Evaluation Summary Report (Pennsylvania)
Last Modified on 03/10/2025 10:05 am CDT
Tool Search: Special Ed Documents
The Evaluation in Campus documents the student's educational needs and determines eligibility for special education. This document describes each editor, the section(s) of the print format that includes the entered information, a description of each field on the editor, and any special considerations and instructions for using the editor and fields.
An evaluation must be created whether or not the student is determined to have a disability. The school district gives a copy of the evaluation summary report, including the documentation of eligibility, to the student’s parents. For information on general functionality, navigation, and additional plan and evaluation features, see the core Plan and Evaluation Information article.
The current format of this document is the PA ER 2024. Evaluation formats are selected in Eval Types.
Editor Home
Evaluation Header
The Evaluation Header editor includes general information about the evaluation, including relevant dates, the type of evaluation, and basic student information.
This editor must be saved before continuing to other parts of the evaluation.
Evaluation Header Editor
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| Field |
Description |
Validation |
|---|
Date of Report
Required |
The date the Evaluation was created. |
This field auto-populates with today's date, but it can be modified. |
Date report Provided to Parent/Guardian/Surrogate
Required |
The date the Evaluation report was given to the student's parent/guardian/surrogate. |
N/A |
| Local Education Agency (LEA) |
A public board of education or other public authority within a state that maintains administrative control of public elementary or secondary schools in a city, county, township, school district, or other political subdivision of a state. |
N/A |
| Current Educational Program |
The student's current educational program. |
N/A |
| LEA Representative Name |
The name of the LEA representative. |
N/A |
| Phone Number |
The phone number for the LEA representative. |
N/A |
| Email Address |
The email address for the LEA representative. |
N/A |
| Other Information |
Any other information regarding the LEA representative or the student's current education program. |
The Template Bank associated with this field is called Evaluation Other Information. |
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Enrollment Information
The Enrollment Information editor reports Special Education information from the student's Enrollment.
The Refresh button retrieves a fresh copy of data from the student's record. See the General Information section for additional information.
This editor is read-only.
Enrollment Information Editor
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| Field |
Description |
Ad Hoc |
Validation |
|---|
| Resident District |
The student's district of residence. |
Learner Planning > Learning Plans > residentDistrictNumber |
This field is pulled from the Enrollment record and cannot be modified. |
| Grade |
The student's current grade. |
Enrollment > Grade
enrollment.grade
|
This field is pulled from the Enrollment record. This field is read only.
|
| School Name |
The name of the school associated with the student's Enrollment record. |
Learner Planning > Learning Plans > servingSchoolName |
This field is pulled from the Enrollment record. This field is read only.
|
| School Phone |
The phone number of the school associated with the student's Enrollment record. |
N/A |
This field is pulled from the Enrollment record. This field is read only.
|
| School Year |
The school year associated with the student's Enrollment record. |
N/A |
This field is pulled from the Enrollment record. This field is read only.
|
|
District Information
|
| District Number |
The district number associated with the Enrolled school. |
System Administration > Resources > District Information > State District Number |
N/A |
| District Name |
The district name associated with the Enrolled school. |
System Administration > Resources > District Information > Name |
N/A |
| District Address |
The district address associated with the Enrolled school. |
System Administration > Resources > District Information > Address |
N/A |
| District Phone |
The district phone number associated with the Enrolled school. |
System Administration > Resources > District Information > Phone |
N/A |
| District SPED Address |
The district special education address associated with the Enrolled school. |
System Administration > Resources > District Information > SPED Address |
N/A |
| District SPED Phone |
The district special ed phone number associated with the Enrolled school. |
System Administration > Resources > District Information > SPED Phone |
N/A |
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Student Information
The Student Information editor displays basic information about the student such as demographic information. This is a read-only editor.
The Refresh button retrieves a fresh copy of data from the student's record. See the General Information section for additional information.
This is a read-only editor.
Student Information Editor
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|
Field Name
|
Description
|
Ad Hoc
|
|---|
|
Last Name
|
The student's last name. |
Census > People > Demographics > Last Name
identity.lastName
|
| First Name |
The student's first name. |
Census > People > Demographics > First Name
identity.firstName
|
| Middle Name |
The student's middle name. |
Census > People > Demographics > Middle Name
identity.middleName
|
| Suffix |
The student's suffix. |
Census > People > Demographics > Suffix Name
identity.suffix
|
| Age |
The age of the student. |
Census > People > Demographics > Age |
| Birthdate |
The student's birthdate. |
Census > People > Demographics > Birth Date
identity.birthDate
|
| Gender |
The student's gender. |
Census > People > Demographics > Gender
identity.gender
|
Federal Designation
|
The student's federally designated race/ethnicity. |
Census > People > Demographics > Federal Designation
identity.raceEthnicityFed |
| Federal Race(s) |
The student's federal race(s). |
Census > People > Demographics > Race(s)
identity.raceEthnicityFed1, raceEthnicityFed2, raceEthnicityFed3, raceEthnicityFed4, raceEthnicityFed5 |
| Race, Ethnicity (state) |
The student's state race/ethnicity designation. |
Census > People > Demographics > State Race/Ethnicity
identity.raceEthnicity |
| Home Primary Language |
The student's home primary language. |
Census > People > Demographics > First Language
identity.homePrimaryLanguage
|
| Address |
The student's address.
This field becomes a dropdown when more than one address exists for the student. The primary household displays by default.
|
Census > Households > Address Info
address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip
|
| Student Number |
The student's identification number. |
Census > People > Demographics > Student Number |
| State ID |
The student's state identification number. |
Census > People > Demographics > State ID |
| Case Manager Information |
| Name |
The name of the student's Case Manager. |
Student Information > Special Ed > General > Team Members > Name |
| Title |
The title of the staff member. |
Student Information > Special Ed > General > Team Members > Caseload Role |
| Phone |
The staff member's phone number. |
Student Information > Special Ed > General > Team Members > Other Phone |
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Parent/Guardian Information
The Parent/Guardian Information editor populates based on the guardian checkbox on the student's Relationships tool. The editor includes Demographics information for the student's guardian.
The Delete button next to each parent/guardian can be used to remove a parent/guardian from the Evaluation.
The Refresh button retrieves a new copy of parent/guardians' data. This also returns any accidentally deleted people. Manually entered fields do not change when the refresh button is clicked. The user must Save after clicking Refresh to capture changes.
Parent/Guardian Information Editor
Click here to expand...
| Field Name |
Description
|
Ad Hoc
|
Validation
|
|---|
| Relationship |
The relation of the parent/guardian to the student. |
Census > People > Relationships |
This field populates from Census. This is part of the header for the parent/guardian.
|
| Last Name |
The last name of the parent/guardian. |
Census > People > Demographics > Last Name
identity.lastName
|
This field populates from Census. This is part of the header for the parent/guardian.
|
| First Name |
The first name of the parent/guardian. |
Census > People > Demographics > First Name
identity.firstName
|
This field populates from Census. This is part of the header for the parent/guardian.
|
| Middle Name |
The middle name of the parent/guardian. |
Census > People > Demographics > Middle Name
identity.middleName
|
This field populates from Census. This is part of the header for the parent/guardian.
|
| Suffix |
The suffix of the parent/guardian. |
Census > People > Demographics > Suffix Name
identity.suffix
|
This field populates from Census. This is part of the header for the parent/guardian.
|
| Print Sequence |
The print order of the parent/guardian(s) on the IEP. |
N/A |
When no Sequence is selected, parent/guardian(s) print in the order displayed in the UI. When any Sequences are selected, only parent/guardian(s) with a sequence number prints in the order defined. |
| Address |
The parent/guardians' address. |
Census > Households > Address Info
address.number; address.street; address.tag; address.prefix; address.dir; address.apt; address.city; address.state; address.zip
|
This field populates from Census.
When there are multiple addresses for a person, a drop down with an option to select which address displays. When there is only one address, the drop down only has one option. The populated address is the one marked "Primary."
|
| Home Phone |
The home phone number of the parent/guardian. |
Census > People > Demographics > Household Phone
|
This field populates from Census. |
| Work Phone |
The work phone of the parent/guardian. |
Census > People > Demographics > Work Phone |
This field populates from Census. |
| Cell Phone |
The cell phone of the parent/guardian. |
Census > People > Demographics > Cell Phone |
This field populates from Census. |
| Email |
The primary email address for the parent/guardian. |
Census > People > Demographics > Email |
This field populates from Census. |
| Home Primary Language |
The home primary language of the parent/guardian. |
Census > People > Demographics > Home Primary Language
identity.homePrimaryLanguage
|
This field populates from Census.
The dropdown options are pulled from the Home Primary Language Attribute/Dictionary list. See the Attribute/Dictionary documentation for additional information.
|
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Reason(s) for Referral
The Reason(s) for Referral editor is used to describe the reason the student is being referred to evaluation.
Reason(s) for Referral Editor
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Sources of Evaluation Data
The Sources of Evaluation Data editor is used to describe the variety of data sources used to consider in determining the student's eligibility.
Sources of Evaluation Data Editor
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| Field |
Description |
|---|
| A. Evaluations and information provided by the parent of the student (or documentation of LEA's attempts to obtain parental input) |
A description of the information given to the student's evaluation team by the parent/guardian(s) of the student. |
| B. Observations - include teacher observations and observations by related services providers, when appropriate |
A description of the observations of the student's behavior(s) by teacher(s) and/or service providers. |
| C. Recommendations by teachers |
A description of the teachers' recommendation for services. |
| D. The student's physical condition (include health, vision, hearing); social or cultural background; and adaptive behavior relevant to the student's suspected disability and potential need for special education |
A description of the student's physical conditions, social/cultural background, and adaptive behaviors relevant to the student's suspected disability. |
| E. Assessments - include, when appropriate, current classroom based assessments; aptitude and achievement tests; local and/or state assessments; vocation technical education assessment results; interests, preference, aptitudes (for secondary transition); etc. |
The assessments used to determine the student's condition(s), disabilities, and/or special education needs. |
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Evaluation Conditions
The Evaluation Conditions editor is used to describe the extent to which the assessment conditions varied from the standard conditions.
Evaluation Conditions Editor
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Determining Factors
The Determining Factors editor is used to document the factors related to the student's instruction in reading and math.
Respond Yes or No to, and provide evidence for, each determining factor.
Determining Factors Editor
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| Ad Hoc |
Description |
|---|
| Lack of appropriate instruction in reading, including the essential components of reading instruction |
Indicates if the student is limited in their reading skills. |
| Lack of appropriate instruction in math |
Indicates if the student is limited in their math skills. |
| Limited English Proficiency
|
Indicates if the student is limited in their English language skills. |
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Summary of Findings
The Summary of Findings editor documents the student's functional levels in academic achievement, functional performance, and behavioral information.
Summary of Findings Editor
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| Field |
Description |
|---|
| A. PRESENT LEVELS OF ACADEMIC ACHIEVEMENT - Describe the student's present levels, strengths, and the resulting academic needs, when appropriate. Include communicative status, motor abilities, and transition needs as appropriate. For students with Limited English Proficiency (LEP), include current level(s) of English language proficiency in reading, writing, speaking and understanding/listening.
|
Describes the student's present academic level and associated academic needs, when applicable. |
| B. PRESENT LEVELS OF FUNCTIONAL PERFORMANCE - Describe the student's present levels, strengths, and the resulting functional needs, when appropriate.
|
Describes the student's present levels of functional performance with resulting functional needs, if applicable. |
| C. BEHAVIORAL INFORMATION - Include social and emotional status and behavioral strengths and needs, when appropriate. |
Describes the student's behavioral strengths and needs, if applicable. |
| Additional Evaluation Information |
Any other information related to the student's evaluation. |
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Conclusion
The Conclusion editor is used to document the determination of eligibility based on the information entered into the previous editors.
Conclusion Editor
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| Field |
Description |
Validation |
|---|
| A. The student does not have a disability and therefore is NOT ELIGIBLE for special education. |
Indicates the student does not have a disability and is not eligible for special ed services. |
N/A |
| B. The student has a disability but does not need specially designed instruction, and therefore is NOT ELIGIBLE for special education.
|
Indicates the student has a disability, but does not need specially designed instruction. |
N/A |
| C. The student has a disability AND is in need of specially designed instruction, and therefore IS ELIGIBLE for special education.
|
Indicates the student has a disability and is in need of special education services. Additional information is required when this option is selected. |
*When C is marked, the following fields display. |
Primary Disability Category
Required
|
The student's primary disability. |
N/A |
| Secondary Disability Category
|
The student's second disability, if applicable. |
N/A |
| Tertiary Disability Category
|
The student's third disability, if applicable. |
N/A |
| Disability Area 4
|
The student's fourth disability, if applicable. |
N/A |
| Disability Area 5
|
The student's fifth disability, is applicable. |
N/A |
| Recommendations for consideration by the IEP team to enable the student to participate as appropriate in the general education curriculum (including special considerations the IEP team must consider before developing the IEP, measurable annual goals, specially designed instruction and supplementary aids and services)
|
A description of the recommendation by the team for the student to participate in the general education curriculum. |
N/A |
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Team Meetings
The Team Meeting editor is used to document meeting information.
Click here to expand...
Team Meeting List Screen
Team Meeting List Screen
| Field |
Description |
|---|
| Padlock Icon |
The user currently working on the record.
|
| Meeting Date |
The date of the meeting. |
| Meeting Location |
The location of the meeting. |
| Print in Evaluation |
Indicates this meeting information prints on the Evaluation. |
Team Meeting Detail Screen
Team Meeting Detail Screen
| Field |
Description |
|---|
| Print in Evaluation |
Indicates this meeting information prints on the Evaluation. |
Meeting Date
Required |
The date of the evaluation meeting. |
| Meeting Time |
The time of the meeting. |
| Meeting Location |
The location of the meeting. |
| Invite Date |
The date the team members were invited to the meeting. |
| Comments |
Any comments related to the meeting. |
| Attendance |
First Name
Required |
The first name of the team member. |
Last Name
Required |
The last name of the team member. |
| Role Name |
The role of the team member. |
| Agreed |
Indicated this team member agrees with the evaluation conducted for the student. |
| Disagreed |
Indicates this team member disagreed with the evaluation conducted for the student. |
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Determination of SLD
The Determination of SLD (Specific Learning Disability) is used to document details related to the determination for eligibility.
This editor must be completed when determining eligibility for Specific Learning Disability.
Determination of SLD Editor
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| Field |
Description |
|---|
| 1. The student does not achieve adequately for the student's age or does not meet State-approved grade-level standards in one or more of the following areas when provided with learning experiences and scientifically based instruction appropriate for the student's age or State-approved grade level standards and level of English language proficiency: oral expression, listening comprehension, written expression, basic reading skill, reading fluency skills, reading comprehension, mathematics calculation, and mathematics problem-solving.
|
Describes if the student is not achieving an academic standard that complies with state-approved grade-level standards. |
| 2. Check below to identify the process(es) used to determine eligibility. |
| Response to Scientific Research-Based Intervention (RtI). Document the criteria below.
|
Indicates that a scientific research based intervention was used to determine the student's special ed eligibility. |
| The student does not make sufficient progress to meet age or State-approved grade-level standards in one or more of these areas: oral expression, listening comprehension, written expression, basic reading skill, reading fluency skills, reading comprehension, mathematics calculation, and mathematics problem-solving.
|
Describes the areas the student is not meeting state approved grade-level standards. |
| Severe Discrepancy between Intellectual Ability and Achievement. Document the criteria below.
|
Indicates that an intellectual ability and achievement process was used to determine the student's special ed eligibility. |
| The student exhibits a pattern of strengths and weaknesses in performance, achievement or both relative to age, standards or intellectual development.
|
Describes the student's pattern of behaviors related to their academic achievement for their age and development. |
| 3. The instructional strategies used and the student-centered data collected
|
Describes the instructional strategies used. |
| 4. The educationally relevant medical findings, if any
|
Describes relevant medical findings. |
| 5. The effects of the student's environment, culture, economic background
|
Describes the effects of the student's environment. |
| 6. Data demonstrating that prior to referral or as part of the referral process for a specific learning disability, the student's regular education instruction was delivered by qualified personnel, including the English as a Second Language (ESL) program, if applicable
|
Describes the data collected prior to the student's referral or as part of the referral process indicating the student was taught by a qualified personnel. |
| 7. Data based on documentation of repeated assessments of achievement at reasonable intervals, reflecting progress during instruction, which was provided to the parents
|
Describes data provided by the parent/guardian(s) of the student. |
| 8. An observation in the student's learning environment (including the regular classroom setting) to document the student's academic performance and behavior in the areas of difficulty. Note the relationship of that behavior to the student's academic functioning.
|
Describes the student' academic performance and behaviors in the areas of difficulty. |
| 9. Other data, if needed, as determined by the evaluation team
|
Describes any other data pertaining to the evaluation. |
| 10. Include a statement for each item below to support the conclusions of the evaluation team that the findings are not primarily the result of |
| Visual, hearing, motor disability |
A statement of the student's conclusion regarding the student's visual, hearing, motor disability. |
| Intellectual Disability
|
A statement of the student's conclusion regarding the student's intellectual disability. |
| Emotional Disturbance
|
A statement of the student's conclusion regarding the student's emotional disturbance. |
| Cultural factors
|
A statement of the student's conclusion regarding the student's cultural factors. |
| Environmental or economic disadvantage
|
A statement of the student's conclusion regarding the student's environmental or economic disadvantage. |
| Limited English proficiency |
A statement of the student's conclusion regarding the student's limited English proficiency. |
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Editor Home
Evaluation Header Editor
Enrollment Information Editor
Student Information Editor
Parent/Guardian Information Editor
Reason(s) for Referral Editor
Sources of Evaluation Data Editor
Evaluation Conditions Editor
Determining Factors Editor
Summary of Findings Editor
Conclusion Editor
Team Meeting List Screen
Determination of SLD Editor
