CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
PRELIMINARY EDUCATION SPECIALIST – MODERATE/SEVERE CREDENTIAL
TEACHING PERFORMANCE EXPECTATIONS
CLINICAL PRACTICE ASSESSMENT
Teacher Candidate: _________________________________ Bronco ID #: _____________________________
Cal Poly E-mail:______________________________
CP Block (circle): 1
2 3 4 _________
University Supervisor (print): _____________________ Cooperating Teacher (print): ___________________
Quarter/Year: ________________________
_____Intern
School/District: ____________________________________
______ Standard Clinical Practice
_____ Mid-Quarter Evaluation
_____Other: ________________________
_____ End-of-Quarter Evaluation
_____ Self-Evaluation
The candidate:
Uses knowledge of the characteristics
1/9.1 of students with moderate/severe
disabilities (e.g., eligible in the
categories of autism, emotional
disturbance, moderate/severe mental
retardation, other health impairments,
traumatic brain injury, deafblindness, multiple disabilities;
physical/orthopedic disabilities) and
their effects on learning, skills
development, and behavior to
develop and deliver appropriate
instruction
Develops and implement systematic,
1/9.2 evidence-based instructional strategies
to teach students with moderate/severe
disabilities within school, community,
and work settings
1/9.3 Effectively, trains, supervises, and uses
paraeducators and other personnel
(e.g., related service providers, peer
tutors) to help students achieve goals
4 = Exceptional
(M/S Standard 1 and 4)
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
3 = Meets
TPE 9: Instructional Planning
Suggested
Evidence(s) for
Meeting TPE
2 = Approaching
TPE 1: Specific Pedagogical Skills
for Subject Matter Instruction
1= Does not meet
TPE Element
ASSESSMENT KEY: Assessment of ES M/S TPEs is made of the candidate at the novice teacher level. To receive
credit for an ES M/S TPE, the candidate must receive a Meets (3) or above rating for each TPE element.
 Does Not Meet (the standard) – Requires significantly more understanding, instruction, and/or experience
 Approaching (meeting the standard) – Understands but requires additional coaching or clarification
 Meets (the standard) – Meets the standard as stated in the ES M/S TPE at the level of a novice teacher
 Exceptional – Performs the standard as stated in the ES M/S TPE at an exceptional level, well beyond novice
OB and POM:
Differentiated
lesson/unit plan
based on IEPs;
Differentiated
data-based
assessment
Same as above;
Same as above;
Arranges for
supports (peers;
paraeducator)
Revised with permission from Cal State San Marcos
1
TPE 8: Learning About Students
Suggested
Evidence(s) for
Meeting TPE
(M/S Standard 2 and 4)
The candidate:
Knows how to assess and identify
3/8.1 students’ verbal and nonverbal
communication skills and use the
data to 1) identify effective
intervention and support techniques,
2) develop needed augmentative and
alternative systems, 3) implement
communication and social skills
instruction, 4) structure opportunities
for interaction, and 5) develop
communication methods so students
can demonstrate academic
knowledge
Knows and uses assessment data
3/8.2 from multiple sources including a)
person-centered and family-centered
planning, b) strength-based
assessment, and c) functional and
ecological assessment across
classroom and non-classroom
contexts to lead to a student’s
progress toward IEP goals and
meaningful participation in core,
standards-based curriculum, life
skills curriculum, wellness
curriculum
Can explain to students and their
3/8.3 families, students’ academic and
behavioral strengths, areas for
growth (including IEP goals), and
how to help students achieve the
curriculum
4 = Exceptional
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
OB and POM;
Differentiated
lesson/unit plan
based on IEPs;
Differentiated
data-based
assessments
4 = Exceptional
TPE 3: Interpretation and Use
of Assessments
3 = Meets
Monitors student progress based
upon each student’s IEP at key points
during instruction to determine
whether students are progressing
adequately and adjusts instruction
systematically to promote maximum
learning and academic achievement
3 = Meets
The candidate:
2 = Approaching
(M/S Standard 4)
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
2 = Approaching
Suggested
Evidence(s) for
Meeting TPE
1= Does not meet
TPE Element
2.1
TPE 2: Monitoring Student
Learning During Instruction
1= Does not meet
TPE Element
CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
OB and POM;
Assesses
communication
proficiency to
achieve one or
more of the five
goals in TPE
element, 3/8.1
OB and POM;
Use of named
assessment
approaches to
establish IEP
goals and deliver
curriculum;
CAPA testing
Same as above;
IEP meeting
facilitation;
Home-school
communication
system
Revised with permission from Cal State San Marcos
2
4 = Exceptional
Same as above
Suggested
Evidence(s) for
Meeting TPE
4 = Exceptional
Same as above
The candidate:
Facilitates students’ communication
abilities and increases the extend and
variety of social interactions in order
to achieve and expand meaningful
social relationships across settings
Has knowledge and advocacy skills
5.2 regarding the various transitions
students experience as they move
from infancy to adulthood
Uses strategies to support students to
5.3 develop independence and practice
self determination and self advocacy
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
OB and POM;
IEP plan;
Differentiated
instruction and
support based on
IEP
(M/S Standard 3 and 7)
5.1
3 = Meets
TPE 5
Student Engagement
3 = Meets
Designs instructional plans, prioritizes
and sequences content, and uses
various instructional strategies,
supports, and resources responsive to
the unique needs of the student to
facilitate student learning and access
to curriculum in inclusive general
education settings
Knows how to support the movement,
4.2 mobility, sensory, and specialized
health care needs for a student to
participate fully in classrooms, other
school settings, and the community
Knows about and uses augmentative
4.3 and alternative communication
systems and devises and services to
facilitate communication and improve
academic performance and skill
development of students
2 = Approaching
The candidate:
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
2 = Approaching
(M/S Standards 4, 5, and 8)
4.1
TPE Element
Suggested
Evidence(s) for
Meeting TPE
1= Does not meet
TPE 4
Making Content Accessible
1= Does not meet
TPE Element
CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
OB and POM;
Facilitation of
Circle of Friends,
Communication
and social goals
Same as above
Self-advocacy
instruction;
MAPs and
student-led IEPs
Revised with permission from Cal State San Marcos
3
(M/S Standards 2 and 3)
The candidate:
Knows and uses a) English Language
Development principles and
instructional practices, b) students’
prior learning and background,
c) analysis of students’ oral and
written language errors, and d)
assessment of students’ verbal and
non-verbal communication abilities to
provide instruction differentiated to
develop students’ English language,
literacy, communication, and social
interaction abilities
Has students express understanding
7.2 in various ways (e.g., augmentative
and alternative communication
systems and technology) and uses
primary language resources (e.g.,
peers, books, paraeducators, students’
primary language skills) to develop
academic language, comprehension,
and knowledge of curriculum content
7.1
4 = Exceptional
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
4 = Exceptional
Suggested
Evidence(s) for
Meeting TPE
3 = Meets
TPE 7: Teaching English Learners
(with Moderate/Severe Disabilities)
3 = Meets
LP, OB, & POM;
PBS or BIP plan;
Planning script
and planning
space/room
OB and POM;
Joins PBS team;
PBS or BIP plan
OB and POM;
Social skills
lesson plan;
Class meetings;
Use planning
area/room;
Set class norms
OB and POM;
PBS or BIP plan
TPE Element
Establishes and maintains an
6/11.1 educational environment free from
coercion and punishment and where
interventions are positive, proactive,
and respectful of students
Knows how to and does participate in
6/11.2 school-wide positive behavior
support processes
Uses a variety of effective
6/11.3 instructional strategies, including
methods for promoting positive
behavior and social skills for
building constructive relationships
among all students, to increase
learner competence
Knows how to design and implement
6/11.4 a Positive Behavior Support Plan and
interventions based upon functional
behavior assessments
2 = Approaching
The candidate:
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
2 = Approaching
TPE 11: Social Environment
(M/S Standard 3 and 6)
Suggested
Evidence(s) for
Meeting TPE
1= Does not meet
TPE 6: Developmentally
Appropriate Teaching Practices
1= Does not meet
TPE Element
CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
OB and POM;
Demonstrated by
meeting TPE in
Mild/Moderate
Education
Specialist clinical
practice;
Integrates ELL
and technological
methods/ tools to
facilitate
communication
Same as above;
Use of resources
in primary
language (e.g.,
paraeducators,
peers, books) or
communication
modality
Revised with permission from Cal State San Marcos
4
12.3
12.4
4 = Exceptional
3 = Meets
Suggested
Evidence(s) for
Meeting TPE
4 = Exceptional
OB and POM;
Team meeting
agenda;
Scheduling of
personnel;
Interpersonal
skill reflection
(M/S Standard 5 and 8)
The candidate:
Knows CA and federal laws,
procedures, and policies pertaining to
students with IEPs, English learners,
RTI, 504 plans, eligibility and
placement, and mandated
considerations for augmentative and
alternative communication
technology and specialized health
care in educational settings
Knows and uses techniques,
procedures, materials, educational
and assistive technology, and other
adaptive equipment that maintain
dignity and are appropriate and safe
Knows and uses district guidelines to
report and respond to dangerous
student behavior and suspected cases
of child abuse, neglect, or sexual
harassment
Models ethical behavior and honors
confidentiality, health, and safety
obligations for students, families, and
school personnel
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
3 = Meets
TPE Element
12.2
TPE 12
Professional, Legal and Ethical
Obligations
2 = Approaching
The candidate:
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
2 = Approaching
(M/S Standard 5)
Coordinates, communicates, and
10.1 consults effectively with other
special education service providers,
general educators, paraprofessionals,
volunteers, and parents to maximize
instructional time and provide
appropriate, safe, and consistent
student support and instructional
activities across all school and
community settings
12.1
Suggested
Evidence(s) for
Meeting TPE
1= Does not meet
TPE 10
Instructional Time
1= Does not meet
TPE Element
CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
OB and POM;
IEP and 504 plan
Same as above
Same as above
Same as above
Revised with permission from Cal State San Marcos
5
Engages in the cycle of planning,
13.1 teaching, reflecting, problem
identification, and instructional
adjustment to improve teaching
Sets professional goals for increasing
13.2 subject matter knowledge and
teaching effectiveness
4 = Exceptional
The candidate:
Description of Evidence(s)
Verifying Assessment of TPE
Common Codes
LP = Lesson Plan
OB = Observation
CA = Course assignment
POM = Post Observation Mtg.
3 = Meets
Suggested
Evidence(s) for
Meeting TPE
2 = Approaching
TPE 13
Professional Growth
1= Does not meet
TPE Element
CAL POLY POMONA
EDUCATION SPECIALIST MODERATE/SEVERE CLINICAL PRACTICE ASSESSMENT
OB & POM re:
TPEs;
Individualized
Transition
Development Plan
Same as above;
Joins professional
organizations;
Seeks continuing
education
NOTES (Explain/clarify any ratings below (3))
To the best of my knowledge, the information is accurate and complete.
Education Specialist Candidate Signature: _____________________________ Date: _________________
CPP Supervisor Signature: _________________________________________ Date: _________________
Other Evaluator: _________________________________________________ Date: _________________
Other Evaluator (print name & title): ________________________________________________
Revised with permission from Cal State San Marcos
6