Remedial/ Intervention Plan Checklist

YES NO OBSERVATIONS

LEARNING STATIONS

1. The target skills of the activities and materials chosen

are appropriate to the skills of the ability groups and
aligned with the target skills for them as well.

2. There are manipulative materials in all four stations.

3. There are enough manipulative materials for all the

students in each station.

4. Not all the available manipulative materials are placed

in the learning stations but just enough quantity that are
intentionally chosen for the ability groups such that
there’ll be new materials every week and in rotation.

FULL INTERVENTION

1. The first lesson chosen in the Lesson Map is based on

the error analysis of the result of the assessment. This is
the New Lesson.

2. The first lesson called the New Lesson is the earliest

lesson in the Lesson Map from among the errors found in
the results of the assessment.

3. The first lesson called the New Lesson is placed under

the directed instruction.

4. A Review Lesson of the previous or pre-requisite

lessons in reference to the Lesson Map is provided before
the New Lesson.

5. The worksheets corresponding to the Review Lesson

are placed under Independent Work/ Evaluation.

6. The worksheets corresponding to the first lesson called

the New Lesson are placed under Independent Work
after the lesson has been presented.

MODERATE INTERVENTION

1. The first lesson chosen in the Lesson Map is based on

the error analysis of the result of the assessment. This is
the New Lesson.

2. The first lesson called the New Lesson is the earliest

lesson in the Lesson Map from among the errors found in
the results of the assessment.

3. The first lesson called the New Lesson is placed under

the directed instruction.

4. A Review Lesson of the previous or pre-requisite

lessons in reference to the Lesson Map is provided before
the New Lesson.

5. The worksheets corresponding to the Review Lesson

are placed under Independent Work/ Evaluation.
 6. The worksheets corresponding to the first lesson called
the New Lesson are placed under Independent Work
after the lesson has been presented.

LIGHT INTERVENTION

1. The first lesson chosen in the Lesson Map is based on

the error analysis of the result of the assessment. This is
the New Lesson.

2. The first lesson called the New Lesson is the earliest

lesson in the Lesson Map from among the errors found in
the results of the assessment.

3. The first lesson called the New Lesson is placed under

the directed instruction.

4. A Review Lesson of the previous or pre-requisite

lessons in reference to the Lesson Map is provided before
the New Lesson.

5. The worksheets corresponding to the Review Lesson

are placed under Independent Work/ Evaluation.

6. The worksheets corresponding to the first lesson called

the New Lesson are placed under Independent Work
after the lesson has been presented.

MEETS EXPECTATION

1. The first lesson chosen in the Lesson Map is based on

the error analysis of the result of the assessment. This is
the New Lesson.

2. The first lesson called the New Lesson is the earliest

lesson in the Lesson Map from among the errors found in
the results of the assessment.

3. The first lesson called the New Lesson is placed under

the directed instruction.

4. A Review Lesson of the previous or pre-requisite

lessons in reference to the Lesson Map is provided before
the New Lesson.

5. The worksheets corresponding to the Review Lesson

are placed under Independent Work/ Evaluation.

6. The worksheets corresponding to the first lesson called

the New Lesson are placed under Independent Work
after the lesson has been presented.

Teacher Evaluated: __________________ Evaluator: ________________ Date: ___________