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PD-3A/4 FORM CONTENTS: |
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Section C |
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THE STATE EDUCATION DEPARTMENT THE UNIVERSITY OF THE STATE OF NEW
YORK / ALBANY, NY 12234 |
To: | Special Education Data Managers
and Chief Administrative Officers of: Department of Correctional Services Office of Children and Family Services Office of Mental Health Office of Mental Retardation and Developmental Disabilities |
Date: October 2006 |
From: | Inni Barone |
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Subject: | PD-3A/4 – State Agency Report: Number of Students with Disabilities Provided Special Education on December 1, 2006 and the Settings in Which Students with Disabilities are Provided Educational Services. Important: Due Date between December 1 and December 15, 2006. |
Attached is a new PD-3A/4 form to be used to report your count of pre-school and school-age students with disabilities provided special education programs and/or services on December 1, 2006. This report also requests the settings in which students with disabilities are provided educational services. This report is due in the State Education Department between December 1, 2006 and December 15, 2006 and should be submitted to:
New York State Education Department
Office of Vocational and Educational Services for Individuals with Disabilities
Strategic Evaluation Data Collection, Analysis and Reporting
Room 1613, One Commerce Plaza
Albany, New York 12234
To be counted in this report, each student with a disability, on December 1, 2006, must meet the following criteria:
Federal law and regulation require that state agencies ensure an unduplicated count of students with disabilities. Before submitting the PD-3A/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 agencies with multiple sites where students receive special education programs and/or services.
The New York State Education Department (NYSED) 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 for your agency, please maintain a list (hard copy or other readily retrievable format) of all students included in this child count 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-3A/4 form) must be submitted to SED.
Compared to the PD-3A/4 report for 2005-2006, the PD-3A/4 report for 2006-2007 has been modified in the following ways:
Please note that 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 call the Strategic Evaluation Data Collection, Analysis and Reporting (SEDCAR) Unit by using the contact information provided in the letterhead. Thank you.
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
One Commerce Plaza - Room 1613
Albany, NY 12234-0001
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School Information |
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(Enter 12-digit
SED Code Below) |
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STATE AGENCY
NAME |
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ADDRESS |
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CITY | STATE | ZIP | |||||||||||||
Contact Person Information* |
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NAME |
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TITLE |
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TELEPHONE |
FAX | ||||||||||||||
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 person information current, including the e-mail address, as most communication will occur via e-mail.
I have reviewed the information reported on this form and certify that this is a complete and accurate count of New York State students with disabilities served on December 1, 2006. I further certify that the students reported were served in accordance with their Individualized Education Programs and in accordance with State standards.
__________________________ |
___________________ |
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Chief Administrative Officer Must Sign and Date on or after December 1, 2006 |
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Section C, Reports 1-14: There are three tables for each disability category-
Table 1, 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.
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 programs and/or 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 percent 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 who are educated in separate educational settings. These are settings that are attended by students with disabilities only. The definition of each separate educational setting follows:
Special Public Day Schools - These schools include public school district or BOCES buildings that are attended by students with disabilities only. These schools also include Special Act School Districts if they are attended on a day school basis, and if they include students with disabilities only.
Special Private Day Schools - Approved private schools for students with disabilities that are attended by students with disabilities only, on a day basis.
Public Residential Facility - A public facility in which students reside and attend an education program affiliated with the agency, in buildings that serve only students with disabilities. If students with disabilities receive educational services in State agency buildings that are attended by both students with and without disabilities, they must be reported in Table 1.
Private Residential Facility - A private facility in which students reside, and attend an education program operated by the agency, in buildings that serve only students with disabilities. If students with disabilities receive special education programs and/or services in buildings that include disabled and nondisabled students, such students are to be reported in Table 1.
Home - Use this setting if the State agency’s Committee on Special Education has determined that the most appropriate educational placement for the student is in the student’s residence (or “home”), and not in a school setting.
Hospital or Other Non-School - These are settings in which students with disabilities are provided special education programs and/or services based on their unique needs.
Table 3: Report the number of students with disabilities for whom the agency has CSE responsibility and who are educated in the specific settings described below.
Incarcerated in Correctional Facilities - Use this setting to report students with disabilities who are incarcerated in county correctional facilities, secure detention facilities or in State correctional facilities. The Department of Correctional Services must report all students with disabilities who are provided special education services as of December 1, 2006 in this category and the Office of Children and Family Services must report all students with disabilities who are provided special education services in secure detention facilities as of December 1, 2006 in this category.
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.
School/Agency Name: ____________________________________ SED Code: _________________
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Check here if no preschool
students with disabilities are provided special education programs
and/or services in your agency on December 1, 2006. If so, skip Section
A. |
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Check here if no school-age students with disabilities are provided special education programs and/or services in your agency on December 1, 2006. If so, skip Sections B and C. |
If both boxes are checked, your PD-3A/4 report is complete. Please complete page 1 and return the entire form to the address printed on the top of page 1.
Table 1: If this agency operates an approved preschool
special education program, in Line 1 report the number of preschool
children provided full-time or part-time special class programs and/or
special education itinerant teacher (SEIT) services on December 1, 2006.
In Line 2, report the number of preschool children provided related
services only on December 1, 2006. If children are provided related
services as well as special class services and/or SEIT services, they
should be included in Line 1 only. Report children by age as of December
1, 2006. Do not include preschool children receiving evaluation services only in this table. Please note that for students receiving itinerant services and/or related services from more than one approved preschool special education program, only the program that provides itinerant services or is designated by the CPSE to coordinate all related services must count the students in this report. |
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Line No. | Type of Preschool Special Education Service | Ages 3-4* | Age 2** |
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1 | Count on December 1, 2006 of preschool children provided full-time or part-time special class services or special education itinerant teacher (SEIT) services. If children receive special class or SEIT services as well as related services, count them in this line, not in Line 2. | ||
2 | Count on December 1, 2006 of preschool children provided only related services. | ||
3 | Total |
*Students who are 5 years of age on December 1 are “school-age” children and
must be reported in Section B of this report and not in Section A.
**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 programs
and/or services should be included in the column for students age 2.
Table 1: Provide an unduplicated count of all school-age students with disabilities provided special education, on December 1, 2006, by this agency. | ||
Line No. |
Report Each Student Only Once |
Ages 4-21* |
1 | Count of school-age students with disabilities provided special education programs and/or services in State agency’s education programs. | ** |
**Only include 4-5 year old students if they are in your school-age program. Students are eligible to enroll in school-age (kindergarten) programs if they become five years old by December 31 or by a later date established by the school/agency. For example, if a student’s birthday is on December 5, 2001, and the school/agency policy for admission to school is “five years of age by December 31”, the student could be enrolled in the Kindergarten program and be 4 years old on December 1, 2006.
Table 2: The numbers provided in this table will be used to determine a portion of this agency’s federal aid allocation under IDEA, under Sections 611 and 619. | |
Line 1: Provide the total enrollment of all school-age students (disabled and nondisabled) who were provided educational services in Kindergarten through grade 12 programs, on December 1, 2006. Do not include individuals who are of school-age but are not enrolled in a special and/or general education program. | |
Line 2: Of the students reported in Line 1, provide the number of students who were eligible to receive a free or reduced price lunch. |
Directions: Please review directions and definitions for
completing reports 1-14 beginning on page 2. The total number of students
reported in reports 1-13, reports 15A and 15B, reports 16A and 16B, reports 17A
and 17B must be equal to the total number of students reported in Section B,
Table 1, Line 1.
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Non-Public School | ||||||
04 | Total |
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 |
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 |
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 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 tables will facilitate the reporting of race/ethnicity, gender, and limited English proficiency data in Reports 15A, 16A and 16B, 17A and 17B.
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 |
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 |
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 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.
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 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) |
Total | ||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 | Total |
Line Number | Type of Setting | A | B | C | D | E | F | G |
---|---|---|---|---|---|---|---|---|
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or 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) |
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 |
Line Number | Type of Setting | A | B | C | D | E | F | |
---|---|---|---|---|---|---|---|---|
Race/Ethnicity of School-Age Students Ages 4-5 | ||||||||
American Indian or 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) |
Total | ||
01 | Incarcerated in 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.
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F | G |
---|---|---|---|---|---|---|---|---|
Race/Ethnicity of School-Age Students Ages 6-21 | ||||||||
American Indian or 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) |
Total | ||
01 | 20% or less | |||||||
02 | 21% to 60% | |||||||
03 | More than 60% | |||||||
04 | Total |
Line Number | Type of Setting | A | B | C | D | E | F | |
---|---|---|---|---|---|---|---|---|
Race/Ethnicity of School-Age Students Ages 6-21 | ||||||||
American Indian or 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) |
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 |
Line Number | Type of Setting | A | B | C | D | E | F | |
---|---|---|---|---|---|---|---|---|
Race/Ethnicity of School-Age Students Ages 6-21 | ||||||||
American Indian or 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) |
Total | ||
01 | Incarcerated in 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.
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 4-5 | Limited English
Proficiency (LEP) Status for Ages 4-5 |
||||||
Male | Female | Total | Yes | No | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 4-5 | Limited English
Proficiency (LEP) Status for Ages 4-5 |
||||||
Male | Female | Total | Yes | No | 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 |
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 4-5 | Limited English
Proficiency (LEP) Status for Ages 4-5 |
||||||
Male | Female | Total | Yes | No | Total | ||
01 | Incarcerated in Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Nonpublic 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 Totals (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.
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 6-21 | Limited English
Proficiency (LEP) Status for Ages 6-21 |
||||||
Male | Female | Total | Yes | No | Total | ||
01 | 20% or less | ||||||
02 | 21% to 60% | ||||||
03 | More than 60% | ||||||
04 | Total |
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 6-21 | Limited English
Proficiency (LEP) Status for Ages 6-21 |
||||||
Male | Female | Total | Yes | No | 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 |
Line Number | Time OUTSIDE Regular Classroom | A | B | C | D | E | F |
---|---|---|---|---|---|---|---|
Gender for Ages 6-21 | Limited English
Proficiency (LEP) Status for Ages 6-21 |
||||||
Male | Female | Total | Yes | No | Total | ||
01 | Incarcerated in Correctional Facilities | ||||||
02 | Home Schooled at Parental Choice | ||||||
03 | Parentally Placed in Nonpublic 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.
Line Number | Disability | Racial/Ethnic Group for Students Ages 4-5 | ||||||
---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | ||
American Indian or 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) |
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.
Line Number | Disability | Racial/Ethnic Group for Students Ages 6-21 | ||||||
---|---|---|---|---|---|---|---|---|
A | B | C | D | E | F | G | ||
American Indian or 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) |
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,16B and 17B 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 | Disability | A | B | C | D | E | F | G |
---|---|---|---|---|---|---|---|---|
American Indian or 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) |
Total | ||
01 |
Students with |