Follow the hall pass sign-out and sign-in procedure
Live goal preview
By the annual IEP review date, when the student needs to leave the classroom to use the restroom, get water, or visit the nurse, the student will complete the classroom sign-out and sign-in procedure using the posted classroom procedure, performing at least 7 of 8 steps independently, on 4 of 5 consecutive observed exits, as measured by a task-analysis checklist collected each time the student leaves the room, summarized weekly.
Baseline: 3 of 8 steps independently.
- Condition
- Observable behavior
- Criterion
- Measurement method
Measurability check10 of 10 met
All structural checks are met.
Met: Observable behavior. The behavior is stated as an action.
Met: Condition. The goal states when or under what conditions the behavior occurs.
Met: Unit fits the behavior. Task-analysis steps is a reasonable way to quantify this behavior.
Met: Explicit criterion. The success criterion is stated with a number and unit.
Met: Mastery rule and schedule. Mastery rule and collection schedule are stated.
Met: Method produces the metric. Task-analysis checklist can produce task-analysis steps data.
Met: Review timeframe. The goal includes a timeframe.
Met: Baseline and target compatible. Baseline and target use the same unit and show change in the intended direction.
Met: Aligned with area of need. The wording still relates to School-Related Independence.
Met: Level of support. The level of support is defined.
What this checks: the goal's structure and wording, using fixed rules: observable behavior, condition, criterion, method, mastery rule, timeframe, baseline/target consistency, and support. It can't judge whether the goal is appropriate, ambitious enough, or legally sufficient for a particular student. That requires assessment data and the IEP team.
About this template
- Level guidance
- Fits students who leave the classroom without using the class procedure, forget to return the pass, or stay out much longer than expected. Present levels and observation, not grade, decide fit.
- Baseline considerations
- Observe the routine on at least 3 typical days before setting a target. Mark each step as independent (no adult prompt of any kind), completed with support (note the prompt type), or not completed. Count only independent steps toward the baseline, and note which steps are missed most often; those may need direct teaching rather than more practice.
- Usage notes
- Restroom and nurse access must never depend on performance of this routine; the goal teaches the procedure, it does not limit access. Mark step 5 only from what can be reasonably observed, such as the return time and reports from other staff.
- Known limitations
- Staff cannot follow the student into the restroom; some steps rely on time data rather than direct observation. Students with health needs that require frequent or urgent access should have that addressed in the IEP or health plan.
- Source
- Original IEP Atlas draft (AI-assisted) based on general measurement principles; not copied from any goal bank. Template ID
fn-si-004.
Short-term objectives (optional)
When are objectives required?Federal IDEA regulations require benchmarks or short-term objectives only for students who take alternate assessments aligned to alternate academic achievement standards (34 CFR §300.320(a)(2)(ii)). Your state or district may require them more broadly.
Matching data sheet
Task-analysis checklist. Your goal counts steps done independently, so the sheet marks each step in each session.
Task-analysis checklist
Task-analysis steps- Student label:
- Target:
- performing at least 7 of 8 steps independently
- Mastery rule:
- on 4 of 5 consecutive observed exits
- Collection schedule:
- each time the student leaves the room, summarized weekly
- Method:
- Task-analysis checklist
- Data collector:
Goal: By the annual IEP review date, when the student needs to leave the classroom to use the restroom, get water, or visit the nurse, the student will complete the classroom sign-out and sign-in procedure using the posted classroom procedure, performing at least 7 of 8 steps independently, on 4 of 5 consecutive observed exits, as measured by a task-analysis checklist collected each time the student leaves the room, summarized weekly.
Key: I completed independently · S completed with support (note prompt type, e.g., G gesture, V verbal, M model, P physical) · N not completed
| Step | Session 1 Date: | Session 2 Date: | Session 3 Date: | Session 4 Date: | Session 5 Date: | Session 6 Date: | Session 7 Date: | Session 8 Date: |
|---|---|---|---|---|---|---|---|---|
| 1. Uses the class signal to request to leave (raised hand, card, or quiet request) | ||||||||
| 2. Waits for the teacher's okay | ||||||||
| 3. Writes name and time out on the sign-out sheet, or taps out on the digital pass | ||||||||
| 4. Takes the hall pass | ||||||||
| 5. Goes directly to the stated location | ||||||||
| 6. Returns within the class time limit | ||||||||
| 7. Returns the pass to its spot | ||||||||
| 8. Writes the time in, or taps in, and returns to the seat | ||||||||
| Steps independent (I) | ||||||||
| Initials / notes |
Preview shows 4 of 12 rows.
- Write the date at the top of each session column. Mark each step I, S, or N.
- Total the number of I marks for the session. The goal counts steps completed independently (target: 7 of 8).
- Use the least intrusive prompt first and record the prompt actually needed.
The CSV opens in Excel or Google Sheets with formulas for the calculated columns. Sheets are blank: IEP Atlas doesn't store student data.