the university of the state of new york

the state education department

Office of Curriculum and Instructional Support

Adult Education and Workforce Development Team

Adult Literacy Compliance Self-Review/Monitoring Form

For agencies operating WIA Title II, Welfare Education Program, Adult Literacy Education, and Employment Preparation Education programs.

      Program Year

Please type or print:

Agency Code:  (Leave blank, if unknown)            

Agency Name:
Address:
City:	County:		Zip:
Program Contact:
Telephone:		E-mail:

Program/s being reviewed receives funding from (check all that apply): 

WIA Title II Literacy         EPE        WIA  Title II EL/Civics  WEP  ALE 

REVIEWED BY:  ___________________________________________ DATE: ______________________________

    Adult Education and Workforce Development Team

Directions:  This Adult Literacy Compliance Self-Review Form will indicate whether the basic skills programs, funded from the Workforce Investment Act Title II, Adult Education and Family Literacy (WIA Title II), Welfare Education Program (WEP), Adult Literacy Education (ALE), and Employment Preparation Education (EPE), comply with federal and State regulations. This review examines compliance issues and not necessarily the quality of programs. A staff member from the Adult Education and Workforce Development Team may contact the Program Contact for clarification of information.

Answer each question by indicating Yes or No in the space provided. Indicate the data examined or process followed to determine the compliance status. The “Evidence” examined must be completed for each compliance item checked, regardless of whether checked “Yes” or “No”. If you answer No to any question, provide a strategy to bring the program into compliance as an appendix to this report. The appendix document should list the item from the self-review form, action steps to be taken, a timeline for implementation and expected outcomes.

All programs should complete all general requirements.  If Distance Learning is not offered, answer N/A.

Please return this form to:

NYS Education Department

Regional Liaison

Adult Education and Workforce Development Team

89 Washington Avenue, Room 307 EB

Albany, New York 12234

Please return this form electronically to your regional:

        Sandra Belitza-Vazquez - NYC            sbelitza@mail.nysed.gov

        Constance Carroll - East                      ccarroll2@mail.nysed.gov

        Claudia Dean - Mid State                       cdean@mail.nysed.gov

        Anne Frank - Hudson Valley                  afrank@mail.nysed.gov

        Susan Lyons - Long Island                     slyons@mail.nysed.gov

        Kathy Sheehy - West                            ksheehy@mail.nysed.gov

        Kathleen Steinchen - Mid West           ksteinch@mail.nysed.gov

LITERACY SELF-REVIEW/MONITORING FORM

A.     INTAKE/ORIENTATION

Item	General Requirements	Compliance Status Yes             No	Evidence
1.	At intake, the participants are presented with the following information in a format they can understand:  Public Notice Under ADA, the name of the person acting as ADA Complaint Coordinator, and Three Step Grievance Policy.  The American Disabilities Act Signature Sheet has been signed and put into the student folder.
2.	A face-to-face intake session is provided to every learner, which includes:  an initial academic assessment, completion of the Individual Student Record Form (ISRF), an Education and Employment Plan (EEP), the identification of goals, and a process to identify the strengths and weaknesses of students for placement in appropriate educational programs.
3.	A face-to-face orientation session is provided to explain the teacher/student roles and responsibilities, and to become familiar with the delivery modality and instructional materials.
4.	Support services and an appropriate referral process are available.
	Distance Learning
5.	At intake, all participants are provided with information, either through an information session or an information sheet, outlining adult educational programming available in the area of residence.
6.	Students have completed the Project IDEAL Distance Learning Survey.
7.	Orientation includes a student/teacher contract.
8.	A referral process is in place to refer learners not appropriate for distance learning.

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B.      STUDENT ELIGIBILITY

Item	General Requirements	Compliance Status		Evidence
		Yes	No
1.	Students meet the age requirement, being 16 years of age or older, and are not enrolled or required to be enrolled in secondary school under NYS law.
2.	Students claimed for EPE generation are 21 years of age or older and do not have high school diplomas or equivalent.
3.	Students claimed for EPE II generation are 21 years of age or older and have a high school diploma or equivalent, but have limited basic education skills not adequate to enter the workforce or further their education.  No more than 2.96% of their total EPE allocation is guaranteed reimbursement, however, EPE II generation claimed is limited to 10%.
4.	Students in ABE programs are academically functioning at less than an eighth grade level in reading or mathematics as indicated by the TABE test.
5.	ESOL students scoring above 540 on the BEST Plus pre-test are retested on the TABE.
6.	Students enrolled in the High School Equivalency programs have tested above the eighth grade level in reading.
	Distance Learning
7.	- Students enrolled in GRASP/GED Connection have TABE tested at    the 9^th grade level or above in reading (NRS level 5 and 6). - Students enrolled in Pre-GED Connection have TABE tested at grade    level 6-8.9 in reading (NRS level 4). - Students enrolled in Skills To Make Adults Ready to Succeed    (SMART) have TABE tested at grade level 4-7 in reading (NRS    level 3 and 4). - Students enrolled in Learn to Read have TABE tested at grade level   0-4 in reading (NRS level 1 and 2). - Students enrolled in Crossroads Café have tested with the BEST Plus   assessment at NRS level 4 or above.
8.	Students enrolled in an EDP (External Diploma Program) have tested at or above the 9^th grade level in reading.
9.	Students coded in a distance learning program are not coded in a traditional classroom program in the ASISTS database.

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C.         SUFFICIENT INTENSITY AND DURATION

Item	General Requirements	Compliance Status		Evidence
		Yes	No
1. *	Each traditional ABE, GED, and ESOL program offers 150 hours of classroom instruction annually per student.
2.	Each traditional class operates at least six but not more than 20 hours per week, unless the agency has received a written waiver from SED.
3.	Each traditional class has a minimum of 10, but not more than 20, students in attendance. Classes do not exceed an average daily attendance (ADA) of 20 unless they have received written waivers from SED.
4.	The agency documents participant attendance.
5.	Instructional strategies include the recommendations made on the diagnostic information provided by appropriate staff.
6.	The agency adapts procedures to allow for disability-related needs which include:  - Allowing students to borrow materials for taping or    enlarging if not provided by the program. - Allowing students with print-related disabilities to use materials    or computers for an extended period of time. -  Allowing students with disabilities to participate in all programs    and activities.
7.	Instruction is customized for each student.
8.	Instruction has at minimum 50% academic content per week.
*    Library and volunteer agencies may respond to this item as a comment in the comment section.
	Distance Learning
9.	Students receive a home study assignment packet with a minimum of twelve hours worth of work twice a month (two week cycle) via regional library network, mail, by hand, or electronically through Career Achieve.
10.	Physical packets are delivered in proximity to the student’s residence.  Students are made aware of multiple pick-up sites in their area.
11.	Instructors are available electronically, in writing or by telephone, to support learners.
12.	The nonacademic content of the packet, if used, is closely aligned with the individual students’ NRS goals for performance and their short and long term goals in their Education and Employment Plan (EEP).
13.	Every teacher has access to distance learning manuals, which must be used with the EPE and NRS manuals and include:  The Program Manager and Instructor Guide for Distance Learning obtained at www.emsc.nysed.gov/aewd , the GRASP (Giving Ready Adults a Study Program) Manual and if applicable, the Career Achieve Guide for Distance Learning obtained in training.
14.	The corrected assignments returned to the student show evidence of thorough teacher review and appropriate comments and questions.
15.	Students in EDP (External Degree Program) meet with the assessor face-to-face for 30 minutes once a week to discuss assigned work.
16.	Teachers maintain a teacher instructional log to demonstrate time spent preparing and correcting assignment packets or working on other educational related activities.
17.	Teachers maintain a student assignment log to track the packets sent out, completed packets returned, the assignments and the results of the assignments.
18.	Students are considered ACTIVE when they have returned their completed packet to the teacher, who has been reviewed it and sent out a new packet.
19.	The distance learning formula is used to claim EPE aid.
20.	The number of instructional hours claimed in a given week does not exceed the ACTIVE enrollment multiplied by .5 [For example, if a teacher works 40 hours in a given week, the ACTIVE enrollment cannot exceed 80.
21.	The educational materials used are appropriate for the program, i.e. GED level preparation materials for GRASP.
22.	GRASP programs have sufficient books available in all five areas of GED preparation so each student can receive instruction in at least two areas simultaneously.
23.	Programs using video/workbook series are using them according to Kentucky Educational Television (KET) or Intelecom guidelines.
24.	Tutoring, when provided, generates traditional EPE.  Distance learning teachers who tutor distance learning students provide this instruction in addition to the hours of EPE generated by the distance learning formula.
25.	If applicable, a maximum of three hours is claimed in a two-week period for the generation of traditional EPE for tutoring. (Tutoring is provided either on a one on one basis or in a classroom setting).
26.	A tutoring roster is maintained.
27.	Student folders contain sufficiently detailed information so that other teachers can pick up instruction at any point.

D.       EDUCATIONAL AND CAREER COUNSELING

Item	General Requirements	Compliance Status		Evidence
		Yes	No
1.	An Education and Employment Plan (EEP) is developed for each student, which includes personal, educational and/or employment goals.  The agency is aware of the difference between counseling and National Reporting System (NRS) goals.
2.	A goal setting procedure has been established to identify students’ primary and secondary NRS goals, which are updated on a quarterly basis.   Goals have not changed in the exit quarter.
3.	Every student establishes at least one primary goal.
4.	Students have up to two additional core measure goals in addition to educational gain.
5.	Teachers are aware of the follow-up requirements and assist in obtaining information to satisfy goals.
6.	Education and career counseling (individual and/or group) or referral to services is made available to enrolled students.

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E.      PROGRAM PERSONNEL

Item	General Requirements	Compliance Status		Evidence
		Yes	No
1.	For programs operated by a public school district or BOCES, the instructional staff has valid temporary or permanent Pre-K-12 NYSED certification or NYSED adult education certification.