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WA IEP Checklist- PLEASE MAKE A COPY AND DO NOT EDIT THIS ONE OR MASH WILL BE VERY UPSET
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TabSectionGuidance from Safety NetComplete?
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PlanningTeam Considerations·       Use complete sentences 
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·       If you say Behavior impedes learning you must include a BIP as attachment in IEPO or explain why a BIP is not needed
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Performance Tab All sections should have a date (month/year is fine). Each of the student’s areas of SDI and related services require a present level 
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 General EducationAt the bottom of this section there needs to be a statement, followed by a rationale that supports the need for a full-time 1:1 IA, nurse, BT, BCBA or placement at an out- of-district placement (NPA, residential). If a student has had a previous IEP that has passed Safety Net, cutting and pasting the previous statement over including any 
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 Adverse Impact:There should be a general statement of how the student’s disability affects their progress in the general education curriculum (check out the Summary of 
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Qualifications and Functioning from the evaluation)
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• Next, each area of SDI/related service has its own individual statement of how that
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specific disability impacts the student’s progress in the general education curriculum
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and continues to require SDI in that area.
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o If a student has had a previous IEP that has passed Safety Net, cutting and
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pasting the previous Adverse Impact statements over including any
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updated information is acceptable.
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• Individual SDI impact statements can follow this format:
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X’s disability in the SDI area of social/behavior skills impacts his involvement and
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progress in the general education curriculum in the skill of regulating his emotions
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and forming relationships with peers. He continues to qualify for SDI in this area.
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 Present Levels of Performance and FunctionFor Present Levels in each area of SDI, please use the following format (ESAs use template 
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provided by team lead):
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• Date, Name, title
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• Narrative (Overall performance in this area)– Include data (taken within the last year)
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from any assessments, classroom-based measures, response to instruction, supports,
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anecdotal information related to progress. Do not cut and paste from previous IEP or
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from the evaluation (the emphasis in the present levels is student performance in the
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school setting, not on assessments removed from in-class performance). Also, if your
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student is requiring extensive support for 1:1 services in this area, you should
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reference that here, e.g. “X requires extensive 1:1 support to manage basic adaptive
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Present Level
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Example
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IEP Procedures and Formatting for Safety Net - Seattle
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Revised 7/15/2022
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needs (e.g. toilet, eat/drink, etc.), monitor self-regulation, transition safely both in
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class and around the school,” . . . etc. Any solid data that reflects this is also a very
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good thing to include.
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• PRIOR IEP GOAL: cut and paste each goal from the previous IEP here
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• PROGRESS: under each goal, provide data on their current level of progress for each
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goal
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• PLAN: If a student did not meet their annual goal, your plan/rationale moving
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forward (e.g. to discontinue, revise, etc.)
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• NEW GOAL BASELINES: add summarized baselines for their new goals (e.g. will
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request break on 20% of opportunities observed)
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• ADVERSE IMPACT STATEMENT: Cut and paste statement specific to the section’s
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disability
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Math Computation SDIPresent Levels
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 Goals 
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Math Problem-Solving SDIPresent Levels
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 Goals 
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Basic Reading SDIPresent Levels
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 Goals 
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Reading Comprehension SDIPresent Levels
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 Goals 
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Reading Fluency SDIPresent Levels
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 Goals 
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Written Expression SDIPresent Levels
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 Goals 
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Adaptive SDIPresent Levels
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 Goals 
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 Social/Beh SDIPresent Levels 
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Goals
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Study/Org SDIPresent Levels
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 Goals 
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 Communication: Expressive SDI  
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 Communication: Receptive SDI  
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Transition For students that can access Naviance, ask the counselor to print out the student’s Naviance 
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HSBP and use the information to inform the Transition Plan
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 Age Appropriate Assessment·       You must enter the date and name of the assessment 
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·       You must include the results of a skill and interest assessment and align with the
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·       information in the HSBP
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 Goals and ServicesGoals are to be accomplished after exiting the school system at 21 
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• Goals can’t be something that can be completed prior to exiting the school system
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• Goals should be able to be checked as either done or not done in the future (avoid
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phrases such as “continuing . . .”)
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• Goals should reflect interests/preferences from the assessment
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• Independent living goals can’t be a placement
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• Services refer to services that are taking place right now. If you say someone other
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than the school is providing services (e.g. DVR) they must be invited to the meeting
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and agree to begin providing those services right now.
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 Course of Study NarrativeList courses the student will be taking each year until graduation. 
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• If the student selects the CTE Graduation Pathway, you must include CTE courses
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• Note any collaboration with the school counselor here as well
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Goals All goals have to be measurable. 
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 Goals should be as layman's terms and student-friendly as possible.
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• Staff prompts held constant in the “When Given”
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• “From” and “To” lines mirror images, with only one number changing
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• Students taking the WA-AIM will need 2 objectives for all reading, writing, and math
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goals.
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ServicesESY and ERPIf the team says “yes” to ESY, an ESY must be completed at that time. It is highly 
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recommended that teams complete the ESY IEP at the time of the annual IEP
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meeting if the student has historically required ESY and the team believes this will
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continue to be the case. Please add Transportation as a Supplementary Aid and
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Service in the Minutes matrix if the student receives special ed. Transportation.
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• If the team says “yes” to ERP, an ERP must be completed, and parental consent
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signed and uploaded to IEPO.