Vermont Department of Education

Vermont School-Wide Positive Behavior Support

Required Readiness Checklist

(To be Completed Prior to PBS First Steps to Implementation Training)

School: SU: Date:

Documents / Evidence Complete? / Steps to PBS Readiness
YES / NO / 1.  A school action plan exists, or is being developed, to include school-wide discipline (i.e., behavior, school safety, school climate) as one of the top three school goals.
§  Attach a copy of your School Action Plan Goals page.
Action / Person(s) Responsible / Timeframe
YES / NO / 2.  A Positive Behavior Support (PBS) Leadership Team of 5-8 individuals is formed and has broad representation
(i.e. behavior specialist or team member with behavioral expertise, administrator(s), guidance counselor, regular and
special education teachers, community member, parent, and school support staff).
§  List the PBS Leadership Team members and their school titles.
Action / Person(s) Responsible / Timeframe
YES / NO / 3.  The Principal or Assistant Principal who is responsible for making discipline decisions commits to active participation on the PBS Universal Leadership Team and agrees to attend all team trainings and team meetings.
§  List participating Administrator(s).
Action / Person(s) Responsible / Timeframe
YES / NO / 4.  The Principal commits to School-Wide PBS and is aware that PBS is a 3-5 year process that will require ongoing training and/or revisions of school’s SW-PBS Plan.
§  Obtain Principal’s Signature of Agreement on PBS Intent to Implement Form.
Action / Person(s) Responsible / Timeframe
YES / NO / 5.  The PBS Universal Leadership Team agrees to commit to (at least) monthly meetings to analyze and problem-solve school-wide data.
§  Describe when the PBS Leadership Team will meet throughout the school year (days, location, and time).
Action / Person(s) Responsible / Timeframe
YES / NO / 6.  The PBS Leadership Team has participated in an awareness presentation on School-Wide PBS.
§  Record the date and location of presentation and the presenter’s name(s).
Action / Person(s) Responsible / Timeframe
YES / NO / 7.  The PBS Leadership Team has provided an awareness presentation on School-Wide PBS to the school’s entire faculty and support staff (all school employees) prior to voting to support PBS.
§  Indicate date of the presentation.
Action / Person(s) Responsible / Timeframe
YES / NO / 8.  At least 80% of your faculty, staff, and administration show interest in implementing School-Wide PBS.
§  Indicate the date and method of obtaining staff buy-in and results (i.e., percentage or range of faculty committed).
Action / Person(s) Responsible / Timeframe
YES / NO / 9.  The school has allocated/secured funding from the SU to support the School-Wide PBS Initiatives.
§  Identify funding source (BEST/Act 230 grant, PBS cost worksheet, etc.).
Action / Person(s) Responsible / Timeframe
YES / NO / 10. An individual at the SU level has been identified as the PBS Supervisory Union Coordinator at least .1 FTE (4 hours per week) depending on number of schools involved. See PBS Intent to Implement form for SU Coordinator responsibilities.
§  Record your SU Coordinator’s name and SU title.
Action / Person(s) Responsible / Timeframe
YES / NO / 11. A PBS School Coordinator has been identified to actively participate in PBS School-Wide initiatives, and is assigned a .1 FTE (4 hours per week) responsibility per school for this work. See PBS Intent to Implement form for PBS School Coordinator responsibilities.
§  Record your PBS School Coordinator’s name and school title.
Action / Person(s) Responsible / Timeframe
YES /
NO / 12. The school uses, or agrees to develop, an office discipline referral (ODR) form and definitions of problem behavior that can be used to make data-based decisions regarding student behavior.
§  Attach a copy of your office discipline referral (ODR) form.
Action / Person(s) Responsible / Timeframe
YES / NO / 13. The school has, or agrees to develop, a coherent office discipline referral process.
§  Describe this process for your school.
Action / Person(s) Responsible / Timeframe
YES / NO / 14. Data entry time is allocated and scheduled to ensure that office discipline referral (ODR) data will be current to within a week at all times.
§  Describe this process for your school.
Action / Person(s) Responsible / Timeframe
YES / NO / 15. The school/SU will cover necessary costs or secure funds to cover costs (e.g., substitutes, food, lodging, etc.) for PBS Universal Leadership Team to participate in trainings.
§  Confirm: Yes OR No
Action / Person(s) Responsible / Timeframe

Adapted in conjunction with the May Institute, OSEP Center for PBIS, and University of Southern Florida. (11/09 version)

Vermont School-Wide Positive Behavior Support Required Readiness Checklist for Individual Schools1 1