1. Appendix A



      Appendix A

       
      Tracking Sheet
      Student: School: Classroom Teacher: Grade:
          



       

       
      Movement Room Activities
      		Sensory Room Activities Hallway Activities
                               
      Classroom
      		                         
      Date
      		Depart Return                         
      Comments
      		Staff Initials
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   
                                   



       

       

       

      This tracking sheet must be retained in the documentation folder in the student’s OSR, until the OSR is purged of all contents, five years after the student retires.  

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