Exhibit 3 - School Experience.pdf
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- Attached to
- Master Agreement AZ|CTR077297
- Contract number
- CTR077297
- Issued by
- Arizona
About this file
This document is a "FYES Exhibit 3 - Assessment of School Experience" form from the Arizona Department of Child Safety. It is an interview and assessment tool designed to gather comprehensive information about a young person's educational experiences, challenges, activities, and support needs. The form is intended to be completed through an interview process with a young person, with the understanding that the information will be shared with their DCS Specialist and potentially an Education Specialist.
The document provides a detailed set of guided questions and sections to explore various aspects of the student's school life, including current and past school experiences, activities, support needs, and challenges. Key areas of focus include school engagement, participation in activities, academic and extracurricular involvement, support requirements (such as transportation, funding for fees, or adult participation), and language/cultural support needs. The form is structured to encourage open dialogue and gather holistic information to help create an education plan that supports the young person's academic and personal development.
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Text version
FIfYES Exhibit 3 - School Experience (03/25)
FYES EXHIBIT 3
Assessment of School Experience
Instructions and Cue Questions to Explore School Experience
The purpose of the School Experience assessment is to explore the young person’s school experience by asking open-ended questions that provide opportunities for them to talk about what has been positive and challenging, and what supports/help they currently have and need. The interviewer should first build rapport with the young person and explain that while we encourage them to openly share information, they are not required to answer every question that is asked. Ensure the young person understands that the information gathered will be shared with their DCS Specialist and an Education Specialist (when available) for the purpose of improving their understanding of the young person’s school experience and their current and future school/education needs. This information will also be summarized in their education plan.
The following cue questions may be used to initiate conversations with young people about their school experiences. The young person is not required to respond to any particular question, but is encouraged to share their experience for the purposes noted above. There is no requirement to ask every question exactly as written, or to ask all of the questions listed below. A young person may respond in such a way that addresses multiple areas in a single response, or their response may not appear to answer the question. Ask additional questions as needed to ensure there is sufficient information to understand and summarize the young person’s experience. Record the summary information and review with the young person to ensure it accurately reflects their school experience. Reaffirm their understanding that the information will be shared with their DCS Specialist and an Education Specialist (when available) to assist with education planning.
Ask the young person for any additional information they would like to include in the summary.
• How would you describe your school year so far (or most recent school year)?
` How has this year compared to other years?
` What has gone well?
` What has been difficult/challenging?
` What are you looking forward to this/next school year?
` What is/are the most important thing(s) that need to happen for you to have a good year?
• Do you feel welcome at your school? What has made you feel welcome/unwelcome at your school?
• What school activities are you participating in (or participated in last year)?
• How has/does your home life/environment support participating in activities?
• Have you had difficulties at school that resulted in consequences/discipline?
• Are you familiar with your school handbook and school policies? How has your caregiver helped you to understand these policies?
• Do you feel your school follows the school handbook and policies when addressing conflicts between students or adults?
• Is there a particular adult(s) you look forward to seeing at school?
• What makes you look forward to seeing them?
• Who are the adults that you are most likely to talk to at school if you have questions or need help?
` What makes you feel comfortable approaching that person(s)?
• Who do you talk to about your questions and plans for your future, including career/work-life?
• What should your teacher(s), coach, school nurse, school support staff (or others) know about you?
• Who is the best person to share that information? (i.e. yourself and/or an adult support such as DCSS or caregiver)
FYES Exhibit 3 - School Experience
Assessment of School Experience
Student Name
Activities and Supports
Please attach separate sheet if more space for any field is required.
Plan Start Date
Education Champion/Primary Adult Advocate
Education Team Members
Employer/Job Schedule:
Support:
Volunteering:
Current School/Community Based Activities:
Academic
I have all the help I need
Service Learning
Athletics
I need help (check all that apply)
Band
Transportation
Other (Clubs/Activities)
Other:
Choir
Faith Based
Funding for fees, uniforms, equipment, travel, etc.
Club Hobby
Theater/Plays
Help/participation from adult(s)
FYES Exhibit 3 - School Experience
Assessment of School Experience
Activities and Supports ~ continued
Name
Contact Information
Relationship/Role
Summary of Student’s School Experience: (see “Instructions and Cue Questions” below)
Language/Cultural Support Needs:
Student’s Education Champion/Primary Adult Support
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