FIDELITY CHECKLIST

School Fidelity Self-Assessment

As a school-level team, complete this self-assessment quarterly to assess and document what essential components are “not yet implemented”, those “in progress”, and those components that are “firmly established and embedded”. These components are critical for effectively implementing school reform, RtI, and ensure academic success for all students.

School: ______Date: ______

District:______Quarter: 1 2 3 4

A. Scientific,
Research-Based Instruction and Intervention / Rating and Comments
Components Not
in Place Yet
0 / Components in
Progress
1 / Embedded/Established
Components
2
Teacher implements scientific, research-based core curriculum in core content areas taught.
Teacher implements scientific, research-based instructional strategies.
Teacher implements scientific, research –based intervention strategies.
Teacher guides self-assessment by students, based upon progress monitoring data, and assist them in devising personal plans for reaching desired performance level(s).
Teacher ensures that all students are instructed at their respective instructional levels using a variety of instructional methods.
B. Fidelity / Rating and Comments
Components Not
in Place Yet
0 / Components in
Progress
1 / Embedded/Established
Components
2
Teacher implements core curriculum, as defined by the publisher’s implementation design.
Teacher has attended professional development trainings regarding the appropriate implementation of the core curriculum/curricula.
Teacher has attended professional development trainings, regarding scientific, research-based interventions.
Teacher implements evidence based interventions in Tier 1 and Tier 2.
Teacher works collaboratively with the school’s SAT at Tier 2 to implement student intervention plans, when necessary.
C. Progress Monitoring / Rating and Comments
Components Not
in Place Yet
0 / Components in
Progress
1 / Embedded/Established
Components
2
Teacher participates in district-wide short cycle assessment program at least three times per year in Tier 1.
Teacher has incorporated Curriculum Based Measures (CBM) into classroom progress monitoring procedures at Tier 2 to determine efficacy of student intervention.
Teacher uses progress monitoring information gathered from short cycle and CBM assessments to make appropriate instructional adaptations.
Teacher continuously monitors student achievement and behavior with appropriate nonstandard measures (everyday assignments, assessments, and observations).
Teacher understands the role of the SAT1 in his/her school and uses the SAT appropriately to provide support at Tier 2.
Teacher informs parents in an understandable manner regarding student performance regarding both informal and formal measures of academic achievement and behavior, including classroom assessment data, short-cycle assessment data, and CMB data (if appropriate).
Teacher disseminates progress monitoring data and charts/graphs to the building administrator.
Teacher disseminates progress monitoring data, including charts/graphs with classroom performance, to the SAT or IEP team.
Teacher participates in professional development opportunities regarding progress monitoring and CBM.

______

1 SAT means Student Assistance Team, the teams are also known as Problem Solving Team (PST) or Teacher Assistant Team (TAT).