1. TO BE COMPLETED AT THE SCHOOL-LEVEL
    1.  
      1. Evidence Sources: Verified:
      2. Evidence Sources:
      3. Verified:
      4. Evidence Sources: Verified:
      5. Evidence Sources: Verified:
      6. Evidence Sources: Verified:
      7. Evidence Sources: Verified:
      8. Evidence Sources: Verified:
      9. Evidence Sources: Verified:
      10. Evidence Sources:
      11. Verified:
      12. X. PROPERTY
      13. Check applicable requirement(s):
      14. Evidence Sources: Verified:
      15. Evidence Sources: Verified:
      16. Verified:
      17. XI. NEEDS ASSESSMENT, SCHOOL IMPROVEMENT AND PARENTAL CHOICE
      18. Evidence Sources: Verified:
      19. NEEDS ASSESSMENT, SCHOOL IMPROVEMENT AND PARENTAL CHOICE
      20. Evidence Sources: Verified:
      21. XII. PARENTAL INVOLVEMENT
      22. Evidence Sources:
      23. Verified:
      24.  
      25. Verified:
      26. Evidence Sources:
      27. Verified:
      28. Evidence Sources: Verified:
      29. Evidence Sources:
      30.  
      31. Evidence Sources:
      32. Verified:
      33. Verified:
      34. XIII. PROFESSIONAL DEVELOPMENT
      35. Evidence Sources:
      36. Verified:
      37. Evidence Sources: Verified:
      38. Evidence Sources: Verified:
      39. 6) Fill in the first date of preplanning for this school year.

TO BE COMPLETED AT THE SCHOOL-LEVEL
DISTRICT ________________________________________________
SCHOOL _________________________________________________
SCHOOLWIDE DETERMINATION OF COMPLIANCE FORM
The school complies with all criteria statements and appropriate documents are on file.
This determination of compliance was based on a review of the Federal laws and
regulations contained in Public Laws 107-110; 34 Code of Federal Regulations (CFR);
Education Department General Administrative Regulations (EDGAR); United States
Department of Education Title I Policy Manual (PM); United States Department of
Education Migrant Education Program Policy Manual (MPM); Florida Statutes; Division
of Public Schools (DPS) Memoranda; and Project Application and Amendment Procedures
for Federal and State Grant Programs Administered by Division of Public Schools.
_______________________________________
_______________________________________
Principal’s Signature
Title I Director/Coordinator’s Signature
_______________________________________
_______________________________________
Date
Date
TITLE I
Page
32
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
IX.
FISCAL REQUIREMENTS
In order to upgrade the entire educational program in a school, a district may select that school for
a schoolwide program. Public Law 107-110, Sections 1114, 1119, 1120A; 34 CFR 200.8, 200.41;
USDE Title I Policy Manual (PM); USDE Migrant Education Program Policy Manual (MPM)
(Check
applicable evidence sources.)
1.
The school meets the following criteria:
[ ] Serves an eligible school attendance area in which not less than 40% of the children are from
low-income families; or
[ ] Not less than 40% of the children enrolled in the school are from such families.
Section 1114(a)
Evidence Sources:
Verified:
[ ] FTE report
[ ] Yes
[ ] Free and reduced lunch applications
[ ] No
[ ] Enrollment data
[ ] Free and reduced lunch list
[ ] Other (specify)___________________________________________
2.
?
When a school uses Migrant funds in a schoolwide program, the school, in consultation with parents
of migratory children or organizations representing those parents, or both, shall document that the
identified special needs of migratory children were met.
Section 1306(b)(1)(4)
Evidence Sources:
[ ] Minutes of meetings
[ ] Description of services
[ ] Certification of eligibility
[ ] Needs assessment data
[ ] Lesson plans
[ ] Other (specify)__________________________________________
Verified:
[ ] Yes
[ ] No
[ ] N/A
3.
?
The school has received high quality technical assistance and support from the district and its school
support team or other technical assistance providers. Section 1114(b)(2)(A)
Evidence Sources:
Verified:
[ ] Documentation of technical assistance from technical assistance centers
[ ] Yes
[ ] Inservice workshops
[ ] No
[ ] Professional development records
[ ] N/A
[ ] Other (specify)___________________________________________
TITLE I
Page
33
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
FISCAL REQUIREMENTS
4.
?
The school has used funds to supplement, and to the extent practical, increase the level of funds that
would, in the absence of Title I funds, be made available from non-federal sources including funds
for children with disabilities and limited English proficiency.
Section 1114(a)(2)(B)
Evidence Sources:
Verified:
[ ] Personnel assignments
[ ] Yes
[ ] Expenditure reports
[ ] No
[ ] Instructional schedules
[ ] Other (specify)______________________________________
5.
?
The principal has deployed state and local resources to Title I children in a manner that is at least
equal to non-Title I children in the same grade levels where the Title I program is implemented.
The allocations are consistent with the district's written allocation procedures and the district's
written procedures for school-based management.
Section 1120A(b)(1)
Evidence Sources:
Verified:
[ ] District’s written allocation procedures
[ ] Yes
[ ] Personnel action forms
[ ] No
[ ] School state and local expenditure report
[ ] Other (specify)_________________________________________
6.
?
The principal has requested, received and deployed additional staff consistent with the district
allocation procedure. Section 1114(a)(2)(B)
Evidence Sources:
Verified:
[ ] Personnel allocations
[ ] Yes
[ ] Personnel action forms
[ ] No
[ ] Other (specify)__________________________________________
7.
?
This school shall devote sufficient resources to carry out professional development activities or
entered into a consortium with another school to carry out such activities.
Section 1114(a)(4)
Evidence Sources:
Verified:
[ ] Professional development activities
[ ] Yes
[ ] Correspondence
[ ] No
[ ] Other (specify)___________________________________________
TITLE I
Page
34
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
FISCAL REQUIREMENTS
8.
This schoolwide program shall include the following components:
?
Comprehensive needs assessment based on State academic content and student academic
achievement standards.
 
Schoolwide reform strategies that:
 
Provide opportunities for all children to meet the State's proficient and advanced
standards.
 
Are based on effective means of improving achievement.
 
Use effective methods and instructional strategies that are based on scientifically-based
research that:
 
Increase the amount and quality of learning time and provide an enriched and
accelerated curriculum.
 
Strengthen the core academic program in the school.
 
Include strategies for meeting the educational needs of underserved populations.
 
Address the needs of all children, but particularly members of target populations, of any
program which may include:
 
Counseling, pupil services, and mentoring.
 
College and career awareness and preparation.
 
The integration of vocational and technical education programs.
 
Address how the school will determine if such needs have been met.
 
Indicate consistency with State and local improvement plans.
 
Instruction by highly qualified teachers.
 
Strategies to increase parental involvement.
?
Professional development for teachers, principals, paraprofessionals, and where appropriate,
others
 
Plans for assisting transition of preschool children
 
Measures to include teachers in decisions regarding the use of academic assessments
 
Activities to ensure that students having difficulty mastering standards shall be provided with
effective assistance, which shall include:
 
Ensuring that students’ difficulties are identified on a timely basis with sufficient
information.
 
Coordination and integration of Federal, State, and local services and programs.
Section 1114(b)(1)
Evidence Sources:
Verified:
[ ] Schoolwide plan
[ ] School improvement plan
[ ] Yes
[ ] Needs assessment documentation
[ ] Joint decision making records
[ ] No
[ ] Coordination activities
[ ] Test scores
[ ] Class schedules
[ ] Professional development activities
[ ] Target student lists
[ ] Transition plan
[ ] Gender equity practices
[ ] Parental involvement activities
[ ] Other (specify)___________________________________________
TITLE I
Page
35
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
FISCAL REQUIREMENTS
9.
?
This school has developed or amended a comprehensive schoolwide plan in consultation with the
district, its school support team, or other technical assistance providers which includes the
following:
 
Description of how the school will use Title I and other resources.
 
Description of how the school will implement the components of schoolwide program.
 
Listing of state, district and appropriate federal programs.
?
Description of individual student academic assessment and interpretation of results to parents of
participants.
 
The comprehensive plan shall be:
?
Developed during a 1-year period, unless the district determined that less time was
needed; or the school is operating a schoolwide program based on the previous law in
which case the school may continue to operate such program, but shall develop
amendments to its existing plan during the first year of assistance.
 
Developed with the involvement of the community, school personnel, and parents.
 
In effect for the duration of the school's participation and reviewed and revised, as
necessary.
 
Available to the district, parents, public, and translated, when appropriate.
 
Developed in coordination with the following programs:
 
Carl D. Perkins Vocational and Technical Education Act of 1998.
 
Reading First, Early Reading First, and/or Even Start. Section 1114(b)(2)
Evidence Sources:
[ ] Schoolwide plan
[ ] Coordination records
[ ] School improvement plan
[ ] Documentation of technical assistance with technical assistance centers
[ ] Interpretation of assessment results
[ ] Parent/community involvement
[ ] Other (specify)_______________________________________
Verified:
[ ] Yes
[ ] No
TITLE I
Page
36
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
X.
PROPERTY
This school has implemented property management practices in accordance with the applicable
Florida Statutes, Chapter 274; Public Law 107-110; 34 CFR Part 80.31, 80.32, 80.33; USDE Title I
Policy Manuals (PM); USDE Migrant Education Program Policy Manual (MPM); Rules of the
Auditor General 10.400
(Check
applicable evidence sources.)
1.
There is a property record at this school which includes the following:
Check applicable requirement(s):
[ ] Identification number
[ ] Location
[ ] Source or percentage of federal funds used in purchase
Chapter 274, Florida Statutes; Rules of the Auditor General 10.400; 34 CFR 80.32(d)(1)
Evidence Sources:
Verified:
[ ] Property inventory records with dates
[ ] Yes
[ ] Property control records
[ ] No
[ ] Other (specify)______________________________________
2.
?
A control system is in effect to ensure adequate safeguards to prevent loss, damage, or theft of
equipment.
Loss, damage or theft of all Title I equipment has been investigated and fully
documented. 34 CFR 80.32(d)(3)
Evidence Sources:
Verified:
[ ] Police/security reports
[ ] Yes
[ ] Damage and loss reports
[ ] No
[ ] Other (specify)______________________________________
3.
?
Maintenance procedures have been implemented to keep property in good condition at this school.
34 CFR 80.32(d)(4)
Evidence Sources:
Verified:
[ ] Maintenance procedures
[ ] Yes
[ ] Maintenance reports
[ ] No
[ ] Other (specify)________________________________________
TITLE I
Page
37
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
XI.
NEEDS ASSESSMENT, SCHOOL IMPROVEMENT AND PARENTAL CHOICE
The program is based on an annual assessment of educational needs which identifies children
failing or most at risk of failing to meet the State's student academic achievement standards. Public
Law 107-110, Section 1116; USDE Title I Policy Manual (PM); USDE Migrant Education Program
Policy Manual (MPM)
(Check
?
applicable evidence sources.)
1.
Each school in consultation with parents, district and school support team shall:
 
Develop or revise its school improvement plan in ways that have the greatest likelihood of
improving the academic achievement of participating students.
 
Submit the plan or revised plan to the district for approval.
 
Review appropriate school-level data including assessment data, on which such identification is
based.
 
Implement the plan or revised plan during the first year immediately following such identification.
Section 1116(b)(3)
Evidence Sources:
Verified:
[ ] School improvement plan or revised plan
[ ] Yes
[ ] Documentation of parent meetings
[ ] No
[ ] Documentation of timeline
[ ] Other (specify)______________________________________
2.
?
Each school identified for school improvement has included professional development activities in
its plan and has demonstrated compliance by:
[
 
] Devoting to such activities an amount equivalent to at least 10% of the Title I funds
received annually.
[
 
] Incorporating strategies based on scientifically-based research.
[
 
] Adopting policies and practices concerning the school’s core academic subjects.
[
 
] Specifying how school improvement funds will be used to remove the school from
school improvement status.
[
 
] Establishing specific annual measurable objectives.
[
 
] Describing how the school will provide written notice about the school identified
for school improvement in a language parents can understand.
[
 
] Specifying the responsibilities of the school, district, state, including the technical
assistance to be provided by the district.
[
 
] Including strategies to promote effective parental involvement.
TITLE I
Page
38
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
NEEDS ASSESSMENT, SCHOOL IMPROVEMENT AND PARENTAL CHOICE
[
 
] Incorporating activities before school, after school, during summer, and during
regular school year.
[
 
] Incorporating a teacher mentoring program.
Section 1116(b)(3)
Evidence Sources:
Verified:
[ ] List of activities
[ ] Yes
[ ] Staff surveys
[ ] No
[ ] School improvement plan
[ ] Financial records
[ ] Other (specify)______________________________________
TITLE I
Page
39
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
XII.
PARENTAL INVOLVEMENT
This school involves parents in the implementation of Title I programs. Public Law 107-110,
Section 1118; USDE Title I Policy Manual (PM); USDE Migrant Education Program Policy
Manual (MPM)
(Check
applicable evidence sources.)
1.
?
Each school shall jointly develop with parents a written parent involvement policy and distribute it to
parents of participating children. The policy has been updated periodically.
Section 1118(b)(1)
Evidence Sources:
[ ] Title I policy
[ ] Listing of parents involved
[ ] Follow-up of parent recommendations
[ ] Documentation of meetings
[ ] Survey results
[ ] Other (specify)_______________________________________
2.
Each school shall:
Verified:
[ ] Yes
[ ] No
Convene an annual meeting to inform parents of their school's participation and their rights to be
involved.
Offer a flexible number of meetings and times of meetings.
Provide transportation, child care, or home visits related to parent involvement.
Involve parents, in an organized, ongoing, and timely way, in the planning, review, and
improvement of programs, including joint development of schoolwide program plan.
Section
1118(c)(1)(2)(3)
Evidence Sources:
[ ] Documentation of meetings
[ ] Newsletter articles
[ ] Log of home visits
[ ] List of participants
[ ] Transportation logs
[ ] Other (specify)_______________________________________
Verified:
[ ] Yes
[ ] No
TITLE I
Page
40
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
PARENTAL INVOLVEMENT
3.
Each school shall provide parents of participating children:
Timely information about programs.
Description and explanation of curriculum in use at the school, the forms of academic assessment
used to measure student progress and proficiency levels students are expected to meet.
Opportunities for regular meetings to share experiences and provide suggestions.
Timely responses to parents' suggestions.
Section 1118(c)(4)
Evidence Sources:
[ ] Calendar of events
[ ] Student test data
[ ] Description and explanation of programs and assessment instruments
[ ] Documentation of meetings
[ ] School performance profiles
[ ] Other (specify)_______________________________________
Verified:
[ ] Yes
[ ] No
4.
?
Each school implementing schoolwide programs shall submit unsatisfactory comments on the
parental involvement plan to the district. Section 1118(c)(5)
Evidence Sources:
Verified:
[ ] Documentation of meetings
[ ] Yes
[ ] Unsatisfactory parental comments
[ ] No
[ ] Survey results
[ ] Other (specify)_______________________________________
TITLE I
Page
41
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
PARENTAL INVOLVEMENT
5.
?
Each school shall jointly develop with parents of Title I children, a school-parent compact that
outlines how parents, the entire school staff, and students share the responsibility for improved
student academic achievement and the means by which school and parents will build and develop a
partnership to help children achieve. Such compact shall:
Describe the school's responsibility to provide high-quality curriculum and instruction in a
supportive and effective learning environment that enables the children served to meet the
state’s student academic achievement standards and the ways parents will be responsible for
supporting their children's learning (monitoring attendance, homework completion, and
television watching) and volunteering in their children's classrooms.
Address the importance of communication between teachers and parents on an ongoing basis
at a minimum through:
Annual parent-teacher conferences in elementary school, during which the compact shall
be discussed relating to the child’s achievement.
Frequent reports to parents on their children's progress.
Reasonable access to staff, opportunities to volunteer, participate in their child’s class and
observe in the classroom.
Section 1118(d)
Evidence Sources:
[ ] School/parent compact
[ ] Documentation of parent workshops
[ ] Volunteer logs
[ ] Documentation of parent/teacher conferences
[ ] Survey results
[ ] Student progress reports
[ ] Other (specify)________________________________________
Verified:
[ ] Yes
[ ] No
TITLE I
Page
42
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
PARENTAL INVOLVEMENT
6.
?
Each school shall ensure effective involvement of parents and support a partnership among the
school, parents and the community to improve student academic achievement by:
?
Providing assistance to parents in such areas as understanding the State's academic content
and student academic achievement standards.
?
Providing assistance in how to monitor their children's progress and work with educators to
improve achievement of their children.
?
Providing materials and training, including coordinating necessary literacy training and using
technology.
 
Training parents to work with their children to improve achievement.
?
Educating teachers, principals, and other staff in the value and contributions parents can
provide as equal partners and build ties between parents and school.
?
Coordinating and integrating parent involvement programs with such programs as Head Start,
Even Start, Reading First, Early Reading First, Home Instruction Programs for Preschool
Youngsters, Parents as Teachers and other preschool programs.
?
Conducting other activities, as appropriate and feasible, such as parent resource centers and
provide opportunities for parents to learn about child development and rearing.
?
Ensuring to the extent possible, that information is sent home in the language used in the
home.
 
Providing for other reasonable support for parental involvement activities as requested by
parents.
Section 1118(e)
Evidence Sources:
[ ] Documentation of meetings
[ ] Documentation of parent workshops
[ ] Documentation of school/business coordination records
[ ] Staff development records
[ ] List of participants
[ ] School/home documents
Verified:
[ ] Yes
[ ] No
[ ] Other (specify)________________________________________
7.
?
Each school shall provide full opportunities for the participation of parents with limited English
proficiency or disabilities, including providing information and school reports in a language and
form such parents understand. Section 1118(f)
Evidence Sources:
Verified:
[ ] Documentation of meetings
[ ] Yes
[ ] List of parent participants
[ ] No
[ ] Correspondence
[ ] Multi-language materials
[ ] Other (specify) __________________________________
TITLE I
Page
43
Rev. 27-Nov-02

SCHOOLWIDE PROJECT
SCHOOL-LEVEL
XIII.
PROFESSIONAL DEVELOPMENT
This school devotes sufficient resources or has entered into a consortium with another school, to
carry out effectively the professional development activities described in subsection (b)(1)(D) in
accordance with Public Law 107-110, Sections 1114 and 1119.
(Check
applicable evidence sources.)
1.
?
This school shall devote sufficient resources to effectively carry out the activities required under
section 1119 or collaborate with a consortium or other school to carry out such activities. Public Law
107-110, Section 1114(a)(4)
Evidence Sources:
[ ] Documentation of resources provided
[ ] List of teachers and paraprofessionals who have not met “highly qualified”
[ ] Documentation of collaboration with other agencies/schools
[ ] Other (specify) __________________________________
Verified:
[ ] Yes
[ ] No
2.
?
If this school is identified for school improvement, the school shall spend not less than 10% of its
Title I funds to provide professional development activities to teachers and principal. Public Law 107-
110, Section 1116(b)(3)(A)
Evidence Sources:
Verified:
[ ] Allocation records for school improvement
[ ] Yes
[ ] Records of expenditures for school improvement
[ ] No
[ ] Other (specify) __________________________________
[ ] N/A
3.
?
This school provides high quality and on-going professional development for teachers, principals, and
paraprofessionals, and if appropriate, pupil services personnel, parents, and other staff. Public Law
107-110, Section 1114(b)(D)
Evidence Sources:
Verified:
[ ] Documentation of professional development activities
[ ] Yes
[ ] Documentation of ongoing professional development
[ ] No
[ ] List of training/workshop participants
[ ] Other (specify) __________________________________
TITLE I
Page
44
Rev. 27-Nov-02

 
 
 
 
(Rev. 27-Nov-02)
FORM D
Page
45
* Read notes at bottom and instructions on back before beginning to complete this form.
Florida Department of Education
Division of Public Schools
~ Bureau of Equity, Safety and School Support
SUPPLEMENT, NOT SUPPLANT (Form D)
SCHOOL-LEVEL
(Complete for all Targeted Assistance Title I schools.)
1.
District
2.
District Staffing Ration (according to Board Policy)
6.
Other Requested Information
School
K
1 - 3
4 - 6
Monitor
7 - 9
10 - 12
(First date of preplanning for this school year.)
Date of Visit
Comments:
Mark applicable items:
Grade
3.
Today’s
Enrollment
Per Grade
4.
Total Homeroom Teachers
Assigned Per Grade
5.
Individual Classroom Enrollment by Grade Levels:
(List horizontally)
a.
 
Teaching units were added since the
first day of preplanning this school
year
K
Title I funded:
List individually below:
Date of
1
st
Name
Grade
Employment
2
nd
3
rd
District funded:
Date of
4
th
Name
Grade
Employment
5
th
6
th
b.
 
All district funded teaching units were
in placed on the first day of
7
th
preplanning this school year
c.
 
All Title I funded teaching units were
8
th
in place on the first day of
preplanning this school year
9
th
d.
 
If this school employed instructional
aides in lieu of teachers, please list
10
th
them here.
Name
Grade
Working Hrs
11
th
12
th
e.
 
If this school employed instructional
aides in lieu of teachers, please list them
here.
Name
Position
Grades Served
Notes: Exclude full-time ESE students.
Exclude Special Area Teachers.
Place students in classes made up of combination grades on vertical consecutive lines and enclose in brackets [ ].
~

Please complete this form to determine whether the district has met the Supplement, Not Supplant requirements at each Title I school. The assigned
number of LEA (district) funded personnel should be consistent with the district’s teacher/pupil staffing ratio at each grade level, before implementing
the Title I project. 34 CFR 200.63
1)
Give the name of the district and school. Fill in your name and the date of visit.
2)
Indicate the district’s teacher/pupil staffing ratio by grade spans. If different from the spans indicated, provide “Comments.”
3)
By grade level, give the total enrollment, as of this date. Exclude full-time ESE students.
4)
?
By grade level, give the total number of LEA (district) funded teachers assigned to each grade. Exclude special area teachers, unless they
were funded through the basic staffing allocation formula.
5)
By grade level, give the total number of children assigned to each class section. List horizontally. Exclude full-time ESE students.
Combination Grades
List on vertical consecutive lines and enclose in brackets.
Example
grade 2
 
10
 
grade 3
13
 
6)
Fill in the first date of preplanning for this school year.
a)
?
Box “a”:
Mark box “a” if some district paid and/or Title I teaching units were added after the first day of preplanning during the
current school year. List these individuals by name, grade and date of employment in the spaces provided.
b)
Box “b”: Mark box “b” if all district paid teachers were employed on the first day of preplanning for the current school year.
FORM D
Page
46
Rev. 27-Nov-02

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