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Home / Inclusive Support / Supportive Planning Templates

Use these forms and templates to support your work.

Functional Assessment and Goals

Regulation Support Plans

Use this plan to support any student who struggles with self regulation in the school environment.  These plans may stand on their own, or be used in conjunction with an Employee Safety Plan or Integration Plan.

Regulation Support Plan Guildelines

Regulation Support Plan Template

Coordinated Team Response Plan

Sample Escalation-Deescalation Guide

Escalation-Deescalation Template

Data Collection

The NCI Data Profile is the recommended tool for establishing a personalized response continuum for a learner.

It is recommended that members of the SBT collaborate around a schedule whereby observations can be gathered at different times of day to create a fulsome picture of the student. 

If this tool is new to you, this NCI Data Profile Quick Tips will provide some suggestions about the most effective way to use it.

The tools below can supplment this process where additonal data is requried.  

This tool is the evolution of the NCI Data Profile to more student-specific supports (i.e., break schedules, essential strategies, scripts). The personalized schedule will support tracking of data related to dysregulation and continually inform enhancements of student programming. A blank template can be found here

Click here to download a sample of a daily personalized schedule or click here to download a sample of a weekly personalized schedule. 

This observational tool allows a third-party observer to better understand what the complex behaviour is communicating.

This observation tool tracks Antecedents, Behaviours, and Consequences.

Click here to download the document.

This observational tool allows a support person to track frequency/time of targeted behaviours (i.e. behaviours of concern).

This tool also allows the team to identify intervention strategies and times when a student is more successful. 

Click here to dowload a template.

 

Make observations about student behaviour by recording activities and time.

Click here to download the document.

The Domain Based Planning Tool can be used in place of the  ISPPs for specific designations, if you wish. 

It is intended to support goal and objective development, and to asisst school teams with programming planning for a student with complex needs.

This tool DOES NOT need to be submitted as part of the eligibility paperwork, but should serve as a working document during IEP meetings.

Because it encompasses skills from all domains, it will not typically be used in it’s entirety.  Instead, Case Managers are encouraged to facilitate collaborative conversation with classroom teachers, parents/guardians, and other relevant support folks, around relevant sections.   

Medical Forms

There are different plans for students with and without Nursing Support Services support.  Please ensure you are aware of the differences between the types of care.

It is very important that nursing plans are followed as written, and that documentation is complete.   There are diifferent methods for managing and documenting care where a nurse is not involved.  

If a student is not followed by NSS, school staff cannot take responsibilty for testing blood sugar, and managing food levels.  This is something that will need to be done independently by the student.  This is the reason that the non-NSS plans are less detailed.  It is important we do not take on delegated nursing responsibilities where there is no delegated care.   

Where parents are utilizing a third-party app to monitor their child’s blood sugar from their phones, this is called “looping,” and is not approved by Health Canada.  We need to be very careful not to have staff making medical decisions as part of the student’s care plan, as NSS will not delegate for this type of program.  

Share information with all staff and ensure that a copies are stored: in the student file, first aid file, TTOC file, EAOC file.   (Due to Ministry of Health regulations, you are not able to copy NSS plans, but they can provide you with something for the designation file to confirm diagnosis if needed).  

It is also important to make sure there is a poster, or cover on the binder where blood sugar levels are recorded, as a quick reference for everyone involved. 

Support Checklists / Links to Care Plans

It is important to work through the links on these checklists to ensure staff are familiar with the type of support for each type of care plan.  If NSS will be coming for training, please ensure the preparatory work has been completed first.

ALL Students with diabetes should have a non-NSS support plan.  Where students also have NSS support, this is the back-up plan for the days that the delegated EAs are not available.

Only students with an NSS nurse should have the NSS Plan.  These are the property of Island Health and must remain in the assigned locations.  They cannot be copied.  Please follow nurse direction in managing these plans.  

The Ministry has recently made changes to seizure support for students.

Please work closely with the student’s parents to develop a Seizure Action Plan, the template is available on the NSS webpage.   Please encourage families to obtain updated information from their family doctor to help inform this process.  You may also wish to share a copy of the Information For Parents that has been provided by the Ministry to explain this change.  

While students will no longer be followed for Delegated Nursing support, it is possible to request training if the student is using one of the specific medications listed on the NSS form, although the number of nurses in our area is limited, so it is necessary to develop a plan between yourselves and the parent, rather than waiting for the nurse.  This training can be requested using the Training Request Form.   Prior to requesting training, you are asked to develop the action plan, and to ask the parents to confirm some information.  Please use the Pre-Training Checklist to ensure these steps have taken place.

When developing the plans, please be  super thoughtful about where the line is in terms of calling 911, as many of these situations are very complex and the student health can be fragile.  We have schools that have held emergency meds without NSS support for students in the past, this is actually a practice that has been used for other emergency medications for some time.  Sometimes an IST or PVP have been responsible for the administration rather than an EA – although this can be difficult for students requiring seizure care because EAs are very front-line in observing the signs of an approaching seizure, and there is often a very short window between it’s onset and a significant medical concern.  Please collaborate as an SBT to ensure that everyone is feeling supported in the development of this plan.

Seizure Care in Schools

Complete this form for a student living with anaphylaxis.  

Share information with all staff and ensure that a copies are stored: in the student file, first aid file, TTOC file, EAOC file.

Click here to download the document. 

Delegated Nursing occurs where a Nurse formally delegates an aspect of their licence to a trained Education Assistant for support with medical needs at school. 

A Principal or Vice-Principal submits the form to HR after it has been signed off on by the nurse.

If the student’s medical needs are monitored through a different type of medical plan, the EA will not qualify for EA 3 classification.

NSS Service Delivery in Schools

 

 

Click here for form.

Please preview the Training Video prior to the School Aged Therapists’ visit to your school.

(You may need to be on a school district computer and login for it to play). 

This plan should be prepared for students who require specialized planning for emergency evacuations.

It is most commonly used for students who are physically dependent, but may be prepared for other complex students if it is felt they can not be safely evacuated without specific, individualized support.

Link to it here

Learning Plans (formerly named Student Support Plans)

Learning Plans are created for a student that does not meet the criteria for a ministry designation and is either:

a.  Working outside the widely held expectaitons of grade level standards in one or more area(s) of their learning (Template)

OR

b.  Requires specific individualized interventions to be successful working within widely held grade level expectations (Template)

Learning plans are managed by the classroom teacher, in collaboration with parents and the appropriate members of the SBT.

For more information, refer to the Elementary Communicating Student Learning Guidelines (pg 14).

Integration Plans

Please work with your Principal/Vice Principal to develop Integration Plans for students.

Transition Planning

Student transitions can be a challenging time for students and their families. These are resources to help support the changes in their programs in a gentle and compassionate way. Whether it is to a new school, district, or grade, each student deserves to be welcomed and supported.

These tools may assist with planning transitions for students moving from elementary to secondary school.

Secondary School Social Stories 

CEDAR

DOVER

LIS

NDSS

LSS

WELLINGTON

Team Planning Checklist

Ministry: Roles, Tasks, Transitions

Checklist Through Adulthood

CLBC Eligibilty Handout For Families

Journey to Adulthood Roadmap

STADD Information Sheet

Community Youth Inclusion Workers assist with training opportunities and transitions for students with intellectual disabilities.  Submit a referral through the online webform to access their services:  Community Youth Inclusion Worker Referral

Year 12+ Confirmation of Continued Attendance forms are updated in January of each year. Your Principal or Vice-Principal can obtain them through the leadership portal.  Please submit them to learningservices@sd68.bc.ca by the end of April.