Form 05-22-023 "Test Security Agreement Level 5" - Alaska

What Is Form 05-22-023?

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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Download Form 05-22-023 "Test Security Agreement Level 5" - Alaska

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Test Security Agreement Level 5
2021-2022
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 Alaska Department of
Education & Early Development 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 test administration and test security regulations referenced in this document can be found on
pages 5-7 of this form.
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 06.761(c); 4 AAC 06.765(f)(1).
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 # 05-22-023
1 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Test Security Agreement Level 5
2021-2022
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 Alaska Department of
Education & Early Development 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 test administration and test security regulations referenced in this document can be found on
pages 5-7 of this form.
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 06.761(c); 4 AAC 06.765(f)(1).
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 # 05-22-023
1 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Identification
Name (Last, First): _______________________________________________________________
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,
assistants)
administer, or monitor test
administration to students.
Note: If a district employee has a signed Level 1, 2, 3, or 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. 4 AAC 06.761(a) and (b)
Training for Testing Personnel – Completion of this section is required for all roles
____Only trained school district employees can help with testing. 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.). 4 AAC 06.765(c)(1)-(d)(4)
____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. 4 AAC 06.765(c)(1)-(d)(4)
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 secure materials” 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 follow types of computer-based assessment materials:
assessments stored on a local caching server, student login information and test tickets.
Secure Testing Practices – Completion of this section is required for all roles
____No one may have the tests before testing begins. 4 AAC 06.765(d)(7)
____Only students may read the test questions. 4 AAC 06.765(b)
Form # 05-22-023
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.
Testing Location – Completion of this section is required for all roles
____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. (4 AAC 06.765(d)(1)-(10)
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.
4 AAC 06.765(g)
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. 4 AAC 06.775(a)
Form # 05-22-023
3 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5
Assurances:
____I have read, and I understand 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 in fulfilling obligations to the public, as an educator I shall cooperate in the
statewide student assessment system established under 4 AAC 06.710 - 4 AAC 06.790 by
safeguarding and maintaining the confidentiality of test materials and information. 20 AAC
10.020(c)(3)
____Under 4 AAC 06.765(e), as a teacher holding a certificate issued under 4 AAC 12, I understand that
my actions may be subject to investigation and adjudication by the Professional Teaching Practices
Commission if I violate any of the provisions detailed in regulation or testing procedures/manual
published by test publisher (4 AAC 06.765(f)(3))
(If you do not possess a teaching certificate, please write N/A)
____I understand that I am obligated to immediately report any test irregularities and/or breaches of
test security to the 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
receiving any materials or administering any assessments.
Signature
Date
First and Last name typed or printed clearly
Form # 05-22-023
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 staff 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 building test
coordinator for each center. The district test coordinator or building test coordinator shall assign
as many test administrators to each school test center as necessary to ensure adequate supervision
or monitoring of students taking the assessment. Each test coordinator, building test coordinator,
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 standards-based tests provided for in
4 AAC
06.737, the alternate
assessment taken under
4 AAC
06.775, and on the English language proficiency assessments
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 secure materials from the time the materials arrive at the school or district
office until the time the materials are returned to the test publisher;
(2) securely store secure materials before distribution to school test centers and after their return;
(3) control distribution of secure materials to and from school test centers;
Form # 05-22-023
5 of 7
Alaska Department of Education & Early Development
Test Security Agreement Level 5