Richmond City Public Schools
2653822-55689100Richmond City Public Schools Day Treatment Service Provider EvaluationAgency: FORMTEXT ?????Service Provider: FORMTEXT ?????School: FORMTEXT ?????Number of Students Served: FORMTEXT ?????Evaluator Name: FORMTEXT ?????Title: Choose an item.Date of Evaluation: Click here to enter a date.~Key~EE (Exceeds Expectations) = Provider consistently performs at a higher level than job requires.ME (Meets Expectations) = Performance is satisfactory; provider meets job duties & expectations.NI (Needs Improvement) = Performance is adequate; provider meets most of the job duties & expectations but needs improvement.U (Unsatisfactory) = Provider performance does not meet job duties & expectations; improvement is essential.NO (Not Observed) = No observations have been completed FORMDROPDOWN Understanding of responsibility: the extent to which the service provider demonstrates and has an overall knowledge of job; knows duties and responsibilities and seeks additional information about student as needed. FORMDROPDOWN Quality of Work: the extent the service provider performs his duties and assigned task in a thorough, accurate and reliable manner and has the skills necessary to work with the student he has been assigned. FORMDROPDOWN Attendance & Promptness: service provider arrives to work on time, observes work hours & has infrequent absences. FORMDROPDOWN Dependability: the extent the service provider can be relied upon to complete duties with due diligence to the difficulty of the given task. FORMDROPDOWN Initiative: the extent the service provider is able to take the lead when working with the behaviors of the student with limited direction from Richmond City Schools staff. FORMDROPDOWN Decision Making: the extent the service provider uses good judgment and common sense in job performance; uses proper technique to re-direct the student. FORMDROPDOWN Adaptability: the extent the service provider has the ability to learn and adjust to new behaviors of the student. FORMDROPDOWN Documentation: service provider meets the needs of staff & administrators to ensure progress & areas of needs of students. FORMDROPDOWN Communication: service provider is able to express ideas and situations clearly to Richmond Public Schools staff and maintains confidentiality. FORMDROPDOWN Productivity: service provider is able to collect the necessary data effectively. FORMDROPDOWN Personal Qualities: this refers to appropriateness of dress, personal neatness, hygiene and the service providers’ ability to maintain a standard of personal appearance in keeping with the demands on his position: poise, sense of humor, response to criticism and control of emotions. FORMDROPDOWN Relationship with people: the service providers’ courtesy, treating all those with whom he must deal in a professional manner which is polite, respectful, tactful, considerate and dignified. FORMDROPDOWN Grammar Usage: the extent the service provider displays competence in oral and written language. FORMDROPDOWN Over All Performance LevelEvaluator Comments: FORMTEXT ?????Continue Services for the Next Year: ?Yes ?No3124223-24736900Richmond City Public Schools Day Treatment Service ProviderEvaluation NarrativeAgency: FORMTEXT ?????Contact: FORMTEXT ?????Evaluator Name: FORMTEXT ?????Title: Choose an item.School: FORMTEXT ?????Date: Click here to enter a date.Instructions: Please provide detailed information regarding agencies and their personnel at your location. Have there been increased measurable outcomes for students? ?Yes ?No (Please Explain): FORMTEXT ?????Has the provider met your expectations and the needs of students? ?Yes ?No (Please Explain): FORMTEXT ?????Have you noticed or observed a positive impact in terms of academic achievement & outcomes? ?Yes ?No (Please Explain): FORMTEXT ?????Has data been provided regarding measurable outcomes at least every 4.5 weeks? FORMTEXT ?????Describe results of the semi-annual evaluations completed with the service provider? FORMTEXT ?????Will the services continue for the upcoming school year ?Yes or ?No? (If no, please explain) FORMTEXT ?????4370726-13271500Richmond City Public Schools Evaluation Of Day Treatment Service Providers(Note: To be completed by provider and returned to the principal two weeks prior to evaluations)Student NameReason for ReferralAttendanceGradesBehaviorProgressBeforeAfter InterventionBeforeAfter InterventionBeforeAfter InterventionMinimalProgressModerateProgressSuccessfulProgress FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ???????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????????School Year: 20 FORMTEXT ????? - 20 FORMTEXT ?????Total Students Served: FORMTEXT ????? ? Name and describe the instrument used to measure students’ progress (include reliability and validity information)? FORMTEXT ?????? Is this tool a qualitative or quantitative instrument? FORMTEXT ?????? Has the agency completed a summary of the students’ progress? ?Individual ?Group~NOTES~ FORMTEXT ????? ................
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