SOCIO-EDUCATIONAL REPORT MODEL

SOCIO-EDUCATIONAL REPORT

REPORT COMMUNICATED BY : □ SS.MM □ School Center □ Others ( Specify)

REPORT START DATE:

REVIEW DATE MADE BY

1.- SCHOOL DATA

Name of the Center:

Address:
Name of the Tutor or Tutor:

2.- MUNICIPAL SERVICES DATA

Worker or Social Worker:

3.- DATA OF THE MINOR OR THE MINOR

Name and surname:

Course and model:
Date and place of birth:
Name of father and mother:
Address (in case of separation, address of both parents):
Phone:

4.- LEVEL OF CLASS ATTENDANCE

Go regularly: YE NO
AH

If not, list of faults according to document:

Puntuality: YE NO
AH
Attendance problems were detected in previous years YE NO
AH

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Observations:

5.- LEVEL OF HYGIENE AND DRESS

 Adequate: always clean and wearing appropriate clothing.

 Regular: sometimes dirty and with clothing that is not suitable for the weather
 Poor: always dirty and wearing inappropriate clothing.
 It gives off a bad smell.
 Presence of lice, fleas, etc. on the body
 Unhealed or poorly healed wounds due to lack of proper care,

Observations:

6.- FOOD

 Adequate: no signs of malnutrition are detected.

 Regular: suspicions that the child sometimes does not eat breakfast, does not eat
regularly...
 Deficient: signs of malnutrition are detected in the child.

Observations:

7.- DREAM

 Adequate: No signs of sleep deprivation detected.

 Regular: you suspect that you are sleeping poorly.
 Poor: signs are detected that he or she is not getting enough sleep (falls asleep in
class, yawns, gets irritated easily, etc.).

Observations:

8.- HEALTH AREA

 Adequate: no deficiencies are detected in the child's health care.

 Deficient: the minor enters school with fever.
 Ignorance of the instructions of the teachers/school doctor in relation to hearing,
visual, motor deficiencies, etc.
 Presence of bruises without logical justification: indicate area of the body, type of
marks, frequency, “excuse me from the child”.
 Repeated domestic accidents.
 Lack of supervision or care for minor illnesses (cough, conjunctivitis, etc.).

2
Observations:

9.- SCHOOL YEAR YOU ARE IN (INDICATE WHICH)

Age-appropriate: YE NO
AH

Has repeated the course YE NO

AH

Reinforcement measures YE NO
AH

Which is it:

He is a special needs student YE NO

AH

Curricular adaptation: Area: YE NO

AH

Areas in which it has curricular adaptation:

Global: YE NO
AH

Individualized attention YE NO
AH

Specialized care outside the center:

 Mental health Center

 Associations
 Psychological Office

3
Observations:

10.- SOCIAL INTEGRATION

With colleagues:

Interacts in class YE NO
AH

He interacts at recess YE NO
AH

Is accepted by others YE NO
AH

Has friends YE NO
AH

Fights or gets angry often YE NO

AH

With the teachers:

Accept authority YE NO
AH

Seeks dependency or protection from the adult YE NO

AH

Ask or claim help YE NO

AH

Needs immediate attention YE NO

AH

Has a predilection or communicates better with a

specific teacher YE NO
AH

Behavior in class:

Respect class rules YE NO

 AH

Impedes the general dynamics of the class YE NO

AH

Indicate how: gets up, makes noises, interrupts the teacher, bothers, etc.

Shows aggressive behavior YE NO

AH

Indicate how: fights, insults, etc.

Bring class materials and supplies YE NO

AH

Participates in class YE NO
AH

Behavior in the dining room:

Respect the rules YE NO

AH

Eat calmly and at a normal pace YE NO

AH

Maintains hygiene and cleanliness YE NO

AH

Gets up and is restless YE NO

AH

Observations:

11.- EMOTIONAL ASPECTS

Has regressive behavior at school YE NO

AH

Enuresis / Encopresis / Onychophagia YE NO

AH

Has manifestations of anxiety YE NO

AH
If yes, mention which ones: sweating, trembling, anxiety, vomiting, agitation, fear of
going to class, fear of leaving school, etc.

It looks like: Dejection YE NO

AH
Sadness YE NO
AH

Presents self-gratifying or self-harming behaviors YE NO

AH

Presents sexual behaviors or knowledge

strange for their age YE NO
AH

Observations:
12.- FAMILY-SCHOOL RELATIONSHIP

The family participates in activities carried out by the

school
Meetings / Talks / Celebrations YE NO
AH

The family comes when the guardians summon them YE NO

AH

Who:

Father Mother Both Others

They show interest in the evolution of their children YE NO

AH

They comply with the guidelines indicated to them YE NO

AH

The family makes demands to the school YE NO

AH

What type:

They pay the fees YE NO

AH

Which: Transportation, books, dining room, etc.

Have incurred any debt with the school YE NO

AH

There have been problems in relationships with the YE NO

family AH

Which ones and for what reasons:

There has been a refusal to establish contact with

Doctor or psychologist upon recommendation of the YE NO
Center AH

Observations:
13.- FAMILY-SOCIAL SERVICES RELATIONSHIPS

 No File prior to the present

 With active social history
 With closed social history

14.- PERSONAL AREA OF THE PARENTS

15.- WORK AND FAMILY ECONOMIC AREA

16.- HEALTH AND FAMILY HYGIENE AREA

17.- LIVING AREA

18.- FAMILY RELATIONSHIPS AND FAMILY ORGANIZATION

19.- ACTIONS CARRIED OUT BY THE SCHOOL (see annex)

20.- ACTIONS CARRIED OUT BY THE CORRESPONDING BASE SOCIAL

SERVICE OR MUNICIPAL SERVICE (see annex)

21.- DERIVATION OR CLOSING DOCUMENT OF THE INTERVENTION

It will be specified on what date and to which institution the case is referred, and on
what date the intervention is closed.
19.- ACTIONS CARRIED OUT BY THE SCHOOL

a) Actions carried out to date and results obtained.

b) Contacts established with the minor, parents or guardians, others, and the results
obtained.

c) Objectives sought with this derivation.

d) Intervention proposals

(date and signature)

20.- ACTIONS CARRIED OUT BY THE BASE SOCIAL SERVICE OR
CORRESPONDING MUNICIPAL SERVICE

a) Actions carried out to date and results obtained.

b) Contacts established with the minor, parents or guardians, others, and the results
obtained.

c) Objectives sought with this derivation.

d) Intervention proposals.

(date and signature)