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HomeMy WebLinkAbout99-05236??:. ;.< _. ";?; ?, ,, ,, 'atN. ?.'! .• FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Rug. 30 2000 10:20AM P20 s 215 887-0916 530 TWINING ROAD DRESHER, AP 19025 MONTGOMERY COUNTY HEAD START 610 326-1050 555 HIGH STREET POTTSTOWN, PA 19464 COMPREHENSIVE EVALUATION REPORT J-Inltlal Evaluation _Reovaluatlon CHILD'S NAME: G DATE OF BIRTH: l f j? 9/a ??)) CRIS' Parents: r O'00tn "t 0Phone: (h)d54a- lAS?(w) Address 3a!7 :SWete4 D-r. f-n111o.,ce,:11n -P, _ 1cL1-7.0 School District: -,46bUde1(+ay,, Other Information (as needed):. Date Permission to Evaluate/Reevaluate Received: q -1:5--j .7 Date of Completion of Multidisciplinary Evaluation: m " Date of Comprehensive Evaluation Report: 9? 1. Reason f r Referral: re ? f O KC aW I d -'O 717U- UTCU,66-Q CCXOMAIL4 ins OBI IYLC? ltn t fic?,l ?Sc.Ir e e v? i yr 5 tic i Ca?2d Ii. History: A. Early Intervention History NC)NIE 7Ri<FN TO M {.'• • T.u , 8 ??S Fo !' S?{e?Clti , c?7Cr Vl t VLq d . 'L° o laQ?t evt ?ro fled i A4tt So odes fax. h?e?d pro rv? ?. { • 14Gq B. Education, Soci and Physleal History ?? ? ? ldww? ??3i/oo Cvey FROM : MONT COUNTY HERD STRRT PHONE NO. : 215 807 0916 Aug. 30 2000 10:21RM P21 DATE: CHILD'S NAME: C-vP?C C)f (,,) M 1 I IC' I I ?S III. Information from the family (parents or other persons with whom the child lives) A. Child's strengths and needs Including physical condition, cultural and language confiderations, an adaptive behavior B. the?chil Y? _fV strengths and needs w ch n hance the 7elipment of ,(?D ?,GUQit,4. ZLbD doQ2Qs4 a4(d JL V '(YOU `?`"? q? IV. Summary of Findings A. B. lr vt_ i Vla c ?ecl J ?' Review of current IEP (for reevaluation only) -TUb 15- MW 7M Z Screening results (initial evaluation only) FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:2 A? 1RM P22 DATE: //- ? - e, eJ _ CHILD'S NAME: C",yr-c of, 'N i I Ie-h4S III. Information from the family (parents or other persons with whom the child lives) N. A. B. Child's strengths and needs including physical condition, cultural and language con ideratlons, an adaptlvv ehavlo J ` Family- erceived strengths and needs w ch It enhance the d elopment of the child WL Ma*&4 Summary of Findings A. Screening results (Initial evaluation only) I ? l vt ?i v?d 'c 4ec? 6-? V- B. Review of current IEP (!or reevaluation only) *am MCIU 7A6 3 FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:22AM P23 DATE' CHILD'S NAME: vey rq f l e (,c C. Developmental Assessment Assessment Instruments and Procedures: Date: I®- q q Procedure/Assessment:_•LG.S? Rresdcool La ,,?I,,Ua4 z Result: Rwk+a( CO VVkpfeblew's?, - S4-wwdaid I y 6COre? Arje. 8c(Uiv-- ?2`?v'. I I VKos- Ci`dvvl ? v1,is ?er . ?c?i evsl?settlve I (ID ,,u { f,I ? f t (e ?o-Lz0a o Date: 16 _& -4 Procedure/Assessment: EXprE'SSi v-e 0"-Wb(di4' c -uw- Voc&b_ Result: -F?a.,ut bec>(v_- ?4o. A,qe 890v -- 3 .o P&cevn+-i u, Roa.A. d 14 ?o Date: 9 - 141-C.C Procedure/Assessment: qo (c1mcj- t - V I STD E'7E s+ J t y}? L Result: OuD?I.bev- ??- &rors- JVldS !A 00(dS '5 c .t/{. ftAl.U t. uu.k- - I o 2. Narrative (including, but not limited to physical development, cognitive .and sensory development, hearing problems, teaming strengths and educational needs, language and speech development, social and e otionat develop ?nt, self-help skills, health onssider on ?tlx??q#Lj(exgi .,1.11 M 7M 0 Y" FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:22API P24 ?• r r ANr-Ee.3 y u.rtiu? Ulf /110 CI M -ED ? At- • d/5 -/n 96 d/K) te r ?s , A? 1n1? n b; 1 I/v % /r d -740 ) ,3 _ ?.f" , / Gaylv.> 6 I?AY?.4i ivy : L'o?Uf r FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:23AM P25 DATE: V CHILD'S NAME: G re?Cjp rci (vl,l t ?,e-hC S D. Observations: (information from observations during daily activities such as play with other children and interaction with family members and/or other ad t8) AVLM& E. Area(s) of Delay: Lc-v-tuCLT - xw(e.ulog ALI 0+ 69eeec'k- F. Skills needed by the child to function successfully in variety of settings, including the home, school, and community 0 1'Knpy-ove ooL)Pgd I roduChbK)' lb ???ir? 1 e Imo` in vp dl?e.v5?t6n? `TD 1?VlC'J2 QGl?-? CL 1#7rX a/)o -* fib kt ii Ciovc?c kz?,d d U D-Q• o?? ya I Vd 1 C2 dvt?I`?? 6peoAt M= 7M 6 FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:23AM P26 DATE: 1 t -'S 41y CHILD'S NAME: Ll reoO #-4 %l < <e-h C S V. Recommendations i A. Recommendations of Eligibility for Early Intervention Services and Programs t • Team recommends eligibility for early intervention services. The following services or programs should be considered by the IEP team: 2• Team recommends continued eligibility (Attach IEP) 3. Team does not recommend eligibility for early Intervention services. Recommendations for follow-up activities (if any) are: B. Recommended Services to meet the family's needs to enhance the child's development , -ALL a4ut POCadD 04LB MCPJ 7/90 7 FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:24AM P27 DATE: CHILD'S NAME: MULTIDISCIPLINARY EVALUATION TEAM St ATURES Please Indicate your agreement or disagreement with the conclusion or content of this report. If you disagree, please write the reasons for disagreement and attach them to this report. SIGNATURE TITLE DATE AGREE DISAGREE 9z L - 43W A 4 L ki This report Is a draft until all MDT members (Including parents) have reviewed and signed the report. Any dissenting opinions must be Included. Mcw WN - /a - gj Date CER sent to parents. 17 FROM : MONT COUNTY HERD START PHONE NO. : 315 887 0915 Aug. 30 2000 10:24AM P28 M 987.-,0916 MONTGOMERY COUNTY HEAD START 610 32 530 TWINING ROAD 6-lo5u 555 HIGH srREIET nr1FF.l4F9, PA 1902 INVITATION TO PARTICIPATE IN THE IEP MEETINpOTTSrOMN,PA 19464 Date: /4 a7-re5 1 ?1I1/,_1If?. /? Child's Name:c vec f 1 Name and Address of Parent; u 3a 7 Dear kQ/ti? a -f 5Y52 We would like you to participate In an indivklualized education program team meeting. The purpose Of this meeting is to: (C1NCk8n1haf4A*) Z Discuss the results and recommendations of the multidisciplinary evaluation and make a determination if Your Child Is In need of special education. If K Is detemtined that your child Is eligible for Early Intervention, an Individualized Education Program (IEP) will be developed at the meeting I 1 Olactuss your child's current IEP to review and revise it as needed,.. The team meeting has been scheduled for this location: _t/ )h. at the following data and timo:-I??o V time, location is riot conventions, please contact me as soon as If this dice, or mutually corwenient. Possible so we can arrange a time and place ace which are and Phone Number Dale The folbwing Is are a ad to attend the meeting for your child: NAME AOLE' (r. - -4 NAME ROLE' 77 NAME ROLE' NAME ROLE' NAME ROLE' NAME ROLE' NAME ROLE' MIS fl0tes this person's Involvement in your child s IEP development. Examples: Regular education teacher, MAWA Agency representative, etc. q I FROM : NONT COUNTY HERD START I will-M ON b a r W W d a a. a r u, N p ? r S i 1 H O 10 S to M r N N ? In O w lI'1 d' L7 U .C H 0 N d a m N J a b n i ~ W y N m > V D o d G 1" (1! 0 N V Z O \ 1 C ? Yd E J J Qa C m co W O p o o z A q ? m a a Ln e p z a U d 1O .L. a of z ° 1 ?+ a n s w co r x CO N o w In M a «- ? G N E W N p z U t U 4 N Q S C 1 Cc U d PHOI•IE IiO. : 215 087 0915 \ 1^ V J D W w -' ¢ O VJ 1 ? O O ° C ? o a m w :c w H U A Q b W O u? G l C W LL F Ly C W ° a $ W 0 a W s m N c e V J O C s 7 Q O C Y .E u r_ W N A.ly. m MOO lot 1?AM P` v m a N a a L_ 0 c A F .o 0 a 8 10 m r 3 4 L' LD g F m c .y co co g A E T ro C. m O E A C N C ? CL FROM MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:13AM P7 IEP Dev Dote of Child's narnsG M ffie hr ? - . 4oi 1. Special Considerations the IEP Team Must Address Before Developing the IEP (Each question must be answered) A. Is the child blind or visually impaired? -NO VES•Tsam mutt address the need for Braill*/Braille instruction based on the child's current and future reading and wdling skills and needs and will be Included In the development of the IEP. YES-Team doss not need to addrass the need for BralllwSrallle Instruction based on the student's current and future reading and nmg skills and needs. B. Is the child deaf or hearing impakad? No YES-Team must address the child's language and communication needs, opponunklss for direct communication with paors and professionals in the child's language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the child's language and communication mode in the development of the IEP. C. Does the child exhibit behaviors that impede NO his/her learning or that of others? YES-Team must develop strategies including Positive behavior intervention supports in the IEP. D. Does the child have limited English NO proficiency? YE$-Team must address the language needs of the child in the development of the IEP, i- Does the child have communication heeds? NO YES-Team must address the communication needs of the child in the development of the IEP. F. Does the child require assistivs NO technology devices and/or services? YES-Team must address the child's assistive technology needs in the development of the IER G. Does the child have any health No concerns? Yes-Team must address intervention strategies necessary to support the child's participation in programs/service. H. Does the child require transition to schoo4ge services? --LNO Yes-The child is within one year of transition. Team must discuss ft transition process and develop transition goals and objectives. MCIU•7/98 Z FROM MONT COUNTY HEAD START PHONE N0. 215 B87 0916 Aug. 30 2000 10:14gM P8 IEP Dev Date ?? " S-?1 ?nl? --,_, ?,L_ _ Child's name Ivl 11. Present Levels of Performance A. Describe the eligible young child's present levels of performance, Including functional Information regarding educational strengths and needs. ?'7re Cv?,c?c?i?azc, n¢.?,o avLc. ?? LA lcnl-l f a.? ? nowt?u?e? ?# 0. With pare at consent, describe what the family perceives as their strengths and needs as they relate td the goals of the child. What are the family's priorities for the child? l -M ? J p e ?fl^?ca.?c, ,vo C. Now as th aliglbl general education curriculum Ahkild-s d appropriate activities? child's participation In the dll ,I?? A 7/0 ??2u? Gam? 2u,o ??o•a , MCIU•7/9a 3 FROM : MONT COUNTY HERD START PHONE NO. : 215 887 051E Aug. 30 2000 10I:14RM P? IEP Dev Date_ Chlld's name {?l- arc III• GOALS AND OBJECTIVES: (Use as many copies of this page as needed) A. MEASUREABLE ANNUAL GOAL ?. ? ?B.r ?SHORT-TERM INSTRUCTIONAL OBJECTIVES OR BENCHMARKS .:oNNt Cemp 2 n.r.nc iropr.e. ?) 1 tve/8encf+mark:_ Ye on (( di?? / p -? nLw A Q Q acted Level of Ac a eme C w.. Evatua icn ???r.re 99%&Rainm.ni 7a%aWm...m If a o i'«I 7mp9.~ww w my .'. ?mr '%*WnmMI %Axa.fn.nl %.NNm.nt ?1SYJ Hair ? ,i c ? Gpmpl.ion of gpal nr progna i sit y 1 O .O abr.euv? .N,nrn.m .Nnm.n Method of Evaluation dailk, imark: ? b v `emu fi? l Lim tl q ??e a c7-e, 3) bJectivQ/Ben?chrn,,a Ex acted Levi a of .0hl ameru .. !. _ WW tnn"/ .od v of of - n Evalual tion Meth da-t??. C?C?' ?l? G?i d?z ???SII?Ua sX/J .Nnm DATE & RESULTS OF REVIEW aaiu lu' - V MCIU•7/98 FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:15gM P10 Child's netreC- lgp DYV Date f? Ill. GOALS AND OBJECTIVES: (Use as many copies of this page as needed) A. MEASURHAf3LE ANNUAL GOAL 8, SHORT-TERM wra..flw ;aevw.l eraaaw ncCAW$ A!nf y E ?- a it Evalua u Aaf aRaiMd Ga1aClly. rslovox.aanmam Method INSTRUCTIONAL OBJECTIVES OR BENCHMArRK$ % Be ma C1 lyffyl gfwiye?`Is 60 (?K' r' $Ct eLlld IIV Evaiuatlon apro7axaa.mm.n QrGt-?"LY.. 7y? 6??fi?17 10 ?fin faa aflaM 1N: LLM/ J ? :.aua+afM aomvNaen OI9sa? ? :•. 7afOn?4Ml g{pyan Irhaf aN??w'1^"•? I px apphMnM{ 1 750 7.W, 74%AUMM "I pdbro f9%aadnmaM i}rNff Nan 75X o W 9ed I ?. 6219S-e Veda 7'0?? "i wyx& L rvameM CRr AFL I /mowlo ' d,L4, alOtion _ . O,-x 3) objecliveBe c m ?ed Level of Apt, nvement Il. LMf aurnn. ?_?.-. 7r7! 1099x aNiNnf7R Sr$Ow 74%anfNTanl DATE & am f.tb w fo%a11aM ad+?+ 4Mf.Inan O.M. Q I- V . r--I iethod o0-a'f Evaluation IM .?.J 00- RESULTS O?IFREVIEW U 5 FROM MONT COUNTY HEAD START PHONE NO. :215 B87 0916 Aug. 30 2000 10:16AM P11 IEP Dev Date_ ?I JS 7 _ Child's nnme .a4.cj 111. GOALS AND OBJECTIVES: (Use as many Copies of this page as needed) A. MEASUREABLE ANNUAL GOAL %a ifilfo B. SHORT-TERM oai.ful cw Wrm at goal n1lManl proTm , ogealvr :MMilant DnOgii "// e Evalua aaMnw is 99%.1w,wtt 107a%aNirynanl Method 49%ahaavnant I Nan 23%4"AmM d ?t oaa ?Caaahll Oem'?-- g 816w Dodo - onamm? progrwo . oaa 0 7a%analrmw 040%ahaiananl Run 75%altamun ? ? _ ? i Aamrt Nov msm Dornpna0n of 9aal OManl Drogre" M"Ienr Poyraoe aao latAn_ ama r?s INSTRUCTIONAL OBJECTIVES OR BENCHMARKS enorunark: (,( ITV ?d ( G7? Level of Achievement ,2P/X. -?000Q 10 / c d le G?bcv-? Evaluation / of ly Evaluation D "% nfMm l«n ?.+ !M f?+ l?lY'1.1.C. \? L V ?JC ?t?(?-' /'(! /VU ?-? 0 7a%aftan"Al/? 049%anMnmarnC. DATE & RESULTS OF REVIEW than 29%all Men ? ? ? ur.111.7/nR dam t?&-ac.W/-x - L-b-serrclafi)-xo FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:16AM P12 IEP Dev Date Child's name 111, GOALS AND OBJECTIVES: (Use as many copies of this Page as needed) A. MEASUREABLE ANNUAL GOAL ID ioZ'-,07 8. SHORT-TERM INSTRUCTIONAL OBJECTIVES OR BENCHMARKS ?oeonawi 7°a owBenchrruirk: h Meected Level o? Ac ? ? e'er s?Q... 0 f?CJ7?? Evaluation le a a14inW ag9ctl•a.. Wb 99% naNN•nt eta, 0? (1?Qp 7c ? ;,. .lm.m Method of Evaluation l i w ?•;..K. •9%.9a'.mMf ?? !1 b? rI?CC. p iv J? w IMr1 ?i'f/!n •n d?? ? ?,(,e? f? - LSD ? ? ?(e.. R.e." Kw joa fw empw-al OW ,NNIMK pm"" • an.v d 9b* .t w99%4 W.rnt l0 74%awW OmM l9 !9%afti~t 2) Objective mchmark: WWf &wa- ' ""`- ? " "" A Ex b7, - p ed evel a ?ievQe'? ° p av jEtx? Ev?tu ado n?Scyih?edu le Method of Evaluation cala?(zc? c?CQ LQ?c i /k d-b-;eVVa7 W 4 ? 3) bjective/Sena chmat: nem y-S p ..rl K+v Yo? t c•.lfW wr.wNen °' 9°" Expected Level of EvaiXqche ?A Method of Evaluation w 99%6n••...m C( aha, Qff 11C /ChlO?t DATE & RESULTS OF REVIEW w e9%an.?r. - `ur?I Tom- G6L avu? ?? II" """"? -- Obsc-V-06L iim -. MCIU•7198 FROM : MONT COUNTY HEAD START PHONE NO. : 215 e67 0916 Aug. 30 2000 10:17AM P13 IEP Dev Date S'`Child's name IV. Specially Designed Instruction, Special Adaptations, and Strategies (Needed to advance toward attaining goals and to be involved and progress In the general cunkulum andror appropriate activities) A. to most Lt: How are Content, method and materials being child's needs? B. -jrited young child to transportation? What Yuppditlve service* to required to assist the eligible n or gain access to spacial education, e.g.,OT,PT, C. Syjlglsmentary Aids and servlpas: What aide, services and supports are required to ensure the eligible young child meaningful participation to the maximum extent appropriate with non-eligible children? D. supports: What training and/or materials will be provided for program personnel In order to allow the child to participate or progress In the general curriculum or appropriate activities? E. Least Restrictive Environment: Explain to what extent, If any, the ellglble young Ild will not participate with'noh-slipble children. n A , /?j p ?2 A?j N l/`?.. D r P. ftograss Reporting: Explain how the program will report progrsae toward annual goals to parents, qnd ho often. emouf/Iu@ -x ?v i? MCIU-7/98 / 1` FROM : MONT COUNTY HEAD START PHONE NO. : 215 eel 0916 Aug. 30 2000 10:17AM P14 MONTGOMERY COUNTY HEAD START 530 TWINING ROAD 555 HIGH STREET i DRESHER, PA 19025 POTTSTOWN, PA 19464 215 887-0916 610 326-1050 OPTIONS CONSIDERED Child's Name ??,/A The following options were considered in descending order when recommending placement for your child, except for the alternative relating to services and programs provided In the tame. Services in the home may be the least restrictive early Intervention program for an etigbte youno child. • Regular preschool program or class for all or most of the program ervention. • Specialized selling for most or all of the program day, with noneligible young children. • Specialized setting for pan of the day, with some programming provided in the regular preschool program or class and opponunkfes for participation with none0grde young children in play or other activities. • Supplemental Intervention, nordassroom setting. • specialized setting Jor most or all of the program day. • Services and programs provided in the fame, Including services which are provided in conjurxtion with services provided in another setting. • Specialized setting, Including the following: Approved Private School. Residential school facility. Approved out-cf•stats program. Reasons for the recommendations (Include evaluation procedures, reports, and other factors used in making the recommendations.): ,:5C4PPn,o A-e*C'jA-??atnCA0-dl7ed 72'57?. CAS$4odm tgi?S'Ft? A54rSCn-?? ?CHEe.?c' ity'.? '7F.f/CHE?/?/9i2ENr t0 uES7'.enni¢.ve, X/ SSVae6-n /g559v_5 nc,t7Jf Reasons why the above recommendation is appropriate and why it represents the least restrictive environment in which your child's needs can be met: _ ,ed t l&. j Age. 4n-r--j in -,?l?z? IPc.._<? Ii PG???c??u.t t°lilyi?'+oN K-•.7?' 0-0 C6- 9,e CLASS w9f0'1 S-4QO -t) Reasons why the options that were considered, but not recommended, are Inappropriate or do not represent the least restrictive environment In which your child's needs can be met: Form: 7/198 7 FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:18AM P15 530 THINING ROAD DRESHER, PA 19025 215 887-0916 MONTGOMERY COUNTY HEAD START 555 HIGH STREET POTTSTOWN, PA 19464 610 326-1050 ' NOTICE OF RECOMME 1DED ASSIGNMENT (NORA) CHILD'S NAME: DATE: /I' This notice describe recommandatbns or proposed changes regarding your child's educational program as a result of the recent Individualized Education Program (IEP) meeting or your request. The assignment roWrrlmended for your Chill Ise I v v This assignment was recommended after a review of the attaohe options, which were used to assist in Identifying the services that will meet your child's needs. t. ? Your child should begin to receive early Intervention services. The MAWA Agency will not p(004 without your approval of this recommendation (the IEP Is attached). 2. ( I Your child's early intervention placement or services should be Changed as noted In the IEP. The MAWA Agency will proceed with this change unless you nouy us, within ten days. of your written disapproval (the IEP Is attached). 3, [ I Your child Is no longer In need of early intervention services because (s)he has met exit criteria . We recommend current early Intervention services be discontinued. The MAWA Agency will proceed with this charge unless you notify us, within ton days, of your written disapproval. 4. [I All early Intervention services provided by the MAWA Agency will be discontinued by the beginning of the coming school term. Education services will become the responsibility of the school district. You will be provided assistance with this ftwilion. 5. I I Your child Is not eligible to receive early Intervention services. 6. I 1 The MAWA Agency Is refusing your request to Initiate or ctWV@ your d1Dd's: (] Identification ( I Evaluation I I rational placement I 1 Provision of a Free Appropriate Public Education The reason and basis for this refusal are' I I Other; Agency Chief c?l'1Ig? Dale FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:18AM PIS 4• CHILD'S NAME: J?f e k 64?7,j?f _ / yf (? ?.D DATE: You have certain rights which are described in the attached Procedural Safeguards Notice. Please carefully read the Information. If you need more Information, you may contact: Early Intervention Supervisor - Phone (610) 538.8330 DIRECTIONS FOR PARENTS: Please chock one of the options below, sign this form, and return it within 10 days to the person listed above. j I approve this recommendation. ( `] I do not approve this recommendation. (Please request an option listed below.) My reason for disapproval is: I request: 1 1 A Prehearing Conference 1 1 Mediation- 1 1 Due-process Hearing" -The attached Procedural Safeguards Notice provides information on these options. I have received a copy and t understand the content of the Procedural Safeguards Notice. Parert's Initials PareftCa Signature iJeEe Daythr Poore MCIU NORA:711M FROM : MONT COUNTY HEAD START PHONE NO. : 215 887 0916 MONTGOMERY COUNTY HEAD START 215 887-0916 Aug. 30 2000 10:19AN P18 610 326-1050 S55 HIGH'STREET 530 TWINING ROAD POTTSTOWN, PA 19464 DRESHER, PA 19025 // PERMISSION TO EVALUATE/REEVALUATE I i1 rOrj0r U 1' I? 1 DATE: Q ?? Y f CHILD'S NAME: NAMPJADDRESS OF PARENT(S): '° iA AL i ? P 4-r S _ Your child has been referred for an inhlal evaluation for the following reason(s): ` V. -4 o1-S ?t ve in RC7'?- . bra 7: -(k, 1 w SO VO-W-9- _ I uLd cci- C, -Fb v,fUv' `}e s+?vt vu-.LdLd . The MAWA agency requests your consent to conduct a Multidisciplinary Evaluation (MOE). We must have your written consent before we can begin. As a parent, you are a member of the multidisciplinary team. You are entitled to participate in all meetings concerning this evaluation. outing the evaluation process You may also provide written comments. The team will review your child's educational reeds and strengths as shown by performance levels. assessment results, observations and information from you. Fallowing is a list of specific types of tests and procedures that will be used and a description of each: The evaluation is proposed for the following date(s): The MAWA agency is planning a reevaluation of your child for the following reason(s): The MAWA agency requests your consent to Conduct this reevaluation. We must have your written consent before the reevaluation can begin. However, pteaze baware h the after rban As le attempts, You area ave n mernbOr received your response, we are permitted by law to p in as meetings concerning this reevaluation. Outing of the multidisciplinary team. You ou are are entitled to participate the reevaluation process, you may also provide written comments. The team will review your child's current IEP and educational needs and strengths, as shown by educational performance levels, assessment results, observations, and information from you. Following is a iist of the specific types of tests and procedures that will be used and a description of each: The reevaluation is proposed for the following date(s): )2. FROM : MONT COUNTY HERD START PHONE NO. : 215 887 0916 Aug. 30 2000 10:20AM P19 The multidisciplinary team will prepare recommendations regarding your drib's educational program and whether your child is eligible, or continues to be eligible. for special education and related services. The findings from the MOE will be contained in a Comprehensive Evaluation Report ICES) and will be the basis for devebpng the IEP. The CER a to to delivered to you within tic days of receipt of your written Consent to evaluate or reavaluate. Please read the enclosed Procedural Safeguards Notice, which includes parent resources such as state or local advocacy organi'Astions. You may contact me y you have any questions Or concerns about the evaluation or if you need the services of a translator or an interpra / ,•? Contact Person 11 Position Phona 26J L?6 7-0 4C DIRECTIONS FOR PARENTS: Please cheek the appropriate Item(s), sign end return this form to the parson named above. /' S I give consent to begin the proposed initial evaluation. [ 1 1 give mnsenl to begin the proposed reevaluation. (1 Pleass cent= me. 1 am not ready to give consent at this time and would lace to ta& about this, [ 1 I do not give consent to the proposed lnkW evaluation or reevaluation. Please do not begin the process. [ ) I object to the proposed initial evaluation or reevaluation; however, I would tike to schedule; [ J An informal meeting. [ J A prehearing confaranoe• [ 1 Mediation' [ j A Due Process Hearing' The enclosed Procedural Safeguards Notice provides Information on those options. I have received a copy and I understand the content of the Procedural Safeguards Notice. (Parent's Inklals) Your family may have strengths and needs which would be helpful to consider as part of the multidisefplinary evaluation In older to enhance the development of your child. Yes. I wish to share such Information. (Parem's Mugs) No, I do not wish to share such information. (Puanes initials) The CER may Include a statement of your lamkys strengths and needs and services recommended to most those needs. Yss, l give permission for the CER to include such information. (Psvenrs Initiate) No, I do not wish the CER to include such Information. (Parenrs Initials) ?Slonature of Parent(#).`ZQ? [l p veto l ? Daytime Telephone. aLci aS6- 6 MAWA Agency Contact DATE SIGNED PERMISSION RECEIVED BY PROGRAM: MCIU: 7/1x98 13 :? ... ?. ? it ? _ . / ? Cl, '. I ! J.r' ,,, S ?? M1` Y c ^ ?? \'? .• SCOTT R. MILLETICS, Plaintiff V. KAREN E. KAMPIA, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN CUSTODY NO. qq - Sa3lo ORDER OF COURT AND NOW, upon consideration of the attached that the parties and their respective cou sel appear be Custod Conference Officer, on the da of it is hereby directed . at d luau, a[ a a Pre-Hearing Custody Conference. ON for At such Con erencd, an -effort will be made to resolve the issues in dispute; or if this cannot be accomplished, to define and narrow the issues to be heard by the Court, and to enter into a Temporary Order. All children age five or older may, at the request of either attorney or party, be present at the Conference. Failure to appear at the Conference may provide grounds for the entry of a temporary or permanent Order. FOR THE COURT, Date of Order: 910911 By: I U?P?II011 Custody Conference O i r L"'?)) YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. The Cumberland County Lawyer Referral Service Court Administrator Cumberland County Courthouse Carlisle, PA 17013 Telephone No. (717) 240-6200 ?- ?;. - ;?r ? ??? y ?'3?99 ?-???i ? 5? ?-3-99 `?/a? n Z y:3 99 Y Y ` SCOTT R. MILLETICS, : IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW KAREN E. KAMPIA, IN CUSTODY Defendant NO. y q. fd y4 COMPLAINT FOR CUSTODY 1. The Plaintiff is Scott A. Milletics, residing at 1009 Brookwood Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055. 2. The Defendant is Karen E. Kampia, residing at 327 Shirley Drive, Lower Salford, Pennsylvania 19438. 3. Plaintiff seeks custody of the following child: Name Present Residences Age Gregory Scott Milletics 327 Shirley Drive 3 Lower Salford, PA 19438 and DOB 1/18/96 1009 Brookwood Drive Mechanicsburg, PA 17055 The child was born out of wedlock. The parties alternate custody of the child on an alternating two week basis. Since birth, the child has resided with the following persons and at the following addresses: Karen E. Kampia 26 Falcon Court 1/18/96 through 6/96 Scott R. Milletics Mechanicsburg, PA 17055 From 6/96 through the present, the parties have been sharing custody of Gregory and he has lived with Father at 1009 Brookwood Drive, Mechanicsburg, PA 17055 and Mother at 327 Shirley Drive, Lower Salford, PA 19438. There was a brief period of time when the parties separated that Ms. Kampia continued to live at the Falcon Court address and Father lived at the 1009 Brookwood Drive address. The mother of the child is Karen E. Kampia currently residing at 327 Shirley Drive, Lower Salford, Pennsylvania 19438. She is single. The father of the child is Scott R. Milletics, currently residing at 1009 Brookwood Drive, Mechanicsburg, Pennsylvania 17055. He is single. 4. The relationship of Plaintiff to the child is that of father. The Plaintiff currently resides with the following persons: Name Relationship Sandra L. Milietics Plaintiffs mother Kendrick Jones Plaintiffs mother's boyfriend Gregory Scott Milletics son 5. The relationship of Defendant to the child is that of mother. The Defendant currently resides with the following persons: Name Relationship Robert Kampia Defendant's father Kenneth Kampia Defendant's brother Michael Defendant's son (Gregory's half-brother) Gregory Scott Milletics son 6. Plaintiff has not participated as a party or witness, or in another capacity, in other litigation concerning the custody of the child in this or another court. Plaintiff has no information of a custody proceeding concerning the child pending in a court of this Commonwealth. Plaintiff does not know of a person not a party to the proceedings who has physical custody of the child or claims to have custody or visitation rights with respect to the child. 7. The best interest and permanent welfare of the child will be served by granting the relief requested because: the parties have had a shared custodial arrangement since June of 1996. Gregory is now 3 % years old and Father would like to enroll him in a pre-school program no later than September 2000. Plaintiff believes that he can provide a more stable environment for his son and will take all steps necessary to ensure that Gregory has frequent, meaningful contact with Mother. 8. Each parent whose parental rights to the child have not been terminated and the person who has physical custody of the child have been named as parties to this action. WHEREFORE, Plaintiff requests the court to grant primary physical custody of the child to him. Sandra L. Meilton, Esquire TUCKER ARENSBERG $ SWARTZ 111 North Front Street P.O. Box 889 Harrisburg, PA 17108-0889 (717) 2344121 ATTORNEYS FOR PLAINTIFF 20589.1 I, the undersigned, Scott Milletics, acknowledge that the facts stated in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unswom falsification to authorities. S ott illetics Dated: 8/24/99 rr_ V }iy V "• • 7 3 & ? a W O C 0 n N a CJ zz u? 0 pU F 0. L LIr L . l ..: f LI' -- L. ('.. L . . r I? m °a g z a IL ? 'L N 'y'y'''' [[ZI n Z Oi = yy Q SCOTT R. MILLETICS, Plaintiff V. KAREN E. KAMPIA, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN CUSTODY NO. 99-5236 Civil AFFIDAVIT OF SERVICE COMMONWEALTH OF PENNSYLVANIA ) SS: COUNTY OF DAUPHIN ) AND NOW, this day of f*1 , 1999, personally appeared before me, a Notary Public in and for the aforesaid Commonwealth and County, Gloria M. Rine, legal assistant to Sandra L. Meilton, who being duly sworn according to law, deposes and says that on September 9, 1999, she mailed a certified copy of a Complaint for Custody with attached Court Order setting a custody conference, by certified mail no. Z 187 542 979, return receipt requested, to Karen E. Kampia, 327 Shirley Drive, Harleysville, PA 19348, and the same was received by her on September 11, 1999 as indicated by the return receipt card which is attached hereto. Gloria M. Rine Sworn to and subs i ed before me this J =day of September, 1999. ra"'e?7-? wall Notary Public Public b. 7.2000 (SEAL) HarrisWsociat ounty Mom er annn 0 olar es CWnOMSM= t antler 4& W Z 1p sddXlpW .arMNe. . a IMnr s d ii° I also wish to rawltis ft . P ' ' W card Iypo nrna address s on ft Nvsna a1 Nde form w WI waNn rNpniMl g fee aetvICe bea (for an ext n exlre f66): Mwttwch.Ih4 tam to the spa of the mYtpYN, or on the beck N VaN dos not W 1. ? Addressee's Address ff } •t irn grpu,?, RaWWPI wlN Wictiii of whom ?mewwii w? "I"M ? he mmbw. dog 2. O Restricted Delivery q deemed. Consult postmaster for fee. 1 3. Andde Addressed to: 4a. Ardde Numga 7F KAREN E. KAMPIA 7, 187 542 979 a 1 327 SHIRLEY DRIVE 4b. SenrIce Type E HARLEYSVILLE PA 19343 E3 Registered XWOerdBed a ? Express Mail O Insured A 0 Return RMO for Mentlsndse O COD i 7. Date of Delivery 5. ReceWed By: (Print Name) 8. Addr 'a Addre(Only If requested and We he geld) 8. Sign re: (Addressee or nf) C X PS Form 3811, DecetnMr 1994 Domestic etllRt eoe pt Z 187 542 979 Receipt for Certified Mail No Insurance Coverage Provided Do not use for International Mail 5,Irr 7 ' L B Sna.i ...,.r v? t? 327 SHIRLEY DRIV rn ?inm nn, Z, ?,.,e. Q ARLEYSVILLE PA 1 Q i cx,lil,nJ ip,. li , a n..lun, M....,Ip •.nnw..... .. w,..:... Uro. a,,,? nnu,,. ;.,• , nnm...., nrr., r?,.r,.l,. Fusima?, of D.n, 9/9/99 4? I MONTGOMERY COUNTY INTERMEDIATE UNIT SERVING THE SCHOOLS OF MONTGOMERY COUNTY 1605-B WEST MAIN ST. - NORRISTOWN PA 19403 - 610/539.8550 - FAX 610/539-7411 SPEECH AND LANGUAGE EVALUATION AND PRESENT LEVELS OF NAME: DATE OF BIRTH: DATE OF EVALUATION C.A.. EVALUATOR: PARENT: ADDRESS: PHONE: COMMUNICATION GREGORY MILLETICS 1-18-96 8-10-99 3 YEARS, 6 MONTHS KATHLEEN WERTLEY, KAREN KAMPIA 327 SHIRLEY DRIVE HARLEYSVILLE, PA. 215-256-6954 BEHAVIORAL OBSERVATIONS/HISTORY M.A., CCC/SLP DEFENDANT'S EXHIBIT 19438 Gregory is a 3 year, 6 month old child who was referred to the Montgomery County Intermediate Unit by his mother due to concerns with his overall development. Following a developmental screening on 5-20-99, he was referred for a Speech/Language Evaluation and Audiologic Evaluation. He was accompanied to today's Speech/Language Evaluation by his mother who acted as informant. Ms. Kambia reported that Gregory has difficulty pronouncing words. Reportedly, Gregory is the product of an uncomplicated 39 week pregnancy with a birth weight of 6 lbs., 5 oz. Ms. Kambia reported that there was a slowing of his heartbeat during the delivery but there were no problems at birth other than mild jaundice. There is no reported history of serious accidentlillness; hospitalization; feeding/swallowing difficulty or chronic ear infections. Ms. Kambia reported that she suspects Gregory may have seasonal allergies but he has not been formally diagnosed. His hearing was tested on 5-20-99. Results indicated that hearing is adequate for speech/language development. Emergence of developmental milestones was reported as follows: sifting unsupported at 6 months; walking at 14 months; first words at 18 months. Gregory has not participated in an educational preschool program to date. His mother is exploring the possibility of enrolling him in a Head Start Program for the fall. He currently lives with his mother and younger brother half of the time and his father the other half. While in the playroom, Gregory was observed playing primarily with toy dinosaurs. He primarily gathered them and carried them around the room but he did at times pretend that they were fighting or growling at each other. He played briefly in the kitchen area MCIU is an equal opportunity employment, educational, and service organization. Speech and Language Evaluation - Gregory Milletics Page 2 and brought a cupcake to the evaluator and said, "Here a cupcake.". He transitioned to the evaluation room with his mother and younger brother but he was able to separate from them upon entering the room. He took the toy dinosaurs with him and refused to separate from them but placed them on the table. He was generally cooperative for labeling pictures and answering questions about pictures. He followed one step directions involving object manipulation. He joined with the evaluator in a spontaneous play activity using a Fischer Price Farm. TESTS/PROCEDURES ADMINISTERED Parent Interview The Communication Screen (3-Year Form) Goldman-Fristoe Test of Articplation (EFTA) Structured Photographic Expressive Language Test-Preschool (SPELT-P) Informal Language Sample EVALUATION RESULTS Receptive/expressive language content and use were assessed using AGS Early Screening Profiles, administered 5-20-99; The Communication Screen and informal language sampling. Gregory appeared to be functioning within age expectations on these measures. He was able to identify actions in pictures. He could follow one step directions using the spatial concepts in, upside down, under, on. He could label pictures of common objects. He responded to what, where, yes/no questions. Expressive language skills were further assessed using the PELT-P. He correctly used prepositional phrases when given a choice (ex. When asked, "Is the dog under the chair or on the chair?", he correctly responded, "under chair"). He did not use plural noun endings; present progressive (is/are verbing); possessive noun endings; pronouns he/she; past/present verb tense endings; copula (is/are) or negation. During spontaneous language sampling sentence length averaged 2.3 words with one 4 word combination recorded. He used sentences to locate (ex. "Sheep in there."); to negate (ex. "No, you don't."); to direct (ex. "Go in there."); to label (ex. "That a mommy.) and to describe (ex. "Here a big sheep."). Gregory's sentence length/complexity and grammar skills were below age expectations. The GFTA was administered to assess speech sound production at the single word level. The following results were obtained. Overall speech intelligibility in connected speech was judged to be poor. Speech and Language Evaluation - Gregory Milletics Target Initial Sound Position P m n b 9 d glottal stop/g k t glottal stop/k f t glottal stop/f ng Y t sh ch j th(voiceless) V s z th(voiced) 1/y Medial Position t/p omission d/n d/b d/g w/k t/f omission d/sh d/sh t glottal stop/ch d/ch w/r Ur d/j of glottal stop/th omission w/v d/v d glottal stop/s d/s I/z d/z I/th d/th Final Position omission omission omission omission omission omission omission omission omission omission omission distortion omission omission omission omission omission Page 3 Gregory also produced the following consonant blend substitutions in the initial position of words: b/bl, b/br, d/dr, t glottal stop/kr, p glottal stop/pl, t glottal stop/skw, t glottal stop/sl, t glottal stop/st, t/tr. In the initial position of words, Gregory frequently followed production of a stop plosive /t,d,p/ with a glottal stop. He demonstrated vowel distortions (ex. heh/house; ne/knife). He also demonstrated the following phonologic processing errors which are expected to be eliminated in the 3rd and 4th years. - final consonant deletion (3rd year): omission of final sounds from words/syllables (ex. heh/house) - stopping (3rd year): stopping air on production of continuous air sounds (ex. didah/scissors) - velar fronting (4th year): use of front sounds /d,t/ for back sounds /k,g/ (ex. du/gun) - cluster reduction (4th year): omission of one sound from consonant blends (ex. boo/blue) Gregory was not cooperative for sound stimulability testing or for an oral peripheral examination. He did imitate single word productions, when he did not know the label Speech and Language Evaluation - Gregory Milletics Page 4 for a picture. His word imitations were generally close approximations of the word given. Verbal imitation skills appeared to be good. Vocal quality and fluency skills were judged to be within normal limits. SUMMARY Gregory is a 3 year, 6 month old child who displayed an expressive language delay and poor speech intelligibility. The following communication strengths and needs were identified. Strenaths - average receptive languag? skills - average expressive language content/use - verbal imitation skills , - age appropriate vocal quality and fluency skills Needs: - develop sound facilitating oral postures - associate sound production with sound facilitating postures - develop sound production in CV combinations; CVCV combinations; words and sentences - develop ability to identify correct/incorrect sound production, - develop 3-5 word combinations for a variety of communicative intentions - parent training to facilitate carry over of therapy targets to all settings RECOMMENDATIONS It is recommended that Gregory receive speech/language therapy 2 times per week. This should be part of his Head Start Program if he is accepted into the program. Parent training to facilitate carry over of speech/language goals to the home setting is also recommended. ?I ?\J Kathleen Wertley, M.A., CC C/SL- Speech and Language Pathologist 1605-B West Main Street Norristown, Pa. 19403 Montgomery County Intermediate Unit Early Intervention Program Phone: (610) 539-8550 Fax: (610) 539-3893 COMPREHENSIVE EVALUATION REPORT _J___ Initial Evaluation ____Reevaluation CHILD'S NAME: GREGORY MILLETICS DATE OF BIRTH: 1/18/96 Guardian: Karen Kambia Phone: (h) 215-256-6954 Address: 327 Shirley Drive Harleysville, Pa. 19438 School District: Souderton Other Information (as needed):N/A Date Permission to Evaluate/Reevaluate Received: 5/20/99 Date of Completion of Multidisciplinary Evaluation: 8/10/99 Date of Comprehensive Evaluation Report: 8/11/99 1. Reason for Referral: Gregory was referred for multidisciplinary assessment to assist in determining eligibility for services as his mother had concerns about his overall development. II. History: A. Early Intervention History VY Gregory has no known diagnosis. He has not received Early Intervention services to date. B. Education, Social, and Physical History Reportedly, Gregory is the product of an uncomplicated 39 week pregnancy with a birth weight of 6 lbs., 5 oz. Ms. Kambia reported that there was a slowing of his heartbeat during the delivery but there were no problems at birth other than mild jaundice. There is no reported history of serious accidentlillness; hospitalization; feeding/swallowing difficulty or chronic ear infections. Ms. Kambia reported that she suspects Gregory may have seasonal allergies but he has not been formally diagnosed. His hearing was tested on 5-20- 99. Results indicated that hearing is adequate for speech/language development. Emergence of developmental milestones was reported as follows: sifting unsupported at 6 months; walking at 14 months; first words at 18 months. Gregory has not participated in an educational preschool program to date. His mother is exploring the possibility of enrolling him in a Head Start Program for the fall. He currently lives with his mother and younger brother half of the time and his father the other half. DATE: 8/11/99 CHILD'S NAME: GREGORY MILLETICS III. Information from the family (parents or other persons with whom the child lives) A. Child's strengths and needs including physical condition, cultural and language considerations, and adaptive behavior Gregory reportedly lives with his mother and younger brother half of the time and his father half of the time. English is the primary language spoken in the home. Ms. Kambia reported that Gregory gets along well with others; is well liked, considerate and sweet. She reported that he has pretty good motor skills; is intelligent and tries to figure out the way things work. She also reported that he needs to learn to share; feed himself; go to the bathroom on the toilet and finish his words. He also needs to not cry at simple requests and to listen and comply better. B. Family-perceived strengths and needs which will enhance the development of the child Ms. Kambia reported that Gregory goes back and forth between his father's and her house about every two weeks. She reported that he has supportive grandparents and relatives at both houses. She reported'that his father works full time and she was going to school and working full time. She also has a younger son. IV. Summary of Findings A. Screening results (initial evaluation only) AGS EARLY SCREENING PROFILES - 5/20/99- MCIU results reveal the need for further Speech and Language Evaluation. Cognitive/Language Profile - standard score 100 (average) Cognitive Subscale - standard score 101 (average) Language Subscale - standard score 100 (average) Motor Profile - standard score 81 (mildly delayed) Articuiation Survey - below average with poor speech intelligibility B. Review of current IEP (for reevaluation only) Not applicable C. Developmental Assessment Assessment Instruments and Procedures: Procedure/Assessment: Speech and Language Evaluation Date: 8/10/99 MCIU 7198 DATE: 8/11/99 Result: Assessment The QQmmunication Screen Goldman-Fristoe Test of 8nir iar QM) Structured Photocraohic ore ive L anqllage Test Informal sampling CHILD'S NAME: GREGORY MILLETICS Scores/ Percentile Rank/ kill Area Standard Score Language/articulation/fluency articulation; expressive Speech Sound Production language delay severe delay Grammar below age norms Language/Fluency expressive language Noice/Articulation delay; poor speech intelligibility Test results indicate that Gregory is a 3 year, 6 month old child who displayed an expressive language delay and poor speech intelligibility. Procedure/Assessment: Audioloiical Evaluation Date: 5/20i99 Result: Hearing is adequate for speech/language development 2. Narrative (including, but not limited to physical development, cognitive and sensory development, hearing problems, learning strengths and educational needs, language and speech development, social and emotional development, self-help skills, health considerations) This information is based on the screening results and evaluation noted in section IV A and C ocial Gregory presented as a child who appeared comfortable in these surroundings. He was not observed initiating interaction with other children. His mother reported that he gets along well with other children. Motor During fine motor tasks, Gregory was able to string 5 beads. Gross motor portions of the flGS were performed within age expectations. General observation revealed that he exhibits functional gross motor skills with adequate ability to sit, stand and walk with coordination. Communication Gregory's poor speech intelligibility inhibits his ability to be understood by others. He combines primarily 2-3 words to make his needs known and make comments. MCIU 7/98 DATE: 8/11/99 CHILD'S NAME: GREGORY MILLETICS Categories of Play Gregory was observed engaging in exploratory, representational and interactive play. He used toys appropriately and was able to functionally manipulate toys. He did not readily initiate play with other children including his brother during the evaluation. Attention Swan Gregory demonstrated an adequate attention span. However, he was unwilling to engage in activities that he did not enjoy. Functional Vision Gregory's vision appeared adequate for the performance of the visual tasks presented. There are no reported vision cortcerns. I Self HeI12. Gregory is reportedly beginning to feed assistance for dressing. himself. He is not toilet trained and requires Cognitive/Language Abilities Gregory demonstrated receptive language skills and expressive contentluse which were within the average range. Cognitive abilities as measured by developmental screening were also within age expectations. D. Observations: (information from observations during daily activities such as play with other children and interaction with family members and/or other adults) While in the playroom, Gregory was observed playing primarily.with toy dinosaurs. He primarily gathered them and carried them around the room but he did at times pretend that they were fighting or growling at each other. He played briefly in the kitchen area and brought a cupcake to the evaluator and said, "Here a cupcake.". He transitioned to the evaluation room with his mother and younger brother but he was able to separate from-them upon entering the room. He took the toy dinosaurs with him and refused to separate from them but placed them on the table. He was generally cooperative for labeling pictures and answering questions about pictures. He followed one step directions involving object manipulation. He joined with the evaluator in a spontaneous play activity using a Fischer Price Farm. E. Area(s) of Delay: Expressive language and articulation delay MCIU 7/98 DATE: 8/11/99 CHILD'S NAME: GREGORY MILLETICS F. Skills needed by the child to function successfully in variety of settings, including the home, school, and community - develop sound facilitating oral postures - associate sound production with sound facilitating postures - develop sound production in CV combinations; CVCV combinations; words and sentences - develop ability to identify correct/incorrect sound production - develop 3-5 word combinations for a variety of communicative intentions - parent training to facilitate carry over of therapy targets to all settings V. Recommendations A. Recommendations of Eligibility for Early Intervention Services and Programs 1. Team recommends eligibility for early intervention services. The following, services or programs should be considered by the IEP team:' An Early Intervention Program to address Gregory's need in the area of speech and language. It is recommended that he receive direct speech/language therapy 2 times per week. This should be part of his Head Start Program if he is accepted into the program. 2. Team recommends continued eligibility (Attach IEP) 3. Team does not recommend eligibility for early intervention services. Recommendations for follow-up activities (if any) are: B. Recommended Services to meet the family's needs to enhance the child's development The Speech/Language Pathologist working with Gregory will provide strategies to the family to facilitate carry over of therapy goals MCIU 7/98 DATE: 8/11/99 CHILD'S NAME: GREGORY MILLETICS MULTIDISCIPLINARY EVALUATION TEAM SIGNATURES Please indicate your agreement or disagreement with the conclusion or content of this report. If you disagree, please write the reasons for disagreement and attach them to this report. SIGNATURE TITLE DATE AGREE DISAGREE d•C?t/U ?z cne rc Q This report is a draft until all MDT members (including parents) have reviewed and signed the report. Any dissenting opinions must be Included. g-1)--gq Date CER sent to parents MCIU 7/98 I . °_J P.7E? P; r 717 Y _ KATHLEEN WERTLEY 1127 Byron Court 215-368-3192 (home) Lansdale, Pa. 19446 610-539.6550 (office) EXPERIENCE: Monig_omet C, o. Intgrrnodilto Unn R _, September 1971 - present Currently, Speech Clinician providing diagnostic )valuations and therapeutic intervention for preschool children. Previously, Speech Clinician serving a caseload of 60.75 Students consisting of regular education, learning disabled, emotionally disturbed, language learning disordered and developmentally delayed students in a public school setting fast co-chair of staff Committee on Mental Retardalion. participant in Committee for Classroom Language Stimulation, Language Committee, Materials Committee. Diagnostic Cvnvmittea, Committee for Staff Development and Staff Advisory Council. Member of Preschool Assistive Technology Core Team Field supervisor for students-in-training from area universities. Clinical Fellowship Year Supervisor for ASHA Certification. Developed and presented parent and teacher workshops in local school districts. Contributed to the development of staff manuals and checklists. Criteria for as2 Spleetion and ismiss,all (regular education population, LD/EMR population, TMR/SPMR population and preschool population); In-Service Workshons for Teachers an Parents: MQU I.n[grmal Soeech and Language Checklist For Early Interven Supervision of a paraprofessional throughout a three year Federal Project exploring the use of paraprofessrunals in a public school speech/language program. EDUCATION Tgm it Universi Phdadol?hia _PA, M. A in Speech Pathology, 1971 B. A in Speech Pathology. 1969 RECEIVED t1AlE ?- 1 10/12/99 07:44 fRorl 610+539+J893 DEFENDANT'S EXHIBIT c?.GL. II."I'EP"P Tli KATHLEEN WERTLEY Page Two FDl1CATION. PAR&Y_Ivania State University Completed Supervisory Cerdtleation Program in Special Education (21 credits). 1990 Participant in Assistive Technology Training related to Core Team Membership Participant in continuing education short courses and workshops. PROFESSIONAL Certiticato of Clinical Cornnr'tencn in.$J).f?ech F'athol= CERTIFICATES. awarded 1/1/73 Pennsylvania TeachinCertiticate=lInstructional II_In S eF h Correction awarded 5/74 PeDingy]y ania.Lic for,Speech Lan auagLPathologist awarded 5/86 Per Lsvlvania SupgrvisOr Gertificate in SpecL Education awarded 8/90 PROFESSIONAL Americdn S ee h Lan ua a HeaQD Association AFFILIATIONS: member 1971 - present Speech Lanauaoe AMs_ociation of Mcntgome Count member 1996 - present RECEIVED UAIE : 10/12/99 07:44 I-Mi :610+539+3893 SCOTT R. MILLETICS, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW KAREN E. KAMPIA, Defendant NO. 99-5236 CIVIL TERM ORDER OF COURT AND NOW, this 361 day of September, 1999, upon consideration of Plaintiff's Petition for Emergency Relief, a hearing is scheduled for Tuesday, October 12, 1999, at 9:00 a.m., in Courtroom No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania. BY THE COURT, J/ esley Oler, J / Sandra L. Meilton, Esq. P.O. Box 889 Harrisburg, PA 17108 Attorney for Plaintiff Karen Kampia 327 Shirley Drive Harleysville, PA 19438 Defendant, Pro Se :rc ? rrP. 0 SCOTT R. MILLETICS, Plaintiff V. KAREN E. KAMPIA, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN CUSTODY NO. 99-5236 Civil ORDER AND NOW, this day of the within petition, it is 1999, upon consideration of HEREBY ORDERED AND DECREED that present physical custody schedule being observed by the parents of Gregory Scott Milletics shall be maintained, i.e. alternating custody on a two week schedule (September 19, 1999 through October 3, 1999 with Father; October 3, 1999 through October 17, 1999 with Mother, and continuing on the same schedule thereafter), until final resolution either through a custody conciliation conference or Court hearing, if necessary. BY THE COURT: 21532.1 J. d'`i SCOTT R. MILLETICS, : IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW KAREN E. KAMPIA, IN CUSTODY Defendant NO. 99-5236 Civil PETITION FOR EMERGENCY RELIEF AND NOW, comes Scott R. Milletics, Plaintiff, by and through his attorney, Sandra L. Meilton, of Tucker Arensberg & Swartz, and petitions this Honorable Court as follows: 1. Plaintiff and Defendant are the parents of a minor son, Gregory Scott Milletics, I born January 18, 1996. 2. The parties have been operating on a shared arrangement of physical custody of their son, Gregory, alternating custody of him every two weeks. 3. A Complaint for Custody was filed with the Court on August 26, 1999 to have the custody situation reviewed so that a primary custody location may be established prior to the beginning of school in September, 2000. 4. A custody conference has been set before Michael L. Bangs, Custody Conference Officer, to be held on October 28, 1999. 5. Defendant has subsequently advised Plaintiff that she has enrolled Gregory in school even though he is only presently 3 % years old. 6. The current custodial arrangement is that Plaintiff has custody of Gregory from September 19, 1999 through October 3, 1999 and Mother has custody of Gregory from October 3, 1999 through October 17, 1999, alternating thereafter on said two week schedule. 7. Plaintiff desires to assure that Gregory continues to have good meaningful contact with both parents and that the status quo is maintained until this matter is resolved either at the custody conciliation conference level or through hearing with the Court. WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Interim Order confirming the current arrangement of the alternating two week schedule of custody of Gregory until the matter is ultimately resolved through a conciliation conference or Court hearing. TUCKER ARENSBERG & SWARTZ By: - ;° Sandra L. Meil n, No. 32551 ` P.O. Box 889, Harrisburg, PA 17108 (717) 234-4121 Dated:/ - Gl ?/ Attorneys for Plaintiff, Scott R. Milletics VERIFICATION I, Scott R. Milletics, acknowledge that the facts stated in the within document are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. cot R. Mi letics DATED: 647.1 n -' W u_ CJ S n ?:1 ii=1. c. r. r. j CT ?^ U CO) 03 s vim,°m U I xS F SEP 2 9 SCOTT R. MILLETICS, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW Y ;2EN E. KAMPIA, Defendant No. 99-5236 CIVIL TERM ORDER OF COURT AND NOW, this 12th day of October, 1999, upon consideration of Plaintiff's Petition for Emergency Relief, and following a hearing, the petition is granted to the extent that the alternating two-week periods of custody, which have been the custom of the parties, shall continue pending the custody conciliation conference on October 28, 1999, and further order of Court. The parties are encouraged to communicate with each other with respect to speech therapy for the parties' child. By the Court, Sandra L. Meilton, Esquire For the Plaintiff Michael Pykosh, Esquire For the Defendant wcy O J •Wesley Olejkl Jr., (/ .A. P. * ScoN 2? NCI\C?i CS Plaintiff V. * K.a?,? E , ?C,otv\P t a Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION LAW NO. Sc)3b CIVIL 19C(9 CUSTODY VISITATION And now, this IN U) I D , upon consideration of the attached complaint, it is hereby directed that the above parties and their respective counssell appear before Mt(h0 r L, ?S1G5 Esquire, the conciliator, at 3 Pennsylvania, on the \ f-?, day of .Y3ti n cal ,)=.at IV, 00 4gD/ P.M., for a Pre-hearing Custody Conference. At such conference, an effort will be made to resolve the issues in dispute; or if this cannot be accomplished, to define and narrow the issues to be heard by the court, and to enter into a temporary order. All children age five or older maybe present at the conference. Failure to appear at the conference may provide grounds for the entry of a temporary or permanent order. FOR THE COURT: By: 1d Custody Conciliator t l YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. THE CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE CARLISLE, PA 17013 (717) 249-3166 1-800-990-9108 ell ?, 1 l ?. ?ti SCOTT R. MILLETICS, : IN THE COURT OF COMMON Plaintiff : PLEAS, CUMBERLAND COUNTY, : PENNSYLVANIA V. CIVIL ACTION-LAW KAREN E. KAMPIA, Defendant : IN CUSTODY : NO. 99-5236 AND NOW this _ day of 1999, it is hereby ordered that primary Physical custody of the subject minor, Gregory Scott Milletics, shall be with his mother, Karen E. Kampia until final resolution; either through a custody conciliation conference or a court hearing if necessary. By The Court: J. SCOTT R. MILLETICS, : IN THE COURT OF COMMON Plaintiff : PLEAS, CUMBERLAND COUNTY, : PENNSYLVANIA V. KAREN E. KAMPIA, : CIVIL ACTION -LAW Defendant : IN CUSTODY : NO. 99-5236 RESPONSE TO PLAINTIFF'S PETITION FOR EMERGENCY RVIRE AND NOW comes Karen E. Kampia, Defendant, by and through her attorney the Law Office of Darrell C. Dethlefs, and in answer to Plaintiffs Petition avers as follows: 1. Admitted. 2. Admitted in part and denied in part. It is admitted that the parties have been operating on a shared arrangement of physical custody of their son, Gregory. It is denied that the alternating times for custody were exacting two week periods. 3. Admitted. It is admitted that a complaint for custody was filed with the Court on August 26, 1999. The complaint is a written document of which the content speaks for itself. 4. Admitted. 5. Admitted in part and denied in part. It is admitted that Defendant enrolled Gregory in the Head Start Program. It is denied that Defendant knew anything about the filing of the custody complaint at the time when Gregory was enrolled in Head Start. It is further denied that Gregory is too young to be enrolled in the Head Start Program. 6. Admitted in part and denied in part. It is admitted that Plaintiff and Defendant have been working on a shared schedule of physical custody with respect to Gregory. It is denied that said shared arrangement was always for a two week period. 7. The allegation as set forth in Paragraph 7 constitutes a Conclusion of Law to which no response is required. If the court should require a response, it is denied that Plaintiff desires to assure that Gregory continues to have good meaningful contact with both parents and that the status quo is maintained until this matter is resolved either by a custody conciliation conference or through a hearing with the court. WHEREFORE, Defendant respectfully requests that this Honorable Court enter an Interim Order awarding primary physical custody of Gregory to Defendant mother so that he may remain in the Head Start Program and receive the necessary therapy that he requires. AND NOW comes Defendant, Karen Kampia, who in further support of her answer to Plaintiff's Petition pleads the following new matter: 1. Gregory Milletics was evaluated by the Montgomery County Intermediate Unit and was found to have a need for speech therapy. 2. The minor child obtains this needed therapy through the Head Start Program. 2. The Head Start Program in which Gregory is presently enrolled has helped the aibresaid child with his self esteem and confidence. 4. The best interest of the minor child, Gregory Milletics, would be best served by awarding primary physical custody to Defendant and allowing Gregory to remain in the Head Start Program. WHEREFORE, Defendant respectfully requests that primary physical custody of Gregory Milletics be awarded to Defendant and the child remain in the Head Start Program. Michael J. Pyko Attorney I.D. 851 3805 Market Street P.O. Box 368 Camp Hill, Pa 17001-0368 (717)975-9446 SCOTT R. MILLETICS, IN THE COURT OF COMMON Plaintiff PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. No. 99-5236 KAREN E. KAMPIA, Defendant IN CUS'DDY I hereby verify that the statements of fact made in the foregoing DOCUMENTS, are true and correct to the best of my knowledge, information and belief. I understand that any false statements therein are subject to the criminal penalties contained in 18 Pa C. S. Section 4904, relating to unworn fasification to authorities. Date: r2 rl Karen E. Kampia SCOTT R. MILLETICS, : IN THE COURT OF COMMON Plaintiff : PLEAS, CUMBERLAND COUNTY, : PENNSYLVANIA v. • CIVIL ACTION -LAW KAREN E. KAMPIA, Defendant : IN CUSTODY : NO. 99-5236 I hereby certify that the foregoing Petition and New Matter in the above captioned matter was served upon the following by United States First Class Mail Sandra L. Meilton, Esquire P.O. Box 889 Harrisburg, Pa 17108 Respectfully Submitted by: 2-ic ael J. Pykosh Date: lC4(Qp I Attorney I.D. 58851 P.O. Box 368 Camp Hill, Pa 17001-0368 (717)975-9446 cw? ;j ` Ut ,J iJ I- SCOTT R. MILLETICS, Plaintiff vs. BY THE COURT, KARENE. KAMPIA, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 99-5236 CIVIL TERM CIVIL ACTION-LAW ORDER AND NOW, this 2 0?? day of .T.t-y? C 2000, upon receipt of the Conciliator's Report, it appearing that a hearing is necessary, it is hereby ordered and directed as follows: 1. A hearing is scheduled for the 1 day of? 2000, at / . 30 o'clock P.M., in Court Room Number / of the Cumberland County Court House, Carlisle, Pennsylvania. Both parties, through counsel, will provide each other and the court with a list of witnesses ten (10) days prior to the date of the hearing along with a statement as to their expected testimony. Additionally, both parties will submit their proposal for a resolution of the matter. Sandra L. Meilton, Esquire Michael Pykosh, Esquire mlb Ine" d//xW .w ?j -SLEY OLE R. J. 40?) V SCOTT R. MILLETICS, Plaintiff VS. KAREN E. KAMPIA, Defendant JUDGE PREVIOUSLY ASSIGNED: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 99-5236 CIVIL TERM CIVIL ACTION-LAW The Honorable J. Wesley Oler, Jr. CUSTODY CONCILIATION CONFERENCE SUMMARY REPORT IN ACCORDANCE WITH CUMBERLAND COUNTY RULE OF CIVIL PROCEDURE 1915.3-8(b), the undersigned Custody Conciliator submits the following report: 1. The pertinent information concerning the child(ren) who is(are) the subject of this litigation is as follows: NAME BIRTHDATE CURRENTLYIN CUSTODY OF Gregory Scott Milletics January 18, 1996 2. A Conciliation Conference was held on May 25, 2000, and the following individuals were present: the Plaintiff and his attorney, Sandra L. Meilton, Esquire; the Defendant and her attorney, Michael Pykosh, Esquire. 3. Items resolved by agreement: See attached Order. 4. Issues yet to be resolved: See attached Order. 5. The Plaintiffs position on custody is as follows: Father, as well as Mother, have been working on a two week on, two week off schedule with the child since the child was six months old. Father lives in Mechanicsburg and Mother lives near Philadelphia. Since the child is approaching school (apparently the child is in K4 or pre-kindergarten this fall), the parties want to modify the existing schedule because it will not work. Father's position is that he is better suited to have the child here during the school year. Father works locally for Bell and lives with his mother and father. His mother provides the daycare for the child. He notes that the parties resided together here and it is the Mother who removed herself from the area. He does not have any complaints with the Mother but he feels that he is better suited to be the primary custodial parent during the school year. 6. The Defendant's position on custody is as follows: Mother reiterates the position of the Father in that they need a change of the existing Order. She lives with her father, sister, and a special-needs brother. She works at the International House of Pancakes. Mother also has another child who was born on December 25, 1997. She has a shared custodial arrangement with that child's natural father. Apparently, the natural father lives close to the Mother near Philadelphia. This child was, of course, bom after the parties split up. Mother believes that she should have the child during the school year and that she is better able to care for the child during the school year. 7. Need for separate counsel to represent child(ren): Neither party requested. 8. Need for independent psychological evaluation or counseling: None requested and the Conciliator does not believe any is necessary. 9. A hearing in this matter will take four hours. 10. Other matters or comments: This is a case where there are two caring parents who really have nothing negative to say about each other. Unfortunately, however, the parties live some distance apart and as school approaches, someone needs to be the custodial parent during the school year. The Conciliator explained to counsel (who have also apparently explained to their clients) that the Court in all likelihood will maintain a shared arrangement but simply will modify it so that someone has primary custody during the school year and the other parent will have primary custody during the holidays and summer months. Additionally, since the parties live so close, it is the perfect situation whereby the parent who is the non-custodial parent during the school year should have more regular weekend visitation, perhaps rotating on a three on, one off basis, so that the parties still have a pure shared arrangement as they are operating under now. The parties have been working on a two week on, two week off schedule since the child was six months old. The Mother did remove herself from Mechanicsburg to Philadelphia so the Court will have to inquire as to why that occurred and if that should be a factor in its determination as to who should have primary custody of the child during the school year. Unfortunately, because of the Father's job and because of Mother's other child, neither one has the ability to move and the Court simply has to make a decision as to who is going to be the primary custodian of the child while the child is in school. Given the fact that there is not any fitness issues or other unusual issues, the Court should not have to take a lot of testimony in this case. Date: June 13, 2000 6? Z Micha I L. Bangs Custody Conciliator JUN 19 2CO12 SCOTT R. MILLETICS, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW KAREN E. KAMPIA, Defendant No. 99-5236 CIVIL TERM IN RE: PLAINTIFF'S COMPLAINT FOR CUSTODY BEFORE OLER. J ORDER OF COURT AND NOW, this 1st day of September, 2000, upon consideration of Plaintiff's complaint for custody with respect to the parties' child, Gregory Scott Milletics (date of birth, January 18, 1996), and following a hearing held on August 31, 2000, it is ordered and directed as follows: 1. Legal custody of the child shall be shared by the parties. 2. Primary physical custody of the child shall be in the mother. 3. Temporary or partial physical custody of the child shall be in the father at the following times: a. On alternating weekends, from Friday at 7:00 p.m. until Sunday at 5:00 p.m.; provided, that when a federal holiday falls on a Monday on such a weekend, the period of partial or temporary physical custody shall extend to Monday at 5:00 P.M. b. During Christmas vacation, from December 26 at 5:00 p.m. until January 2 at 3:00 p.m. 4. Notwithstanding the foregoing, during the summer, the father shall have custody of the child for five consecutive weeks at the beginning of the summer and five consecutive weeks at the end of the summer; the mother shall have custody of the child for one week between the said five-week periods. 5. Transportation of the child shall be the responsibility of the parent receiving custody. 6. Nothing herein is intended to preclude the parties from varying the terms of this order by mutual agreement. By the court, ley Oler, J, Sandra L. Meilton, Esquire V P.O. Box 889 Harrisburg, PA 17108 For the Plaintiff Michael Pykosh, Esquire /-"- 3805 Market Street Camp Hill, PA 17011 For the Defendant R?5 wcy