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HomeMy WebLinkAbout06-29-101N THE COURT OF COMMON PLEAS OF In re: :CUMBERLAND COUNTY, PENNSYLVANIA Alisha Sharpe :ORPHAN'S COURT DIVISION CIVIL ACTION -ADJUDICATION OF :INCAPACITY AND APPOINTMENT OF A : GUARDIAN OF THE PERSON AND OF THE :ESTATE ~ G ~o ~~ ~ xn -, _,~ ~ -~ : ~_ -~ - ~"- " ~: PETITION OF DONALD ROCHELLE AND JESSICA SHARPE SUPPORTINE~ ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A GUARDIAN OF THE PERSON AND OF THE ESTATE OF ALISHA SHARPE AN INCAPACITATED INDIVIDUAL PURSUANT TO 20 Pa.C.S. CH. 55 TO THE HONORABLE JUDGES OF SAID COURT: The Petitioners, Donald, Rochelle, and Jessica Sharpe, residing at 836 Franklin Street, Carlisle, Pennsylvania, 17013, depose and say: 1. Donald, Rochelle, and Jessica Sharpe are the named Petitioners in the above titled civil cause of action and Alisha Sharpe is the allegedly incapacitated person. 2. Donald and Rochelle Sharpe are the parents of Alisha Sharpe. 3. Jessica Sharpe is the adult, older sister of Alisha Sharpe. 4. This petition is to inform the Court as to the incapacity of Alisha Sharpe and to appoint Donald and Rochelle Sharpe as joint and several, primary legal guardians r -a -_, of Alisha Sharpe's person and of her estate, and Jessica Sharpe as secondary legal guardian of Alisha Sharpe's person and of her estate. 5. Alisha Sharpe turned eighteen (18) years old on March 8, 2009, has never been married, and resides at home with her father, Donald Sharpe, her mother, Rochelle Sharpe, and her sister, Jessica Sharpe, at 836 Franklin Street, Carlisle, Cumberland County, Pennsylvania, 17013. 6. The name and address of Alisha Sharpe's primary physician is: Dr. William J. Phelan 2 Tyler Court Carlisle, PA 17013 7. The name and address of Alisha Sharpe's neurologic specialist is: Dr. Todd Barron We11Span Medical Group WellSpan Neurology - Peds 370 Charles Way York, PA 17402 8. The name and address of Alisha Sharpe's special education provider is: Carlisle Area School District 623 West Penn St. Carlisle, PA 17013 9. The name and address of Alisha Sharpe's support services provider is: Cumberland and Perry Counties' Mental Health and Mental Retardation Program Renee Snyder, Supports Coordinator 16 West High St., Suite 301 Carlisle, PA 17013 10. Guardianship of the person and of the estate is being sought because Alisha Sharpe suffers from mental retardation and has a history of Complex Partial Seizures which were first diagnosed in 1996. Her conditions impair her capacity to make and communicate decisions. This petition is instituted to aid and benefit Alisha Sharpe. The nature of Donald and Rochelle Sharpe's relationship with Alisha Sharpe is that of parents and caretakers. Donald and Rochelle Sharpe have been the primary caretakers for Alisha Sharpe since she was born. Jessica Sharpe's relationship with Alisha Sharpe is that of an older sibling. Jessica Sharpe assists her parents, Donald and Rochelle Shape, in caring for her sister, Alisha Sharpe. 11. Alisha Sharpe is incapacitated as defined in the Decedents, Estates and Fiduciaries Code at Title 20 Pa.C.S. §5501. She is an adult whose ability to receive and evaluate information effectively and to communicate decisions is impaired to such a significant extent that she is totally unable to manage her financial resources and to meet essential requirements of her physical health and safety. 12. On August, 6, 2009, Kara Perella, Certified School Psychologist of the Carlisle Area School District, performed a psychological evaluation on Alisha Sharpe. Ms. Perella reports that Alisha Sharpe has a Full Scale IQ of fifty-one (51). On the Woodcock Johnson Tests of Academic Achievement, Alisha Sharpe scored as functioning at a Kindergarten or First grade level in Reading, Math and Spelling. Alisha Sharpe's performance in this evaluation was found to be consistent with cognitive testing done in previous years and to continue to support a classification of Mental Retardation. A letter from Ms. Perella to the undersigned certified legal intern dated February 8, 2010 and a Reevaluation Report from the Carlisle Area School District dated September 11, 2009 are attached to this petition, as Petitioners' Exhibits 1 and 2 and are incorporated herein by reference. 13. The Petitioners have made efforts to allow Alisha Sharpe to retain as much autonomy as possible. However, she continues to be dependent upon others to assist her in all aspects of her life. Because of Alisha Sharpe's mental retardation, she is unable to make responsible decisions concerning her person, health, welfare, finances, and safety. Alisha Sharpe is unable to independently communicate her needs, tend to her personal hygiene, medicate herself or provide for her own personal safety. 14. No other guardian of the person or of the estate has been appointed for Alisha Sharpe by any court. 15. All less restrictive alternatives to the appointment of a guardian of the person and of the estate have been considered. The Petitioners believe that such alternatives would be ineffective. 16. The type of guardianship of the person and of the estate sought by Petitioners is plenary. 17. The Petitioners are qualified to be Alisha Sharpe's guardians because they are interested in her welfare and have no interests adverse to hers. WHEREFORE, Petitioners respectfully request that this Court adjudicate Alisha Sharpe an incapacitated person and assign to Petitioners Donald and Rochelle Sharpe joint and several primary powers of guardianship of the person and the estate of Alisha Shape, and if Donald and Rochelle Sharpe become unwilling, unable, or unavailable, assign to Petitioner Jessica Sharpe secondary powers of guardianship of the person of and of the estate of Alisha Sharpe. Date: ` ' ~ (~ VERIFICATION 1 ~/ _` Rachel Thiessen Certified Legal Intern Robert E. Rains Supervising Attorney The Disability Law Clinic 45 North Pitt Street Carlisle, PA 17013 (717) 243-3696 We verify that the statements made in the foregoing PETITION SUPPORTING ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A GUARDIAN OF THE PERSON AND OF THE ESTATE are true and correct, to the best of our knowledge, information and belief. We understand making a false statement would subject us to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsifications to authorities. Date: ~-a-~--rte- onald Sharpe Petitioner %`~ Date: ~ ~ ~ _ ~ c~ ~ ~, Rochelle Sharpe Petitioner n Date: y " ~ ~" ~ ~ o r ~" ~ ~~' Je sica Sharpe P titioner NOTARIZED On this, the ~ day of ~ .l.-,c~r~f , 2010, before me, /;',~z,~~:;;~;%',"f y~~%~~' Notary Public of the Commonwealth of Pennsylvania, the undersigned officer, personally appeared Donald Shame ,known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Verification, and acknowledge that he executed the some for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. r L-- , ' "'~'~~ ' I ~ Notary Public LINDA M. CARVER NOTARY PUBLIC MY COMtv1S~ ON~EXP RE S DEC~22~2010 My Commission Expires: <" Date On this, the ¢ day of C ~,~~s~, 2010, before me, U='~~=>~-r ; ~`% Notary Public of the Commonwealth of Pennsylvania, the undersigned officer, personally appeared _Rochelle Sharpe ,known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Verification, and acknowledge that he executed the some for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. ~? ~. ', iA~ `, ~ ~~-- Notary Public LINDA M. CARUFrt iti~ n2, p-;=-~ ~ cARI_IS~EaoP~ ~~~~~;;r4~,,N~; ~ My Commission Expires: MY CGIv1P~~11SSION Ch(li?ES ACC. t2. ~.'G ; t .~~~.= r-.a_~.J ~~ ~ G'1 L ~ ~~ ~~~ 1 ~ r. ' ~~~~-. Date On this, the ,~_ day ofj",~ ~ , 2010, before me,/ ~. ~,/;r,% %' ~; ~~'. ~a Notary Public of the Commonwealth of Pennsylvania, the undersigned officer, personally appeared _ Jessica Shame ,known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Verification, and acknowledge that she executed the some for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. ,,~,,~ Notary Public M. Date My Commission Expires: t _ 4, ~.,. /yea Scho~ /~ ' ... :_ ~, v ry: ~C.A,g.01 2/8/ 10 Disability Law Clinic 45 North Pitt Street Carlisle, PA 17013 Dear Ms. Thiessen, CARLISLE AREA SCI-IOpL DISTRICT 623 W. Penn Street Carlisle, Pennsylvania 17013 Telephone: 717-240-6800 MRn,/ Kai Durltan~i, Superintendent The purpose of this letter is to clarify and inform the Disability Law Clinic and related parties of assessments conducted within aschool-based reevaluation report for Alisha Sharpe. Alisha participated in Subtests from the Woodcock Johnson Tests of Cognitive Ability, Third Edition (WJCA- III) on 8/5/09 and the Wechsler Abbreviated Scale of Intelligence (WASI) on 8/6/09, which were administered by Kara L. Perella, Certified School Psychologist. These tests were used to assess Alisha's cognitive abilities within the context of a reevaluation report as requested by Alisha's parents, Mr. and Mrs. Donald and Rochelle Sharpe. Alisha's performance on the WJCA-III provided information regarding Alisha's cognitive skills, but a reliable General Intellectual Ability (GIA) from the WJCA was not obtained due to Alisha's behavior indicating a lack of understanding of two of the tasks. However, Alisha performed within the "very low range" on all of the tasks administered on the WJCA with all of her standard scores at 40 or below. A WASI also was administered to provide another estimate of her overall ability on 8/6/09. Her Verbal standard score, which represented the Vocabulary and Similarities tasks was 55 and fell at the 0.1 percentile rank, which identifies her as doing better than less than 0.1 students her same age. Alisha's standard score for the Performance tasks which represented her performance on Block Design and Matrix Reasoning was 54, which fell at the 0.1 percentile rank. Alisha's Full Scale IQ, which is an overall estimate of her cognitive ability, was 51, which fell at the 0.1 percentile rank. All scores were based upon Alisha's age at the timing of testing, which was 18 years, 5 months. Alisha's performance on the WJCA-III and the WASI was consistent with cognitive testing done in previous years based upon her school assessment records, and along with rating scales and reports that indicate adaptive deficits, continue to support her previous classification of Mental Retardation. Please contact me with any additional questions at 717-240-6800 x 17816. Sincerely, Kara L Perella Certified School Psychologist ~P Qd ... ~~ .C'.gRcJ,.O~ '.~A.~~~~~ AREA 'SC;~`~~L ~ISTRI~T' ~S~ee~~l ~~>~ea-~o>a . 623 West Penn ~S~reet ~Carl~sle, PA 17013 3~~U.A~UA~`SON .RUP.O~T (RR) School Age DEMOGRAPHICS DATE OF REPORT: 9/11/09 DATE REPORT WAS PROVED TO T1~E PARENT: 9/11/09 STUDENT NAME: Alisha E. Shame GENDER:Female STUDENT BIRTH DATE: 3/8/91 AGE: 18 SOCIAL SECURITI' NUMBER: 052-80-1239 ET)EINIC BACKGROUND: Black. not Hispanic Orin DISTRICT OF RESIDENCE: Carlisle COUNTY OF RESIDENCE: Cumberland County Student Address Home Phone Number R-MaII -address .836 Franklin Street, Carlisle, PA 17013 717-258-9740 Additional Contacts & Addresses Relationshi to Child Phone Agency Type Name Address Type Number E-Mail Address Parent/Guardian with whom the child Lives Father Donald Sharpe NA Work 717-249-4422 Parent/Guardian with whom the child Lives Mother Rochelle Sharpe NA Cell 717-385 2703 SCHOOL STUDENT IS ATTENDING: Boiling Snrinss High School GRADE: 11 TEACSER: 7anice Zink CURRENT EDUCATION PROGRAM: Life Skills, Speech/Langtzaee and Occupational TheraQy Date IEP Team Reviewed Existing Evaluation Data: 9/24/09 The IEP team must decide if it has enough data to determine: the student's educational needs; the present levels of academic achievement and related developmental needs of the student; whether any additions or mod cations #o the special education and related services are needed to enable the student fo meet the measurable annual goals in the IEP and to participate as appropriate in the general education curriculum; and whether the student continues to need special education and related services. DIST~.IBUTE TO: ti'/ Parent/Guardian Support Teacher Physical Therapist Guidance Office (middle/high school levels) _ Special Education Office . Speech/L.anguage CIinician Vocational Education Office Psychologist Occupational Therapist Other: Building Principal (elementary level) RR for Alisha.E. Sharpe I. SUMMARIZE INFORMATION REVIEWED Complete items 1~7~for all students. 1. Physical condition, social, or cultural background, and adaptive behavior relevant to the student's disability andneed for special education: Physical: Alisha's records indicate that she was diagnosed with Complex: Partial Seizures in 1996/1997, and had taken Depakote beguming 9/10/08. During an unstructured parent interview.conducted on 8/6/09, Alisha's mother reported that Alisha has been seizure free since elementary school. She also has not taken medication for her seizure disorder since then. She continues to be followed by a neurologist. Ms. Sharpe reported that Alisha was diagnosed with Scoliosis approximately 2 years ago, and has participated in Physical Therapy, which also includes weekly horseback riding. Alisha is allergic to Bee Stings, and wears glasses. However, Ms. Sharpe suggested that it had been difficult getting her vision tested and hypothesized that Alisha may not need her glasses. She wears them only at school. No difficulties with hearing were reported at this time. Social: History of School Attendance/Special Education Services: Alisha attended school at Bellaire Elementary School within the Carlisle Area School District (CASD) during Kindergarten and 1" grades. She participated in counseling fort months at Stevens Mental Heath Center in 1997. She has participated in Speech and Language Services since entering school. She participated in'/z day Kindergarten and'h day Learning Support during a second Kindergarten yeaz. She continued in the Learning Support class while participating in Occupational Therapy in 1 S` grade. AIisha participated in the Diagnostic Classroom at Mooreland Elementary within the CASD during her.3'~ grade year. In ~4a' grade, Alisha went to Crestview Elementary within the CASD, .and received Learning Support services as well as OT and Speech. She has participated in the I:ife Skills classroom at the Yellow Breeches Middle School and the Boiling Springs High School within the South Middleton School District. She completed her 10a` grade year during-the school year prior to the .writing of the currentreevaluation report. She is currently identified as meeting special education classification under Mental Retardation and Speech.and Language Impairment. Cultural: Alisha speaks English as her first IanDuage. Her ethnicity is listed as Black, Not Hispanic. No other LTlformation relevant to culture was reported for this reevaluation. Adaptive: Alisha has received Speech and Language services since entering Kindergarten. She also began receiving Occupational Therapy during her 1 ~` grade school .yeaz. Speech Asessment Information: Ms. Karen Etter, Speech Clinician, provided the following information about Alisha: "Alisha is an 1 S-year old female referred for a reevaluation to assess current speech and langaage functioning. This student currently attends Yellow Breeches Highschool where she receives speech and language support. AIisha participated in a speech and language evaluation on August 19, 2009. She was escorted to the evaluation by her mother and sister. She willingly entered into the evaluation room with the examiner. During the evaluation, Alisha made minimal eye contact with the examiner when spoken to. She kept her head in a downward position with her eyes directed toward the floor during communication attempts made by the examiner. Conversation wes difficult to engage the student in at the time of the evaluation. Alisha utilized a soft vocal volume when answering questions posed by the examiner, making it difficult to identify what the student was trying to convey. The student did not initiate conversation with the examiner at the time of the evaluation. The Goldman Fristoe Test of Articulation 2 was attempted, however the student was reluctant to verbalize or repeat the items presented Therefore a score was unable to be obtained at the time of testing. This test was also revisted as the testing session continued and as the student appeared to become more comfortable. However a score was unable to be obtained. The Receptive One Word Picture Vocabulary Test was administered to assess this student's current ability to identify vocabulary. Alisha participated in this evaluation without difficulty and was able to complete the exam. Standard scores between 85-115 are PDEBSE EVALUATION REPORT (Rev. 8/2008) Page: 2 RR for Alisha E. Sharpe considered to be within normal Iimtits. Upon completion of this assessment, Alisha received the following scores: Standard Score: 57; Percentile, Ranlc <l. This assessment reveals receptive language scores falling significantly below the average range, which would impact her understanding of vocabulary presented in a regular education text. The Fxnressive One Word Picture Vocabutarv Test was administered to assess Alisha's ability to name vocabulary and provide category names provided a set of related items. Alisha was able to participate in this exam, although at times when she was unsure of an answer, she would just sit there and not say anything. She required prompts to say " I don't know" when unsure of an answer. Standard scores falling between 85-115 are considered to be within normal limits. Upon completion of this assessment, Alisha received the following scores: Standard Score: 55, Percentile Rank: 1. It is expected that an individual's receptive language is higher than the expressive language. Conclusions of these assessments indicate that Alisha's receptive language is slightly higher than her expressive language. Although these two scores do not indicate a discrepancy they do fall significantly below the average range. AIisha's current language functioning would impact her ability to successfully participate within a regular education setting. Speech and language support continues to be recommended to improve language and communication skills in order to successfully participate within a classroom setting." Occupational Therapy -Present Educational Levels August2009 Submitted by: Dawn Toutkaldjian, OTR/L Fine Motor Skills: Alisha receives occupational therapy consultative support for 20 minutes .per marking period. Although she demonstrates left hand preference for writing tasks and most of the other fine motor tasks explored .today, she uses her right hand on the scissors for cutting activities. During fine motor tasks, .she uses her non-preferred hand functionally for assistance when familiar with the task. With less familiar fine motor activities presented today and as reported, Alisha becomes easily frustrated and needed simplified one step directions to be a more successful participant in the learning process. Hand Writing Skills: During hand writing tasks, Alisha continues to use a functional tripod grasp with her left hand and uses her right hand to stabilize the paper. Her hand writing mechanics are functional for the writing demands at school, including weight bearing and isolated finger movement. Alisha can print the upper and lower case letters of the manuscript alphabet from a model and her letter formations are easily legible and automatic for her. The K, k, X & x are slightly less legible but still recognizable. When working on improving the legibility of these letters and copying other less familiar designs, Alisha demonstrates some frustration when motor planning the formation and sequencing of the model. She can copy a sentence with over 80% legibility for word recognition and spacing of words and letters and sizing is functional although slightly larger than expected. Her tail letters are often placed on the writing Line but this does interfere with readability. Overall, when given a model to copy, Alisha's writing. legibility is very functional. Cutting and Motor Planning Skills: During cutting activities, Alisha uses her right hand on the scissors in an appropriate thumbs-up position. Her left hand is used cooperatively with the right to stabilize the paper. She can cut a straight Line accurately and a curved and angled Line within 1/16" accuracy. Her attention is very focused on the task and her cutting line is slightly segmented as the difficulty increases. Overall, Alisha shows functional cutting skills, including the cooperation of her two hands together. Again, if the task of assembling a cutting project is less familiar to her or too much of a challenge, she can demonstrate frustration in the area of motor planning and needs more assistance to help her navigate and motor plan each step. Self Help Skills: Alisha is independent with familiar self help skills at school, including book bag management, donning and doffing her coat, the lunch routine, and personal hygiene. She did have difficulty last year changing clothes for her swimming class: With instructions to help her work through this task, she eventuall}~ became successful and confident. This new school year Alisha will be participating in the CIT program. She may need modifications for the job tasks and extra prompting and assistance getting acquainted with the new setting. Impressions: Alisha appears to be successful in fine motor tasks that she is familiar with, including cutting and hand writing, and needs additional time, modifications and/or assistance to be successful in new settings or with new tasks. When she can't figure out a new motor planning task, she can become frustrated and emotional very quickly and needs assistance to work through these difficulties. It is recommended that the team consider continuing OT services on a quarterly basis. Strengths Functional fine motor shills with familiar tasks Independent with familiar self help skills Functional printing skills PDEBSE EVALUATION REPORT (Rev. 8/2008) Page: 3 RR far Alisha E. Sharpe Needs Continue experience with vocational preparation skills Continued experience with community living shills ILecommendations: I. Alisha may need modifications for new tasks, including job tasks in a new setting such as CIT. Repetition, single step practice and chaining steps together may be some types of modifications needed to decrease her frustration and improve. her initial success and motivation to continue the~task. 2. Continue to provide OT consultation .quarterly on a consultative basis (20 minutes per quarter) for self help and vocational skills in the educational setting. Adaptive Behavior Assessment System- Second Edition (ABAS-FII; The Adaptive Behavior Assessment System- Second Edition (ABAS-II) was used to assess Alisha's adaptive skills. This scale identifies three adaptive domains and a General Adaptive Composite (GAC). The three .domains are: Conceptual which looks at the skill areas of communication, functional academics, and self-direction, Social which looks at leisure time and social activities, and Practical which assesses community use, school living, self-care skills, and health and safety. The General Adaptive Composite is the total score by combining the six different skill areas. Standard scores (SS} between 90.and 109 are considered in the average range of functioning. Ms. Janice Zink, Alisha's Life Skills Teacher, completed the teacher checklist. and Ms. Sharpe completed the parent checklist on 8/6/09. The scores are as follows. Parent Teacher SS PERCENTILE SS PERCENTILE Conceptual 49 <0.1 53 0.1 Social 5~5 0.1 68 2 Practical 40 <0:1 52 0.1 •EsAC ~0 <03 -53 01 The GAC represents a comprehensive and global estimate of an individual's.adaptive functioning. It.generally.provides the most complete measure of an individual's adaptive behavior and is likely to be the most reliable and accurate estimate of an individual's overall adaptive functioning. Alisha obtained a General Adaptive Composite score of40 on.the parent.checkiist and. a score of 53 on the teacher checkdist. AIisha's overall level of adaptive behavior is within.the mentally deficient range. of functioning and supports her diagnosis of Mental Retardation. Some behaviors.that.Alishawri marked by her mother as performing.consistently include: saying the names of known others, respondinD by shaking her head "yes" or "no".for simple questions, listens. closely when.people talk, states her telephone number, reads and writes .herfirstname, states day and time of favorite television shows, follows a daily schedule, puts thinga away when finished using them, keeps belongings neat and clean, makes her own: bed, swallows Liquid medicine when needed, buckles seat belt in car, follows general safety rules, carries scissors safely, uses electrical sockets safely, plays alone, looks .at books or magazines during free time, follows Hiles in games, listens .to music for fun, uses a fork to eat solid food, washes hands with soap, blows and wipes nose with a hankerchieij drinks liquids without spilling, bathes daily, dresses herself, controls temper, has good relations with parents and older adults, stands a comfortable distance from others when having a conversation, shows sympathy for others when they are:ugset, -shows positive attitude about job, and behaves safely/follows rules at job, However, Alisha struggles with many other behaviors such.as taking turns in conversation with others, answering the telephone appropriately, .finding the restroom in public places, .carrying money for small purchases, thaking simple meals, calling for help when someone is hurt, swallowing pills when needed for illness, tying her own shoes, using public restrooms alone, combining hot and cold water for a bath, cutting meat into bite size pieces, cutting nails and fingernails on own, and e~.~pressing emotions when sad, happy, scared, or angry. I~.s. Zink :commented on this form that "Alisha has entered .the wrong restroom at times", and noted that "The class does. not travel more than 50 miles from home". With functional academics, Ms. Zink stated that "Alisha cannot read cursive writing. Alisha tells time to the hour". She also noted that regarding school behaviors, `Alisha must be verbally prompted to perform" all of the tasl~. She does not get homework. Furthermore, she described "One of my major concerns with Alisha is that she will not express her physical needs (thir st3~, bathroom, hot/cold, or pain). She needs to be prompted to do this and often says nothing and starts crying. She refuses to make eye contact, even v<2th prompting. Alisha has verbally expressed her desire to work at CIT! She responds to men more than women". PDEBSE EVALUATION REPORT (Rev. 8/2005) Page: 4 RR for AIisha E. Sharpe Additional Information from IEP: "AIisha does not respond to direct questions, although sometimes she reduces the amount of information she could respond with and uses a very soft voice. Other times she responds to questions quite appropriately and with good vocal.volume. AIisha often needs teacher cues to respond to peers when they initiate conversation with her. Her teachers report that her• spontaneous social comments have increased in the classroom. AIisha can be inconsistent in repeating teacher models for responding to peers or engaging with them in conversation. Sometimes she will repeat the models easily and other times, she i.s reluctant.to engage. She is inconsistent in complying with teacher cues to face or look at a person she is tallcing to. Although AIisha is a verbal communicator, she responds well to the use of icons to engage in instruction with her peers. Continued use of icons is suggested as a way to increase daily communication." 2. Evaluations and information provided by the parent (or documentation of LEA's attempts to obtain parental input): Parent Evaluation Report: Ms. Sharpe completed a Parent Evaluation Report on 8/5/09. She described Alisha's strengths with the following information: "Alisha likes music, going to the movies, and horseback riding. She enjoys reading activities and enjoys looking at books. She also likes to practice copying sentences in her journal". Alisha's needs were stated as: "AIisha has difficulty with functional Reading and Math skills. She also has trouble with Handwriting in regards to size and spacing. Another need ofAIisha's is to improve social skills (i.e. eye contact, initiating, and holding a conversation). Regarding her academic ability, Ms. Sharpe indicated that "AIisha is doing very well with the Edmarlc survival words and Signs. AIisha is cooperative and completes most tasks in a timely manner when given to her. She has had a lot of success through small steps in the classroom". With friends and adults, AIisha was described.in the following way: "Alisha is easygoing and gets along well with friends and adults. However, when interactng with friends, she tends to interact in a passive manner. Alisha will speak to adults, but tends to look away and keeps her had to the side while tallcing". Furthermore, with family: "AIisha has a very positive relationship with all of her family members. She makes conversations, laughs, and smiles. She enjoys interacting with her family and is vey close to her family". Other information about home included: "AIisha has difficulty completing chores or tasks that involve more than 1-2 steps. She generally needs to be prompted in order for her to remember what she needs to do". Ms. Sharpe also commented that medically "AIisha has Scoliosis and this gives her great difficulty when she has to take Long quick walks or sit for long periods of time". Ms, Sharpe also indicated that Alisha's neurologist mentioned that "AIisha appears to have/present Autistic-like manners an characteristics". 3. Aptitude and achievement tests: Cognitive Ability: Alisha's performance on measures of cognitive abilit}~ from prior reevaluation reports are summarized below: Stanford-Binet Intelligence_ Scale- 4~' Edition: 12/96 Verbal Reasoning- 70 Abstract/Visual Reasoning- 59 Quantitative Reasoning-70 Short-Term Memory- 60 Stanford-Binet Intelligence Scale- 4`~' Edition: 3/99 Verbal Reasoning- 53 Abstract/Visual Reasoning- 47 Quantitative Reasoninb 68 Short-Term Memory- 45 Composite Score- 44 Current Cognitive Assessment: AIisha participated in two standardized batteries of cognitive ability: The Wechsler Abbreviated Scale of Intelligence (WASI) and the Woodcock Johnson Tests of Cognitive Ability, Third Edition (WJCA-II17. Her results were as follows: Woodcock Johnson Tests of Cognitive Abiliri~, Third Edition (WJCA)• Subtests from the Woodcock Johnson Tests of Cognitive Ability, Third Edition (WJCA) was used to assess Alisha's cognitive abilities or aptitude on 8/5/09. The WJCA can be described by three broad domains: Verbal Ability, Thinking Ability, and Cognitive Efficiency. All scores are based upon Alisha's age at the timing of testing, which was 18 years, 5 months. PDEBSE EVALUATION REPORT (Re~~. 8/2008) Page: 5 1tR for Alisha E. Sharpe Verbal Ability: On tasks of verbal ability, ~.li ha performed in-the very low range when asked to provide the names of pictures orally, identify opposite and similar words, and provide a word to complete analogies (Verbal Comprehension}. Thinking Ability: Alisha's thinking ability-was a product of the following activities: learning pictographicallyrepresented words (Visual-Auditory Learning), identifying the component parts of an object among an array of six possible component parts (Spatial Relations), putting together sound segments to .create .areal word (Sound Blending), and using inductive logic to derive rules to visual puzzles (Concept Formation). Collectively, Atisha performed in the very lowrange on activities related to Thinking Ability. Cognitive Efficiency; Cognitive Efficiency was a measure of automatic cognitive processing and is based on tasks involving quicky circling similar numbers in a row of six numbers (Visual Matching) and recalling a series of numbers backward (Numbers Reversed). While sample/practice items were provided for each type of task, Alisha did not demonstrate adequate understanding on these two tasks, and thus,. scores were not able to be obtained. However, based upon her performance and previous scores on cognitive testing, it is likely that she will have difficulties on tasks requiring her~to recall information .and complete visual scanning tasks quickly. Wechsler Abbreviated Scale of Intelligence (WASH: While Alisha's performance on-the WJCA provides informationregarding Alisha's learning and cognitive skills, areliable General Intellctual Ability (GIA) from the WJCA was not obtained due to AIisha's performance on two of the.tasks. Therefore, a WASI was administered to provide a more definite estimate of her overall ability on 8/6/09. Alisha performed within the e~.~tremely low range a.^ross tasks. She had to identify and describe pictures (Vocabulary), put together blocks to represent.amodel or picture (Block Design}, indicate or describe howtwo items were alike (Similarities);.and complete visual puzzles (Matrix Reasoning). Her Verbal standard score, whichrepresentedtpe Vocabulary and Similarities tasks was:55 and fell.at the 0.1 percentile rank, which identifies her as doing better than less than 0.1 students her same age. Alisha's -standard score for the Perfonnance.tasks which represented her performance on Block Design and Matrix Reasoning was. 54, which fell at the 0.1 percentile rank. Alisha'.s Full Scale IQ, which is an overall estimate of her cognitive abilty was 51, which fell at the 0.1 percentile rank. Academic Achievment: Alishaparticipated in subtests from the Woodcock Johnson Tests of Academic Achievement, Third Edition (WTfA-III) on 8/5/09 and 8/6/09 to provide information regarding her academic achievement. Her results are described below. Reading: Alisha was able to identify letters and some words as well as read some words in isolation for Letter-Word Identification. Alisha read the following words: "to" "do " "in" "care" " et" "was" "have" ~" they" "about" "could" and "because" but was unable to read s g ~ s ~ a° s s > > > > > words such as "as", "must", "when", "there", and "only".For Passage Comprehension, Alisha was able to identify pictures out of an array that matched a word or few words and filled in a word that made sense within a sentence with apicture cue, but was unable to fill inwards for most of the sentences. Overall, her performance on reading tasks fell within the very low range based upon others her same age, suggesting that her reading skills are comparable to most students at the 1 °t grade level. Math: Alisha was presented with paper and pencil math problems for the Calculation subtest, which she attempted, but did not lead to any correct responses. For example, Alksha wrote a " 2" to complete " 2+2=", a "I" to complete "1+1=", and a "4" to complete "2+4-=", When required to answer questions r awarding math reasoning for Applied Problems, Alisha was able to demonstrate an .understanding of counting, identified time to the hour, and named coins, but was unable to complete items that required addition or subtraction. Her performance on math items fell within the very low range and is comparable to most students at the Kindergarten level. SpeIIing: Alisha also completed the Spelling task, which required her to write letters and words verbally presented to her. While Alisha was able to write some letters, she was unable to write any words. It should be noted that when asked to write her name on the outside of her workbook for these subtests, Alisha was able to do so, but many of her letters overlapped in a way that made it difficult to read. Her performance on Spelling was within the very low range and also fell'at the level that most Kindergarteners would achieve. Overall, Alisha's performance on tests of academic achievement suggest skills that fell within a range typically expected for most Kindergartener and 1 ~` graders, and is consistent with what would be expected based upon her cognitive abiIit~~. PDEBSE EVALUATIOl~T REPORT (Rev. 8/2008) Page: 6 RR for Alisha E. Sharpe 4. Current classroom based assessments and local and/or state assessments: Classroom Based Assessments: The following information was taken directly from Alisha's most recent Individualized Education Program (IEP) dated 3/09: . "Reading: Alisha is reading at a Pre-K reading level. She has completed the Signs Around Us-Boot: 2, in the Edmarh Functional Words Series,~mastering a1150 words with 99% accuracy. She has mastered 13 words in the Edmarlt Sob/Work Words, Boolc 1. Her rate of word recognition is 99% and her accuracy on her worksheets is 99%. Alisha is able to read the words in the daily calendar exercise each day. She can recognize the names of the months, days and names of her classmates. Math: Alisha is able to count to ten with 99% accuracy when asked, but does not grasp the concept of one-to-one correspondence when asked to count items. Her accuracy is inconsistent when counting above 10 and recognizing numbers greater than 19. When working with money, Alisha is able to recognize pennies consistently and she knows they are worth one cent. She confuses nickels and dimes and their values. When asked to find quarters in a mixed group of coins, Alisha is able to fmd them, but does not lrnow their value. She does not grasp the concept of the value of money and has difficulty discriminating between which .costs more and/or less. Alisha is able to consistently tell time to the hour. She needs prompting to tell time to the half hour and often misreads the hour hand. She has difficulty telling time to the quarter. hour. Writing: Alisha's writing shills are Iimited. She uses a weighted pencil which helps her control her pencil better, malting her writing more legible. When given a prompt, she is able to write short lists with prompts in spelling." 5. Behavior Assessments: Unstructured Parent Interview: h7 an unstructured parent interview with the school psychologist, Ms. Sharpe reported on 8/6/09 that there have been concerns noticed by herself Alisha's neurologist and a speech clinician in the past involving aspects of her behavior. Ms, Sharpe reported that in the last approximately 2 years, Alisha has picked at her hands and fingers, made unusual hand movements, and hummed in a way for which Alisha does not seem to be aware. Furthermore, Ms. Sharpe described a behavior where Alisha will loop over one of her shoulders as if she sees something. Alisha has also exhibited being teary-eyed without apparent cause of late. Ms. Sharpe reported that Alisha's neurologist has suspected an Autism Spectrum Disorder. While those behaviors described have emerged more recently, Ms. Sharpe descn'bed that Alisha has always been "particular with certain things". An example she gave was that Alisha would Line up her food at lunch during middle school. However, Ms. Sharpe indicated that Alisha does not typically react outwardly when something. is disrupted. Alisha does not seem to understand the difference between friends and acquaintances, and has difficulty connecting with her peers. The Behavior Assessment System for Children. Second Edition BASC21: The Behavior Assessment System for Children, Second Edition (BASC2) is a system of integrated forms for students aged2 through 25 used to provide assessments of their social, emotional, and behavioral functioning. Rating scale scores from the BASC2 are based upon normative comparison data of the-ratings of other students in AIisha's age group. However, all scores should be considered a reflection of the rater's perceptions of the student. Differences in ratings are likely attributed to many variables such as familiarity with the student, setting, and time frame. Ratings within normal limits refer to behaviors that occur similarly to others within Alisha's age group. At-risk scores suggest a problem or difficulty maybe developing and should be monitored..Clinically significant scores are Likely the product of ah•eady developed difficulties in need of intervention. PRS: Ms.~Sharpe completed the Parent Rating Scales (PRS) form of the BASC2 on 8/8/09. Based upon the assessment's validity scales, Ms. Sharpe is considered a reliable rater. Based upon her ratings of Alisha, Alisha fell within normal limits with regards to her level of activity, ability to manage her feelings, her attention span, and ability to follow rules and regulations. However, Ms. Sharpe's ratings led to at-risk range results for the Alisha in the area of atypicality, withdrawal, and resiliency, which suggest that Alisha may be exhibiting odd or unusual behaviors, tends to have difficulty being involved with others and may want to be alone, and has difficulty withstanding stress and adversive situations easily. Alisha was rated as within the clinically significant range for the following areas related to her adaptive skills: social skills, leadership, activities of daily living, and functional communication. These results connimed the findings of the ABAS-II described in a previous section that Alisha struggles with everyday behaviors typically expected for someone her age related to her ability to communicate effectively, participate in a group situation, and carry out other self-help related behaviors such as brushing her teeth without a reminder. Overall, these findings suggest that Alisha is likely functioning similarly to PDEBSE EVALUATION REPORT (Rev. S/2008) Page: 7 RR for Alisha E. Sharpe others within her age group with regards to most aspects of her social, emotional, or behavioral functioning, but does have adaptive deficits that are typical of students with Mental Retardation. Furthermore, she Likely tends to have difficulties interacting with others with a tendency to withdraw, may become more easily stressed by changes in her routine, and is seen exhibiting some behaviors considered unusual. IRS: Ms. Zinlc.also completed the Teacher Rating Scales (IRS) form of the BASC2 on 8/19/09.. Ms. Zink is considered a valid rater due to validity scales falling within acceptable~ranges. According to Ms. Zink's ratings, Alisha fell within the at-risk range for.attention problems, withdrawal, adaptability, social skills, leadership, study skills, functional communication, .anger control,. and resiliency. Therefore, as her mother did, Ms. Zink's ratings indicate that Alisha has difficulties with communicating. and. effectively interacting with others with.a tendency to withdrawal from social situations and an overall tendency to become stressed.by change. Furthermore, Ms. Zink'sratings suggested that Alisha has diffcuhy managing frustration, managing her. school materials, and maintaining her focus on tasks. However, Ms..Zink did not rate Alisha as within the clinically significant range, suggesting the areas noted are likely in need of beingmonitored. 6. Observations by teacher(s) and related services provider(s), when appropriate: Testing Observations_bvthe School Psycholo~ist: Alisha participated in individual testing sessions with Ms. Kara Perella, School Psychologist, on 8/5/09.and S/6/09. She entered the testing situation willingly .after being brought to testing.by her. mother and older sister. Alisha sat still with body posture hunching slightly forward throughout sessions. She had predominantly minimal eye contact with the examiner, but smiled occasionally when interacting, particularly when giving the examiner "high fives". However, Alisha's overall. body language suggested a shy, possibly nervous demeanor, which was also indicated by her low voice quality and minimal responses to questions. Alisha had difficulty answering many questions asked of her, particularly questions about her preferences such as "What do you like to do for fun?" :and "What is your favorite subject in school?". She could not state her year of birthday, the current month, or identify who her classmates were, but did report that she Lives with her mother, father, grandparents, younger brother, and older sister. She named her dog, her teacher, andreported her correct age and birthday. She often needed to be given direct examples or,choices by the examiner before providing an answer. Often, Alisha would sit without making eye contact orproviding an answer, and often with~prompting indicated she did~not Imow. During fisting items, Alisha continued to need some prompting in order to provide a response on many occasions, but appeared to beputting forth her best e$'ort evidenced by her eye gaze being fixed on testing-materials and herproviding some responses more quickly. Her speech was, at times, difficult forthe examiner to understand, but Alisha generally responded when asked gently to speak louder. Overall, despite Alisha presenting herself as a more shy, hesitant student, if is hlcely that-the current results are an accurate~representation of Alisha's current functioning based upon results being similar to previous assessment information and anecdotal reports from other sources. 7. Teacher recommendations: See information throughout.the report 8. ID~T~RI~INING'FACTORS - A studentmustnot be foundto be eligible for special education and related services if the determining factor forthe student's disability is any of those listed below. Respond Yes or No to, and provide evidence for, each detPrn,in;ng factor below. ^ Yes ® No Lack of appropriate instruction in reading, including the essential .components of readmg instruction. Provide evidence: Alisha has received appropriate instruction in Reading as deemed appropriate by the CASD. ~ ^ Yes ID No Lack of appropriate instruction in math. Provide.evidence: Alisha has received appropriate instruction in Math as .deemed appropriate by the CASD. ^ .Yes ® No Limited English proficiency. Provide evidence: Alisha speaks English is her p_*imary language. PDEBSE EVALUATION REPORT (Rev. 8/2008) Page: 8 RR for Alisha E. Sharpe Il. DIJTERMINATION OF N1C)/D FOR ADDITIONAL DATA, SUMMARY AND CONCLUSIONS Based on all evaluation data reviewed, complete item 1 or item 2. 1. ® The I'CrP team deterntinecl that additional data are not needed. Reason(s) additional data. are not needed: Alisha's educational strengths and needs are able to be identified by the information obtained through the current reevaluation and recommendations for educational instruction and intervention can be made. Conclusion: Complete section A or B or• C. A. ~ The student has a disability AND continues to need specially designed instruction. i. Disability Category Primary disability category: Mental Retardation Secondary disability category(s), if any: Speech or Laneuaee Impairment ii. Summary of Findings Student's educational stye a°~ and needs: Stren hs; -Complies with tasks -Family Support -Has done well with survival words -Responds well to encouragement =Seems to enjoy school -Maintains a neat desldworlc area at school Needs: -Continue to improve functional academic skills (telling time, identifying/counting money, counting numbers, handwriting) -Transition needs to improve job performance skills -Monitor concerns with unusual behaviors (ex: looking over shoulder, slin picking) with healthcare provider -Encourage participation in enjoyable or relaxing activities when Alisha appears upset -Improve communication of needs using pictures as needed Present levels of academic achievement and related developmental needs, including transition needs as appropriate: Present Levels and Neeeds: Alisha's academic skills based upon her performance on standardized tests of academic achievement are consistent with her performance on standardized tests of cognitive ability, and fell within a range typically expected of students at the Kindergarten or 16` grade level. Alisha's IEP has focused on basic skills including recognition of survival words. She is participating in job training as part of her transition planning as well. Atisha's current placement in the Life Slaps classroom is meeting her developmental needs as are the Speech and Occupational Therapy services that are in place for her in the school setting. Transition Information: The following is documented on Alisha's most recent IEP regarding transition needs: "Alisha has expressed an interest in going to CIT next year. Some of her work experience has been at school, where she has helped the custodians clean the cafeteria after lunches. This job involves putting chairs up on the tables, waiting for the custodian to mop the floor and then putting the chairs down. While Alisha will perform this job, the chairs are heavy and she needs assistance lifting the chairs up and down as well as prompted to keep working. Alisha also goes to the local food bank once a month where she packs bags of groceries for dkstribution to homebound ckients. Alisha enjoys this job. She does need assistance and requires prompts to get each item, but she keeps working until she's told to stop. However, Alisha is not able to perform this job alone. Alisha also performs clerical jobs, such as colkating, folding, kabeling and stamping newsletters. She needs assistance with folding papers, but is able to place address labels and stamps in the proper places. PDEBSE EVALUATION REPORT (Rev. 8/2008) Page: 9 RR for Alisha E. Sharpe Alisha needs prompted to aslc for more materials and for help if she can't perform a job. At times she becomes frustrated and either gives up or cries wpen she has difficulty doing something." Recommendations for consideration by the IEP team regarding any additions or modifications to the special education and related- services needed to enable the student to. meet the measurable annual goals in the lEP and to participate as appropriate in the general education curriculum (including special considerations the IEP team must consider before developing the lEP, measurable annual goals, specialty designed instruction, and supplementary aids and services): Recommendations: *Alisha continues to meet criteria as a student with Mental Retardation and a Speech and Language Impairment, and thus, should continue in her current educational placement in the Life Skills classroom where her needs can best be met as well as receive Speech and Language services and Occupational Therapy consult. *Alisha's family should continue to consult with licensed medical professionals regarding her medical conditions and more recent concerns with unusual behaviors. AIisha's family may fmd it beneficial to provide a copy of this reevaluation report to Alisha's healthcare providers as additional information to help guide her treatment. *Alisha's mother described concern with Alisha's unexpected bursts of emotions and other behaviors that may be related to her own thoughts or feelings, and it may be helpful for Alisha to be encouraged to engage in an enjoyable or relaying activity when she is exhibiting such signs. Such activities may include looking at magazines or listening to music, which were reported as Alisha's preferred activities. *Alisha should continue to be encouraged to express her feelings and identify situations with words or pictures. Due to her difficulties with expressive language, using pictures or other signals for Alisha to signal for help, bathroom needs, .etc. may be beneficial. Use of pictures are aheady being used at times within the school setting, and it may be helpful for this practice to extend to home/community. Alisha's family may want to wprk with her teacher to identify pictures that Alisha is familiar with and incorporate these onto .acing that Alisha may carry with her or have access to outside of the school setting. DR B. ^ The student does not have a disability and no longer is eligible for special. education. (The parent may request an assessmentto determine whether the student continues to be a student with a disability.) OR C. ~ The student has a disability but no longer needs specially designed inst<uction, and no longer is eligible for special education. (The parent/guardian/surrogaternay request an assessment to determine whether the student continues to be a student with a disability.) 2. _^ The.IEP team determined that there is a need for additions! data. The LEA must issue the Permission to Reevaluate -Consent Form and administer tests and other evaluation materials as may be needed to produce the data below. NOTE: IF REEVALUATING THE STUDENT TO DETERMINE SPECIFIC LEARNING DISABILITY, COMPLETE THE DETERMINATION OF SPECIFIC LEARNING DISABILITY COMPONEArI' AT THE END OF THIS DOCUMENT BEFORE COMPLETING THE SECTION BELOW. PDEBSE EVALUATION REPORT (Re~~. 8/2008) Page: I O RR for Alisha E. Sharpe Interpretation of additional data: Conclusion: Complete section A or B or C. A. ^ The student has a disability AND continues to need specially designed instruction. i. Disability Category Primary disability category: Secondary disability category(s), if any: None ii. Summary of Findings Student's educational strengths and needs: Present levels of academic achievement and related developmental needs, including transition needs as appropriate: Recommendations for consideration by the IEP team regazding any additions or modifications to the special education and related services needed to enable the student to meet the measurable annual goals in the lEP and to participate as appropriate in the general education curriculum (including special considerations the IEP team must consider before developing the ]EP, measurable annual goals, specially designed instruction, and supplementary aids and services): OR B. ^ The student does not have a disability and no longer is eligible for special education. (The parent may request an assessment to determine whether the student continues to be a student with a disability.) OR C. ^ The student has a disability but no longer needs specially designed instruction, and no longer is eligible for special education. (The parent/guardian/surrogate may request an assessment to determine whether the student continues to be a student with a disability.) Upon completion of the reevaluation, the Local Education Agency will complete and issue,the report to the members of the evaluation team. PDE/BSE EVALUATION REPORT (Ree. 8/2008) Page: 11 RR far ALISHA E. SHARPE R~~~S'ALU.FI.T'.ION R~2'ORT SIGNA,TU~t~S DIP~C7r'ION~ T0~ T)f~A.1Y.l 1VII<a11~~T~S: Check ~i.GR.EE i!'you agree witl~ this xepoxl; check.DI~AGF.~I; if ,you do not agt'ee. I:f you do not agree, Please sign Form B instead and write the reason for yow• disagreement in the space provided, A ree Disa., ee Evaluation Team Participants Name or Signature's"' Tine (Required when evnluatinb ahudren Ih B))e01fIC lanrn" ~ disabllitias,) Parent [] Parent [) [] Student ^ (~ Special Education Administrator (~ School Psychologist* Principal or• Assistant Principal ~ [] Guidance Counselor [f 1 Support Teacher (~- [~ ~~_ Speech/Language Clinician ~~ Regular Education Teacher ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ~ O * A certified school psychologist is required for evaluation of the following disabtlit)~ categories: Autism, Emotional Disturbance, Mental Retardation, Multiple Disabilities; Other Aealth Impairments, Specific Learning Disabilit)~ or Traumatic Brain Injury. A certified school psychologist is not required for Deaf-blindness, Deaf and Hard of Hearing, Speech/Language Impairment, Visual Impairment, _and Orthopedic Impairment. *~ For specific learning disabilit)~ only, if a team member disagrees with the team's conclusion related to the identification of the student as having•a specific learning disabiIit)~, the member must submit a separate statement presenting the member's dissent to the LEA. This information must be attached to the Evaluation Report. Please submit this statement to: Christina Spielbauer 7] 7-244-6500 717814 spielbauerc@carlisleschools.org LEA Representative Name Phone Number Email Address A cop)' ofthe Procedural Sq(eguar ds Notice is available upon request from your child's school or• is available on the District's web page • This document explains your rights, and includes state and ]oeal advocacy organizations that are available to help you understand your rights and how the special education process works. For help in understanding this form, an annotated Reevaluati.o~a Repor! is available on the PaTTAN website at v,~~~.pattan.net Type "Annotated Forms" in the Search feature on the website. If you do not have access to the Internet, you can request the annotated form by calling PaTTAN at 800- 441-3215. V,~aiver of Vlaiting Period (If Applicable) I would like the LEP Planning meeting to in~rnediately follow the ldiultidisciplinar5~ Team meeting• I understand that I will not have a finalized cop3~ of the "Reevaluation Report" prior to the IEP planning meeting, and I am waiving, yr' ht to the m' 10 day wait period to revievr the report. Parent Signature Date RR f'or ALISHA E. SHARPE r~~~~A.LU.A.TION REPORT SIGNEI.TU.R.~S T)'OP~..M B (To be used when a team u~ember disabrees wiith the report of a child with ~ Le~erinixzg Disabilit~~ or when ,n tr3am menabor does ~nc,t .have success -to the uribii;nal ~~P~. si;nateere plebe) DIR,ECTION~' TO TEAM N~MSER~; Checlc ~.GREE if ,you a~•ee with this report; check AIS,A.GRE~; if you do not abr•ee. A.ree Disn ree l:;valuation Team Participants Tide (Required when evaluating Name or Signature cblldren with spcoific I nrnin ~ disabllitiesJ SCHOOL PSYCHOLOGIST ^ ^ ^ If you disagree with the report please write the reason foz• youx• disagreement here, or attach a separate statement. 1N THE COURT OF COMMON PLEAS OF In re: :CUMBERLAND COUNTY, PENNSYLVANIA Alisha Sharpe :ORPHAN'S COURT DIVISION CIVIL ACTION -ADJUDICATION OF INCOMPETENCY AND APPOINTMENT OF A GUARDIAN OF THE PERSON AND OF THE ESTATE NO. ~ ~- ~(~7- ~~p~~ CONSENT OF INDIVIDUAL TO APPOINTMENT AS GUARDIAN I, Donald Sharpe, hereby consent to my appointment as joint plenary guardian of the person and estate of Alisha Sharpe, an alleged incapacitated person, and certify that: 1. I am 18 years of age or older. 2. I reside at 836 Franklin Street Carlisle Pennsylvania, 17013. 3. I speak, read, and write the English language. 4. I am a citizen of the United States. 5. I do not have any interest adverse to the alleged incapacitated person. 6. I am not a fiduciary, or an officer or employee of a corporate fiduciary, of an estate in which the alleged incapacitated person has an interest, or a surety, or an officer or employee of a corporate surety, of such a fiduciary. 7. I am the biological father of the alleged incapacitated person. nald Sharpe Petitioner : IN THE COURT OF COMMON PLEAS OF In re: :CUMBERLAND COUNTY, PENNSYLVANIA Alisha Sharpe :ORPHAN'S COURT DIVISION CIVIL ACTION -ADJUDICATION OF INCOMPETENCY AND APPOINTMENT OF A GUARDIAN OF THE PERSON AND OF THE ESTATE NO. ~~ I ~_ ~5.3 CONSENT OF INDIVIDUAL TO APPOINTMENT AS GUARDIAN I, Rochelle Sharpe, hereby consent to my appointment as joint plenary guardian of the person and estate of Alisha Sharpe, an alleged incapacitated person, and certify that: 1. I am 18 years of age or older. 2. I reside at 836 Franklin Street Carlisle Pennsylvania, 17013. 3. I speak, read, and write the English language. 4. I am a citizen of the United States. 5. I do not have any interest adverse to the alleged incapacitated person. 6. I am not a fiduciary, or an officer or employee of a corporate fiduciary, of an estate in which the alleged incapacitated person has an interest, or a surety, or an officer or employee of a corporate surety, of such a fiduciary. 7. I am the biological mother of the alleged incapacitated person. Date: -~-- ~ ~ ~ ~` ~.' Rochelle Sharpe Petitioner IN THE COURT OF COMMON PLEAS OF In re: :CUMBERLAND COUNTY, PENNSYLVANIA Alisha Sharpe :ORPHAN'S COURT DIVISION CIVIL ACTION -ADJUDICATION OF INCOMPETENCY AND APPOINTMENT OF A GUARDIAN OF THE PERSON AND OF THE ESTATE CONSENT OF INDIVIDUAL TO APPOINTMENT AS GUARDIAN I, Jessica Sharpe, hereby consent to my appointment as secondary plenary guardian of the person and estate of Alisha Sharpe, an alleged incapacitated person, and certify that: 1. I am 18 years of age or older. 2. I reside at 836 Franklin Street Carlisle Pennsylvania, 17013. 3. I speak, read, and write the English language. 4. I am a citizen of the United States. 5. I do not have any interest adverse to the alleged incapacitated person. 6. I am not a fiduciary, or an officer or employee of a corporate fiduciary, of an estate in which the alleged incapacitated person has an interest, or a surety, or an officer or employee of a corporate surety, of such a fiduciary. 7. I am the biological sister of the alleged incapacitated person. Date: out (~ J ssica Sharpe titioner