VA ICP Reliability Agreement
General Information: This is the person who will work with the TTAC representative to schedule the training and manage team logistics for your division.
Administrator Name
*
First Name
Last Name
Title
*
School Division/ Program
*
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
How many inclusive classrooms are in your division/program (children with IEPs enrolled)?
*
How many inclusive classrooms are you considering observing using the ICP (children with IEPs enrolled)?
*
Are you on the waitlist for Cohort 2?
Yes
No
N/A
Childcare providers: Do you currently collaborate with your local school division to provide special education services? If yes, in what ways?
*
Are you currently participating in an Intensive TA Grant with T/TAC or the Virginia Commonwealth University Autism Center for Education (i.e., IPOP)?
*
What is your most recent Indicator 6a and 6b data?
*
Reliability training information:
How many people in your division would you like to send through reliability training (maximum of 3)?
*
Please Select
1
2
3
1. List their name/position/ email address
*
2. List their name/position/ email address
*
3. List their name/position/ email address
*
Would you be willing to host Virginia Reliability training in your division?
*
Please Select
yes
no
Designate two classrooms for observation; ensure teachers have time to conference with observers before/after observation for the interview and document review position of the observation.
*
Please briefly describe your plan for implementing the ICP observations. Please include how you will integrate CLASS and ICP, how you will prepare teachers to be observed, and your plan for debriefing/coaching teachers.
*
Would you be willing to host VA reliability training? This means conducting practice observations in 2 classrooms in your division/program, providing a space for the training and debriefing conversations after the two observations. For more information, see the chart on p.6 of the Reliability Training agreement.
*
Please Select
Yes
No
Please read over each statement and check each box below.
*
I understand that ICP reliable observers are expected to attend annual VA ICP Reliable Observers Virtual Meetings and recalibrate after 3 years.
I understand that VDOE will collect data from ICP training observations and other observations conducted in my program/division to improve their programming.
I commit to meeting with T/TAC following the training to create an action and sustainability plan for ICP implementation.
Submit
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