A Completed Student Packet Checklist & Form Sequence 1 Notify victim’s/ perpetrators’/witnesses’ parents within 24 hours of the

incident. CPS if applicable within 48 hours. 2 Administrator(s), victim(s), witness(es), school staff and perpetrator(s)

statements: (Before front page of police report is provided, copies of statements must be given to the police officer prior to determine the charge(s).

3 Ensure to photograph the injury(ies), graffiti, damaged items, weapons, knives w/ruler, drugs, etc. (Required for placement; provide copies to police officer)

4 Under the Influence Checklist to be completed by School Administrator ONLY

5 Copy of student referral with offense and action codes included (Skyward copy only; if parent refuses to sign, obtain a witness signature)

6 Student’s Disciplinary Due Process Conference Form (Done within 3 school days of incident; if parent refuses to sign, obtain a witness signature)

7 F.S. Lara (DAEP) Placement / JJAEP Expulsion Placement Letters (Ensure parent receives the correct recommend placement letter.)

8

If Applicable, complete Employee/Volunteer Injury Assault form. (Required for placement)

9

Copy of police report and if applicable copy of 435 Student Restraint and Taken Into Custody Forms provided by police officer

10

Discipline Intervention Documentation (Attached Skyward referrals required for discretionary recommendation placement to DAEP (Lara))

11

Counselor Referral Form (Required for discretionary recommendation placement to DAEP (Lara))

12

Opportunity to Complete Coursework Form (High School should have complete 10 period schedule) Semester 1&2

13

Copy of Student Withdrawal / Record Transfer Form (Skyward copy only)

14

Copy of Academic Achievement Record (Skyward copy only; Transcript)

15

Copy of Report Card (Include all grading periods for the current school year)

16 Copy of STAAR / Copy of EOC scores/ Copy of Vaccination Record 17 Copy of Home Language Survey, HOST, Power of Attorney or Grandparent

Affidavit/McKinney–Vento

Page 1 of 36

B Completed Extra Documentation Required for Special Education/504 Student 1 Copy of Sp. Ed. / Section 504 MDR

2 Administrator reviews Sp. Ed. / 504 lists, BIP, Schedule of Services, etc. 3 SPED/504 Eligibility: Instructional Setting Code: 4 Total of ISS/OSS placements this school year: _________

* more than 10 consecutive school days requires an ARD

5 Date of previous ARD/504 committee meeting: 6 ARD (held within 10 school days of date in which decision was made to take

disciplinary action).7 Linkage: □ YES □ No

8 Sp. Ed. / Section 504 Committee Manifestation Determination /

Modifications and Accommodations.9 Manifestation Determination Page (Place at beginning of ARD packet) 10 Updated FBA (Functional Behavioral Assessment) from Manifestation

Determination Review meeting (MDR) for this offense.

11 Updated BIP (Behavior Intervention Plan) targeting behavior.

12 Schedule of services (courses at F.S. Lara (DAEP) / JJAEP) & related services.

Page 2 of 36

   

Page 3 of 36

Laredo Independent School District ’20-’21 Student Discipline Referral Form

Campus: ___________________________________ □ Regular Ed □Special Ed. □504 □Homeless □Foster Care □Transfer Student Student’s Name: __________________________________________ ID#: _____________________ Grade: _______ D.O.B. ________________ Parent/Guardian Name: ________________________________________ Incident (PEIMS)#: ____________________ PD Case/Citation #: _______________ Address: _______________________________ Home Phone#: ____________________ Work Phone#: ____________________ Cell Phone#: ________________ Date of Incident (Offense): __________________ Behavior Location of Incident (Offense): _______________________ Time of Incident (Offense): _________ 101 Excessive Tardy 100 Excessive Absences – Actions Taken: 111 Attendance Officer 114 Attendance Boot Camp Attendance Officer Notified by Teacher/Administrator: _____________________________________ Date: ___________________ Time: __________________ - Under incident codes of 100s student cannot be placed in action codes 06 ISS, 26 ISS Partial Day, 05 OSS or 25 OSS Partial Day - Include RtI/MTSS discipline interventions on DMAC (if applicable)

Level I – Minor Incidents/Offenses DC: Violates Dress/Grooming Code bottoms shirt other:_______ SO: Walked Out/Nev. Return to Class V19: Insubordination COVID 19 Disruption of . . . DIP=Class CMD=Campus BR=Bus SCOC Offense: _________________________________

Level II – Serious Incidents/Offenses Bullying: BUE(Race) BUG(Gender) BUL(Disability) BUO(Other) CYB: Cyberbullying 41: Fighting / Mutual Combat (1st fight) SCOC Offense: _________________________________

Level III – Discretionary DAEP (Lara) (Administrative Use Only) Tobacco: TBC (Substance) TV (Vapes) Bullying: BUE(Race) BUG(Gender) BUL(Disability) BUO(Other) CYB: Cyberbullying * After Intervention(s) of Bullying/Cyberbullying 41: Fighting / Mutual Combat (Two or more fights) SCOC Offense: _________________________________

Level III — Mandatory DAEP (Lara) (Administrative Use Only) 04: Non-Felony Substance: ____________________________ 05: Non-Felony Alcohol: _____________________________ 09: Title 5 Felony Off Campus *Contact Student Hearings Officer 26: Terroristic Threat 27: Assault on School Staff 28: Assault on Student 35: False Alarm/Report SCOC Offense: _________________________________

Level IV – Discretionary JJAEP (Administrative Use Only) 59: Lara Only Serious Misbehavior SCOC Offense: _________________________________ *Contact Student Hearings Officer

Level IV – Mandatory JJAEP (Administrative Use Only) 36: Felony Controlled Substance FV: Felony Vapes 11: Firearm Using/Exhibiting/Possessing

14: Prohibited Weapon 16: Arson SCOC Offense: _________________________________ *Contact Student Hearings Officer

Administrative Use Only – Action(s) Taken 100 Warning 104 After School Detention 105 Lunch Detention 106 Counselor: _______________________________ 113 Discipline Boot Camp 115 Stay Away Contract Other Action Taken: _________________________ Action Code: ______ Parent must be notified of action taken before 5 pm of the same day of incident/offense 101 Parent Conference/ Due Process: Date: _____________ Time: _______ In-school Suspension (ISS) Date(s): ________________________ __ / __ 06 all day 26 partial day __ / __ 06 all day 26 partial day __ / __ 06 all day 26 partial day Out-of-school Suspension (OSS) Date(s): _______________________ __ / __ 05 all day 25 partial day __ / __ 05 all day 25 partial day __ / __ 05 all day 25 partial day All Elementary OSS must be approved by Elementary Director 21s for Secondary OSS must be approved by Secondary Director HB 692 prohibits OSS placement for homeless students as per page 21 of SCOC Provide foundation curriculum course work for student to complete at home

Recommend DAEP (Lara) Placement (07D) Discretionary ________ days (07M) Mandatory ________ days Request for Review Hearing – Parent/Guardian must fill out next page Recommend Expulsion to JJAEP (*Contact Student Hearings Officer) (02D) Discretionary__________ days (02M) Mandatory________ days Parent/Guardian must fill out next page to schedule a hearing

Comments:_____________________________________________________ ______________________________________________________________ ______________________________________________________________

_____________________________________________________________ _______________________________________________________________ Parent/Guardian (Print Name) Signature & Date Student (Print Name) Signature& Date

_____________________________________________________________ _______________________________________________________________ LISD Staff (Print Name) Signature & Date LISD Administrator (Print Name) Signature& Date *Witness for Teleconference/Virtual Meeting or Parent/Guardian denying to sign

Page 4 of 36

*DAEP discretionary placements will require proper interventions implemented by the campus and must be

submitted to Secondary Director for approval. Submit documentation supporting the interventions.

Interventions Reviewed by:_________________________Date:______________

Possible Interventions: Intervention Date:

Possible Interventions: Intervention Date:

Administrator/ Parent Conference (Face/Face)

Licensed Chemical Dependency Counselor

ARD/ Brief Mentor

Attendance Contract/Att. Officer Sessions/Truancy Court

Out of School Suspension

Behavior Contract Parent Notification ( ____ Call _____ Letter)

BIP Revised (Behavior Intervention Plan)

Parent Shadowing

Buddy System/Class Parent/teacher Conference (Face/Face)

Behavior Specialist Referral Physical Restraint

Change classes early/late Parking Permit Revocation

Change of schedule Police Intervention (Informal/Formal)

Communities In School (CIS)

Positive Behavior Facilitator

Conflict Resolution Proceedings Principal’s Plan (Attendance)

Counselor’s Referral Form

Probation Officer Intervention

Detention (Moring, Lunch, Afterschool)

Reassignment to another classroom

Exclusion from extracurricular activity

Referral to outside agency

Escort to class MTSS DMAC Report

Functional Behavior Assessment/Behavior Intervention Plan (for Sp.Ed. Students)

Saturday Class(es)/Boot Camp/Beautification Day Service

Gang Intervention Facilitator

Schedule/class change

Home Visits Seating changes in the classroom

In School Suspension Student/Teacher Conference

In-School/District Community Service

Timeout/Cooling Off

Intervention Class (9th – 12th only w/ certified teacher)

Other:

Laredo Independent School District Discipline Intervention Documentation Form

_____Reg. Ed. ____ Sp. Ed. _____EL ____Section 504 ____Homeless ____Foster Care Student’s Name: ____________________ I.D. #: ________________ Campus: ________________ Grade: __________

Page 5 of 36

STUDENT'S NAME: GRADE:

I.D. #: ROOM #:

TEACHER:

DATE:Incident Type:

STUDENT SIGNATURE:Parent/Guardian Contacted-Date: Time:

DATE:Incident Type:

STUDENT SIGNATURE:Parent/Guardian Contacted-Date: Time:

DATE:Incident Type:

STUDENT SIGNATURE:Parent/Guardian Contacted-Date: Time:

IN

CID

EN

T #

3

TIME/PERIOD:

Intervention:

Please refer to the S.C.O.C. for Behavior Management Techniques (Warning, Teacher/Student Confer., Call Parent, Parent Conference, After School Detention with Teacher, Change Seating Arrangement, Counselor/Student Confer., etc.). After Teacher completes all possible interventions for classroom misconducted referral can be submit to an

Administrator for further actions. Only 21s S.C.O.C. incidents, see Discipline Flow Chart for more details.

Intervention:

IN

CID

EN

T #

1

INC

IDE

NT

#2

TIME/PERIOD:

Intervention:

TIME/PERIOD:

Incident Details:

Incident Details:

Incident Details:

POSITIVE BEHAVIORAL INTERVENTIONS AND SUPPORTS (P.B.I.S.)

Student: ________________________ I.D.#: ______________ Grade: ______ D.O.B.: ____________ Student Status: ___Regular ED ___ Special ED ___ 504 ___ ESL ___EL ____Foster Care ____ Homeless _____ Pending Manifestation Determination Review: _____ ARD _____ Section 504 Committee Meeting

Parents/Legal Guardian: _________________________ Address: ________________________ Zip Code: ________

Home #: _________________ Cell #: __________________ Work #: _________________ Parents were notified of conference on _______________ by __________________________ Time: __________ First Attempt ______________ 2nd Attempt ________________ Final Attempt _________________

Date & Time Date & Time Date & Time

Offense: _____________________________________________ Date: ________ Incident #:_______P.D. Case # ________

Is student on a Permission Transfer: ____Yes ____No

Due Process Conference was conducted in _____ English ______ Spanish *_________________________________ *Interpreter’s Signature Date

Due Process Conference Date: ____________

Time Began: _______ Time Ended: _______

Present during the Due Process Conference: ____Tele-Conference____Virtual____Face to Face _____Student: ________________________ _____Mother: _______________________________ _____Father: ______________________________ _____Guardian: _____________________________ _____Other: _______________________________ _____Administrator: _________________________

Disciplinary Action: *All Elementatry OSS must be approved by Elementary Director. * 21's for Secondary OSS must be approved by Secondary Director. *HB692 prohibits OSS placement for homeless students. * Provide foundation curriculum coursework for student to complete at home.

____ In-School Suspension Dates:

______ 06 all day 26 partial day

______ 06 all day 26 partial day

______ 06 all day 26 partial day

_____Out-of-School Suspension Dates:

______ 05 all day 25 partial day

______ 05 all day 25 partial day

______ 05 all day 25 partial day

_____Recommended DAEP F.S. Lara Academy

Placement _____(07D) Discretionary _____(07M) Mandatory _____Days to be served.

_____Recommended Expulsion J.J.A.E.P. Placement

_____(02D) Discretionary

_____(02M) Mandatory _____Days to be served.

Comments:

Parent Initials _____ I certify that the Due Process Conference was conducted in compliance with the state and local policy and that all safeguards for the student’s due process rights were extended. (Notified parents within 24 hours of time of offense and 72 hours to complete Due Process.) ______ I acknowledge receipt verification of the Student Code of Conduct either through the internet and/or paper copy, I understand that the Student Code of Conduct contains information that my child and I need during the school year and will be held accountable for their behavior and will be subject to the disciplinary consequences outlined in the Student’s Code of Conduct.

_________________________________________ ________________________________________

Parents/Legal Guardian Signature & Date Administrator’s Signature & Date

_________________________________________ ________________________________________ Student’s Signature & Date Translator’s Signature & Date

Page 6 of 36

LAREDO INDEPENDENT SCHOOL DISTRICT DAEP REMOVAL PARENT NOTIFICATION LETTER (Upholding Other District Placement Recommendation)

Parents Name: _________________

Address: _________________

Laredo, TX ________

RE: Dear _________________: As per the Laredo ISD Student Code of Conduct, a newly enrolled student assigned to a DAEP in another district will be placed directly into the district’s F.S. Lara Academy for the term designated by the previous district. Please be advised Laredo ISD will uphold the other district’s placement order for the following student:

Date of Enrollment: ____________________________________________

Student Name: _________________________________________________

ID#__________________________________________________________

DOB: ________________________________________________________

PLACEMENT ORDERED BY: ________________________________ISD

PERIOD OF PLACEMENT: _________________________________DAYS

Student will be eligible to return to his/her home school campus once all the instructional DAEP days are completed at F.S. Lara Academy. Please be advised your son/daughter is prohibited from attending any Laredo ISD school functions. If he/she is found on campus or at a school function, the administration will file trespassing charges. If you need any further assistance, please contact me at ___________________________________.

Parent Print Name: _______________________ Parent Signature: ___________________________ Date: _____________ ____Parent refused to sign. Witness Name and Signature: __________________________ Date: ________________ Sincerely, ___________________________________________________________ Date: ___________ Assistant Principal Signature ___________________________________________________________ Date: ____________ Campus Behavior Coordinator Signature

Page 7 of 36

SAMPLE

11/14/2017 NOTIFICATION OF DISCIPLINARY INCIDENT(S) Page: 1 1413 CLARK BLVD UNIT 8 LAREDO TX 78040-0000

We would like to inform you of the following disciplinary incident(s) for

Offense : ASSAULT OTHER THAN EMPLOYEEOffense Date : 09/20/2017 Time: School :Location : On CampusReferred By :Disc Officer :Motivation : ADMINOffense Level :Incident # : 636Comment : Parent was informed of the incident on Sept. 20, 2017 at 8:56 a.m. Action : IN SCHOOL SUSPENSION School : Length : 3.00 Day(s) Status : Open Comment : Parent was informed at 8:56 a.m. on Sept. 20, 2017. Parent of the other student is pressing charges for assault. and her sister were hitting outside of Mr. Heredia's room T building at 7:40 a.m. on Sept. 20, 2017. This is second fight for . Action : MANDATORY OFF CAMPUS DAEP School : Length : 30.00 Day(s) Status : Open

Student Signature: _______________________ Date: ___________

Parent Signature: _______________________ Date: ___________

Administrator: _______________________ Date: ___________

Page 8 of 36

Page 9 of 36

   

LISD Official Form 731-007(A) Print Name Administration Signature Date Last Updated: Septmber 2020 

F.S. LARA ACADEMY PLACEMENT LETTER

Conference Date: ___________

_____________________ _____________________ RE: _______________________, I.D #_____________ Laredo, TX __________

Dear _________________,

This letter is to inform you that your son/daughter, _________________, I.D. # _________________, will be placed in a disciplinary alternative education program at F.S. Lara Acad emy, which is located at 2901 E. Travis, Laredo, TX 78043 for the following offense(s):

List Offense(s): __________________________________________________________________________________________________________________________________________________________________________ Date ______________ Time: __________________ Location:

Registration at F.S. Lara Academy is as follows: 8:00am – 11:00am or 1:30pm to 4:00pm ONLY.

____________________ shall be placed at F.S. Lar a Academy approximately on ______________ and shall continue to receive educational services for a period of ______ days. A copy of the Disciplinary Alternative Education Program placement packet will be delive red to the Webb County Juvenile Depart as mandated by the Texas Education Code under section 37.010. Transportation to and from this campus is provided by the school District.

If student does not attend F.S. Lara Academy for the duration of the placement for any reason other than reasons that constitute an “excused absence” under the LISD policy, the student shall require completing the number of days missed in the academy before allowed to return to the regular campus.

Please be advised that while a student is at F.S. Lara Academy, he/she shall not participate in any school-sponsored or school-related activities of any kind nor will not be allowed on school district property at any time. Upon completion of the student’s term at F.S. Lara, he/she may return to their home campus. If he/she does not abide by terms imposed, LISD will take whatever legal action is necessary including trespassing

NOTE: A student who transfers out of LISD to another public or private institution (including a student who is withdrawn for the purpose of home schooling) during the period of alternative placement shall be required, upon returning to LISD, to complete the number of days missed at F.S. Lara Academy before being allowed to return to the regular campus.

Should you wish to contest your son /daughter’s placement at F.S. Lara Academy, you may contact the Hearings Office at (956) 273-1484 to arrange a review hearing. Any decision by the Hearings Officer is final and non-appealable.

Should you have any further questions regarding this matter, please do not hesitate to contact my office.

Sincerely,

__________________ _____________________ ______ Print Name Parent Signature Datexc: Graciela Perez Hearings Officer __________________ _____________________ ______

Page 10 of 36

REVIEW/EXPULSION HEARING FORM

Student’s Name: ______________________________ ID:____________________________________________

Review Hearings (Placement to F.S. Lara Academy) Only

I, _________________________________ the parent/guardian (circle one) of , is requesting a review hearing based on the campus disciplinary action for my son/daughter. My reason for requesting this review is

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________ Process of Review Hearing will not start until student is registered at F.S. Lara Academy and has been one full day present. Student must continue to attend F.S. Lara Academy until Student Hearings Officer makes a decision.

Preferred Review Hearing: □Tele-Conference □ Virtual (parent/guardian email): ____________________________ □ Face-to-Face

Review Hearings only to be held on Thursdays, do you prefer □ Morning-Time: ____________ □ Afternoon-Time: _____________

Will you have an attorney present?: □Yes, if so who: ____________________________________ □ No

Expulsion Hearings (Recommendation of Placement to Juvenile Justice Alternative Education Program) Only

Expulsion Hearing to be held: □Tele-Conference □ Virtual (parent/guardian email): ___________________________ □ Face-to-Face

Will you have an attorney present?: □Yes, if so who: ____________________________________ □ No

Preferred time for Expulsion Hearing to be held: □ Morning-Time: ____________ □ Afternoon-Time: _____________

*Face-to-Face Hearings Only: Parent/Guardian please be advised only one parent/guardian can be present during the hearing. Student can be present, no other children will be allowed. All participants must follow guidelines and procedures stated further in the hearings letter you will receive from the hearings office within 3 to 4 days. This includes proper nose and mouth face covering, body temperature less than 100 degrees and 6ft of social distancing. Failure to comply with these regulations will result in rescheduling of hearing.

_______________________________________________ __________________________ (Parent/Guardian Signature) (Date)

Administrator please submit this form to Claudia Espinoza, Secretary to Student Hearings Officer via email at cmespinoza@laredoisd.org

Give a copy to parent/guardian of this form

For further information, please contact Student Hearings Office at 956-273-1484 or 956-273-1485

REVISIÓN / FORMULARIO DE AUDIENCIA DE EXPULSIÓN

Nombre del estudiante: ______________________________ Identificación: ____________________________________________

Audiencias de Revisión (para la Academia F.S. Lara) Solamente

Yo, _________________________________ el padre/tutor (circule uno), solicito una audiencia de revisión basada en la acción disciplinaria del plantel escolar que se a tomado contra mi hijo / hija. Mi razón para solicitar esta revisión es ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________

El proceso de audiencia de revisión no comenzará hasta que el estudiante esté registrado en F.S. Lara Academy y haya estado presente un día completo. El estudiante debe continuar asistiendo a F.S. Lara Academy hasta que el Oficial de Audiencias Estudiantiles tome una decisión.

Audiencia de revisión preferida: □Teleconferencia □Virtual(correo electrónico del padre/tutor): ____________________________

□ Cara-a-Cara

Revision de Audiencias solo se llevarán a cabo los jueves. Prefiere: □ Hora de la mañana: ________ □ Hora de la tarde: __________

¿Tendrá un Abogado presente ?: □ Sí y quién sera: ____________________________________ □ No

Audiencias de Expulsión (Recomendación al Programa de Educación Alternativa de Justicia Juvenil) Solamente

Audiencia de Expulsión preferida: □ Teleconferencia □ Virtual (correo electrónico del padre / tutor): _________________________

□ Cara-a-Cara

¿Tendrá un Abogado presente ?: □ Sí, y quién sera: ____________________________________ □ No

Hora preferida para la Audiencia de Expulsión: □ Hora de la mañana: _____________ □ Hora de la tarde: ____________

* Solo audiencias Cara-a-Cara: Padre/Tutor, tenga en cuenta que solo un padre/tutor puede estar presente durante la audiencia. El estudiante puede estar presente, no se permitirán otros niños. Todos los participantes deben seguir las reglas y procedimientos establecidos más adelante en la carta de audiencias que recibirá de la oficina de audiencias dentro de 3 a 4 días. Esto incluye la cobertura adecuada de la nariz y la boca, la temperatura corporal de menos de 100 grados y 6 pies de distancia social. El incumplimiento de estas regulaciones resultará en la reprogramación de la audiencia.

_______________________________________________ __________________________ (Firma del Padre/Tutor) (Fecha)

Administrador, envíe este formulario a Claudia Espinoza, Secretaria del Oficial de Audiencias Estudiantiles por correo electrónico a cmespinoza@laredoisd.org

Entregue una copia al padre/tutor de este documento

Para obtener más información, comuníquese con la Oficina de Audiencias Estudiantiles al 956-273-1484 o 956-273-1485

Page 11 of 36

Prior to registering your son/daughter at F.S. Lara Academy it is important to be aware of the following protocols and procedures. The home campus will advise you as to when you can go register your son/daughter at F.S. Lara Academy.Please set up a registration appointment during the following times with Mr. Alonso Martinez, F.S. Lara Registration Clerk, at 956-273-7904, after the home campus advises you that you can go register at F.S. Lara Academy.

Mornings Appointments 8:00 a.m. to 11:00 a.m.

Afternoon Appointments 1:30 p.m. to 4:00 p.m.

Before any student goes and registers at F.S. Lara parents must ensure that the following guidelines are followed: 1. No long fingernails, fake nails, nail polish or make up allowed. 2. All male students must be clean-shaven. 3. Pants must be worn at the waist with a belt (No design on the belt, belt must be black or brown with a small buckle; No designer buckles). 4. Shorts, Miniskirts, or DENIM pants will not be allowed; no designer logos may be evident (e.g. Guess, POLO of any kind) only solid khaki, black or navy blue dress uniform pants will be allowed. (NO SKINNY JEANS NOR TIGHT UNIFORM PANTS) Students who do not comply will wear Scrubs. 5. No jewelry (watches, religious pendants, rosaries, tongue piercings, belly piercings, eye piercings, stones on teeth, or threads in ears). They may not be worn underneath clothing! No sunglasses or contacts without a prescription. 6. Hair must be short and well groomed, no designer haircuts, hair longer than the bottom of the shirt collar must be pulled back into a ponytail or hair bun without clips or hair pins (Bobby Pins). No caps, No bandannas or headgear of any kind will be allowed for either gender. 7. Only solid color tennis shoes will be allowed. 8. All coats and jackets must be checked in. Under no circumstances will any student be allowed to keep any jackets or sweater in the classroom. F.S. Lara Academy is not responsible for lost or stolen jackets. 9. All visible tattoos and hickies must be covered at all times. 10. No money, cell phones or electronic devices will be permitted. If a student brings any of these items, the parents/guardian may pick up the confiscated item from the front office. 11. Any students not following the dress code will have their parents/guardians called to bring proper attire. 12. F.S. Lara Shirts must always be worn during online remote instruction. 13. Students are not permitted to wear an additional set of outer garments under their uniform.

______ The Due Process Administrator has read, explained, and given me a copy of the F.S. Lara Registration Protocols and Procedures, and as a parent/legal guardian it is my responsibility to comply.

______ I, __________________ together with my son/daughter, ___________________ have read, understood, and will abide by the above guidelines before registering at F.S. Lara Academy

Parent Name: ______________________Parent Signature: ________________________________ Date: ___________

Student Name: _____________________Student Signature: _______________________________ Date: ___________

Administrator’s Name: ____________________ Administrator’s Signature:________________________ Date: ___________ Page 12 of 36

  

LISD Official Form 731-007(B) _____________________________ ______________________ _____Last Updated: September 2020 Nombre en Letra de Molde Firma del Administrador Fecha 

CARTA DE COLOCACION A F.S. LARA ACADEMY

Fecha de Conferencia______________ _____________________ _____________________ Laredo, TX __________ RE: _________________, ID # ______________

Estimado(a) _________________,

Esta carta es para informarle que su hijo/hija. ________________________, I.D. # _______________, ha sido colocado(a) en un programa de educación alternativa disciplinaria en F.S. Lara Academy, localizada en 2901 E, Travis, Laredo TX, por la(s) siguiente ofensa(s):

Listar Ofensa(s): _____________________________________________________________________________________ _____________________________________________________________________________________ Fecha_____________ Hora ____________________ Escuela El horario para matricular en F.S. Lara Academy es: 8:00am-11:00am o 1:30pm-4:00pm SOLAMENTE.

____________________ será asignado(a) a La Academia de F.S. Lara aproximadamente en la fecha de ____________________ y seguirá recibiendo servicios educativos por ____________ días. Se mandará una copia del paquete de colocación del programa de educación alternativa al departamento juvenil del condado de Webb como es el mandato del código de educación de Tejas bajo sección 37.010. Transportación ir y regreso de la escuela donde pertenece el estudiante será previsto por el distrito escolar.

Si su hijo(a) no asiste a La Academia de F.S. Lara durante el ter mino asignado, el estudiante tendrá que reponer el número de días ausentes en el programa antes de poder regresar a su escuela de planta.

Por favor tome nota de que mientras su hijo(a) está en La Academia de F.S.Lara, no podrá participar en ningún tipo de actividad escolar ya sea patrocinado o relacionado con las escuelas. Al completar el termino en La Academia F.S. Lara, su hijo(a) podrá regresar a su escuela de planta. Si el estudiante no acata los términos ya expresados, LISD tomara cualquier acción legal necesaria incluyendo

Nota: Un estudiante que se transfiere o se cambia a otra institución pública o privada fuera del distrito de LISD (incluyendo un estudiante que se ha retirado para seguir sus estudios en casa) tendrá que, como requisito, regresar al distrito y completar el número de días ausentes en el programa alternativo en La Academia de F.S. Lara antes de poder regresar a su escuela de planta.

Si desea apelar el cambio de su hijo(a) a La Academia de F.S. Lara, puede comunicarse a la oficina del Director de Audiencias de Disciplina al número (956) 273-1484 para hacer arreglos para una audiencia de revisión. La decisión del Oficial de Audiencias será final y no es apelable.

Si tiene alguna pregunta respecto a este asunto, por favor llámeme.

Sinceramente

xc: Graciela Perez _____________________________ ______________________ _____ Oficial de Audiencias Nombre en Letra de Molde Firma del Padre Fecha

Page 13 of 36

Antes de registrar a su hijo o hija en La Academia de F.S. Lara es importante que este consiente de los siguientes protocolos y procedimientos. La escuela de planta le avisara cuando podra registrar a su hijo/hija en La Academia de F.S. Lara. Por favor hacer una cita con el Sr. Alonso Martínez, el secretario de registro, despues de que le haya confirmado la escuela de planta que puede ir a registrar a su hijo/hija a La Academia de F.S. Lara. Para mas informacion llamar al956-273-7904

Citas Matutinas 8:00 a.m. to 11:00 a.m.

Citas Vespertinas 1:30 p.m. to 4:00 p.m.

Antes de registrar a su hijo o hija en La Academia de F.S. Lara es importante que este consiente de las siguientes reglas: 1. No se permiten uñas largas, uñas postizas, uñas pintadas o maquillaje. 2. Todos los estudiantes deben estar bien afeitados. 3. Los pantalones se deben llevar en la cintura con un cinturón (No hay diseño en el cinturón, el cinturón debe ser negro o café, No se debe usar una hebilla de diseñador). 4. Pantalones cortos, minifaldas o pantalones DENIM No Serán Permitidos; no se mostrarán logotipos de diseñadores (por ejemplo, Guess, POLO de ningún tipo), solo se permitirán pantalones de uniforme de color caqui, negro o azul marino. (NO SKINNY JEANS) Los estudiantes que no cumplan usarán Scrubs. 5. Sin joyas (relojes, colgantes religiosos, rosarios, piercings en la lengua, piercings en el vientre, piercings en los ojos, piedras en los dientes o hilos en los oídos). ¡No pueden ser usados debajo de la ropa! Sin gafas de sol ni lentes de contacto sin receta. 6. Todo el cabello femenino debe retirarse con una cola de caballo o un moño. No se permiten diseños ni líneas en el cabello. 7. Solo se permitirán zapatos de tenis de color sólido. 8. Todos los abrigos y chaquetas deben ser registrados. Bajo ninguna circunstancia, se permitirá a los estudiantes guardar chaquetas o suéteres en el aula. La Academia de F.S. Lara no es responsable de las chaquetas pérdidas o robadas. 9. Todos los tatuajes e hickies visibles deben estar cubiertos en todo momento. 10. No se permitirá dinero, teléfonos celulares o dispositivos electrónicos. Si un estudiante trae alguno de estos artículos, serán confiscados y los padres / tutores pueden recoger el artículo confiscado de la oficina principal. 11. A los estudiantes que no sigan el código de vestimenta se les llamará a sus padres / tutores para que traigan la vestimenta adecuada. 12. Las camisas siempre deben estar fajadas. 13. Los estudiantes no pueden usar un conjunto adicional de prendas exteriores debajo de su uniforme.

Iniciales del Padre ______ El Administrador encargado del Debido al Proceso me ha leído, explicado, y otorgado una copia de los protocolos y procedimientos antes de ir a registrar a mi hijo/hija a La Academia de F.S. Lara y como padre/guardian legal es mi responsabilidad acatar. ______ Yo, __________________ junto con mi hijo/hija, ___________________hemos leído, comprendido, y acataremos a las reglas y normas de La Academia de F.S. Lara. Nombre del Padre: ________________________ Firma: ________________________________ Fecha: ___________

Nombre del Estudiante: _____________________Firma: ________________________________ Fecha: ___________

Nombre del Administrador: _______________________Firma: ___________________________ Fecha: ___________

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RECOMMENDATION FOR EXPULSION  

LISD Official Form 731-008(A) Last Updated: September 2020  

Confernce Date:________

_____________________ _____________________ Laredo, TX ___________ re: ____________________, I.D. # __________ Dear _________________, This letter is to inform you that I am recommending _____________________________, I.D. # _______, for expulsion from the Laredo Independent School District for _____________ school days. This conference is being held with you and ________________________ on _______________, in which we discussed the reason for my recommendation, which is the following: List offenses: Date_____________ Time_______________ Place________________ The placement of a student with a disability being served in Special Education/504 has been made in accordance with all the applicable state and federal laws. Please see the LISD Student Code of Conduct for more information. Please be advised that while a student is at Webb County Juvenile Justice Alternative Education Program(JJAEP), he/she shall not participate in a ny school-sponsored or school related activities of any kind nor will not be allowed on school district property at any time. Upon completion of the student's term at J.J.A.E. P., he/she may return to their home campus. If he/she does not abide by terms imposed, LISD will take whatever legal actionis necessary including possible trespassing charges filed. I regret that __________________________ was unable to comply with the rules and regulations of the Laredo Independent School District and of this campus, __________. You will be notified in writing of the date, time and place of the expulsion hearing. If you have any questions, please do not hesitate to contact me. Sincerely, __________________________ ___________________ ________ Aministrator's Signature Date _____________________ ____________________ _______xc. Graciela Perez Parent/Guardian Name Signature Date Hearings Officer

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RECOMENDACION DE EXPULSION  

LISD Official Form 731-008(B) Last Updated: September 2020  

Fecha de Confererncia ______

_____________________ _____________________ Laredo, TX ___________ RE: ____________________, I.D. # _________ Estimado(a) _________________, Esta carta es para informarle que estoy recomendando la expulsión de ___________________________, I.D. # _______, del Distrito Independiente de Laredo por _____________ días escolares. Esta conferencia con usted y ________________________ fue disponible en la fecha ______________, en la que discutimos la razón de mi recomendación, la cual fue la siguiente: Lista ofensas: Fecha _____________ Hora _______________ Local ________________ La colocación de un estudiante con una discapacidad que reciba servicios de Educación Especial o Sección 504 se ha llevado a cabo de acuerdo con todas las leyes estatales y federales pertinentes. Por favor consulte el Código de Conducta del Estudiante del Distrito Independiente de Laredo para más información. Por favor tome note de que mientras su hijo(a) esta en el programa de Webb County Juvenile Justice AlternativeEducation Program (JJAEP), no podra participar en ningun tip de actividad escolar ya sea patrocinado o relacionado con las escuelas. Al completar el termino en la Academia de F.S. lara, su hijo(a) podra regresar a su escuela de plantaSi el estudiante no acanta los terminos ya expresados, LISD tomara cualquier accion legal necesaria incluyendo cargosde traspaso ilegal. Siento mucho que __________________________ no pudo cumplir con los reglamentos y regulaciones de acuerdo con el distrito escolar y de esta escuela, _____________________________. Se le notificará por escrito de la fecha exacta, la hora, y el lugar en donde se llevará acabo la audiencia de expulsión. Para obtener más información o si tiene más preguntas al respecto, por favor llámeme. Sinceramente, __________________________ ___________________ _____ Firma del Director Fecha _______________________ _____________________ _____xc. Graciela Perez Nombre en letra de Molde Firma Fecha Oficial de Audencias

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LISD Official Form 731-011 Last Updated: September 2020  

LAREDO INDEPENDENT SCHOOL DISTRICT

Opportunity to Complete Coursework Form (To Be Completed by Counselor)

Student Name: ____________________ I.D. # ______ Campus: Grade: Counselor:___________________

Notice to Parents: Students shall receive full credit for assignments completed in a Disciplinary Alternative Education Program. St udents who a re placed in the district's disciplinary education pr ogram will be offered an opportunit y to complete coursework required for graduation at no cost to the student. Available methods to complete coursework include, but are not limited to; A. Course offered at F.S. Lara/JJAEP; B. Lessons prepared by a teacher and sent to F.S. Lara/JJAEP; C. Correspondence courses; D. Distance learning; or e. Summer school.

__________________________________ __________ _______________________________ ___________ Parent Signature Date Student Signature Date

STUDENT STATUS: ___ Reg. Ed. ___ Sp. Ed. ___ Section 504 ___ESL ___ EL

FOUNDATION SCHOOL PROGRAM: ___ Foundation ___ w/Endorsements ___ DLA

Please complete the following:

1. _____________________________ S1 S2

2. _____________________________ S1 S2

3. _____________________________ S1 S2

4. _____________________________ S1 S2

5. _____________________________ S1 S2

6. _____________________________ S1 S2

7. _____________________________ S1 S2

8. _____________________________ S1 S2

9. _____________________________ S1 S2

[Circle above the appropriate letter(s) for LISD methods of course completion listed below.] a. Course being offered FSL/JJAEP b. Lessons prepared by a teacher and sent to FSL/JJAEP (i.e., Advanced Placement courses,

Business classes, etc. c. Please indicate credit recovery courses to be taken on Odyssey Ware Program

Comments: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________ _________ ______________________________ ___________ Counselor’s Signature Date Administrator’s Signature Date

Courses at the time of Placement/Expulsion

Opportunity to Complete Coursework at F.S. Lara/J.J.A.E.P.

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STAAR/TELPAS Middle School Student Information

Home Campus: __________________________

Student Name: ______________________ Student I.D. #: _____________ Grade: _________

____Regular: ____ Sp.Ed. ____ 504 ______ EL (IF STUDENT IS LEP, PLEASE REFER TO TELPAS SECTION)

D.O.B.: _________________ S.S./PEIMS #: _______________________

STAAR

STAAR TEST Passed Score Did Not Meet Approaches Meets Masters 6th Math 6th Reading 7th Math 7th Reading 7th Writing 8th Math 8th Reading 8th Writing 8th Science 8th Social Studies

TELPAS

*During TELPAS window February 24th-April 3rd, 2020 Writing Samples must be submitted to F.S. Lara

Academy.

_____No Samples Submitted _____No Test Taken

Attachments:

_____ Current Student Schedule

_____ Texas Assessment Data Portal

Verified by: ______________________________ Date: _______________________

Writing Samples Submitted:

Pending Test:

_____Expository _____Speaking _____Narrative _____Reading _____Past Event _____Content

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STAAR/TELPAS High School Student Information

Home Campus: __________________________

Student Name: ______________________ Student I.D. #: _____________ Grade: _________

____Regular: ____ Sp. Ed. ____ 504 ______ EL (IF STUDENT IS LEP, PLEASE REFER TO TELPAS SECTION)

D.O.B.: _________________ S.S./PEIMS #: _______________________

STAAR

STAAR TEST Passed Score Did Not Meet Approaches Meets Masters Algebra I Biology ELA I ELAII U.S. History

Pending/Make-up STAAR Test: ____ Alg.: ____ Bio.: ____ U.S.: ____ ELA I: ____ ELA II

TELPAS

_____No Samples Submitted _____No Test Taken

Attachments:

_____ Current Student Schedule

_____ Texas assessment Data Portal

Verified by: ______________________________ Date: _______________________

Writing Samples Submitted:

Pending Test:

_____Expository _____Speaking _____Narrative _____Reading _____Past Event _____Content

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LISD Official Form 731-005 Last Updated: September 2020

Observation Checklist for Administrators “Under the Influence” Form

Campus:

Student: _____________________________ ID #: _____________ Grade: _____ Time: __________

Address: _____________________ Age: _____ D.O.B.: _______ Date: _________ Phone: ________________

Under the Influence: means not having the normal use of mental or physical faculties; however, the pattern of abnormal or erratic behavior and/or the presence of physical symptoms of drug or alcohol use. (LISD Student Code of Conduct, Board Policy FNCF (Local))

Please check all that apply:

Did the student admit to using drugs: ☐ Yes ☐ No

What drug(s) were allegedly used? ______________________________________________________

Speech: □ Clear □ Slurred □ Rapid

Behavior: □ Quiet □ Apathetic □ Withdrawn □ Drowsy

□ Dazed □ Yawning □ Lethargic

□ Nervous □ Restless □ Irritable □ Shaky

□ Over-reacts (without cause)

□ Aggressive □ Agitated □ Anxious □ Argumentative

□ Relaxed □ Cooperative □ Attentive □ Alert

□ Talkative □ Silly □ Euphoric □ Dizzy

□ Laughing (without cause)

Cognitive Level: □ Normal use of mental facilities □ Coherent □ Confused

□ Oriented to person □ Oriented to place □ Non-communicative

Galt: □ Normal use of physical facilities □ Staggering □ Wobbling

□ Clumsy

Eyes: □ Bloodshot □ Tearing □ Glazed □ Other

Comments: _________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

Certified DITEP Administrator: ____________________________ Signature: ___________________________

Date: _____________________

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I, __________________________, agree to making this statement at ____________________

as a/an___ administrator ___ victim ____witness on a voluntary basis before _____________________

on this ____ day of _______________ 20 ____ at __________ o’clock in Laredo, Webb County Texas.

My Name is _________________________________________________________________.

My address is _____________________________________ in _________________________.

My date of birth is______________________ and my present age is _________________.

My home telephone number is ____________________________.

I am employed by_____________________ in the capacity of _________________________.

The business phone number is ________________________.

This Statement in reference to:

__________________________________________________________________________________________

__________________________________________________________________________________________

Details of Statement

Laredo Independent School District

Voluntary Statement

(Last Name, First Name)

(City, County, State)

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__________________________________ _____________

Signature Date

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POLICE REPORT 

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Case #:_________________

LAREDO INDEPENDENT SCHOOL DISTRICT POLICE DEPARTMENT

VOLUNTARY STATEMENT FORM

I, __________________________, AM MAKING THIS STATEMENT AT

_______________________________ AS A REPORTING PARTY VICTIM WITNESS, ON

VOLUNTARY BASIS BEFORE ________________________ON THIS ______________________

DAY OF ___________________________ 20____ AT __________ O’CLOCK IN LAREDO, WEBB

COUNTY TEXAS.

MY NAME IS ___________________________________________

MY ADDRESS IS __________________________________________IN ____________________

MY DATE OF BIRTH IS _________________ AND MY PRESENT AGE IS_________

MY HOME TELEPHONE IS _______________ I AM EMPLOYED BY

LAREDO ISD IN THE CAPACITY OF __________________________________________

BUSINESS PHONE NUMBER IS ________________________________.

THIS STATEMENT IS IN REFERENCE TO,

_____________________________________________________________________________

_____________________________________________________________________________

DETAILS OF STATEMENT

(City)

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_______________________ ___________________________

I HEREBY SWEAR OR AFFIRM THAT THE CONTENTS OF THIS WRITTEN STATEMENT ARE TRUE

AND CORRECT AND I UNDERSTAND THAT ANY FALSIFICATION OR UNTRUTHFULNESS WILL

CONTITUTE A VIOLATION OF LAW OF PERJURY.

__________________________ VICTIM’S SIGNATURE

REPORTING PARTY SIGNATURE WITNESS SIGNATURE

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LAREDOINDEPENDENTSCHOOLDISTRICT

TAKINGSTUDENTINTOCUSTODYFORM       

 

1. My  name is                                                                                                 Badge #     

2. I am (check the box that applies) 

a. A Texas law enforcement officer with (name of agency)  

b. A Webb County juvenile probation officer. 

3. I declare that  I am authorized to take  immediate possession of the student named below  for one of the following  lawful reasons,  in accordance with LISD Board Policy GRA (Legal), Texas Family Code 52.01 and Health and Safety Code, Ch. 573: 

 a. Pursuant to an  order of the juvenile court; 

 b. Pursuant to the laws of arrest; 

 

c. By a law enforcement officer if there is probable cause to believe that the student has engaged in delinquent conduct or conduct in need of supervision; 

 

d. By a probation officer if there is probable cause to believe the student has violated a condition of probation imposed by the juvenile court; 

 e. Pursuant to a properly issued directive to apprehend. 

 

f. Emergency Detention without a warrant.   

 

                                                                       (Name of student)             I.D. #           (Name of School)          (Grade)   

Offense(s):                  (Signature of representative or officer)        Date & time of signature on document  

                              

Informed Parent/Guardian:           

                                                                           (Name)          (Date)        (Time)  

Scan form and email it to Assistant Superintendent of Student Services:  Campus Administrator’s Signature: 

 (Name)        (Date)        (Time)  

 

 

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LISD Official Form 731-009 Last Updated: January 2019  

EMPLOYEE/VOLUNTEER INJURY FROM ASSAULT REPORT

Name of Employee/Volunteer: ________________________________________ D.O.B.: ______________

Date of Incident: ___________ Incident #: ___________ Campus:

PART of BODY INJURED or AFFECTED

☐ Skull, Scalp ☐Chest ☐Abdomen ☐Mouth ☐Back ☐Neck ☐Nose ☐Spine

☐ Shoulder: ☐ R ☐ L ☐ B ☐ Wrist: ☐ R ☐ L ☐ B ☐ Knee: ☐ R ☐ L ☐ B

☐ Foot: ☐ R ☐ L ☐ B ☐ Eye: ☐ R ☐ L ☐ B ☐ Upper Arm: ☐ R ☐ L ☐ B

☐ Lower Arm: ☐ R ☐ L ☐ B ☐ Hand: ☐ R ☐ L ☐ B ☐ Thigh: ☐ R ☐ L ☐ B

☐ Toe: ☐ R ☐ L ☐ B ☐ Finger: ☐ R ☐ L ☐ B ☐ Lower Leg: ☐ R ☐ L ☐ B

☐ Ankle: ☐ R ☐ L ☐ B ☐ Forearm: ☐ R ☐ L ☐ B ☐ Hip: ☐ R ☐ L ☐ B

☐ Pelvis: ☐ R ☐ L ☐ B ☐ Jaw: ☐ R ☐ L ☐ B ☐ Elbow: ☐ R ☐ L ☐ B

☐ Other Body Part: ____________________________

NATURE of INJURY or ILLNESS

☐ Abrasion ☐ Amputation ☐ Bruise, Contusion ☐ Burn ☐ Chemical Exposure

☐ Cumulative Trauma Disorder ☐ Dislocation ☐ Foreign Body ☐ Fracture

☐ Hearing Loss ☐ Hernia ☐ Infection ☐ Irritation ☐ Laceration

☐ Muscle Sprain ☐ Muscle Strain ☐ Puncture ☐ Respiratory ☐ Skin Disorder

☐ Other: _________________________

DISPOSITION DIAGNOSIS SEVERITY

☐Days away from work # _____

☐Restricted workdays # _____

☐Date Retuned to Work _______

Sent to: ☐Doctor ☐Hospital

EMPLOYEE’S DESCRIPTION of INCIDENT (Attached sheet for additional comments)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Employee’s Signature: ___________________________________________ Date: ________________________

SUPERVISOR’S DESCRIPTION of INCIDENT (Attached sheet for additional comments)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Supervisor’s Signature: __________________________________________ Date: ________________________

_____________________________

_____________________________

_____________________________

_____________________________

_____________________________ 

☐ First Aid ☐Medical Treatment ☐Lost Workdays ☐Fatality ☐Other: Specify ________________________

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  Counseling Referral Form         

LISD Official Form 731-010 Last Updated: January 2019

 

Priority Level Low

Moderate

HighStudent ___________________________________ I.D. # ________ Grade ___________

Counselor Date

Homeroom Teacher (Elementary Only)

Reason for referral: ☐___ Poor peer relationships ☐ Family changes (death, divorce, re-marriage, moving, etc.)

☐ Behavioral problems ☐ Aggressiveness/Bullying

☐ Academic problems ☐ Sudden changes in mood, attitude, or behavior

☐ In need of Social Services ☐ PEP (Parenting Ed. Program)

_____________________ Other (Please Specify) Services provided to student by School Counselor:

Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)

Date: ***********************************************************************************************

Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)_________________________________________

_

_____________________________________________________________________________________________________________________

Date: _______________________________

***********************************************************************************************Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.)

Date:

***********************************************************************************************Strategies used (Resources, Presentations, Counseling, Mediation, Family Counseling, etc.) _

Date: ************************************************************************************************

Date Counselor’s Signature

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REQUEST HOME

LANGUAGE SURVEY

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