Northern Humboldt Union High School District
Certificated Speech-Language Pathologist Observation Report
Name:
School:
Event Observed:
Observed Period:
Employment Status:  Temporary
MS: Meets Standards
 Probationary 1
PNI: Progress Needs Improvement
Standard One: Organizational and Managerial Skills
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
 Permanent
UPS: Unsatisfactory Progress Toward Meeting Standards
Comments
MS

PNI

UPS

Comments
MS

PNI

UPS

Comments
MS

PNI

UPS

Respects the cultural values of others
Creates a positive learning environment for students and
colleagues
Maintains professionalism during interactions with
teachers, parents, students, colleagues and other outside
professionals
Provides information, counseling and support to
individuals, families, educational teams and others
regarding a student’s communication disorders
Provides guidance and leadership to school staff as needed.
Creates successful transitions for students through
collaboration and communication with all necessary parties
Standard Three: Intervention
o
Probationary 2
Devises and maintains an efficient and effective schedule
for meeting the roles and responsibilities of a school-based
speech-language pathologist
Fulfills the duties of case manager as appropriate
Meets responsibilities and obligations to the caseload
Follows risk management procedures
Completes LEA/MAA billing
Coordinates, supervises, and/or conducts screenings as
needed
Keeps clear and comprehensive records and informs
parents and teachers of the student’s progress
Standard Two: Interpersonal Skills and
Professionalism
o
o
Date:
Participates in the team process of identifying students who
may need assessments to determine a continuum of
intervention strategies and/or possible eligibility for special
education or related services
Promotes the education of how to minimize the risks and
prevention of communication disorders
Collaborates with the educational team to create
curriculum-based, educationally relevant treatment plans
Advocates for students’ needs
Prepares for treatment sessions by incorporating academic
instruction/curriculum into treatment strategies to achieve
communication goals
Uses a variety of materials/methods, and incorporates
advanced technology into administrative/therapeutic tasks
Works with students one-on-one and in small groups as
needed
Uses materials, resources and technologies to make subject
matter accessible to students
Standard Four: Evaluation
o
o
o
o
o
o
o
o
o
o
MS

PNI

UPS

Comments
MS

PNI

UPS

Selects, administers and interprets appropriate standardized
tools to support diagnostic impressions
Interprets data to determine the nature and severity of a
student’s communication disorder, delay or difference, and
its effect on academic and social performance
Synthesizes information from other non-standardized
measures and sources as necessary
Designs short-term and long-term plans to foster student
learning
Collaborates with members of the educational team to
synthesize information from the evaluation to determine
disability, level of severity, impact on learning and/or
eligibility
Develops recommendations for accommodations based on
student’s needs
Summarizes all information relative to the student’s
history, impairment/disability/handicap, and other factors
such as age, attention, cognition, sensory deficits,
social/emotional development, and cultural and/or
linguistic diversity
Modifies instructional plans to adjust for student needs
Standard Five: Assessment
o
Comments
Collects data using a variety of sources including
interviews, curricula, checklists, portfolios, and
observation
Conducts thorough, appropriate, and balanced speech,
language, and/or communication assessments using a
comprehensive assessment plan
Applies assessment models that incorporate standardized
and non-standardized procedures and tools
MS: Meets Standards
PNI: Progress Needs Improvement
UPS: Unsatisfactory Progress Toward Meeting Standards
Professional Responsibilities:
Observation:
General:
Comments:
Overall Rating:
 Satisfactory
_______________________________ _________
Evaluator’s Signature
Date
 Needs Improvement
 Unsatisfactory
_______________________________
Certificated SLP Signature*
___________
Date
*Signature does not indicate agreement. Employee may attach a written ten days of receipt of evaluation.