TPEP Focused Evaluation Form
Criterion 5
Includes student growth rubrics from criterion 3 or 6 /
Name: Click here to enter text. / Assignment: Click here to enter text.
School Year: Click here to enter text. / School: Click here to enter text.
Observation Dates: Click here to enter text. / Total Obs. Time: Click here to enter text.
Final Rating: / Unsatisfactory ☐ / Basic ☐ / Proficient ☐ / Distinguished ☐
CRITERION 5: Fostering and managing a safe, positive learning environment.
Criterion Rating: / Unsatisfactory ☐ / Basic ☐ / Proficient ☐ / Distinguished ☐
5.1: Organizing the Physical Layout of the Classroom
The teacher organizes a safe physical layout of the classroom to facilitate movement and focus on learning. / 5.4: Applying Consequences for Lack of Adherence to Rules and Procedures
The teacher applies consequences for lack of adherence to rules and procedures.
5.2: Reviewing Expectations to Rules and Procedures
The teacher reviews expectations regarding rules and procedures to ensure their effective execution. / 5.5: Acknowledging Adherence to Rules and Procedures
The teacher acknowledges adherence to rules and procedures.
5.3: Demonstrating “Withiness”
The teacher demonstrates awareness of the classroom environment at all times (withitness). / 5.6: Displaying Objectivity and Control
The teacher builds positive relationships with students by displaying objectivity and control.
Evidence and Comments

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CRITERION 3: Recognizing individual student learning needs and developing strategies to address those needs.
Student Growth 3.1: Establish Student Growth Goal(s)
Rating: / *Unsatisfactory ☐ / Basic ☐ / Proficient ☐ / Distinguished ☐
Student Growth 3.2: Achievement of Student Growth Goal(s)
Rating: / *Unsatisfactory ☐ / Basic ☐ / Proficient ☐ / Distinguished ☐
*A rating of 1 on any student growth rubric row triggers a student growth inquiry.
Evidence and Comments

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CRITERION 6: Using multiple student data elements to modify instruction and improve student learning.
Student Growth 6.1: Establish Student Growth Goal(s)
Rating: / *Unsatisfactory ☐ / Basic ☐ / Proficient☐ / Distinguished ☐
Student Growth 6.2: Achievement of Student Growth Goal(s)
Rating: / *Unsatisfactory ☐ / Basic ☐ / Proficient ☐ / Distinguished ☐
*A rating of 1 on any student growth rubric row triggers a student growth inquiry.
Evidence and Comments

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Check here ☐ if a statement from the staff member is attached.

I hereby acknowledge this evaluation has been discussed with me, and I am aware of its contents.

Certified Staff Member Date

Evaluator Date