Harrison School District Two

SSP Summative Evaluation Report

School Psychologist

Name: / School Year:
Department: / Assignment:
Name of Evaluator: / Building(s) Served:
Date of the Summative:
Data sources upon which conclusions are drawn and findings are based:
Spot Observations
Informal Observations
Formal Observations
Student Outcomes
Professional Growth Plans
SSP Products
Parent and/or student survey data
Peer or community input
Memos and letters
Awards and recognitions
Other:
Date of
Pre-Observation Conference / Date/Time
of
Formal Observation / Date of
Post-Observation Conference
1st Semester / /
2nd Semester / /
Optional / /
/
Spot Observations / Dates:
1st Semester
2nd Semester
Overall Performance Rating
Standard 1. Planning and Preparation
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
1a. / Establish and maintain clear and organized procedures for referrals.
Establish session goals or meeting outcomes.
Plan interventions, accommodations & modifications to maximize likelihood of student success. Apply knowledge of state and federal regulations and of resources both within and beyond the school and district.
1b.
1c.
1d.
Standard 2. Data Informed Decision Making
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
2a. / Evaluate student needs in compliance with the National Association of School Psychologists (NASP) guidelines.
Demonstrate knowledge & skill in using psychological instruments to evaluate students.
Analyze and use results from multiple sources or assessments in decision making.
Provide appropriate feedback.
Utilize technology to gather data and enhance the learning environment.
2b.
2c.
2d.
2e.
Standard 3. Delivery of Service
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (5.0-5.9) / (6.0-6.9) / (7.0-7.9) / (8.0)
3a. / Respond to referrals; consulting with teachers and administrators.
Assume director designee responsibilities.
Ensure sessions or meetings are focused and productive while promoting active participation.
Use a variety of materials, methods, and strategies to remove barriers to learning.
Demonstrate flexibility and responsiveness.
Maintain contact with physicians and community mental health service providers.
3b.
3c.
3d.
3e.
3f.
Standard 4. Interventions
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
4a. / Implement or monitor academic interventions.
Recommend, implement or monitor appropriate interventions for students with social, emotional & behavioral needs.
Use appropriate tools for identifying early warning signs of children at risk and implement pre-referral interventions for learning and social/emotional behavioral problems.
Participate as a member of an intervention or solution team.
4b.
4c.
4d.
Standard 5. Contributions to the Learning Environment
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
5a. / Model positive and respectful rapport.
Respect diversity among others.
Ensure that students with special needs are placed within the Least Restrictive Environment (LRE).
5b.
5c.
Standard 6. Leadership
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
6a. / Understand their role and responsibility in implementing the District, Department and/or Building Action Plan.
Promote the concept of Professional Learning Communities through purposeful involvement.
Continue professional growth.
Support collaborative partnerships.
Supervise volunteers and paraprofessionals – when applicable.
6b.
6c.
6d.
6e.
Standard 7. Professional Responsibilities
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
(0-1.9) / (2.0-2.9) / (3.0-3.9) / (4.0-4.9) / (5.0-5.9) / (6.0-6.9) / (7.0)
7a. / Adhere to federal laws, state statutes and regulations pertaining to education, the Board of Education (BOE) policies, the Agreement of Trust and Understanding (ATU), and school rules.
Demonstrate professionalism.
Effectively communicate.
Maintain confidentiality.
Solve problems.
Perform assigned and related duties.
7b.
7c.
7d.
7e.
7f.

With the exception of the conditions outlined below, total the points for each rating of standards 1-7 (point ranges are in parenthesis).

  • An SSP with two or more performance standard ratings of “Unsatisfactory” would receive an overall performance evaluation rating of “Unsatisfactory” with a maximum score of 8.
  • An SSP with one performance standard rating of “Unsatisfactory” would receive a maximum overall performance evaluation rating of “Progressing I” with a maximum score of 11.

Evaluation of Performance
Unsatisfactory / Progressing I / Progressing II / Proficient I / Proficient II / Proficient III / Exemplary
0-10 / 11-17 / 18-24 / 25-31 / 32-38 / 39-45 / 46-50

Evaluation of Performance Points Earned:

[See Performance Standards Rubrics]

Unsat / Prog. I / Prog. II / Prof. I / Prof. II / Prof. III / Exemplary
0-10 / 11-17 / 18-24 / 25-31 / 32-38 / 39-45 / 46-50

Evaluation of Student Outcomes Points Earned:

[This score must reflect the Final Student Outcomes Score from the Score Compiler Report in Galileo.]

Unsat / Prog. I / Prog. II / Prof. I / Prof. II / Prof. III / Exemplary
0-7 / 8-15 / 16-22 / 23-34 / 35-43 / 44-47 / 48-50

Add the total points recorded above for Evaluation of Performance in section 1 and Evaluation of Student Outcomes in section 2.

Unsat. / Prog. I / Prog. II / Prof. I / Prof. II / Prof. III / Exemplary
0-18 / 19-33 / 34-47 / 48-66 / 67-81 / 82-85 / 86-100
Eligible for Distinguished Eval:**
YES NO

** To be eligible for a Distinguished Special Service Provider Evaluation (DSSPE), an SSP must meet all of the criteria outlined in Section 8 of the SSP Evaluation and E&R Handbook. SSPs who score 67 points or more on the summative evaluation but do not meet the established criteria for DSSPE are only eligible for a 1-step increase in Overall Effectiveness Level (salary placement), not to exceed Proficient I.

  • Unsatisfactory on performance will result in an overall unsatisfactory evaluation.

Exemplary

Proficient IIIIf eligible for Distinguished Evaluation, the next page must be completed.

Proficient II

Proficient I

Progressing II

Progressing I

Unsatisfactory

*The Summative Evaluation Rating is a one-year rating that reflects an SSP’s evaluation of performance and student outcomes during a specific year. The Summative Evaluation Rating may differ from the Overall Effectiveness Level at which SSPs are placed if they are on the pay-for-performance (E&R) compensation plan.

Further Action (if applicable)

Recommendation to not renew the SSP’s contract

Evaluator Comments (required)
Strengths:
Recommended Areas of Growth:
Note: unsatisfactory ratings must always be supported with a written explanation

Eligible for District Distinguished Evaluation (initial one of the following)

SSP agrees to submit an application for a District Distinguished

Evaluationwithinthe established DSSPE timeline. ______(initials)

SSP is not currently a distinguished SSP and declines invitation to submit an application for a District Distinguished Evaluation. SSP’s Overall Effectiveness Level will not exceed “Proficient I.” ______(initials)

SSP is currently a distinguished SSP and declines invitation to submit an application for District Distinguished Evaluation.SSP understands that a District Distinguished Evaluation is required to advance in Overall Effectiveness Level. ______(initials)

  • If a distinguished SSP has attained a student outcomes rating that is lower than the SSP’s current Overall Effectiveness Level for two consecutive years (this school year and the previous school year), the SSP must submit an application for Paper Review to determine whether the SSP will maintain his or her current Overall Effectiveness Level.

A Paper Review application will be submitted. (circle one) YES NO*

*Failure to submit a Paper Review application will result in an automatic decline of one Overall Effectiveness Level.

I have reviewed this evaluation and discussed it with my evaluator. My signature indicates that I have been advised of my performance status; it does not necessarily imply that I agree with this evaluation.

Provider’s Signature:Date:

Evaluator’s Signature:Date:

Evaluator’s Supervisor Signature:Date:

The Evaluator’s Supervisor Signature on this form verifies that the report has been reviewed and that the proper procedure appears to have been followed.