Sunrise School Division
Student Name: _____________________________
Individual Education Plan - Report Form (IEP-R)
The Individual Education Plan Report provides information about the progress of the student related to goals identified
in the student’s Individual Educational Plan (IEP). The IEP Report will be completed at regular reporting periods and
included as part of the provincial report card.
Student Specific Outcome Achievement Rubric (SSOAR)
The student’s achievement is based on the following scale.
Scale
The student’s progress is …
Somewhat more than expected
4
Expected (Student Specific Outcomes)
3
On target to achieve the objective
2
Much less than expected
1
At this time the domain is not applicable or Does not yet demonstrate required concept of skill
NA or ND
*Note: Grades 1-8 will enter reporting periods 1, 2 & 3 while Grades 9-12 will enter reporting periods 1, 2, 3 & 4
Omit the Domains that are not applicable but report on those that are specific to the student’s needs.
Domain: Academic/Cognitive
Current level of performance
Subject:
Student Specific Outcome
1
2
3
4
3
4
Domain: Behavioural (Social Skills/ Emotional/Relationships)
Current level of performance
Student Specific Outcome
1
2
3
4
(Add more as needed)
Domain: Communication (Verbal/Non-verbal)
Current level of performance
Student Specific Outcome
1
2
Domain: Self-Help
Current level of performance
Student Specific Outcome
1
2
3
4
2
3
4
Domain: Physical
Current level of performance
Student Specific Outcome
1
Sunrise School Division
Student Name: _____________________________
Domain: Vocational
Current level of performance
Student Specific Outcome
1
2
3
4
2
3
4
1
2
3
4
1
2
3
4
Domain: Recreation/Leisure
Current level of performance
Student Specific Outcome
1
Domain: Independent Living
Current level of performance
Student Specific Outcome
Local Choice
Domain:
Current level of performance
Student Specific Outcome
Comments on Strengths/Challenges/Next Steps
Reporting Period 1
Comments on Strengths/Challenges/Next Steps
Reporting Period 2
Comments on Strengths/Challenges/Next Steps
Reporting Period 3
Principal’s Signature _________________________________________
Parent’(s)/Guardian’(s) Comments:
Parent’(s)/Guardian’(s) Signature(s): ____________________Student Signature (if 18 or older):____________________