RTI Reference Sheet
**All forms are available on Neesa’s website**
Tier 2
· All Tier 2 students will need to have paperwork filled out by the homeroom teacher and kept in a yellow folder in Turner/Ruth’s room.
· If they are serviced in the classroom, the homeroom teacher will fill out both pages below. These students must be receiving an additional 30 minutes of intervention in the classroom. This is why it is so important to be aware of who your Tier 2 serviced in the classroom students are.
· If they are serviced by pull-out, the homeroom teacher will fill out the first page, email it to Turner/Ruth, and then they will complete the paperwork to keep on file.
Documentation of Tier 1/2 Support
· At the end of the year, Turner/Ruth will print the Annual Progress and Test Record for all Tier 2 students.
o The following students’ yellow folders will be placed in their cumulative files:
§ 6th grade students
§ Students who moved out of Tier 2 & back into only Tier 1
§ Students who were placed for Special Education
o The following students’ yellow folders will be kept in Turner/Ruth’s room.
§ All current Tier 2 students’ files in kindergarten through fifth grade.
Tier 3
· Once a student moves to Tier 3, Turner/Ruth will initiate the following paperwork. It will need to be completed by the teacher and Turner/Ruth and kept on file in the student’s yellow folder in Turner/Ruth’s room.
Student Data and Review Form
Problem Solving Intervention Plan
Documentation of Tier 1/2 Support (this will have already been filled out with Tier 2)
· At the end of the year, Turner/Ruth will print the Annual Progress, Student Progress Monitoring, and Test Record for all Tier 3 students.
o The following students’ yellow folders will be placed in their cumulative files:
§ 6th grade students
§ Students who were placed for Special Education
o The following students’ yellow folders will be kept in Turner/Ruth’s room.
§ Students who moved from Tier 3 to Tier 2 in grades kindergarten through fifth grade.
§ All current Tier 3 students’ files in kindergarten through fifth grade.
New Students
· If a new moves into your classroom, we will have a 6-8 week time of observation before placing him/her in tier 2/3.
· If the child is already in tier 2/3 from a previous school, he/she will continue to be placed in that tier. This does not mean he/she will necessarily be in pull-out, however this can be re-evaluated after 6-8 weeks.
Special Education
· When you are ready to fill out a referral for special education, you should see Mrs. Lacey for a referral form.
· We are providing a checklist that must be included with the actual referral.
· All referrals must be completed within 7 days of checkout.
· If you need help filling out the referral, please see a resource teacher.