2022-2023 OUSD PTHV Log
Welcome PTHV champions! Please use this form to log your visits. 
Visits conducted beyond contract hours will be compensated at the regular PD in-service rate. 
For further information, please contact Sara.Nuno@ousd.org
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Email *
School Site *
Employee ID # *
Certificated Staff (OEA): Enter Full Name
(Enter your name here if you are a teacher, counselor, administrator)
Classified Staff (SEIU, AFSCME): Enter Full Name
(Enter your name here if you are support staff: community school manager, attendance clerk, community assistant, etc)
Student 1 Visited: Enter Full Name *
(First Name, Last Name)
Student 1 Visited: Student ID *
(Enter ID number only)
Student 2 Visited: Enter Full Name
(First Name, Last Name)
Student 2 Visited: Student ID
(Enter ID number only)
Student 3 Visited: Enter Full Name
(First Name, Last Name)
Student 3 Visited: Student ID
(Enter ID number only)
Student 4 Visited: Enter Full Name
(First Name, Last Name)
Student 4 Visited: Student ID
(Enter ID number only)
Was your Home Visit conducted in person or virtually? *
What grade level? *
Visits conducted DURING the School Day: Please List Date, Time, Duration of Visits
(Enter date, time, and duration of each visit.  Example: 11/15/20, 1:15PM, 45 minutes)
Visits conducted OUTSIDE the School Day: Please List Date, Time, Duration of Visits
(Enter date, time, and duration of each visit.  Example: 10/13/20, 4:15PM, 45 minutes)
Total hours DURING School Day *
(Enter total hours spent on home visits during the school day.  Example: 5.25 hours)
Total hours OUTSIDE School Day *
(Enter total hours spent on home visits during the school day.  Example: 5.25 hours)
Reflection
What did you learn from your families?  How might this help enhance your instruction?
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