Classroom Assessment Templates based on
the CCLB resource: Integrating CLB into your ESL Classroom
1. An Example of a Form used for Peer/Self Assessment of an Activity
It provides an opportunity for positive feedback, and suggestions for improvement based on
the criteria/performance indicators that you have chosen for the task.
Task: i.e. Returning an Item
Name:
CLB Level:
(Performance Indicators)
Did I........
Describe the problem and
request action
Use eye contact
Use good vocabulary
Use a good opening and
closing
Other Comments:
NO
ALMOST
YES
Feedback
2. An Example of an Instructor Feedback Form
For higher levels there could be more criteria that you wish to use. The form is similar to the
Peer/Self Assessment form.
Task: i.e Role Play
Name:
CLB Level:
(Performance Indicators)
Did the student........
i.e. Describe the problem
Describe the action she
wanted
Use eye contact
Speak clearly
Use appropriate vocabulary
Use a good opening and
closing
Other Comments:
NO
ALMOST
YES
Feedback
3. An Example of a Rating Form
This can be used for Listening, Speaking, Reading, and Writing tasks. It is also appropriate for
Summative Assessments or Outcomes/Exit Tests. Add more rows as you wish, as well as
other criteria, including holistic.
Task:________________ Name:_______________ CLB Level:______
Criteria for
Performance Indicators
Overall – how the learner
performed overall/the
ease, the fluency etc.
Content –
appropriateness of
answers, questions,
responses etc.
coherence, fluency,
pronunciation, vocabulary
Grammar – language
functions appropriate to
the level, for the task etc.
Total
Comments
Rating
1
2
3
4
1
2
3
4
1
2
3
4
/12
4. An Example of a Form for Instructor Anecdotal Feedback
This format could be used for oral feedback. The assessment criteria are determined by the
teacher. It is an example of a job interview role-play
Task:________________ Name:_______________ CLB Level:______
Criteria
Describes previous experience and
responds appropriately
Responds to introductions, opening
and closing questions or statements.
Identifies and maintains small talk
Recognizes the question which signals
the close of the interview
Supporting Evidence
(How and in what detail etc)
(Uses the appropriate courtesy, shakes
hands, etc)
(Asks appropriate closing questions)
5. An Example of a Form for Instructor Written Anecdotal Feedback
This type of format can be used to evaluate the learner’s performance on a task.
Decide what are the performance indicators that you wish to use.
Task:______________ Name:_______________ CLB Level:_________
Learner was able to:
Comments (strengths & areas to
improve)
i.e.
Respond to introductions, small talk,
and closings.
i.e.
You were relaxed and natural, good
intro, small talk and closing
Describe previous education and
experience in a positive way and
answer questions with adequate detail.
You described your previous
experience in a positive way. Say “high
school diploma” instead of “degree”.
When you were complimented on your
English your response might be “thank
you” etc.
Ask appropriate questions about the
company and job.
Good question regarding training, but
asking about the salary at this point is
not good in Canada.
6. An Example of a Checklist for Group Discussion
You can use check marks or comments. One form per group is suggested.
Observation Checklist
Criteria
Participated
appropriately
Used clarification
strategies
Used vocabulary
appropriate to topic
Student
name
Student name
Student
name
Student
name
7. An Example of a Feedback Form for Group Discussion
This form is easy to use. Some teachers leave out the criteria, photocopy a lot of the forms
and fill in the criteria as needed or appropriate. This could be used for Formative or
Summative Assessment as well as for the Informal Assessment Strategy in SAM.
Feedback on _______________
Name: ______________________
Date: _____________________
Task: _______________________
Criteria
Effectiveness:
i.e. expresses opinions using
evidence from the article
Vocabulary:
Uses vocabulary from article
Conversation
Management:
Uses strategies to take turns,
hold the floor, and encourage
others
1 2 3 4
Comments
CLB: ________
8. An Example of an Assessment Form with ratings and standards
Assessment Form
Learner: _____________________________
CLB level: _______
Task:
Date: ____________
______________________________
Comments:
2
4
6
8
1
2
3
4
Overall Effectiveness:
Writing does not accomplish the purpose of the task. It is difficult
understanding the writer’s meaning in several places. The style and
voice do not match the purpose.
Writing generally accomplishes the purpose of the task. There are
some places where the meaning isn’t completely clear because
information is missing or there are language errors.
Writing accomplishes the purpose of the task. Adequate information
is included and the message is clear. The style and voice are
appropriate for the task.
Writing accomplishes the purpose of the task. There is additional
detail or analysis beyond what is required. The text is clearly written
and the style and voice match the purpose of the writing. The
writing is convincing and fluent.
Vocabulary:
Almost no vocabulary specific to the topic. The choice of words
sometimes causes confusion.
Some vocabulary specific to the topic. There are some problems
with correct word form.
Several instances of vocabulary specific to the topic. The other
vocabulary used is appropriate to the purpose of the task. Most
vocabulary is used correctly.
Many instances of vocabulary specific to the topic. Throughout the
text the word choice is accurate and precise. In almost all cases
vocabulary is used correctly and appropriately.
1
2
3
4
Organization:
Organization is weak. There isn’t a clear introduction and
conclusion. It is difficult to follow the organization of the main body
of the text.
Organization is developing but there is still some difficulty with
organization. Either the introduction or conclusion may be unclear
or may not be closely related to the body of the text. There may be
some difficulty with logical development of ideas.
Organization is satisfactory. There is a clear introduction and
conclusion that connects to the body of the text. There is clear,
logical development and the paragraph structure is appropriate.
Very strong organization. The introduction provides a clear lead into
the text. The organization flows smoothly. Paragraph structure
matches the purpose. The conclusion provides a satisfying
summary to the text.
Sentence Structure:
1
2
3
4
Text includes many sentence errors which make it difficult to
understand. Few or no complex structures are used.
Some use of complex structures. There are sentence errors but
they don’t interfere with understanding.
Writer uses a variety of sentences, including many complex
structures. Occasional sentence errors occur but they do not
interfere with understanding.
Writer uses a variety of complex structures to connect ideas and
provide coherence. The sentences flow naturally. Few sentence
errors.
1 - unable to achieve yet
2 - developing
3 - satisfactory benchmark achievement
4 - higher than satisfactory achievement