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VI STAFF MEMBER CASELOAD PROFILE: SAMPLE
STAFF NAME: Carey Hardy

NUMBER OF SCHOOLS SERVED: 9

VI STAFF MEMBER CASELOAD PROFILE

<< SAMPLE >>

** CONFIDENTIAL STUDENT INFORMATION **

NUMBER OF HOURS IN WORK WEEK: 37.5

DATE: May 10,1995

STUDENT NAME 1 SCHOOL & GRADE DIRECT/ CONSULT ONLY % REG SP. ED. SETTING # HOURS/ WEEK/ PER ARD # HOURS/WK ACTIVITIES IN SUPPORT OF INSTRUCTION # HOURS OF TRAVEL PER/WK AREAS OF INSTRUCTION OR CONSULTATION CHANGE NEEDED: AMT OR TYPE OF SERVICE BRL/ DUAL B / D O&M X= YES
SAM Fox / 6 D 100%R 2X1hr/wk 2 hrs/wk .5 hrs/wk soc. skills, organiza. -.5 hr/wk - X
ANN Gray / 5 D 50%R 2X.75 1.5 hrs/wk 0.5 indep.liv. skills, soc. -.5 hr/wk
X
RAY Wren / 3 D 100%R 2X.75 3 hrs/wk 0.5 braille, abac., tech. + 1 hr/wk B X
JOE Tell / 3 D 100%R 2X.75 3 hrs/wk 0.5 SAME AS ABOVE + 1 hr/wk B X
NAT Sun / 7 D 100%R 3X.75 3 hrs/wk 0.25 brl maps, + 2 hrs/wk D X
SARA Sun / 7 D 80%R 2X.75 1.5 hrs/wk 0.25 soc.skills, lv devices     X
AMY High / 2 D 100%R 1X1 1 hr/wk 0.25 organiz., lv devices     X
GRACE Infant D ----------- 1X1 1 hr/wk 0.5 visual dev, language     X
TED Post / 10 C 100%S 2X1.25 1 hr/wk 0.25 adapt. class - 1 hr/wk   X
KATHIE Ray / K. C 100%R 1X1 1 hr/wk 0.5 effic. use of vision     X
TOTAL: 2 8D 2C 3 4 15.75 5 18 hrs/wk 6 4 7 8 + 1.5 hrs/wk 9 3 10 10 11

Completion of this form provides the Work Group with a format for analyzing and comparing caseloads. This form may be completed by VI teachers, O&M specialists and VI paraprofessionals prior to the meeting on caseload analysis. Names of referrals should be added at the end of each staff members' caseload list and clearly marked as such. Information requested includes:

  • Staff Name: Each staff member should complete a separate form listing students served.
  • Number of Schools Served: Enter the total number of schools or sites visited by this staff member, including home visits to infants.
  • Number of Hours in Work Week: Enter the number of hours in the work week, excluding lunch.
  • Date: Always enter the date this form is completed, as caseload changes can be tracked by looking for the most current date.
  1. Student Name: List names alphabetically, last name first.
  2. School/Grade: Enter the name of school and grade level of each student.
  3. Direct/Consult: Indicate if student receives direct instruction or consultation only.
  4. % Regular/Special Education Setting: Indicate the percentage of time spent in regular and special education settings. Example: 80% regular, 20% special education.
  5. # Hours/week per ARD: Indicate the number of hours of service (direct or consultation only) to be provided to each student as per ARD decision. Include the frequency of service, if more than once a week. Example: 1 hour 3x/week = 3 hours/week. Translate monthly, semester or yearly hours into a weekly equivalent for the sake of comparison. Example: 1 hour per month is written 15 minutes per week. These hours should not include any teacher activities in support of instruction (planning, preparation, ARD meetings, inservices, etc.).

    NOTE: For the sake of analyzing the time commitment required to meet students needs, as determined by ARD committee decision, it is requested that times for service be calculated on a weekly basis. This is not to suggest that all students should be seen weekly. Whatever the decision of the ARD committee, that time and frequency of services should be provided.

    • This is an aid to converting times from monthly to weekly.
    • 30 minutes/month = .12 hours/week (7.5 minutes/week)
    • 1 hour/month = .25 hours/week (15 minutes/week)
    • 2 hours/month = .50 hours/week (30 minutes/week)
    • 3 hours/month = .75 hours/week (45 minutes/week)
    • 4 hours/month = 1 hour/week (60 minutes/week)
  6. # Hours per Week of Activities in Support of Instruction: Estimate the amount of time needed to deliver the services mandated by ARD Committee decision. Consider the time commitment for the staff member to fulfill all the roles and responsibilities appropriate to each staff position. Before the VI staff completes these forms, consider a group activity in which a list is made of all possible activities in support of instruction. The results will be more useful if the entire staff is using the same list of activities.
  7. # Hours of Travel Per/Week: Estimate the amount of time spent weekly traveling to and room students and to fulfill other professional responsibilities.
  8. Areas of Instruction or Consultation: Indicate the focus or purpose of the direct or consultative services.
  9. Change Needed/Amount or Type of Service: This column may be left blank prior to the QP/VI group meeting, to be completed after group discussion of each student. When completed, it should reflect any change needed in the amount or type of services the student currently receives. Enter the addition or deletion of time or frequency of services in weekly terms. Examples: +1hour 2x/week or -30 minutes 1x/week. By indicating only additions or deletions in this column the task of arriving at a grand total will be simplified (See Sample)
  10. Braille/Dual: Enter "B" if a student is a braille or pre-braille student. Write "D" for students performing in print and braille.
  11. O&M: Indicate in this column those students receiving orientation and mobility instruction.

The last row on the page provides space for totaling the figures in the non-shaded columns. These should represent numbers of students or numbers of hours per week, depending on the column.