Home Visit Evaluation Form

HSP Home Visit Evaluation Form
Evaluator Name:

First NameLast Name
Date of Evaluation:

MonthDayYear
Student Name:

First NameLast Name
Grade:
Enter "0" for Kindergarten.
Participating Parent:

First NameLast Name
Does the Student's work show evidence of regular and thorough instruction?

YesNo
If "no," what adjustments are necessary to be in compliance with the guidelines for "regular and thorough instruction"?
Does the student's work reflect ongoing evaluation (i.e. tests, reports, projects, review of daily assignments) by the parent?

YesNo
If "no," is the parent applying appropriate interventions (i.e. curriculum adjustment, tutoring, professional evaluation, etc.) for any academic deficiency?

YesNo
Please specify below:
The homeschool program of the above listed student has been reviewed as in compliance with the Maryland State Department of Education regulation COMAR 13A.10.01 for Home Instruction.

By clicking "Submit Home Visit Evaluation Form Online," both the Evaluator and Participating Parent are agreeing to the statement above.
Should be Empty:

HSP Home Visit Evaluation Form