"UNION SCHOOL DISTRICT CLASSROOM SUBSTITUTE PERFORMANCE ASSESSMENT"
UNION SCHOOL DISTRICT CLASSROOM SUBSTITUTE PERFORMANCE ASSESSMENT Directions: Please take the time to assess the substitute’s performance. Upon completion of assessment, please forward it to your Principal. This must be completed within one day of the teacher’s return in the following instances: The substitute is new to the site/program. The substitute’s performance is excellent. The substitute’s performance is ineffective. Please take the time to provide substitutes with feedback. All students benefit from well prepared substitutes and effective performance requires feedback. ___________________________________________ ____________________________ Name of Substitute (Print clearly, first/last name) Date Worked ___________________________________________ ____________________________ School Site Position (teacher, instructional assistant, etc.) YES NO N/A 1. Did the substitute arrive to work on time? 2. Did the substitute return from his/her breaks/lunch on time? 3. Did the substitute teacher follow the lesson plans? 4. Did the substitute follow the classroom routine? 5. Did the substitute exhibit satisfactory classroom management skills? 6. Did the substitute exhibit satisfactory teaching skills? 7. Did the substitute demonstrate effective supervision skills when working with the children? 8. Did the substitute interact positively with the children/students? 9. Did the substitute interact positively with the parents? 10. Did the substitute interact positively with the staff? 11. Were the substitute’s skills compatible with the needs of your classroom? 12. Was the substitute productive/able to complete specific tasks or jobs required for the position? Overall rating of the substitute’s skills: Excellent Satisfactory Unsatisfactory NOTE: If you answered “No” to any of the questions, please provide an explanation in the Comments section below. Comments (attach additional paper, if necessary): _______________________________________________________ ________________________________________________________________________________________________ ________________________________________________________________________________________________ ____________________________________________________________ _______________________ _____________ Person Completing Form Title/Position Date Print & Sign Name Principal: I (print name)_____________________________________have reviewed the information and I agree do not agree with the assessment. I met with the substitute to discuss the performance assessment YES NO, on ___________(date). Based on the Performance Assessment, I recommend the substitute: Continue with employment Continue with reservation Be excluded* from this classroom Be excluded* from my site Be excluded* from Special Education *EXCLUSIONS REQUIRE THE PRINCIPAL SPEAK WITH THE SUBSTITUTE Principal’s _____________________________ ___________________ (signature) (date) Print; Complete; Send Original to District Office Receptionist; Keep a Copy