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Write a weekly sleep and activity plan

9-12Rubric scoreTemplateReview and individualize before use. How templates are made
When to use this goal

For high school students who know sleep and exercise guidelines but have no plan that fits their own week of school, work, and family duties. Present levels, not grade, decide fit.

Baseline
Score one plan made from a sample schedule and one from their own. Ask what gets in the way of sleep and activity; real barriers make better plans.
Tips
Score each row 0 to 2. The plan is scored, not whether the student followed it. Respect work, caregiving, and religious practice in the plan.
Limits
Health conditions, medication, and home situations affect sleep; questions go to the nurse and family. Does not measure follow-through.

Original IEP Atlas template based on general measurement principles; not copied from any goal bank. ID ca-hlth-016.

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Student

How the goal refers to the student

Skill

What the student will do

Something an adult can see, count or time.

Condition

When or under what conditions

Support

Support allowed

Criterion

Score on a rubric with defined criteria and score levels.

Sample numbers. Replace them with the student's data.

Rubric criteria

Each one becomes a scoring column on the data sheet.

Criterion wording

Data collection

Scoring completed student work (permanent products) against a defined answer key or checklist.

How often data are collected
Mastery rule

How many measurements must meet the criterion.

Timeframe

Timeframe

Goal

By the annual IEP review date, given their weekly schedule and a planning template, the student will write a weekly plan with a bedtime and wake time for school nights, three activity times, and one barrier with a fix independently, earning a score of at least 7 out of 8 on a 4-row weekly health plan rubric scored 0 to 2 per row, on 3 of 4 consecutive weekly plans, as measured by work-sample analysis collected weekly during the unit.

Baseline: 3 out of 8 rubric points.

  • Condition
  • Observable behavior
  • Criterion
  • Measurement method

ObjectivesCopy by fieldData sheet

Measurability check11 of 11 met
  • Met: Observable behavior. Stated as an action.

  • Met: Condition. Stated.

  • Met: Unit fits the behavior. Rubric score fits this behavior.

  • Met: Explicit criterion. Number and unit stated.

  • Met: Mastery rule and schedule. Both stated.

  • Met: Method produces the metric. Work-sample analysis gives rubric score data.

  • Met: Review timeframe. Stated.

  • Met: Baseline and target compatible. Same unit, change in the right direction.

  • Met: Aligned with area of need. Still about Health Education.

  • Met: Level of support. Defined.

  • Met: Blanks filled in. Nothing left to fill in.

Checks structure and wording only. Whether the goal fits the student is the team's call.

Short-term objectives (optional)

When are objectives required?

Required for students on alternate assessments (34 CFR §300.320(a)(2)(ii)); some states require them for everyone.

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Paste into your IEP system

Most district systems have a separate box for each part of a goal. Copy them one at a time, or all at once as labeled text.

Area of need
Science, Social Studies & Digital Literacy - Health Education
Baseline
3 out of 8 rubric points.
Annual goal437 characters
By the annual IEP review date, given their weekly schedule and a planning template, the student will write a weekly plan with a bedtime and wake time for school nights, three activity times, and one barrier with a fix independently, earning a score of at least 7 out of 8 on a 4-row weekly health plan rubric scored 0 to 2 per row, on 3 of 4 consecutive weekly plans, as measured by work-sample analysis collected weekly during the unit.
Timeframe
By the annual IEP review date
Condition
Given their weekly schedule and a planning template
Behavior
The student will write a weekly plan with a bedtime and wake time for school nights, three activity times, and one barrier with a fix independently
Criteria
Earning a score of at least 7 out of 8 on a 4-row weekly health plan rubric scored 0 to 2 per row, on 3 of 4 consecutive weekly plans
Evaluation method
Work-sample analysis
Schedule
Weekly during the unit

Copied as plain text, with straight quotes and plain dashes.

Matching data sheet

Rubric tracker. Scores each rubric criterion and totals them.

The CSV opens in Excel or Google Sheets, with formulas. Sheets print blank; no student data is stored.