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Student Info & Key Dates
Auto-populated from SEIS/SIS — verify before the IEP meeting.
Student Name / Birthdate / Age / Grade — Confirm all match current SIS enrollment records.
IEP Date — Must match the current annual IEP. ESY is determined as part of the annual IEP — dates must match.
⚠ ESY eligibility must be considered at EVERY annual IEP — it cannot be a blanket policy. Each determination must be individualized and documented separately for each student.
Definitions — Know These Before Starting
Team members must understand these terms before completing the worksheet:
ESY Services — Not summer school. ESY targets the SAME IEP goals where the student has shown regression and limited recoupment. Only those specific areas qualify — not all goals automatically apply.
Regression — Documented loss of previously attained skills due to an extended break. Must be evidenced by data, not assumptions.
Rate of Recoupment — How long it takes to re-learn lost skills after a break.
Rate of Recoupment
The length of time required to re-learn skills following an extended school break.
This is a key eligibility factor. Evidence of slow recoupment:
• Progress monitoring dips at the return from Thanksgiving, Winter, and Spring breaks
• Beginning-of-year assessments showing significant skill loss from prior May levels
• Teacher notes describing extended re-teaching needed after each break
Document specific timelines where possible — "approximately 3–4 weeks to return to pre-break levels" is far stronger than "takes time to recoup."
Regression of Recoupment — §3043 Standard
The most legally significant definition on this form.
Under 5 CCR §3043, ESY is required when ALL of the following are true:
1. The disability is likely to continue indefinitely 2. An interruption is likely to cause regression 3. The student has limited recoupment capacity 4. Together, these would make it impossible or unlikely to attain expected independence
If this standard applies, ESY is not discretionary — it is required as part of FAPE. Page 2 provides the structured analysis of these criteria.
Directions — IEP Team Process
ESY eligibility is an IEP team decision requiring input from both staff AND parents.
Parent input is required — not optional. Document specifically what the parent shared about regression and recoupment at home.
⚠ ESY cannot be denied because of: • Cost or budget constraints
• Staff availability
• A blanket district policy
If ESY is recommended, it must be in the IEP offer of FAPE with specific dates, frequency, duration, and location.
Question 1 — Regression After Summer Break
"At the start of the school year, was the student unable to regain skills lost over the summer?"
Most direct evidence of ESY need. Look for:
• End-of-year goal levels (May) vs. beginning-of-year (September)
• Progress monitoring data showing regression at year start
• Teacher notes from the first weeks describing skill loss
⚠ "Yes" here is strong evidence for ESY eligibility.
Specify WHICH areas: reading fluency, math, communication, behavioral self-regulation, daily living. This drives which goals are targeted in ESY.
Question 2 — Regression During School Year Breaks
"Does the student lose skills following shorter breaks (Thanksgiving, Winter, Spring)?"
If regression happens after 1–2 week breaks, it strongly predicts greater regression over a 10-week summer.
Evidence to look for:
• Progress monitoring data the week before vs. week after each break
• Graphs of IEP goal progress showing dips after break returns
• Teacher notes documenting re-teaching needed after each holiday
⚠ This is one of the strongest predictors of summer regression. Specify each break and the areas affected.
Question 3 — Crucial Stage of Skill Acquisition
"Is the student at a critical point where an interruption could cause irreversible skill loss?"
Some skills have developmental windows — once missed, much harder to acquire:
• Early phonological awareness in young readers
• Toileting independence at a critical stage
• AAC/communication requiring daily practice
• Behavioral self-regulation being actively shaped
If Yes, describe specifically why this is a critical stage and what would be irreversibly lost. "Student is making good progress" is not sufficient documentation.
Question 4 — Skill Maintenance Without ESY
"Can the student maintain identified skills WITHOUT Extended School Year?"
If No — identify exactly which skills cannot be maintained and why, based on:
• Prior regression data from Questions 1 and 2
• The nature of the disability and its impact on retention
• Parent reports of skill loss at home during breaks
Specify the skill(s) — "Student cannot maintain toilet training without daily structured support" is far stronger than "student may lose some skills."
Question 5 — Level of Independence Requires ESY
"Does the student require ESY to achieve the level of independence expected given their disability?"
This invokes the §3043 standard directly. Consider: Without ESY, will the student be unable to achieve the level of independence realistically possible for someone with this specific disability profile?
⚠ If Yes — the team MUST complete Page 2 of this worksheet. Page 2 provides the structured criteria analysis required under state regulations and builds the legal record supporting the ESY determination.
P2 Q1 — Pattern of Past Regression (4+ Week Breaks)
"Does the student demonstrate past regression following breaks of more than four weeks?"
Yes / No / Unknown — Use Unknown for new students or where prior data is unavailable. Do not default to "No" when data is missing.
Comments must describe the DEGREE: • Minimal — some skill loss, typically recovers in a few weeks
• Serious — significant loss requiring extended re-teaching, or skills don't return to prior levels before the next break
⚠ "Serious" regression is a strong indicator for ESY. Include specific data — goal levels in May vs. September.
P2 Q2 — Estimated Time to Regain Skills
"How long does it take the student to regain prior skill levels after a break?"
• One Month or Less — may not support ESY eligibility on its own
• Up to 3 Months — significant; nearly the length of summer break itself
• 4 to 6 Months — strong indicator; student may never fully recoup before the next break
• Other — describe specifically
⚠ If recoupment takes 3+ months, the student spends more time re-learning than acquiring new skills. This makes ESY likely required as part of FAPE.
P2 Q3 — Rate of Learning vs. Rate of Recoupment
"Describe the student's rate of learning compared to their ability to recoup after a break."
Narrative required — no checkbox. Describe:
• How quickly the student acquires new skills during the school year
• How that compares to how long recoupment takes after breaks
Key insight: If a student learns slowly (4 months to master a skill) AND recups slowly (3 months to recover), they spend the majority of the year re-learning rather than progressing — a cycle that prevents meaningful gains toward independence without ESY.
P2 Q4 — Disability Will Continue Indefinitely
"Does the IEP team believe the student's disability will continue indefinitely or for a prolonged period?"
Yes / No / Unknown — Establishes the first prong of 5 CCR §3043.
Comments must include: 1. The degree of regression (minimal or serious) expected following a break
2. The degree, nature, and severity of the disability — how the disability profile makes this student particularly vulnerable to regression
⚠ "Yes" here + "Yes" on Q5 establishes the full §3043 standard making ESY legally required as part of FAPE.
P2 Q5 — Self-Sufficiency & Independence at Risk
"Will it be impossible or unlikely the student will attain expected self-sufficiency following a break?"
Second prong of §3043. "Expected" means expected in view of the student's disability — not compared to typical peers.
Consider: Is the student's skill development trajectory so fragile that a summer break would set them back to a point they cannot recover from within the school year?
⚠ Yes on Q4 + Yes on Q5 = ESY is required as part of FAPE under 5 CCR §3043.
Comments must describe the degree of regression and connect it to the independence standard.
P2 Q6 — Critical Point of Skill Acquisition
"Is the student at a critical point where an interruption will cause skills to be lost or greatly reduced?"
Describe specifically:
• The skill(s) at a critical juncture
• Why this instructional moment is time-sensitive
• What would be lost by a summer interruption
• Why re-acquisition after the break would be significantly harder
Example: "Student is at the threshold of independent toileting after 18 months of instruction. A 10-week break without structured support would likely require full re-establishment of the routine from the beginning."
P2 Q7 — Other Adverse Impacts Without ESY
"Are there other physical, medical, emotional, social, behavioral, or vocational issues that may be adversely impacted without ESY?"
Consider ALL areas:
• Physical/Medical — conditions requiring consistent management
• Emotional/Mental Health — anxiety or depression that worsens with disrupted routine
• Social — peer relationships, inclusion with typically developing peers
• Behavioral — behavioral momentum, BIP continuity
• Vocational — work skills being generalized in job training settings
⚠ A well-documented "Yes" here can support ESY eligibility even without regression data.
El Dorado County Charter SELPAESY Eligibility WorksheetSpecial Education Local Plan Area
