PBIS Coaching and Action Planning Tool
Tier 1
1.
2.
3.
4.
Guiding Questions
Does the School have a PBIS
Leadership Team that meets at
least monthly?
Does team feel the meetings are
productive?
Is Administrator actively involved
in PBIS implementation (ie:
attends Leadership Team
meetings, allows time for PBIS PD,
is involved in PD and staff
presentations)?
Does this schools implement core
PBIS Tier 1 Strategies?:
- Define Expectations
- Teach Expectations
- Acknowledge Expectations
- Manage Discipline
Consistently
5. Does PBIS team collect and
review discipline data monthly?
6. Is data analyzed by:
 Avg ODRs/day/month
 ODRs by type of behavior
 ODRs by location
 ODRs by time
 ODRs by student
 Custom ODRs by sub-group (IEP,
grade, ethnicity, etc.)
Assessment/Data Source
 Interview with
Administrator and/or
PBIS coach
 Team Implementation
Checklist (TIC)
 PBIS Annual Plan
 Interviews with
Administrator and/or
PBIS coach
 Team Implementation
Checklist (TIC)
 School-wide Evaluation
Tool: SET
 Benchmarks of Quality:
BOQ
 PBIS Products Book
 ODR reports (SWIS,
Infinite Campus, etc)
generated. By whom?
How often?
 Suspension/Expulsion
reports
 Interviews with
Administrator and PBIS
Coaches
 PBIS Annual Plan




Tools
PBIS Leadership Team SelfAssessment and Planning Tool
Team Effectiveness Checklist
Coaching Self-Assessment
TIC Action Plan
 TIC Action Plan
 BOQ Action Plan
 PBIS Data Reflection
Action Steps
By Whom?
By When?
 Suspension/Expulsion data
7. Does PBIS team share data with
all staff at least quarterly?
8. Does administrator and/or staff
feel that data accurately reflects
what is happening in the
building?
9. Is PBIS implemented consistently
and with fidelity in classrooms?
10. Are paras involved in PBIS and
implementing PBIS strategies?
11. Are families and community
members informed and involved
with PBIS?
12. Is Tier 1 being implemented with
fidelity at this school?




ODR reports
parent on PBIS team
para on PBIS team
# of parents involved in
Tier 1 activities
 PBIS Parent Handbook
 PBIS on school website
 pbis assessments:
- TIC: 80/80?
- SAS: 80/80?
- SET: 80/80?
- BOQ
 Does triangle data
reflect: 80-15-5?
 Classroom Assessments:
- Proven Effective Classroom
Practices
- Lewis additional classroom
resources
- EFFECTIVE CLASSROOM
MANAGEMENT PRACTICES
- Curriculum TA Guide
- Classroom Self-Assessment
Mar07
- Classroom Management:
Self-Assessment Revised
 Non-classroom Mgmt SelfAssessment Checklist
 PBIS in the Classroom article
 Family Involvement Checklist
 TipsandStrats.doc
 Parent contact log
 Family survey.doc
 C5 Worksheet
 TIC Action Plan
 SAS Action Plan
 BOQ Action Plan
Tier 2


Does building have a Tier 2 team?
Does Tier 2 Team meet
2x/month?
 How are others involved in Tier 2
support planning/provision
(guidance counselor, AEA team
rep, Success Street Counselor?)
 Does Tier 2 team review data to
determine students receiving 2-5
ODRs per month?
 What is the percentage of
students with 2-5 ODRs?
 What % of students are receiving
Tier 2 supports?
 Do other referral indicators exist?
1. Does a menu of Tier 2 supports
exist?
2. Is progress of Tier 2 supports
being monitored?
3. Are teachers provided updates
re: students receiving Tier 2
supports?
 Suspension/Expulsion
reports
 # of Manifestation
Determinations
 # of parent calls to the
principal and/or district
office
 Special Education rate
and LRE percentage
 Attendance
 Graduation rates
 Drop-out rates
 Interview with
Administrator and/or
PBIS coach
 Monitoring of
Advanced Tiers (MAT)
 Multi-tiered
Committee Structure
 ODR reports generated
by student (SWIS,
Infinite Campus, Heart,
Power School, etc)
 At-risk report (Tableau)
 Interview with
Administrator and/or
PBIS coach
 Completed Tier 2/3
Tracking Tool
 CICO on SWIS or other
 MAT Action Plan
 Tier 2 Support Booklet
(Yellow Book)
 3-Tiered Systems Model
 Targeted Data Activity
 Guiding Questions.doc
 Teacher Nomination Form
 BEP Readiness Checklist
 Tier II Intervention Assessment
Tool
 RTI Behavior Decision Triangle
 Tier 2/3 Tracking Tool
 HS BEP Handbook
4. Does Tier 2 team have a process
to discontinue Tier 2 supports if
successful?
5. Does Tier 2 team have a process
to identify students in need of
Tier 3/individualized supports?
6. Is Tier 2 being implemented with
fidelity at this school?
Tier 3







Does Team(s) exist to provide
individualized supports for
students receiving 6+ ODRs?
How are others involved in Tier 3
support planning/provision
(guidance counselor, AEA team
rep, Success Street Counselor?)
Have teachers and staff attended
Wraparound training?
Do they use the Home School
Community Checklist?
Are Wraparound services
provided to students?
What percentage of students in
this school are receiving 6 or
more ODRs?
Do other referral indicators exist?
data monitoring system
 Daily Progress Report
(DPR) with PBIS school
expectations
 Benchmarks of
Advanced Tiers (BAT)
 Does triangle data
reflect 80-15-5?
 Suspension/Expulsion
reports
 # of Manifestation
Determinations
 # of parent calls to the
principal and/or
district office
 Interviews with
Administrators and PBIS
Coaches
 Multi-tiered Committee
Structure
 SIMEO data
 SWIS or Tableau
reports generated by
student
 Triangle Data
 BAT Action Plan
 Targeted Intervention
Checklist
 Tier 2 Matching Group Activity




What % of students are receiving
individualized supports?
Is SIMEO data collected and
entered on students involved in
Wraparound?
Is the Competing Pathways
Checklist (brief or Efficient FBA)
used to develop a Behavior
Intervention Plan (which
addressed function of behavior
and replacement skills?)
 At-risk report (Tableau)
 SIMEO data
Is Tier 3 being implemented with
fidelity at this school?
 Does PBIS triangle
reflect 80-15-5?
 Suspension/Expulsion
reports
 # of Manifestation
Determinations
 # of parent calls to the
principal and/or district
office
 Interviews with
Administrators and
PBIS Coaches
Systemic  How does PBIS link with other data
analysis and planning processes in this
building? (ie: IDM/RTI, Leader in Me,
Character Counts, Child Find, PLCs,
SINA, Iowa Core, etc)
 Interviews with
Administrators and
PBIS Coaches, AEA
Team reps
 Competing Behavior Pathway
 Self-Check for Designing
Support Plans
 Checklist for Assessing Quality
of Behavior Support Plan
 Efficient Functional Behavioral
Assessment: The Functional
Assessment Checklist for
Teachers and Staff: FACTS
 AIM: Assess-InterveneMonitor FBA Tool
 Individual Student Systems
and Evaluation Tool: ISSET
 Working Smarter Matrix