Appendix B: Sample PWN 4 Unilateral Placement and Reimbursement
Date Parent/Guardian
Address Line 1 Address Line 2 Subject: Parent Request to Initiate or Change Identification – Johnny Doe (DOB 01/11/00) Dear Parent/Guardian, The LEA is in receipt of your letter dated February 1, 2008 , requesting that a one-to-one-aide be assigned to your child Johnny Doe , date of birth: 01/00/00. Please consider this the LEA’s response to your request under 34 Code of Federal Regulations (C.F.R.) Section 300.300 and 300.503. The LEA is denying your request to assign a one-to-one aide to Johnny at this time. Based on the information below, we believe that Johnny does not require a one-to-one aide in order to benefit from his educational program. In reaching this decision, the LEA considered the following information: Special Circumstances Instructional Assistance (SCIA) Evaluation conducted in November of 2007, a SCIA Evaluation Report dated 12/2/07, Johnny ’s first semester report card and progress report, his IEP dated 10/31/07, as well as his triennial psycho-educational report dated 5/31/07. Also, during the 12/14/07 IEP meeting, the team considered assigning a classroom aide during Johnny ’s math and science courses, which are the only courses he is having difficulty. The team discussed the possible reasons for Johnny ’s difficulty in these classes: failure to turn in homework and missing quizzes due to asthma attacks and leaving school early to visit his grandparents. The team added a goal for homework completion and an accommodation to permit Johnny to take quizzes he misses due to asthma attacks. Therefore, the team determined that the new goal and accommodation would address his difficulties in math and science, whereas adding an aide to these classes would likely cause Johnny to revert to his negative behaviors that he displayed last year and increase his dependence on an adult to socialize and communicate appropriately with his peers. The LEA also considered that when an aide was assigned to Johnny last school year, his negative behaviors increased (inappropriately touching classmates and yelling out answers during classroom instruction). Johnny was overly dependent upon his aide for initiating games and conversations with his peers and resisted volunteering in class. Since the beginning of the school year, when he started (School Name) without an aide, Johnny initiates games and conversations with only one verbal prompt by the recess aide and appropriately raises his hand during class to respond to questions with the teacher and classroom aide using only 2 visual prompts.
BP 1001 – Procedural Safeguards
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Desert Mountain Charter Special Education Local Plan Area (DMCS) (rev. 11/16)
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