(C-7) Performance Data Collection Form - Checklist

(C-7) Performance Data Collection Form - ChecklistCounselor Date of VisitPeriod/BlockSchool Time -Principal or Designee PositionEVIDENCE OF PERFORMANCE STANDARDSDomain: Knowledge of Students INDIVIDUAL PLANNINGa. Standard: Provides learning opportunities that support students’ learning styles and intellectual, social, and personal development.______ObservedEvidence:______Not Observed______N/A______Needs ImprovementDomain: Knowledge of Content SCHOOL GUIDANCE CURRICULUMa. Standard: Effectively articulates the central concepts and understandings of the discipline(s).______ObservedEvidence:______Not Observed______N/A______Needs Improvementb. Standard: Communicates content knowledge and processes used by adults working in the discipline(s).______ObservedEvidence:______Not Observed______N/A______Needs ImprovementDomain: Planning, Delivery, and Assessment of Instruction PROGRAM ORGANIZATION, SCHOOL GUIDANCECURRICULUM, INDIVIDUAL PLANNINGa. Standard: Develops and implements yearlong plans for instruction that reflect division curriculum and SOLs.

______Observed______Not Observed______N/A______Needs ImprovementEvidence:

. Standard: Sets standards for classroom behavior and follows through consistently.______ObservedEvidence:______Not Observed______N/A______Needs Improvementc. Standard: Applies classroom procedures to maximize academic learning time.______ObservedEvidence:______Not Observed______N/A______Needs Improvementd. Standard: Establishes and maintains a safe environment for students at all times.______ObservedEvidence:______Not Observed______N/A______Needs ImprovementDomain: Communication and Collaboration RESPONSIVEa. Standard: Maintains effective communication and works collaboratively with students, parents, colleagues,administration, and community to promote student success.______ObservedEvidence:______Not Observed______N/A______Needs ImprovementDomain: Professionalism SYSTEM SUPPORTa. Standard: Models professionalism and ethical standards as well as personal integrity in all interactions.______ObservedEvidence:______Not Observed______N/A______Needs Improvementb. Standard: Participates in meaningful and continuous professional growth, including self-evaluation.______ObservedEvidence:______Not Observed______N/A______Needs Improvement

c. Standard: Contributes to the school community.______ObservedEvidence:______Not Observed______N/A______Needs ImprovementGENERAL COMMENTS ON COUNSELOR'S PERFORMANCE: (Attach sheet if necessary)COUNSELOR'S COMMENTS: (Attach sheet if necessary)_______________________________________________ ___ ______________________________________Counselor Signature* Principal or Designee Signature________________________________________________ ______________________________________Date of Signature Date of Signature*Teacher's signature does not imply agreement with the observation, but onlythat the observation has been discussed and a copy received by the teacher. If checked, see attached statement COPIES: COUNSELOR PRINCIPAL OBSERVER