I have been tutoring a student in first grade for the past several weeks.  I have given him several assessments and he struggled completing most of them.  He has  receive additional tiered instruction the entire year,  however, still remains to struggle.  I was especially alarmed in the phonemic and phonics awareness areas.  He continues to have difficulty orally manipulating sounds.  Should I focus on phonemic awareness and continue this until he masters or should I move on to other areas of literacy?

This student should definitely continue to develop his phonemic awareness skills.  Phonemic awareness is an essential building block and without having a good grasp on the sounds that are made, he'll likely struggle at anything else you throw his way.  As you're continuing to work with this student on his phonemic awareness, maybe you could begin to introduce some word families, but don't just give up on the phonemic awareness altogether and move on to something else.