[[Commonweaith of Pennsylvania [DEPARTMENT OF EDUCATION [333 Market St. Hamisburg, PA 17126-0833
Pennsylvania Statewide Evaluation Form for Student Professional Knowledge and Practice
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Student’Candidate's Last Name First Midale Social Security Number
Kindergarten 1
Subject(s) Taught Grade Level
This form is to serve as a permanent record of a student teacher/candidate’s professional performance evaluation during 2
specific time period, based on specific eriteria, This form must be used at least twice during the 12-week (minimum) student
teaching experienc
PERFORMANCE EVALUATION
Directions: Examine all sources of evidence provided by the student teacher/candidate and bear in mind the aspects of
teaching for each of the four categories used in this form. Check the appropriate aspects of student teaching, and indicate the
sources of evidence used to determine the evaluation of the results in each category. Assign an evaluation for each of the four
categories and_then assign an overall evaluation of performance. Sign the form and gain the signature of the student teacher.
‘Category I: Planning and Preparation — Stadt teacer/candldate demonstrates thorough lnowcdge of content and pedagogcal sll planning and
preparation, Student teacher wakes plan and sets goal based on the conten tobe taughtearned, knowledge of aesigned students, nd the istrctionsl
“Alignment 384.83. (1A), (8) (C)(G). (8)
‘Student TeacheriCandidate’s performance appropriately demonstrate
+ Knowledge of content
Knowledge of pedagosy
Knowledge of Ponasylvania's K-12 Academic Standards
Knowledge of students and how to use this knovledge to impart insrution
Use of resources, materials or technology available through te stool or district
Instructional goals that show a recognizable sequence with adaptations for individual student needs
Assessments of student learning aligned tothe instructional goal and adapted a required for student needs
Use of educational psychological principles theories inthe construction of lesson plans and secing instructional goals
Sources of Evidence (Check ll shat apply nd include dates, rypesiites and number)
Def Lessonvtnit Plans See Atached 430-A Bd Student Teacher Interviews See Attached 430-A
CJResources/MaterialsrTechnology See Attached 430-A_Bd]Classtoom Observations See Attached 430-A,
Bz Assessment Materials See Attached 430-4 [] Resource Documents See Attached 430-4
Citntormation About Studens See Attached 430-4 [] Other See Attached 430-4
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Justification for Evaluation
Lesson Plans ELA and MATH
PDE-30 |(Commonwealth of Pennsylvania [DEPARTMENT OF EDUCATION | 333 Market St, Hanisburg, PA 17126-0333 |
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Student/Cendidate’s Last Name First Middle Social Security Number
able environment fr learning, i
rent — Stent eacher/candiate establishes and maintains a purposeul and
Ging routines ad ting kent expectations for stadt behavior.
‘Category Hy Classroom Envi
Seca pape earaeses wes
Aligaeents 3843. (D/H) (8)
‘Student TeacheriCandidate's performance appropriately emonstaies
Expectations for student achievement with value placed on the quality of student work
Altention to equitable leasing opportunities for students
“Appropriate interactions between teacher and students and among stents
[Elective classroom routines and procedures reculting in ile or no lass of instructional time
Clear standards of conduct and effective management of student behavior
Appropriate attention given 0 safety inthe classroom tothe extent that iis under the contol of the student teacher
[Ability to establish and maintain rapport with students
Sources af Evidence (Check all hat apply and include dates, pestle, and number)
Eq Classroom Observations See Attached 430-A.
(informal Observations/Visits See Auached 430-A [J Visual Technology See Attached 430-A
[student TeacheriCandidate See Atached 430-A—-) ResourcevMaterialsTechnology/Space_ See Attached 430-A
Fiinerviews See Atached 430-4) Other See Attached 430-A,
Category play 3 Pains [Super ? Fos Suibfactory T Point isacony 0 Pate
Crier for Rating | The caniate consent] The cae wualvand Ths canine enerner and Te cnt rey ornever and
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