Appendix B: Sample PWN 2 Independent Educational Evaluation (IEE)
4. Beery-Buktenica Developmental Test of Visual-Motor Integration – 5th Edition, (VMI-5) 5. Test of Visual-Perceptual Skills – 3rd Edition, (TVPS-3) PRIOR WRITTEN NOTICE Re: Independent Educational Evaluation (IEE) Page 2 6. Connors’ 3-Parent Short 7. Connors’ 3-Teachers Short 8. The Attention Deficit Disorder Evaluation Scale – 3rd Edition: Home Version, (ADDES-3 HV) 9. The Attention Deficit Disorder Evaluation Scale – 3rd Edition: School Version, (ADDES-3 SV) 10. Behavior Assessment System for Children, 2nd Edition – (BASC-2) The LEA psychologist who assessed your child has 13 years of experience and is qualified to complete psycho-educational evaluations per California Department of Education. Your statement that your child is failing to make expected progress toward the initial IEP goals is premature as the goals are expected to be met by the next annual IEP, which does not take place until (Date of Next Annual IEP) and the fact that on (Date IEP Meeting) an IEP was held to adjust his academic placement based on a review of his progress at the time. You have protections under state and federal procedural safeguard provisions. Please refer to the enclosed Notice of Procedural Safeguards for an explanation of these rights. For further information about your rights or the proposed action and/or referral, contact (Contact Person Name) at (760) 000-0000 , 12345 School Lane, Anytown, CA 90000 . Sincerely, 11. Parent Rating Scales-Adolescent: (PRS-A [Ages 12-21]) 12. Teacher Rating Scales-Adolescent (TRS-A [Ages 12-21])
Name Title/Position
ENCLOSURE: NOTICE OF PARENTAL RIGHTS AND PROCEDURAL SAFEGUARDS
BP 1001 – Procedural Safeguards
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Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 11/16)
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