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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
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