Assurances Checklist

For more information, contact
        Sherry Marchant
Career Connections Specialist
Career and Technical Education
Utah State Office of Education
250 East 500 South - PO Box 144200
Salt Lake City, UT 84114-4200

 

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Page last updated on February 6, 2007


Assurances Checklist
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ASSURANCES CHECKLIST

Cone:______________________________________________ Date Completed:_____________________________________________

Utah State Board of Education Rule R277-916-6 states, "Work-based Learning (WBL) shall be integrated into all levels of the education delivery system and shall be coordinated within the cones of the district and between regions."

For purposes of this document, the following definition will apply to work-based learning programs:

Work-based learning is a coherent sequence of career awareness, exploration, job training, and workplace experience activities that are coordinated with school-based learning activities. There are work-based learning activities appropriate for every grade level, K-12, to support students in developing career awareness, exploring career options, developing appropriate workplace skills and relating academic skills to real world applications.

This checklist is part of the annual Work-based Learning Funding Application. It serves a dual purpose of self-evaluation to determine program strengths and weaknesses and to provide information for the Utah State Office of Education to make funding determinations. This checklist will also be discussed when district and/or State Office staff make monitoring visits to the schools.

Please note that this assurances checklist is subject to change each funding year as part of the annual funding process.

Please rate each indicator below using the following criteria:


1 = Below Standard 2 = Essentially Meets 3 = Meets Standard

For items rated 1 or 2 please attach a written description of plans to meet the indicator.

To be eligible for WBL funds, districts/schools shall:
1. Have the program approved by the local board
1 2 3
• A copy of board approval is attached: (one copy per district application)  
1.1 (a) Addresses work-based learning career awareness, exploration and preparation activities K-12  
1.1 (b) Addresses Work-based Learning Liability Policy, SB-28  
1.2 The board supports the use of USOE sponsored  
  1.2 (a) Utah's Work-based Learning Manual  
  1.2 (b) Work-based learning endorsement criteria  
  1.2 (c) Utah work-based learning coordinator standards document  
  1.2 (d) Partnership agreements  
2. Employ qualified work-based learning coordination personnel
1 2 3
2.1 All work-based learning personnel meet ATE work-based learning licensure qualifications  
2.2 All work-based learning personnel have passed background checks  
2.3 All work-based learning personnel have completed the state-approved work-based learning basic training (30 hours)  
3. Document that a work-based learning committee representing all schools within the cone has been created, is functioning effectively and regularly addresses work-based learning issues
1 2 3
3.1 A work-based learning committee is identified for each cone and meets a minimum of two (2) times per year
3.2 Committee membership includes a representative from each building in the cone and work-based learning personnel
3.3 Work-based learning appears in meeting agendas and minutes to document that work-based learning needs are being addressed
4. Complete a cone-wide student/parent/teacher work-based learning needs assessment
1 2 3
4.1 The cone's work-based learning program needs have been identified for the present funding year in coordination with work-based learning cone activities
5. Develop work-based learning preparation, participation and evaluation activities for students and teachers involved in all work-based learning cone activities
1 2 3
5.1 Preparation
5.1 (a) Community partnerships will be established
5.1 (b) Training agreements, skills grids and other forms/documents as outlined in state Work-based Learning Manual are used
5.1 (c) SEOP coordination is assured
5.2 Participation
5.2 (a) Identify K-12 work-based learning options to be provided during this funding year: Evaluate each item checked using definition in Utah WBL Manual
        • Apprenticeships
        • Career Fairs and Related Activities
        • Clinical Work Experience
        • Cooperative Work Experience
        • Educator Internships
        • Field Studies/Tours
        • Guest Speakers
        • Job Shadows
        • Mentorships
        • School-based Enterprises
        • Service Learning
        • Student Internships
        • Other (Please specify)_____________________________________
5.3 Evaluation
5.3 (a) Participating employer evaluations are completed at the end of each activity
5.3 (b) Student evaluations are completed at the end of each activity
6. Maintain evidence that work-based learning components have been integrated and coordinated with elementary career awareness, secondary career exploration, integrated core curriculum activities, Technology, Life, and Careers, Comprehensive Guidance and Counseling and skill certification
1 2 3
6.1 Work-based learning coordination personnel are in place to develop, monitor or facilitate:  
  6.1 (a) Core Career Connection activities  
  6.1 (b) Employer coordination visits, including periodic internship site visits for every student  
  6.1 (c) Student internships  
  6.1 (d) Related work-based learning training including internships seminars/critical workplace skill classes, etc.  
  6.1 (e) TLC work-based learning days

 
7. Maintain evidence of work-based learning activities developed in coordination with IEP/SEP/SEOP/504 requirements in each cone
1 2 3
7.1 Student participation in work-based learning activities is based upon each student's academic/career planning process  
7.2 A process is in place to communicate student career goals/objectives to work-based learning personnel  
7.3 Work-based learning personnel receive appropriate cone/district IEP/SEP/SEOP/504 training  
8. Require the inclusion of all student groups within the cone in career development and preparation
 1 2 3
8.1 Equality of student access and participation in work-based learning activities is ensured  
8.2 In-house resources are utilized by work-based learning personnel to meet diverse student needs  
9. Demonstrate work-based learning coordination with employers and with other school/community development activities
 1 2 3
9.1 Use of appropriate documentation/forms as outlined in the state Work-based Learning Manual  
9.2 Work-based learning personnel coordinate with district/school calendars  
9.3 Work-based learning personnel have opportunity to meet regularly with cone administrators  
10. Verify that state work-based learning funds are supporting work-based learning personnel, that state funds are matched by the local recipient of funds, and that sufficient budget for work-based learning personnel facilities, materials, equipment and support staff is available
 1 2 3
10.1 State work-based learning funds and matching funds are used exclusively to support work-based learning personnel for the purpose of developing, implementing, and maintaining work-based learning programs as described herein  
10.2 Work-based learning funding is matched dollar for dollar according to State Board Rule R277-916-5  
10.3 Sufficient budget for work-based learning personnel, facilities, materials, equipment and support staff is provided  
11. Require work-based learning personnel to complete state-sponsored work-based learning coordinator basic training and participate in periodic on-going coordination and inservice activities
 1 2 3
11.1 All work-based learning personnel have completed the state-approved work-based learning coordinator basic training (30 hours)  
11.2 District/cone supports the work-based learning personnel's participation in related training, workshops and inservices  
12. Require work-based learning personnel to participate in state and district data collection and reporting
 1 2 3
12.1 A database of the employer and other community partners is kept and maintained by each cone/district/region  
12.2 Work-based learning personnel participate in state/local data collection and reporting  

Signatures:

Names and signatures of cone work-based learning personnel and the grade levels they serve:

Name Signature Grade Levels

1. __________________________________________________________________________________________________________

2. __________________________________________________________________________________________________________

3. __________________________________________________________________________________________________________

4. __________________________________________________________________________________________________________

High School Administrator______________________________________ Date__________________________________

(On Behalf of Cone)

District ATE Director__________________________________________ Date__________________________________