Grade Level(S)/Subject Area(S)

SAFE-T LOG (ET4)

Teacher’s name / SC Teaching Certificate No.
District / School
Grade level(s)/Subject area(s)
Academic year / Contract level
Evaluator/Chair / SC Teaching Certificate No.
Evaluator / SC Teaching Certificate No.
Evaluator / SC Teaching Certificate No.
Preliminary Evaluation Period (PEP) / Date / Teacher’s Initials
The teacher received a comprehensive orientation to SAFE-T.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The teacher submitted the long-range plan.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The teacher submitted the unit work sample.
Preliminary Evaluation Period (PEP) / Date / Evaluator’s Initials
Integral classroom observation #1 for the PEP was conducted.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The teacher submitted the reflection on PEP observation #1.
Preliminary Evaluation Period (PEP) / Date / Evaluator’s Initials
Integral classroom observation #2 for the PEP was conducted.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The teacher submitted the reflection on PEP observation #2.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The professional performance review was submitted.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The teacher submitted the professional self-assessment.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The evaluation team consensus meeting was held.
Preliminary Evaluation Period (PEP) / Date / Chair’s Initials
The preliminary evaluation conference was held with the teacher.

Comments and/or description of other SAFE-T related activities (e.g., additional integral classroom observations, additional reflections, walk-through observations) conducted during the preliminary evaluation period. (optional)

Final Evaluation Period (FEP) / Date / Chair’s Initials
The teacher submitted the long-range plan, if required.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The teacher submitted the unit work sample, if required.
Final Evaluation Period (FEP) / Date / Evaluator’s Initials
Integral classroom observation #1 for the FEP was conducted.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The teacher submitted the reflection on FEP observation #1.
Final Evaluation Period (FEP) / Date / Evaluator’s Initials
Integral classroom observation #2 for the FEP was conducted.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The teacher submitted the reflection on FEP observation #2.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The professional performance review was submitted.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The teacher submitted the professional self-assessment, if required.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The evaluation team consensus meeting was held.
Final Evaluation Period (FEP) / Date / Chair’s Initials
The final evaluation conference was held with the teacher.

Comments and/or description of other SAFE-T related activities (e.g., additional integral classroom observations, additional reflections, walk-through observations) conducted during the final evaluation period. (optional)

By signing below, I verify the accuracy of the above SAFE-T log.
Evaluator / Date
Evaluator / Date
Evaluator / Date
Teacher / Date

March 2009