Training Verification For Bips, Health Plans And/or Safety Plans
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1SOUTH
B END
C OMMUNITY
S CHOOL
C ORPORATION
SPECIAL
E DUCATION
S ERVICES
TRAINING
V ERIFICATION
F OR
B IPS,
H EALTH
P LANS
a nd/or
S AFETY
P LANS
The
b elow
n amed
s tudent
h as
a
B ehavioral
I ntervention
P lan
( BIP)
a nd/or
H ealth
P lan
a nd/or
Safety
P lan
a s
p art
o f
h is/her
I EP
f or
t he
2 016- 17
s chool
y ear.
Student
N ame:
S BCSC
I D#:
S TN#:
School:
D ate
o f
B irth:
I
h ave
b een
t rained
i n
t he
p rocedures
a nd
s trategies
i n
t his
s tudent’s
m ost
r ecent
B ehavioral
Intervention
P lan
a nd/or
H ealth
P lan,
a nd/or
S afety
P lan
i n
t he
I EP
d ated
_ ___________.
I
am
a ware
t hat
t hese
m ust
b e
i mplemented
d aily
a s
w ritten.
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
__________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
___________________________________
___________________________
____________
Name
Role
Date
I
h ave
t rained
t he
a ppropriate
p araprofessionals
a nd
s taff
r egarding
t he
p rocedures
a nd
s trategies
outlined
i n
t his
s tudent’s
m ost
r ecent
B ehavioral
I ntervention
P lan
a nd/or
H ealth
P lan,
a nd/or
S afety
Plan
i n
t he
I EP
d ated
_ _____________.
_____________________
____________
TOR
Date
Rev.
9 /2014
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