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VI Staff Member Caseload Review
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Staff Name:
Position:
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Number of Schools Served:
Number of Students Served:
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Date:
Number of Braille/Dual Students:
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Directions: Use the information entered on the "VI Staff Member Caseload Profile" to complete this form. Calculate the total time commitment per week. Enter the number of hours in the staff members' work week on line (1). Enter the time commitment per week on line (2). Subtract line (2) from line (1) and enter the number on line (3). That figure represents the number of hours over or under the work week the staff member's caseload requires and may be a positive or negative number.
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TIME COMMITMENT PER CASELOAD
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NUMBER OF HOURS PER WEEK OF:
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Direct Instruction: (a)0.00Number of Students:0
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Consultation Only: (b)0.00Number of Students:0
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Activities in Support of Instruct: (c)0.00
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Travel (service related): (d)0.00
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Total Time Commitment/ Week: (e)0.00Number of Students Served: 0
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37.5
(1) Total number of hours in work week, excluding lunch
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0.00
(2) Time commitment per week in service to students and work related travel
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37.50
(3) Number of hours over or under hours in the work week
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Changes to be made (if needed), plans or concerns:
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(a) DIRECT INSTRUCTION: Students receiving direct instruction from VI staff, as specified by ARD committee decision.
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(b) CONSULTATION ONLY: Students served by VI staff on a "consultation only" basis, not receiving direct instruction.
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(c) ACTIVITIES IN SUPPORT OF INSTRUCTION: All activities in support of instruction delivered as per ARD committee decision: for example, liaison with other school and non-school personnel, developing and preparation of materials, staff development, etc.
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(d) TRAVEL (SERVICE RELATED): Estimate the amount of travel to and from students and executing other job related duties.
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(e) TOTAL TIME COMMITMENT PER WEEK: Add lines a, b, c, and d.
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