Teacher Self-Assessment
Worksheet
Employee use and retention
Name
and
Emp #:
Date of Assessment:
Rate your need for
Professional Growth
Standard I: SETS HIGH EXPECTATIONS FOR LEARNING AND VALUE STUDENT
DIFFERENCES.
I A. Maximizes student potential.
I A. I Establishes high expectations
for all students.
I A.2 Respects and values the
unique characteristics of individual
students.
I A. 3 Acknowledges, values, and
utilizes characteristics of culture
and their impact on learning.
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D
S
E
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
Teacher Self-Assessment
Worksheet
Employee use and retention
Name
and
Emp #:
Date of Assessment:
Standard II: CREATES AND MAINTAINS A SAFE AND EFFECTIVE LEARNING
ENVIRONMENT THAT SUPPORTS LEARNING FOR ALL STUDENTS.
IIA. Organizes and manages an
appropriate physical environment
for teaching and learning.
U
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E
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
2A. I Organizes physical space to
support learning.
2A. 2 Organizes instructional
materials and supplies efficiently.
2B. I Establishes high standards of
conduct.
2B. 2 Monitors student behavior and
responds appropriately.
IIB. Develops standards and
implements procedures that
promote respect and responsibility.
(mm/dd/yyyy)
2B. 3 Models respect in interactions
with students.
2B. 4 Manages student groupings to
support learning.
2B. 5 Manages transitions to
maximize instructional time.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary
Teacher Self-Assessment
Worksheet
Employee use and retention
Name and
Emp #:
Date of Assessment:
Standard III: DEMONSTRATES KNOWLEDGE OF SUBJECT CONTENT AND THE
ELEMENTS OF EFFECTIVE INSTRUCTION.
IIIA. Demonstrates command of
content-area knowledge and state
standards, as well as implements
district-adopted resources and
curriculum.
U
D
S
E
(mm/dd/yyyy)
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
3A. I Demonstrates depth of contentarea knowledge.
3A. 2 Demonstrates understanding of
state standards.
3A. 3 Implements district-adopted
resources and curriculum.
3B. 1 Develops clear lesson objectives
aligned to academic standards.
3B. 2 Uses students’ life experiences
and interests to make learning
relevant.
IIIB. Plans effective lessons.
3B. 3 Plans instruction that is
appropriate for the age group.
3B. 4 Identifies a variety of
instructional strategies to respond to
students’ diverse needs.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary
Teacher Self-Assessment
Worksheet
Employee use and retention
Name and
Emp #:
Date of Assessment:
3C. I Matches instructional strategies
with lesson objective.
3C. 2 Implements lessons using
strategies that respond to students’
diverse needs.
IIIC. Delivers effective instruction.
3C. 3 Uses clear oral and written
language.
3C. 4 Communicates clear
instructional directions.
3C. 5 Uses questions, prompts, and
cues to enhance student learning.
3C. 6 Monitors and adjusts lessons.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary
(mm/dd/yyyy)
Teacher Self-Assessment
Worksheet
Employee use and retention
Name and
Emp #:
Date of Assessment:
Standard IV: USES ONGOING ASSESSMENT TO REINFORCE AND EVALUATE
STUDENT ACHIEVEMENT AS WELL AS TO PLAN INSTRUCTION.
U
D
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E
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
4A. 1 Maintains accurate records /
grades.
IVA. Establishes and communicates a
fair and consistent assessment
system.
4A. 2 Communicates assessment
criteria.
4A. 3 Provides feedback to all
students.
4B. 1 Aligns assessment with
instruction.
IVB. Utilizes an assessment system to
guide instruction.
(mm/dd/yyyy)
4B. 2 Uses formative and summative
assessment results to plan
instruction.
4B. 3 Involves and guides students in
assessing their own learning to
promote self-direction and
autonomy.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary
Teacher Self-Assessment
Worksheet
Employee use and retention
Name and
Emp #:
Date of Assessment:
Standard V: CONTRIBUTES TO SCHOOL EFFECTIVENESS THROUGH
COLLABORATION WITH OTHERS AND COMMITMENT TO LIFE-LONG
LEARNING.
U
D
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E
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
5A. I Attends and /or participates in
school events and decisions.
VA. Contributes and seeks
opportunities to learn and work with
others.
(mm/dd/yyyy)
5A. 2 Participates in district
initiatives (i.e., SIP trainings, etc.).
5A. 3 Shares within the profession.
5A. 4 Collaborates with school
personnel, parents /families in
making educational decisions.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary
Teacher Self-Assessment
Worksheet
Employee use and retention
Name and
Emp #:
Date of Assessment:
Standard VI: PROMOTES POSITIVE INTERACTION WITH FAMILIES.
U
D
S
E
Will this standard/component(s) be an area of focus
for the current year? If yes, include rationale.
6A. I Communicates positively with
families regarding instructional
program and assessment methods.
VIA. Involves families in their child’s
learning.
(mm/dd/yyyy)
6A. 2 Communicates positively with
families regarding student progress
and social development.
6A. 3 Involves parents in establishing
a plan of action for students in need
of additional resources.
6A. 4 Provides opportunities for
family involvement.
U = Unsatisfactory D = Developing S = Skillful E = Exemplary