Site Supervisor Evaluation

Counseling Student Name

Your Name

Name of Your School

Please note semester, year, and course (i.e. Spring 2020 Intern OR Spring 2020 Practicum OR Fall 2021 Intern)

The School Counseling Student (please select one answer per statement):

The School Counseling Student (please select one answer per statement):
	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates empathic understanding of clients (SC 3. f.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
develops appropriate rapport with students (SC 3. f.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates clarity in work with students (SC 3. f.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
appropriately identifies and intervenes with students who exhibit risk factors and warning signs of mental health and behavioral disorders, substance abuse, and/or those who have experienced crisis or trauma (SC 2. g.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
recognizes signs and symptoms of substance abuse in children and adolescents as well as the signs and symptoms of living in a home where substance abuse occurs (SC 2. i.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
engages with students about academic issues in a way that is developmentally appropriate (SC 3. d.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
engages with students about college and/or career issues in a way that is developmentally appropriate (SC 2. c.; SC 3. d.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
engages with students about personal/social issues in a way that is developmentally appropriate (SC 3. f.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates a commitment to culturally appropriate interventions and promotes equity for diverse students (SC 3. k.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
practices according to ethical standards and shows awareness of legal and ethical standards important in the school setting (SC 2. n.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT

Classroom Management and Teaching:

The School Counseling Student (please select one answer per statement):

Classroom Management and Teaching:
The School Counseling Student (please select one answer per statement):
	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates appropriate classroom management skills when providing classroom guidance (SC 3. c.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
differentiates instruction and interaction based on students' developmental and learning needs (SC 3. c.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
skillfullly develops curriculum and lesson plans (SC 3. c.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
appropriately applies technology for the field (I.e. powerschool, presentation tools, tele-health platforms)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT

Performance and Supervision/Collaboration:

The School Counseling Student (please select one answer per statement):

Performance and Supervision/Collaboration:
The School Counseling Student (please select one answer per statement):
	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
uses collaboration through consultation (with school personnel, families, and community agencies) and other methods as appropriate for the promotion of academic, social/personal, and career development in students (SC 1.d.; SC 2. a., SC 2. b.; SC 2. d.;	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
exhibits self-awareness (SC 2. j.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates responsibility (SC 2. j.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates professional dress and manner (SC 2. j.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT
demonstrates punctuality e at site and with work responsibilities (SC 2. j.)	DOES NOT APPLY	POOR	AVERAGE	GOOD	EXCELLENT

Recommendation for Course Grade

Satisfactory
Unsatisfactory (please provide comments in areas for growth below)

Comments on student's notable strengths:

Comments on student's needs for growth and improvement:

Please provide feedback on the JMU School Counseling Program’s curriculum, in terms of strengths, weaknesses and suggestions from your perspective and experiences with our students.

Feedback from Supervisors about the JMU School Counseling Program. We are particularly interested in feedback on any OR all of the following: How is hosting a JMU student beneficial to your school community?; Was the student adequately prepared for their expected professional development level prior to placement?; Does JMU have reasonalbe entry and exit requirement for the school counseling students?

SCREENSHOT OR PRINT NOW BEFORE SUBMITTING IF YOU WANT TO REVIEW HARD COPY WITH YOUR STUDENT