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Michigan Department of Education - Low Incidence Outreach

Orientation and Mobility Goal Bank and Assessment

Low Incidence Outreach

702 W. Kalamazoo St.

Lansing, MI 48915

www.mdelio.org

Updated 01.29.2019

Table of Contents

Preface

Introduction

Instructions

Skill Level Key

Acknowledgments

Concept Development

Posture and Gait

Communication Skills For Travel

Guided Travel Techniques

Protective Techniques

Low Vision

Enter and Exit a Car Safely

Basic Cane Knowledge

Diagonal Cane Technique

Constant Contact Cane Technique

Two Point Touch Cane Technique

Indoor Travel Skills

Outdoor Cane Techniques

Environmental Concepts Level 1

Environmental Concepts Level 2

Basic Residential Travel Skills

Street Concepts

Street Crossings

Crossing At Traffic Lights

Orientation Skills Level 1

Orientation Skills Level 2

Mapping Skills

Numbering System: Inside

Numbering System: Outside

Commercial Travel Concepts

Commercial Travel Skills

Community Experiences

Public Transportation

Follows Procedure for Bus, Train, Subway Travel

Follows Procedure for Accessing Taxicabs/Paid Transportation

Follows Procedure for Accessing Paratransit or Rural Transportation

Alternative Travel Aids

Skills of Daily Living as Relates to Travel Skills

Preface

Introduction

This document provides appropriate Orientation and Mobility (O&M) goals for use in a student’s individualized education program (IEP). It includes tables for

tracking progress on each goal.

Instructions

The Orientation and Mobility Goal Bank Assessment can be used to determine appropriate O&M goals based on the needs of the individual student. Use the

level key to determine student’s current skill level. The code provides ve possibilities for scoring: emerging; competence; generalized; skill has not yet been

introduced, and not appropriate to the abilities, needs or level of the student.

Skill Level Key

Code Skill Level

Emerging: The student can do the task only within a familiar routine when there is no novelty and needs a considerable amount of prompting

to perform.

Competence: The student performs the task consistently in at least one setting or inconsistently in several settings.

Generalized: The student performs the task in many settings over a period of time.

Skill has not yet been introduced.

Not appropriate to the abilities, needs, or level of the student.

Acknowledgments

The Orientation and Mobility Goal Bank Assessment is a collaborative project of the Michigan Department of Education - Low Incidence Outreach Orientation

and Mobility Task Force.

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Concept Development

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies major body parts (head, chest, back, arms, legs, etc.)

Identies minor body parts (nose, ears, ngers, toes, knees)

Identies body planes (front, back, top, bottom, sides)

Demonstrates body positioning (knees bent, arm straightened,

neck turned)

Demonstrates spatial and positional concepts (next to, between,

on top of, under)

Demonstrates comparative sizes (big, little, long, short, narrow,

wide)

Demonstrates understanding of laterality (left, right)

Identies shapes of items in the environment

Identies colors of items in the environment

Identies sounds in familiar and outdoor environments

Identies smells in a variety of environments

Independently moves toward and locates a sound source

Demonstrates understanding of time concepts (day of week,

month of year, seasons, times of day, time schedules)

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Posture and Gait

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Maintains head in an upright position when walking

Maintains shoulders and arms in a relaxed position when walking

Walks with a rhythmic, coordinated movement

Maintains body in erect posture

Positions toes in direction of travel when walking

Maintains adequate speed when walking with a group,

independently, or using human guide

Makes accurate turns (180, 360, 90, 45 degrees)

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Communication Skills For Travel

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Follows 1-step directions for routes in a familiar environment

Follows 2-to-3-step directions for routes in a familiar environment

Follows 2-step directions for routes in an unfamiliar, but similar

environment

Follows complex directions for routes in unfamiliar environments

Requests travel information via phone, another device, or in

person

Able to give adequate information to driver of car to locate

destination

Verbalizes and/or writes step by step route information

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Guided Travel Techniques

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Locates guide after a verbal or tactual cue is given

Assumes a correct grip position on guide’s arm

Maintains contact in all situations such as turning, stopping,

change in pace, etc.

Refrains from pulling or pushing excessively on the guide

Ascends/descends stairs

Maintains control of cane while walking with a guide/avoids

interference with guide

Negotiates closed doors

Negotiates narrow spaces

Transfers sides

Adapts to different guides

Can explain technique to others

Accepts or refuses unsolicited aid appropriately

Sits down safely and independently in a variety of situations

Positions cane appropriately when using a guide

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Protective Techniques

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Demonstrates hand trailing technique

Demonstrates parallel alignment

Demonstrates squaring off and direction taking

Demonstrates upper hand and forearm technique

Demonstrates lower hand and forearm technique

Locates dropped objects in a systematic manner

Demonstrates the ability to self-familiarize to a room

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Low Vision

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Uses and maintains low vision devices (i.e., monocular, hand-

held magnier)

Visually identies landmarks, clues, etc.

Visually identies drop offs

Demonstrates efcient scanning, tracking, spotting procedures

Visually identies pedestrian crossing signal

Determines appropriate time / setting for low vision device use

Initiates use of low vision device(s) independently

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Enter and Exit a Car Safely

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Determines direction car is facing

Locates door handle

Demonstrates appropriate cane storage when in vehicle

Enters and exits car safely and independently

Able to locate curb when exiting vehicle (both parallel and

perpendicular)

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Basic Cane Knowledge

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Demonstrates use of an Adaptive Mobility Device

Identies various parts and purposes of cane

Demonstrates an awareness of different types of canes and cane

tips

Demonstrates proper placement of cane when not in use

Identies preferred cane type, length, and cost

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Diagonal Cane Technique

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Assumes correct hand, arm, and grip with tip in correct position

Changes hands using diagonal technique

Negotiates objects using cane

Negotiates closed doors

Negotiates open doorways

Trails using diagonal cane technique

Negotiates intersecting hallways

Ascends/descends stairs

Examines objects with cane

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Constant Contact Cane Technique

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Assumes correct grip

Assumes correct arm/hand position

Uses correct wrist action

Maintains correct width and height of arc of cane tip

Maintains correct in-step rhythm

Trails/shorelines using a cane

Changes from diagonal technique to constant contact technique

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Two-Point Touch Cane Technique

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Assumes correct grip

Uses correct wrist action

Maintains correct in-step rhythm

Changes from diagonal technique to two-point touch technique

Assumes correct arm/hand position

Maintains correct width and height of arc of cane tip

Trails/shorelines using touch technique

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Indoor Travel Skills

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Travels independently in a classroom setting (i.e., own desk/

table, instructional areas)

Travels independently to other rooms within the school building

(i.e., bathroom, gym, library, other classrooms, ofce, cafeteria)

Demonstrates responsible behavior while walking independently

within the school building

Travels independently on the campus grounds (i.e., bus stops,

parking lot, playground)

Demonstrates indoor trailing skills

Moves up/down steps and/or stairs with sufcient balance to be

safe from falling

Operates various types of door handles

Verbalizes emergency procedures

Locates alternative exits for emergency situations

Safely uses escalators when traveling

Safely uses revolving doors when traveling

Safely uses an elevator when traveling

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Outdoor Cane Techniques

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Renes touch and/or constant contact technique

Uses shorelining technique

Uses sidewalk recovery technique

Uses touch-and-slide technique

Uses touch-and-drag technique

Uses three-point check technique

Uses cane appropriately in congested areas

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Environmental Concepts Level 1

Identies Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Street

Corner at a street

Parkway, tree lawn, easement

Lawn

Concept of “angle” or “angular”

Shrub

Hedge

Landscaping

Telephone pole

Fire hydrant

USPS mailbox

Variety of fences

Manhole cover

Block

Goal Bank Assessment Updated 01.29.2019

Identies Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

House

Broken sidewalk

Level sidewalk or street

Rounded curb

Blended curb

Alley

Driveway

Sidewalk

Expansion crack

Opposite sidewalk

Camber of the street

Shoreline

Storm sewer

Gutter

Guy wire

Stop sign

Yield sign

Goal Bank Assessment Updated 01.29.2019

Identies Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Speed limit sign

Circular drive

Curb cut

Square curb

Path

Step curb

Crosswalk

Decline

Lateral tilt / slope

Incline

Caddy-corner (or “kitty-corner”)

Overhead

Walking with or against trafc

Explains the relationship of sidewalk to street

Identies types of clothing needed for different weather

conditions

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Environmental Concepts Level 2

Explain The Concept: Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Directionality of streets (north-south or east-west)

Four-way stop intersection

Left/right turn of vehicles

Trafc ow

Through streets

Variety of trafc patterns

Speed of vehicles

Two-way stop intersection

Opposite direction

Approaching intersection

Offset intersection

Distances (block, mile, etc.)

Time / distance concepts

Perpendicular

Goal Bank Assessment Updated 01.29.2019

Explain The Concept: Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Right of way

Detour

Parallel

Width of street

Effects of weather conditions (snow, rain) on sounds

Warning signals or sounds in the environment (i.e., sirens, back-

up signals, vehicles honking, etc.)

Various aspects of construction zones

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Basic Residential Travel Skills

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Dresses appropriately for the weather

Maintains a straight line of travel on a sidewalk without excessive

veering

Corrects for veering into a driveway

Reacts appropriately to warning signals or sounds in the

environment (i.e., sirens, back-up signals, vehicles honking, etc.)

Travels safely in areas without curbs or sidewalks

Corrects for veering on a sidewalk

Detects a curb, drop-off, or blended curb at the corner

Uses trafc for orientation purposes

Maneuvers safely around obstacles in the travel path

Travels safely in areas without curbs or sidewalks

Safely navigates around an idling car

Safely navigates around a non-idling car or other object in the

travel path

Identies locations of streets in relation to self while traveling

Goal Bank Assessment Updated 01.29.2019

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Plans and executes a straight line route and reverses it

Dresses appropriately for the weather

Demonstrates an understanding of print and braille references to

route shapes (L, U, Z)

Plans and executes an L-shaped route and reverses it

Plans and executes a U-shaped route and reverses it

Plans and executes a Z-shaped route and reverses it

Plans and executes a route around a complete square block

Recognizes block length differences

Recalls number of blocks traveled and turns in a route

Develops the concept of an intersection and its relationship to a

city block

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Street Concepts

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies approaching trafc

Identies or describes a crosswalk

Identies the camber of a street

Explains the concept of “right of way”

Identies or describes a yield sign

Identies or describes a stop sign

Identies trafc making a left/right turn

Explains the differences in speed of trafc

Identies a through street

Explains speed limit rules for residential, business, highway, etc.

Explains the concept of intersection streets

Identies a two-way stop intersection

Identies a four-way stop intersection

Identies an offset intersection

Goal Bank Assessment Updated 01.29.2019

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Describes trafc patterns at intersections

Identies street directionality (north-south or east-west)

Plans a detour route

Identies a one-way street

Explains the rule of “vehicles keep to right” on two-way streets

Identies the direction of trafc ow

Identies or explains street divider lines (solid-broken)

Explains distances such as block, half-block, mile

Identies the directionality of each street in order to determine

one-way and two-way streets

Estimates distances based on trafc information

Identies trafc intensity (i.e., heavy, moderate, light)

Understands and describes intersection geometry (e.g., +, Y, T,

offset, slip lanes, roundabouts, ve- or six-way intersection)

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Street Crossings

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Recognizes street and curb drop-offs

Differentiates between cars slowing, accelerating, and idling

Aligns self in relation to trafc using appropriate input (sounds /

movement)

Identies type of trafc control (stop sign, uncontrolled)

Chooses appropriate time to cross at a stop sign controlled

intersection (lull / parallel trafc)

Identies the geometry of intersection while traveling

Demonstrates the ability to negotiate intersections of differing

geometric shapes including roundabouts / trafc circles

Understands the concept of indenting and applies where

appropriate

Negotiates trafc control islands

Makes an accurate assessment of risks when crossing a variety

of uncontrolled streets

Lists alternatives to crossing

Determines appropriate time for crossing at locations without

trafc control

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Crossing At Traffic Lights

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies trafc intensity (i.e., heavy, moderate, light)

Identies amount and speed of trafc

Identies the various phases of light cycles at multiple

intersections

Determines type of control at intersection (e.g., lighted, turn

arrows, actuated, multi-cycle)

Understands the use of and utilizes crosswalk buttons

Utilizes audible pedestrian signals

Initiates crossing with closest parallel surge of trafc

Crosses at a simple four-way intersection with no turn arrows

Crosses at an intersection with an actuated signal

Utilize visual pedestrian crossing signals

Crosses a street with a trafc island

Crosses at one-way streets

Goal Bank Assessment Updated 01.29.2019

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Crosses at an intersection with right turn on red

Crosses at an intersection with a with a green right-turn arrow

Crosses at an intersection with left-turn arrows

Demonstrates ability to cross at a variety of unfamiliar

intersections

Recognizes when the risk is unacceptable and chooses not to

cross at a specic intersection

Recognizes when a crossing is too confusing or unsafe

Applies alternatives to crossing

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Orientation Skills Level 1

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Recognizes and utilizes landmarks and clues

Utilizes self-familiarization techniques

Aligns with parallel and perpendicular surfaces in the

environment

Uses trafc characteristics for orientation

Identies physical characteristics, general clues, and landmarks

in the neighborhood

Identies relationship of objects or sounds to self in room

Identies relationship of objects or sounds to self while traveling

indoor route

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Orientation Skills Level 2

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies opposite directions of north/south, east/west

Reads and uses a compass correctly

Identies relationships after changes in body position (180, 360,

90, 45 degrees)

Identies relationship of objects or sounds to self in building

Identies relationship of objects or sounds to self while traveling

outdoor route

Identies the directional side of a street

Identies the directional corners of an intersection

Uses the sun to determine cardinal directions

Identies the direction of the ow of trafc

Demonstrates ability to use multiple clues for orientation

Travels in construction areas

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Mapping Skills

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Describes the parts and purpose of a map (i.e., key, compass

rose, scale)

Identies own specic location on a tactile or print map

Creates personal tactile or print map of a familiar environment

Identies compass directions on a map

Utilizes a map to plan a route

Demonstrates use of internet mapping

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Numbering System: Inside

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Describes the purpose of a numbering system

Demonstrates an understanding of the progression of numbers

in a numbering system (i.e., even-odd, wrap-around, numbers

progression, etc.)

Identies the system used in own school building

Identies the range of numbers on each oor

Transfers numbering system from oor to oor

Identies system irregularities

Uses numbering system to locate a specic room or location

within a building

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Numbering System: Outside

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

States and writes own address

Describes the purpose of a numbering system

Demonstrates an understanding of commonly used numbering

systems in local communities

Identies central dividing line for north/south and east/west

streets in own community (main arterial lines)

Describes the concept of quadrants (NW, NE, SW, SE) in cities

divided in that manner

Uses address to locate specic destination

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Commercial Travel Concepts

Identies Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Trash can

Bus stop (bench, shelter)

Parking meter

Storm drain

Recessed doorway (outdoors)

Outdoor stairs of various kinds

Sidewalk clutter (newspaper boxes, bike racks, planters, etc.)

Drinking fountains, outdoor patio eating area, etc.

USPS mailbox

Manhole cover

Loading dock

Alley

Dumpster

Telephone pole

Goal Bank Assessment Updated 01.29.2019

Identies Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Guy wire

Metal grate (in sidewalk)

Access ramp

Ramped curb cut

Store awning or canopy

Tactile warning strips (truncated domes)

Goal Bank Assessment Updated 01.29.2019

Student Name:

Birth Date:

School: Grade:

Commercial Travel Skills

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies physical characteristics, general clues, and landmarks

in the commercial neighborhood

Executes routes to a specic objective in a commercial area

Recognizes and crosses railroad tracks

Negotiates construction tunnels and construction areas

Identies and negotiates open space in a commercial

environment (i.e., gas station, shopping centers, parking lot)

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Community Experiences

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Locates and enters store doors

Exits store using landmarks and clues

Secures assistance from personnel in a store

Makes simple purchases while accompanied

Identies appropriate coins to make a purchase

Interacts with clerk and makes purchases unaccompanied

Demonstrates an understanding of the layout of familiar retail

establishments (i.e., grocery store, shopping malls, restaurants)

Understands the function of a post ofce, bank, laundromat,

doctor’s ofce, train, or bus station

Shows an understanding of various community resources (i.e.,

re, police, Secretary of State, Bureau of Services for Blind

Persons, etc.)

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Public Transportation

Follows procedures for bus, train, subway travel

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Identies parts of a bus (engine, doors, steps, coin box, seats,

etc.)

Obtains information necessary for route planning

Shows general knowledge of bus routes

Locates bus stops, shelters, stations

Locates appropriate bus using assistance, auditory clues,

devices

Waits for the bus in an appropriate manner

Boards and exits appropriately

Pays or shows pass to bus driver

Provides destination information to the bus driver

Locates a seat appropriate to needs

Locates stop independently or solicits assistance from bus driver

or other passengers

Initiates and maintains contact with driver regarding destination

Goal Bank Assessment Updated 01.29.2019

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Maintains orientation after disembarking

Transfers to a second bus after disembarking

Implements a contingency plan if the planned stop is missed

Applies principles of bus travel to travel on subways and railways

Follows procedures for traveling on public transportation systems

between cities

Follows procedures for accessing taxis/paid transportation

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Accesses names and phone numbers in home community

Obtains fare information and estimates cost of trip

Provides appropriate location information for pick up and drop off

to dispatcher

Waits in an appropriate manner

Maintains orientation after reaching the destination

Goal Bank Assessment Updated 01.29.2019

Follows procedures for accessing paratransit or rural transportation

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Obtains rules for eligibility for paratransit services

Obtains paratransit pass

Knows procedures for obtaining access to service

Arranges for transportation pick up and drop off by giving

appropriate location information to dispatcher

Waits for pick-up in an appropriate manner and location

Interacts appropriately with driver and veries correct drop-off

location

Maintains orientation after disembarking

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Alternative Travel Aids

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Demonstrates use of electronic travel aids and/or smartphone

applications for accessibility

Demonstrates use of a variety of GPS systems

Obtains information regarding guide dog schools, entrance

requirements, and cost

Goal Bank Assessment Updated 01.29.2019

Student Name: Birth Date:

School: Grade:

Skills Of Daily Living As Relates To Travel Skills

Objective Date 1 Level Date 2 Level Date 3 Level Date 4 Level Date 5 Level

Demonstrates ability to tie shoelaces

Demonstrates ability to zip a variety of coats

Demonstrates ability to access and dial a variety of cell phones

Identies all coins and their values

Demonstrates a method for folding or organizing paper money

Demonstrates ability to use a familiar ATM

Goal Bank Assessment Updated 01.29.2019

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