MIAMI-DADE COUNTY PUBLIC SCHOOLS DIVISION OF STUDENT SERVICES CASE #: 3-99-1000 MULTI-DISCIPLINARY TEAM REPORT Initial Evaluation STUDENTS NAME: SEX: female GRADE: 3rd DATE OF BIRTH: 6-7-90 SCHOOL:John I. Smith Elementary School ADDRESS:9900 NW 44th Terrace, 33178 ETHNIC ORIGIN: H HOME PHONE: 639-3250 DATE OF CURRENT EVALUATION: 5-26-99 ASSESSMENT AREAS ADAPTIVE BEHAVIOR/SOCIAL HISTORY PSYCHO-EDUCATIONAL VISION HEARING SPEECH/LANGUAGE OBSERVATIONS REFERRAL INFORMATION REFERRAL FORM/STRATEGIES ATTACHMENTS PERMISSION TO CONDUCT AN EVALUATION EXAMINER T. Hankerson Maria Gibed A:O:311es, Ed.S. Siddons Nolan Wllensky Wllensky Bello Blandon CST Ginny Hernandez DATE COMPLETED 11-24-98 5-26-99 11-23-98 6-4-99 2-9-99 2-9-99 12-3-98 11-2-98 11-6-98 11-6-98 CONFIDENTIAL MM08-S NUEVA-000069 3501.160-029 Page I of I EFTA_00069497 EFTA01247277