Office of Field Services Student Teaching Record and Evaluation Form

OFFICE OF FIELD SERVICES STUDENT TEACHING RECORD AND EVALUATION FORM

EST
481 / INTERN:______EXP: ST PR
SCHOOL______SEMESTER/YEAR______
GRADE LEVEL/SUBJECT______ / EST
481

This form is to inform intern, mentor and supervisor of Intern’s progress on assignments and observations throughout semester. Supervisor is to returned Completed Form to OFS at end of semester.

Rubrics in Taskstream DRFs are used to determine Scores on assignments. Final scores are to be recorded here.

ASSIGNMENTS / DESCRIPTION
(A SCORE OF “2” IS CONSIDERED PROFICIENT) / TASKSTREAM
DRF / SCORE
(0-3)
edTPA / TPA
Classroom Management* / LICENSURE
Employment portfolio* / LICENSURE
Post-observation Reflections / OFS / See Below
* Denotes SPA Requirements Above
OBR / If not completed in Practicum, Module Quizzes are to be submitted to Manager, Cleveland State
Survey
Student Teaching
(Survey is emailed to student) / Proof submitted to Supervisor via Taskstream
Survey submitted to OBR / Student Completed
YES NO

List each Observation.

OBSERVATIONS / DATE/TIME / Walk Through OR Observation / Taskstream Score
Met/ Not Met / LESSON PLAN
Completed / COMMENTS
OBS / Met Not Met / Met Not Met
OBS / Met Not Met / Met Not Met
OBS / Met Not Met / Met Not Met
OBS / Met Not Met / Met Not Met
W/T OBS / Met Not Met / Met Not Met
W/T OBS / Met Not Met / Met Not Met

Please circle type of letter completed for intern by Mentor and Supervisor

MENTOR LETTER / SUPERVISOR LETTER
RECOMMENDATION Letter or COMPLETION Letter / RECOMMENDATION Letter or COMPLETION Letter
TRIADS / DATE OF TRIAD / MEDIATED SCORE
Midterm
Final

SIGNATURES:

INTERN:______

(DATE)

MENTOR:______

(DATE)

SUPERVISOR:______

(DATE)

Description / GRADE / % of
Final Grade
FINAL GRADE TOTALS / ASSIGNMENTS / 40%
CANDIDATE PRE-SERVICE ASSESSMENT OF
STUDENT TEACHING (CPAST) / 40%
C.O.E.H.S./SPA / 20%
Final Grade for Semester / Grade Calculator can be found on OFS website

GRADE KEYS

ASSIGNMENTS GRADE KEY OBSERVATIONS AND FINAL GRADE

Grade / Points or%
A / >2.14
A- / 2.13-2.02
B+ / 2.01-1.90
B / 1.89-1.78
B- / 1.77-1.66
C+ / 1.65-1.54
C / 1.53-1.42
D / 1.41-1.30
F / 1.29 >
Grade / Points or
%
A / >2.14
A- / 2.13-2.02
B+ / 2.01-1.90
B / 1.89-1.78
B- / 1.77-1.66
C+ / 1.65-1.54
C / 1.53-1.42
D / 1.41-1.30
F / 1.29 >
RECOGNITION / Please circle if applicable
OUTSTANDING STUDENT TEACHER / GOLDEN APPLE / EXCEPTIONAL STUDENT TEACHER
List other awards/recognitions received
Criteria for each recognition can be found on OFS website

Last Revised Date: 8/19/16