South Kitsap School District No. 402
INTERVENTIONIST/COUNSELOR SUMMATIVE EVALUATION
School Year
Name:
(Last)
School:
(First)
Assignment:
Evaluator’s Name:
PREOBSERVATION CONFERENCE DATE:
PATTERN OF OBSERVATION SERIES:
Observation
Date
Date
Number
Planned
Held
1
Time
Begun
Time
Ended
Confer.
Date
Evaluator
Initial
Employee
Initial
2
3
4
Leave Replacement Employee
Post Retirement Employee
Provisional
Continuing Employee:
1.
Summative New Hire Year 1
Summative New Hire Year 3
Summative Cycle For One Year
Summative by Mutual Agreement
Summative New Hire Year 2
Summative New Hire Year 4
Summative at
INTERVENTIONIST/COUNSELOR
Option
Other
2. and the interventionist/counselor will be placed on the following evaluation cycle for the
Summative New Hire Year 2
Summative New Hire Year 4
Summative at
INTERVENTIONIST/COUNSELOR
Option
Other
FINAL 8-22-08
Summative New Hire Year 3
Summative by Mutual Agreement
Formative Year 1
school year:
EVALUATION SUMMARY
P: PROFICIENT1
S: SATISFATORY2
NI: NEEDS IMPROVEMENT3
U: UNSATISFACTORY4
*Ratings in the NI and U categories must be substantiated by comments and suggestions for improvement.
CRITERIA AND INDICATORS
RATING
1 – KNOWLEDGE AND SCHOLARSHIP Each interventionist/counselor demonstrates a depth
and breadth of knowledge, of theory and of content in the special field. He/she demonstrate
an understanding of and knowledge about common school education and the educational
milieu grades K-12, and demonstrates the ability to integrate the area of specialty in to the
total school milieu.
1.1 Able to develop and articulate components of Comprehensive Counseling and
Guidance Program (CCGP) as appropriate for specific building(s) and student
needs.
1.2 Demonstrates knowledge and use of accepted theories and techniques
appropriate to school counseling.
1.3 Understands the connection between the CCGP and building/SIP goals.
1.4 Knowledgeable about statewide education reform efforts and the role of CCGP
within those efforts.
.
EVIDENCE:
P
S
2 – SPECIALIZED SKILLS Each interventionist/counselor demonstrates in his/her performance a
competent level of skill and knowledge in designing and conducting specialized programs of
prevention,
2.1 Knowledge of students.
2.2 Uses school/student data to determine appropriate levels of prevention and intervention
activities.
2.3 Provides responsive and preventative counseling services to students.
2.4 Demonstrates knowledge in student test/appraisal interpretation. Contributes to
student’s successful school transitions and promotions. Facilitates student’s long-range
educational and career plans.
P
S
P
S
NI
NI
U
U
EVIDENCE:
3 – MANAGEMENT OF SPECIAL AND TECHNICAL ENVIRONMENT Each interventionist/counselor
demonstrates an acceptable level of performance in managing and organizing the special
materials, equipment, and environment essential to the specialized programs.
3.1 Manages work environment.
3.2 Manages time and plans appropriately.
3.3 Effectively incorporates the use of technology into interventionist/counseling services.
EVIDENCE:
FINAL 8-22-08
NI
U
4 –INTERVENTIONIST/COUNSELOR AS A PROFESSIONAL Each interventionist/counselor
demonstrates awareness of his/her limitations and strengths and demonstrates continued
professional growth.
4.1 Communicating in a professional environment (Communicates in an effective manner
both in oral and written form).
4.2 Develops and maintains relationships with parents, students, colleagues and
administrators.
4.3 Interventionist/counselor is current regarding applicable laws (e.g., FERPA, WACs) and
ethical standards (e.g., ASCA).
4.4 Interventionist/counselor demonstrates and applies an understanding of confidentiality
and its limits within the educational environment.
4.5 The interventionist/counselor contributes to a positive school environment.
4.6 Identifies and participates in continuous professional development needs.
4.7 Interventionist/counselor shares ideas and resources with others.
P
S
NI
U
P
S
NI
U
EVIDENCE:
5 – INVOLVEMENT IN ASSISTING PUPILS, PARENTS, AND EDUCATIONAL PERSONNEL Each
interventionist/counselor demonstrates an acceptable level of performance in offering
specialized assistance in identifying those needing specialized programs.
5.1 Works with individual students and small groups to address school/individual
intervention needs. Provides classroom instruction on pertinent student/school issues.
Works with individual students and groups on goal setting.
5.2 Works collaboratively with administration, staff, and parents regarding students’
academic success and well-being. Implements a referral system(s) process.
5.3 Student advocacy.
5.4 Provides students with knowledge and skills needed to understand and respect self and
others. Provides students with personal safety and healthy decision making skills.
Provides students with knowledge and skills needed to effectively solve problems.
5.5 Interventionist/counselor facilitates meaningful interactions resulting in a positive
impact on student achievement and behavior.
5.6 Interventionist/counselor links behavior intervention and learning outcomes to students’
prior knowledge and future experiences.
5.7 Demonstrates sensitivity, knowledge and skills to work with individuals and groups from
a variety of racial, cultural, ethnic, experiential, special needs, social/economic and
linguistic backgrounds.
5.8 Interventionist/counselor uses a variety of techniques such as providing examples and
discussing consequences or outcomes to improve student achievement and behavior.
5.9 Interventionist/counselor provides feedback to students in a constructive and timely
manner.
EVIDENCE:
_______________________________ ___________
Signature of Evaluator
Date
________________________________________
Signature of Interventionist/Counselor Date
Section 8.2.7.2 The employee shall sign the final observation and evaluation (Summative Track Evaluation) report to
indicate that he/she has received a copy of the evaluation section and a conference was held. The signature of the
employee does not, however, necessarily imply that the employee agrees with the contents of the final evaluation.
Within five (5) days of the conference, the employee may submit signed comments concerning his/her evaluation
report. These signed comments shall be made a part of the official observation and evaluation report.
FINAL 8-22-08
Definitions:
1Proficient-the
interventionist/counselor has mastered all of the indicators of the evaluative criteria and has been a
model of superior performance.
2Satisfactory-the interventionist/counselor is successful in meeting the indicators of the evaluative criteria.
3Needs Improvement-the interventionist/counselor has room for improvement to consistently meet the indicators of the
evaluative criteria.
4Unsatisfactory-the interventionist/counselor is not successful in meeting the indicators of the evaluative criteria.
FINAL 8-22-08