School District Information Package



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MASSACHUSETTS DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION


School District:







School:




Room #:




COORDINATED PROGRAM REVIEW

Level:

PS



EL



MID



HS



MULTI






Date:




Time of Observation:




Document #5: FACILITIES/CLASSROOM OBSERVATION FORM





TEACHER (S)

FLOOR

LOCATION




CLASSROOM USE



FOR ROOM WITH HEARING-IMPAIRED STUDENTS:





Resource Room



Tutorial




  1. Classroom Has:

YES

NO



Other: _________________________________

  1. Ceiling treated for good acoustics











_________________________________






ELL instructional space




  1. Shades or drapes on windows













BSMT



1



2



3



Other

TEACHER / STUDENT RATIO

OK


  1. Adequate overhead lighting
















Among other classrooms

# Students






  1. Visually cued fire alarm







End of corridor

# Teachers








Other:

# Aides






  1. Good maintenance of audio feedback equip.




















PHYSICAL

CONDITION

SUMMARY





OK


PROBLEM (DESCRIBE)


FOR FACILITY WITH MOBILITY IMPAIRED STUDENTS:

Space






Accessible:

YES

NO

Ventilation






a. Building Entrance





Lighting






b. lavatories





Acoustics






c. classrooms





Attractiveness






d. corridors





Maintenance






e. cafeteria





Distractions:







f. auditorium





Visuals






g. playground





Auditory






h. gymnasium














i. pool














j. all programs required by IEP





CLASSROOM/FACILITY IS:

YES

NO

COMMENTS

If no mobility-impaired student is presently enrolled and building is the only one at the level, e.g., one high school and it is not accessible, there is a plan as required by s.504 for modifications to make building accessible.


COMMENTS:



  1. At least equal to average standard for rest of system





____________________________________________________________

  1. Adequate for type of instruction/activity





____________________________________________________________

  1. Adequate for number of students





____________________________________________________________

  1. Placed in an area to facilitate integration with regular education





____________________________________________________________

  1. Identified with positive or neutral sounding name, if any





____________________________________________________________

  1. Free of physical problems





____________________________________________________________













LUNCHROOM:

Students sit with regular education students







____________________________________________________________

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