Form 05-19-021 "Test Security Agreement Level 5" - Alaska

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This is a legal form that was released by the Alaska Department of Education and Early Development - a government authority operating within Alaska. As of today, no separate filing guidelines for the form are provided by the issuing department.

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Test Security Agreement Level 5
2018-2019
Level 5 Test Administration Support: employees who come in contact with test materials or assist with testing;
these employees are not administering or monitoring students during test administration.
School and district personnel responsible for test administration shall read and sign a Test Security
Agreement (TSA), on a form provided by the Alaska Department of Education & Early Development,
affirming that they will follow the test administration procedures required by the department and the
test publisher, if applicable.
• Test security regulations apply to all statewide assessments required by the Statewide Student
Assessment System 4 AAC 06.710.
• All district employees involved in testing must read and follow all testing procedures and
manuals published by the test publisher per regulation 4 AAC 06.765(f)(3).
• These regulations apply to both paper-based assessments and computer-based assessments; all
testing personnel are required to maintain the same standards of security for both modes of
assessment.
• This form must be signed annually and must be on file prior to receiving any test materials
and/or administering any tests. 4 AAC 06.765 (f)(1); 4 AAC 06.761(c).
Directions:
• Please fill out the identification section accurately, indicating all applicable roles.
• Read each statement carefully and initial each line to indicate that you agree to follow these
procedures in the context of your role(s).
• Please sign your full name and date the form.
• Submit this completed TSA to the District Test Coordinator or other designated district employee
Form # 05-19-021
1 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Test Security Agreement Level 5
2018-2019
Level 5 Test Administration Support: employees who come in contact with test materials or assist with testing;
these employees are not administering or monitoring students during test administration.
School and district personnel responsible for test administration shall read and sign a Test Security
Agreement (TSA), on a form provided by the Alaska Department of Education & Early Development,
affirming that they will follow the test administration procedures required by the department and the
test publisher, if applicable.
• Test security regulations apply to all statewide assessments required by the Statewide Student
Assessment System 4 AAC 06.710.
• All district employees involved in testing must read and follow all testing procedures and
manuals published by the test publisher per regulation 4 AAC 06.765(f)(3).
• These regulations apply to both paper-based assessments and computer-based assessments; all
testing personnel are required to maintain the same standards of security for both modes of
assessment.
• This form must be signed annually and must be on file prior to receiving any test materials
and/or administering any tests. 4 AAC 06.765 (f)(1); 4 AAC 06.761(c).
Directions:
• Please fill out the identification section accurately, indicating all applicable roles.
• Read each statement carefully and initial each line to indicate that you agree to follow these
procedures in the context of your role(s).
• Please sign your full name and date the form.
• Submit this completed TSA to the District Test Coordinator or other designated district employee
Form # 05-19-021
1 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Identification
Name (Last, First MI):
District:
School/Site:
Responsibility Level
Testing Role (check all that apply)
Level 5: Support
____ Testing Personnel (such as: administrative assistant, secretary, mail
Any district employee who
room, custodian, etc.)
comes into contact with
testing materials; these
____ Technology Assistance Personnel (such as computer lab or technology
employees do not proctor,
administer, or monitor test
assistants)
administration to students.
Note: If a district employee has a signed Level 1-3 or Level 4 TSA on file it is not necessary to sign a Level 5 TSA.
Read and initial each line below. By initialing I am verifying that I agree to follow these procedures as they apply
to my district testing personnel duties.
Testing Location – Completion of this section is required for all roles
____No one can go into the classrooms except for district employees that are in charge of testing. The
classroom where students take the test must be set up so that students can focus on the assessment and do
their best work.
Each school test center must be secure, free of disruptions, have an established seating arrangement, and be well lighted.
4 AAC 06.761(b); Only designated district test coordinators, associate test coordinators, proctors, or test administrators
may be in the test center rooms at the time of testing students. 4 AAC 06.761(b)
Testing Personnel & Training – Completion of this section is required for all roles
____Only trained school district employees can help with testing.
Only employees of the school district will participate in test administration. 4 AAC 06.765(c-h); All staff participating in
statewide assessment administration will attend district training and complete all required activities. 4 AAC 06.765 (f)(3)
Test Materials Security – Completion of this section is required for all roles
____Tests cannot be copied (this includes photocopies, photographs, scanning, etc).
____All testing materials must be secure at all times; materials must be checked in, inventoried, and tracked.
At no time should tests be left in an unlocked room.
School and district personnel responsible for test administration shall ensure that no test or test question is
copied in any manner, whether on paper or by electronic means. Materials must be secure, inventoried and
tracked from the time the materials arrive at the district office or school until the time the materials are
returned to the test publisher. 4 AAC 06.765(c)(1)-(d)(4)
upon arrival in the district,
when transferred from district to site(s),
when distributed to test administrators within the sites,
when distributed to students within rooms,
when collected at the end of each session,
when collected within a site,
Form #05-19-021
2 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Read and initial each line below. By initialing I am verifying that I have read and agree to follow these procedures
as they apply to my district testing personnel duties.
Test Materials Security, cont. – Completion of this section is required for all roles
when transferred from site(s) to district office, and
when returned to the test publisher.
NOTE: Application of these regulations to computer-based assessments includes, but is not limited to, the
following examples:
“Controlling the storing, distribution, administration, and collection of tests” includes, but is not limited
to, secure storing of the assessment on a local caching server, secure use of student login information,
ensuring students are not able to easily view others’ device screens, checking student devices to ensure
that the test engine is operating properly.
“Materials” includes, but is not limited to, the following types of computer-based assessment
materials: assessments stored on a local caching server, student login information, and directions and
access information for re-activating an assessment.
Secure Testing Practices – Completion of this section is required for all roles
____No one may have the tests before testing begins.
____Only students may read the test questions.
____Students may not receive help before, during, or after the test. For example:
Students must complete the test on their own.
Students may not share information or answers with others.
Test questions cannot be read aloud.
Words cannot be defined.
Test questions may not be paraphrased, summarized, or explained.
Answers may not be changed by anyone after the test is complete.
School personnel at a school test center shall ensure that no individual receives a copy of the test, or learns of a specific
test question or item, before the test date and time set by the commissioner, unless knowledge of the question or item is
necessary for delivery of accommodations under 4 AAC 06.775. 4 AAC 06.765(d)(7); School personnel at a school test
center shall ensure that no test or test question is copied, or reproduced in any manner, by an examinee or anyone else.
4 AAC 06.765(d)(5); School personnel at a school test center shall ensure that no examinee is assisted in responding to or
review of specific test questions or items before, during, or after a test session. 4 AAC 06.765(d)(10); Testing personnel
shall not read test items aloud, silently, or to another individual, unless specified in the test administration directions or
specifically required to provide an accommodation to an individual or student group. 4 AAC 06.765(b); School personnel at
a school test center shall ensure that no test or test question is paraphrased in any manner by an examinee or anyone
else. 4 AAC 06.765(d)(5); School personnel at a school test center shall ensure that examinees do not exchange
information during a test, except when the test procedure so specifies. 4 AAC 06.765(d)(8); School personnel at a school
test center shall ensure that an examinee's answer is not altered after testing is completed. 4 AAC 06.765(d)(9)
Accommodations – Completion of this section is required for all roles
____Students with special needs may have accommodations (assistance) on the assessment as determined by
their teacher and student plan.
Ensure that students with disabilities and students identified as English Learners (ELs) receive allowed accommodations on
state academic assessments as listed in the student’s Individualized Education Plan, 504 plan, and/or their student file. 4
AAC 06.775(a), Participation Guidelines for Inclusion of Alaska Students in State Assessments
Data and Test Results – Completion of this section is required for all roles
____Any reports about the tests, including student scores, are confidential and must be secure.
All school and district personnel shall maintain the security and confidentiality of electronic test data files, individual
student reports (ISRs), and other testing reports designated as secure. 4 AAC 06.765(g)
Form # 05-19-021
3 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Read and initial each line below. By initialing I am verifying that I have read and agree to follow these procedures
as they apply to my district testing personnel duties.
Assurances:
____I have read and I understand the attached regulations 4 AAC 06.761 Test Administration and 4 AAC
06.765 Test security; consequences of breach (found on pages 5-7 of this document)
____I understand that I am obligated to immediately report any test irregularities and/or breaches of
test security to the Associate or Building Test Coordinator at my site or, if appropriate, the District Test
Coordinator. 4 AAC 06.765(h)
All employees must submit this TSA to their District Test Coordinator or other designated staff prior to
handling any assessment materials.
Signature
Date
First and last name typed or printed clearly
Form #05-19-021
4 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Test Administration & Security Regulations
4 AAC 06.761. Test administration
(a) Unless an assessment is specifically exempted, or the department has approved in writing a
different process, a district shall administer the statewide assessments described in 4 AAC
06.710
in conformance with the requirements of this section.
(b) A district shall administer an assessment under this section only in a school test center
designated by each district. Each school test center must be secure, free of disruptions, have an
established seating arrangement, and be well lighted. Only designated district test coordinators,
associate test coordinators, proctors, or test administrators may be in the test center rooms at the
time of testing students.
(c) Each district shall designate an employee of the district as the district test coordinator. In
districts with two or more school test centers, the district shall designate an on-site associate test
coordinator for each center. The district test coordinator or associate test coordinator shall assign
as many test administrators or proctors to each school test center as necessary to ensure adequate
supervision or monitoring of students taking the assessment. Each test coordinator, associate test
coordinator, proctor, and test administrator must execute an agreement, on a form provided by
the department, affirming that the test procedures of the department and test publisher will be
followed.
4 AAC 06.765. Test security; consequences of breach
(a) All test questions on norm-referenced tests, standards-based tests, and the high school
graduation qualifying examinations, which are provided for in 4 AAC
06.700
- 4 AAC
06.790,
the college and work preparedness assessment provided for in 4 AAC
06.717,
and on the English
language proficiency assessment provided for in 4 AAC
34.055,
are confidential, and may be
disclosed only as provided in this section.
(b) Test questions may be disclosed to
(1) a student on the date and at the time specified by the commissioner, to the extent necessary to
administer the test;
(2) testing personnel in the course of fulfilling their duties;
(3) a department official as required for the performance of that official's duties; and
(4) a test administrator if necessary to fulfill duties under 4 AAC
06.775
regarding the delivery
of accommodations.
(c) School and district personnel responsible for test administration shall
(1) inventory and track test materials from the time the materials arrive at the school or district
office until the time the materials are returned to the test publisher;
Form #05-19-021
5 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5