Attachment VI

This attachment focuses on Specialized Academic Instruction, Specially Designed Instruction, and Related Services. Special education programs are to be provided under an approved special education local plan area (SELPA) Local Plan and must include elements specified in California Education Code (EC) Section 56001, Chapter 2.5 (commencing with EC Section 56195) and Chapter 3 (commencing with EC Section 56205). Attachment VI of a SELPA Local Plan includes the physical location at which the services will be provided. This information is gathered from each local educational agency (LEA) member participating in the Local Plan, as well as from the written agreements between the LEA member, and non-member LEAs and/or entities providing special education instruction and related services under these written agreements. As applied to special education, an LEA is defined as a school district, charter school designated as an LEA for special education purposes, a COE, or a SELPA providing direct services pursuant to EC Section 56026.3.

All entities and individuals providing related services must meet the qualifications found in Title 34 of the Code of Federal Regulations (34 CFR) Section 300.156(b), Title 5 of the California Code of Regulations (5 CCR) Section 3001(r) and the applicable portions 3051 et. seq.; and must be either employees of an LEA or COE, employed under contract pursuant to EC sections 56365-56366, or employees, vendors or contractors of the State Departments of Health Care Services or State Hospitals, or any designated local public health or mental health agency.

Attachment VI of a SELPA Local Plan includes the school or site name at which the services identified in Section E will be provided. Local Plan Attachment VI must include the following information:

  • Row “1” – enter the date Attachment VI was completed;
  • Row “2” – using the drop-down menu, select the fiscal year for the applicable Local Plan Section E: Annual Service Plan submission; and
  • Row “3” – enter the complete SELPA name as recognized by the California Department of Education (CDE).

Beginning with Row “6,” Attachment VI must include the following information:

  • Column A – enter or copy and paste the LEA member participating in the Local Plan as the District of Accountability (DOA) for placing the student(s) receiving services at the school or site listed in Column B. If more than one LEA member is accountable for placing student(s) receiving services at a school or site listed in Column B, a separate entry will be required for each LEA. The LEA Name must be entered in Column A as it appears in the California School Directory. 
  • Column B – enter or copy and paste the official name of the school or site where special education instruction and/or service(s) are provided to students with an individualized education program (IEP) in the SELPA (e.g. school sites, hospitals, service provider locations). The name of the school or site must be entered in Column B as it appears in the California School Directory, if applicable. 
  • Column C – if applicable, enter the county, district, and school code for the school or site listed in column B, which can be obtained from the California School Directory;
  • Column D – if applicable, enter or copy and paste the four-digit charter number for the school or site listed in column B, which can be obtained from the California School Directory; and
  • Columns E through AY – enter an “X” in the corresponding cell for each special education instruction and/or service provided at the school or site identified in Column B. Only services identified as being provided by the SELPA in Section E of the Local Plan should be identified with an “X” in Attachment VI. Information generated by electronic IEP data systems may be copied and pasted in Attachment VI.