Meeting Date: 2/25/2020

Review Date: 4/18/2020

MTSS Team: A B C D E F

MTSS Intervention Plan

Part 1. General Information

Student Name: KW8 Grade: 8 Teacher: Wampler

Part 2. Area for Improvement & MTSS Action Goal

Area for Improvement: Behavior Academics

Baseline Data: During 2nd quarter, KW8 grade fell approx. 2 letter grades in every subject
except science

MTSS Outcome Goal: KW8 will achieve Ds in all subjects by the end of 2nd quarter and Cs
or higher in all subjects by 4th quarter progress reports

Part 3A. Intervention 1

Intervention Description: Check-In / Check-Out with homework planning and progress

monitoring

Person Responsible: Lindsay Timmerman

Progress Monitoring Tool: Assignment Checklist

Timeline Intensity

Start Date: 2/26 Frequency: 2 x day

End Date: 4/18 Duration: 15 min per check-in