ESTR- Number of Items Enderle-Severson Transition Rating Scale - ‘orm J-Revised (Transition assessment for leamers with mild disabilities.) ESTR-J-Revised Learner Information Name_ 2°? PorenGuardion Evaluators Name. Title. Date of Evaluation_10/30 //9 Anticipated Date Previous ESTR-J Scale Total Performance Score(s) and Date( Name_MiVAVIO Freyling. tive ASSessor Name_ Title, School/Agency_HOI| k Primary Disability Sea (matn) Grade_9]" Birth Date [2/18/2000 Age jH| Gena! MAIC f Graduation. May 21 vA -J-Revised Profile: # of Yes Items (13) EMPLOYMENT @) oe RECREATION AND LEISURE at ey (15) HOME LIVING () COMMUNITY PARTICIPATION _4 (8) POSTSECONDARY EDUCATION _ (0. (47) TOTAL PERFORMANCE scorE _ 344 number of yas | Heme vied amber of temsCircle Yes Onl) Circle No if if Performed Independently and Consistently = 1 lot Performed or Performed Inconsistently = 0 . The learner demonstrates good attendance. * Good attendance in school. + Good attendance in and employment situstion (if applicable). . The learner demonstrates appropriate hygiene and grooming The learner is punctual... * Punctuality in school. Employment + Punctuality in work situations (if applicatle) . The learner recognizes the heed to eventually support himselffherself. Gs) + Understanding the relationship between working and paying for personal needs, + Understands how wor relationships * Understands how wor * Understands how wor provided opportunity to develop personal contributes to self-confidence. ers contribute to society * Understands a paycheck. . The learner responds app: + Follows directions. + Shows respect, . The learner demonstrates an varying levels of training ( other) ... ‘The learner demonstrates a job retention, dismissal, and + Understands factors te lead to termination of employment. * Understands factors The leatner is able to acces: searching... + Want Ads. + Employment Agencie * On-line resources. riately authority figures....... understanding of factors that influence ‘promotion. 'S understanding that different jobs require g. college, technical colleges, high school, lead to promotioa in employment. various resources for assistance in job No No NoCircle Yes Only if Performed Independently and Con: Circle No if Not Performed or Performed Inconsistet tently = 1 9, The learner demonstrates the necessary interpersonal skills t0 wo! with others * Good listening skills. * Good verbal communication skills. 10, The learner demonstrates the skills necessary to perform success in a job interview. + Communicates information about themselves. * Answers job interview questions. + Demonstrates appropriate job interview behaviors. 11. The leamer demonstrates the skills necessary to accurately comp! job application... * Knows personal information. + Neatly completes job application. 12. The leamer has realistic expectations of his/her vocational potent + Communicates job interest. * Understands his/her own persona; strengths and weaknesses. * Understands how personal characteristics relate to jobs of int 13. The leamer has had successful community-based work experienct Please list: * Work experience program, job shadow, apprenticeship, summ part-time job. Recreation and Leisure ‘The learner chooses appropriate free time activities..... Please list: 2. The learner acts appropriately in public... + Helps others. + Makes reasonable demands. * Acts courteous. 3. The learner initiates and participates in a variety of recreational/lbi activities with friends outside the home.......... 4, The leamer effectively communicates with others... Kk uly @® ® tea © ® rest. er job, No No No NoCirele Yes Onl} Circle No if| if Performed Independently and Consistently = 1 {ot Performed or Performed Inconsistently = 0 . The learner demonstrates |the ability to use the telephone... The leamer dresses appropriately for specific situations........ * Weather conditions. * Various activities. The leamer performs hous . The leamer is able to safe * Uses basic appliance: + Demonstrates safety + Performs basic home The learner demonstrates| * Obeys rules and laws, * Shows consideration * Respects the environ + Knows how to vote. + Knows about state ant The learmer has an accept sexual awareness... + Awareness of physi + Understands the repr + Understands dating, ". The leamer treats minor and knows how and whei |. The leamer understands * Could open a pea account. * Check writing, maki: + Making deposits and + Understanding interest. * Can use ATM. Home Living on Gs schold cleaning/laundty... eee Gs) No ly perform light household maintenance... (+s) No and tools chen using appliances and tools. ar tasks. ‘the qualities of a gcod citizen. for others. nent. federal governments. ible understanding of concepts related to @&) : a - No self. \ductive process. Jationships, marriage. edical problems, performs basic frst aid, to seek medical assistance. a . Yes shecking and savings accounts.........- Yes GO deposits, and recording checking transactions. thdrawals and recording saving transactions. nw reCircle Yes Only if Performed Independently and Con: Cirele No if Not Performed or Performed Inconsis stently = 1 tly = 0 9. The leaner has the skills necessary to perform written correspondence. + Notes + Letters + Phone Messages + Emails 10. The leamer practices preventive health care .....--.... : + Manages body weight * Gets sufficient sleep + Does not abuse aleohol/drugs + Makes and keeps routine medical/dental appointments + Gets proper exercise 11, The leamer knows how to respond to household emergency situations. + Plumbing problems * Heating problems ° Fire * Accidents * Poisoning 12. The leamer understands nutrition and is able to plan balanced meals... | * Understands basic food groups + Plans meals within a budget 13, The leamer manages his/her own money responsibly . + Knows how to develop a budget * Understands the importance of financial records + Pays bills on time * Understands taxes 14, The learner demonstrates an understanding of basic parenting skills. 15. The learner is able to prepare and serve foods that require a variety of cooking procedures... peta tnt + Proper food storage + Personal Hygiene + Kitchen safety procedures + Food preparation Yes (No) ‘Yes BoeCircle Yes Only if Performed Indeendently and Consistently = 1 Circle No iff Not Performed or Performed Inconsistently = 0 Community Participation 1. The learner is able to use relevan facilities, bank, library, Laundro hair stylist) + Making appointments + Identify appropriate resoure 2. The learner demonstrates appropriate social behaviors in the commu- nity... 3, The learner demonstrates an undi + Comparison shopping + Understanding sale prices ‘community resources, (health care mat, postal services, church, restaurant, ©) | : No for problem solving standing of cost seving techniques... =) + Discount stores versus depajtment stores 4. The learner can get around in the community... + Driver's license/vehicle + Public transportation + Maps/ schedules/asking for 5. The learner has a realistic plan needs and demonstrates the abil + Understands cost of differe Yes) No tirections r addressing post secondary ee { ity to secure housing .. Wat, No 1 types of housing * Understands housing contrabts + Understands the process of 6. The leamer is able to understan purchases in the community * Credit Cards + Loans 7. The learner demonstrates an uni and where to purchase coverag elocating purchasing options and pay for large mo) ee Te eon aae lerstanding of basic insurance needsCircle Yes Only if Performed Independently and Consistently = Circle No if Not Performed or Performed Inconsistently = 0 Post Secondary Education transition plan... * Rehabilitation services + Higher education support services + Adult services 1. Relevant supports have been identified and included in the student’s. (3 ( S Sede teatets sevfecee{ Yes) No 2. The learner can identify a variety of post secondary options * Universities + Technical school + Employment agencies + Community education 3. The leaner demonstrates self-awareness. + Understanding of physical self + Identifies abilities/interests, Areas of weakness + Understands personal emotions + Understands the implications (if any) of his/her disability * Understands and identifies personal goals 4, The learner demonstrates self confidence : + Communicates need for appropriate accommodations + Practices self-advocacy skills in a variety of settings + Feels good about self 5. The learner had undergone vocational assessment ....... Please list: © Aptitude * Achievement + Interest = Personality * Learning style 6. Plans have been made for post secondary housing options + 2) No 7. Application for post secondary training/leaming has been made (if leamer is directly entering employment, score yes) ..... yee © 0. Identify 8, Application has been made for financial assistance to access a post secondary training/learning option (if financial assistance is not re- \ quired, score yes) .. Ze a! No.Name, EMPLOYMENT. ‘After [hayg,completed my educat se EAR [RE OUTCOMES/GOALS ASSESSMENT. (Student preferences and interests) Date. ion (high school and post high school), the career I would like to have To reach this goal, I will need to: | 1 at RECREATION AND LEISURE After I graduate from high school] these are the things that I will do in my free time: (check all that apply) _bowling ___dining|out golfing joing to the movies dating Sal Xtravaling exercising regularly ane ie ete partying volunteering “X watching TV skiing) playing softball driving around reading “XK sporting events joining a health club dancing > listening to music__joining the Y otrer- DiC Rivet To reach this goal, I will need to: | talleng on the phone taking community education classes SU | HOME LIVING: Tnimiomvesvayfomnome tent LG con. (lr oF (nigh Scmn00 1) ‘When I get my own place, I plan tb live in: <_an apartment a mobile home a house acondominium I want to live: alone with one roommate witk a spouse with several roommates over: _ pet (bunny) Twill do my own: (check all that apply) cleaning ___| budgeting X laundry paying bills cooking _X [grocery shopping checking account clothing shopping X taking medications _X | scheduling of appointments X home repairs Other: I plan to live in: A in the city X in the dountry Ir or near what city? -Up_norti_(Luidingson) To reach this goal, I will need to: (pet jgCOMMUNITY PARTICIPATION When I’m living on my own, I plan to get around by: (check all that appl X driving my own car riding the city bus riding with relatives riding my bike “Xariding amotoreycle riding with friends ___walking Other: Places I will go in my community: (check all that apply XX banks public library restaurants X bars ‘employment agencies vote ‘work X friends’ houses department stores _X grocery stores movie theatres shopping malls video rental stores golf courses church Other: To reach this goal, I will need to: AVIOVG! QONEV SEE GAC QU NAM ys 158i POST SECONDARY EDUCATION Right after high school, I plan to: ‘work full time ‘work part time attend a2 year college |_DX attend a technical attend a 4 year college or university* Other. college* *The school(s) I am most interesting in attending: (OCN CENtét To reach this goal, I will need to: have food pivadet —______