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Test Security Staff Assurance Report– Prior to Testing

Washington Comprehensive Assessment Program (WCAP)

Office of Superintendent of Public Instruction

All persons having direct or indirect access to secure test material are prohibited from duplicating, transmitting, or by any

means disclosing secure test content, including, but not limited to, test questions, passages, or performance tasks and/or the

contents of student test books, answer booklets, accommodated forms (online or paper-pencil), unless specifically authorized

to do so by OSPI. The security of all state assessment materials must be maintained before, during, and after each testing

session. RCW 28A.635.040, RCW 42.56.250, and WAC 181-87-060 provide descriptions of the penalties for the unauthorized

review, use, or disclosure of test content and flagrant disregard of generally recognized professional standards in test

preparation and administration.

Prohibited activities include, but are not limited to:

 Reviewing and/or revealing secure test content;

 Copying secure test content;

 Developing or knowingly using instructional resources derived from secure test content;

 Assisting students with the interpretation of test questions, passages, or tasks;

 Changing, altering, or otherwise interfering with student responses;

 Copying or reading student responses;

 Leaving secure assessment materials in an unsupervised or non-secure location.

If any of the above activities need to be provided as a stipulated accommodation, Test Administrators (TAs) are permitted to

provide the accommodation(s), if consistent with the Guidelines on Tools, Supports, & Accommodations for state

assessments:

Spring Administrations: 



Smarter Balanced

HSPE

Off-Grade Level HS

MSP

EOC

WA-AIM

ELPA21

Retake Administrations: 



Fall/Smarter Balanced HS

Fall/ Off Grade HS

Winter/EOC

School/Site Name:

/__/__/__/__/

___________________________________________________________________________________________________________________________

School 4-digit Code

To be completed by all staff who have responsibility in the administration of state assessments or access to secure testing

materials. All “NO” responses must be explained below and reported to your School Test Coordinator (SC).

This form must be signed twice: Once after training and before testing, and again after testing has been completed.

Submit the completed form with signature to your SC.

YES NO



 Were you trained in test administration and security procedures?



 Did you review and understand the Training Materials, Test Administration Manual and/or Directions for Administration?



 Do you understand your school’s Test Security and Building Plan “chain of custody” for all assessment material?

I have read and understand the non-disclosure restrictions that apply to secure assessment materials, as described in this

document. I will not read, reveal, or disclose information about secure test content and I will not engage in activities that

would violate the security of the state assessments or cause student achievement to be inaccurately represented or reported. I

state that the above information is true and correct to the best of my ability.

_______________________________________________

_________________________________________________

Staff Member Name (please print)

Signature

____/____/_______

Date

Submit both pages of this original form (completed/two signatures) to the SC for retention. Retain a copy for your records.

A copy of this form should be retained at school or district and available for audit according to district retention policy.

FRN1004.WCAP

Page 1 of 2

2/17/2016

Test Security Staff Assurance Report Form - Washington Comprehensive Assessment Program (Wcap)

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