SCHOOL NAME: West Jefferson High School                 Verification of Implementation of the     Positive Behavior Interv...
VERIFICATION FOR                 REQUIRED ATTTACHED DOCUMENTS FOR                       PBIS MODEL MASTER PLAN            ...
Mission StatementSchool VisionStudents will leave WJHS college and career ready and will become stewards and leaders in ou...
SWPBIS Team MembersLarry SaveryAssistant PrincipalTeam LeaderSecretaryData ManagerTeam MemberTeam MemberTeam MemberTeam Me...
Faculty CommitmentDuring a professional learning community meeting, Larry Savery, the Assistant Principal for StudentServi...
Effective Procedures for Dealing with DisciplineThe faculty and staff will be provided with staff development on the disci...
Data Entry and Analysis PlanWhenever possible, data concerning infractions will be entered within two days of the occurren...
Expectations and Rules DevelopedBe ThereBe in the designated area, at the designated time – physically and mentally.Unders...
Space             Be There                      Understand Your                 Choose Your                               ...
Reward and Recognition Program EstablishedBuc BucksBuc Bucks are green tickets for students who demonstrate BUCS expectati...
Lesson Plans for Teaching Rules and ExpectationsStudents will learn the expectations through a series of videos that were ...
Implementation PlanCALENDAR.WHAT WAS DONE MONTH BY MONTH FOR SWPBIS
Crisis PlanThe Crisis Plan is on file in the main office.
EvaluationInformation will be gathered and analyzed about the SWPBIS program through staff and student surveysand focus gr...
The School Master Plan for DisciplinePositive Behavior Intervention SupportIn order to assure classroom management using p...
The leadership team will monitor, evaluate and modify the school master plan, as needed, throughout theschool year.WEST JE...
Parental and Community InvolvementWEST JEFFERSON HIGH SCHOOL is committed to parental involvement and family strengthening...
It is the duty of all staff at WEST JEFFERSON HIGH SCHOOL to cooperate fully with the visiting teachers, orsupervisors of ...
__________________________________ __________________________________Leadership Team Member             Leadership Team Me...
This worksheet and accompanying documentation should be kept on file with a copy of theSchool Master Plan for Discipline a...
Yes     5. Leadership Team has revised the Zero Tolerance Policy to comply with R.S.           17:416.15.Yes     6. Leader...
21. Leadership Team is working to help improve communication, coordination, and          collaboration between the school ...
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
West jeffmasterplan working copy
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West jeffmasterplan working copy

  1. 1. SCHOOL NAME: West Jefferson High School Verification of Implementation of the Positive Behavior Interventions and Supports Process (PBIS) for Inclusion in the Monitoring Report for the Corrective Action Plan (CAP) 2011-2012To demonstrate compliance with the CAP as it pertains to PBIS, all schools will have todemonstrate verification of PBIS implementation by providing the following information to theSchool Safety & Discipline Office by the date indicated.Each report should include the following Critical Elements and their Benchmarks of Quality:CHECK LIST OF ITEMS TO BE INCLUDED IN PBIS IMPLEMENTATION PLAN Mission Statement (benchmark 4) List of PBIS Team Members (benchmark 1-3) Faculty Commitment (benchmark 5-7) Effective Procedures for Dealing with Discipline (benchmark 8-14) Data Entry & Analysis Plan Established (benchmark 15-19) Expectations & Rules Developed (benchmark 20-24) Reward/Recognition Program Established (benchmark 25-32) Lesson Plans for Teaching Expectations/Rules (benchmark 33-38) Implementation Plan (benchmark 39-45) Crisis Plan (benchmark 46-48) – DO NOT INCLUDE IN PBIS PLAN - EmergencyManagement Plan that was submitted on September 1, 2011 to School Safety and DisciplineOffice (include Verification Form only) Evaluation (benchmark 49-53) (See attached Louisiana School-Wide Benchmarks ofQuality.) The School Master Plan for Discipline Forms (2) must be completed and included in yourPBIS Implementation Plan Verification for Required Attached Documents for PBIS Model Master Plan 2011-2012FormImplementation Plan, Model Master Plan and this checklist are due November 11, 2011 (Due for Technical Assistance schools on October 14, 2011)Please forward ONE hard copy of the report via pony to the School Safety & DisciplineOffice by the appropriate date to the attention of Carol Mancuso c/o Shannon Cummings.Please keep a copy on file in your school office and copies available for your PBIS Team andfaculty. The report will be kept on file at our office as part of the CAP Monitoring Plan. Thank you for all you do to keep our schools a safe place for our students to learn. PLEASE INCLUDE A COPY OF THIS CHECK LIST WITH YOUR PLAN /mnt/temp/oo/20120509184317/westjeffmasterplanworkingcopy-120509134315-phpapp01.doc
  2. 2. VERIFICATION FOR REQUIRED ATTTACHED DOCUMENTS FOR PBIS MODEL MASTER PLAN 2011-2012SCHOOLPBIS TEAM LEADERPRINCIPALDATE_______A copy of the Emergency Management Plans has been placedin every Teacher Emergency Kit which has been strategically placed ineach classroom. Date_______ A copy of the Emergency Management Plan has beensent to the School Safety and Discipline Office. Date_______ A copy of the SIP is available at school site for review. DatePrincipal’s signatureThe PBIS Model Master Plan requires the School Improvement Plan (SIP) andCrisis Plan. This verification form assures that a copy of each plan is on file andavailable for review at your school.This form is to be submitted with PBIS Implementation Plan. /mnt/temp/oo/20120509184317/westjeffmasterplanworkingcopy-120509134315- phpapp01.doc
  3. 3. Mission StatementSchool VisionStudents will leave WJHS college and career ready and will become stewards and leaders in ourcommunity.School MissionIn partnership with families and the community, WJHS will: o provide safe and supportive learning environments o present engaging, relevant, rigorous, and technologically rich educational experiences o ensure the success of every studentSchool MottoI am a BUC.When I am RESPECTFUL, RESPONSIBLE, PERSISTANT and CONFIDENT,I have the POWER to succeed.I WILL SUCCEED.I am a BUC.SWPBIS MissionResearch and implement interventions grounded in data so that teachers can teach, students can learnand every member of the school community feels valued and respected.
  4. 4. SWPBIS Team MembersLarry SaveryAssistant PrincipalTeam LeaderSecretaryData ManagerTeam MemberTeam MemberTeam MemberTeam MemberTeam MemberTeam MemberTeam MemberTeam Member
  5. 5. Faculty CommitmentDuring a professional learning community meeting, Larry Savery, the Assistant Principal for StudentServices, led faculty members in constructing their 3-5 positively stated classroom rules. These ruleswere aligned with the SWPBIS expectations but grounded in what the teachers thought were the mainproblems in their classroom. The teachers also thought of their 4 step consequence ladder, with thereferral being the result of the 4th minor infraction. Lastly, they thought of their rewards and incentives.These rules, consequences and incentives were posted in every classroom and checked for complianceby the Student Services office. In addition, teachers were required to modify the Minor Infraction Formwith their rules on it so that they were clearly implementing their rules and using them to manage theirclassroom.INSERT DATES AND SLIDES FROM PROFESSIONAL DEVELOPMENT
  6. 6. Effective Procedures for Dealing with DisciplineThe faculty and staff will be provided with staff development on the discipline process. Procedures forhandling both minor and major infractions will be outline and/or discussed during staff development,professional learning communities, and in the faculty handbook. Faculty and staff will be informed of theprocedure for documenting infractions during staff development meetings and through faculty memos.Discipline referrals will include name, date, time, grade, location, referring staff member, race, specialeducation or regular education classification, problem behavior, motivation, others involved, andadministrative action.The faculty handbook will include information about both minor and major infractions and theirconsequences. These infractions will be defined and discussed during faculty and professional learningcommunity meetings. Appropriate responses to behaviors will be discussed.Insert blank copy of the referralMinor Infractions Major Infractions• Willful disobedience • Willful and disrespectful disobedience• Refusal to provide identification/name • Physical abuse of school personnel• Class or campus disturbance • Threatening school personnel• Name-calling/taunting • Indecent behavior/inappropriate touching• Profanity, obscenity (verbal or written), abusive • Threatening or intimidating students or disrespectful language • Hitting, pushing, shoving, kicking, biting or any• Entering/leaving through wrong gate physical abuse of students• Forgery/cheating • Fighting• Pushing or shoving • Body injury to student• Running in the hallway • Stealing or possession of stolen property• Eating without permission • Possession, display or use of matches, lighters,• Sleeping tobacco• Talking without permission • Possession, display or use of weapons• Uniform violations • Possession or display of weapon facsimiles• Yelling, screaming or loud talking in building • Possession, display or use of drugs, alcohol or• Failure to submit homework inhalants• Tardiness to school • Possession, display or use of fireworks or explosives • Blackmail or extortion • Vandalism at school or school functions • Damage to school property • Refusal to provide identification/name • Leaving class without permission • Leaving campus/truancy/trespassing • In an unauthorized area without permission • Misrepresents facts or makes false statements • Major class or campus disturbance • Name-calling and taunting • Bullying • Forgery/cheating • Unwanted physical contact with another student • Instigating arguments or fights through gossip, taunting or teasing • Repeated uniform violations • Possession or use of a cell phone/electronic device • Circumventing testing procedures • Repeated tardiness to school
  7. 7. Data Entry and Analysis PlanWhenever possible, data concerning infractions will be entered within two days of the occurrence. At aminimum, information will be entered weekly. Minor infractions will be submitted using the “ClassroomIntervention Form.” Upon the fourth minor infraction, a referral will be written.Monthly reports will be printed and analyzed during monthly SWPBIS meetings. Information from thereports will be included in faculty notes and distributed during professional learning community meetings.
  8. 8. Expectations and Rules DevelopedBe ThereBe in the designated area, at the designated time – physically and mentally.Understand Your PurposeUnderstand what is expected of you while in that area.Choose Your AttitudeComplete your business with the appropriate attitude.SucceedWhen you are there, understand your purpose and choose the right attitude – you succeed by learningand not receiving negative consequences.
  9. 9. Space Be There Understand Your Choose Your Purpose AttitudeClassroom • Be on time • Give 100% • Be patient with the • Have all supplies • Take charge of your needs of others needed own education • Be respectful to • Pay attention to the • Actively and yourself and others lesson appropriately • Maintain a positive • Contribute to the participate attitude lesson • Know your objective • Pay attentionOffice • Stay in waiting area • Sign in and sign out of • Quietly and respectfully • Present your ID office complete your business • Uniform in tact • Line up in orderly fashion • Respect time of office staffBathroom • Only go during • Quickly complete your • Act maturely and designated times business responsibly • Have your pass • Maintain hygieneCafeteria • Only at lunch during • Clean your table • Speak in appropriate Succeed designated time • Think about what you’re voice • Stay at your place in eating • Socialize responsibly line • Pause and recharge • Restore order to your • Present your lunch eating space numberHallway • Only at transition or with • Report quickly to your • Respond respectfully to a pass destination others • ID properly displayed • Get to class on time • Use appropriate volume • Walk at a steady pace • Honor the space of • Smile • Be in appropriate others • Be mature hallway • Have your agenda with • Listen for instructions you at all timesHealth • Have proper pass • Healthy students are • Ask politelyCenter • Get there in a timely attentive students • Be honest and up front fashion • Go only when you have about your needs • Return promptly to class to go • Non-emergencies may be rescheduledLibrary • Follow sign-in • Be respectful of others • Act responsibly by procedures • Academic use only returning materials on • Only go with designated • Use materials for time class or with signed intended purposes agenda • Respect others and • On your own, you can resources go before school, during • Ask for assistance when lunch or after school necessaryFaculty • Be on time • Submit to administration • Be concerned • Be at door and present to students • Encourage achievement • Get students moving engaging, rigorous and • Keep students technology rich lessons motivated • Get your students involved • Overcome obstacles • Set goalsGym • • •Auditorium • • •
  10. 10. Reward and Recognition Program EstablishedBuc BucksBuc Bucks are green tickets for students who demonstrate BUCS expectations. Students can do twothings with them: 1) Turn them into the office for daily drawings or 2) Hold on to them and spend them inthe SWPBIS store for items determined by the team. These items include school t-shirts or spirit gear, therights to a bulletin board for 1 week, or lunch for the student and 5 friends.10 Minutes Early to LunchThese passes are given to students who go above and beyond and live the expectations. It allowsstudents to leave their 3rd period class with their teacher’s permission to go to lunch early. These are alsoused for students who are Student of the Week.Blue Jeans DayThese passes are given to students who go above and beyond and live the expectations. It allowsstudents to wear jeans that are not too baggy or too tight. These are also used for students who areStudent of the Week.T-Shirt DayThese passes are given to students who go above and beyond and live the expectations. It allowsstudents to wear an appropriate t-shirt to school. These are also used for students who are Student of theWeek.Free Concession ItemThese passes are given to students who go above and beyond and live the expectations. It allowsstudents to receive one item that is $2 or less from the school concession stand. These are also used forstudents who are Student of the Week.Front of the Lunch LineThese passes are given to students who go above and beyond and live the expectations. It allowsstudents to skip the lunch line in the cafeteria. These are also used for students who are Student of theWeek.Sweet TreatsThese passes were used for students with perfect attendance for the entire semester. The entire facultymade baked goods for the students and these passes allowed students to obtain several snacks on aparticular day during lunch.Here On Time (HOT)Students are to class on time are rewarded with HOT rewards. These HOT rewards come in the form ofhot chips, fireball candy or spicy treats. These days are determined by the team and not told to studentsso they are not expected.FreshStudents who are in full uniform are rewarded with a FRESH reward. The FRESH reward comes in theform of a mint. These days are determined by the team and not told to students so they are not expected.Student of the WeekTeachers submit two students for the Student of the Week by Friday. On Tuesday they are givencertificates for their students. Two students from every grade level are chosen to be the spotlight studentof the week and are given additional incentives and have their name on the Student of the Week bulletinboard.
  11. 11. Lesson Plans for Teaching Rules and ExpectationsStudents will learn the expectations through a series of videos that were created by team members andtheir students. The videos focus on particular areas, including the library, hallway and offices. Thesepublic areas seem to be the most confusing. Teachers will also model the behaviors expected in theirclassrooms through their individual classroom management plans.The Advisory classroom will also provide an avenue for ancillary topics to be discussed. These include:dealing with grief, handling conflict respectfully, planning for the future, de-escalation, self-esteem, actionplanning for multiple tasks, etc. While these sessions do not directly deal with expectations, there is nodoubt that the behaviors discussed will directly impact the SWPBIS expectations.
  12. 12. Implementation PlanCALENDAR.WHAT WAS DONE MONTH BY MONTH FOR SWPBIS
  13. 13. Crisis PlanThe Crisis Plan is on file in the main office.
  14. 14. EvaluationInformation will be gathered and analyzed about the SWPBIS program through staff and student surveysand focus groups. An analysis of data will be made at the end of each year to determine if disciplinedocumentation was appropriate and if the staff and faculty used the reinforcement system appropriately.An analysis of all monthly reports will be made by the SWPBIS team and the outcomes will be used infuture planning. In addition, monthly meetings with the principal and SWPBIS team leader will ensure thatschool and team priorities are aligned.INCLUDE BENCHMARKS OF QUALITY FINALIZED
  15. 15. The School Master Plan for DisciplinePositive Behavior Intervention SupportIn order to assure classroom management using positive behavioral supports and effective disciplinarytools, WEST JEFFERSON HIGH SCHOOL will identify data-driven academic, career and technical,discipline/behavioral performance results in the School Improvement Plan (SIP). WEST JEFFERSON HIGHSCHOOL will establish and use a school-based leadership team to meet on a regularly scheduled basis toreview data and guide the positive behavior process. This leadership team shall, to the extent possible,include representatives of the school administration, both regular and special education teachers,parents, guidance counselors, and school bus operators (It may also include other groups, e.g., foodservices workers).The leadership team will use a decision-making process utilizing a data-management system that allowsgraphical representation of discipline issues. Said data system will permit regular and efficient monitoringand evaluation of the effectiveness of the implementation of a school-wide system of discipline. Schooldata collection shall include, but not be limited to, average referrals per day per month, referrals byproblem behavior, referrals by location, referrals by time, referrals by student, referrals by staff, individualstudent report by month and by year, and referrals by grade level. Environmental changes may be madeas indicated by data. For instance, increased monitoring, schedule changes, or changes in recessstructure may help to alleviate congestion or over- crowding at certain times during the day.Leadership Team is fully implementing the requirements of R.S. 17:252(D), as required by the provisionsof Act 136 enacted by the 2010 Regular Session of the Louisiana Legislature (as contained in its MasterPlan for Discipline Worksheet attached).Leadership Team is ensuring that the school affords itself the opportunity to have all applicable personnel,including classroom teachers, participate in classroom management courses required by Act 136 (ascontained in its Master Plan for Discipline Worksheet attached).The team will uniformly use the two BESE-approved forms, i.e., “School Behavior Report Form” and“School Bus Behavior Report Form,” to report incidents of alleged discipline violations. The referralsystem will be utilized consistently and appropriately.The leadership team will review and revise any Zero Tolerance Policy of WEST JEFFERSON HIGH SCHOOL toensure that the policy is in compliance with R. S. 17:416.15; the policy does not violate R. S. 17:416 (H)which prohibits disciplinary action against any pupil reasonably acting in self-defense; and thatinappropriate referrals are not made to agencies serving children.The leadership team will review and revise its policies and procedures for handling suspensions andexpulsions at WEST JEFFERSON HIGH SCHOOL to ensure that suspension/expulsion policies are consistent withR. S. 17.416; suspension/expulsion policies are consistently and fairly executed; and alternativeinterventions, consistent with best theory and practice, to suspensions/expulsions are used including, butnot be limited to, counseling, conflict resolution, social and family responsibility, peer mediation, andstress and/or anger management.The leadership team will make referrals, as appropriate, to Alternative Education Programs that aredesigned to offer variations of traditional instructional programs, as well as strategies for the purpose ofincreasing the likelihood that students who are unmotivated or unsuccessful in traditional programs, or aredisruptive in the traditional school environment, remain in and be successful in school.The leadership team will review the current Code of Student Conduct of WEST JEFFERSON HIGH SCHOOL toassure that it is in compliance with R.S.17:416.12, R.S. 17:416.13 and Section 4114 of the No Child LeftBehind Act of 2001 (NCLB). They will refine consequences to create a reward/incentives program forpositive student and teacher behavior and ensure the delivery of consistent reinforcement. The team willdefine consequences for rule violations that are clear, reasonable, and consistently enforced and whichsupport maximum time in instruction.
  16. 16. The leadership team will monitor, evaluate and modify the school master plan, as needed, throughout theschool year.WEST JEFFERSON HIGH SCHOOL adopts the following clearly defined behavioral expectations in these five(can be less) basic rules. (Keep them simple and positive, e.g., "Keep your hands to yourself.” "Respectothers." "Be kind.")1. Be There2. Understand Your Purpose3. Choose Your Attitude4. SucceedThese rules shall be posted in prominent places around the school site, e.g., hallways, cafeterias,gymnasiums, and classrooms. These rules shall be provided to parents and shall be known by allstudents and school staff.Each teacher at WEST JEFFERSON HIGH SCHOOL shall develop lesson plans and teach expectations acrosseach school setting by providing direct instruction on expected behaviors at the beginning of the schoolyear and reinforced throughout the year for all students.WEST JEFFERSON HIGH SCHOOL shall design programs for students with special needs so that the studentsare challenged and engaged in school curriculum, and are appropriately placed so they remain in schoolrather than being suspended/expelled or becoming drop-outs.The principal of WEST JEFFERSON HIGH SCHOOL shall submit annual reports to the district’s DisciplinePolicy Review Committee.Safe School PlanningWEST JEFFERSON HIGH SCHOOL has established and shall maintain grade-appropriate programs of alcohol,drug and substance prevention, education, information and counseling as provided in R.S. 17:404.WEST JEFFERSON HIGH SCHOOL has established a plan, in accordance with Sec. 4114, of the No Child LeftBehind Act of 2001, for keeping the school safe and drug-free that includes appropriate and effectiveschool discipline policies that prohibit disorderly conduct, the illegal possession of weapons, and theillegal use, possession, distribution, and sale of tobacco, alcohol, and/or other drugs; has establishedsecurity procedures at school and while students are on the way to and from school; has establishedprevention activities that are designed to create and maintain safe, disciplined, and drug-freeenvironments; has established a crisis management plan for responding to violent or traumatic incidentson school grounds; and has established a Code of Student Conduct (and as also required by R.S.17:416.12 and R.S. 17:416.13) for all students that clearly states the responsibilities of students,teachers, and administrators in maintaining a classroom environment that allows a teacher tocommunicate effectively with all students in the class; allows all students in the class to learn; allows allstudents and school employees to be treated respectfully; has consequences that are fair anddevelopmentally appropriate; considers the student and the circumstances of the situation; and, isenforced accordingly.
  17. 17. Parental and Community InvolvementWEST JEFFERSON HIGH SCHOOL is committed to parental involvement and family strengthening. As setforth in R. S. 17:406.1, effective approaches to involving families more fully as partners in the process oftheir children’s learning require the participation and coordination of numerous state and local, public andprivate agencies shall be encouraged WEST JEFFERSON HIGH SCHOOL shall seek to make connectionsthrough a variety of local and culturally sensitive methods to facilitate parents/family members/access tolocal/regional family strengthening programs available in the community. (Programs can be specificallyidentified, as applicable, e.g., Families Helping Families, Regional Family Resource centers, ParentInformation Resource Center, Families In Need of Services [FINs] programs and other familystrengthening programs exhibiting peer to peer support systems and positive mental health initiatives).WEST JEFFERSON HIGH SCHOOL shall seek training to facilitate mutual understanding of research-basedpractices promoting positive relationships between parents, LEA personnel and community serviceproviders.WEST JEFFERSON HIGH SCHOOL shall seek to identify the mental health needs of its students and matchthose needs with available local resources including public, nonpublic and/or volunteer organizations(These can be specified to the extent possible). Pending inclusion of mental health services in theMedicaid Health Services Program (School-Based), the availability of mental health services will beexpanded in WEST JEFFERSON HIGH SCHOOL.Inter-Agency CooperationWEST JEFFERSON HIGH SCHOOL shall seek to improve communication, coordination and collaborationbetween schools and agencies serving children; shall foster cooperation regarding the sharing of dataabout children, youth and families involved agencies serving children; and shall work in cooperation withother schools/districts/communities/regional planning boards to facilitate the successful re-entry andtransition of youth formerly in state custody into their diverse school/community settings in order toencourage the continuation of education and their access to other needed services in order to preventrecidivism.Student RecordsWEST JEFFERSON HIGH SCHOOL shall provide for the transfer of student education records upon writtenrequest of any authorized person on behalf of an education facility operated within any correctional orhealth facility or, for children in the custody of the state, an education facility operated within any otherstate approved facility, whether within or outside the state of Louisiana, where such student has becomeenrolled or is seeking enrollment. The transfer of such records, whether by mail or otherwise, shall occurnot later than 10 business days from the date of receipt of the written request. If the student has beenexpelled, the transferred records shall include the dates of the expulsion and the reason(s) for which thestudent was expelled.No education record of any student may be withheld as the result of lack of payment of any fine, debt, orother outstanding obligation.A student or his or her parent(s) may inspect the education record of that in accordance with the federalFamily Education Rights and Privacy Act.Any student seeking admission to WEST JEFFERSON HIGH SCHOOL who has been suspended or expelledfrom any public or nonpublic school within or outside the state of Louisiana shall provide information onthe dates of any suspensions or expulsions and the reason or reasons for which the student wassuspended or expelled.Visiting Teacher/ Child Welfare and Attendance Supervisor/Families in Need of Services (FINS)Officer
  18. 18. It is the duty of all staff at WEST JEFFERSON HIGH SCHOOL to cooperate fully with the visiting teachers, orsupervisors of child welfare and attendance. WEST JEFFERSON HIGH SCHOOL shall make available tovisiting teachers, or supervisors of child welfare and attendance, FINS officers, and Truancy Assessmentand Service Centers such information as will assist them in promoting the regular attendance and schooladjustment of these children.[For schools/programs housing children in state custody: It is the duty of the principals, superintendents,or heads of the training and correctional schools to notify the visiting teachers, or supervisors of childwelfare and attendance, and FINS officer (if applicable) when a child is to be released and/or returned toa parish.]Visiting teachers, or supervisors of child welfare and attendance (pursuant to R. S. 17:235), and FINSofficers, shall cooperate fully with the state departments of social services, labor, and health andhospitals, and with other state and local agencies, including interchange of confidential and privilegedinformation; cooperate fully with juvenile and family court authorities, training and correctional schools,law enforcement officers; and make such referrals and conduct such investigations as seem necessaryfor the enforcement of school attendance laws, including interchange of confidential and privilegedinformation.Statements of complianceEach homeroom teacher of students in grades 4-12 shall, on the first day of school each school year,provide information to and answer any questions from students relative to the statement of compliance asprovided by JEFFERSON PARISH PUBLIC SCHOOLS BOARD.Each parent/guardian of each student in grades 4-12 shall sign a statement of compliance committing todo all of the following: ensure that his child attends school daily, except for school absences; ensure thathis child arrives at school on time each day; ensure that his child completes all required homeworkassignments; and attend all required parent and teacher or parent and principal conferences.__________________________________ __________________________________Dr. Christine Templet Larry SaveryPrincipal Assistant Principal__________________________________ __________________________________Leadership Team Member Leadership Team Member__________________________________ __________________________________Leadership Team Member Leadership Team Member__________________________________ __________________________________Leadership Team Member Leadership Team Member__________________________________ __________________________________Leadership Team Member Leadership Team Member
  19. 19. __________________________________ __________________________________Leadership Team Member Leadership Team Member__________________________________ __________________________________Leadership Team Member Leadership Team Member
  20. 20. This worksheet and accompanying documentation should be kept on file with a copy of theSchool Master Plan for Discipline and the Student Handbook for purposes of review ormonitoring. A. School-Based Leadership Team Membership: (Complete Chart Below or Attach List) Member’s Name Member’s Title Member’s Phone Member’s E-mailLarry Savery Assistant Principal 504.368.6055 larry.savery@jppss.k12.la.us 504.368.6055 504.368.6055 504.368.6055 504.368.6055 504.368.6055 504.368.6055 504.368.6055 B. School-Level Data System Requirements: Requirement Collection Tool Exists If Yes, List. If No, Suggestion(s) (Yes/No)Average Referrals per Day per Month Yes Infinite CampusReferrals By Problem Behavior Yes Infinite CampusReferrals by Location Yes Infinite CampusReferrals by Time Yes Infinite CampusReferrals by Student Yes Infinite CampusReferrals by Staff Yes Infinite CampusIndividual Student Report by Month and Yes Infinite Campusby YearReferrals by Grade Level Yes Infinite CampusOther: SummaryOther: C. Type “Yes” or “No” in the box as applicable to the following. No 1. School consistently and uniformly utilizes the two BESE-approved forms. If no, explain:JPPSS uses paperless referrals which contain all of the required elements. Yes 2. School has addendum to two BESE-approved forms to assist with data collection. If yes, attach a copy of the addendum with worksheet. Yes 3. School has a Zero Tolerance Policy. If Yes, go to #4. If no, go to # 6. Yes 4. Leadership Team has reviewed the Zero Tolerance Policy to ensure compliance with R.S. 17:416.15, including R.S. 17:416 (H) which prohibits disciplinary action against any pupil reasonably acting in self-defense.
  21. 21. Yes 5. Leadership Team has revised the Zero Tolerance Policy to comply with R.S. 17:416.15.Yes 6. Leadership Team has reviewed policies for handling suspensions and expulsions to ensure compliance with R.S. 17:416.Yes 7. Leadership Team has reviewed procedures for handling suspensions and expulsion to ensure consistent and fair execution and to ensure that alternative interventions are used.Yes 8. Leadership Team has reviewed policies and procedures related to referrals to Alternative Education Programs.Yes 9. Leadership Team has reviewed the current Code of Student Conduct to ensure compliance with R.S. 17:416.12, R.S. 17:416.13 and Section 4114 of the No Child Left Behind Act of 2001.Yes 10. Leadership Team has refined consequences to create a reward/incentives program for positive student and teacher behavior.Yes 11. Leadership Team has created a procedure/protocol to ensure the consistent delivery of the reward/incentives program.Yes 12. Leadership Team has defined consequences for rule violations that are clear and reasonable, that will be consistently enforced, and that will support maximum time in instruction.Yes 13. Leadership Team has identified the clearly, defined behavioral expectations in a small set of school rules (5 or fewer).Yes 14. Leadership Team has worked with teachers to develop lesson plans that teach these expectations across each school setting.Yes 15. Leadership Team has worked with teachers to establish a schedule for direct instruction to be provided at the beginning of the school year and reinforced throughout the school year.Yes 16. Leadership Team will work with the principal to develop and submit an annual report to the district’s Discipline Policy Review Committee.Yes 17. Leadership Team has reviewed programs as required under R.S. 17:404.Yes 18. Leadership Team has reviewed the school’s Safe and Drug Free Schools and Communities plan and the Crisis Management Plan. (Attach a copy of the Crisis Management Plan).Yes 19. Leadership Team has developed a plan/continues to develop a plan to improve and strengthen parental and community involvement in the school, including the facilitation of partnerships with programs and organizations/agencies. (Attach a list of programs and organizations/agencies with which the school is working to strengthen family and community involvement). Yes 20. Leadership Team has worked/continues to work with counselors, and other mental health professionals to develop a plan to identify the mental health needs of its students and to match those needs with available local resources. Yes
  22. 22. 21. Leadership Team is working to help improve communication, coordination, and collaboration between the school and agencies that serve children.Yes 22. Leadership Team is working with the local youth planning boards to help meet the needs of all children.Yes 23. Leadership Team has reviewed existing procedures/established procedures to ensure that records for transfer students are provided not later than 10 business days from the date of the receipt of the written request.Yes 24. Leadership Team has reviewed existing procedures/established procedures to ensure that information on the dates and reasons for any suspension or expulsion is included on transferred student records.Yes 25. Leadership Team has reviewed existing procedures/established procedures to ensure that all staff within the school cooperates fully with the visiting teachers/supervisor of child welfare and attendance. And Team is working with administration to ensure that all staff is aware of procedures.Yes 26. Leadership Team has reviewed student and parent/guardian statements of compliance that must be disseminated and collected at the beginning of school each year.Yes 27. Leadership Team is fully implementing the requirements of R.S. 17:252(D), as required by the provisions of Act 136 enacted by the 2010 Regular Session of the Louisiana Legislature, including incorporating pre-service and ongoing grade- appropriate classroom management training for teachers, principals, and other appropriate personnel regarding positive behavioral supports and reinforcement, conflict resolution, mediation, cultural competence, restorative practices, guidance and discipline, and adolescent development into the school’s master discipline plan.Yes 28. Leadership Team is ensuring that the school affords itself the opportunity to have all applicable personnel, including classroom teachers, participate in classroom management courses required by Act 136.

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