UMTSS Systems Level Coach’s Self-Assessment
Systems Level Coach Name __________________________________________ Years of Coaching Experience_________
District or Agency _____________________________
The checklist below outlines specific coaching and content skills required of
UMTSS District Coaches to implement and sustain the essential features of the District Action Plan.
Circle the following if you: Strongly Disagree (1), Disagree (2), Agree (3), Strongly Agree (4) for each category.
I am knowledgeable
/skilled in this area
Goals for
Improvement
(Circle one)
1. Phases of implementation and schools’ readiness for change
SD
D
A
SA
2. Data system to evaluate school-wide student outcomes
a.
SD
D
A
SA
b. numeracy (e.g., AIMSweb, YPP, SAGE)
b.
SD
D
A
SA
c. positive behavior support (e.g., SWIS, Educator’s Handbook)
c.
SD
D
A
SA
a.
SD
D
A
SA
a. literacy (e.g., DIBELS, AIMSweb, SAGE, PMfocus.org)
b.
SD
D
A
SA
b. numeracy (e.g., AIMSweb, YPP, SAGE, PMfocus.org)
c.
SD
D
A
SA
a. literacy (e.g., DIBELS, AIMSweb, SAGE)
3. Data system to evaluate individual student progress monitoring outcomes for:
c. positive behavior support (e.g., SWIS/CICO, PMfocus.org)
1
I am knowledgeable
/skilled in this area
Goals for
Improvement
(Circle one)
3. School decision rules and timeline for collecting and analyzing data to
guide decision making and action planning (e.g., benchmarking, progress monitoring
frequency, intervention decision rules) for:
a.
SD
D
A
SA
a. literacy
b.
SD
D
A
SA
b. numeracy
c.
SD
D
A
SA
c. positive behavior support
5. Disaggregating relevant data in easy to read formats (e.g., visual
representations/graphs, appropriate units of analyses to display data)
for:
a. literacy
Better graphs for
individual behavior
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
b. numeracy
c. positive behavior support
6. Tools to assess fidelity of implementation at the universal
level for:
a. literacy (e.g., PET-R, R-SET)
b. numeracy (e.g., MQI, N-SET)
positive behavior support (e.g., SET, EBS Survey)
2
I am knowledgeable
/skilled in this area
Goals for
Improvement
(Circle one)
7. Tools to assess fidelity of implementation at the secondary
and tertiary level for:
a. literacy (PET-R, R-SET)
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
b. numeracy (e.g., N-SET)
c. positive behavior support (e.g., ISSET, CICO, BAT)
8. Use of Team Initiated Problem Solving (TIPS) Checklist with building level teams
SD
D
A
SA
9. Delivery of professional development related to:
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
a. literacy
b. numeracy
c. positive behavior support
10. Facilitation of building level PD (support in/coaching of planning,
coordinating, and evaluating PD) for:
a. literacy
b. numeracy
c. positive behavior support
3
I am knowledgeable
/skilled in this area
Goals for Improvement
(Circle one)
11. Communicating with community stakeholders (e.g., mental health, parent groups,
community council) that are relevant to district and school-wide implementation
related to:
a. literacy
b. numeracy
c. positive behavior support
12. Presenting school and student outcomes to district, superintendent,
and/or school board for:
a. literacy
b. numeracy
c. positive behavior support
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
a.
SD
D
A
SA
b.
SD
D
A
SA
c.
SD
D
A
SA
13. Maintaining a high positive to negative ratio of interactions with school
teams and interactions with school personnel and district personnel
SD
D
A
SA
14. Providing immediate, effective feedback to school team members using
the TIPS protocol
SD
D
A
SA
SD
D
A
SA
15. Helping teams effectively set goals and develop action plans
4
I am knowledgeable
/skilled in this area
Follow up on items
from last meetings
withBC's
(Circle one)
16. Following up with requests for assistance from team members and other
school staff.
SD
D
A
SA
17. Helping schools celebrate success (e.g., create graphs that demonstrate
improvement, start each meeting with a celebration, etc.)
SD
D
A
SA
SD
D
A
SA
18. Implementing effective communication skills including listening
and empathy?
Goals for Improvement
5
6