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   Ventura County Special Education Local Plan Area (SELPA)
  

SELPA has moved!
New
Address:  5100 Adolfo Road, Camarillo, CA  93012
New Phone number:  (805) 437-1560  ~  Fax number:  (805) 437-1599
 
 

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SESP & Survival Guide (IEP Forms)Pre IEP Forms
 

Survival Guide "Pre-IEP" Forms 
 Spanish Forms

Instructions - Section I - Pre-IEP Meeting Forms 

    
Appendix A - Flowchart for Determining Need for Special Circumstances Paraprofessional Assistance

    Appendix B - Decision Making Process for Surrogate Parents for Special Education

    Appendix C - Three Year Old Transition Timeline

Forms

Assessment Plan 

Assessment Plan Memo for Private School Students
California Alternate Performance Assessment Participation Criteria

Central Auditory Processing Referral Form

Consideration for Determining Participation in STAR Program for Special Education Students:
    
First Year of Testing
    Subsequent Years of Testing

Designation of Educational Representative

Excusal of IEP Team Member

Extended School Year Consideration
Family Interview Worksheet
Home Language Survey
IEP Meeting Notice:
    Notice of IEP Meeting   
    Staff Notice of IEP Meeting

Interdistrict Referral:
    Referral Form
    
    Consent for Release of Information

Notification of Age of Majority:
    
Parent
    Student

Notice to Parent of Referral

Parent/Adult Student Rights:
    
Parent Rights - Full
    Parent Rights - Abbreviated
    Adult Student Rights

Parent Contact Log

Prior Written Notice to Parent of Action
Reassessment Prior to Transition to Kindergarten:
    
Checklist
    Memo to Parents

SCANS Assessment Form N

SCANS Assessment Form S

Special Circumstances Paraprofessionals (SCPs) Forms:
    
SCPS Form 1 - Rubric
    SCPS Form 2 - Checklist of Existing Environmental Supports
    SCPS Form 3 - School Day Analysis 
    SCPS Form 4 - Summary Sheet

Surrogate Parent Forms:
    Request to Social Service Agency for Information About Educational Rights (SP-1)

    
Educational Rights Information Sheet (SP-2)

    
Appointment/Acceptance of Surrogate Parent (SP-3)

    Foster Parent Agreement to Represent Special Education Student (SP-4)

    Educational Representative Information/Registration (SP-5)

    
Surrogate Parent Evaluation (SP-6)    

Three Year Old Transition:
    
Referral From Early Start Program to School District for Special Education Assessment

    Three Year Old Transition Checklist

Triennial Review (Documentation of Parent/Adult Student Decision)

Triennial Review (Worksheet for Determination of Need)

 Spanish Forms 

Assessment Plan 

Consent for Release of Information

Designation of Educational Representative

Excusal of IEP Team Member

Interdistrict Referral:
    Consent for Release of Information

Notification of Age of Majority:
    
Parent
    Student

Notice of IEP Meeting

Notice to Parent of Referral

Parent/Adult Student Rights:
    
Parent Rights - Full
    Parent Rights - Abbreviated
    Adult Student Rights

Prior Written Notice to Parent of Action

Reassessment Prior to Transition to Kindergarten:
    
Memo to Parents

Transfer of Rights at 18 - Parent letter

Triennial Review (Documentation of Parent/Adult Student Decision)

Triennial Review (Worksheet for Determination of Need)

 

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5100 Adolfo Road ~ Camarillo, CA, 93012 ~ Phone:  (805) 437-1560 ~ Fax: (805) 437-1599

 
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