1. HB 5 Community and Student Engagement Campus Report Rev. 9/15/14 Indicator: Wellness and Physical Education Campus: _________________ Principal: __________________ Campus Rating: __________________

2. Metric Campus Level Compliance Indicators Requirement Due By May 8, 2015Completed C_W1ALL Student Teacher Ratio Physical Education classes have a 45 to 1 ratio of students to teacher. C_W2ALLMVPA The campus has Moderate to Vigorous Physical Activity (MVPA) level for 50% of the class period in a minimum of 3 observations (1 per grade level). C_W3ALLFitnessgram The campus has Fitnessgram Assessment for all non-exempt students in PE grades 3rd- 12 grade C_W4 ECEC, ES, MS Program Implementation The campus has 135 minutes weekly of structured Physical Education. C_W5 ECEC, ES, MS Program Implementation The campus implements TEA and District approved Coordinated School Health Program (Bienestar, SPARK, Great Body Shop). C_W6HS Program Implementation The campus has 225 minutes weekly of structured Physical Education. Metric Campus Level Recognized/ Exemplary Indicators Requirement Due By May 8, 2015Completed RE_W1ALLWellness Journals The campus implements personal wellness journals in PE/Health class. RE_W2ALLWellness Clubs The campus implements wellness clubs such as student walking/running clubs, or PE3 clubs. RE_W3ECEC, ESRecessThe campus implements recess during school hours. RE_W4ALLCycling The campus holds a Bicycle Rodeo/Cycling Club/Field Day or participates as a team in Siclovia. RE_W5ALL Community Wellness Activities The campus participates in Kid's Rock/Go Kids Challenge/San Antonio Sports Activities/First Tee Golf/Bowling Teams/Jump Rope for Heart/Hoops for Heart. RE_W6ALLZumba The campus holds or participates in campus or District sponsored Zumba classes. RE_W7ALLWellness NewsletterThe campus publishes a wellness newsletter. RE_W8ALLWellness FairThe campus holds a wellness/health fair for students and parents. RE_W9ALLNutrition The campus holds nutrition classes/healthy cooking/recipes demonstrations for students and parents. RE_W10ALL District or SAISD Foundation Wellness Activities The campus participates as a team in local fitness activities such as the 4E Run (5k Walk/Run), Komen Race for the Cure, etc. RE_W11ALL Wellness Needs Analysis The campus completes the 'Let's Move Initiative' inventory or the School Health Index. Wellness and Physical Education Roger Rodriguez, Senior Coordinator, Health and Physical Education, 210.554.2540 HB 5 Community and Student Engagement Campus Report Campus Self Rating - Please Circle one: Exemplary Recognized Acceptable Unacceptable Not Rated Campus Coordinator/Department Chair Signature_________________________________________________ Date ____________________ Principal Signature__________________________________________________________________________ Date ____________________ Rev. 9/30/14 Verified by: ___________________________________________ Title _________________________________ Date ___________________ Rating Verification – Final Campus Rating: Exemplary Recognized Acceptable Unacceptable Not Rated For District Department Use Only Campus:_______________________ Principal: _______________________