Fillable Student Support and Progress Team Referral Log (Los Angeles Unified School District)

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Student Support and Progress Team Referral Log (Los Angeles Unified School District)

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Student Support and Progress Team Referral Log
School: ________________________________ Local District: ___________ Referrals From: _________________ To: ___________________
ATTACHMENT E
Instructions: Enter each student referral into the log with dates and supporting information. The SSPT Referral Log and supporting SSPT documentation are to be kept on file at
the school for a minimum of 5 years. For EO, IFEP, and RFEP students, copies of the referral form, the Intervention Plan, and Follow Up Meeting Notes are to be filed in the
student’s red intervention folder in the cumulative record. For EL students, including LTELs, copies of the referral form, the Intervention Plan, and Follow Up Meeting Notes are
to be filed in the student’s blue Master Plan folder in the cumulative record.
Student Name/
Student ID #
Grade
Teacher or
Counselor
Language
Classification
Date of SSPT
Referral
Initial
Meeting Date
Case Manager
First
Follow-up
Meeting Date
Second
Follow-up
Meeting Date
Third
Follow-up
Meeting Date
Comments
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Student Support and Progress Team Referral Log (Los Angeles Unified School District)

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Completed 14 September 2021

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