ECE 2999: PRACTICUM

INTERNSHIP EVALUATION FORM

 

NAME OF STUDENT:_______________________________________________

 

Due Date for Evaluation: _____________________________________________

 

Completed by:

Name: _____________________________________________________________

Title:_______________________________________________________________

Agency/Business: ____________________________________________________

Address: ____________________________________________________________

Phone:  _____________________________________________________________

 

Hours of Work Documented:  __________________________________________

(A minimum of 400 hours of on-the-job observable work experience is required.

If less than 400 hours, please provide an explanation regarding the time frame for completion of the assignment.)

  

The evaluation of a student=s performance in the internship experience should be completed the host agency supervisor with the student.  The evaluation will consist of regular informal reviews by the supervisor with the student culminating with the completion of the attached formal evaluation instrument.  The evaluation form should be signed by the host agency supervisor and the student.  The student should be given the opportunity to provide any remarks which he/she feels would clarify or justify any of the ratings which may indicate unsatisfactory performance.  A copy of the signed form should be retained by the host agency, a copy given to the student, and a copy mailed or faxed to the Internship Coordinator by the due date indicated above:

 

Dr. Mary Ann Rollans, Dean

School of Community Education

61 Lake Point Lane

Arkansas Tech University

Russellville, AR 72802

(479) 968-0205 (fax)

(479) 968-0234 (telephone)


ASSESSMENT BY EVALUATOR:

 

The following areas are competencies required for completion of the Child Development Associate Credential and are used as the basis for evaluating the competencies demonstrated by the student intern completing the ECE Practicum.  Please utilize the variable scale by circling the number which best represents the degree to which the student has demonstrated each competency area:

 

1.       SAFETY:  Provides a safe environment for children; proper care of infants in cribs; proper precautions followed for mobile infants; monitors older children’s use of playground equipment; selects age-appropriate toys, games, etc.

 

1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

Inadequate           Minimal                 Good            Excellent  

 

2.       HEALTH:  Models good nutrition and health habits to children; maintains an environment free of material or conditions that endanger children’s health; follows daily cleaning schedule to sanitize rooms, equipment, furniture, changing tables, and other items in contact with children.

 

   1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

   Inadequate          Minimal                    Good              Excellent

 

3.       LEARNING ENVIRONMENT:  Provides enjoyable environment which encourages learning, exploration, and play.  Rattles, mobiles, and teething toys provided for young infants along with push toys, stack toys and toys that make noise along with a soft climbing area; for toddlers, block areas, dramatic play materials, puppets, puzzles, and other manipulative items as well as a library area with age-appropriate books.

 

1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

   Inadequate          Minimal                     Good            Excellent

 

4.       PHYSICAL:  Provides opportunities for large and small muscle activities and sensory development through use of teething toys, rattles, and mobiles to help young infants develop motor skills of grasping, pulling, kicking, and mouthing.  Mobile infants have opportunities for pulling up, climbing, crawling, and learning to walk; toddlers enhance small muscle development by doing puzzles, coloring with markers and crayons, and dressing and undressing dolls and develop large muscles by running, riding tricycles, climbing up and sliding down the slide, and dancing to music.

 

1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

Inadequate          Minimal                    Good            Excellent

 

5.       COGNITIVE:  Provides healthy development in areas like emotional behavior and positive social interactions; opportunities for manipulation and exploration, responds to individual child’s interests; involves child in activities which to watch and interact with other children and adults and practice imitating sounds, movements, cause and effect activities, etc.

 

1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

       Inadequate           Minimal                   Good           Excellent

 

6.       COMMUNICATION:  Encourages children’s use of language by responding to infant’s cooing and other sounds, helps toddlers with short phrases, extends vocabulary through reading, music making, and pictures by showing relationship between spoken and printed words.

 

 1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

                Inadequate          Minimal                    Good            Excellent

 

 

7.       CREATIVITY:  Encourages children’s creativity by providing ample floor space for young infants to play by kicking their feet and moving their arms, studying themselves in mirrors, making faces to imitate; use rhythm instruments with toddlers, fabrics with different colors and textures and introduce other toys and foods that allow children to explore and play creatively.  Say rhymes, read imaginative stories, sing songs, and say silly nonsense words.

 

      1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

          Inadequate         Minimal                    Good             Excellent

 

8.       SELF:  Provides opportunities for children to learn self-help skills; infants learn to hold their own bottle; provide time for young infants to calm themselves which teaches self-regulation skills; give mobile infants finger foods to learn self-feeding skills; toddlers have opportunities to dress themselves, pour their own milk, make cots for nap time, etc.  Work with parents on toilet training and provide assistance about guidance and discipline and age-appropriate behaviors for their children.

 

              1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

          Inadequate          Minimal                    Good            Excellent

 

9.       PROFESSIONALISM:  Demonstrates interest in personal growth and professional development.  Able to talk with parents, colleagues, supervisors in a pleasant, caring, and friendly manner.  Maintains confidentiality;  withholds opinions about children, parents, and others; keeps business matters in-house; does not divulge information without written consent; handles disagreements in a positive manner; maintains accurate records, documents assessments in a professional format and works with parents for the benefit of the children.  Exhibits pride in the work setting and avoids critical assessments of management and/or ownership.  

 

1.       . . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

Inadequate             Minimal                      Good            Excellent

 

10. FAMILY SERVICES:  Encourages families to use or learn how to access community resources as needed.  Refer families to community resources/services if there is a need for special assistance or therapy.  Share developmental goals with parents and provide recommendations regarding activities and teaching in the home.  

 

1. . . . . 2. . . . . . . . .3. . . . . . . 4. . . . . . . . . 5. . . . . . .6. . . . . . . .7

       Inadequate           Minimal                    Good            Excellent

 

 

REMARKS BY EVALUATOR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

___________          ___________________________________________

                                 DATE                           SIGNATURE OF EVALUATOR

 

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REMARKS BY STUDENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

__________          _________________________________________________

                               DATE                              SIGNATURE OF STUDENT