Routine Champions Checklist Morning Champion!
Arrival & Folder Daily Checklist
Name ________________________
Date ____ / ____ / ____
🚀
Be a superstar today! Complete each step, check the box, and keep your materials organized. Laminated? Use a dry-erase marker to check off your stars!
☀️
Step 1: Morning Arrival
First
Unpack Backpack
Take out folder, lunchbox, and water bottle.
Second
Put Away Belongings
Hang coat and backpack neatly on your hook.
Third
Deliver Your Folder
Hand teacher your communications folder and work.
📂
Step 2: Neat Binder & Folder
Step 1
Open with Care
Lay folder flat. Zip or snap binders slowly.
Step 2
Put Papers Inside
Slide completed papers directly into pockets. No loose piles!
My Daily Evaluation
Color your star rating with your teacher or helper!
⭐️ Awesome!
✨ Keep Trying
Routine Champion!
Transitions, Meals & Departure
Name ________________________
Date ____ / ____ / ____
🧼
Step 3: Meal, Wash, & Clean-Up
Restroom
Bathroom & Wash
Flush toilet, wash hands with soap, and dry.
Mealtime
Eat Nicely
Sit at table, eat with good manners, stay in seat.
Clean-Up
Tidy Up & Trash
Clear table. Throw garbage away. Put chair in.
🎒
Step 4: End of Day Departure
First
Gather Folder & Mail
Put check-in folder, newsletters, and papers inside backpack.
Second
Pack Coat & Bag
Put on coat/jacket and zip backpack completely.
Third
Safe Line Up
Stand in line quietly with hands to yourself.
My Daily Evaluation
Color your star rating with your teacher or helper!
⭐️ Awesome!
✨ Keep Trying
Routine Champions IEP Tracker Routine Champions IEP Tracker
Daily Task Analysis, Prompt Level Logs, and 80% Weekly Target Tracker • Kindergarten
Prompt Key
I : Independent V : Visual Ve : Verbal G : Gestural P : Physical
Student Name _____________________
Week Of ____ / ____ / ____
Scoring Instructions Record sub-step prompt levels (I/V/Ve/G/P). Score daily trial (+) for success or (-) if physical/heavy prompt was needed. Target: 4/5 (80%).
Routine, Sub-Steps & IEP Objectives Mon Tue Wed Thu Fri Weekly Summary ☀️ ROUTINE 1: DAILY ARRIVAL (Goal: 80% accuracy) GOAL MET? (4/5) A. Unpack backpack (take out folder & lunchbox) _____ _____ _____ _____ _____ Total Successes: _____ / 5 Trials
|
| B. Put away belongings neatly (hook or locker) | _____ | _____ | _____ | _____ | _____ |
| C. Deliver communication folder to teacher/bin | _____ | _____ | _____ | _____ | _____ |
| Daily Trial Score (+ / -) | + / - | + / - | + / - | + / - | + / - | ________ % |
| 📂 ROUTINE 2: FOLDER & BINDER MAINTENANCE (Goal: 4/5 trials, 80% accuracy) | GOAL MET? (4/5) |
| A. Open folder/binder flat with appropriate care | _____ | _____ | _____ | _____ | _____ |
Total Successes:
_____ / 5 Trials
|
| B. Place loose papers flat inside sleeves/pockets | _____ | _____ | _____ | _____ | _____ |
| Daily Trial Score (+ / -) | + / - | + / - | + / - | + / - | + / - | ________ % |
| 🧼 ROUTINE 3: TRANSITIONS & MEALS (Goal: 4/5 trials, 80% accuracy) | GOAL MET? (4/5) |
| A. Restroom transition (flush toilet, wash/dry hands) | _____ | _____ | _____ | _____ | _____ |
Total Successes:
_____ / 5 Trials
|
| B. Mealtime routine (sit politely, stay in seat) | _____ | _____ | _____ | _____ | _____ |
| C. Clean-up (discard trash, clear eating space, push chair) | _____ | _____ | _____ | _____ | _____ |
| Daily Trial Score (+ / -) | + / - | + / - | + / - | + / - | + / - | ________ % |
| 🎒 ROUTINE 4: DAILY DEPARTURE (Goal: 80% accuracy) | GOAL MET? (4/5) |
| A. Gather binder/folder & daily printouts into bag | _____ | _____ | _____ | _____ | _____ |
Total Successes:
_____ / 5 Trials
|
| B. Pack up coat/outerwear & close bag zippers completely | _____ | _____ | _____ | _____ | _____ |
| C. Stand safely and quietly in dismissal/exit line | _____ | _____ | _____ | _____ | _____ |
| Daily Trial Score (+ / -) | + / - | + / - | + / - | + / - | + / - | ________ % |
Weekly Percentage Threshold Helper
1/5 Trials = 20%
2/5 Trials = 40%
3/5 Trials = 60%
4/5 Trials = 80% (Goal Met)
5/5 Trials = 100% (Goal Met)
Observation Notes & Support Descriptions
Success cues, student motivation & faded prompts:
Trigger points or adjustments for next week:
Educator Signature: _________________________________________
Paraeducator Signature: _________________________________________
Routine Champions Service Log Routine Champions Service Log
IEP Service Documentation • Mandate: 1x Weekly for 30 Minutes
SERVICE MANDATE
Frequency: 1x Weekly
Duration: 30 Minutes
Student Name _____________________
Service Provider _____________________
Grading Period / Quarter _____________________
IEP Goals Coordinated During Sessions
1. Arrival Routine Unpacking, hook hanging, and communications folder.
2. Folder Care Maintaining folders and paper organization.
3. Transitions Bathroom safety, hand washing, & clean-up.
4. Departure Pack up, outerwear zipping, and lining up safely.
| Wk | Date | Service Time | Mins
(Target: 30) | Setting
(Push/Pull) | Goals Targeted
(Circle Goals) | Session Focus & Progress Notes | Init |
| --- | --- | --- | --- | --- | --- | --- | --- |
| 1 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 2 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 3 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 4 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 5 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 6 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 7 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 8 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
| 9 | ___ / ___ | _____ to _____ | ______ | In / Pull | 1 2 3 4 | | ____ |
Absence / Exception Codes:
A : Student Absent T : Teacher Absent NS : No School (Holiday) FT : Field Trip EX : Activity/Testing Exception
Quarter Progress Review Summary
Compliance & Progress Summary Statement:
Intervention/Accommodations Adjustments For Next Quarter:
Service Provider Signature: _________________________________________
IEP Case Manager Signature: _________________________________________