The Commonwealth of Massachusetts Department of Education 350 Main Street, Malden, Massachusetts 02148-5023 Telephone: (781) 338-3700 TTY: N.E.T. Relay 1-800-439-2370 October 10, 2006 Gregg Williams Riverside School Northeast Family Institute, Inc. 34 Berry Road Lowell, MA 01854 Re: Onsite Follow-up Monitoring Report: Program Review Corrective Action Plan Verification and Mid-cycle Review Dear Gregg: Enclosed is the Department's Program Review Follow-up Monitoring Report together with findings regarding your private school’s Mid-Cycle Program Review. This report contains the Department's findings based on the onsite activities conducted in your school on August 16 and 17, 2006. This report includes a report on the status of implementation for new state or federal special education requirements enacted since your school’s initial approval. The Department’s onsite team found certain noncompliance or partial compliance issues. Therefore, the Department is issuing a “Provisional Approval” status effective from the date of this letter and indicated on your approval certificate. Your “Provisional Approval” will expire on February 15, 2007. The reasons for the “Provisional Approval” are clearly indicated on the attached Corrective Action Plan Implementation Checklist. In cases where a private school is not in full compliance with all criteria during a mid-cycle review, the Department must prepare a Corrective Action Plan for the school, which must be implemented without delay. You will find these requirements for corrective action and progress reporting included in the attached report together with any steps that must be taken by the school to fully implement new special education requirements. Please provide the Department with your written assurance that the Department's requirements for corrective action will be implemented by your private school within the timelines specified. Your statement of assurance must be submitted to the Department's Onsite Chairperson by October 27, 2006. Your staff's cooperation throughout these follow-up monitoring activities is appreciated. Should you require additional clarification of information included in our report, please do not hesitate to contact the Onsite Team Chairperson at 781-338-3701. Sincerely, Diane L. Chadwell, Program Review Follow-up Chairperson Program Quality Assurance Services Darlene Lynch, Director Program Quality Assurance Services c: David P. Driscoll, Commissioner of Education Margaret Zusky, Chairperson, Board of Directors Encl.: Follow-up Monitoring Report Provisional Private School Approval Certificate, Expiration Date: February 15, 2007 MASSACHUSETTS DEPARTMENT OF EDUCATION PRIVATE SCHOOL MID-CYCLE PROGRAM REVIEW Northeast Family Institute, Riverside School ONSITE VERIFICATION OF CORRECTIVE ACTION PLAN IMPLEMENTATION AND/OR IDENTIFICATION OF ADDITIONAL FINDINGS REQUIRING CORRECTIVE ACTION Onsite Visit Conducted on August 16 and 17, 2006 Date of this Report October 10, 2006 Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 1.3 This criterion has been replaced by 7.1 below. Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance See 7.1 below. Program’s Curriculum 28.09(9) Riverside School, Northeast Family Institute, Inc., Program Review Mid-cycle Report October 10, 2006 Page 1 of 24 Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 2.2 Approvals, Licenses, Certificates of Inspection Documentation Riverside School maintains all current licenses, approvals and certificates of inspection by state and local agencies. Documentation Riverside School has a current, full license from Early Education and Care. 28.09 (2)(b)4-5 28.09(5) 28.09(6) 18.04(1) 102 CMR 3.06 (4)(b) 2.3 EEC Licensure (Not Applicable to Day Schools) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 3.2 Health Care Manual Documentation Riverside School maintains a written and current health care policies and procedures manual containing all required healthrelated policies and procedures as described in 603 CMR 28.00 and 603 CMR 18.00. A licensed physician approves this manual. Documentation Riverside School has written procedures for notifying the Department of substantial changes within the program. 18.05 (9)(d) 4.4 Advanced Notice of Program/ Facility Change 28.09(5)(c) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 4.5 Immediate Notification 18.03(10) 18.05(7) 28.09(12) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews Student Records Riverside School provides immediate notification to the parent, the public school district special education administrator, any State Agency involved in the student care or placement and the Department of Education for all required serious incidents. As the program maintains copies of the incident reports in student records, the program will also maintain copies of Form 2s submitted to the Department in the student records. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 5.2 Policies and Procedures for Coordination/ Collaboration with Public School Districts & Content requirements policies/procedures for Coordination/ Collaboration with Public School Districts 28.06(2-3) 28.09(9)(c)&(d )28.09(2)(b)7 Federal Regulations: 300.349 and 300.400-.401 Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Riverside Schools has policies and procedures covering all required areas of coordination and collaboration with public schools to ensure that to the maximum extent appropriate, children with disabilities are educated with children who do not have disabilities and are given opportunities to return to a less restrictive educational program. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 6.1 Daily Instructional Hours Documentation Interviews Riverside School provides an average annual minimum of five and a half hours per school day for secondary age students and 5 hours per school day for elementary age students. Documentation Interviews Riverside School indicated that students in its program do not participate in school- to- work activities. Time spent by students in the Culinary Arts program in the program are verified by the Culinary Arts Coordinator. 603 C.M.R. 27.00 6.2 School-towork (Instructional hours) 603 CMR 27.02, 27.04 6.3 Kindergarten (Instructional hours) 603 CMR 27.03(5) Not applicable Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 6.4 School Days per Year Documentation Interviews Riverside School is approved as an eleven- month school program and is in session 212 school days while the requirement is for 198 school days. Not applicable Documentation Interviews Riverside School’s student population is younger than grade 12. 28.09(9) 6.5 Early Release of High School Seniors 603 CMR 27.05 Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 7.1 Curriculum Frameworks 28.09(9)(d) Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Documentation Interviews Riverside School’s curriculum includes the content areas specified in the Massachusetts Curriculum Frameworks. The program provides students with essential learning opportunities that prepare the students to reach the state graduation standards. Documentation Interviews Student Records Riverside School has written procedures that outline how students will participate in state and/or district wide assessments that includes how Riverside School will provide for MCAS testing accommodations and/or the administration of alternate assessments as determined by each student’s Team. 28.09(9)(b) 7.3 State/District Wide Assessments Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified The program should develop a description of the process and/or documentation that clearly demonstrates the steps the program has taken to provide students with essential learning opportunities that prepare the students to reach the state graduation standards. Submit to the Department by December 18, 2006, the required description. Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 8.4 Program Modifications and Support Services for Limited English Proficient Students Documentation Interviews Riverside school submitted a copy of its policy and procedures indicating that they will work with the public school to implement necessary program modifications and support services to serve limited English proficient students who need language assistance. Documentation Student Records Riverside School has policies and procedures to ensure that the program contacts and coordinates with the public school district and parents whenever the IEP needs to be revised to reflect a change in goals, placement, or a return to a less restrictive setting. Title VI: 42 U.S.C. 2000d 8.9 IEP- Revisions & Changes 34 CFR 300 Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 10.1 Student/Teacher Ratios Documentation Interviews Riverside School ensures that instructional groupings do not exceed 6 students to 1 certified teacher with an aide. Documentation Interviews Riverside School’s childcare ratios are 4 to 1 on nonschool days and 6 or 8 to 1 during sleep hours. Documentation Riverside School has written personnel policies and procedures that meet the requirements of 603 CMR 28.09(7), 603 CMR 28.09(11)(a) and 603 CMR 18.05(11). 28.06(6)(d)&( g) 28.09(7)(e) 10.4 Student: Child Care Ratios 28.09(7) 18.01(2) 11.1 Personnel Policies 28.09(7) 28.09(11)(a) 18.05(11) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 11.3 Educational Administrator Qualifications Documentation Interviews 28.09(7)(b)(c) 18.05(11)(f) Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Riverside School’s educational administrator does not have the required qualifications for his position. By December 18, 2006 submit evidence that the educational administrator is appropriately qualified for his position, has been waivered by DOE, or his DOE application is ready to be reviewed. 28.09(7)(a) 603 CMR 44.00 and 44.04 11.4 Teachers Special Education Teachers and Regular Education Teachers Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews All Riverside School teachers are either licensed or waivered by the Department for the area in which they are employed. Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 11.4(a) Professional Development Plans Documentation Riverside School has signed professional development plans for each of their teachers as required. Documentation Riverside School has appropriately credentialed related services providers. Documentation Riverside School maintains a master list of all staff for every position within the program that includes the person’s job title together with their corresponding UFR title numbers and full-time equivalents (FTE’s). 28.09(7)(b)(c) 18.05(11)(f) 11.5 Related Services Staff 28.09(7)(d) 11.6 Master Staff Roster 28.09(7) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 11.7 Job Descriptions Documentation Riverside School maintains job descriptions for all staff positions. 11.8 Salary Ranges 18.05(11)(e) Documentation Riverside School provided a statement of its salary ranges and benefits for each position. 11.9 Organizational Structure Documentation Interviews Riverside School demonstrated that its organizational structure provides for the effective and efficient operation of the school, supervision of school staff and supervision of students. 18.05(11)(d) 28.09(7) 28.07(c) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 11.11 Supervision of Students 28.09(7) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews Riverside School has developed a plan that ensures that it provides appropriate supervision to students while they are engaged in school-related activity on and off school grounds. A comprehensive list of recreation and leisure activities was provided. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 11.12 Accessibility of Extracurricular Activities Title VI: 42 U.S.C. 2000d; 34 CFR 100.3(a), (b); Title IX: 20 U.S.C. 1681; 34 CFR 106.31, 106.41; Section 504: 29 U.S.C. 794; 34 CFR 104.4,104.37(a ), (c); Title II: 42 U.S.C. 12132; 28 CFR 35.130; NCLB: Title X, Part C, Sec. 721; Mass. Const. amend. art 114; M.G.L. c. 76, s. 5; 603 CMR 26.06 Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews Interviews indicated that Riverside School provides equal opportunity for all students to participate in all recreational and extracurricular activities. The program provided a list of its intramural and interscholastic sports offerings, extracurricular activities and clubs sponsored by the school as well as requirements for participation in each of these activities. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 12.2 Annual InService Training Plan and Calendar 28.09(7)(f) 18.05(11)(h) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews Review of training rosters indicated that not all staff receive mandated training within their first month of employment. According to program administrators, however, these staff are not allowed to be with students alone and are not counted as part of the staff student ratio. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 13.3 Comparability of Facilities Title VI: 42 U.S.C. 2000d; 34 CFR 100.3(b)(2); Title IX: 20 U.S.C. 1681; 34 CFR 106.33,106.40( b)(3); Section 504: 29 U.S.C. 794; 34 CFR 104.34(c); Mass. Const. amend. art. 114; 603 CMR 28.03(1)(b) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Observation Riverside School does not have separate facilities for members of a specific group. Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 15.1 Parental Involvement and Parents’ Advisory Group Documentation Interviews Title VI; EEOA: 20 U.S.C. 1703(f); M.G.L. c. 76, s. 5; 603 CMR 26.02(2) Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Riverside School has a plan for involving parents and has invited parents to participate in a Parent’s Advisory Group. Although the program has held meetings with parents, it did not provide copies of agendas and sign-in sheets from these meetings of the Parent Advisory Council. Submit copies of agendas and sign-in sheets from Parent Advisory Council meetings held during the fall 2006 to the department by December 18, 2006. 18.05(4)(a) 15.3 Information to be translated into Languages other than English Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Documentation Interviews Riverside School has developed a written plan to ensure that when students have parents or guardians with limited English language skills, it ensures that general announcements and notices of extracurricular activities and other opportunities are distributed to them in the primary language of the home. One sample announcement letter translated in to Spanish was included with the documentation. Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 15.8 Registering Complaints Documentation Riverside School has a written grievance procedures that may be used by parents and students to register complaints regarding the student’s education and care at the school and allegations of discrimination based on sex and disability. Documentation Riverside School has developed a policy and procedures regarding the care of students who have DNR orders. 18.05(1)(b)16 Title IX: 20 U.S.C. 1681; 34 CFR 106.8; Section 504: 29 U.S.C. 794; 34 CFR 104.7; Title II: 42 U.S.C. 12132; 28 CFR 35.107; NCLB: Title X, Part C, Sec. 722(g)(1)(J)(ii) 16.9 Students with Comfort/Care Do Not Resuscitate Orders Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 16.10 Meningococcal Disease and Vaccination 28.09(10) MGL c. 71, s. 34H 603 CMR 23.00 Family Educational Rights and Privacy Act (FERPA) Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting Documentation Interviews MGL, Chapter 76, s.15D 105 CMR 220.700 18.2 Student Records Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Student Records Riverside Schools has a policy and procedure to ensure that all new students receive information about meningococcal disease and vaccine and that students receive the required vaccine or are appropriately exempted. Review of student records indicated that the section on the student face sheet regarding the IEP, date initially eligible for special education, date of most recent special education evaluation, date of next expected 3-year reevaluation, etc., is not completed. Submit to the Department by December 18, 2006, copies of the student record face sheets from a sample of 5 student records. Additional compliance criteria added by the Department relative to specific findings in the school’s last Program Review Final Report Criterion Number and Topic Implementation Status of Requirements or Corrective Action Plan Determined to be Substantially Implemented Method(s) of Verification Comments Regarding Corrective Action Plan Implementation 1.2 Program & Student Description Program Capacity Documentation Riverside School has a program and student description that includes the operational capacity, educational and behavioral characteristics of students, philosophy, goals and objectives and the mechanism for the delivery of services to all students in the school. Documentation Riverside School maintains a comprehensive policies and procedures manual that contains all required information. 28.09(2)(b)(2, 3,7) 3.1 Policies & Procedures Manual 28.09(11)(b) Corrective Action Plan Determined to be Not Fully Implemented or Additional Issues Identified Findings Regarding Incomplete Implementation of Approved Corrective Action Plan or Identification of Additional Issues of Noncompliance Further Corrective Action Ordered by the Department of Education and Timelines for Implementation and Further Progress Reporting 8.5 Current IEP & Student Roster Interviews Student Records Student record review indicated that Riverside School did not have on file a current IEP for each enrolled Massachusetts student who was identified as receiving special education services. Interviews indicated that while Team meetings had occurred or meetings were scheduled for these students, the program did not document in the student record its efforts to obtain a current IEP. Submit to the Department by December 18, 2006 an updated student roster of all enrolled Massachusetts students including the required elements under this criterion, dates of the students’ most recent IEP meeting, and the IEP period for the student’s current IEP, etc. Student Records Interviews Riverside School’s progress reports do not indicate the student’s goals and do not state whether the student’s progress is sufficient for the student to meet his goals by the end of the year. Submit to the Department by December 18, 2006 a copy of the first quarterly progress reports from a sampling of five student records. 28.09 8.8 IEP – Progress Reports 28.07(3) 20 U.S.C. Chapter 33, Section 1414(d)(1)(A)( viii) IDEA Regulations: 300.347 13.1 Educational Facilities and Materials 28.09(8) Documentation Interviews Observation Riverside School demonstrated that it has a physical facility including equipment, technology, textbooks, supplies and materials needed to serve students.