Agency Designee Enrollment Form

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The Center for Teacher Innovation is a Subsidiary of Riverside County Office of Education 7/10/15 Agency Designee Enrollment Form

The purpose of this form is to collect your contact information to authorize access to online services, program information, resources, newsletters, etc., as appropriate for your role and/or relationship with the Center for Teacher Innovation (CTI) Professional Teacher Induction Program. Your contact information will remain valid until you request an update or are removed from our database. You may notify [email protected] to make a change.

Name:_______________________________________________________________Today’s Date:____________ (please print)

Work Title___________________________________________________________________________________ Work Mailing Address:_________________________________________________________________________ City: __________________________________________ State:___________ Zip Code:_____________ Primary Phone: ( ) Secondary Phone optional: ( )

Primary Email: _______________________________________________________________________________ Secondary Email optional: ______________________________________________________________________

Name of educational agency(ies) you represent:

1. ___________________________________________________________________________________ 2. ___________________________________________________________________________________ 3. ___________________________________________________________________________________

Indicate your induction-related role/s (check all that apply):

Agency Representative – provides induction leadership and oversees candidate and reflective coach participation.

Credential Advisor – provides guidance and/or support with candidate credential matters and/or eligibility. Assistant – assists Agency Representative and/or Credential Advisor with induction responsibilities. Affiliate – interested in induction resources/services if none of the above roles apply.

Mailing list only – no access to induction program records.

If you are replacing someone from your agency previously assigned to the above role(s), please provide that person’s name for removal from our contact list:

____________________________________________________________________________________________ Have you participated in any capacity with the CTI Induction Program since July 1, 2015? (e.g., currently a reflective coach, former candidate, etc.)

No Yes – state role and most recent year: ______________________________________________

Return this completed form to: Riverside County Office of Education Center for Teacher Innovation P. O. Box 868

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The Center for Teacher Innovation is a Subsidiary of Riverside County Office of Education

4/7/15R

General Education Credentials Authorized for 2015-2016

Teachers may be authorized for placement in the General Education Induction Program based on the

following criteria:



Teaching assignment or setting with access to instruct students on a regular basis for the school year.



Matched with a reflective coach who holds a clear credential in a closely-aligned subject matter or

grade span.



CTC-issued Multiple Subjects or Single Subject credential dated on or before December 1 with one

of the renewal codes shown below. The renewal code appears on a teacher’s electronic credential

(

www.ctc.ca.gov

).

General Education

Credential Type

Credential

Renewal Code

Preliminary Multiple Subjects

R14I, R14S, R14T, RS3, PRO

Preliminary Single Subject

R14I, R14S, R14T, RS3, PRO

Induction staff will review the eligibility status of enrolled candidates to authorize placement in the General

Education Induction Program for teachers who indicate on the enrollment form that they want to clear a

multiple subjects or single subject credential. Some (but not all) preliminary credentials may require

completion of additional CTC statutory requirements based on the preparation route to earn the credential.

Enrolled candidates will be advised if any of the requirements shown below apply to them. Resources for

completion outside of induction will be provided.

Possible CTC Statutory Clear

Credential Requirements

6 Years Private

School

Experience

Teacher Prep

Out-of-State

Teacher Prep

Outside of

the U.S.

CPR

X

Basic Skills (RC)

X

Subject Matter (RSMC)

X

Reading (READ)

X

U.S. Constitution (US)

X

English Learner (REL)

X

Authorized candidates may request a clear Multiple Subjects and/or Single Subject credential

recommendation from the Riverside County Office of Education when all clear credential requirements have

been completed.

Please see separate information for Education Specialist credentials. Eligible candidates may simultaneously

participate in both Clear Education Specialist and General Education Induction Programs and will need

appropriate experiences with students in both settings. Candidates in dual programs may not apply for the

accelerated one-year Early Completion Option.

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Three-Year Extension

(Issued one time with option for additional one- or two-year extension.)

Two-Year Extension

(Issued one time with option for additional one-year extension.)

One-Year Extension

(Issued one time with an option for an additional one-year extension if the extenuating

circumstances continue and sufficient progress has been made.)

Purpose

To obtain additional time to seek a position that will allow applicant to complete clear credential requirements.

To obtain additional time to complete clear credential requirements while employed in a teaching position that provides eligibility for participation in an Induction or Clear Program.

To obtain additional time to complete clear credential requirements.

Qualifications

Is not or has not been employed in a position that allows for the completion of a Clear or Induction Program, but needs a valid credential to seek employment.

Only for teachers who were issued a preliminary multiple subjects or single subject with renewal code of R14I (SB 2042 issued on or after August 30, 2004.)

Must be employed in a teaching position that allows for completion of the clear credential requirements, and is enrolled or is reenrolling in an Induction or Clear Program.

Only for teachers who were issued a

preliminary multiple subjects or single subject with renewal code of R14I (SB 2042 issued on or after August 30, 2004.)

May have held a three-year extension.

The teacher must be enrolled (or pending enrollment) in an Induction or Clear Program to complete clear requirements.

For teachers who hold a preliminary or Level I teaching credential.

If previously held a two- and/or three-year extension, applicant must be employed in a position to complete clear requirements.

Requirements

 CL-884 includes applicants’ statement of why renewal requirements were not met and a plan for completion.

 CTC 41-4 application (with processing fee).

 CL-885 includes verification by

employing agency and program sponsor.  Applicants’ statement of why renewal

requirements were not met and a plan for completion.

 CTC 41-4 application (with processing fee).

 Verification of Induction status (letter from program sponsor).

 Applicants’ statement of why renewal requirements were not met, documentation of the extenuating circumstances, and plan for completion.

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The Center for Teacher Innovation is a Subsidiary of Riverside County Office of Education

4/7/15R

Education Specialist Credentials Authorized for 2015-2016

Special education teachers may be authorized for placement in the Clear Education Specialist Induction Program based on the following criteria:

 Teaching assignment or setting with access to instruct special education students on a regular basis and case management responsibilities that align with the credential specialty area.

 Matched with a reflective coach who holds a clear credential in the same specialty area as the candidate.

 CTC-issued Education Specialist credential dated on or before December 1 with one of the renewal codes below. The renewal code appears on a teacher’s electronic credential (www.ctc.ca.gov).

Education Specialist Credential Type* Credential Renewal Code Preliminary R19N Level I R19L, R19M, R19D, R19F, RSN Level I (Generic Focus)** R19H, R19J, RSG, RSGN

*Candidates with an Education Specialist Certificate of Eligibility must convert to a Level I Education Specialist credential during the first year of induction and prior to a clear recommendation.

**Statutory requirements for Level I credentials based on a generic preparation program should be completed prior to induction enrollment (see chart below).

Induction staff will review the eligibility status of enrolled candidates to authorize placement in the Clear Education Specialist Induction Program for teachers who indicate on the enrollment form that they want to clear a special education credential. Some (but not all) Level I credentials may require completion of additional CTC statutory requirements based on the preparation route for the credential. Enrolled candidates will be advised if any of the requirements shown below apply to them. Resources for completion outside of induction will be provided.

Possible CTC Statutory Clear Requirements for Level I Credentials

Teacher Prep in California Teacher Prep Out of State Teacher Prep Outside of U.S. Level II Content X X X

English Learner (REL) X X

Foundational Technology (COMP) X X Preliminary Health and/or CPR (HEAL) X X

Basic Skills (RC) X X

Subject Matter (RSMC) X

U.S. Constitution (US) X

Reading/RICA (READ) X

Level I Equivalent (Preliminary)* * X X Non-Special Education Pedagogy** (NEEP) X Supervised General Ed Field Experience** (NSEE) X

Authorized candidates may request a clear Education Specialist credential recommendation from the Riverside County Office of Education when all clear credential requirements have been completed.

Please see separate information for General Education credentials. Eligible candidates may simultaneously participate in both Clear Education Specialist and General Education Induction Programs and will need appropriate experiences with students in both settings. Candidates in dual programs may not apply for the accelerated one-year Early Completion Option (ECO).

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Agency Representative Meetings

2015-2016

Date Satellite(s) Location

Tuesday, August 18, 2015 1, 2, 3, 5 & 6 Riverside County Office of Education, Conference Center 3958 Twelfth Street, Riverside, CA 92501

(Inyo/Mono Counties, CEA & Palo Verde USD via Videoconference)

Thursday, August 20, 2015 4 & 5 San Bernardino County Superintendent of Schools, Support Center 4595 Hallmark Parkway, San Bernardino, CA 92407

Tuesday, August 25, 2015 2 Riverside County Office of Education – Indio 47-110 Calhoun Street, Indio, CA 92201 Thursday, August 27, 2015

Wednesday, August 26, 2015

5 Desert Mountain Educational Service Center 17800 Highway 18, Apple Valley, CA 92307

Victor Elementary School District

12219 Second Avenue, Victorville, CA 92395

Wednesday, January 20, 2016 1, 2, 3, 5 & 6 Riverside County Office of Education, Conference Center 3958 Twelfth Street, Riverside, CA 92501

Thursday, January 21, 2016 4 & 5 San Bernardino County Superintendent of Schools, Support Center 4595 Hallmark Parkway, San Bernardino, CA 92407

Tuesday, January 26, 2016 5 Desert Mountain Educational Service Center 17800 Highway 18, Apple Valley, CA 92307 Friday, January 29, 2016 2 Riverside County Office of Education – Indio

47-110 Calhoun Street, Indio, CA 92201

Wednesday, April 13, 2016 1, 2, 3, 5 & 6 Riverside County Office of Education, Conference Center 3958 Twelfth Street, Riverside, CA 92501

Thursday, April 14, 2016 4 & 5 San Bernardino County Superintendent of Schools, Support Center 4595 Hallmark Parkway, San Bernardino, CA 92407

Wednesday, April 20, 2016 5 Desert Mountain Educational Service Center 17800 Highway 18, Apple Valley, CA 92307 Friday, April 22, 2016 2 Riverside County Office of Education – Indio

47-110 Calhoun Street, Indio, CA 92201

For additional information, please contact Barbara Howard, Director II at (951) 826-6632.

The Center for Teacher Innovation is a Subsidiary of Riverside County Office of Education

The meetings are scheduled from 9:00 a.m. – 12:00 p.m.