Denver Public Schools

Teacher on Special Assignment – Central Administration

Comprehensive Professional Evaluation Form

Educator Being Evaluated:

Assignment:

Evaluator:

School:

School Year of Evaluation:

20_____ – 20_____

/ Educator Name: / DPS ID no.: / School/Dept: Assignment:
 Probationary  Non-Probationary  Special Comprehensive Professional Evaluation
Teacher on Special Assignment – Central Administration
Comprehensive Performance—TOSA
Performance Criteria and
Standards Rating
E=Exceeding; M=Meeting;
D=Developing; NM=Not Meeting / Criteria Rating
(each standard has from 3–5 criteria) / Standard Rating* / *Instructions for Standard Rating: If 50% or more criteria are rated NM (Not Meeting), the resulting Standard Rating is NM. For example, 2 out 3 criteria, 2 out of 4 criteria, or 3 out of 5 criteria represents 50% or more.
Click on links below to reference each standard’s criteria, rubrics, and indicators. / A / B / C / D / E / Evaluator Comments – Required if NMor Erating for a criteria and/or standard is given.
Standard 1: Direct Service/Instructional Support
Standard 2: Assessment
Standard 3: Programand Planning
Standard 4: Consultation and Contribution to Learning Environment
Standard 5: Professional Responsibilities
Comprehensive (overall) Performance Rating (select one)  Satisfactory  Unsatisfactory – Put on Remediation
Instructions for comprehensive performance rating:
A teacher receives an “Unsatisfactory” comprehensive performance rating when:
  • One or more of the standards are rated NM, or
  • A total of five or more criteria (across all the standards) are rated NM.
With all other combinations, a teacher receives a “Satisfactory” comprehensive performance rating.
Narrative Summary
Evaluator Comments / Teacher Comments
Strengths: / Strengths
Area(s) for Improvement: / Area(s) for Improvement

© Denver Public Schools, 2008 Page 1

/ Educator Name: / DPS ID no.: / School/Dept: Assignment:
 Probationary  Non-Probationary  Special Comprehensive Professional Evaluation
Teacher on Special Assignment – Central Administration
Summary of Evidence Journal
** Any information used to evaluate the educator must be documented on the Summary of Evidence Journal **
Evaluator: Document data sources of the educator’s performance where each standard is referenced by two different types of data:
1) records of teaching provided by the educator and 2) another type of data provided by you. It is important to understand that a single record of teaching or data source (e.g., classroom observation) may be used to reference multiple standards. This is the minimum required to complete the evaluation, however, the evaluator may document more data sources.
Notification and Orientation Date Within first 60 days / Pre-observation Conference Date / Observation Date
20-45 minutes / Post-observation Conference Date / Mid-evaluation Structured Conference Date / Final Evaluation
Conference
Date / Remediation / Types of Data:
I=Interview or conference
R=Records of teaching or service O=Observation
W=Written Communication
 Yes  No
Note: A single data source or a record of teaching may be used to document multiple standards.
Date / Time; Place; Subject and/or Activity / Type(s) of Data / Standard(s) Referenced, Data Description, Comments
Note to Evaluator! Attach additional list of data sources, as needed. Inventory: make note when you reference each performance standard and who provided it
Standard 1: Educator 
Evaluator / Standard 2: Educator 
Evaluator  / Standard 3: Educator 
Evaluator  / Standard 4: Educator 
Evaluator  / Standard 5: Educator 
Evaluator 
Summary of Evidence Journal COMPLETE / Educator Initials (indicating review of this journal)

© Denver Public Schools, 2008 Page 1

/ Educator Name: / DPS ID no.: / School/Dept: Assignment:
 Probationary  Non-Probationary  Special Comprehensive Professional Evaluation
Teacher on Special Assignment – Central Administration
Action Plan for Professional Development
Teacher completed and submitted to the evaluator an Action Plan?  Yes  No If no, please explain:
Required Signatures
Evaluator / Date
Building or Home School Principal
(if different from evaluator) / Date
Principal/Manager’s Supervisor / Date
Principal/Manager’s Supervisor’s Name (Print/Type)
Teacher and evaluator signatures are required. The teacher’s signature indicates that he or she has seen the list of performance standards and their criteria, rubrics, and indicators; and the completed Comprehensive Professional Evaluation form. The teacher’s signature does not imply agreement with the evaluation conclusion.
I have read this evaluation report. I understand that I may attach additional comments to this report.
Teacher / Date
Additional Comments

© Denver Public Schools, 2008 Page 1