University Supervisor Check List for Concurrent Pathway

Fall Semester

Supervisor Name:______

CandidateName: ______

Cooperating Teacher: ______School:______

Please check and attach evidence of the following for each candidate’sfile:

Multiple Subject OR Single Subject Practicum Checklist(Candidate, Cooperating Teacher)

Timesheet & Absence Report Forms(Credential Candidate, Cooperating Teacher)

4 CORE Observation Packets including Lesson Plans(Supervisor)

2 CORE Observation Packets including Lesson Plans(Cooperating Teacher)

Initial Three-Way Conference Form(Candidate)

Mid Semester Three-Way ConferenceForm (Candidate)

Final Three-Way Conference Checklist(Candidate)

_____ Self-evaluation TPE/ Disposition Form (CredentialCandidate completes)

______CORE Competency/Disposition Evaluation Form (Supervisor, Cooperating Teacher)

MULTIPLESUBJECT PROGRAM

PRACTICUM IICHECKLIST*

*Please request other form for Single Subject

ASSIGNMENTS / DATE / CT’s
INITIALS
  1. At beginning ofpracticum, review Practicum II Requirements, Professional Expectations and Practicum II Checklist with Cooperating Teacher (see syllabus).

  1. At beginning of practicum, review your Practicum I strengths and areas for growth with your Practicum II Cooperating Teacher. Review the TPE and Disposition rubrics and set goals for the semester.

  1. Usingasmall binderor electronic format,collect schoolsitedocumentsregarding demographics, policies, procedures, curriculum, and school calendar.

  1. Get to know the individual students in teaching assignment, including their family/community contexts and the multiple developmental factors that impact learning (academic, language, social). Know services for which students qualify (Special Education, GATE). Know students’ English language proficiency levels

  1. Becomefamiliar withschool’s tiered intervention (RTI) process.

  1. Withthehelpofthe Cooperating Teacher becomefamiliar withthedistrict’s web-basedstudentdatacollectionsystemor management software.

  1. Attendat least onefacultymeetingeachmonth.

  1. Attendstaffdevelopment and/or gradelevel meetings.

  1. Attend “Open House” or “Back-to-School Night”(as applicable).

  1. Becomefamiliar withIEPforms andhow togather informationanddata for their completion.

  1. Attenda minimumofoneIndividualizedEducationPlan (IEP) meeting.

  1. Attenda minimumofoneStudent Study Team (SST) or Response to Intervention (RTI) meeting.

  1. Participateinscheduledparent conferences.

  1. Attendoneor moreschoolboardmeeting(s).

  1. Attendall required meetingswithCooperating Teacher & University Supervisor (e.g., cluster meetings, three-way meetings).

  1. MaintainLesson/Unit PlanBook inhardor electronic copy.

  1. Observe and teach across content areas for the Multiple Subject credential (math, language arts, social studies, science, physical education, visual/performing arts and health).

  1. Assume full responsibility for teaching all content areas for a minimum of two weeks.

  1. Completeall requiredCooperating Teacher & University Supervisor observationsof teaching.

  1. WithCooperating Teacher & University Supervisor, completemidandfinal teachingevaluation forms for Teaching Practicum II and the Exit Interview/Induction Preview Form.

  1. Complete PACT teaching event.

CONCURRENT PATHWAY TIME SHEET
Month: ______
SCHOOL ______
Candidate’s Name:______/ CT’s Name: ______
Classroom Grade Level(s)______
Classroom Setting/type: ______
Monday / Tuesday / Wednesday / Thursday / Friday
I was late/absent because: / CT’s Initials:
Date:
I was late/absent because: / CT’s Initials:
Date:
I was late/absent because: / CT’s Initials:
Date:
I was late/absent because: / CT’s Initials:
Date:
I was late/absent because: / CT’s Initials:
Date:

School of Education Concurrent Pathway

Absence Request Form

NameSchool Site: Date:

Request for Absence with Special /Emergency Circumstances

To request an absence from your student teaching site and/or credential courses because of special circumstances, please fill out this form with complete information and documentation. Please refer to the Concurrent Handbook for further clarification and general information regarding the program policy on absences.

Absence was from (check one or both):

School Placement Site / and/or / Program Courses

List date(s):______

Reason for absence: ______

______

Attach supporting documentation, if desired.

Turn in completed form to your University Supervisor, who will give the completed form to the Program Coordinator, who will review the request and reach a decision as to whether or not the absence can be excused and whether extra placement days or coursework will be required to address the absence.

Do not fill out information below this line.

Coordinator’s Decision:

Request granted / Request denied (see comments below) / Request conditionally granted (see comments below) / Further information and/or documentation needed (see comments below / Request withdrawn by candidate

Comments: ______

______

Coordinator’s Signature: ______Date:______

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INITIAL THREE-WAY CONFERENCE

(Review goals/objectives, prepare for Solo-Teaching)

Meeting Date:School Site:

Present at the meeting:

Candidate signatureCooperating Teacher signature

University Supervisor signature Other

A summary of this meeting follows below:

1.The purposes and structure of the Concurrent Education Specialist Pathway, including the three-way conferences during the term were reviewed and each member received a copy of the Concurrent Policies and Procedures.

2.The candidate has a copy of the school handbook, knows the students’ names, and is becoming familiar with school-wide and classroom procedures:

Yes Not Yet Has begun a site information binder 

3.General Goals that the candidate and cooperating teacher would like to focus on during Phase I:

a. Assessment

b. Behavior

c. Curriculum

d. Other

4.Specific routine tasks for which the candidate has partial responsibility during Phase I (see Handbook- Phase I chart):

  1. Goals and actions for participation in teaching of reading/language arts.

GOALS / ACTION
READING PROGRAM FOR CLASS: (including TEXT and supplementary program) / Candidate will….
WRITING PROGRAM FOR CLASS (including TEXT and supplementary program) / Candidate will….
Observe/participate in reading instructions at different grade level (3 above or below) / Candidate will….
  1. Single Subject candidates only: please indicate your student teaching schedule for the semester: ______
  2. The candidate has attended a faculty meeting. Yes  No 

7.The substitute teaching policy has been reviewed. Yes  No 

8.The following program forms were given to Cooperating Teacher and candidate and reviewed.

Policies and Procedures Handbook

Lesson Plan Format

Observation Forms

Time Sheets

TPE Rubric

Follow-up or additional comments:

______

Cooperating Teacher’s weekly planning day is

Next scheduled visit

(Copies of this form are to be provided to the Cooperating Teacher and University Supervisor.)

California State University, Chico

School of Education

Concurrent Teacher Preparation Pathway

MID-WAY CONFERENCE

(Review goals/objectives, prepare for Solo-Teaching)

(This form is to be completed together by the CT & Student: a copy will be given to the Supervisor)

MEETING DATE:School Site:

PRESENT AT THE MEETING: (signatures)

Candidate‘s signatureCooperating Teacher signature

University Supervisor signatureOther

  1. In reviewing the goals and objectives from the first Three-Way Conference:
  1. What objectives has the candidate adequately addressed:
  1. What objectives need to carry over into the remaining weeks or need to be added before the Solo Teaching experience:

2.In preparation for Solo Teaching, we have discussed the following:

Dates of Turnaround Days:

Dates of Solo Teaching: ______

Resources needed:

Candidate’s letter to parents regarding his/her Solo Teaching:

Dated letter will be reviewed by cooperating teacher:

Supervisor has reviewed the Competency Checklist with the cooperating teacher:  Yes  No

Two-week solo plan and approved by the cooperating teacher on:

Date:

  1. The following items have been reviewed for updated progress:
  1. Time sheets are current and signed-off by CT:
  2. Weekly Lesson Plan Book is complete and current:
  3. Field Assignment Tracking Form is updated:
  4. Number of days Candidate has substituted to date (or not):
  1. Any further questions or concerns?

School of Education

Concurrent Pathway

FINAL THREE-WAY CONFERENCE CHECKLIST

Candidate:Date:

Cooperating Teacher(s): School:

Grade: Setting: Supervisor:

1. Final Progress Assessment Form (completed and all signatures obtained)

 Cooperating Teacher

 Candidate

 University Supervisor

2. Cooperating Teacher Observation Forms

3. Candidate provides to supervisor the following completed forms:

 Time Sheets

 Assignment Tracking Sheet

 All prior feedback forms from observed lessons

4.Letters for Candidate:

 Cooperating Teacher

5. Copies of all “solo” lesson plans

6.Required components of PACT have been submitted

Signed by:

CandidateDate

Cooperating TeacherDate

University SupervisorDate

TEACHING PRACTICUM I SELF-EVALUATION FORM

Credential Candidate: ______Date: ______

Please complete both sections of this form based on your Teaching Practicum I experience. Note your areas of strength and areas for future focus. This form should be submitted to your Cooperating Teacher and University Supervisor one week before the 3-way Teaching Practicum I Culminating Conference.

CORE Competencies
CORE Competency 1 – Culture of Learning
  • Facilitating student behavior and equitable teaching practices

CORE Competency 2 – Essential Content
  • Planning and delivering lessons effectively
  • Planning instruction and designing learning experiences for all students

CORE Competency 3 – Academic Ownership
  • Maintaining high academic expectations
  • Building thinking skills

CORE Competency 4 – Demonstration of Learning
  • Leading instruction
  • Checking for understanding
  • Responding to student misunderstanding

Dispositions
Disposition 1 - The candidate appreciates and values human diversity, recognizes community and cultural norms, shows respect for students' varied talents and perspectives, seeks to foster culturally appropriate communications and demonstrates best practices in his or her field.
Disposition 2 - The candidate believes that all children can learn, appreciates their varying abilities, and persists in helping all children achieve success.
Disposition 3 - The candidate is committed to continuous, self-directed learning, critical thinking and reflection in order to refine instructional practice and deepen knowledge in the academic disciplines.
Disposition 4 - The candidate demonstrates pride in the education profession and participates in collaborative relationships with colleagues, students, parents, and social and professional communities and agencies.
Disposition 5 - The candidate is committed to the expression and use of democratic values and to the creation of a learning environment that fosters active engagement in learning and encourages positive social interaction.

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