Step 4

Block 1 Assessment

Foundations & Routine Assessment Checklist · “This Is Me” · Identity · Emotions · Phonics
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Student Info

I = Independent VP = Verbal/Visual Prompt PP = Physical Prompt O = Observing
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1. Name Puzzles — Identity & Letter Recognition

Skill Observed
Prompt Level
Mode of Response
Identifies own name/photo among others
Matches letters to the model
Completes name sequence left-to-right
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2. Picture Schedule — Routine & Sequencing

Skill Observed
Prompt Level
Mode of Response
Identifies current activity on the chart
Transitions when the activity changes
Predicts / Names the next activity
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3. Stop & Go Game

Self-Regulation & Receptive Language
Skill
B
P
A
LC.1Responds to “Stop” (freezes)
LC.1Responds to “Go” (moves/marches)
AP.1Waits for signal (impulse control)
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4. Emotion Mirror Match

SEL Vocabulary
Skill
B
P
A
SE.1Matches emotion card to teacher's face
SE.1Imitates expression in the mirror
SE.1Labels the emotion (Happy, Sad, etc.)
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Teacher Reflection & Adaptation Plan

This field is for validation purposes and should be left unchanged.
Auto populated once student is selected
Identifies own name/photo among others
Matches letters to the model
Completes name sequence left-to-right
Identifies own name/photo among others mode of response
Matches letters to the model mode of response
Completes name sequence left-to-right mode of response
Identifies current activity on the chart
Transitions when the activity changes
Predicts / Names the next activity
Identifies current activity on the chart mode of repsonse
Transitions when the activity changes mode of response
Predicts / Names the next activity mode of response
Responds to "Stop" (freezes)
Responds to "Go" (moves/marches)
Waits for signal (impulse control)
Matches emotion card to teacher's face
Labels the emotion (Happy, Sad, etc.)
Imitates expression in the mirror