Specialist Evaluation System Handbook 2015-16 · K-8 Counselor Performance Profile and Rating (Form 2F) 83-84 . 4 Professional Refinement Plan (Form 3) 85 ... specialist performance,

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Acknowledgements This handbook was created with input and support from: Arizona Revised Statute § 15-203(A)(38) District Administrators and Specialists Charlotte Danielson, Enhancing Professional Practice: A Framework for Teaching (2nd Edition) Electronic Forms and Rubrics for Enhancing Professional Practice: A Framework for Teaching, by Charlotte Danielson. Alexandria, VA: ASCD, 2008. Used by permission. All rights reserved. Mesa Public Schools Educators The Arizona State Board of Education, Arizona Framework for Measuring Educator Effectiveness

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Table of Contents District Vision, Mission, Core Values, Priorities and Goals

5

Evaluation Introduction

6

Specialist Performance

6-8

Professional Development

Professional Refinement Plan

8

Professional Remediation Plan

8

Inadequate Specialist Performance

8-9

Appeal of Evaluation

9

Evaluation Timelines and Activities

10

Forms

Specialist Performance Evaluation

Nurse Performance Evaluation (Form 1A)

12-20

Psychologist Performance Evaluation (Form 1B)

21-32

Instructional Specialist Performance Evaluation (Form 1C)

33-42

Therapeutic Specialist Performance Evaluation (Form 1D)

43-51

Student Advisor Performance Evaluation (Form 1E)

52-61

K-8 Counselor Performance Evaluation (Form 1F)

62-70

Performance Evaluation Profile and Rating

Nurse Performance Profile and Rating (Form 2A)

71-72

Psychologist Performance Profile and Rating (Form 2B)

73-75

Instructional Specialist Performance Profile and Rating (Form 2C)

76-77

Therapeutic Specialist Performance Profile and Rating (Form 2D)

78-79

Student Advisor Performance Profile and Rating (Form 2E)

80-82

K-8 Counselor Performance Profile and Rating (Form 2F)

83-84

4

Professional Refinement Plan (Form 3) 85

Professional Remediation Plan (Form 4) 86

Notice of Inadequate Specialist Performance-Fall (Form 5) 87

Notice of Inadequate Specialist Performance-Final (Form 5) 88

Appendix

Appendix A-List of Specialists 90

Appendix B-Summary of Domains 91

Appendix C-Performance Classifications 92

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District Vision, Mission, Core Values, Priorities and Goals Vision Statement Unprecedented Excellence in Education

Mission Statement The mission of Mesa Public Schools is to develop a highly educated and productive community, one student at a time. Core Values In Mesa Public Schools, we believe…

…each child is important. …learning is our focus. …collaboration and innovation are indispensable. …sound fiscal stewardship is essential. …diversity increases our opportunities. …success is expected and celebrated.

Priorities and Goals Priority 1: Learning and Achievement Goals

1.! Provide educational offerings that maximize learning and achievement by meeting individual student’s varied needs and interests.

2.! Maximize the efficient and effective use of time, resources and staff to ensure academic excellence. 3.! Monitor and support the academic progress of students. 4.! Expect all stakeholders to take personal responsibility for student learning.

Priority 2: Relevant and High-Quality Comprehensive Curriculum Goals

1.! Develop and implement a comprehensive, relevant curriculum that is aligned with state academic standards. 2.! Provide a wide range of co-curricular and extracurricular opportunities to develop a wide variety of skills. 3.! Provide an optimal learning environment for high student performance. 4.! Utilize technology that is relevant and enhances learning.

Priority 3: Highly Qualified and Highly Effective Personnel Goals

1.! Recruit highly qualified personnel. 2.! Retain highly effective personnel. 3.! Provide professional and personal support, recognition and rewards.

Priority 4: Safe Health and Nurturing Learning Environments Goals

1.! Incorporate health, physical activity and nutrition concepts into the curriculum. 2.! Provide a safe environment. 3.! Maintain a clean environment. 4.! Provide a supportive environment for the workplace and educational excellence.

Priority 5: Students, Staff, Parents and Community Working Together Goals

1.! Provide timely and accurate information. 2.! Promote and expand involvement with all families. 3.! Develop meaningful, student-oriented community partnerships.

Priority 6: Optimal and Equitable Utilization of Resources Goals

1.! Capitalize on all viable revenue sources. 2.! Allocate district resources in an equitable manner. 3.! Manage district resources efficiently and effectively while emphasizing quality.

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Evaluation Introduction The Mesa Public Schools specialist evaluation system is a collaborative model leading to improved specialist performance, enhanced teaching and increased student achievement. All employees listed in Appendix A will be evaluated using the specialist evaluation system. Mesa Public Schools has developed a specialist evaluation system that aligns with the classroom teacher evaluation system and the vision, mission, core values, priorities and goals that are part of the district’s strategic plan. The evaluation system includes annual evaluations for specialists, using rubrics aligned with job performance expectations. The specialist evaluation system is intended to bring clarity, conversation and improvements to specialist performance by:

•! Providing a common district wide definition of effective specialist performance •! Embracing meaningful discussion and collaboration regarding professional practice •! Focusing on continuous growth for all specialists •! Identifying and emphasizing strategies that provide the greatest support for teaching and

student learning Based on established rubrics, the performance indicators of Highly Effective, Effective, Developing and Ineffective will be used to rate specialist performance. Specialist Performance Charlotte Danielson’s Frameworks for Specialists were used as a resource and guide in establishing specialist frameworks for Mesa Public Schools. The specialist performance evaluations are organized into four domains and 22 components. The four domains are listed below. Descriptions of the domains can be found in Appendix B.

•! Planning and Preparation •! The Environment •! Delivery of Service •! Professional Responsibilities

Mesa Public Schools will refer to the specialist frameworks as the Specialist Performance Evaluations (Nurses- Form 1A, Psychologists-Form 1B, Instructional Specialists-Form 1C and Therapeutic Specialists-Form 1D, Student Advisors-Form 1E, K-8 Counselors-Form-1F). The Specialist Performance Evaluations identify specialist job expectations and responsibilities. Evidence of specialist performance will be gathered for all components of the framework. Evidence for all domains will be collected through pre- and post-observation conferences, observation experiences, program planning documents, communication logs, conversations about specialist practice, and other professional artifacts. The Specialist Performance Evaluations emphasize that planning precedes the work as a specialist; a positive and engaging environment must be in place for delivery of quality services; and specialists embracing high professional standards contribute to better performance. Evaluators will be required to conduct one observation experience before completing the Fall Summative Specialist Performance Evaluation and one observation experience before completing the Spring Summative Specialist Performance Evaluation. The evaluator will give

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the specialist prior notice of the observation experience for the Fall Summative Specialist Performance Evaluation.

The evaluator, in consultation with the specialist, will establish an observation experience that will serve in place of the formal classroom observation required for classroom teacher evaluations. The observation experience may consist of one or more physical observations of the specialist while delivering services in the work environment. The duration of the observation experience as a whole will be sufficient to allow the specialist to demonstrate delivery of skills assessed through the evaluation instrument.

During pre- and post-observation conferences, which are part of the specialist evaluation process, specialists must be prepared to engage in professional dialogue with the evaluator regarding job expectations and performance. Within 10 business days after each observation experience, a post-observation conference must be completed and the evaluator must provide written feedback to the specialist. The specialist will also be provided the opportunity to complete a self-review during the Fall and Spring Summative Specialist Performance Evaluations. Specialists will be evaluated in each of the 22 components based on the evidence collected through pre- and post-observation conferences, observation experiences, self-reviews, program planning documents, communication logs, conversations about specialist practice, and other professional artifacts. Written communications and other information regarding interactions with students, parents, and co-workers may be considered by the evaluator, provided that the specialist is given an opportunity to comment on the information during a conference or other communication with the evaluator.

If a specialist has continuing teacher status as defined in A.R.S. §15-538.01(D), or is a nurse or psychologist or audiologist who has been employed by the district for the major portion of three consecutive school years and receives a “Highly Effective” or “Effective” rating on the Fall Summative Specialist Performance Evaluation, the evaluator may waive the requirement of conducting a Spring Summative Specialist Performance Evaluation. If the waiver occurs, the employee’s Final Summative Specialist Performance Evaluation will be completed using the Fall Summative Specialist Performance Evaluation scores. The evaluator or specialist may request the completion of a Spring Summative Specialist Performance Evaluation.

All other specialists will receive a Fall Summative Specialist Performance Evaluation and Spring Summative Specialist Performance Evaluation. The results of the two evaluations will be used to complete a Final Summative Specialist Performance Evaluation. If the specialist receives unequal scores for the same component of the Fall and Spring Summative Specialist Performance Evaluations, the evaluator will determine, in his or her sole discretion, which score most accurately reflects the specialist’s performance over the school year. At least 60 calendar days must elapse between the observation experience of the Fall Summative Specialist Performance Evaluation and the observation experience of the Spring Summative Specialist Performance Evaluation.

A specialist scheduled to be evaluated by a school principal or other evaluator rated “Ineffective” or “Unsatisfactory” for the preceding school year may decline to be evaluated by the evaluator. By September 1, the district will notify specialists who have the foregoing right. The specialist must exercise the right by delivery of written notice to the Assistant Superintendent of Human Resources no later than September 15 of the current school year. Upon receipt of notice from the specialist, the Assistant Superintendent of Human Resources will assign responsibility for the specialist’s evaluation to another evaluator.

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After the review of all specialist performance evidence, the specialist will receive a Final Summative Specialist Performance Evaluation that will be used to determine the Specialist Performance Profile and Rating (Form 2) resulting in a Final Specialist Evaluation Rating of Highly Effective, Effective, Developing or Ineffective as adopted by the governing board. The classifications and descriptions can be found in Appendix C. Professional Development Professional Refinement Plan A Professional Refinement Plan (Form 3) will be established for every specialist who receives a final rating of “Highly Effective” or “Effective” on the Specialist Performance Profile and Rating (Form 2). Prior to the end of the present school year, the evaluator, in collaboration with the specialist, will develop a plan to target an area for refinement. The professional refinement plan will be implemented throughout the next evaluation cycle. Professional Remediation Plan A Professional Remediation Plan (Form 4) will be established for every specialist who receives a final rating of “Developing” or “Ineffective” on the Specialist Performance Profile and Rating (Form 2) or at any time at the discretion of the evaluator. The evaluator, in collaboration with the specialist, will develop a plan to target the areas(s) of deficiency. The plan will include goals, strategies, and action steps; identify training opportunities and other resources available for the employee to correct the deficiencies and demonstrate adequate specialist performance; and specify the date by which the employee must correct any deficiencies and demonstrate adequate specialist performance. Inadequate Specialist Performance A specialist shall be deemed inadequate when he or she receives a rating of “Ineffective” as a result of the Fall or Final Summative Specialist Performance Evaluation, or a rating of “Developing” or “Ineffective” as a result of the Fall or Final Summative Specialist Performance Evaluations for two consecutive school years. If a specialist meets the definition of Inadequate Specialist Performance based on the Fall or Final Summative Specialist Performance Evaluations, the evaluator will initiate the inadequate specialist performance process by completing the Notification of Inadequate Specialist Performance (Form 5) and submitting the form and the signed Specialist Performance Profile and Rating (Form 2) to the Human Resources Department. The fall notification must occur prior to the last Monday in November and the spring notification prior to the last Monday in April. The Superintendent may issue a preliminary notice of inadequate specialist performance at any time if the specialist meets the definition of inadequate specialist performance outlined above. If the inadequate specialist performance process is not completed by the end of the school year in which it started, the process will continue in the following school year as necessary to allow the specialist the opportunity to complete the Professional Remediation Plan (Form 4), correct inadequacies and demonstrate adequate specialist performance. If a specialist has been issued a preliminary notice of inadequate specialist performance, the Assistant Superintendent of Human Resources will assign a second evaluator to independently complete a second summative evaluation, which will include a review of all evidence collected by the original evaluator and at least one observation experience completed by each evaluator after the employee has been given an opportunity to complete a Professional Remediation Plan. The original

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evaluator and second evaluator will meet to determine whether there is interrater agreement identifying the employee has corrected inadequacies and demonstrated adequate specialist performance. The evaluators will inform the employee and the Assistant Superintendent of Human Resources of the results of the Fall or Final Summative Specialist Performance Evaluation.

If a specialist receives a preliminary notice of inadequate specialist performance, the notice will be accompanied by a Professional Remediation Plan that is designed to help the specialist correct inadequacies and demonstrate adequate specialist performance. The plan will include goals, strategies, and action steps; identify training opportunities and other resources available for the employee to correct the deficiencies and demonstrate adequate specialist performance; and specify the date by which the employee must correct any deficiencies and demonstrate adequate specialist performance. The Professional Remediation Plan will remain in effect for not less than 45 instructional days.

Appeal of Evaluation

A specialist who disagrees with a Final Summative Specialist Performance Evaluation may submit a written appeal to the Assistant Superintendent of Human Resources or designee within 10 calendar days after receipt of the evaluation instrument. The appeal must describe with specificity the alleged error or errors that are the basis for the appeal. Allegations of error regarding the evaluator’s judgment of the specialist’s performance during an observation experience will not be considered in an appeal, if the evaluator’s perceptions of the specialist’s performance with regard to specific elements are properly documented. The Assistant Superintendent may decline to consider an appeal if the appeal is not timely or if the Assistant Superintendent determines that the evaluation will not affect the employee’s eligibility for, or amount of, performance pay, or other form of compensation and will not materially affect an administrative decision regarding the employee’s employment for the subsequent school year.

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Evaluation Timelines and Activities Timeline Activities Within the first two weeks of the school year

Specialist Evaluation Orientation •!Evaluator will provide an overview of the specialist evaluation system to all

specialists. Prior to the end of the first semester

Fall Summative Specialist Performance Evaluation •!Collect evidence for Domains 1, 2, 3 and 4 through the pre- and post-observation conference process and the observation experience •!Specialist completes self-review •!Complete the Fall Summative Specialist Performance Evaluation and record component scores in the Specialist Performance Profile and Rating (Form 2)

Prior to the end of March Spring and Final Summative Specialist Performance Evaluations •!Collect evidence for Domains 1, 2, 3 and 4 through the pre- and post-observation conference process and the observation experience •!Specialist completes self-review •!Complete the Spring and Final Summative Specialist Performance Evaluations for all

probationary specialists and continuing status specialists requiring a Spring Summative Specialist Performance Evaluation and record component scores in the Specialist Performance Profile and Rating (Form 2)

•!Complete and submit each specialist’s signed Specialist Performance Profile and Rating (Form 2) to the Human Resources Department

•!Final Summative Specialist Performance Evaluation scores will be used for specialist RIF profiles

Prior to the last day of school

Development of Refinement Plans •!A Professional Refinement Plan (Form 3) will be established for every specialist

who receives a final rating of “Highly Effective” or “Effective” on the Specialist Performance Profile and Rating (Form 2). Prior to the end of the present school year, the evaluator, in collaboration with the specialist, will develop a plan to target an area for refinement. The professional refinement plan will be implemented throughout the next evaluation cycle.

No timeline Development of Remediation Plans •!A Professional Remediation Plan (Form 4) will be established for every specialist

who receives a final rating of “Developing” or “Ineffective” on the Specialist Performance Profile and Rating (Form 2) or at any time at the discretion of the evaluator. The evaluator, in collaboration with the specialist, will develop a plan to target the areas(s) of deficiency.

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Forms

Copyright*©2008*by*the*Association*for*Supervision*and*Curriculum*Development*(ASCD)*12

Nurse Performance Evaluation (Form 1A) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**

!Fall*Summative*Evaluation**□* Spring*Summative*Evaluation**□*

!Evaluator:**

! *

Status:** Probationary**□* Continuing**□* Evaluation*□* SelfHReview**□**

!DOMAIN!1!FOR!NURSES:�PLANNING!AND!PREPARATION*

!

!COMPONENT!

!INEFFECTIVE!

!DEVELOPING!

!EFFECTIVE!

!HIGHLY!EFFECTIVE!

!1a.!!!Demonstrating!knowledge!of!school!nurse!practice!by!maintaining!student!!health!and!safety!on!campus/Understanding!the!professional,!ethical!and!legal!standards!that!guide!the!nurse!in!the!school!setting!

*

Nurse*demonstrates*little*

understanding*of*school*nurse*

practice.**Nurse*has*little*

understanding*of*professional*

expectations*and*legal*regulations*

related*to*the*practice*of*school*

nursing.*

*

*

*

*

* *□*

*

Nurse*demonstrates*basic*

understanding*of*school*nurse*

practice,*through*the*utilization*of*

data,*documentation*and*treatment*

planning.*Nurse*has*basic*

understanding*of*professional*


related*to*the*practice*of*school*

nursing.*

*

*

□*

!Nurse!demonstrates!adequate!understanding!of!School!nurse!practice,!through!the!utilization!of!data,!documentation!and!treatment!planning.!Nurse!has!understanding!of!professional!expectations!and!legal!regulations!related!to!the!practice!of!school!nursing.!!!

□!

*

Nurse*demonstrates*deep*and*

thorough*understanding*of*school*

nurse*practice.**School*nurse*actively*

maintains*student*health*through*

assessment,*planning,*treatment,*

documentation*and*evaluation.*The*

school*nurse*has*a*thorough*

understanding*of*the*ethical*


and*provides*leadership*in*sharing*

such*knowledge*with*colleagues.*

□*

**

EVIDENCE:***

**

!1b:!!!Demonstrating!knowledge!of!child!and!adolescent!development!

*

Nurse*displays*little*knowledge*of*

child*and*adolescent*development*

and*has*little*ability*to*assess*student*

developmental*milestones.*

*

*

□*

*

Nurse*displays*basic*knowledge*of*

child*and*adolescent*development.*

Supports*are*needed*to*further*skills*

in*developmental*assessment.*

*

*

□*

!Nurse!displays!accurate!understanding!of!child!and!adolescent!development!and!is!able!to!apply!this!knowledge!in!health!teachings,!health!promotion!and!special!education!meetings.!!

□!

*

Nurse*displays*thorough*knowledge*

of*child*and*adolescent*development.*

Nurse*displays*knowledge*of*

development*delays*and*their*impact*

on*student*performance.*Nurse*

provides*leadership*in*sharing*such*

knowledge*with*colleagues.*

□*

**

EVIDENCE:***

**

*


!1c:!!!Establishing!goals!for!the!school!health!program!appropriate!to!the!setting!and!the!students!served!

*

Nurse*has*no*clear*goals*for*the*

school*health*program,*or*they*are*

inappropriate*to*either*the*situation*or*

the*age*of*the*students.*

*

*

*

*

□*

*

Nurse’s*goals*for*the*school*health*

program*are*rudimentary*and*are*

partially*suitable*to*the*situation*and*


*

*

*

*

□*

!Nurse’s!goals!for!the!school!health!program!are!clear!and!appropriate!to!the!situation!and!age!of!the!students.!Nurse!is!able!to!coordinate!work!and!establish!goals!independently!by!communicating!with!the!school!community.!

□!

*

Nurse's*goals*for*the*school*health*

program*are*highly*appropriate*to*the*

situation*and*to*the*age*of*the*

students.*Goals*have*been*

developed*through*consultations*with*

students,*parents,*and/or*colleagues.*

*

□*

**

EVIDENCE:***

**

!1d:!Demonstrating!knowledge!of!nursing!scope!of!practice/Utilizing!district!resources!and!health!manual!procedures/Following!state!and!federal!regulations,!by!maintaining!appropriate!license!and!certifications!!

*

Nurse*demonstrates*little*or*no*

knowledge*of*nursing*scope*of*

practice,*governmental*regulations*or*

district*procedures/resources.*

*

*

*

*

*

*

□*

*

Nurse*demonstrates*basic*


practice.*Nurse*displays*awareness*

of*governmental*regulations*and*of*

most*district*procedures/resources.*

Nurse*demonstrates*limited*

knowledge*of*resources*available*

within*the*community.*

*

*

□*

!Nurse!demonstrates!adequate!knowledge!of!nursing!scope!of!practice.!Nurse!displays!awareness!of!governmental!regulations,!district!procedures!and!resources!for!students!available!through!the!school,!district!and!the!community.!!!

□!

*

Nurse*demonstrates*substantial*


practice.*Nurse’s*knowledge*of*

governmental*regulations,*district*

procedures*and*resources*is*

extensive.*Nurse*takes*a*leadership*

role*in*sharing*knowledge*and*

participates*in*department*review*and*

ongoing*evaluation*of*health*manual*

guidelines.*

□**

**

*EVIDENCE:***

!1e:!Writing!individual!healthcare!plans!for!students!

*

Nurse*does*not*appear*to*have*an*

overall*plan*but*instead*provides*

services*in*a*seemingly*random*way.*

Nurse*does*not*use*a*problemH

solving*framework*to*work*with*

teachers,*colleagues,*and*parents*in*

writing*and*implementing*care*plans*

for*the*students.*

*

□*

*

Nurse*writes*an*individual*healthcare*

plan*but*does*not*individualize*the*

plan.**Does*not*consistently*use*a*

problemHsolving*framework.*

*

*

*

*

*

□*

!Nurse!writes!student!individual!healthcare!plans!that!are!individualized!and!utilizes!problem!solving!approach!to!respond!to!concerns!by!consulting!with!parent!and!medical!provider.!!Nurse!is!able!to!collaborate!with!school!staff!in!implementing!the!plan.!

□!

*

Nurse*writes,*individualizes*and*

implements*student*individual*

healthcare*plans*that*are*detailed,*

relevant*and*appropriate*to*the*

school*setting.*Nurse*consistently*

utilizes*problem*solving*framework*in*

responding*to*concerns*and*assumes*

a*leadership*role*in*training.*

*

□*

**

*EVIDENCE:***


!1f:!Demonstrating!knowledge!of!school!and!community!resources!

*

Nurse*has*little*knowledge*of*school*

and*community*resources.**Does*not*

know*how*to*access*district*

resources*webpage.*

*

□*

*

Nurse*has*some*knowledge*of*school*

and*community*resources*and*may*

occasionally*research*resources.*

*

*

□*

!Nurse!utilizes!resources!for!the!benefit!of!students!or!the!school!community.!

*

*

□!

*

Nurse*utilizes*and*develops*

resources*for*the*school*and*

community.**Nurse*regularly*provides*

feedback*regarding*the*use*of*

resources.*

□*

**

*EVIDENCE:*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*


!DOMAIN!2!FOR!NURSES:�THE!ENVIRONMENT!

!

!COMPONENTS!

!INEFFECTIVE!

!DEVELOPING!

!EFFECTIVE!

!HIGHLY!EFFECTIVE!

!2a:!Creating!an!environment!of!respect!and!rapport!in!professional!relationships!and!with!students,!staff!and!parents!

*

Nurse’s*interactions*with*some*staff,*

students*or*parents*may*be*negative*

or*inappropriate.*School*nurse*rarely*

engages*in*collaborative,*effective,*

and/or*ethical*professional*

relationships.*The*school*nurse*does*

not*promote*teamwork.*

************□*

*

Nurse’s*interactions*with*staff,*

students*or*parents*are*a*mix*of*

positive*and*negative.*School*nurse*

engages*in*some*collaborative*

relationships*but*these*are*not*

always*effective.**

*

************□*

*

Nurse’s!interactions!with!students,!parents!or!staff!are!positive!and!respectful.!The!school!nurse!engages!in!collaborative,!effective,!and!ethical!professional!relationships!that!promote!a!positive!team!environment.!

************□*

*

In*addition*to*the*standard,*students,*

staff*and*parents*often*seek*out*the*

nurse,*reflecting*a*high*degree*of*

comfort*and*trust*in*the*relationship*

and*collaborative*outcomes.*

*

*

************□*

!EVIDENCE:!**

**

**

!2b:!!Establishing!an!environment!that!is!culturally!sensitive!

*

Nurse*makes*no*attempt*to*establish*

a*culturally*sensitive*environment*in*

the*health*office.*

************□*

*

Nurse*attempts*to*establish*a*

culturally*sensitive*environment*in*the*

health*office,*but*additional*support*

and*training*are*necessary.*

************□*

*

Nurse!promotes!a!culturally!sensitive!environment!in!the!health!office!by!understanding!the!cultural!diversity!of!the!school!population.!

************□*

*

A*culturally*sensitive*environment*is*

promoted*and*fostered*by*the*school*

nurse.*The*school*nurse*actively*

seeks*knowledge*and*works*with*

others*to*promote*acceptance.**

□*

!EVIDENCE:!**

**

**

!2c:!Utilizing!health!protocols!and!procedures!in!providing!care!to!students!

*

Nurse*does*not*consistently*follow*

procedures*as*outlined*in*the*health*

manual*and*state/county*

immunization*reporting*guidelines.*

*

*

*

*

************□*

*

Nurse*partially*follows*procedures.*

Nurse*is*able*to*locate*district*policy,*

health*services*guidelines*and*is*

aware*of*immunization*regulations.*

*

*

*

*

************□*

*

Nurse!follows!procedures!in!a!consistent!and!predictable!manner,!utilizing!the!health!services!manual!and!other!state/county!reporting!documents.!Identifies!and!refer!students!who!are!not!in!compliance!with!State!Immunization!Law.!

************□*

*

In*addition*to*the*standards,*nurse*

consistently*follows*procedures*in*a*

seamless*fashion,*anticipating*

unexpected*situations.*Suggestions*

for*changes*are*appropriate*and*data*

driven.*

*

*

************□*

!EVIDENCE:!**

**

**

*

*


!2d:!Supervising!health!assistants!

*

No*guidelines*for*delegated*duties*

have*been*established*or*the*

guidelines*are*unclear.*Nurse*does*

not*monitor*health*assistant*activities*

or*documentation.*

*

*

************□*

*

Nurse’s*efforts*to*establish*guidelines*

for*delegated*duties*are*partially*

successful.*Nurse*monitors*health*

assistant*activities*sporadically.*

*

*

*

************□*

*

Nurse!has!established!guidelines!for!delegated!duties!and!monitors!health!assistant!activities!on!a!regular!basis!including!review!of!documentation!and!ongoing!mentoring.!*

************□*

*

Nurse*provides*clear*guidance*and*

ongoing*supervision*of*the*health*

assistant.*Nurse*facilitates*

independent*and*safe*functioning*of*

health*office*duties*by*the*health*

assistants*and*provides*ongoing*

mentoring.*

************□*

!EVIDENCE:!**

**

**

!2e:!Organizing!health!office!

*

Health*office*is*disorganized*and*

unkept.*Substitute*folder*is*not*

properly*maintained.**

*

*

************□*

*

Health*office*is*adequately*

organized,*and*clean.**Substitute*

folder*is*often*out*of*date.*

*

*

************□*

*

Health!office!is!well!organized!and!clean.!Resource!information!and!student!care!plans!are!accessible!and!substitute!folder!is!up!to!date.!!

************□*

*

Health*office*is*efficiently*organized.*

Resource*information,*care*plans*and*

student*information*is*accessible.*

Nurse*is*able*to*prioritize*

organizational*tasks.******

□*

!EVIDENCE:!**

**

**

*

*


!DOMAIN!3!FOR!NURSES:�DELIVERY!OF!SERVICE*

!

!COMPONENTS!

!INEFFECTIVE!

!DEVELOPING!

!EFFECTIVE!

!HIGH!EFFECTIVE!

!3a:!Assessing!student!needs!

*

Nurse*does*not*assess*student*

needs*or*the*assessment*results*are*

inaccurate.*Cannot*apply*triage*

principles*to*identify*critical*incident.*

*

************□*

*

Nurse*provides*basic*assessment*of*

student's*needs*and*can*apply*some*

triage*principles.*

*

*

************□*

*

Nurse!provides!adequate!assessment!of!student!needs!and!applies!appropriate!interventions!during!incidents!of!a!critical!nature.!

************□*

*

Nurse*conducts*detailed*and*

individualized*assessment*of*student*

needs*and*applies*intervention*

strategies*to*determine*the*best*use*

of*resources.*

************□*

!EVIDENCE:!**

**

!3b:!Administering!medications!to!students!

*

Medications*are*administered*with*no*

regard*to*state*or*district*policies.*

Medications*are*not*properly*stored.*

*

*

*

*

************□*

*

Medications*are*administered*by*

designated*individuals.*Nurse*

assures*basic*training*of*delegated*

persons*and*effective*record*

keeping.*Medications*are*difficult*to*

find.*

*

************□*

*

Medications!are!appropriately!administered!by!designated!individuals.!Nurse!evaluates!and!reWadjusts!delegation!duties!as!needed.!Medications!are!properly!stored!and!well!organized.!!

************□*

*

Medications*are*administered*by*

designated*individuals*in*a*highly*

effective*manner.*Students*take*an*

active*role*in*medication*compliance.*

Parent*and*medical*provider*are*

informed*of*potential*problems*in*a*

timely*and*professional*manner.*

************□*

!EVIDENCE:!**

**

!3c:!Promoting!wellness!through!individual,!classroom!or!school!wide!education!and!acts!as!a!public!health!resource!

*

Nurse*does*not*provide*wellness*

education*programs*or*provide*public*

health*information*to*school*

community.**

*

*

************□*

*

Nurse*promotes*wellness*through*

classroom*presentations*or*individual*

education.*Public*health*information*

is*not*clear*and*concise.**

*

*

************□*

*

Nurse!promotes!wellness!through!classroom!presentations!and!individual!education.!Public!health!information!and!monitoring!are!performed!on!a!regular!basis!and!are!effective.!

************□*

*

Nurse*promotes*wellness*through*

classroom*presentations*and*

individual*education.*Public*health*

information*and*monitoring*are*highly*

effective.*Positive*life*choices*are*

encouraged.*

************□*

!EVIDENCE:!**

**


!3d:!Managing!emergency!situations!

*

Nurse*has*no*contingency*plans*for*

emergency*situations.*

*

*

*

*

*

*

************□*

*

Nurse’s*plans*for*emergency*

situations*have*been*developed*for*

the*most*frequently*occurring*

situations.*

*

*

*

*

************□*

*

Nurse’s!plans!for!emergency!situations!have!been!developed!for!many!situations!and!are!clear!and!concise.!*

*

*

*

************□*

*

Nurse's*plans*for*emergency*

situations*have*been*developed*for*

many*situations.*Students*and*

teachers*have*learned*their*

responsibilities*in*case*of*

emergencies.*Nurse*provides*input*

into*preparedness*planning*and*

followHup.*

************□*

!EVIDENCE:!**

**

!3e:!Collaborating!with!parent!and!teachers!to!develop!individualized!healthcare!plans!(IHP)!and!services!for!students!with!special!medical!needs!

*

Nurse*declines*to*collaborate*with*

parents*and*teachers*to*develop*

individualized*healthcare*plans.*Few*

staff*are*trained*to*provide*service.*

*

*

*

*

************□*

*

Nurse*collaborates*with*parents*and*

teachers*in*developing*individualized*

healthcare*plans*when*asked.*Some*

staff*are*trained*to*provide*service.*

*

*

*

*

************□*

!Nurse!initiates!collaboration!with!parents!and!teachers!in!developing!individualized!healthcare!plan!(IHP)!for!students.!!IHP!is!clear,!concise!and!is!reviewed!annually!or!as!needed.!Training!and!delegation!follows!guidelines!with!at!least!three!school!staff!trained.!

************□*

*

In*addition*to*standards,*the*nurse*

initiates*collaboration*with*parents,*

medical*providers*and*teachers*in*

developing*individualized*healthcare*

plans.*Nurse*actively*locates*

resources*for*parents,*students*and*

teachers,*as*appropriate.*

*

*

************□*

!EVIDENCE:!**

**


!DOMAIN!4!FOR!NURSES:�PROFESSIONAL!RESPONSIBILITIES*

!

!COMPONENT!

!

!INEFFECTIVE!

!DEVELOPING!

!EFFECTIVE!

!HIGHLY!EFFECTIVE!

!4a:!Reflecting!on!nursing!practice!which!is!based!on!current!scientific!evidence!

*

Nurse*does*not*show*evidence*of*

school*nurse*practice,*or*the*

reflections*are*inaccurate*or*selfH

serving.**

*

*

*

*

*

************□*

*

Nurse's*reflection*of*evidence*based*

practice*is*moderately*accurate*and*

objective.**Nurse*needs*development*

in*analysis*of*planning*and*

implementation*of*school*nurse*

techniques*and*practice.*

*

*

*

□*

*

Nurse's!reflection!provides!an!accurate!and!objective!description!of!evidence!based!practice,!citing!specific!positive!and!negative!characteristics.!Nurse!actively!seeks!ideas!for!program!improvement!through!selfWdirection!and!feedback!from!colleagues.!!!

************□!

*

Nurse's*reflection*is*highly*accurate*

and*perceptive.*Nurse*draws*on*an*

extensive*repertoire*to*suggest*

alternative*strategies*to*improve*

health*office*activity.*Health*office*

activities*support*the*educational*

goals*of*the*school.*Nurse*serves*as*

a*mentor*and*engages*in*professional*

activities.**

************□*

!EVIDENCE:!**

**

!4b:!Maintaining!health!records!in!accordance!with!policy!and!submitting!reports!in!a!timely!fashion!

*

Nurse’s*health*log,*medication*

records*and*immunization*records,*

are*frequently*missing,*late*or*

inaccurate.*

*

*

*

************□*

*

Nurse’s*health*log,*medication*

records*and*immunization*records*are*

generally*accurate,*but*are*

occasionally*late.*

*

*

*

************□*

*

Nurse’s!health!log,!medication!records!and!immunization!records!are!accurate!and!are!submitted!in!a!timely!manner.!!!!!

************□!

*

In*addition*to*meeting*the*criteria*on*

this*standard,*the*nurse’s*approach*to*

record*keeping*is*highly*systematic*

and*efficient.*Nurse's*documentation*

serves*as*a*model*for*colleagues*

across*the*school.*Reports*are*

accurate*and*timely.*

************□*

!EVIDENCE:!**

**

!4c:!Professional!communication!

*

Nurse*does*not*communicate*clearly*

or*effectively*and*in*a*timely*manner*

with*students,*parents*and*school*

personnel.*

*

*

*

*

************□*

*

Nurse*makes*an*effort*to*

communicate*with*students,*parents,*

and*school*personnel,*but*these*

communications*may*not*always*be*

made*in*a*timely*manner*or*may*

occasionally*lack*clarity*and/or*

sensitivity.**

*

************□*

!Nurse!regularly!communicates!with!students,!parents,!and!school!personnel!and!these!communications!are!made!in!a!timely!manner!and!are!delivered!with!clarity!and!sensitivity.!The!nurse!frequently!acts!as!a!resource!person!to!staff!and!families.!!

************□!

*

In*addition*to*meeting*the*criteria*on*

this*standard,*the*nurse*proactively*

consults*with*families,*medical*

providers*and*colleagues.**

*

*

*

*

************□*

!EVIDENCE:!**

**


!4d:!Maintaining!confidentiality!

*

Nurse*violates*confidentiality*of*

sensitive*issues*when*dealing*with*

colleagues*or*student*issues.*

*

*

*

*

*

************□*

*

Nurse*appropriately*maintains*

confidentiality*of*sensitive*issues*

when*dealing*with*colleagues*or*

student*issues*in*most*interactions.*

*

*

*

*

************□*

!Nurse!appropriately!maintains!confidentiality!in!all!interactions.!Nurse!is!sensitive!to!issues!when!dealing!with!health!related!concerns!and!provides!information!when!appropriate.!!!!!

************□!

*

Nurse*maintains*confidentiality*in*all*

interactions.*Nurse*is*seen*as*a*

resource*and*instructs*colleagues*in*

confidentiality*rules.*Nurse*has*a*clear*

understanding*of*HIPPA*and*FERPA*

laws*pertaining*to*interactions*in*the*

school*setting.*

!EVIDENCE:!**

**

!4e:!Engaging!in!professional!development!

*

Nurse*does*not*participate*in*

professional*development*activities,*

even*when*such*activities*are*clearly*

needed*for*the*development*of*school*

nursing*skills.*

*

*

*

*

*

************□*

*

Nurse’s*participation*in*professional*

development*activities*is*limited*to*

those*that*are*convenient*or*are*

required.*

*

*

*

*

*

*

************□*

!Nurse!seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!Nurse!networks!with!colleagues!to!share!strategies.!!!!!!!!

************□!

*

Nurse*actively*pursues*professional*

development*opportunities*and*makes*

a*substantial*contribution*to*the*

profession*through*such*activities*as*

offering*workshops*to*colleagues.*

Nurse*belongs*to*professional*

organizations*for*increased*continuing*

education.*Nurse*stays*up*to*date*

with*school*nursing*journals,*articles,*

websites.**

************□*

!EVIDENCE:!**

**

!4f:!Shows!professionalism!by!being!a!good!role!model!including!dependable!attendance,!punctuality!in!performance!of!duties!and!professional!appearance.!

*

Nurse*is*not*seen*as*a*role*model*in*

the*school.*Nurse*displays*dishonesty*

in*interactions*with*colleagues,*

students,*and/or*the*public,*does*not*

exercise*good*judgment*in*

professional*settings*and*does*not*

have*dependable*attendance.*

*

*

*

************□*

*

Nurse*is*seen*as*a*role*model*in*

some*situations.*Nurse*is*honest*in*

interactions*with*colleagues,*students,*

and/or*the*public,*plays*a*moderate*

advocacy*role*for*students,*and*

exercises*good*judgment*in*

professional*settings.*

*

*

*

************□*

*

Nurse!is!seen!as!a!role!model!in!the!school!in!most!interactions.!Nurse!displays!high!standards!of!honesty,!integrity!with!interactions!with!colleagues,!students,!and/or!the!public.!Nurse!exercises!good!judgment!in!professional!settings!and!advocates!for!students!when!needed.!*

************□*

*

Nurse*is*consistently*seen*as*a*

professional*role*model*by*students*

and*colleagues*in*the*school.*Nurse*

can*be*counted*on*to*hold*the*highest*

standards*of*honesty,*integrity,*

professional*judgment*and*advocates*

for*students,*taking*a*leadership*role*

with*colleagues.*

*

*

************□*

!EVIDENCE:!**

**

*21

Psychologist Performance Evaluation (Form 1B) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**


!Evaluator:**

! *


!!DOMAIN!1!FOR!SCHOOL!PSYCHOLOGISTS:�PLANNING!AND!PREPARATION*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

1a:!!Demonstrating!knowledge!of!the!profession!of!psychology,!including!professional,!ethical,!and!legal!standards!and!regulations!that!guide!the!practice!of!psychology!in!education!

School*psychologist*has*limited*

knowledge*of*professional*

standards,*ethical*expectations,*and*

legal*regulations*related*to*the*

practice*of*psychology*in*the*

schools.*

*

*

************□*

School*psychologist*has*a*general*




practice*of*psychology*in*the*

schools,*but**requires*support*to*

further*develop*this*knowledge.*

*

************□*

School!psychologist!consistently!practices!in!ways!that!demonstrate!knowledge!of!professional!standards,!ethical!expectations,!and!legal!regulations!related!to!the!practice!of!psychology.!!

!!!!!!!!!!!!□*

School*psychologist*consistently*

practices*in*ways*that*demonstrate*




practice*of*psychology*and*provides*

leadership*in*sharing*such*

knowledge*with*colleagues.*

************□*

EVIDENCE:!!

1b:!!Demonstrating!knowledge!!of!child!and!adolescent!characteristics,!including!knowledge!of!development,!cultural!diversity,!and!psychopathology!

School*psychologist*demonstrates*

little*or*no*knowledge*of*child*and*

adolescent*development,*cultural*

diversity,*and/*or*psychopathology.*

*

*

*

************□*


basic*knowledge*of*child*and*

adolescent*development,*cultural*

diversity,*and/*or*psychopathology,*

but*requires*support*to*further*

develop*this*knowledge.*

*

************□*

School!psychologist!consistently!demonstrates!thorough!knowledge!of!child!and!adolescent!development,!cultural!diversity,!and!psychoWpathology.!!!

!!!!!!!!!!!!□*


demonstrates*thorough*knowledge*of*

child*and*adolescent*development,*

cultural*diversity,*and*psychoH

pathology*and*provides*leadership*in*

sharing*such*knowledge*with*

colleagues.*

************□*

EVIDENCE:!

*

22

1c:!!Demonstrating!knowledge!of!assessment,!including!selecting!and!using!a!range!of!psychological!instruments!to!evaluate!students,!linked!to!assessment!concerns!and!potential!interventions!


little*or*no*knowledge*and*skill*in*

selecting*different*psychological*

instruments*to*evaluate*students,*

tending*to*select*only*one*or*two*

instruments*regardless*of*the*referral*

concern.*

************□*

School*psychologist*knows*a*number*

of*tests*but*tends*to*select*a*

standard*battery*for*all*assessments,*

with*limited*regard*to*the*specific*

assessment*needs*of*each*case.*

*

*

************□*

School!psychologist!selects!different!psychological!instruments!to!evaluate!students!based!on!referral!concern!and!assessment!needs.!!!

!!!!!!!!!!!!□!

School*psychologist*selects*from*

among*a*wide*range*of*psychological*

instruments*to*evaluate*students,*

selecting*instruments*based*on*the*

referral*concern,*and*linking*choice*

of*assessment*tools*to*potential*

interventions.*

************□*

EVIDENCE:!

1d:!Demonstrating!knowledge!of!procedures!and!resources,!including!district!procedures,!state!and!federal!regulations,!resources!within!and!beyond!the!school!and!district,!and!the!continuum!of!services!available!to!students!


little*or*no*knowledge*of*

governmental*regulations*or*district*

procedures*or*of*resources*for*

students*available*through*the*

school,*district,*and*community.*

*

*

************□*

School*psychologist*displays*

awareness*of*governmental*

regulations*and*of*most*district*

procedures*and*of*resources*for*


school*or*district,*but*has*limited*


within*the*community.*

************□*

School!psychologist!displays!awareness!of!governmental!regulations!and!district!procedures!and!of!resources!for!students!available!through!the!school!or!district!and!the!community.!!

!!!!!!!!!!!!□*

School*psychologist’s*knowledge*of*

governmental*regulations*and*district*

procedures*and*of*resources*for*

students*is*extensive,*including*

those*available*through*the*school*or*

district*and*in*the*community*and*

takes*a*leadership*role*in*sharing*

that*knowledge.*

************□*

EVIDENCE:!

*

23

1e:!!Designing!a!cohesive!service!delivery!system!that!solves!schoolWwide!problems,!meets!the!needs!of!individual!students,!and!includes!prevention!

School*psychologist*does*not*appear*

to*have*an*overall*plan*but*instead*

provides*services*in*a*seemingly*

random*way,*does*not*use*a*

problemHsolving*framework*to*work*

with*teachers*and*colleagues,*and/or*

is*not*involved*with*prevention*

activities.*

*

************□*

School*psychologist*implements*a*

number*of*worthwhile*activities*but*

does*not*appear*to*have*a*coherent*

plan*for*these,*does*not*consistently*

use*a*problemHsolving*framework*to*

meet*needs*of*students,*and/or*has*

limited*involvement*in*prevention*

activities.*

*

************□*

School!psychologist!has!a!coherent!plan!for!delivering!psychological!services!in!the!school,!typically!utilizes!a!problemWsolving!approach!to!responding!to!concerns,!and!is!involved!in!schoolWwide!activities!focused!on!prevention!of!mental!health!or!learning!problems.!

!!!!!!!!!!!!□!


utilizes*a*problemHsolving*framework*

in*responding*to*concerns*and*

assumes*a*leadership*role*in*training*

and*supporting*schoolHwide*activities*

focused*on*prevention*of*mental*

health*or*learning*problems.*

*

*

************□*

EVIDENCE:!

1f:!!Demonstrating!knowledge!of!researchWbased!instructional,!behavioral,!and!mental!health!interventions!!

School*psychologist*has*little*

knowledge*of*researchHbased*

instructional,*behavioral,*and/or*

mental*health*interventions.*

*

*

*

*

************□*

School*psychologist*has*some*

knowledge*of*researchHbased*

instructional,*behavioral,*and/or*

mental*health*interventions.*

*

*

*

*

************□*

School!psychologist!demonstrates!knowledge!of!researchWbased!instructional,!behavioral,!and!mental!health!interventions.!!

!!!!!!!!!!!!!□*

In*addition*to*meeting*the*effective*

standard,*the*school*psychologist*

regularly*provides*feedback*

regarding*the*use*of*researchHbased*

interventions,*supports*the*

intervention*provider,*and*suggests*

modifications*if*an*intervention*is*not*

successful.*

************□*

EVIDENCE:!

*

*

24

!DOMAIN!2!FOR!SCHOOL!PSYCHOLOGISTS:�THE!ENVIRONMENT*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

2a:!!Maintaining!an!environment!of!respect!and!rapport!in!professional!relationships!and!with!students!!

School*psychologist’s*interactions*

with*students*are*negative*or*

inappropriateY*school*psychologist*

rarely*engages*in*collaborative,*

effective,*and/or*ethical*professional*

relationships.*

*

************□*

School*psychologist’s*interactions*

with*students*are*a*mix*of*positive*

and*negativeY*the*school*

psychologist*engages*in*some*

collaborative*relationships*but*these*

are*not*always*effective*and/or*

professional/ethical.**

************□*

School!psychologist’s!interactions!with!students!are!positive!and!respectful^!school!psychologist!consistently!engages!in!collaborative,!effective,!and!ethical!professional!relationships.!

!!!!!!!!!!!!□*

Students,*teachers,*and*others*seek*

out*the*school*psychologist,*

reflecting*a*high*degree*of*comfort*

and*trust*in*the*relationship*and*

effective*collaboration*outcomes.*

*

*

************□*

EVIDENCE:!

2b:!!Supporting!a!culture!of!learning!and!achievement!in!classrooms,!by!promoting!dataWbased!decisionWmaking!and!researchWbased!interventions!!

School*psychologist*makes*no*

attempt*to*establish*a*culture*of*

learning*and*achievement,*does*not*

use*data*in*making*decisions,*and*

does*not*promote*the*use*of*

researchHbased*interventions.*

*

*

*

*

************□*

School*psychologist*attempts*to*

establish*a*culture*of*learning*and*

achievement,*to*use*data*in*making*

decisions,*and*to*promote*the*use*of*

researchHbased*interventions.*

*

*

*

*

*

************□*

School!psychologist!consistently!supports!a!culture!of!learning!and!achievement,!uses!data!in!making!decisions,!and!promotes!the!use!of!researchWbased!interventions.!!!!

!!!!!!!!!!!!!□*

In*addition*to*meeting*the*criteria*for*

effective*on*this*standard,*the*school*

psychologist*actively*promotes*the*

culture*of*learning*and*achievement*

by*conducting*research,*by*helping*

teachers*make*better*dataHbased*

decisions,*and/or*by*routinely*

suggesting*changes*in*interventions*

if*the*data*do*not*support*their*

effectiveness.*

************□*

EVIDENCE:!

*

25

2c:!!Implementing!clear!procedures!for!referrals!and!for!working!with!the!buildingWlevel!child!study!process!!

No*procedures*for*referrals*have*

been*establishedY*when*teachers*

want*to*refer*a*student*for*special*

services,*they*are*not*sure*how*to*go*

about*it.**There*is*no*buildingHlevel*

child*study*process*in*place.*

*

*

*

*

************□*

School*psychologist*has*established*

procedures*for*referrals,*but*the*

details*are*not*always*clear.**The*

buildingHlevel*child*study*process*is*

ineffective*or*poorly*implemented.*

*

*

*

*

*

************□*

Procedures!for!referrals!and!for!meetings!and!consultations!with!parents!and!administrators!are!clear!to!everyone.!!The!school!psychologist!supports!the!buildingWlevel!child!study!process!by!providing!training!and/or!consultation!to!the!team!on!a!regular!basis.!!

!!!!!!!!!!!!□*

Procedures*for*all*aspects*of*referral*

and*testing*protocols*are*clear*to*

everyone,*have*been*developed*in*

consultation*with*teachers*and*

administrators,*and*are*regularly*

shared*with*buildingHlevel*staff.**The*

buildingHlevel*child*study*process*

works*effectively*and*the*school*

psychologist*provides*onHgoing*

support*and*training*to*the*team.*

************□*

EVIDENCE:!

2d:!Establishing!procedures!for!analyzing!student!behavior!and!providing!positive!behavioral!supports!

School*psychologist*does*not*

provide*consultation*on*behavior*

problems,*does*not*consider*

antecedents,*consequences,*and*

functions*of*behavior,*and*does*not*

understand*principles*of*positive*

behavior*supports.*

*

*

*

*

*

*

************□*

School*psychologist*provides*some*

consultation*on*behavior*problemsY*

usually*considers*antecedents,*

consequences,*and*functions*of*

behaviorY*and*demonstrates*a*basic*

knowledge*of*principles*of*positive*

behavior*supports.*

*

*

*

*

*

*

************□*

School!psychologist!regularly!provides!consultation!on!behavior!problems^!regularly!considers!antecedents,!consequences,!and!functions!of!behavior^!and!demonstrates!knowledge!of!principles!of!positive!behavior!supports.!!!!!!

!!!!!!!!!!!!□*

In*addition*to*meeting*the*effective*

criteria*for*this*standard,*the*school*

psychologist*is*able*to*help*teachers*

develop*effective*positive*behavior*

intervention*plans*linked*to*the*

functional*behavioral*assessment.**In*

addition,*the*school*psychologist*

regularly*follows*up*with*the*teacher*

to*assure*that*the*behavior*plan*is*

being*implemented*with*fidelity*and*

helps*modify*the*behavior*plan*if*

desired*changes*in*the*student’s*

behavior*are*not*taking*place.*

************□*

EVIDENCE:!

*

26

2e:!!Organizing!physical!space,!including!appropriate!testing!space,!space!to!consult!with!teachers!and!parents,!and!maintaining!confidential!storage!for!!test!materials!and!files!!

The*school*psychologist’s*workspace*

is*disorganized*and*poorly*suited*to*

student*evaluations.*Materials*are*

not*stored*in*a*secure*location*and/or*

are*difficult*to*find*when*needed.*

*

************□*


is*not*efficiently*organized*and*

student*testing*arrangements*aren’t*

adequate*for*all*children.*Materials*

usually*are*stored*securely,*but*may*

still*be*difficult*to*find*when*needed.*

************□*

The!school!psychologist’s!workspace!is!well!organized^!materials!are!stored!in!a!secure!location!and!are!available!when!needed.!!

!!!!!!!!!!!!□*


is*highly*organized*and*is*inviting*to*

students.*Materials*are*stored*in*a*

secure*location*and*are*convenient*

when*needed.*

*

************□*

EVIDENCE:!

*

27

!DOMAIN!3!FOR!SCHOOL!PSYCHOLOGISTS:�DELIVERY!OF!SERVICE!!

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

3a:!!Communicating!effectively!by!responding!in!a!timely!manner!to!referrals,!parent!requests,!and!reWevaluation!schedules^!consulting!regularly!with!teachers!and!administrators!

School*psychologist*fails*to*

communicate*clearly,*effectively*and*

in*a*timely*manner*with*students,*

parents,*and*school*personnel.*

*

*

*

************□*

School*psychologist*makes*an*effort*

to*communicate*with*students,*

parents,*and*school*personnel,*but*

these*communications*may*not*

always*be*made*in*a*timely*manner*

or*may*occasionally*lack*clarity*

and/or*sensitivity.*

************□*

School!psychologist!regularly!communicates!with!students,!parents,!and!school!personnel,!and!these!communications!are!made!in!a!timely!manner!and!are!delivered!with!clarity!and!sensitivity.!

!!!!!!!!!!!!□*



psychologist*proactively*seeks*

opportunities*to*share*information*

with*students,*parents,*and*school*

personnel.*

*

************□*

EVIDENCE:!

3b:!!Gathering!information!systematically!from!multiple!sources,!using!test!instruments!appropriately,!and!considering!the!context!for!assessment!and!intervention!

School*psychologist*resists*

administering*evaluations,*selects*

instruments*inappropriate*to*the*

situation,*and/or*does*not*link*

selected*assessments*to*the*

individual*context.*

*

*

*

************□*

School*psychologist*collects*data*

from*multiple*sources*and*

administers*appropriate*evaluation.*

*

*

*

*

*

*

************□*

School!psychologist!consistently!collects!data!from!multiple!sources,!administers!appropriate!evaluation!instruments!linking!the!choice!of!instruments!to!the!referral!question,!and!links!assessment!to!interventions!in!general!and!special!education!settings.!

!!!!!!!!!!!!□*



psychologist*assumes*a*leadership*

position*in*data*analysis*in*order*to*

improve*educational*outcomes*in*

general*education*and*special*

education*settings.***

*

*

************□*

EVIDENCE:!

*

28

3c:!!Serving!as!case!manager!of!the!evaluation!team,!maintaining!contact!with!other!professionals!throughout!the!assessment!process,!and!writing!integrated!MET!reports!!

School*psychologist*rarely*assumes*

leadership*of*the*evaluation*team,*

does*not*work*effectively*with*other*

team*members,*and/or*misses*

district*timelines.*

*

*

*

*

************□*

School*psychologist*assumes*

leadership*of*the*evaluation*team*

and*maintains*occasional*contact*

with*team*members*throughout*the*

assessment*process.**MET*Reports*

may*not*be*completed*prior*to*

meetings*and*other*professionals*

may*or*may*not*have*their*portions*

completed.*

************□*

School!psychologist!consistently!assumes!leadership!of!the!evaluation!team^!assures!that!all!team!members!complete!their!portions!of!an!assessment!plan!and!enter!data!into!the!MET!report!prior!to!meetings^!and!assures!that!timelines!are!met.!!

!!!!!!!!!!!!□*

School*psychologist*assumes*

leadership*of*the*evaluation*team*

and*takes*initiative*in*assembling*

materials*for*meetings.*METs*are*

prepared*in*advance*of*meetings*

and*information*from*all*specialists*is*

integrated*in*an*exemplary*manner.**

All*timelines*are*met.*

*

************□*

EVIDENCE:!

3d:!!Addressing!socialWemotional!needs!of!students!by!providing!social!skills!training,!counseling,!and/or!behavioral!coaching,!and!working!with!teachers!and/or!parents!to!plan!and!implement!interventions!!!

School*psychologist*fails*to*plan*or*

deliver*interventions*suitable*to*

student*needs*or*suggested*

interventions*are*mismatched*with*

the*findings*of*the*assessments.*

*

*

*

*

************□*

School*psychologist*provides*some*

social*skills*training*and*suggests*

interventions*to*teacher*but*rarely*

provides*counseling*or*behavioral*

coaching*to*students.**

*

*

*

*

************□*

School!psychologist!consistently!provides!social!skills!training,!counseling,!and!behavioral!coaching!and!consults!with!teachers!to!develop!appropriate!interventions!targeted!to!assessment!outcomes.!!!

!!!!!!!!!!!!□*



psychologist*assumes*a*leadership*

role*that*includes*teaching*teachers*

how*to*incorporate*strategies*into*

their*classroom*routines*and*

provides*modeling*and*coaching*to*

assure*that*interventions*are*

implemented*with*fidelity.*

************□*

EVIDENCE:!

*

29

3e:!!Demonstrating!flexibility!and!responsiveness!

School*psychologist*adheres*to*

standard*ways*of*delivering*

psychological*services*in*spite*of*

evidence*of*its*inadequacy.*When*

leading*meetings,*can*be*directive,*

inflexible,*and*unresponsive*to*other*

team*members.*

*

*

*

*

*

************□*

School*psychologist*makes*modest*

changes*in*the*delivery*of*

psychological*services*when*

confronted*with*evidence*of*the*need*

for*change.*Typically*asks*others*to*

share*information*at*meetings*but*

does*not*always*thoughtfully*

consider*that*information*in*leading*

the*team*to*decisions.*

*

*

*

************□*

School!psychologist!consistently!reviews!and!revises!the!delivery!of!psychological!services!in!ways!that!are!responsive!to!the!needs!of!students,!families,!teachers,!and!schools.!!Consistently!encourages!discussion!at!team!meetings!and!leads!the!team!to!thoughtfully!consider!all!information!in!coming!to!a!decision.!!

!!!!!!!!!!!!□*

School*psychologist*is*continually*

seeking*ways*to*improve*the*delivery*

of*psychological*services,*making*

changes*in*response*to*student,*

parent,*or*teacher*input.**The*school*

psychologist*regularly*shares*

expertise*at*the*school,*department,*

and/or*district*level.**Is*an*advocate*

of*team*decision*making,*soliciting*

multiple*views*and*leading*the*team*

to*thoughtfully*consider*all*

information*in*coming*to*a*decision.*

************□*

EVIDENCE:!

*

30

!DOMAIN!4!FOR!SCHOOL!PSYCHOLOGISTS:�PROFESSIONAL!RESPONSIBILITIES!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

4a:!!Reflecting!on!practice!!

School*psychologist*does*not*reflect*

on*practice,*or*the*reflections*are*

inaccurate*or*selfHserving.*

*

*

*

*

*

*

************□*

School*psychologist’s*reflection*on*


objective*without*citing*specific*

examples,*and*with*only*global*

suggestions*as*to*how*it*might*be*

improved.*

*

*

*

************□*

School!psychologist’s!reflection!provides!an!accurate!and!objective!description!of!practice,!citing!specific!positive!and!negative!characteristics.!School!psychologist!makes!some!specific!suggestions!as!to!how!delivery!of!psychological!services!might!be!improved.!

!!!!!!!!!!!!□*

School*psychologist’s*reflection*is*

highly*accurate*and*perceptive,*citing*

specific*examples*of*interventions*

that*were*not*fully*successful*for*at*

least*some*students.**School*

psychologist*draws*on*an*extensive*

repertoire*to*suggest*alternative*

strategies.*

*

************□*

EVIDENCE:!

4b:!!Maintaining!accurate!records!!

School*psychologist’s*records*are*in*

disarrayY*components*may*be*

missing,*illegible,*or*stored*in*an*

insecure*locationY*case*files*are*

inconsistently*submitted*to*special*

education*records*for*scanning.*

*

*

*

************□*

School*psychologist’s*records*are*

accurate*and*legible*and*are*stored*

in*a*secure*location.**Case*files*are*

usually*submitted*in*keeping*with*

district*guidelines.*

*

*

*

*

************□*

School!psychologist’s!records!are!accurate!and!legible,!well!organized,!and!stored!in!a!secure!location.!!Case!files!are!consistently!submitted!in!keeping!with!district!guidelines.!!MET!reports!are!written!in!a!way!that!parents!and!teachers!find!them!to!be!useful.!!!

!!!!!!!!!!!!□*


effective*on*this*standard,*case*files*

are*always*submitted*in*keeping*with*

district*guidelines,*deadlines*are*

always*met,*and*MET*reports*are*

complete,*wellHwritten,*edited,*and*

understandable.*

*

*

************□*

EVIDENCE:!

*

31

4c:!!Communicating!with!families!!!

School*psychologist*fails*to*

communicate*with*families*and*

secure*necessary*permission*for*

evaluations*or*communicates*in*an*

insensitive*manner.*

*

*

************□*

School*psychologist’s*

communication*with*families*is*

partially*successfulY*permissions*are*

obtained,*but*there*are*occasional*

insensitivities*to*cultural*and*

linguistic*traditions.**

*

************□*

School!psychologist!consistently!communicates!with!families!and!secures!necessary!permission!for!evaluations!and!does!so!in!a!manner!that!is!sensitive!to!cultural!and!linguistic!traditions.!!

!!!!!!!!!!!!□*

School*psychologist*secures*

necessary*permissions*and*

communicates*with*families*in*a*

manner*highly*sensitive*to*cultural*

and*linguistic*traditions.*School*

psychologist*reaches*out*to*families*

of*students*to*enhance*trust.*

************□*

EVIDENCE:!

4d:!!Participating!in!professional!communities,!including!those!established!at!assigned!schools!and!with!school!psychologist!colleagues!

School*psychologist’s*relationships*

with*colleagues*are*negative*or*selfH

serving,*and*school*psychologist*

avoids*being*involved*in*school*and*

district*events*and*projects.*

*

*

*

************□*

School*psychologist’s*relationships*

with*colleagues*are*cordial,*and*

school*psychologist*participates*in*

school*and*district*events*and*

projects*when*specifically*requested*

to*do*so.*

*

*

************□*

School!psychologist!participates!actively!in!school!and!district!events!and!projects!and!maintains!positive!and!productive!relationships!with!colleagues.!Occasionally!takes!on!a!mentoring!role!with!colleagues!new!to!the!profession!or!district.!

!!!!!!!!!!!!□*

School*psychologist*makes*a*

substantial*contribution*to*school*and*

district*events*and*projects*and*

assumes*leadership*with*colleagues.*

Often*takes*on*a*mentoring*role*with*

colleagues*new*to*the*profession*or*

district.*

*

************□*

EVIDENCE:!

4e:!!Growing!and!developing!professionally!!

School*psychologist*rarely*

participates*in*professional*

development*activities,*even*when*

such*activities*are*clearly*needed*for*

the*ongoing*development*of*skills.*

*

************□*

School*psychologist’s*participation*in*

professional*development*activities*

is*limited*to*those*that*are*

convenient*or*are*required.*

*

*

************□*

School!psychologist!seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!!!!

!!!!!!!!!!!!□*

School*psychologist*actively*pursues*

professional*development*

opportunities*and*makes*a*

substantial*contribution*to*the*



************□*

EVIDENCE:!

*

32

4f:!!Demonstrating!professionalism!!

School*psychologist*sometimes*

displays*dishonesty*in*interactions*

with*colleagues,*students,*and/or*the*

public,*does*not*exercise*good*

judgment*in*professional*settings,*

and/or*violates*principles*of*

confidentiality.*

*

************□*

School*psychologist*is*honest*in*

interactions*with*colleagues,*

students,*and*the*public,*plays*a*

moderate*advocacy*role*for*students,*

exercises*good*judgment*in*

professional*settings,*and*does*not*

violate*confidentiality.**

*

************□*

School!psychologist!displays!high!standards!of!honesty,!integrity,!and!confidentiality!in!interactions!with!colleagues,!students,!and!the!public^!exercises!good!judgment!in!professional!settings^!and!advocates!for!students!when!needed.!

!!!!!!!!!!!!□!

School*psychologist*can*be*counted*

on*to*hold*the*highest*standards*of*

honesty,*integrity,*professional*

judgment,*and*confidentiality*and*to*

advocate*for*students,*taking*a*

leadership*role*with*colleagues.*

*

*

************□*

EVIDENCE:!

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

Copyright*©2008*by*the*Association*for*Supervision*and*Curriculum*Development*(ASCD)*

33

*

Instructional Specialist Performance Evaluation (Form 1C) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**


!Evaluator:**

! *


!DOMAIN!1!FOR!INSTRUCTIONAL!SPECIALISTS:�PLANNING!AND!PREPARATION!!

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

1a:!!Demonstrating!knowledge!of!current!trends!in!specialty!area!and!professional!development!

Instructional*specialist*demonstrates*

little*or*no*familiarity*with*specialty*

area*or*trends*in*professional*

development.*

*

************□*


basic*familiarity*with*specialty*area*

and*trends*in*professional*

development.**

*

************□*

Instructional!specialist!demonstrates!thorough!knowledge!of!specialty!area!and!trends!in!professional!development.!!

!!!!!!!!!!!!□!

Instructional*specialist’s*knowledge*

of*specialty*area*and*trends*in*

professional*development*is*wide*

and*deepY*specialist*is*regarded*as*

an*expert*by*colleagues.*

************□*

EVIDENCE:!

1b:!!Demonstrating!knowledge!of!the!school’s!program!and!levels!of!teacher!skill!in!delivering!that!program!


little*or*no*knowledge*of*the*school’s*

program*or*of*teacher*skill*in*

delivering*that*program.*

*

*

************□*


basic*knowledge*of*the*school’s*

program*and*of*teacher*skill*in*

delivering*that*program.**

*

*

************□*

Instructional!specialist!demonstrates!thorough!knowledge!of!the!school’s!program!and!of!teacher!skill!in!delivering!that!program.!!!

!!!!!!!!!!!!□*

Instructional*specialist*is*deeply*

familiar*with*the*school’s*program*

and*works*to*shape*its*future*

direction*and*actively*seeks*

information*as*to*teacher*skill*in*that*

program.*

************□*

EVIDENCE:!

*


34

*

1c:!!Establishing!goals!for!the!instructional!support!program!appropriate!to!the!setting!and!the!teachers!served!!

Instructional*specialist*has*no*clear*

goals*for*the*instructional*support*

program,*or*they*are*inappropriate*to*

either*the*situation*or*the*needs*of*

the*staff.*

*

*

************□*

Instructional*specialist’s*goals*for*the*

instructional*support*program*are*

rudimentary*and*are*partially*suitable*

to*the*situation*and*the*needs*of*the*

staff.*

*

*

************□*

Instructional!specialist’s!goals!for!the!instructional!support!program!are!clear!and!are!suitable!to!the!situation!and!the!needs!of!the!staff.!!!

!!!!!!!!!!!!□*

Instructional*specialist’s*goals*for*the*

instructional*support*program*are*

highly*appropriate*to*the*situation*

and*the*needs*of*the*staff.*They*

have*been*developed*following*

consultations*with*administrators*and*

colleagues.*

************□*

EVIDENCE:!

1d:!!Demonstrating!knowledge!of!resources,!both!within!and!beyond!the!school!and!district!!


little*or*no*knowledge*of*resources*

available*in*the*school*or*district*for*

teachers*to*advance*their*skills.*

*

************□*


basic*knowledge*of*resources*

available*in*the*school*and*district*for*

teachers*to*advance*their*skills.**

*

************□*

Instructional!specialist!is!fully!aware!of!resources!available!in!the!school!and!district!and!in!the!larger!professional!community!for!teachers!to!advance!their!skills.!!

!!!!!!!!!!!!□*

Instructional*specialist*actively*seeks*

out*new*resources*from*a*wide*range*

of*sources*to*enrich*teachers’*skills*

in*implementing*the*school’s*

program.*

************□*

EVIDENCE:!

1e:!!Planning!the!instructional!support!program,!integrated!with!the!overall!school!program!!

Instructional*specialist’s*plan*

consists*of*a*random*collection*of*

unrelated*activities,*lacking*

coherence*or*an*overall*structure.*

*

*

*

*

************□*

Instructional*specialist’s*plan*has*a*

guiding*principle*and*includes*a*

number*of*worthwhile*activities,*but*

some*of*them*don’t*fit*with*the*

broader*goals.*

*

*

*

************□*

Instructional!specialist’s!plan!is!well!designed!to!support!teachers!in!the!improvement!of!their!instructional!skills.!!!!!

!!!!!!!!!!!!□*

Instructional*specialist’s*plan*

is*highly*coherent,*taking*

into*account*the*competing*demands*

of*making*presentations*and*

consulting*with*teachers,*and*has*

been*developed*following*

consultation*with*administrators*and*

teachers.*

************□*

EVIDENCE:!


35

1f:!!Developing!a!plan!to!evaluate!the!instructional!support!program!!

Instructional*specialist*has*no*plan*to*

evaluate*the*program*or*resists*

suggestions*that*such*an*evaluation*

is*important.*

*

*

************□*

Instructional*specialist*has*a*

rudimentary*plan*to*evaluate*the*

instructional*support*program.*

*

*

*

************□*

Instructional!support!specialist’s!plan!to!evaluate!the!program!is!organized!around!clear!goals!and!the!collection!of!evidence!to!indicate!the!degree!to!which!the!goals!have!been!met.!

!!!!!!!!!!!!□*

Instructional*specialist’s*evaluation*

plan*is*highly*sophisticated,*with*

imaginative*sources*of*evidence*and*

a*clear*path*toward*improving*the*

program*on*an*ongoing*basis.*

*

************□*

EVIDENCE:!


36

!DOMAIN!2!FOR!INSTRUCTIONAL!SPECIALISTS:�THE!ENVIRONMENT!!

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

2a:!!Creating!an!environment!of!!trust!and!respect!

Teachers*are*reluctant*to*request*

assistance*from*the*instructional*

specialist,*fearing*that*such*a*

request*will*be*treated*as*a*sign*of*

deficiency.*

************□*

Relationships*with*the*instructional*

specialist*are*cordialY*teachers*don’t*

resist*initiatives*established*by*the*

instructional*specialist.*

*

************□*

Relationships!with!the!instructional!specialist!are!respectful,!with!some!contacts!initiated!by!teachers.!!

!!!!!!!!!!!!□!

Relationships*with*the*instructional*

specialist*are*highly*respectful*and*

trusting,*with*many*contacts*initiated*

by*teachers.*

*

************□*

EVIDENCE:!

2b:!!Establishing!a!culture!for!ongoing!instructional!improvement!

Instructional*specialist*conveys*the*

sense*that*the*work*of*improving*

instruction*is*externally*mandated**

and*is*not*important*to*school*

improvement.*

************□*

Teachers*do*not*resist*the*offerings*

of*support*from*the*instructional*

specialist.*

*

*

************□*

Instructional!specialist!promotes!a!culture!of!professional!inquiry!in!which!teachers!seek!assistance!in!improving!their!instructional!skills.!

!!!!!!!!!!!!□*

Instructional*specialist*has*

established*a*culture*of*professional*

inquiry*in*which*teachers*initiate*

projects*to*be*undertaken*with*the*

support*of*the*specialist.*

************□*

EVIDENCE:!

2c:!!Establishing!clear!procedures!for!teachers!to!gain!access!to!instructional!support!!

When*teachers*want*to*access*

assistance*from*the*instructional*

specialist,*they*are*not*sure*how**

to*go*about*it.*

*

************□*

Some*procedures*(for*example,*

registering*for*workshops)*are*clear*

to*teachers,*whereas*others*(for*

example,*receiving*informal*support)*

are*not.*

************□*

Instructional!specialist!has!established!clear!procedures!for!teachers!to!use!in!gaining!access!to!support.!!

!!!!!!!!!!!!□*

Procedures*for*access*to*

instructional*support*are*clear*to*all*

teachers*and*have*been*developed*

following*consultation*with*

administrators*and*teachers.*

************□*

EVIDENCE:!


37

2d:!!Establishing!and!maintaining!norms!of!behavior!for!professional!interactions!

No*norms*of*professional*conduct*

have*been*establishedY*teachers*are*

frequently*disrespectful*in*their*

interactions*with*one*another.*

*

*

************□*

Instructional*specialist’s*efforts*to*

establish*norms*of*professional*

conduct*are*partially*successful.*

*

*

*

************□*

Instructional!specialist!has!established!clear!norms!of!mutual!respect!for!professional!interaction.!!!

!!!!!!!!!!!!□*

Instructional*specialist*has*

established*clear*norms*of*mutual*

respect*for*professional*interaction.*

Teachers*ensure*that*their*

colleagues*adhere*to*these*

standards*of*conduct.*

************□*

EVIDENCE:!

2e:!!Organizing!physical!space!for!workshops!or!training!!

Instructional*specialist*makes*poor*

use*of*the*physical*environment,*

resulting*in*poor*access*by*some*

participants,*time*lost*due*to*poor*

use*of*training*equipment,*or*little*

alignment*between*the*physical*

arrangement*and*the*workshop*

activities.*

************□*

The*physical*environment*does*not*

impede*workshop*activities.*

*

*

*

*

*

*

************□*

Instructional!specialist!makes!good!use!of!the!physical!environment,!resulting!in!engagement!of!all!participants!in!the!workshop!activities.!!!!

!!!!!!!!!!!!□*

Instructional*specialist*makes*highly*

effective*use*of*the*physical*

environment,*with*teachers*

contributing*to*the*physical*

arrangement.*

*

*

*

************□*

EVIDENCE:!


38

!DOMAIN!3!FOR!INSTRUCTIONAL!SPECIALISTS:�DELIVERY!OF!SERVICE!!

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

3a:**

Collaborating!with!teachers!in!the!design!of!instructional!units!and!lessons!*

Instructional*specialist*declines*to*

collaborate*with*classroom*teachers*

in*the*design*of*instructional*lessons*

and*units.*

*

*

************□*

Instructional*specialist*collaborates*

with*classroom*teachers*in*the*

design*of*instructional*lessons*and*

units*when*specifically*asked*to*do*

so.*

*

************□*

Instructional*specialist*initiates*

collaboration*with*classroom*

teachers*in*the*design*of*

instructional*lessons*and*units.*

*

*

************□*

Instructional*specialist*initiates*

collaboration*with*classroom*

teachers*in*the*design*of*

instructional*lessons*and*units,*

locating*additional*resources*from*

sources*outside*the*school.*

************□*

EVIDENCE:!

3b:!!Engaging!teachers!in!learning!new!instructional!skills!!

Teachers*decline*opportunities*to*

engage*in*professional*learning.*

*

*

************□*


engage*teachers*in*professional*

learning*are*partially*successful,*with*

some*participating.*

************□*

All!teachers!are!engaged!in!acquiring!new!instructional!skills.!!!!

!!!!!!!!!!!!□*

Teachers*are*highly*engaged*in*

acquiring*new*instructional*skills*and*

take*initiative*in*suggesting*new*

areas*for*growth.*

************□*

EVIDENCE:!

3c:!!Sharing!expertise!with!staff!!

Instructional*specialist’s*model*

lessons*and*workshops*are*of*poor*

quality*or*are*not*appropriate*to*the*

needs*of*the*teachers*being*served.*

*

*

*

*

************□*

The*quality*of*the*instructional*

specialist’s*model*lessons*and*

workshops*is*mixed,*with*some*of*

them*being*appropriate*to*the*needs*

of*the*teachers*being*served.*

*

*

*

************□*

The!quality!of!the!instructional!specialist’s!model!lessons!and!workshops!is!uniformly!high!and!appropriate!to!the!needs!of!the!teachers!being!served.!!!!

!!!!!!!!!!!!□*

The*quality*of*the*instructional*

specialist’s*model*lessons*and*

workshops*is*uniformly*high*and*

appropriate*to*the*needs*of*the*

teachers*being*served.*The*

instructional*specialist*conducts*

extensive*followHup*work*with*

teachers.*

************□*

EVIDENCE:!


39

3d:!!Locating!resources!for!teachers!to!support!instructional!improvement!!

Instructional*specialist*fails*to*locate*

resources*for*instructional*

improvement*for*teachers,*even*

when*specifically*requested*to*do*so.*

*

*

************□*


locate*resources*for*instructional*

improvement*for*teachers*are*

partially*successful,*reflecting*

incomplete*knowledge*of*what*is*

available.*

************□*

Instructional!specialist!locates!resources!for!instructional!improvement!for!teachers!when!asked!to!do!so.!!!

!!!!!!!!!!!!□*

Instructional*specialist*is*highly*

proactive*in*locating*resources*for*

instructional*improvement*for*

teachers,*anticipating*their*needs.*

*

*

************□*

EVIDENCE:!

3e:!!Demonstrating!flexibility!and!!responsiveness!!

Instructional*specialist*adheres*to*his*

plan,*in*spite*of*evidence*of*its*

inadequacy.*

*

*

*

************□*

Instructional*specialist*makes*

modest*changes*in*the*support*

program*when*confronted*with*

evidence*of*the*need*for*change.*

*

*

************□*

Instructional!specialist!makes!revisions!to!the!support!program!when!it!is!needed.!!!!

!!!!!!!!!!!!□*

Instructional*specialist*is*continually*

seeking*ways*to*improve*the*support*

program*and*makes*changes*as*

needed*in*response*to*student,*

parent,*or*teacher*input.*

*

************□*

EVIDENCE:!


40

!DOMAIN!4!FOR!INSTRUCTIONAL!SPECIALISTS:�PROFESSIONAL!RESPONSIBILITIES!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

4a:!Reflecting!on!practice!!

Instructional*specialist*does*not*

reflect*on*practice,*or*the*reflections*

are*inaccurate*or*selfHserving.*

*

*

*

*

*

*

************□*

Instructional*specialist’s*reflection*on*


objective*without*citing*specific*

examples*and*with*only*global*

suggestions*as*to*how*it*might*be*

improved.*

*

*

*

************□*

Instructional!specialist’s!reflection!provides!an!accurate!and!objective!description!of!practice,!citing!specific!positive!and!negative!characteristics.!!Instructional!specialist!makes!some!specific!suggestions!as!to!how!the!support!program!might!be!improved.!

!!!!!!!!!!!!□!

Instructional*specialist’s*reflection*is*

highly*accurate*and*perceptive,*citing*

specific*examples.*Instructional*

specialist*draws*on*an*extensive*

repertoire*to*suggest*alternative*

strategies,*accompanied*by*a*

prediction*of*the*likely*consequences*

of*each.*

*

************□*

EVIDENCE:!

4b:!!Compliance!and!reporting!!


follow*established*law,*policy,*

regulations*or*procedures.**Reports,*

budgets*or*other*required*routines*

are*not*completed*correctly*or*are*

routinely*late.*

*

*

************□*


adhere*to*law,*policy,*regulations*or*

procedures*are*partially*successful.*

Reports,*budgets*or*other*required*

routines*are*completed*with*

assistance*from*others.*

**

*

************□*

Instructional!specialist!adheres!to!law,!policy,!regulation!and!procedures!required!for!the!position.!!Specialist!completes!budgets,!plans!and!reports!accurately!and!in!a!timely!manner,!as!directed.!!

!!!!!!!!!!!!□*

Instructional*specialist*anticipates,*

with*limited*or*no*direction,*

responsibilities*related*to*law,*policy,*

regulation*and*procedures*required*

for*the*position.**Specialist*

completes*budgets,*plans*and*

reports*accurately*and*in*a*timely*

manner.*

************□*

EVIDENCE:!


41

4c:!!Coordinating!work!with!other!instructional!specialists!!

Instructional*specialist*makes*no*

effort*to*collaborate*with*other*

instructional*specialists*within*the*

district.*

*

************□*

Instructional*specialist*responds*

positively*to*the*efforts*of*other*

instructional*specialists*within*the*

district*to*collaborate.*

*

************□*

Instructional!specialist!initiates!efforts!to!collaborate!with!other!instructional!specialists!within!the!district.!!

!!!!!!!!!!!!□*

Instructional*specialist*takes*a*

leadership*role*in*coordinating*

projects*with*other*instructional*

specialists*within*and*beyond*the*

district.*

************□*

EVIDENCE:!

4d:!!Participating!in!a!professional!community!!

Instructional*specialist’s*relationships*

with*colleagues*are*negative*or*selfH

serving,*and*the*specialist*avoids*

being*involved*in*school*and*district*

events*and*projects.*

************□*

Instructional*specialist’s*relationships*

with*colleagues*are*cordial,*and*the*

specialist*participates*in*school*and*

district*events*and*projects*when*

specifically*requested.*

************□*

Instructional!specialist!participates!actively!in!school!and!district!events!and!projects!and!maintains!positive!and!productive!relationships!with!colleagues.!

!!!!!!!!!!!!□*

Instructional*specialist*makes*a*

substantial*contribution*to*school*and*

district*events*and*projects*and*

assumes*a*leadership*role*with*

colleagues.*

************□*

EVIDENCE:!

4e:!Engaging!in!professional!development!!


participate*in*professional*

development*activities,*even*when*


the*enhancement*of*skills.*

*

*

************□*

Instructional*specialist’s*participation*

in*professional*development*

activities*is*limited*to*those*that*are*


*

*

*

************□*

Instructional!specialist!seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!!!!

!!!!!!!!!!!!□*

Instructional*specialist*actively*

pursues*professional*development*




participating*in*state*or*national*

conferences*for*other*specialists.*

************□*

EVIDENCE:!


42

4f:!!Showing!professionalism,!including!integrity!and!confidentiality!!

Instructional*specialist*displays*

dishonesty*in*interactions*with*

colleagues*and*violates*norms*of*

confidentiality.*

*

*

************□*

Instructional*specialist*is*honest*in*

interactions*with*colleagues*and*

respects*norms*of*confidentiality.*

*

*

*

************□*

Instructional!specialist!displays!high!standards!of!honesty!and!integrity!in!interactions!with!colleagues!and!respects!norms!of!confidentiality.!!

!!!!!!!!!!!!□*

Instructional*specialist*can*be*

counted*on*to*hold*the*highest*

standards*of*honesty*and*integrity*

and*takes*a*leadership*role*with*

colleagues*in*respecting*the*norms*

of*confidentiality.*

************□*

EVIDENCE:!

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*


43

Therapeutic Specialist Performance Evaluation (Form 1D) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**


!Evaluator:**

! *


!DOMAIN!1!FOR!THERAPEUTIC!SPECIALISTS:�PLANNING!AND!PREPARATION!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

1a:!Demonstrating!knowledge!and!skill!in!the!specialist!therapy!area^!holding!the!relevant!certificate!or!license!

Specialist*demonstrates*little*or*no*

knowledge*and*skill*in*the*therapy*

areaY*does*not*hold*the*necessary*

certificate*or*license.**

************□*

Specialist*demonstrates*basic*


areaY*holds*the*necessary*certificate*

or*license.*

************□*

Specialist!demonstrates!thorough!knowledge!and!skill!in!the!therapy!area^!holds!the!necessary!certificate!or!license.!

!!!!!!!!!!!!□!

Specialist*demonstrates*extensive*


areaY*holds*an*advanced*certificate*

or*license.*

************□*

EVIDENCE:!

1b:!!Establishing!goals!for!the!therapy!program!appropriate!to!the!setting!and!the!students!served!

Specialist*has*no*clear*goals*for*the*

therapy*program,*or*they*are*

inappropriate*to*either*the*situation*

or*the*age*of*the*students.*

*

*

************□*

Specialist’s*goals*for*the*therapy*



to*the*age*of*the*students.*

*

*

************□*

Specialist’s!goals!for!the!therapy!program!are!clear!and!appropriate!to!the!situation!in!the!school!and!to!the!age!of!the!students.!!!

!!!!!!!!!!!!□*

Specialist’s*goals*for*the*therapy*

program*are*highly*appropriate*to*the*

situation*in*the*school*and*to*the*age*

of*the*students*and*have*been*

developed*following*consultations*

with*administrators*and*teachers.*

************□*

EVIDENCE:!


44

1c:!!Demonstrating!knowledge!of!district,!state,!and!federal!regulations!and!guidelines!!


knowledge*of*special*education*laws*

and*procedures.**

*

*

************□*


knowledge*of*special*education*laws*

and*procedures.*

*

*

************□*

Specialist!demonstrates!thorough!knowledge!of!special!education!laws!and!procedures.!!!

!!!!!!!!!!!!□*

Specialist’s*knowledge*of*special*

education*laws*and*procedures*is*

extensiveY*specialist*takes*a*

leadership*role*in*reviewing*and*

revising*district*policies.*

************□*

EVIDENCE:!

1d:!!Demonstrating!knowledge!of!resources,!both!within!and!beyond!the!school!and!district!!


knowledge*of*resources*for*students*

available*through*the*school*or*

district.*

*

*

************□*




district.*

*

*

************□*

Specialist!demonstrates!thorough!knowledge!of!resources!for!students!available!through!the!school!or!district!and!some!familiarity!with!resources!outside!the!district.!

!!!!!!!!!!!!□*

Specialist*demonstrates*extensive*



district*and*in*the*larger*community.*

*

*

************□*

EVIDENCE:!

1e:!!Planning!the!therapy!program,!integrated!with!the!regular!school!program,!to!meet!the!needs!of!individual!students!

Therapy*program*consists*of*a*

random*collection*of*unrelated*

activities,*lacking*coherence*or*an*

overall*structure.*

************□*

Specialist’s*plan*has*a*guiding*

principle*and*includes*a*number*of*

worthwhile*activities,*but*some*of*

them*don’t*fit*with*the*broader*goals.*

************□*

Specialist!has!developed!a!plan!that!includes!the!important!aspects!of!work!in!the!setting.!!!

!!!!!!!!!!!!□*

Specialist’s*plan*is*highly*coherent*

and*preventive*and*serves*to*support*

students*individually,*within*the*

broader*educational*program.*

************□*

EVIDENCE:!


45

1f:!Developing!a!plan!to!evaluate!the!therapy!program!!

Specialist*has*no*plan*to*evaluate*

the*program*or*resists*suggestions*

that*such*an*evaluation*is*important.*

*

*

************□*

Specialist*has*a*rudimentary*plan*to*

evaluate*the*therapy*program.*

*

*

*

************□*

Specialist’s!plan!to!evaluate!the!program!is!organized!around!clear!goals!and!the!collection!of!evidence!to!indicate!the!degree!to!which!the!goals!have!been!met.!

!!!!!!!!!!!!□*

Specialist’s*evaluation*plan*is*highly*

sophisticated,*with*imaginative*

sources*of*evidence*and*a*clear*path*

toward*improving*the*program*on*an*

ongoing*basis.*

************□*

EVIDENCE:!


46

!DOMAIN!2!FOR!THERAPEUTIC!SPECIALISTS:�THE!ENVIRONMENT!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

2a:!!Establishing!rapport!with!students!!

Specialist’s*interactions*with*

students*are*negative*or*

inappropriateY*students*appear*

uncomfortable*in*the*testing*and*

treatment*center.*

************□*

Specialist’s*interactions*are*a*mix*of*

positive*and*negativeY*the*specialist’s*

efforts*at*developing*rapport*are*

partially*successful.*

*

************□*

Specialist’s!interactions!with!students!are!positive!and!respectful^!students!appear!comfortable!in!the!testing!and!treatment!center.!

!!!!!!!!!!!!□!

Students*seek*out*the*specialist,*


and*trust*in*the*relationship.*

*

*

************□*

EVIDENCE:!

2b:!!Organizing!time!effectively!!

Specialist*exercises*poor*judgment*

in*setting*priorities,*resulting*in*

confusion,*missed*deadlines,*and*

conflicting*schedules.*

*

*

************□*

Specialist’s*timeHmanagement*skills*

are*moderately*well*developedY*

essential*activities*are*carried*out,*

but*not*always*in*the*most*efficient*

manner.*

*

************□*

Specialist!exercises!good!judgment!in!setting!priorities,!resulting!in!clear!schedules!and!important!work!being!accomplished!in!an!efficient!manner.!

!!!!!!!!!!!!□*

Specialist*demonstrates*excellent*

timeHmanagement*skills,*

accomplishing*all*tasks*in*a*

seamless*mannerY*teachers*and*

students*understand*their*schedules.*

*

************□*

EVIDENCE:!

2c:!!Establishing!and!maintaining!clear!procedures!for!referrals!!

No*procedures*for*referrals*have*

been*establishedY*when*teachers*

want*to*refer*a*student*for*special*

services,*they*are*not*sure*how*to*go*

about*it.*

************□*

Specialist*has*established*

procedures*for*referrals,*but*the*

details*are*not*always*clear.*

*

*

************□*

Procedures!for!referrals!and!for!meetings!and!consultations!with!parents!and!administrators!are!clear!to!everyone.!!

!!!!!!!!!!!!□*

Procedures*for*all*aspects*of*referral*

and*testing*protocols*are*clear*to*

everyone*and*have*been*developed*

in*consultation*with*teachers*and*

administrators.**

************□*

EVIDENCE:!


47

2d:!!Establishing!standards!of!conduct!in!the!treatment!center!!

No*standards*of*conduct*have*been*

established,*and*specialist*

disregards*or*fails*to*address*

negative*student*behavior*during*

evaluation*or*treatment.*

*

*

************□*

Standards*of*conduct*appear*to*have*

been*established*for*the*testing*and*

treatment*center.*Specialist’s*

attempts*to*monitor*and*correct*

negative*student*behavior*during*

evaluation*and*treatment*are*partially*

successful.*

************□*

Standards!of!conduct!have!been!established!for!the!testing!and!treatment!center.!Specialist!monitors!student!behavior!against!those!standards^!response!to!students!is!appropriate!and!respectful!!!!!!!!!!!!!!!!!!!!!!!!!□*

Standards*of*conduct*have*been*

established*for*the*testing*and*

treatment*center.*Specialist’s*

monitoring*of*students*is*subtle*and*

preventive,*and*students*engage*in*

selfHmonitoring*of*behavior.*

*

************□*

EVIDENCE:!

2e:!!Organizing!physical!space!for!testing!of!students!and!providing!therapy!!

The*testing*and*treatment*center*is*

disorganized*and*poorly*suited*to*

working*with*students.*Materials*are*

usually*available.*

*

************□*


moderately*well*organized*and*

moderately*well*suited*to*working*

with*students.*Materials*are*difficult*

to*find*when*needed.*

************□*

The!testing!and!treatment!center!is!well!organized^!materials!are!available!when!needed.!!!

!!!!!!!!!!!!□*


highly*organized*and*is*inviting*to*

students.*Materials*are*convenient*

when*needed.*

*

************□*

EVIDENCE:!


48

!DOMAIN!3!FOR!THERAPEUTIC!SPECIALISTS:�DELIVERY!OF!SERVICE!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

3a:!!Responding!to!referrals!and!evaluating!student!needs!!

Specialist*fails*to*respond*to*referrals*

or*makes*hasty*assessments*of*

student*needs.*

*

************□*

Specialist*responds*to*referrals*when*

pressed*and*makes*adequate*

assessments*of*student*needs.*

*

************□*

Specialist!responds!to!referrals!and!makes!thorough!assessments!of!student!needs.!!

!!!!!!!!!!!!□!

Specialist*is*proactive*in*responding*

to*referrals*and*makes*highly*

competent*assessments*of*student*

needs.*

************□*

EVIDENCE:!

3b:!!Developing!and!implementing!!treatment!plans!to!maximize!students’!success!

Specialist*fails*to*develop*treatment*

plans*suitable*for*students,*or*plans*

are*mismatched*with*the*findings*of*

assessments.*

************□*

Specialist’s*plans*for*students*are*

partially*suitable*for*them*or*

sporadically*aligned*with*identified*

needs.*

************□*

Specialist’s!plans!for!students!are!suitable!for!them!and!are!aligned!with!identified!needs.!!

!!!!!!!!!!!!□*

Specialist*develops*comprehensive*

plans*for*students,*finding*ways*to*

creatively*meet*student*needs*and*

incorporate*many*related*elements.*

************□*

EVIDENCE:!

3c:!!Communicating!with!families!!

Specialist*fails*to*communicate*with*

families*and*secure*necessary*

permission*for*evaluations*or*

communicates*in*an*insensitive*

manner.*

*

************□*

Specialist’s*communication*with*

families*is*partially*successfulY*

permissions*are*obtained,*but*there*

are*occasional*insensitivities*to*

cultural*and*linguistic*traditions.**

*

************□*

Specialist!communicates!with!families!and!secures!necessary!permission!for!evaluations,!doing!so!in!a!manner!sensitive!to!cultural!and!linguistic!traditions.!!

!!!!!!!!!!!!□*

Specialist*secures*necessary*

permissions*and*communicates*with*

families*in*a*manner*highly*sensitive*

to*cultural*and*linguistic*traditions.*

Specialist*reaches*out*to*families*of*

students*to*enhance*trust.*

************□*

EVIDENCE:!


49

3d:!!Collecting!information^!writing!reports!

Specialist*neglects*to*collect*

important*information*on*which*to*

base*treatment*plansY*reports*are*

inaccurate*or*not*appropriate*to*the*

audience.*

*

************□*

Specialist*collects*most*of*the*

important*information*on*which*to*

base*treatment*plansY*reports*are*

accurate*but*lacking*in*clarity*and*not*

always*appropriate*to*the*audience.*

*

************□*

Specialist!collects!all!the!important!information!on!which!to!base!treatment!plans^!reports!are!accurate!and!appropriate!to!the!audience.!!

!!!!!!!!!!!!□*

Specialist*is*proactive*in*collecting*

important*information,*interviewing*

teachers*and*parents*if*necessaryY*

reports*are*accurate*and*clearly*

written*and*are*tailored*for*the*

audience.*

************□*

EVIDENCE:!

3e:!!Demonstrating!flexibility!and!!responsiveness!!

Specialist*adheres*to*the*plan*or*

program,*in*spite*of*evidence*of*its*

inadequacy.*

*

*

************□*

Specialist*makes*modest*changes*in*

the*treatment*program*when*


for*change.*

*

************□*

Specialist!makes!revisions!in!the!treatment!program!when!they!are!needed.!!!

!!!!!!!!!!!!□*

Specialist*is*continually*seeking*

ways*to*improve*the*treatment*




************□*

EVIDENCE:!


50

!DOMAIN!4!FOR!THERAPEUTIC!SPECIALISTS:�PROFESSIONAL!RESPONSIBILITIES!!

*

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

4a:!!Reflecting!on!practice!

Specialist*does*not*reflect*on*

practice,*or*the*reflections*are*


*

*

*

*

************□*

Specialist’s*reflection*on*practice*is*

moderately*accurate*and*objective*

without*citing*specific*examples,*and*

with*only*global*suggestions*as*to*

how*it*might*be*improved.*

*

*

************□*

Specialist’s!reflection!provides!an!accurate!and!objective!description!of!practice,!citing!specific!positive!and!negative!characteristics.!Specialist!makes!some!specific!suggestions!as!to!how!the!therapy!program!might!be!improved.!

!!!!!!!!!!!!□*

Specialist’s*reflection*is*highly*

accurate*and*perceptive,*citing*

specific*examples*that*were*not*fully*

successful*for*at*least*some*

students.*Specialist*draws*on*an*


alternative*strategies.*

************□*

EVIDENCE:!

4b:!!Collaborating!with!teachers!and!administrators!!

Specialist*is*not*available*to*staff*for*

questions*and*planning*and*declines*

to*provide*background*material*when*

requested.*

************□*

Specialist*is*available*to*staff*for*

questions*and*planning*and*provides*

background*material*when*

requested.*

************□*

Specialist!initiates!contact!with!teachers!and!administrators!to!confer!regarding!individual!cases.!*

!!!!!!!!!!!!□!

Specialist*seeks*out*teachers*and*

administrators*to*confer*regarding*

cases,*soliciting*their*perspectives*

on*individual*students.*

************□*

EVIDENCE:!

4c:!!Maintaining!an!effective!dataWmanagement!system!!

Specialist’s*dataHmanagement*

system*is*either*nonexistent*or*in*

disarrayY*it*cannot*be*used*to*monitor*

student*progress*or*to*adjust*

treatment*when*needed.*

*

*

************□*

Specialist*has*developed*a*

rudimentary*dataHmanagement*

system*for*monitoring*student*

progress*and*occasionally*uses*it*to*

adjust*treatment*when*needed.*

*

*

************□*

Specialist!has!developed!an!effective!dataWmanagement!system!for!monitoring!student!progress!and!uses!it!to!adjust!treatment!when!needed.!!!

!!!!!!!!!!!!□!

Specialist*has*developed*a*highly*

effective*dataHmanagement*system*

for*monitoring*student*progress*and*

uses*it*to*adjust*treatment*when*

needed.*Specialist*uses*the*system*

to*communicate*with*teachers*and*

parents.*

************□*

EVIDENCE:!


51

4d:!!Participating!in!a!professional!community!!!

Specialist’s*relationships*with*

colleagues*are*negative*or*selfH

serving,*and*specialist*avoids*being*

involved*in*school*and*district*events*

and*projects.*

************□*

Specialist’s*relationships*with*

colleagues*are*cordial,*and*specialist*

participates*in*school*and*district*

events*and*projects*when*specifically*

asked*to*do*so.*

************□*

Specialist!participates!actively!in!school!and!district!events!and!projects!and!maintains!positive!and!productive!relationships!with!colleagues.!!

!!!!!!!!!!!!□*

Specialist*makes*a*substantial*

contribution*to*school*and*district*

events*and*projects*and*assumes*a*


*

************□*

EVIDENCE:!

4e:!!Engaging!in!professional!!development!!

Specialist*does*not*participate*in*

professional*development*activities,*


needed*for*the*development*of*skills.*

*

*

************□*

Specialist’s*participation*in*




*

*

************□*

Specialist!seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!!!!

!!!!!!!!!!!!□*

Specialist*actively*pursues*






************□*

EVIDENCE:!

4f:!!Showing!professionalism,!including!integrity,!advocacy,!and!maintaining!confidentiality!!

Specialist*displays*dishonesty*in*


students,*and*the*public*and*violates*

principles*of*confidentiality.*

*

*

************□*

Specialist*is*honest*in*interactions*

with*colleagues,*students,*and*the*

public,*plays*a*moderate*advocacy*

role*for*students,*and*does*not*

violate*norms*of*confidentiality.**

*

************□*

Specialist!displays!high!standards!of!honesty,!integrity,!and!confidentiality!in!interactions!with!colleagues,!students,!and!the!public!and!advocates!for!students!when!needed.!

!!!!!!!!!!!!□*

Specialist*can*be*counted*on*to*hold*

the*highest*standards*of*honesty,*

integrity,*and*confidentiality*and*to*



*

************□*

EVIDENCE:!

!!!!


52

Student Advisor Performance Evaluation (Form 1E) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**


!Evaluator:**

! *


!!DOMAIN!1!FOR!STUDENT!ADVISORS:�GRADUATION/COLLEGE!&!CAREER!READINESS!(PLANNING!AND!PREPARATION)*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

1a:!!Develop!and!implement!strategies!to!facilitate!successful!transition!from!eighth!grade!to!high!school!

Limited*ability*to*develop*and*

implement*strategies*to*facilitate*

successful*transition*from*eighth*

grade*to*high*school.*

□ *

Inconsistently*demonstrates*the*

ability*to*develop*and*implement*

strategies*to*facilitate*successful*

transition*from*eighth*grade*to*high*

school.*

□ *

Consistently!demonstrates!the!ability!to!develop!and!implement!strategies!to!facilitate!successful!transition!from!eighth!grade!to!high!school.!

□ !

Demonstrates*the*ability*to*develop*

and*implement*strategies*to*facilitate*

successful*transition*from*eighth*

grade*to*high*school*in*a*competent*

and*deliberate*manner.**

□ *

EVIDENCE:!!

1b:!!Monitor!students’!academic!progress!and!provide!personalized!guidance,!including!transcript!evaluation,!and!support!to!those!who!are!not!on!track!to!graduate!within!four!years.!!Develop!and!implement!studentWspecific!and!systemWlevel!strategies!that!increase!the!schools’!rate!of!graduation!and!postsecondary!enrollment!

Rarely*monitors*students’*academic*

progress*and*provide*personalized*

guidance,*including*transcript*

evaluation,*and*support*to*those*who*

are*not*on*track*to*graduate*within*

four*years.**Develop*and*implement*

studentHspecific*and*systemHlevel*

strategies*that*increase*the*schools’*

rate*of*graduation*and*

postsecondary*enrollment.*

*

□ *

Inconsistently*monitors*students’*

academic*progress*and*provide*

personalized*guidance,*including*

transcript*evaluation,*and*support*to*

those*who*are*not*on*track*to*

graduate*within*four*years.**Develop*

and*implement*studentHspecific*and*

systemHlevel*strategies*that*increase*

the*schools’*rate*of*graduation*and*


*

□ *

Regularly!monitors!students’!academic!progress!and!provide!personalized!guidance,!including!transcript!evaluation,!and!support!to!those!who!are!not!on!track!to!graduate!within!four!years.!!Develop!and!implement!studentWspecific!and!systemWlevel!strategies!that!increase!the!schools’!rate!of!graduation!and!postsecondary!enrollment.!

□ *

Consistently*monitors*students’*

academic*progress*and*provide*

personalized*guidance,*including*

transcript*evaluation,*and*support*to*

those*who*are*not*on*track*to*

graduate*within*four*years.**Develop*

and*implement*studentHspecific*and*

systemHlevel*strategies*that*increase*

the*schools’*rate*of*graduation*and*


□ *

EVIDENCE:!!


53

1c:!!In!collaboration!with!administrators!and!faculty!members,!develop!and!implement!intervention!strategies!for!students!who!demonstrate!absentee,!behavioral,!or!academic!issues!

Does*not*collaborate*with*

administrators*and*faculty*members*

to*develop*and*implement*

intervention*strategies*for*students*

who*demonstrate*absentee,*

behavioral,*or*academic*issues.*

*

*

□ *

Occasionally*collaborates*with*






*

*

□ *

Collaborates!with!administrators!and!faculty!members!to!develop!and!implement!intervention!strategies!for!students!who!demonstrate!absentee,!behavioral,!or!academic!issues.!!!

□ *

Continually*collaborates*with*






□ *

EVIDENCE:!!

1d:!!In!collaboration!with!students,!teachers!and!parents,!ensure!that!each!student!develops!an!ECAP!specific!to!his/her!interests,!talents!and!aspirations.!!Modify!students’!schedules!and!courses!of!study!when!appropriate!!

Rarely*collaborates*with*students,*

teachers*and*parents*to*ensure*that*

each*student*develops*an*ECAP*

specific*to*his/her*interests,*talents*

and*aspirations.**Modify*students’*

schedules*and*courses*of*study*

when*appropriate*

*

□ *

Occasionally*collaborates*with*

students,*teachers*and*parents*to*

ensure*that*each*student*develops*

an*ECAP*specific*to*his/her*interests,*

talents*and*aspirations.**Modify*

students’*schedules*and*courses*of*

study*when*appropriate.*

*

□ *

Collaborates!with!students,!teachers!and!parents!to!ensure!that!each!student!develops!an!ECAP!specific!to!his/her!interests,!talents!and!aspirations.!!Modify!students’!schedules!and!courses!of!study!when!appropriate.!!

□ *

Continually*collaborates*with*

students,*teachers*and*parents*to*

ensure*that*each*student*develops*

an*ECAP*specific*to*his/her*interests,*

talents*and*aspirations.**Modify*

students’*schedules*and*courses*of*

study*when*appropriate.*

*

□ *

EVIDENCE:!!

1e:!!Provide!ongoing!exposure!to!the!information!and!experiences!necessary!to!make!informed!decisions!when!selecting!a!postsecondary!program!or!career!

Does*not*provide*ongoing*exposure*

to*the*information*and*experiences*

necessary*to*make*informed*

decisions*when*selecting*a*

postsecondary*program*or*career.*

*

*

□ *

Provides*ongoing*exposure*to*the*

information*and*experiences*

necessary*to*make*informed*

decisions*when*selecting*a*


*

*

□ *

Consistently!provides!ongoing!exposure!to!the!information!and!experiences!necessary!to!make!informed!decisions!when!selecting!a!postsecondary!program!or!career.!!

□ *

Continually*provides*ongoing*

exposure*to*the*information*and*

experiences*necessary*to*make*

informed*decisions*when*selecting*a*


□ *

EVIDENCE:!*!


54

1f:!!Assist!students!in!establishing!postsecondary!goals!and!successfully!completing!a!high!school!course!of!study!that!prepares!them!to!meet!those!goals!

Minimally*assists*students*in*

establishing*postsecondary*goals*

and*successfully*completing*a*high*

school*course*of*study*that*prepares*

them*to*meet*those*goals.*

*

□ *

Periodically*assists*students*in*



school*course*of*study*that*prepares*

them*to*meet*those*goals.*

*

□ *

Regularly!assists!students!in!establishing!postsecondary!goals!and!high!school!course!of!study!that!prepares!them!to!meet!those!goals.!!!

□ *

Continually*assists*students*in*



school*course*of*study*that*

prepares*them*to*meet*those*goals.*

□ *

EVIDENCE:!!

1g:!!Promote!preparation!for!and!participation!in!college!and!career!assessments!such!as!the!PSAT/NMSQT,!ASVAB,!ACCUPLACER,!SAT!and!ACT.!!Facilitate!students’!understanding!of!results!and!how!this!information!can!be!applied!to!course!selection!and!skill!development!

Does*not*promote*preparation*for*

and*participation*in*college*and*

career*assessments*such*as*the*

PSAT/NMSQT,*ASVAB,*

ACCUPLACER,*SAT*and*ACT.**

Does*not*facilitate*students’*

understanding*of*results*and*how*

this*information*can*be*applied*to*

course*selection*and*skill*

development.*

□ *

Occasionally*promotes*preparation*

for*and*participation*in*college*and*


PSAT/NMSQT,*ASVAB,*


Occasionally*facilitates*students’*




development.

□ *

Regularly!promotes!preparation!for!and!participation!in!college!and!career!assessments!such!as!the!PSAT/NMSQT,!ASVAB,!ACCUPLACER,!SAT!and!ACT.!!Regularly!facilitates!students’!understanding!of!results!and!how!this!information!can!be!applied!to!course!selection!and!skill!development.!

□ !

Continuously*promotes*preparation*

for*and*participation*in*college*and*


PSAT/NMSQT,*ASVAB,*


Continuously*facilitates*students’*




development.

□ *

EVIDENCE:!!


55

1h:!!Provide!students!and!families!with!comprehensive!information!about!college!expenses.!!Help!students!and!families!successfully!navigate!financial!aid!and!scholarship!processes!enabling!them!to!plan!and!prepare!for!postsecondary!educational!expenses.!!Provide!coaching,!consultation!and!direct!services!as!appropriate!

Rarely*provides*students*and*

families*with*comprehensive*

information*about*college*expenses.**

Helps*students*and*families*

successfully*navigate*financial*aid*

and*scholarship*processes*enabling*

them*to*plan*and*prepare*for*

postsecondary*educational*

expenses.**Provide*coaching,*

consultation*and*direct*services*as*

appropriate.*

*

□ *

Irregularly*provides*students*and*

families*with*comprehensive*

information*about*college*expenses.**

Helps*students*and*families*

successfully*navigate*financial*aid*

and*scholarship*processes*enabling*

them*to*plan*and*prepare*for*

postsecondary*educational*

expenses.**Provide*coaching,*

consultation*and*direct*services*as*

appropriate.*

*

□ *

Regularly!provides!students!and!families!with!comprehensive!information!about!college!expenses.!!Helps!students!and!families!successfully!navigate!financial!aid!and!scholarship!processes!enabling!them!to!plan!and!prepare!for!postsecondary!educational!expenses.!!Provide!coaching,!consultation!and!direct!services!as!appropriate.!!

□ *

Provides*students*and*families*with*

comprehensive*information*about*

college*expenses.**Helps*students*

and*families*successfully*navigate*

financial*aid*and*scholarship*

processes*enabling*them*to*plan*

and*prepare*for*postsecondary*

educational*expenses.**Provide*

coaching,*consultation*and*direct*

services*as*appropriate.*

□ *

EVIDENCE:!!


56

!!DOMAIN!2!FOR!STUDENT!ADVISORS:�SUPPORT!SERVICES!(THE!ENVIRONMENT)*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

2a:!!Support!the!504!referral,!evaluation,!and!accommodation!processes!for!students!in!one’s!caseload!!

Does*not*support*the*504*referral,*

evaluation,*and*accommodation*

processes*for*students*in*one’s*

caseload.*

************□ *

Rarely*supports*the*504*referral,*



caseload.*

□ *

Regularly!supports!the!504!referral,!evaluation,!and!accommodation!processes!for!students!in!one’s!caseload.!

□ !

Continually*supports*the*504*referral,*



caseload.*

□ *

EVIDENCE:!!

2b:!!Assist!students!in!crisis!situations,!and!refer!to!district!or!community!resources!when!appropriate!!!

Does*not*assist*students*in*crisis*

situations,*and*refer*to*district*or*

community*resources*when*

appropriate.*

************

□ *

Occasionally*assists*students*in*

crisis*situations,*and*refer*to*district*

or*community*resources*when*

appropriate.*

*************

□ *

Routinely!assists!students!in!crisis!situations,!and!refer!to!district!or!community!resources!when!appropriate.!!

!!!!!!!!!!!□ !

Consistently*assists*students*in*crisis*

situations,*and*refer*to*district*or*

community*resources*when*

appropriate.*

************

□ *

EVIDENCE:!!

2c:!!Manage!routines!!and!procedures!!

Routines*for*the*student*advisement*

center*or*classroom*work*are*

nonexistent*or*in*disarray.*

*

*

************□ *

Rudimentary*and*partially*successful*

routines*for*the*student*advisement*

center*or*classroom.*

*

*

************□ *

Routines!for!the!student!advisement!center!or!classroom!work!effectively.!!!

!!!!!!!!!!!!□ *

Routines*for*the*student*advisement*

center*or*classroom*are*seamless.*

*

*

*

************□ *

EVIDENCE:!!


57

2d:!!Establish!standards!of!conduct!and!contribute!to!the!culture!for!student!behavior!throughout!the!school!!

Establishes*no*standards*of*conduct*

for*students*during*student*

advisement*sessions*and*makes*no*

contribution*to*maintaining*an*

environment*of*civility*in*the*school.*

*

*

*

************□ *

Efforts*to*establish*standards*of*

conduct*for*student*advisement*

sessions*are*partially*successful.*

Student*Advisor*attempts,*with*

limited*success,*to*contribute*to*the*

level*of*civility*in*the*school*as*a*

whole.*

*

************□ *

Establishes!clear!standards!of!conduct!for!student!advisement!sessions!and!makes!a!significant!contribution!to!the!environment!of!civility!in!the!school.!!!!

!!!!!!!!!!!!□ *

Establishes*clear*standards*of*

conduct*for*student*advisement*

sessions*and*takes*a*leadership*role*

in*maintaining*the*environment*of*

civility*in*the*school.*

*

*

*

************□ *

EVIDENCE:!!

2e:!!Organize!physical!space!!

The*physical*environment*is*in*

disarray*or*is*inappropriate*to*the*

planned*activities.*

*

*

************□ *

Attempts*to*create*an*inviting*and*

wellHorganized*physical*environment*

are*partially*successful.*

*

*

************□ *

Advisement!center!or!classroom!arrangements!are!inviting!and!conducive!to!the!planned!activities.!!

!!!!!!!!!!!!□ *

Advisement*center*or*classroom*

arrangements*are*consistently*

inviting*and*conducive*to*the*planned*

activities**

*

************□ *

EVIDENCE:!!


58

!!

DOMAIN!3!FOR!STUDENT!ADVISORS:�SYSTEM!SUPPORT!(DELIVERY!OF!SERVICE)*!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

3a:!!Contribute!to!school!wide!efforts!such!as!largeWscale!assessment!administration!!

Does*not*contribute*to*school*wide*

efforts*such*as*largeHscale*

assessment*administration.*

*

************□ *

Infrequently*contributes*to*school*

wide*efforts*such*as*largeHscale*


*

************□ *

Actively!contributes!to!school!wide!efforts!such!as!largeWscale!assessment!administration.!!

!!!!!!!!!!!!□ !

Consistently*contributes*to*school*

wide*efforts*such*as*largeHscale*


*

************□ *

EVIDENCE:!!

3b:!!Contribute!to!and!support!school!improvement!efforts!

Does*not*contribute*to*and*support*

school*improvement*efforts.#*

*

************□ *

Rarely!contributes*to*and*supports*school*improvement*efforts.*

*

*

************□ *

Regularly!contributes!to!and!supports!school!improvement!efforts.!!

!!!!!!!!!!!!□ *

Consistently*contributes*to*and*

supports*school*improvement*efforts.*

*

*

************□ *

EVIDENCE:!!

3c:!!Demonstrate!flexibility!and!responsiveness!!

Adheres*to*the*plan*or*program,*in*

spite*of*evidence*of*its*inadequacy.*

*

*

*

*

*

************□ *

Makes*modest*changes*in*the*

student*advisement*program*when*


for*change.*

*

*

*

************□ *

Makes!revisions!in!the!student!advisement!program!when!they!are!needed.!!!!!

!!!!!!!!!!!!□ *

Continually*seeks*ways*to*improve*

the*student*advisement*program*

based*on*data*and*makes*changes*

as*needed*in*response*to*student,*

parent,*administrator*or*teacher*

input.*

*

************□ *

EVIDENCE:!!


59

3d:!!Assess!student!needs!!

Does*not*assess*student*needs,*or*

the*assessments*result*in*inaccurate*

conclusions.*

*

*

************□ *

Assessments*of*student*needs*are*

perfunctory.*

*

*

*

************□ *

Assesses!student!needs!through!data!collection,!and!understands!the!range!of!student!needs!in!the!school.!!

!!!!!!!!!!!!□ *

Conducts*detailed*and*individualized*

assessments*of*student*needs*to*

contribute*to*program*planning.*

*

*

************□ *

EVIDENCE:!!

3e:!!Other!duties!as!assigned!by!school!administrators!!

Does*not*perform*other*duties*as*

assigned*by*school*administrators.*

*

*

************□ *

Occasionally*performs*other*duties*

as*assigned*by*school*

administrators.*

*

************□ *

Routinely!performs!other!duties!as!assigned!by!school!administrators.!!

!!!!!!!!!!!!□ *

Continually*performs*other*duties*as*

assigned*by*school*administrators.*

*

*

************□ *

EVIDENCE:!!


60

!!DOMAIN!4!FOR!STUDENT!ADVISORS:�PROFESSIONAL!KNOWLEDGE!(PROFESSIONAL!RESPONSIBILITIES)*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

4a:!!Adhere!to!current!federal!laws,!state!statutes!and!district!policies!related!to!guidance!functions,!including,!but!not!limited!to,!the!Family!Educational!Rights!and!Privacy!Act,!child!abuse!reporting!and!graduation!requirements!!!!

Does*not*adhere*to*current*federal*

laws,*state*statutes*and*district*

policies*related*to*guidance*

functions,*including,*but*not*limited*

to,*the*Family*Educational*Rights*

and*Privacy*Act,*child*abuse*

reporting*and*graduation*

requirements.*

*

************□ *

Infrequently*adheres*to*current*

federal*laws,*state*statutes*and*

district*policies*related*to*guidance*





requirements.*

*

************□ *

Adheres!to!current!federal!laws,!state!statutes!and!district!policies!related!to!guidance!functions,!including,!but!not!limited!to,!the!Family!Educational!Rights!and!Privacy!Act,!child!abuse!reporting!and!graduation!requirements.!

!!!!!!□ !

Actively*adheres*to*current*federal*

laws,*state*statutes*and*district*

policies*related*to*guidance*





requirements.*

*

************□ *

EVIDENCE:!!

4b:!!Remain!current!with!postsecondary!career!and!college!opportunities!

Does*not*remain*current*with*

postsecondary*career*and*college*

opportunities.*

*

************□ *

Rarely*remains*current*with*


opportunities.*

*

************□ *

Remains!current!with!postsecondary!career!and!college!opportunities.!!

!!!!!!!!!!!!□ *

Actively*remains*current*with*


opportunities.*

*

************□ *

EVIDENCE:!!

4c:!!Remain!current!with!changes!in!college!admission!and!financial!aid!criteria!!

Does*not*remain*current*with*

changes*in*college*admission*and*

financial*aid*criteria.*

*

************□ *

Seldom*remains*current*with*



*

************□ *

Remains!current!with!changes!in!college!admission!and!financial!aid!criteria.!!

!!!!!!!!!!!!□ *

Actively*remains*current*with*



*

************□ *

EVIDENCE:!!


61

4d:!!Participate!in!a!professional!community!!

Relationships*with*colleagues*are*

negative*or*selfHserving,*and*avoids*

being*involved*in*school*and*district*

events*and*projects.*

*

************□ *

Relationships*with*colleagues*are*

cordial,*and*participates*in*school*

and*district*events*and*projects*when*


*

************□ *

Participates!actively!in!school!and!district!events!and!projects!and!maintains!positive!and!productive!relationships!with!colleagues.!!

!!!!!!!!!!!!□ *

Makes*a*substantial*contribution*to*

school*and*district*events*and*

projects*and*assumes*leadership*

with*colleagues.*

*

************□ *

EVIDENCE:!!

4e:!!Engage!in!professional!development!!

Does*not*participate*in*professional*

development*activities*even*when*


the*development*of*student*

advisement*skills.*

*

************□ *

Participation*in*professional*

development*activities*is*limited*to*

those*that*are*convenient*or*are*

required.*

*

*

************□ *

Seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!!!

!!!!!!!!!!!□ *

Actively*pursues*professional*

development*opportunities*and*

makes*a*substantial*contribution*to*

the*campus*by*sharing*relevant*

information*with*faculty*and*staff.*

*

************□ *EVIDENCE:!!

4f:!!Display!professionalism!!

Displays*unprofessionalism*in*


students,*and*the*publicY*violates*


*

*

************□ *

Sporadically*displays*professional*


students,*and*the*publicY*and*

recognizes*the*need*for*

confidentiality.***

*

************□ *

Displays!honesty,!integrity,!and!confidentiality!in!interactions!with!colleagues,!students,!and!the!public^!advocates!for!students!when!needed.!!

!!!!!!!!!!!!□ !

Can*be*counted*on*to*hold*the*

highest*standards*of*honesty,*




*

************□ *

EVIDENCE:!!


62

K-8 Counselor Performance Evaluation (Form 1F) !*

Employee:**

! *

School*Year:**

**

EIN:**

*

Date:**

!School:**

! *

Fall*Summative*Evaluation**□**

Spring*Summative*Evaluation**□*!Evaluator:**

! *


!!DOMAIN!1!FOR!KW8!COUNSELORS:�PLANNING!AND!PREPARATION*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

1a:!!Demonstrating!knowledge!!of!counseling!theory!and!techniques!!

Counselor*demonstrates*little*

understanding*of*Counseling*theory*

and*techniques.*

*

□ *

Counselor*demonstrates*basic*

understanding*of*Counseling*theory*

and*techniques.*

*

□ *

Counselor!demonstrates!understanding!of!counseling!theory!and!techniques.!!

□ !

Counselor*demonstrates*deep*and*

thorough*understanding*of*

counseling*theory*and*techniques.*

*

□ *

EVIDENCE:!!

1b:!!Demonstrating!knowledge!!of!required!Educational!Career!Action!Plan!(ECAP)!!

Counselor*demonstrates*little*or*no*

knowledge*of*Educational*Career*

Action*Plan*(ECAP).*

*

*

□ *

Counselor*demonstrates*basic*

awareness*of*Educational*Career*

Action*Plan*(ECAP).*

*

*

□ *

Counselor!demonstrates!a!complete!understanding!of!Educational!Career!Action!Plan!(ECAP).!!

□ *

Counselor*demonstrates*a*complete*

and*comprehensive*understanding*of*

Educational*Career*Action*Plan*

(ECAP).*

*

□ *

EVIDENCE:!!


63

1c:!!Establishing!goals!for!the!counseling!program!appropriate!to!the!setting!!and!the!students!served!

Counselor*has*no*clear*goals*for*the*

counseling*program,*or*they*are*

inappropriate*to*either*the*situation*

or*the*age*of*the*students.*

*

*

*

*

□ *

Counselor’s*goals*for*the*counseling*




*

*

*

*

□ *

Counselor’s!goals!for!the!counseling!program!are!clear!and!appropriate!to!the!situation!in!the!school!and!to!the!age!of!the!students.!!!!

□ *

Counselor’s*goals*for*the*student*

counseling*program*are*highly*

appropriate*to*the*situation*in*the*

school*and*to*the*age*of*the*students*

and*have*been*developed*following*

consultations*with*students,*parents,*

and*colleagues.*

*

□ *

EVIDENCE:!!

1d:!!Demonstrating!knowledge!of!state!and!federal!regulations!and!of!resources!both!within!and!beyond!the!school!and!district!!

Counselor*demonstrates*little*or*no*

knowledge*of*governmental*

regulations*and*of*resources*for*


school*or*district.*

*

*

□ *

Counselor*displays*awareness*of*

governmental*regulations*and*of*

resources*for*students*available*

through*the*school*or*district,*but*no*


more*broadly.*

*

□ *

Counselor!displays!awareness!of!governmental!regulations!and!of!resources!for!students!available!through!the!school!or!district,!and!some!familiarity!with!resources!external!to!the!school.!!

□ *

Counselor’s*knowledge*of*

governmental*regulations*and*of*

resources*for*students*is*extensive,*

including*those*available*through*the*

school*or*district*and*in*the*

community.*

*

□ *

EVIDENCE:!!

1e:!!Planning!the!counseling!program,!integrated!with!the!regular!school!program!

Counseling*program*consists*of*a*

random*collection*of*unrelated*

activities,*lacking*coherence*or*an*

overall*structure.*

*

*

□ *

Counselor’s*plan*has*a*guiding*

principle*and*includes*a*number*of*

worthwhile*activities,*but*some*of*

them*don’t*fit*with*the*broader*goals.*

*

*

□ *

Counselor!has!developed!a!plan!that!includes!the!important!aspects!of!Counseling!in!the!setting.!!!

□ *

Counselor’s*plan*is*highly*coherent*

and*serves*to*support*not*only*the*

students*individually*and*in*groups,*

but*also*the*broader*educational*

program.*

*

□ *

EVIDENCE:!!


64

1f:!!Developing!a!plan!to!evaluate!the!counseling!program!

Counselor*has*no*plan*to*evaluate*

the*program*or*resists*suggestions*

that*such*an*evaluation*is*important.*

*

*

*

□ *

Counselor*has*a*rudimentary*plan*to*

evaluate*the*Counseling*program.*

*

*

*

*

□ *

Counselor’s!plan!to!evaluate!the!program!is!organized!around!clear!goals!and!the!collection!of!evidence!to!indicate!the!degree!to!which!the!goals!have!been!met.!!

□ *

Counselor’s*evaluation*plan*is*highly*

sophisticated,*with*imaginative*

sources*of*evidence*and*a*clear*path*

toward*improving*the*program*on*an*

ongoing*basis.*

*

□ *

EVIDENCE:!!


65

!!DOMAIN!2!FOR!KW8!COUNSELORS:�THE!ENVIRONMENT*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

2a:!!Creating!an!environment!of!!respect!and!rapport!!

Counselor’s*interactions*with*

students*are*negative*or*

inappropriate,*and*the*Counselor*

does*not*promote*positive*

interactions*among*students.*

*

************□ *

Counselor’s*interactions*are*a*mix*of*

positive*and*negativeY*the*

Counselor’s*efforts*at*encouraging*

positive*interactions*among*students*

are*partially*successful.*

*

□ *

Counselor’s!interactions!with!students!are!positive!and!respectful,!and!the!Counselor!actively!promotes!positive!studentWstudent!interactions.!!

□ !

Students*seek*out*the*Counselor,*


and*trust*in*the*relationship.*

Counselor*teaches*students*how**

to*engage*in*positive*interactions.*

*

□ *

EVIDENCE:!!

2b:!!Establishing!a!culture!for!productive!communication!!!

Counselor*makes*no*attempt*to*

establish*a*culture*for*productive*

communication*in*the*school*as*a*

whole,*either*among*students*or*

among*teachers,*or*between*

students*and*teachers.*

*

************□ *

Counselor’s*attempts*to*promote*a*

culture*throughout*the*school*for*

productive*and*respectful*

communication*between*and*among*

students*and*teachers*are*partially*

successful.*

*

************□ *

Counselor!promotes!a!culture!throughout!the!school!for!productive!and!respectful!communication!between!and!among!students!and!teachers.!!!

!!!!!!!!!!!!□ *

The*culture*in*the*school*for*

productive*and*respectful*

communication*between*and*among*

students*and*teachers,*while*guided*

by*the*Counselor,*is*maintained*by*

both*teachers*and*students.*

*

************□ *

EVIDENCE:!!

2c:!!Managing!routines!!and!procedures!!

Counselor’s*routines*for*the*

Counseling*center*or*classroom*work*

are*nonexistent*or*in*disarray.*

*

*

************□ *

Counselor*has*rudimentary*and*

partially*successful*routines*for*the*

Counseling*center*or*classroom.*

*

*

************□ *

Counselor’s!routines!for!the!Counseling!center!or!classroom!work!effectively.!!!

!!!!!!!!!!!!□ *

Counselor’s*routines*for*the*

Counseling*center*or*classroom*are*

seamless,*and*students*assist*in*

maintaining*them.*

*

************□ *

EVIDENCE:!!


66

2d:!!Establishing!standards!of!conduct!and!contributing!to!the!culture!for!student!behavior!throughout!the!school!!

Counselor*has*established*no*

standards*of*conduct*for*students*

during*counseling*sessions*and*

makes*no*contribution*to*maintaining*

an*environment*of*civility*in*

the*school.*

*

************□ *

Counselor’s*efforts*to*establish*

standards*of*conduct*for*counseling*

sessions*are*partially*successful.*

Counselor*attempts,*with*limited*

success,*to*contribute*to*the*level*of*

civility*in*the*school*as*a*whole.*

*

************□ *

Counselor!has!established!clear!standards!of!conduct!for!counseling!sessions!and!makes!a!significant!contribution!to!the!environment!of!civility!in!the!school.!!

!!!!!!!!!!!!□ *

Counselor*has*established*clear*

standards*of*conduct*for*counseling*

sessions,*and*students*contribute*to*

maintaining*them.*Counselor*takes*a*

leadership*role*in*maintaining*the*

environment*of*civility*in*the*school.*

*

************□ *

EVIDENCE:!!

2e:!!Organizing!physical!space!!

The*physical*environment*is*in*

disarray*or*is*inappropriate*to*the*

planned*activities.*

*

*

*

************□ *

Counselor’s*attempts*to*create*an*

inviting*and*wellHorganized*physical*

environment*are*partially*successful.*

*

*

*

************□ *

Counseling!center!or!classroom!arrangements!are!inviting!and!conducive!to!the!planned!activities.!!!

!!!!!!!!!!!!□ *

Counseling*center*or*classroom*

arrangements*are*inviting*and*

conducive*to*the*planned*activities.*

Students*have*contributed*ideas*to*

the*physical*arrangement.*

*

************□ *

EVIDENCE:!!


67

!!DOMAIN!3!FOR!KW8!COUNSELORS:�DELIVERY!OF!SERVICE*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

3a:!Assessing!student!needs!!

Counselor*does*not*assess*student*

needs,*or*the*assessments*result*in*

inaccurate*conclusions.*

*

*

************□ *

Counselor’s*assessments*of*student*

needs*are*perfunctory.*

*

*

*

************□ *

Counselor!assesses!student!needs!and!knows!the!range!of!student!needs!in!the!school.!!!

!!!!!!!!!!!!□ !

Counselor*conducts*detailed*and*

individualized*assessments*of*

student*needs*to*contribute*to*

program*planning.*

*

************□ *

EVIDENCE:!!

3b:!!Assisting!students!and!teachers!in!the!formulation!of!academic,!personal/social,!and!career!plans,!based!on!knowledge!of!student!needs!

Counselor’s*program*is*independent*

of*identified*student*needs.*

*

*

*

************□ *

Counselor’s*attempts*to*help*

students*and*teachers*formulate*

academic,*personal/social,*and*

career*plans*are*partially*successful.*

*

************□ *

Counselor!helps!students!and!teachers!formulate!academic,!personal/social,!and!career!plans!for!groups!of!students.!!

!!!!!!!!!!!!□ *

Counselor*helps*individual*students*

and*teachers*formulate*academic,*

personal/social,*and*career*plans.*

*

*

************□ *

EVIDENCE:!!

3c:!!Use!of!instructional!strategies!in!classroom!lessons!!

Counselor*is*not*using*effective*

instructional*strategies*in*classroom*

instruction.*

*

*

************□ *

Counselor*inconsistently*uses*

effective*instructional*strategies*in*

classroom*instruction.*

*

*

************□ *

Counselor!consistently!uses!a!variety!of!effective!instructional!strategies!in!classroom!instruction.!!

!!!!!!!!!!!!□ *

Counselor*uses*a*variety*of*highly*

effective*instructional*strategies*in*

classroom*instruction.*

*

*

************□ *

EVIDENCE:!!


68

3d:!!College!and!career!readiness!framwork!!

Counselor*shows*no*evidence*of*

College*and*Career*readiness*

Framework*implementation*in*

assigned*grades.*

*

************□ *

Counselor*shows*inconsistent*

implementation*of*College*and*

Career*readiness*Framework*in*

assigned*grades.*

*

************□ *

Counselor!provides!consistent!implementation!of!College!and!Career!readiness!Framework!in!assigned!grades.!!

!!!!!!!!!!!!□ *

Counselor*demonstrates*exceptional*

and*comprehensive*implementation*

of*College*and*Career*Readiness*

Framework*in*assigned*grades.*

*

************□ *

EVIDENCE:!!

3e:!Demonstrating!flexibility!and!responsiveness!!

Counselor*adheres*to*the*plan*or*

program,*in*spite*of*evidence*of*its*

inadequacy.*

*

*

*

************□ *

Counselor*makes*modest*changes*in*

the*Counseling*program*when*


for*change.*

*

*

************□ *

Counselor!makes!revisions!in!the!Counseling!program!when!they!are!needed.!!!!

!!!!!!!!!!!!□ *

Counselor*is*continually*seeking*

ways*to*improve*the*Counseling*




*

************□ *

EVIDENCE:!!


69

!!DOMAIN!4!FOR!KW8!COUNSELORS:�PROFESSIONAL!RESPONSIBILITIES*

!

COMPONENT!!

INEFFECTIVE!!

DEVELOPING!!

EFFECTIVE!!

HIGHLY!EFFECTIVE!!

4a:!!Reflecting!on!practice!!

Counselor*does*not*reflect*on*

practice,*or*the*reflections*are*


*

*

*

*

*

************□ *

Counselor’s*reflection*on*practice*is*

moderately*accurate*and*objective*

without*citing*specific*examples*and*

with*only*global*suggestions*as*to*

how*it*might*be*improved.*

*

*

*

************□ *

Counselor’s!reflection!provides!an!accurate!and!objective!description!of!practice,!citing!specific!positive!and!negative!characteristics.!!Counselor!makes!some!specific!suggestions!as!to!how!the!Counseling!program!might!be!improved.!

!!!!!!!!!!!!□ !

Counselor’s*reflection*is*highly*

accurate*and*perceptive,*citing*

specific*examples*that*were*not*fully*

successful*for*at*least*some*

students.**Counselor*draws*on*an*


alternative*strategies.*

*

************□ *

EVIDENCE:!!

4b:!!Maintaining!records!and!submitting!them!in!a!timely!fashion!!

Counselor’s*reports,*records,*and*

documentation*are*missing,*late,*or*

inaccurate,*resulting*in*confusion.*

*

*

************□ *

Counselor’s*reports,*records,*and*

documentation*are*generally*

accurate*but*are*occasionally*late.**

*

*

************□ *

Counselor’s!reports,!records,!and!documentation!are!accurate!and!are!submitted!in!a!timely!manner.!!!!

!!!!!!!!!!!!□ *

Counselor’s*approach*to*record*

keeping*is*highly*systematic*and*

efficient*and*serves*as*a*model*for*

colleagues*in*other*schools.**

*

************□ *

EVIDENCE:!!

4c:!!Communicating!with!families!!

Counselor*provides*no*information*to*

families,*either*about*the*Counseling*

program*as*a*whole*or*about*

individual*students.*

*

************□ *

Counselor*provides*limited*though*

accurate*information*to*families*

about*the*Counseling*program*as*a*

whole*and*about*individual*students.*

*

************□ *

Counselor!provides!thorough!and!accurate!information!to!families!about!the!Counseling!program!as!a!whole!and!about!individual!students.!

!!!!!!!!!!!!□ *

Counselor*is*proactive*in*providing*

information*to*families*about*the*

Counseling*program*and*about*

individual*students*through*a*variety*

of*means.*

************□ *

EVIDENCE:!!


70

4d:!!Participating!in!a!professional!community!!

Counselor’s*relationships*with*

colleagues*are*negative*or*selfH

serving,*and*Counselor*avoids*being*

involved*in*school*and*district*events*

and*projects.*

*

************□ *

Counselor’s*relationships*with*

colleagues*are*cordial,*and*

Counselor*participates*in*school*and*

district*events*and*projects*when*


*

************□ *

Counselor!participates!actively!in!school!and!district!events!and!projects!and!maintains!positive!and!productive!relationships!with!colleagues.!!

!!!!!!!!!!!!□ *

Counselor*makes*a*substantial*

contribution*to*school*and*district*

events*and*projects*and*assumes*

leadership*with*colleagues.*

*

*

************□ *

EVIDENCE:!!

4e:!!Engaging!in!professional!development!!

Counselor*does*not*participate*in*



needed*for*the*development*of*

Counseling*skills.*

*

*

************□ *

Counselor’s*participation*in*




*

*

*

************□ *

Counselor!seeks!out!opportunities!for!professional!development!based!on!an!individual!assessment!of!need.!!!!

!!!!!!!!!!!!□ *

Counselor*actively*pursues*






*

************□ *

EVIDENCE:!!

4f:!!Showing!professionalism!!

Counselor*displays*dishonesty*in*


students,*and*the*publicY*violates*


*

*

*

************□ *

Counselor*is*honest*in*interactions*

with*colleagues,*students,*and*the*

publicY*does*not*violate*

confidentiality.*

*

*

*

************□ *

Counselor!displays!high!standards!of!honesty,!integrity,!and!confidentiality!in!interactions!with!colleagues,!students,!and!the!public^!advocates!for!students!when!needed.!!

!!!!!!!!!!!!□ !

Counselor*can*be*counted*on*to*hold*

the*highest*standards*of*honesty,*




*

*

************□ *

EVIDENCE:!!

*

71

Nurse Performance Profile and Rating (Form 2A)

Employee: EIN: Fall Summative

Observation Experience #1

Date: __________

Spring Summative Observation Experience #2

Date: __________

Final Summative

Due No Later Than March 31 School/Department: School Year:

Evaluator:

Inef

fect

ive

Dev

elop

ing

Effe

ctiv

e

Hig

hly

Effe

ctiv

e

Inef

fect

ive

Dev

elop

ing

Effe

ctiv

e

Hig

hly

effe

ctiv

e

Inef

fect

ive

Dev

elop

ing

Effe

ctiv

e

Hig

hly

Effe

ctiv

e

Status: Probationary □ Continuing □

Domain 1: Planning and Preparation 1a: Demonstrating knowledge of school nurse practice by maintaining student health and safety on campus/Understanding the professional, ethical and legal standards that guide the nurse in the school setting

1b: Demonstrating knowledge of child and adolescent development 1c: Establishing goals for the school health program appropriate to the setting and the students served

1d: Demonstrating knowledge of nursing scope of practice/Utilizes district resources and health manual procedures/Follows state and federal regulations, by maintaining appropriate license and certifications

1e: Writing Individual Healthcare Plans for Students. 1f: Demonstrating knowledge of school and community resources Domain 2: The Environment 2a: Creating an environment of respect and rapport in professional relationships and with students, staff and parents

2b: Establishing an environment that is culturally sensitive 2c: Utilizing health protocols and procedures in providing care to students 2d: Supervising Health Assistants 2e: Organizing health office Domain 3: Delivery of Service 3a: Assessing student needs 3b: Administering medications to students 3c: Promoting wellness through individual, classroom or school wide education, Acts as a public health resource

3d: Managing emergency situations 3e: Collaborating with parent and teachers to develop Individualized Healthcare Plans (IHP) and services for students with special medical needs

*

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Domain 4: Professional Responsibilities 4a: Reflecting on Nursing Practice which is based on current scientific evidence 4b: Maintaining health records in accordance with policy and submitting reports in a timely fashion

4c: Professional communication 4d: Maintaining confidentiality 4e: Engaging in professional development 4f: Shows professionalism by being a good role model including dependable attendance, punctuality in performance of duties and professional appearance

Final Summative Specialist Performance Rating

Ineffective (0) □ Developing (1) □ Effective (2) □ Highly Effective (3) □

3 or more Ineffective ratings

1 or 2 Ineffective ratings

or 4 or more Developing ratings

Zero Ineffective ratings and fewer

than 4 Developing ratings

At least 7 Highly Effective ratings

and Zero Ineffective and Developing ratings

Final Specialist Evaluation Rating Evaluator’s Printed Name Specialist’s Printed Name Fall Summative Evaluator’s Signature Specialist’s Signature Date Date Final Summative Evaluator’s Signature Specialist’s Signature Date Date

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73

Psychologist Performance Profile and Rating (Form 2B)



Date: __________


Date: __________

Final Summative


Evaluator:

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Domain 1: Planning and Preparation 1a: Demonstrating knowledge of the profession of psychology, including professional, ethical, and legal standards and regulations that guide the practice of psychology in education

1b: Demonstrating knowledge of child and adolescent characteristics, including knowledge of development, cultural diversity, and psychopathology

1c: Demonstrating knowledge of assessment, including selecting and using a range of psychological instruments to evaluate students, linked to assessment concerns and potential interventions

1d: Demonstrating knowledge of procedures and resources, including district procedures, state and federal regulations, resources within and beyond the school and district, and the continuum of services available to students

1e: Designing a cohesive service delivery system that solves school-wide problems, meets the needs of individual students, and includes prevention

1f: Demonstrating knowledge of research-based instructional, behavioral, and mental health interventions

Domain 2: The Environment 2a: Maintaining an environment of respect and rapport in professional relationships and with students

2b: Supporting a culture of learning and achievement in classrooms, by promoting data-based decision-making and research-based interventions

2c: Implementing clear procedures for referrals and for working with the building-level child study process

2d: Establishing procedures for analyzing student behavior and providing positive behavioral supports

2e: Organizing physical space, including appropriate testing space, space to consult with teachers and parents, and maintaining confidential storage for test materials and files

*

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Domain 3: Delivery of Service 3a: Communicating effectively by responding in a timely manner to referrals, parent requests, and re-evaluation schedules; consulting regularly with teachers and administrators

3b: Gathering information systematically from multiple sources, using test instruments appropriately, and considering the context for assessment and intervention

3c: Serving as case manager of the evaluation team, maintaining contact with other professionals throughout the assessment process, and writing integrated MET reports

3d: Addressing social-emotional needs of students by providing social skills training, counseling, and/or behavioral coaching, and working with teachers and/or parents to plan and implement interventions

3e: Demonstrating flexibility and responsiveness Domain 4: Professional Responsibilities 4a: Reflecting on practice 4b: Maintaining accurate records 4c: Communicating with families 4d: Participating in professional communities, including those established at assigned schools and with school psychologist colleagues

4e: Growing and developing professionally 4f: Demonstrating professionalism

*

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*

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Instructional Specialist Performance Profile and Rating (Form 2C)



Date: __________


Date: __________

Final Summative


Evaluator:

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Domain 1: Planning and Preparation 1a: Demonstrating knowledge of current trends in specialty area and professional development

1b: Demonstrating knowledge of the school’s program and levels of teacher skill in delivering that program

1c: Establishing goals for the instructional support program appropriate to the setting and the teachers served

1d: Demonstrating knowledge of resources, both within and beyond the school and district

1e: Planning the instructional support program, integrated with the overall school program

1f: Developing a plan to evaluate the instructional support program Domain 2: The Environment 2a: Creating an environment of trust and respect 2b: Establishing a culture for ongoing instructional improvement 2c: Establishing clear procedures for teachers to gain access to instructional support

2d: Establishing and maintaining norms of behavior for professional interactions 2e: Organizing physical space for workshops or training Domain 3: Delivery of Service 3a: Collaborating with teachers in the design of instructional units and lessons 3b: Engaging teachers in learning new instructional skills 3c: Sharing expertise with staff 3d: Locating resources for teachers to support instructional improvement 3e: Demonstrating flexibility and responsiveness

*

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Domain 4: Professional Responsibilities 4a: Reflecting on practice 4b: Preparing and submitting budgets and reports 4c: Coordinating work with other instructional specialists 4d: Participating in a professional community 4e: Engaging in professional development 4f: Showing professionalism, including integrity and confidentiality Final Summative Specialist Performance Rating










*

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Therapeutic Specialist Performance Profile and Rating (Form 2D)



Date: __________


Date: __________

Final Summative


Evaluator:

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Domain 1: Planning and Preparation 1a: Demonstrating knowledge and skill in the specialist therapy area; holding the relevant certificate or license

1b: Establishing goals for the therapy program appropriate to the setting and the students served

1c: Demonstrating knowledge of district, state, and federal regulations and guidelines

1d: Demonstrating knowledge of resources, both within and beyond the school and district

1e: Planning the therapy program, integrated with the regular school program, to meet the needs of individual students

1f: Developing a plan to evaluate the therapy program Domain 2: The Environment 2a: Establishing rapport with students 2b: Organizing time effectively 2c: Establishing and maintaining clear procedures for referrals 2d: Establishing standards of conduct in the treatment center 2e: Organizing physical space for testing of students and providing therapy Domain 3: Delivery of Service 3a: Responding to referrals and evaluating student needs 3b: Developing and implementing treatment plans to maximize students’ success 3c: Communicating with families 3d: Collecting information; writing reports 3e: Demonstrating flexibility and responsiveness

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Domain 4: Professional Responsibilities 4a: Reflecting on practice 4b: Collaborating with teachers and administrators 4c: Maintaining an effective data-management system 4d: Participating in a professional community 4e: Engaging in professional development 4f: Showing professionalism, including integrity, advocacy, and maintaining confidentiality











*

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Student Advisor Performance Profile and Rating (Form 2E)



Date:


Date:

Final Summative


Evaluator:

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Domain 1: Graduation/College & Career Readiness (Planning and Preparation) 1a: Develop and implement strategies to facilitate successful transition from eighth grade to high school

1b: Monitor students’ academic progress and provide personalized guidance, including transcript evaluation, and support to those who are not on track to graduate within in four years. Develop and implement student-specific and system-level strategies that increase the schools’ rate of graduation and postsecondary enrollment.

1c: Develop and implement intervention strategies for students who demonstrate absentee, behavioral or academic need

1d: Ensure that each student develops an ECAP specific to their interests, talents and aspirations. Modify student’s schedules and courses of study when appropriate.

1e: Provide ongoing exposure to the information and experiences necessary to make informed decisions when selecting a postsecondary program or career

1f: Assist students in establishing postsecondary goals and successfully completing a high school course of study that prepares them to meet those goals

1g: Promote preparation for and participation in college and career assessments such as the PSAT/NMSQT, SAT, ACT, ASVAB and ACCUPLACER. Facilitate students’ understanding of results and how this information can be applied to course selection and skill development.

1h: Provide students and families with comprehensive information about college expenses. Help students and families successfully navigate financial aid and scholarship processes enabling them to plan and prepare for postsecondary educational experiences. Provide coaching, consultation and direct services as appropriate.

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Domain 2: Support Services (The Environment) 2a: Support the 504 referral, evaluation and accommodation processes for students in one’s caseload

2b: Assist students in crisis situations and refer to district or community resources when appropriate

2c: Managing routines and procedures 2d: Establish standards of conduct and contribute to the culture for student behavior throughout the school

2e: Organize physical space Domain 3: System Support (Delivery of Service) 3a: Contribute to school wide efforts such as large-scale assessment administration 3b: Contribute to and support school improvement plans 3c: Demonstrate flexibility and responsiveness 3d: Assess student needs

3e: Other duties as assigned by school administrator Domain 4: Professional Knowledge (Professional Responsibilities) 4a: Adhere to current with federal laws, state statutes and district policies related to guidance functions, including but not limited to, the Family Educational Rights and Privacy Act, child abuse reporting and graduation requirements

4b: Remain current with postsecondary college and career opportunities 4c: Remain current with changes in college admission and financial aid criteria 4d: Participating in a professional community 4e: Engage in professional development 4f: Display professionalism

*

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Final Specialist Evaluation Rating

Evaluator’s Printed Name Student Advisor’s Printed Name Fall Summative

Evaluator’s Signature Student Advisor’s Signature

Date Date Spring and Final Summative

Evaluator’s Signature Student Advisor’s Signature

Date Date

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K-8 Counselor Performance Profile and Rating (Form 2F)



Date:


Date:

Final Summative


Evaluator:

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Domain 1: Planning and Preparation 1a: Demonstrating knowledge of counseling theory and techniques 1b: Demonstrating knowledge of required Educational Career Action Plan (ECAP) 1c: Establishing goals for the counseling program appropriate to the setting and the students served

1d: Demonstrating knowledge of state and federal regulations and of resources both within and beyond the school and district

1e: Planning the counseling program, integrated with the regular school program 1f: Developing a plan to evaluate the student advisement program Domain 2: The Environment 2a: Creating an environment of respect and rapport 2b: Establishing a culture for productive communication 2c: Managing routines and procedures 2d: Establishing standards of conduct and contributing to the culture for student behavior throughout the school

2e: Organizing physical space Domain 3: Delivery of Services 3a: Assessing student needs 3b: Assisting students and teachers in the formulation of academic, personal/social, and career plans, based on knowledge of student needs

3c: Use of instructional strategies in classroom lessons 3d: College and career readiness framework 3e: Demonstrating flexibility and responsiveness

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Domain 4: Professional Responsibilities 4a: Reflecting on practice 4b: Maintaining records and submitting them in a timely fashion 4c: Communicating with families 4d: Participating in a professional community 4e: Engaging in professional development 4f: Showing professionalism Final Summative Specialist Performance Rating









Final Specialist Evaluation Rating

Evaluator’s Printed Name Specialist’s Printed Name Fall Summative

Evaluator’s Signature Specialist’s Signature

Date Date Spring and Final Summative

Evaluator’s Signature Specialist’s Signature

Date Date

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Professional Refinement Plan (Form 3) Employee:

School Year:

EIN:

School/Department:

Evaluator:

Status: Probationary □ Continuing □ Specialist Classification:

Nurse □

Psychologist □

Instructional □ Specialist

Therapeutic □ Specialist

Student □ Advisor

K-8 □ Counselor

Area for Refinement

Plan Evaluator’s Signature Specialist’s Signature Date Date

Summary of Work Completed Evaluator’s Signature Specialist’s Signature Date Date

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Professional Remediation Plan (Form 4) Employee:

School Year:

EIN:

School/Department:

Evaluator:


Nurse □

Psychologist □



Student □ Advisor

K-8 □ Counselor

Plan

Goal: Strategy 1: Action Steps: Strategy 2: Action Steps: Strategy 3: Action Steps: Evaluator’s Signature Specialist’s Signature Date Date

Results

□ Progress on goal

□ Limited or no progress on goal Comments: Evaluator’s Signature Specialist’s Signature Date Date

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Notification of Inadequate Specialist Performance-Fall (Form 5) Employee:

School Year:

EIN:

School/Department:

Evaluator:


Nurse □

Psychologist □



Student □ Advisor

K-8 □ Counselor

The specialist listed above has been rated “Ineffective” on the Fall Summative Specialist Performance Evaluation or is a continuing status specialist who has been rated “Ineffective” or “Developing” on last year’s Final Summative Specialist Performance Evaluation and this year’s Fall Summative Specialist Performance Evaluation. A signed copy of the specialist’s Specialist Performance Profile and Rating (Form 2-Specialist Specific) is included with this notification. Listed below are the “Ineffective” components (and “Developing” components if the specialist is continuing status and rated “Ineffective” or “Developing” for two consecutive years as described above):

1.!

2.!

3.!

4.!

5.!

6.!

7.!

8.!

9.!

10.!

11.!

12.! Evaluator’s Signature Specialist’s Signature

Date Date

!88

Notification of Inadequate Specialist Performance-Final (Form 5) Employee:

School Year:

EIN:

School/Department:

Evaluator:


Nurse □

Psychologist □



Student □ Advisor

K-8 □ Counselor

The specialist listed above has been rated “Ineffective” on the Final Summative Specialist Performance Evaluation. A signed copy of the specialist’s Specialist Performance Profile and Rating (Form 2-Specialist Specific) is included with this notification. The Ineffective components are:

1.!

2.!

3.!

4.!

5.!

6.!

7.!

8.!

9.!

10.!

11.!

12.! Evaluator’s Signature Specialist’s Signature Date Date

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Appendix

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Appendix A-List of Specialists • Career & Technical Education Specialist •! Community Education Specialist • Content/Program Specialist •! Counselor (K-8) •! Department Specialist • Educational Technology Trainer •! Elementary/Secondary Division Specialist • English as a Second Language/Bilingual Specialist •! Flight Simulator Teacher •! Instructional Intervention Specialist •! Math/Reading Coach •! Mesa Distance Learning Program Specialist • Music Specialist • Native American Specialist •! Preschool Evaluator • Preventive Programs Specialist • Professional Development Specialist •! Project Mesa Teacher •! School Nurse •! School Psychologist •! Space Integration Module Teacher •! Speech Language Pathologist •! Student Advisor •! Sub Cadre Teacher •! Therapeutic Specialist (OT/PT) • Title 1 Specialist

Copyright!©2008!by!the!Association!for!Supervision!and!Curriculum!Development!(ASCD)!!

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Appendix B-Summary of Domains The organization of the frameworks for specialists closely follows that of the framework for teaching. Each has four domains and 22 components. Each domain has the same emphasis as in the framework for teaching: Planning and Preparation, The Environment, Delivery of Service and Professional Responsibilities. Domain 1: Planning and Preparation (Student(Advisor/Graduation/College(&(Career(Readiness) Each specialist framework includes a domain titled Planning and Preparation. Every specialist must plan and prepare, although some of the details of that planning may differ from that done by a teacher. However, it is primarily a matter of emphasis. For some specialists, the knowledge of resources is critical; it is integral to the work of, for example, a school psychologist. Domain 2: The Environment (Student(Advisor/Support(Services) Each specialist framework includes a domain that covers environment. In some cases, the environment for school nurses may be an office or center that students go to and that should be inviting. For instructional specialists, who work primarily with other teachers, the environment may refer to the tone in the room where the workshop is conducted. For those specialists whose responsibilities include working with students, such as a speech and language specialist or occupational therapist, the environment is similar to that of a classroom teacher. Domain 3: Delivery of Service (Student(Advisor/System(Support) In the specialist frameworks, Delivery of Service is equivalent to Instruction in the framework for teaching. All specialists do important work, but not all of it is actual teaching; in some cases it involves assessing individual student needs or conducting small group or individual counseling sessions. Specialists in all fields follow the established protocols and best practice of their own organizations; the components of the framework for teaching do not always apply. Domain 4: Professional Responsibilities (Student(Advisor/Professional(Knowledge) All specialists have obligations in the domain of Professional Responsibilities, and many of these are virtually identical to those of classroom teachers. They all reflect on their practice and maintain records. For some, communicating with families is a significant part of their work. Furthermore, all specialists participate in a professional community, and their collaboration with other teachers is central to their work. !

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Appendix C-Specialist Performance Classifications

Classification Description

Highly Effective

There is evidence of high levels of knowledge, implementation, and integration of performance standards, along with evidence of leadership initiative and willingness to model and serve as a mentor for colleagues. Specialists performing at this level are masters of their specialist responsibilities and leaders in the field, both inside and outside their school.

Standard: 7 or more “Highly Effective” ratings and no “Developing” or “Ineffective” ratings

Effective There is evidence of increased knowledge, implementation, and integration of performance standards, and clear proficiency and skill in the performance area. This rating refers to successful, professional specialist performance that is consistently at a high level. It is expected that most experienced specialists frequently perform at this level. Standard: 3 or fewer “Developing” ratings and no “Ineffective” ratings

Developing There is evidence of basic knowledge and implementation of performance standards. Integration of performance standards is not evident. This indicates that the specialist has the necessary knowledge and skills to be effective, but the application of those skills is inconsistent.

Standard: 4 or more “Developing” ratings or 1 or 2 “Ineffective” ratings

Ineffective There is little or no knowledge and minimal implementation of performance standards. The specialist does not meet minimal performance standards and needs substantial improvement. This rating refers to specialist performance that does not convey an understanding of the concepts underlying the component. This level of performance is hindering learning.

Standard: 3 or more “Ineffective” ratings!

!

Documents

Specialist Evaluation System Handbook 2015-16 · K-8 Counselor Performance Profile and Rating (Form 2F) 83-84 . 4 Professional Refinement Plan (Form 3) 85 ... specialist performance,