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Mock IEP Sydne Faith Yanez College of Southern Nevada Running head: MOCK IEP 1 [Blake Griffin III] Individual Education Plan © Name: Blake Griffin Ill Grade: 1 DOB: 06/05/1997 ‘Student ID #: 1005249 STUDENT/PARENT INFORMATION, Address:_1313 Mockingbird Lane City/State/Zip: Mountainville, Montana 89014 Students Phone: (902) 563-9634 Parent/Guardian/Surrogate: Gail Griffin. Parents Phone: (902) 563-9635 Parents Phone (Work): (902) 789-9090 Email Address: _Mountainvillemomma@gmail,com Optional (Home): (902) 567-8876 Primary Language Spoken at Home: Enalish Emergency ContaclPhone Number: Tommy Griffin (902) 578-0098 Current School: Cathecral High School Zoned School: Cathedral High School ELIGIBILITY CATEGORY Primary: Health Impairment ELIGIBILITY DATE: 42/02/2013 ANTICIPATED 3-YR REVALUATION: 12/01/2016 MEETING INFORMATION Date of Meeting: 12/02/2013 Date of Last IEP Meeting: Running head: MOCK TEP 2 Purpose of Meeting: Interim IEP Annual IEP Revision To IEP Dated: Initial EP. IEP Following 3-Yr Reevaluation [_] ExivGraduation Reason: Other: IEP Revision without a meeting: At the request Parent or School District IEP SERVICES WILL BEGIN: 12/02/2013, ANTICIPATED DURATION OF SERVICES: 12/10/2014 JEP REVIEW DATE: 42/10/2014 COMMENTS: {Blake Griffin's ] IEP Team Tam. Doc Rivers | Chris Paul DeAndre —_| Blake Griffin Jordan m Myrole isu Class teacher | School team | pérent ecialist. | Student me je, Present hf 7 vu “Required partcpant, {Student must be invited when rans is dscussed (beginning at age 14 or younger if appropriate) ‘"The IEP team must include atleast one regular educstion teacher of the student (the student i, Or may be, participating in the regular education environment), Running head: MOCK TEP 3 PROCEDURAL SAFEGUARDS: Ihave received a statement of procedural safeguards under the Individuals With Disabilities Education Act (IDEA) and these right have been explained to me in my primary language. received the Middle/High School Graduate profile. NVA prior to 14 years of age Parent/Guardian Signature, AT LBAST ONE YEAR PRIOR TO REACHING AGE 18, STUDENTS MUST BE INFORMED OF THEIR RIGHTS UNDER IDEA AND ADVISED THAT THESE RIGHTS WILL TRANSFER TO THEM AT AGE 18. Not applicable. Student wit nol be 18 within one year, and the student's next annual EP meeting will accurno late than the students 17th bithsay. ‘The student has been informed of hse rights under IDEA and advised ofthe tranefor af these rights at age 18. Running head: MOCK 1EP 4 Mountain Momma School District Mountainville, Montana Student Support Services Division PRESENT LEVELS OF ACADEMIC ACHIEVEMENT AND FUNCTIONAL PERFORMANCE Student name: Blake Griffin Il Grade:_414_ DOB: 6/05/1997 _ ID #:_1005249 Assessments Assessments Results EFFECT ON STUDENT'S Conducted INVOLVEMENT AND PROGRESS IN GENERAL EDUCATION Heath Assessment | Heat ‘Most 11th grade studens do nothave 2 The Reyes Intellectual Assessment Scales RAs) 9972013 Bake was friendly and cooperative during the henkh assessment, He completed the Vision and hearing screening wihout any problems, Blake has Neuroyenic, Syncope, migraines, asthma, and Osgood-Schlater Disease. Bike is prescribed multiple modicalions that he fakes at home, Blake's heath may advarrely impact his bly to leam in the seademie environment. Cognitive: Blake's Verbal Intetience index (VOX) sore of 82 fallin the Below Average range and atthe 73th peresntle wien ‘compared to came-age peore. Blake's performance on tis test suggests that ho has dificulies wih the ait to ‘eason verbaly using vocabulary knowedge, language

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