Practicum Evaluatin Frm - Frmative Assessment Candidate Name: Candidate ID#: Mentr/Principal Name: LEA/District: Cllege/University: Prgram Crdinatr: This frm is t be cmpleted and frmally shared with the intern by the site-based principal/mentr wh has assumed the respnsibility fr supervising the administrative intern. We sincerely appreciate the assistance yu have prvided in serving as a mentr and the cntributin yu have made t the success and effectiveness f the internship prgram. In the student s initial semesters, he/she will receive a frmative assessment f prgress with accmpanying feedback in rder t help t imprve the student's perfrmance tward meeting each cmpetency fr licensure. This frmative dcument serves as a bridge between the electrnic prtfli categrized as Emerging/Develping, Prficient and the Certificate f Cmpetency categrized as Met/Nt Met. At the cnclusin f the internship, the student will receive a final ( summative ) assessment regarding whether r nt he/she has met r nt met each cmpetency. In additin t fulfilling all ther state and institutinal requirements including a prficient six cluster electrnic prtfli, t be recmmended fr licensure, the candidate must meet each and every ne f the cmpetencies identified in this dcument. Please place a check beside the descriptr that best describes the MSA/PMC Intern s perfrmance during the Practicum and write cmments where apprpriate. Principal Licensure Candidate Prfessinal Expectatins Prmpt (arriving at wrk and attending meetings and ther wrk-related activities). Met Nt Met Prfessinal appearance. Met Nt Met Respnsible/Dependable (e.g., fllwing thrugh n prfessinal cmmitments made, taking the initiative t get things dne, when apprpriate) Met Nt Met Understands and balances his/her rle and its evlving cmplexity at the site. Met Nt Met Develps apprpriate and direct wrking relatinships with his/her mentr. Met Nt Met Develps apprpriate wrking relatinships with site-based cnstituencies. Met Nt Met Cmmunicates effectively verbally, in writing, and in prfessinal presentatins Met Nt Met VISION Cmpetency Descriptr Ratings/Cmments Envirnment al Awareness Becmes aware and remains infrmed f external and internal trends, interests and issues with ptential impacts n schl plicies, practices, prcedures and psitins Develps apprpriate wrking relatinships with site-based cnstituencies. Designs strategies fr achieving a cllabrative and psitive wrk envirnment within the schl. Seeks input frm the Schl Imprvement Team and ther stakehlders t make decisins. Utilizes data gained frm the Teacher Wrking Cnditins Survey and ther surces t Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met
identify perceptins f the wrk envirnment. Cmments: Glbal Perspective Understands the cmpetitive nature f the new glbal ecnmy Is clear abut the knwledge and skills students will need t be successful in this ecnmy. Understands the imprtance f cperatin and crss-cultural understanding Is clear abut the knwledge and skills students will need t be glbal citizens Is pen t, seeks, and respnds t ideas and suggestins fr imprvement Wrks with thers t build systems and relatinships that utilize the staff s diversity, idelgical differences, and expertise t realize the schl s gals. Systems Thinking Understands the interrelatinships and impacts f schl and district influences, systems and external stakehlders Applies that understanding t advancing the achievement f the schl r team Develps apprpriate and direct wrking relatinships with his/her mentr. Wrks with thers t systematically cnsider new and better ways f leading fr imprved student achievement fr all students and engages stakehlders in the change prcess. Wrks with thers t engage parents/guardians and all cmmunity stakehlders in a shared respnsibility fr student and schl success reflecting the cmmunity s visin f the schl. Visinary Encurages imagineering by creating an envirnment and structure t capture stakehlder dreams f what the schl culd becme fr all the students Uses shared values, beliefs and a shared visin t prmte a schl culture f learning and success. Wrks with thers t develp a shared visin and strategic gals fr student achievement that reflect high expectatins fr students and staff. Maintains a fcus n the visin and strategic gals thrughut the schl year. Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: RELATIONSHIPS Cmpetency Descriptr Ratings/Cmments Cmmunicatin Effectively listens t thers Assessment f Prgress: Clearly and effectively presents and understands infrmatin rally and in writing Emerging/Develping (1) Acquires, rganizes, analyzes, interprets, maintains infrmatin needed t achieve schl r team 21 st Prficient (2) century bjectives Nt Observed (0) Cmmunicates effectively verbally, in writing, in prfessinal presentatins, and invites dialgue arund educatinal trends and issues. End f Semester Status: Effectively engages staff and cmmunity in the change prcess in a that ensures their Met Nt Met supprt f the change and its successful implementatin Wrks with thers t utilize a system f pen cmmunicatin that prvides fr the timely, Cmments: respnsible sharing f infrmatin within the schl cmmunity. Wrks with thers t prvide infrmatin in different frmats in multiple ways thrugh different media in rder t ensure cmmunicatin with all members f the cmmunity. Wrks with thers t cmmunicate and enfrce clear expectatins, structures, rules, and prcedures fr students and staff. Wrks with thers t effectively implement district rules and prcedures. Cnflict Anticipates r seeks t reslve cnfrntatin, disagreements, r cmplaints in a cnstructive Assessment f Prgress: Emerging/Develping (1) Wrks with thers t reslve prblems and/r areas f cnflict within the schl in ways that Prficient (2) imprve student achievement Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Cultural Awareness Custmer Fcus Understands and embraces differences within and between cultures Relates t peple f varying ethnic, cultural, and religius backgrunds Visibly supprts the psitive, culturally-respnsive traditins f the schl cmmunity Wrks with thers t address diversity and equity as the schl develps, mnitrs, and adjusts the schl imprvement plan. Understands the students as custmers f the wrk f schling and the servant nature f leadership and acts accrdingly Supprts, mentrs, and caches staff members and emerging teacher leaders. Wrks with thers t prvide frmal feedback t teachers cncerning the effectiveness f their classrm instructin and ways t imprve their instructinal practice. Wrks with thers t implement district and state evaluatin plicies in a fair and equitable. Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met
Cmments: EMPOWERMENT Cmpetency Descriptr Ratings/Cmments Dialgue/ Inquiry Is skilled in creating a risk free envirnment fr engaging peple in cnversatins that explre issues, challenges r bad relatinships that are hindering schl perfrmance Assessment f Prgress: Emerging/Develping (1) Wrks with thers t systematically fcus n the alignment f learning, teaching, curriculum, Prficient (2) instructin, and assessment t maximize student learning. Nt Observed (0) Helps rganize targeted pprtunities fr teachers t learn hw t teach their subjects well with engaging lessns. End f Semester Status: Utilizes multiple surces f data, including the Teacher Wrking Cnditins Survey, fr the Met Nt Met imprvement f instructin. Wrks with thers t create pprtunities fr staff t demnstrate leadership skills by Cmments: empwering them t assume leadership and decisin-making rles. Wrks with thers t encurage teachers and supprt staff t assume leadership and decisinmaking rles in the schl. Sensitivity Effectively perceives the needs and cncerns f thers; Assessment f Prgress: Deals tactfully with thers in emtinally stressful situatin r in cnflict Emerging/Develping (1) Knws what infrmatin t cmmunicate and t whm Prficient (2) Designs strategies fr achieving a cllabrative and psitive wrk envirnment within the Nt Observed (0) schl End f Semester Status: Met Nt Met Cmments: Emtinal Is able t manage neself thrugh self awareness and self management Assessment f Prgress: Intelligence Is able t manage relatinships thrugh empathy, scial awareness and relatinship Emerging/Develping (1) management Prficient (2) Seeks input frm the Schl Imprvement Team and ther stakehlders t make decisins. Nt Observed (0) Utilizes data gained frm the Teacher Wrking Cnditins Survey and ther surces t identify perceptins f the wrk envirnment. End f Semester Status: Identifies strategies fr building a sense f efficacy and empwerment amng staff. Met Nt Met Identifies strategies fr develping a sense f well-being amng staff, students, and Cmments: parents/guardians. ETHICS Cmpetency Descriptr Ratings/Cmments Judgment Effectively reaches lgical cnclusins and making high quality decisins based n available infrmatin Assessment f Prgress: Emerging/Develping (1) Prficient (2) Gives pririty and cautin t significant issues Nt Observed (0) Analyzes and interprets cmplex infrmatin End f Semester Status: Wrks with thers t incrprate the input f the Schl Imprvement Team in budget and resurce decisins. Met Nt Met Wrks with thers t use feedback and data t assess the success f funding and prgram Cmments: decisins. Persnal Ethics and Values Cnsistently exhibits high standards in the areas f hnesty, integrity, fairness, stewardship, trust, respect, and cnfidentiality. Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Persnal Respnsibilit y fr Perfrmance Practively and cntinuusly imprves perfrmance by fcusing n needed areas f imprvement and enhancement f strengths Prmpt (arriving at wrk and attending meetings and ther wrk-related activities). Apprpriate appearance. Respnsible/Dependable (e.g., fllwing thrugh n prfessinal cmmitments made, taking the initiative t get things dne, when apprpriate) Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: CHANGE Cmpetency Descriptr Ratings/Cmments Change Anticipates r seeks t reslve cnfrntatin, disagreements, r cmplaints in a cnstructive Wrks with thers t ensure cmpliance with federal, state, and district mandates. Cntinually assesses the prgress f district initiatives and reprts results t district-level Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0)
Creative Thinking decisin-makers. Wrks with thers t implement district initiatives directed at imprving student achievement. Wrks with thers t systematically cnsider new and better ways f leading fr imprved student achievement fr all students and engages stakehlders in the change prcess. Wrks with thers t incrprate principles f cntinuus imprvement and 21st century cncepts int the Schl Imprvement Plan. Wrks with thers t systematically cllect, analyze, and use data regarding the schl s prgress tward attaining strategic gals and bjectives. Engages in and fsters an envirnment fr thers t engage in innvative thinking Wrks with thers t prvide structures fr and implement the develpment f effective prfessinal learning cmmunities and results-riented prfessinal develpment. Rutinely participates in prfessinal develpment fcused n imprving instructinal prgrams and practices. End f Semester Status: Met Nt Met Cmments: Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Results Effectively assumes respnsibility. Orientatin Recgnizes when a decisin is required. Takes prmpt actin as issues emerge Reslves shrt-term issues while balancing them against lng-term gals Wrks with thers t use established criteria fr perfrmance as the primary basis fr reward and recgnitin. Wrks with thers t ensure cmpliance with federal, state, and district mandates. Cntinually assesses the prgress f district initiatives and reprts results t district-level decisin-makers. Wrks with thers t implement district initiatives directed at imprving student achievement. Cmments: MANAGEMENT Cmpetency Descriptr Ratings/Cmments Delegatin Effectively assigns wrk tasks t thers in ways that prvide learning experiences fr them and in ways that ensure the efficient peratin f the schl Assessment f Prgress: Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Organizatina l Ability Effectively plans and schedules ne s wn and the wrk f thers s that resurces are used apprpriately Assessment f Prgress: Emerging/Develping (1) Adheres t legal requirements fr planning and instructinal time. Prficient (2) Reviews scheduling prcesses and prtcls that maximize staff input and address diverse Nt Observed (0) student learning needs End f Semester Status: Met Nt Met Cmments: Respnsivenes Des nt leave issues, inquiries r requirements fr infrmatin g unattended Assessment f Prgress: s Creates a clearly delineated structure fr respnding t requests/situatins in an expedient Emerging/Develping (1) Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: Time Effectively uses available time t cmplete wrk tasks and activities that lead t the achievement f desired wrk r schl results Assessment f Prgress: Emerging/Develping (1) Runs effective meetings Prficient (2) Nt Observed (0) End f Semester Status: Met Nt Met Cmments: TECHNOLOGY Cmpetency Descriptr Ratings/Cmments Technlgy Effectively utilizes the latest technlgies t cntinuusly imprve the management f the schl and enhance student instructin Emerging/Develping (1) Prficient (2) Nt Observed (0) Cmments:
Nte: The candidate's signature des nt imply agreement with the ratings. Individual (Printed) Signature Date Candidate LEA Official (Principal/Mentr) IHE Official Candidate Cmments (ptinal): LEA Cmments (ptinal): IHE Cmments (ptinal):