SEN Mentoring Interview Sheet

• Mentoring Interview Sheet

• Year:

  Select 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20

  • 2014/15
  • 2015/16
  • 2016/17
  • 2017/18
  • 2018/19
  • 2019/20

• Personnel:

• Students name:

Student details

• Person Code:

• DOB:

  Date

• Course

• Achievement Tutor:

• Contact Tel No:

• Date:

  Date

• Time Taken:

  Date

• Mentor Day:

• Start Time:

  Date

• End Time:

  Date

• Please tick appropriate box:

  Free Writing

  Referral

  Interview

  In-Class Observation

  Mentor Adjustment/Action Plan

• Nature of learning disability/learning difficulty:

  Select EBSD Visual Impairment D/deaf Learning Difficulty SPLD Physical Disability Mental Health Difficulties Medical Health Condition Accessibility/Mobility Personal Care ESOL English Maths

  • EBSD
  • Visual Impairment
  • D/deaf
  • Learning Difficulty
  • SPLD
  • Physical Disability
  • Mental Health Difficulties
  • Medical Health Condition
  • Accessibility/Mobility
  • Personal Care
  • ESOL
  • English
  • Maths

• Support Requirements

  Select 1- Emotional / behavioural difficulties 2 - Multiple disabilities 3 - Multiple learning difficulties 4 - Visual impairment 5 - Hearing impairment 6 - Disability affecting mobility 7- Profound complex disabilities 8 - Social and emotional difficulties 9 - Mental health difficulty 10 - Moderate learning difficulty 11 - Severe learning difficulty 12 - Dyslexia 13 - Dyscalculia 14 - Autism spectrum disorder 15 - Asperger's syndrome Temporary disability after illness (for example post - viral) or accident 93 - Other physical disability 94 - Other specific learning difficulty (e.g. Dyspraxia 95 - Other medical condition ( for example epilepsy, asthma, diabetes) 96 - Other learning difficulty 97 - Other disability

  • 1- Emotional / behavioural difficulties
  • 2 - Multiple disabilities
  • 3 - Multiple learning difficulties
  • 4 - Visual impairment
  • 5 - Hearing impairment
  • 6 - Disability affecting mobility
  • 7- Profound complex disabilities
  • 8 - Social and emotional difficulties
  • 9 - Mental health difficulty
  • 10 - Moderate learning difficulty
  • 11 - Severe learning difficulty
  • 12 - Dyslexia
  • 13 - Dyscalculia
  • 14 - Autism spectrum disorder
  • 15 - Asperger's syndrome
  • Temporary disability after illness (for example post - viral) or accident
  • 93 - Other physical disability
  • 94 - Other specific learning difficulty (e.g. Dyspraxia
  • 95 - Other medical condition ( for example epilepsy, asthma, diabetes)
  • 96 - Other learning difficulty
  • 97 - Other disability

• Checked to EBS:

• Background Information: e.g. Home, any previous support (ratios/types). EAA! Previous qualifications, work experience, barriers to learning, medical/health conditions, medications etc.

• External Support Networks/agencies Accessed. (Agency, Key Contact, Telephone).

• Support Focus/Strategies (to inform Support Plan targets):

• Skills, strengths, hobbies & Interests:

• Future Aspirations:

• Select R1- SEN Support for learners R2-Achievement Tutor R3-Course Tutor R4-Self Referral R5-Student Services R6-DSP R7-Assistant Achievement Tutor R8-Enrolment

  • R1- SEN Support for learners
  • R2-Achievement Tutor
  • R3-Course Tutor
  • R4-Self Referral
  • R5-Student Services
  • R6-DSP
  • R7-Assistant Achievement Tutor
  • R8-Enrolment

• SO- No Disciplinary

  S1-Stage 1 Verbal Warning

  S2-Stage2 Written Warning

  S3-Stage3 Final Written Warning

  S4-Stage 4 Suspension (and Exclusion-Permanent or Temporary)

• Support Recommendations:

  Select LSA in class observation LSA in class LSA out of class CSW in Class CSW out of class Educational Psychologist Assessment Counselling Learning Mentor in class Learning Mentor out of class Independence Coach start of year Independence Coach ongoing English Support Maths Support ESOL EAA Assessment Assistive Technology Assessment Enrolment Support Materials Adaption Tutor Adjustments Risk Assessment PEEP Medical alert to Portfolio area ELM Support Travel Training (Taxi) Independent Travel Training Vulnerable Learner RAO

  • LSA in class observation
  • LSA in class
  • LSA out of class
  • CSW in Class
  • CSW out of class
  • Educational Psychologist Assessment
  • Counselling
  • Learning Mentor in class
  • Learning Mentor out of class
  • Independence Coach start of year
  • Independence Coach ongoing
  • English Support
  • Maths Support
  • ESOL
  • EAA Assessment
  • Assistive Technology Assessment
  • Enrolment Support
  • Materials Adaption
  • Tutor Adjustments
  • Risk Assessment
  • PEEP
  • Medical alert to Portfolio area
  • ELM Support
  • Travel Training (Taxi)
  • Independent Travel Training
  • Vulnerable Learner
  • RAO

• Colour Codes:

  Red

  Amber

  Green

• Banding:

  Under £5,000

  Over £5,000

  Over £19k

• I agree to this information being shared with College and with relevant outside bodies as necessary to support me.

  Yes

  No

  N/A

• Student Signature-I understand that I may lose my allocated support sessions if I do not attend support sessions regularly and notify The Point of any absence.

  Sign

• Staff Signature:

  Sign

• Person to cost for:

  Select Melanie Cartwright Jenny Osborn-Jones Andrew Osmond Andrew Williams Val Gathercole Julia Durney Michelle Lynch

  • Melanie Cartwright
  • Jenny Osborn-Jones
  • Andrew Osmond
  • Andrew Williams
  • Val Gathercole
  • Julia Durney
  • Michelle Lynch

• Date:

  Date

• Time taken:

  15mins=0.25

  30mins=0.50

  45mins=0.75

  60mins=1.00 hour

  75mins= 1.25

• Person to cost for:

  Select Melanie Cartwright Jenny Osborn-Jones Andrew Osmond Andrew Williams Val Gathercole Julia Durney Michelle Lynch

  • Melanie Cartwright
  • Jenny Osborn-Jones
  • Andrew Osmond
  • Andrew Williams
  • Val Gathercole
  • Julia Durney
  • Michelle Lynch

• Date:

  Date

• Time Taken:

  15mins=0.25

  30mins=0.50

  45mins=0.75

  60mins=1.00 hour

  75mins= 1.25