SCHOOL OF EDUCATION
Guidelines and Forms for Issuing a
STATEMENT OF CONCERN AND
PERFORMANCE IMPROVEMENT CONTRACT
According to the California Commission on Teacher Credentialing, Candidates in professional
programs must demonstrate competence in knowledge, skills, and attitudes/dispositions as
outlined in the program standards. The following procedure is designed to support Candidate
success by identifying issues early and providing a course of action.
Should a Candidate perform unsatisfactorily in coursework or clinical practice field experiences
by failing to meet one or more program standards by the end of the semester, she/he will receive
a grade less than a C+ in a course or a “no credit” grade in clinical practice.
1. Performance issues in courses will be handled by the instructor of record for the course.
2. Performance issues in clinical practice will be handled by the University Supervisor,
Clinical Practice Coordinator, and/or the Program Coordinator.
This document focuses on issuing a Statement of Concern and Performance Improvement
Contract during coursework or clinical practice when informal means of coaching have not been
successful.
During coursework, the primary responsibility for issuing a Statement of Concern and
Performance Improvement Contract and following the process rests with the course instructor.
During clinical practice, the primary responsibility for issuing a Statement of Concern and
Performance Improvement Contract and following the process rests with the University
Supervisor.
No more than two Statements of Concern and Performance Improvement Contracts will be
issued to any single candidate in any program under any circumstances. If a candidate is
determined to possibly warrant a third Statement of Concern and Performance Improvement
Contract, in either coursework or clinical practice, a conference must be held with the Candidate,
Course Instructor (if applicable), University Supervisor (if applicable), Clinical Practice
Coordinator, Program Coordinator, and Associate Dean to determine an immediate and
appropriate course of action, which may include immediate disqualification from the program.
Statement of Concern – Guidelines For Issuing/Form
Updated Spring 2013
page 1
ISSUING A STATEMENT OF CONCERN AND PERFORMANCE
IMPROVEMENT CONTRACT
A Statement of Concern and Performance Improvement Contract should be issued as soon as a
Candidate demonstrates difficulty in meeting a standard that may result in failure to successfully
complete clinical practice. (See SOC and Performance Improvement Contract form.) The process
below shall be followed in order to give the Candidate adequate time and support to address the
issue.
However, should any of the actions listed below occur, a Statement of Concern and Performance
Improvement Contract will be issued immediately resulting in a conference with the Course
Instructor (if applicable), University Supervisor (if applicable), Clinical Practice Coordinator
Program Coordinator, and Associate Dean to determine an immediate and appropriate course of
action, which may include immediate disqualification from the program.
A Statement of Concern and Performance Improvement Contract will immediately be issued
when a Candidate:
1. Endangers students or others;
2. Violates recognized codes of conduct, e.g. CSUSM Student Code of Conduct, CSUSM
Academic Honesty Policy NEA Code of Ethics, CA Education Code Section 44932;
3. Is dismissed from the classroom or school site by the Cooperating Professional or district
administrator.
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
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STATEMENT OF CONCERN AND PERFORMANCE IMPROVEMENT
CONTRACT PROCESS
1. When a performance issue that has not been remediated by informal means is identified,
the Statement of Concern and Performance Improvement Contract form shall be
completed by the course instructor/University Supervisor in consultation with the
Cooperating Professional, if appropriate.
2. The course instructor/University Supervisor must meet with the Candidate to discuss the
issues outlined in the Statement of Concern and Performance Improvement Contract.
The conversation should focus on meeting the performance standards and the elements of
the Performance Improvement Contract to remediate the identified issues. In the even the
candidate fails to attend the conference a copy of the SOC will be sent by certified mail.
3. The Candidate must receive a copy of the signed Statement of Concern and Performance
Improvement Contract. An additional copy must be immediately provided to the Clinical
Practice Office (coursework and clinical practice).
4. The Performance Improvement Contract must specifically address the issues identified in
the Statement of Concern. The timeline provided in the Performance Improvement
Contract supersedes any other timelines or schedules previously established. This
Statement of Concern and Performance Improvement Contract shall be presented to the
candidate and delivered to the Clinical Practice Office within 5 days of the conference
with all required signatures.
5. All parties must sign the Performance Improvement Contract indicating agreement with
the provisions of the plan.
6. A copy of the signed Statement of Concern and Performance Improvement Contract must
be on file in the Student Services and Clinical Practice Office to be retained in the
Candidate’s file in accordance with SoE student record maintenance guidelines. Please
note that programs may have additional procedures for filing additional copies. Please
check with the Program Coordinator.
7. If the Candidate is not able to address the issues at the level and within the timeline
identified in the Performance Improvement Contract, a conference must be held with the
Candidate. The course instructor/University Supervisor has the option to revise the plan if
extenuating circumstances are evident. The course instructor/University Supervisor must
submit a revised Performance Improvement Contract with rationale to the Clinical
Practice Coordinator and Program Coordinator for approval.
8. In the event that it becomes apparent that the Candidate is unable to meet the conditions
of the Performance Improvement Contract, a conference must be held with the Candidate,
course instructor, University Supervisor, Clinical Practice Coordinator, and Program
Coordinator to determine an appropriate course of action.
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
page 3
OUTCOMES RESULTING FROM A STATEMENT OF CONCERN
Because of the variation in program standards and Candidate performance, there is no one
outcome for a Statement of Concern and Performance Improvement Contract. Rather, the
outcome is individualized to address Candidate needs, meet credential requirements, and
maintain program integrity. Possible outcomes include:
1. The Candidate meets the stipulations outlined in the Performance Improvement Contract
and continues in the placement and the program.
2. The Candidate does not quite meet the stipulations in the Performance Improvement
Contract but has demonstrated significant growth and is close enough to completion to
warrant additional time in the course/placement to demonstrate competency.
3. The Candidate does not meet the Performance Improvement Contract and receives a
failing grade for the course or “no credit” for the clinical practice. However, mitigating
circumstances justify a second opportunity the following semester to successfully
complete the course/clinical practice. Should a second opportunity be granted, a
Performance Improvement Contract must be developed and signed in advance of
beginning the new course/placement. The content of the contract must be based on the
Statement of Concern and Performance Improvement Contract and other supporting
performance evidence.
4. The Candidate does not meet the Performance Improvement Contract, receives “no
credit” for the clinical practice, or failing grade for a course(s) and is terminated from the
program.
EXPECTATIONS OF UNIVERSITY SUPERVISORS/COURSE INSTRUCTORS
1. Statement of Concern and Performance Improvement Contracts are issued based on
candidate performance in meeting program standards. The Statement of Concern and
Performance Improvement Contract form must contain detailed supporting evidence
defining the issues. Supporting documents may be attached.
2. Statement of Concern and Performance Improvement Contracts are issued early to ensure
that adequate notification and support is provided to Candidates.
3. Appropriate records are kept on Candidate performance to justify the issuing of a
Statement of Concern and Performance Improvement Contract.
4. Notes are kept on meetings with Cooperating Professionals and the Candidate as the
Statement of Concern and Performance Improvement Contract process continues.
5. Written statements from Cooperating Professionals and/or the site administrator are
obtained to document violations of codes of conduct and/or poor professional behavior.
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
page 4
6. Because Statement of Concern and Performance Improvement Contracts for clinical
practice are issued early, there is generally no need to issue a Statement of Concern and
Performance Improvement Contract at the conclusion of clinical practice unless an
egregious violation of professional practice as outlined on page 1 occurs. Should a
Statement of Concern and Performance Improvement Contract be issued at the
conclusion of a beginning level of clinical practice in which there is insufficient time to
remediate, immediately contact the Clinical Practice and Program Coordinator/s. Do not
issue a course grade without consultation.
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
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College of Education, Health and Human Services
School of Education
STATEMENT OF CONCERN
Teaching Credential Programs
Candidate:
Date of SOC:
Semester: Fall Spring Summer
Year:
Credential Program:
Circle one: Coursework Practicum I (ICP) Practicum II (ICP) CP I CP II
Education Specialist Clinical EDMX 570 571 572 573 671 672
The Statement of Concern is designed to clearly identify issues that may prevent a Candidate
from successfully completing a credential program. Your development as a professional
educator and effective teacher for students is our primary focus. This Statement of Concern has
been issued because concerns have arisen. The concerns related to the TEACHING
PERFORMANCE EXPECTATIONS (TPE) and/or PROFESSIONAL DISPOSITION (PD) are
outlined in the DESCRIPTION OF PERFORMANCE. If continuation is recommended,
remedial actions are outlined in the PERFORMANCE IMPROVEMENT CONTRACT.
TPE/PD
DESCRIPTION OF PERFORMANCE
PERFORMANCE IMPROVEMENT CONTRACT
The following plan is a performance contract stipulating specific actions that must be completed by the Candidate.
If the contract is not met, the Candidate can be disqualified from the program and will be determined to be a
student not in good standing. The following timeline supersedes any prior calendar or timeline.
TPE/PD
PERFORMANCE BENCHMARK
The
Candidate
will…..
ADDRESSED
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
TIMELINE
By…..
page 6
Candidate Name:
Date:
If at any time during clinical practice the school site or university supervisor determines that the
learning of K-12 students is negatively impacted by the teacher candidate, said teacher candidate
will be removed from the school site and receive no credit. Continuation in the program will be
determined by the program coordinator, clinical practice coordinator, and the Director of
Education.
If stipulations of this contract are not met, one or more of the following will occur:
 Continue with Performance Improvement Contract
 Removal from Program
 Removal from Placement and/or course
 Credit
 No Credit
Subsequent course instructors, clinical practice cooperating teachers, and university supervisors
may receive a copy of this Statement of Concern in order to continue to support your progress.
Required Signatures:
I acknowledge receipt of this Statement of Concern and Performance Contract:
Candidate:
Date:
Signatures of Appropriate Personnel
Course Instructor
Date:
Program Coordinator
Date:
University Supervisor
Date:
Cooperating Teacher
Date:
Onsite Liaison
Date:
Clinical Practice Coordinator
Date:
Statement of Concern completed by:
Name/Title:
CC:
Date:
Clinical Practice Coordinator
Program Coordinator
Cooperating Teacher
Onsite Liaison
Student Services
Credential Candidate
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
page 7
Statement of Concern – Outcomes
(To be prepared by the SOC author)
Based on the Statement of Concern above, please provide a summary of the outcome.
(Box expands as you type summary.)
Outcome update completed by:
Name/Title:
_____________________________________________________________
Date:
Cc:
Clinical Practice Coordinator
Program Coordinator
Statement of Concern – Guidelines for Issuing/Form
Updated Spring 2013
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