DIRETORIA REGIONAL DE EDUCAÇÃO JAÇANÃ/

TREMEMBÉ

FICHA DE OBSERVAÇÃO/ ENCAMINHAMENTO DO ALUNO PARA SAAI

Nome do aluno: _________________________________________________________

Data de nascimento:____/____/_____ Deficiência: ____________________________
U.E.: __________________________________________________________________
Ano/ ciclo: ______________
Responsável: _______________________________________ telefone: ____________

Realiza acompanhamento em Instituição conveniada? ( )SIM ( ) NÃO

Qual? ( ) RECANTO ( ) SAGRADO ( ) PROMOVE ( ) OUTRA ______________
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_____ BIMESTRE

1. O que o aluno realiza com autonomia:

PEDAGÓGICO:___________________________________________________________
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Higiene, alimentação, locomoção e comunicação: _______________________________
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2. O que necessita de ajuda para realizar:

PEDAGÓGICO:___________________________________________________________
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Higiene, alimentação, locomoção e comunicação: _______________________________
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3. O que é esperado (pela idade) e o aluno não realiza:
PEDAGÓGICO:___________________________________________________________
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Higiene, alimentação, locomoção e comunicação: _______________________________
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4. Comportamentos inadequados: ___________________________________________

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5. Informações adicionais: _________________________________________________

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ass. Professor(a): _______________________________________________________

ass. C P: ___________________________________________Data: ____/____/_____

UMA CÓPIA DESTA FICHA DEVE SER ARQUIVADA NO PRONTUÁRIO DO ALUNO E O ORIGINAL
SEGUE PARA A SAAI, ONDE DEVE SER ARQUIVADA NA PASTA DE ACOMPANHAMENTO DO ALUNO