Single Subject 155B Final Evaluation Form
Please complete this evaluation form for each candidate you are mentoring.
Date: _____________________
Candidate’s First Name: _____________________
University Coach: _____________________
Grade/Content Area: _____________________
School Site: _____________________
Candidate’s Last Name: _____________________
Mentor Teacher: _____________________
Mentor Teacher’s Email: _____________________
| Does Not Meet Expectations 1 | Meets Expectations 2 | Meets Expectations at a High Level 3 | Exceeds Expectations 4 | Score |
|---|---|---|---|---|
| Expectations for, and responses to, behavior are limited to inappropriate for maintaining control of the class. Routines are unclear or ineffective. | Expectations for, and responses to, behavior are designed to maintain control of the class. Routines focus primarily on management. | Expectations for, and responses to, behavior are designed to maintain control of the class and promote positive, fair and respectful treatment of students. Routines are designed to facilitate learning, not just management. | Expectations for, and responses to, behavior are designed to promote individual responsibility, multiple perspectives, and an inclusive environment for all students. Routines are designed to facilitate independent learning and regular student–to-student interactions. | [FORM FIELD] MaintainingScore: 0 |
| Does Not Meet Expectations 1 | Meets Expectations 2 | Meets Expectations at a High Level 3 | Exceeds Expectations 4 | Score |
|---|---|---|---|---|
| No or limited monitoring of students and adjustment to the lesson. Focus is on external factors (e.g., time, schedule) rather than student behavior or learning. | Monitoring of students and adjustment to the lesson are focused primarily on behavior or lesson structure rather than student learning. | Monitoring of students and adjustment to the lesson are focused on student learning and engagement. | Monitoring of students and adjustment to the lesson are focused on providing access to the content for specific students and encouraging active engagement by all students. | [FORM FIELD] Monitoring Score: 0 |
| Does Not Meet Expectations 1 | Meets Expectations 2 | Meets Expectations at a High Level 3 | Exceeds Expectations 4 | Score |
|---|---|---|---|---|
| Lesson objectives and instruction are not clearly related to content or literacy standards. Instruction is: (a) ineffective or inconsistent with current subject-specific pedagogy, (b) includes a limited variety in instructional and engagement strategies. | Lesson objectives and instruction primarily address either content or literacy standards, focusing primarily on lower levels of learning. Instruction is: (a) consistent with current subject-specific pedagogy, (b) includes a variety of instructional and engagement strategies. | Lesson objectives and instruction clearly address both content and literacy standards, including a focus on higher level learning. Instruction is: (a) consistent with current subject-specific pedagogy, (b) includes a variety of instructional and engagement strategies, (c) provides opportunities for critical and creative thinking. | Lesson Objectives and instruction seamlessly integrate content and literacy standards, focusing on higher level learning and real world connections. Instruction is: (a) consistent with current subject specific pedagogy, (b) includes a variety of instructional and engagement strategies, (c) provides opportunities for critical and creative thinking, (d) utilizes a range of communication or activity modes. | [FORM FIELD] Subject Pedagogy Score: 0 |
| Does Not Meet Expectations 1 | Meets Expectations 2 | Meets Expectations at a High Level 3 | Exceeds Expectations 4 | Score |
|---|---|---|---|---|
| Instructional approaches are limited or inappropriate for at least two of the following groups: (a) different levels of English proficiency, (b) students with identified special needs, (c) students with different instructional needs. | Instructional approaches are generally appropriate for at least two of the following groups: (a) different levels of English proficiency, (b) students with identified special needs, (c) students with different instructional needs. | Instructional approaches are specifically aligned with the needs of at least two of the following groups: (a) different levels of English proficiency, (b) students with identified special needs, (c) students with different instructional needs. | Instructional approaches are specifically aligned with the needs of all the following groups: (a) different levels of English proficiency, (b) students with identified special needs, (c) students with different instructional needs. | [FORM FIELD] Addressing Needs Score: 0 |
| Does Not Meet Expectations 1 | Meets Expectations 2 | Meets Expectations at a High Level 3 | Exceeds Expectations 4 | Score |
|---|---|---|---|---|
| Assessments: (a) lack congruence with learning outcomes and level of learning (e.g., DOK level), (b) include little or no attention to the assessment of content knowledge or literacy skills, (c) reflect a “one size fits all” method of assessment. | Assessments: (a) are congruent with learning objectives in either content or level of learning (e.g., DOK level), (b) primarily assess either content knowledge or literacy skills, (c) reflect some variety of methods for students to demonstrate learning, (d) primarily assess lower level learning. | Assessments: (a) are congruent with learning objectives in content and level of learning (e.g., DOK level), (b) include assessment of both content knowledge and literacy skills, (c) reflect a variety of methods for students to demonstrate learning, (d) include assessment of higher level thinking (e.g., complex task). | Assessments: (a) are clearly congruent with the learning outcomes in both content and level of learning (e.g., DOK level), (b) include specific attention to the assessment of integrated content knowledge and literacy skills, (c) reflect a variety of methods for students to demonstrate learning, (d) include those requiring an integration of knowledge, skills, and reasoning, (e) include student choice or ways to demonstrate learning. | [FORM FIELD] Assessment Score: 0 |
Rubric Score:
Rubric Mean:
Professional Competencies:
Yes No
Takes initiative.
Handles information about children, peers, families, colleagues, and supervisors
ethically.
Accepts criticism and suggestions from the Master Teacher and/or University Supervisor.
Is punctual (arrives on time, submits assignments in a timely manner, etc.)
Respects the attitudes and opinions of others.
Has attended a professional conference, in-service, or meeting.
University Coach Comments (Candidate’s strengths, areas for growth, other comments):
[FORM FIELD] Rubric Score: 0
[FORM FIELD] RubricMean: 0
Mentor Teacher Comments (candidate’s strengths, areas for growth, other comments):
Optional Second Mentor’s Comments (candidate’s strengths, areas for growth, other
comments):
Teacher Candidate Comments:
University Coach’s Signature:
Teacher Candidate’s Signature:
Mentor Teacher’s Signature:
Second Mentor’s Signature (optional):
Enter date University Coach verified the Time Log:
University Coach’s Recommendation: Yes, I recommend the Candidate to complete the
program.
No, I do not recommend the Candidate to complete the program (please submit a Statement
of Concern form).
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