Fillable Family Needs Self-Assessment to Address Attendance Barriers

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Family Needs Self-Assessment to Address Attendance Barriers

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  • 36 check-boxes
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PHILADELPHIA PITTSBURGH
1800 JFK Blvd., Suite 1900A 429 Fourth Ave., Suite 702
Philadelphia, PA 19103 Pittsburgh, PA 15219
T 215-238-6970 T 412-258-2120
F 215-772-3125 F 412-535-8225
WWW. ELC-PA.ORG
Ensuring that all of Pennsylvania’s children have equal access to a quality public education.
Family Needs Self-Assessment to Address Attendance Barriers
!
My child is age 18 or older and NOT of compulsory school age
!
My contact information (phone number, email, or address) needs to be updated with the
school. My current contact information is:
.
!
I prefer to speak in
(language(s)) and read in
(language(s))
My Child Is Experiencing Barriers To Accessing School
!
I need help enrolling my child in school
!
There was a delay between when my child was enrolled and when my child was allowed to
attend class, and these absences were wrongly treated as unexcused absences instead of
excused absences
!
COVID-19 is preventing
my child from attending school (e.g., health concerns, family member
illness)
!
I am not receiving communications from school and/or do not know how to find information
about the school
!
I need a stable internet connection or a working device (if yes, see “remote issues” below)
!
We are living in temporary housing and I need additional support to access learning
(e.g., a quiet place to learn, extra supplies, etc.)
Temporary housing includes living with friends, relatives, or others due to loss of
housing or economic circumstance, living in a motel, shelter, substandard housing
or emergency housing
!
My child needs to receive meals at school
!
My child is being bullied or harassed at school
!
My child is pregnant or parenting and needs additional support at school
!
My child needs more school uniforms
!
My child is experiencing transportation problems:
!
Transportation is not set up
!
Bus is late or not showing up
!
Trans passes are needed
!
The pickup or drop off location is wrong
!
My child needs specialized transportation.
My Child Needs Supports in School
!
My child needs accommodations for a disability or chronic condition like asthma,
diabetes, anxiety, or other mental o
r behavioral health conditions
!
I am concerned about my child’s academic or behavioral progress at school
!
I think my child may need to be evaluated for an IEP to get learning supports at school
!
My child may need a 504 Plan to get accommodations for learning in school
2
!
My child already has a 504 or IEP but needs more support or the Plan is not followed
!
My child needs English Language (EL) supports
!
My child needs other supports
Barriers Accessing to Remote or Virtual Learning
!
My child doesn’t have computer access
!
The device I got from the school doesn’t work
!
The device or equipment is broken or missing
!
I need help using the device or platform the school is using
!
I need help getting internet access or a hot spot
!
I want to apply for my child to go to an Access Center where my child can do virtual school
I Need Help Documenting Absences
!
M
y child’s doctor won’t give me an excuse note for an appointment or care
!
The school isn’t accepting the notes I am providing to excuse absences
!
My child was marked abse
nt on days he/she/they were in school
!
I or my child was told that my child cannot come back without getting a
psychological evaluation
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Family Needs Self-Assessment to Address Attendance Barriers

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Completed 6 October 2021

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