BOURBON COUNTY FORMATIVE ADMINISTRATIVE EVALUATION FOR SCHOOL PSYCHOLOGISTS
Information completed on this form should be gathered from specific products and behaviors such as observations work samples, professional development
activities, etc. Conferencing should occur with-in one week of observation.
Evaluatee: ________________________________________
Position: _________________________________________
Evaluator: ______________________________________________
Position: _______________________________________________
Date: __________________________________________________
School/Work Site: _______________________________________
1.
1.1
1.2
1.3
1.4
1.5
1.6
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Adheres to Professional Standards – The school psychologist is a professional who acts within legal and ethical guidelines to
accomplish educational purposes.
Adheres to professional code of
ethics of the National Association of
School Psychologists and the Code
of Ethics adopted by the Kentucky
Educational Professional Standards
Board.
Adheres to federal and state laws and
regulations related to educational
child protection.
Is responsible for ongoing
professional development consistent
with an individual professional
growth plan.
Acts in a role that clearly distinguishes
him/her from any professional who
administers disciplinary action.
Is knowledgeable of the position
statements of the National
Association of School Psychologists
and the Kentucky Association of
Psychologists in the schools.
Identifies activities that would be in
conflict with the primary roles of the
school psychologist and advocated
for best practices of the profession.
-Certified Personnel
E3.18e
2.
2.1
2.2
2.3
2.4
2.5
2.6
2.7
2.8
2.9
2.10
3.
3.1
3.2
3.3
3.4
3.5
3.6
3.7
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Demonstrates Professional Leadership – The school psychologist provides professional leadership within the school, community
and education profession to improve student learning and well being.
Builds positive relationships within
and between school and community
Promotes leadership potential in
students and colleagues.
Participates in professional
organizations and activities
Writes and speaks effectively.
Guides or assists in the development
or curriculum and instructional
materials.
Participates in policy design and
development at the local school,
within professional organizations
and/or within community
organizations with educationally
related activities.
Initiates and develops educational
projects and programs.
Practices effective listening conflict
resolution and group facilitation
skills as a team member.
Presents programs in a manner that
reflects sensitivity to a multicultural
and global perspective.
Writes for publication, presents at
conferences and provides
professional development.
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Communicates Effectively – The school psychologist communicates effectively with all stakeholders including parents, students,
administrators, teachers, school councils and community groups.
Utilizes appropriate and correct oral
and written communication.
Presents ideas and information
logically.
Gives direction or information in a
clear concise and reasonable manner.
Uses a variety of verbal and nonverbal
techniques.
Elicits and responds to questions.
Summarizes effectively.
Uses active listening skills.
-Certified Personnel
4.
4.1
4.2
4.3
4.4
4.5
4.6
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5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
E3.18e
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Implements Programs Effectively – The school psychologist works to implement the programs and policies of the school district.
Explains and discusses purposes of
assessment, procedural safeguards,
due process rules and regulations and
other information for parents,
students, staff and administrators.
Provides helpful information to
teachers, counselors and
administrators for educational
planning.
Provides up to date information
regarding issues based on sound
research findings.
Provides assistance in identifying
useful resources.
Follows district special education
policies and procedures, including
timelines for psychological
evaluations.
Follows school/district policies and
procedures including employee time
and attendance.
Performance/Products/Portfolio Ratings
More than one (1) rating may be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Consultation/Collaboration - The school psychologist functions in a cooperative process to effectively meet the needs of students.
Through consultation the school psychologist advocates for students. Integrates the curriculum so that students can make
connections between knowledge and experiences.
Consults with parents, faculty, staff,
administrators and others to enhance
their work with students.
Interprets relevant information
concerning the developmental needs
of students.
Reduces barriers to student learning
through direct or referred services.
Works with teachers and other
support personnel to provide support
for students in a crisis situation.
Interacts with school councils, the
school board, Family Resource
Center/Youth Service Centers,
Advisory Councils and other school
or community committees.
Facilitates successful communication
between and among teachers, parents
and students.
Works with teachers and
administrators relevant to behavior
management to promote and support
intervention strategies.
Consults with external community
and professional resources.
-Certified Personnel-
6.
6.1
6.2
6.3
6.4
7.
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
7.9
E3.18e
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Provides Effective and Appropriate Assessment Services – The school psychologist utilizes a variety of assessment techniques and
instruments to contribute to comprehensive assessment for students experiencing academic and/or behavioral difficulty.
Serves a member of the school’s
multidisciplinary and problem
solving teams.
Suggests and helps implement
strategies and interventions for
students exhibiting learning/behavior
difficulties.
Participates in the development of a
comprehensive evaluation plan.
Completes relevant components of
evaluation as specified in an
evaluation plan, using appropriate
assessment tools and diagnostic
practices.
Performance/Products/Portfolio Ratings
More than one (1) rating can be checked
Growth
Professional Growth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Individual/Small Group Counseling – The school psychologist uses short-term individual counseling and structured and
unstructured small group counseling to address the mental, physical and emotional barriers to learning and to help each child
learn at high levels.
Provides a safe confidential setting
in which students present their needs
and concerns
Promotes wellness
Responds to crises.
Communicates empathy and
understanding.
Utilizes a broad range of techniques
and accepted theories appropriate to
school counseling.
Intervenes in problem/conflict
situations and conduct follow-up
sessions as needed.
Respects and nurtures the uniqueness
of each student.
Mediates classroom and student
conflict.
Empower students, parents and
colleagues to develop and use their
resources.
-Certified Personnel-
8.
8.1
8.2
8.3
8.4
8.5
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Performance/Products/Portfolio Ratings
More than one (1) rating may be checked
Growth
Professiona lGrowth
STANDARDS/PERFORMANCE CRITERIA
Meets
Needed
Unsatisfactory
Activities Discussed
Use Technology Effectively – The school psychologist uses the technology available to him/her through the school district to
enhance his/her professional practice.
Uses word processing and data base
programs to maintain files and
reports as necessary.
Communicates with staff and others
through electronic mail.
Uses the internet to stay abreast of
new developments in the national
and state professional organizations.
Produces reports and Power Point
presentations.
Reviews and evaluates new software
programs relevant to the practice of
school psychology.
__________________________________________________________
Evaluatee
_______________________________________________
Date
________________________________________________________
Evaluator
_______________________________________________
Date
-Certified Personnel
E3.18e
BOURBON COUNTY SCHOOLS SUMMATIVE EVALUATION FOR SCHOOL PSYCHOLOGIST
Tenured _____
Non-Tenured _____
This summarizes all the evaluation data including formative data, products and performances, portfolio materials, professional development
activities, conferences and other documentation.
Evaluatee: _______________________________
Position: ______________________________________
Evaluator: _______________________________
Position: ______________________________________
School: ________________________________________________________________________________________
Dates(s) of Conference(s) 1st _______________ 2nd ________________ 3rd _______________ 4th ________________
Ratings
Administrator Standards:
1. Adheres to Professional Standards
2. Demonstrates Professional Leadership
3. Communicates Effectively
4. Implements Programs Effectively
5. Consultation/Collaboration
6. Provides Effective and Appropriate
Assessment Services
7. Individual/Small Group Counseling
8. Uses Technology Effectively
Overall Rating
Meets
__________
__________
__________
__________
__________
Unsatisfactory
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
Individual professional growth plan reflects a desire/need to acquire further knowledge/skills in the standard numbers checked below:
1. __________
2. __________
3. __________
4. __________
5. __________
6. __________
7. __________
Evaluatee’s Comments:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Evaluator’s Comments:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
To Be Signed After All Information Above Has Been Completed and Discussed:
Evaluatee: _____ Agree with the summative evaluation
_____ Disagree with this summative evaluate
____________________________
Signature
____________________________
Date
Evaluator:
____________________________
Signature
____________________________
Date
(Opportunities for appeal process at both local and state levels are a part of Bourbon County School Evaluation Plan)
Employment Recommendation to Central Office: _______ Meets Administrator Standards for Re-Employment
_______ Does Not Meet Administrator Standards for Re-Employment
Certified employees must make their appeals to this evaluation within time frames, mandated in 704KAR 3:345 Sections 7, 8, 9 & local district plan.
*Any rating in the “does not meet” column requires the development of an Individual Corrective Action Plan.*