environments in which preschool students with disabilities attend and receive educational services. The preschool environments are new for 2006-07. Use the following decision rules to determine which environment to use when reporting each student. Please note that the order of the environments for students with disabilities ages 3-4 does not reflect a continuum from least to most restrictive.
Early childhood program - is a program that includes at least 50% nondisabled children. Early childhood programs include, but are not limited to:
- private preschools;
- Head Start;
- child care facilities (group child care, day care centers);
- preschool classrooms open to an eligible pre-kindergarten population by the public school system (universal pre-k programs);
- special class in an integrated setting , if class contains at least 50% nondisabled children.
Special education program – is a program that includes less than 50 percent nondisabled students. Special education programs include, but are not limited to, special education programs and related services provided in:
- Special education classrooms in
- Regular school buildings;
- Trailers or portables outside regular school buildings;
- Child care facilities;
- Hospital facilities on an outpatient basis;
- Other community-based settings
- Separate schools; and
- Residential facilities.
When determining whether to report a student in lines 1.1, 1.2, or 1.3, you must calculate the percentage of time the child spends in a regular early childhood program. The numerator for this calculation is the amount of time per week the child spends in a regular early childhood program. The denominator for this calculation is the total number of hours the student spends in a regular early childhood program PLUS any time the child spent receiving special education and related services outside of a regular early childhood program. The result is multiplied by 100. For example,
Line 1.1 | In the regular early childhood program at least 80% of the time. Unduplicated total who attended an early Childhood program for at least 80% of time (see instructions for Calculating Time in Regular Early Childhood Programs). |
Line 1.2 | In the regular early childhood program 40% to 79% of time. Unduplicated total who attended an early childhood program and were in the early childhood program for no more than 79%, but no less than 40% of time (see instructions for Calculating Time in Regular Early Childhood Programs). |
Line 1.3 | In the regular early childhood program less than 40% of time. Unduplicated total who attended an early childhood program and were in the early childhood programs for less than 40% of time (see instructions for Calculating Time in Regular Early Childhood Programs). |
Line 2.1 | Separate class. Unduplicated total who attended a special education program in a class with less than 50% non-disabled students. (Do not include students who also attended a regular early childhood program. These students should be reported in lines 1.1, 1.2, or 1.3.) |
Line 2.2 | Separate school. Unduplicated total who received education program in public or private day schools designed specifically for students with disabilities. (Do not include students who also attended a regular early childhood program. These students should be reported in lines 1.1, 1.2 or 1.3.) |
Line 2.3 | Residential facility. Unduplicated total who received education programs in publicly or privately operated residential schools or residential medical facilities on an inpatient basis. (Do not include students who also attended a regular early childhood program. These students should be reported in lines 1.1, 1.2 or 1.3.) |
Line 2.4 | Home. Unduplicated total who received special education and related services in the principal residence of the student’s family or caregivers, and who did not attend an early childhood program or a special education program provided in a separate class, separate school, or residential facility. Include students who receive special education both at home and in a service provider location. The term caregiver includes babysitters. |
Line 2.5 | Service provider
location. Unduplicated total who received all of their special
education and related services from a service provider, and who
did not attend an early childhood program or a special education
program provided in a separate class, separate school, or
residential facility. For example, speech instruction provided in:
Do not include students who also received special education at home. Students who received special education both in a service provider location and at home should be reported in the home category. |
Section B, Table 1, requests the count of all school-age students for whom the district has CSE responsibility to provide special education services, and is providing such services on December 1, 2005. To comply with requirements of IDEA section 612(a)(10), this Table is also used to collect the numbers of students with disabilities who are parentally placed in nonpublic elementary and secondary schools, located in the school district, and provided publicly funded special education services. Additional directions to assist school districts to accurately complete this Table are provided above the Table. The school districts of residence maintain CSE responsibility for students except in the following circumstances:
Section C,
Reports 1-14: There are three tables for each disability category-
Table 1 and Table 2 and Table 3. These tables request placement information for all
school-aged students with disabilities, ages 4-21, who are the
responsibility of your CSE and are provided school-age special education
programs and/or services on December 1, 2006. Each student is reported
only once in one of the three tables.
Table 1: Report the number of students with disabilities who are educated in regular school buildings and removed from regular classes for "Less than 20%", "21% to 60%", or "More than 60%" of the school day or school week. "Regular school buildings" are buildings for both disabled and nondisabled school-age students. "Regular classes" are classes for both disabled and nondisabled school-age students. Time outside of regular classroom is a measure of the extent of removal from the regular classroom setting, NOT of the total amount of special education services provided. It is the percent of each school day or week that a student receives special education including related services, apart from nondisabled students while within a regular school building. For purposes of these data collection, students in the following settings should be reported in Table 1 (regular school buildings):
In order to determine the percentage of time students receive services outside regular classrooms (i.e., in rooms/groupings attended by students with disabilities only), it is important to consider where the service is provided rather than the type of service that is provided. To calculate the percentage of time outside the regular classroom, divide the number of hours the student receives special education and related services outside the regular classroom each day or week by the total number of hours in the school day or school week. Use the length of the entire school day, including all periods and lunch. The following examples are provided for purpose of clarification:
Table 2: Report the number of students with disabilities for whom the school district has CSE responsibility and who are educated in separate educational settings. These are settings, which are attended by students with disabilities only. The definition of each separate educational setting follows:
Special Public Day Schools - Include public day schools that are
attended by students with disabilities only. These schools include
public school district or BOCES buildings, which are attended by
students with disabilities only. These schools also include Special Act School
Districts if students attend on a day school basis, and if they include students
with disabilities only. Students with disabilities who attend the two State-operated schools, on a day basis, would also be
reported in this category.
Special Private Day Schools -
Include approved private schools for
students with disabilities, and State-supported schools (Section 4201
schools), which are attended, by students with disabilities only, on a
day basis.
Public Residential Facility - Include public residential
facilities in which students with disabilities are placed by the school
district and attend an education program affiliated with the facility
in buildings that serve only students with disabilities. Public
residential facilities include the two State-operated schools, and the
Special Act School Districts. Students with disabilities, who are in
residential facilities but are provided special education services in
buildings that include nondisabled students, should be reported in Table
1.
Private Residential Facility - Include private residential
facilities in which students with disabilities are placed by the school
district and attend an education program affiliated with the facility
in buildings that serve only students with disabilities. Also,
include students with disabilities who are placed in private residential
facilities by the courts or State agencies, but for whom the district
has CSE responsibility (e.g., students with disabilities who were
residents of the district at the time they were placed by the courts or
State agencies in private out-of-State residential facilities). Private
residential facilities include State-supported schools (Section 4201
Schools) with a residential component and approved private schools
(in-State and out-of-State). Students with disabilities, who are in
residential facilities but are provided special education services in
buildings that include nondisabled students, should be reported in Table
1.
Home - Use this setting if the school district
Committee on Special Education has determined the home as the student’s
placement on December 1. Students who are home-schooled by parent’s choice
should not be reported in this category, but rather in Table 3.
Hospital or Other Non-School-
These are settings in which
students with disabilities are provided special education services based
on their unique needs.
Table 3: Report the number of students with disabilities for whom the
school district has CSE responsibility and who are educated in the
specific setting described below.
Incarcerated in Correctional Facilities - Use this setting to report
students with disabilities who are incarcerated in county correctional
facilities or in secure detention facilities. All students with
disabilities in secure detention facilities will be reported by the Office of
Children and Family Services (OCFS). School districts will report in this row
only students with disabilities who are provided special education services in
county correctional facilities that are located in the school district.
Home Schooled - Use this setting to report students with disabilities who
are home-schooled at parent choice, but who are provided special
education programs or services at public expense.
Parentally Placed in Non Public Schools - Use this setting to report
students with disabilities who are parentally placed in non-public
schools at private expense, but who are provided special education
services at public expense.
Enter the total number of preschool students with disabilities for whom this school district has CPSE responsibility to ensure the provision of special education programs and/or services. Report preschool students who were 3 to 4 years of age and who received preschool special education programs and/or services on December 1, 2006. In Column N, report the number of students who were provided related services only. Students reported in Column N are a subset of Column C. Column N cannot be greater than Column C. Only count students who were served pursuant to Sections 4410 or 4201 of the Education Law. Please determine age as of December 1, 2006. Counts reported in Tables 1 and 2 of this section, Table 1 of Section B and information contained on the SEDCAR-1 forms which school districts will receive from approved special education programs, will assist school districts in determining the amount of federal IDEA funds, under sections 611 and 619, which must be sub-allocated to other programs, and the amount to be retained by the school district, for students with disabilities, ages 3-5. (Important information for completing this section is included in the Directions and Definitions for Section A, beginning on page 3.)
A | B | C | D | E | F | G | H | I | J | K | L | M | N | |||
Educational Environment1 |
Age 3 | Age 4 |
Total # of Students Ages 3-4 |
Male | Female |
Total Gender |
American Indian/ Alaska Native |
Asian or Pacific Islander |
Black (Not of Hispanic Origin) |
Hispanic or Latino |
White (Not of Hispanic Origin) |
Multi- Racial (Not of Hispanic Origin) |
Race Total |
Subset of Column C (# of Students Receiving Related Services only) |
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(1.0) Students Attending Regular Early Childhood Program |
(1.1) In the Regular Early Childhood Program at Least 80% of Time |
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(1.2) In the Regular Early Childhood Program 40% to 79% of Time |
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(1.3) In the Regular Early Childhood Program Less than 40% of Time |
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(2.0) Students Not Attending a Regular Early Childhood Program |
Attending a Special Education Program |
(2.1) Separate Class |
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(2.2) Separate School |
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(2.3) Residential Facility |
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Not Attending a Special Education Program |
(2.4) Home |
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(2.5) Service Providers Location |
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(3.0) TOTAL |
*Students who are 5 years of age on December 1, are “school-age”
students, and must be reported in Sections B and C of this report and
not in Section A.
1The order of these settings does not reflect a continuum from least to
most restrictive.
Of the preschool students reported in Table 1, Line 3.0, Column N, enter the number of preschool students with disabilities, by age as of December 1, 2006, provided preschool special education programs and/or services by the five approved preschool special education providers listed below. Provide a count of preschool students who received special education and/or related services from these providers only or if these providers were designated as the “coordinating provider” by the CPSE for children serviced by multiple providers. The information entered in this table is a subset of data provided in Table 1 above. (All students reported in Column D of this Table must also be reported in Table 1 above.) The information provided below will be used by the State to calculate the minimum per-pupil amount of federal IDEA funds to be sub-allocated by school districts to approved special education providers for the 2007-08 school year. The methodology for calculating the per-pupil amount of federal funds for sub-allocation to approved special education providers was revised for the 2006-07 and subsequent school years and is described in Chapter 437 of the Laws of 2005. Please reconcile the data you provide in this table with records maintained by the county of the number of preschool children provided special education services by the county operated preschool program. The following contacts are provided for your information:
Hamilton County | Ann LaForest Phillips | (518) 648-6141 |
Niagara County | Stacy Lampman | (716) 439-7463 |
Otsego County | Patricia Zawisza | (607) 547-6674 |
Suffolk County | Meryl Zaglin | (631) 853-2296 |
Westchester County | Marina Yoegel | (914) 813-5088 |
Line Number |
Specific Preschool Programs |
A | B | C | D |
Age 3 |
Age 4 |
Total Ages 3 to 4 |
Subset of Students in Column C Receiving Related Services Only | ||
01 |
Hamilton County
Preschool Program (BEDS Code: 200401640009) |
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02 |
Niagara
County Preschool Program (BEDS Code: 400400880021) |
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03 |
Otsego County Preschool Program (BEDS Code: 471701640030) |
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04 |
Suffolk County Preschool Program (BEDS Code: 580506640005) |
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05 |
Westchester County Preschool Program (BEDS Code: 662200640002) |
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06 | Total |
Line Number |
Description |
Age 2* |
1 |
Provide the count of preschool students with disabilities, who were 2 years old on December 1, 2006, and were receiving preschool special education programs and/or services on December 1, 2006. Report students who were the responsibility of your school district’s CPSE, and who were provided services pursuant to sections 4410 or 4201 of the Education Law. |
*Students who are 2 years old on December 1, 2006 (who will turn 3 years of age by December 31, 2006) and are receiving
preschool special education services, pursuant to section 4410 of the Education Law, should be included in this column.
Provide an unduplicated count of all school-age students
with disabilities who are the responsibility of this school
district’s CSE or are parentally placed in nonpublic elementary and
secondary schools located in this school district
and receiving special education programs and/or services on December 1,
2006. School districts will use the counts reported in Lines 1-7 in this section, child count data from Charter Schools on the PD-1C/4C forms, any enrollment expansion information from Charter Schools, and information in the SEDCAR-1 forms from approved special education providers to determine the per-pupil amount of 2007-08, federal IDEA funds under Sections 611 and 619 to be sub-allocated to approved special education providers, Charter Schools, and the per-pupil amount to be available to serve students who are parentally placed in nonpublic elementary and secondary schools located in the school district and the amount to be retained by school districts for school-age students with disabilities. In addition to the description provided for each Line below, the following are additional clarifications:
Please see additional directions and definitions for Section B, Table
1 on page 5 of 34 for information regarding CSE responsibility and
school district’s responsibilities related to students who are
parentally placed in nonpublic elementary and secondary schools located
in the school district. If you have specific questions regarding school
district’s responsibilities please contact your regional associate. |
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Line No. |
Report Each Student Only Once | Ages 4-5 | Ages 6-21 |
1 | Count of school-age students provided special education services in district-operated programs. (See above directions for additional guidance on who to include.) | ||
2 | Count of school-age students who are residents of this school district and are parentally placed in nonpublic schools located in this school district and who are provided publicly funded special education services as of December 1, 2006. | ||
3 | Count of students with disabilities who are residents of other school districts and parentally placed in nonpublic schools located in this school district and who are provided publicly funded special education services as of December 1, 2006. | ||
4 | Count of school-age students placed by the CSE in other public school district programs and provided special education programs and/or services. (Do not include in this line students placed in a Special Act School District.) | ||
5 | Count of school-age students provided special education services full-time in programs operated by a Board of Cooperative Educational Services (BOCES). | ||
6 | Count of school-age students provided special education services while enrolled in a Charter School. | ||
7 | Count of school-age students provided special education services in approved private schools for students with disabilities, and State-supported schools listed in Section 4201 of the Education Law. Include students with disabilities who were resident to this district at the time they were placed in out-of-State residential schools by courts or other State agencies. Also include in this line, all other out-of-State placements. | ||
8 | Subtotal (Sum of Lines 1-7): This number and information received by school districts on the SEDCAR-1 forms and information from Charter Schools will assist school districts to determine a per pupil amount of 2007-2008 IDEA funds to be sub-allocated to approved special education programs, Charter Schools and proportionate amount of IDEA funds that will be available for students with disabilities who are parentally placed in nonpublic elementary and secondary schools located in this school district. | ||
9 | Count of school-age students, provided special education services by contracting with Special Act School Districts, or in the New York State School for the Blind in Batavia or the New York State School for the Deaf in Rome. | ||
10 | Numbers of students with disabilities who are residents of this school district and are parentally placed in nonpublic schools located in other school districts and who are provided publicly funded special education services as of December 1, 2006. | ||
11 | Sum of Lines 1, 2, 4, 5, 6, 7, 9 and 10: This number represents the total number of school-age students who are the responsibility of this school district’s CSE and are provided special education programs and/or services on December 1, 2006. (The number entered for this line must match the number entered in Section C, Report 14 of this form.) |
Directions: Please review directions and definitions for completing reports 1-14 beginning on page 6. Report each student in only one disability report, in only one table and in only one Line.
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
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01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
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01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School
districts do not place students in these settings. Instead, students are in
these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in
these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in
these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in
these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
The three sections below aggregate the data reported in Reports 1 to 13 to facilitate State and local data verification procedures. Completing these two tables will facilitate the reporting of race/ethnicity, gender, and limited English proficiency, data in Reports 15A and 15B, 16A, 16B, 17A, and 17B.
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
Age Group | |||||||
4-5 | 6-11 | 12-13 | 14-17 | 18-21 | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Table 2: In Separate Settings. Outside of regular school facilities, in buildings that are attended by the students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Type of Setting | A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Special Public Day School | ||||||
02 | Special Private Day School | ||||||
03 | Public Residential Facility | ||||||
04 | Private Residential Facility | ||||||
05 | Home Placement | ||||||
06 | Hospital or Other Non-school | ||||||
07 |
Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Type of Setting |
A | B | C | D | E | F |
Age Group |
|||||||
4 - 5 |
6 -11 |
12 - 13 |
14 - 17 |
18 - 21 |
Total |
||
01 | Incarcerated in County Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 |
Total |
For all students reported in Tables 1, 2 and 3 of Report 14, in Column A (age group 4-5), enter the number, which appear to belong, identify with, or are regarded in the community as belonging to each race/ethnic group. (Each student should be counted once.) The Total (Column G) for each Line in this Report must match the number reported in Column A of each corresponding Line in Report 14.
Table 1: In Regular School-Based Programs in buildings attended by disabled and
nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Special Public Day School | |||||||
02 | Special Private Day School | |||||||
03 | Public Residential Facility | |||||||
04 |
Private Residential Facility | |||||||
05 | Home Placement | |||||||
06 | Hospital or Other Non-school | |||||||
07 | Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Incarcerated in County Correctional Facilities | |||||||
02 | Home Schooled at Parental Choice | |||||||
03 | Parentally Placed in Non-Public School | |||||||
04 | Total |
For all students reported in Tables 1, 2 and 3 of Report 14, in Columns B-E (age group 6-21) enter the number, which appear to belong, identify with, or are regarded in the community as belonging to each race/ethnic group. (Each student should be counted once.) The Total (Column G) for each Line in this Report must match the number reported in Column B-E of each corresponding Line in Report 14.
Table 1: In Regular School-Based Programs in buildings attended by disabled and
nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Special Public Day School | |||||||
02 | Special Private Day School | |||||||
03 | Public Residential Facility | |||||||
04 |
Private Residential Facility | |||||||
05 | Home Placement | |||||||
06 | Hospital or Other Non-school | |||||||
07 | Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Incarcerated in County Correctional Facilities | |||||||
02 | Home Schooled at Parental Choice | |||||||
03 | Parentally Placed in Non-Public School | |||||||
04 | Total |
For all students reported in Tables 1, 2 and 3 in the 4-5 year old age group of Report 14, enter the number, by gender and limited English proficient status. The Totals (Columns C and F) for each Line in this Report must match the Total (Column A) on each Line of Report 14.
Table 1: In Regular School-Based Programs in buildings attended by disabled and
nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Special Public Day School | |||||||
02 | Special Private Day School | |||||||
03 | Public Residential Facility | |||||||
04 |
Private Residential Facility | |||||||
05 | Home Placement | |||||||
06 | Hospital or Other Non-school | |||||||
07 | Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Incarcerated in County Correctional Facilities | |||||||
02 | Home Schooled at Parental Choice | |||||||
03 | Parentally Placed in Non-Public School | |||||||
04 | Total |
For all students reported in Tables 1, 2 and 3 in the 6-21 year old age group of Report 14, enter the number, by gender and limited English proficient status. The Total (Columns C and F) for each Line in this Report must match the Total of Columns B-E combined on each Line of Report 14
Table 1: In Regular School-Based Programs in buildings attended by disabled and nondisabled students
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 |
Total |
Table 2: In Separate Settings Outside of regular school facilities, in buildings that are attended by students with disabilities only. In Line 5, include students who are placed on home instruction by the CSE. Students who are home-schooled by parent choice should be reported in Table 3.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Special Public Day School | |||||||
02 | Special Private Day School | |||||||
03 | Public Residential Facility | |||||||
04 |
Private Residential Facility | |||||||
05 | Home Placement | |||||||
06 | Hospital or Other Non-school | |||||||
07 | Total |
Table 3: In Other Specific Settings. School districts do not place students in these settings. Instead, students are in these settings because of court decisions or parental choice.
Line Number |
Time OUTSIDE Regular Classroom |
A | B | C | D | E | F | G |
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or Alaskan Native |
Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi- |
Total |
||
01 | Incarcerated in County Correctional Facilities | |||||||
02 | Home Schooled at Parental Choice | |||||||
03 | Parentally Placed in Non-Public School | |||||||
04 | Total |
In the table below, report race/ethnicity data by disability and age group 4-5 for all students reported in Tables 1,2 and 3 age group 4-5 of Reports 1 to 13.
The total reported below in Column G for each disability must match the sum of
totals reported in Tables 1, 2 and 3 under the corresponding disability and age
group 4-5 in Reports 1 to 13. Also, the total reported in Line 14 for each
column must match the sum of corresponding columns of Tables 1, 2 and 3 of
Report 15A.
Racial/Ethnic Group for Students Ages 4-5 |
||||||||
Line Number |
Disability |
A | B | C | D | E | F | G |
American Indian or Alaskan Native | Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi-Racial (Not of Hispanic Origin) |
Total | ||
01 | Autism | |||||||
02 | Emotional Disturbance | |||||||
03 | Learning Disability | |||||||
04 | Mental Retardation | |||||||
05 | Deafness | |||||||
06 | Hearing Impairment | |||||||
07 | Speech or Language Impairment | |||||||
08 | Visual Impairment (includes Blindness) | |||||||
09 | Orthopedic Impairment | |||||||
10 | Other Health Impairment | |||||||
11 | Multiple Disabilities | |||||||
12 | Deaf-Blindness | |||||||
13 | Traumatic Brain Injury | |||||||
14 | Total (Lines 1-13) |
In the table below, report race/ethnicity data by disability and (age group
6-21) for all students reported in Tables 1,2 and 3 (age group 6-21) of Reports
1 to 13.
The total reported below in Column G for each disability must match the sum of
totals reported in Tables 1, 2 and 3 under the corresponding disability and age
group 6-21 in Reports 1 to 13. Also, the total reported in Line 14 of each
column must match the sum of corresponding columns of Tables 1, 2 and 3 of
Report 15B.
Racial/Ethnic Group for Students Ages 6-21 |
||||||||
Line Number |
Disability |
A | B | C | D | E | F | G |
American Indian or Alaskan Native | Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi-Racial (Not of Hispanic Origin) |
Total | ||
01 | Autism | |||||||
02 | Emotional Disturbance | |||||||
03 | Learning Disability | |||||||
04 | Mental Retardation | |||||||
05 | Deafness | |||||||
06 | Hearing Impairment | |||||||
07 | Speech or Language Impairment | |||||||
08 | Visual Impairment (includes Blindness) | |||||||
09 | Orthopedic Impairment | |||||||
10 | Other Health Impairment | |||||||
11 | Multiple Disabilities | |||||||
12 | Deaf-Blindness | |||||||
13 | Traumatic Brain Injury | |||||||
14 | Total (Lines 1-13) |
(These students are also reported in Reports 15B and 16B of this report.)
In the table below, report race/ethnicity data for students with disabilities ages 14-21 for whom the school district has CSE Responsibility. The total number of students reported in Column G of this report must be the same as the total number of students reported in Report 14, Tables 1, 2, and 3 in Columns D and E combined.
Line Number |
Category of Students |
A | B | C | D | E | F | G |
American Indian or Alaskan Native | Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi-Racial (Not of Hispanic Origin) |
Total | ||
01 |
Students with Disabilities, |
(These students are also reported in Reports 15A, 15B, 16A, 16B, 17A, 17B and, if applicable, in Report 18.)
In the table below, report race/ethnicity data for school-age students with disabilities, enrolled in Charter Schools, BOCES, approved private schools (including out-of-State court placements and emergency interim placements as of December 1, 2006), Special Act School Districts, State-Operated, and State-Supported Schools. The total reported in Line 7, Column G below must be the same as the sum of numbers reported in Section B, Table 1, Lines 5, 6, 7 and 9 of this PD-1/4 form. Furthermore, Line 1 below should equal Section B, Table 1, Line 6; Line 2 below should equal Section B, Table 1, Line 5; Line 3 plus Line 6 below should equal the number of students reported in Section B, Table 1, Line 7; Line 4 plus Line 5 below should equal the number of students reported in Section B, Table 1, Line 9.
Line Number |
Category of Students |
A | B | C | D | E | F | G |
American Indian or Alaskan Native | Asian or Pacific Islander |
Black (not of Hispanic origin) |
Hispanic or Latino |
White (not of Hispanic origin) |
Multi-Racial (Not of Hispanic Origin) |
Total | ||
01 |
Charter School |
|||||||
02 | BOCES | |||||||
03 | Approved Private School | |||||||
04 | Special Act School District | |||||||
05 | State-Operated Schools (In Rome and Batavia) | |||||||
06 | State-Supported Schools (Section 4201) | |||||||
07 | Total |