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Template: Employer Evaluation of Student Intern

Date: May 6, 2024

Student Name: Chase Rajala

Directions for Employer: Answer the items in Categories A through C, and provide any
remarks in the Additional Comments section, based upon your experience observing the
student. Please be objective and candid in your assessment; your responses will help
strengthen our program. Note that the descriptions of each item listed in Categories A
through C are available in the corresponding Scoring Guide that is attached at the end.

Category A: Foundational Skills


Rate the student’s foundational skills using the rating scale below. (If you have not had the
opportunity to observe the student’s skill level or behavior in a particular area, please
respond N/A: “No Opportunity to Observe.”)

1 2 3 4 N/A
Does Not Meet Partially Meets Meets Above No Opportunity
Expectations Expectations Expectations Expectations to Observe

Enter Rating Scale


Items to Rate
Number or N/A
Locating, Comprehending, and Evaluating Information 4
Listening 4
Workplace Safety 4
Problem-Solving/Troubleshooting 4
Oral Communication 4
Written Communication 4
Attention to Detail 4
Ability to Grasp Concepts 4
Following Workplace Guidelines 4

Record student’s overall rating (i.e., 1, 2, 3, or 4) for Category A: 4

Template Developed by the California Department of Education


May 2021 Page 1 of 10
Category B: Applied Workplace Skills
Rate the student’s applied workplace skills using the rating scale below. (If you have not had
the opportunity to observe the student’s skill level or behavior in a particulararea, please
respond N/A: “No Opportunity to Observe.”)

1 2 3 4 N/A
Does Not Meet Partially Meets Meets Above No Opportunity
Expectations Expectations Expectations Expectations to Observe

Enter Rating Scale


Items to Rate
Number or N/A
Understanding the Organizational Structure
4
and Processes

Information Technology Application 4

Teamwork 4

Customer Service 4

Responsiveness to Change 4

• Does the student demonstrate ethical behavior/integrity? Select Yes, No, or N/A N/A

Record student’s overall rating (i.e., 1, 2, 3, or 4) for Category B: 4


___________
Category C: Self-Management and Personal Responsibility
Rate the student’s self-management skills and personal responsibility using the rating scale
below. (If you have not had the opportunity to observe the student’s skill level or behavior in
a particulararea, please respond N/A: “No Opportunity to Observe.”)

1 2 3 4 N/A
Does Not Meet Partially Meets Meets Above No Opportunity
Expectations Expectations Expectations Expectations to Observe

Enter Rating Scale


Items to Rate
Number or N/A
Absenteeism 4

Punctuality 4

Template Developed by the California Department of Education


May 2021 Page 2 of 10
Category C: Self-Management and Personal Responsibility (Continued)
Enter Rating Scale
Items to Rate
Number or N/A
Time-Management 4

Self-Directed; Takes Initiative; Resourceful 4

Takes Responsibility for Learning; Seeks to Learn 4

Motivation 4

Record student’s overall rating (i.e., 1, 2, 3, or 4) for Category C: 4

Additional Comments
Any additional comments may be provided in the space below. Comments could include
where the student exceeded expectations and/or areas that need improvement.

Please provide comments here:


It has been a pleasure to have Chase in my classroom for 2 years. Chase quickly gains
respect from all of the students and easily builds rapport. The students love having him
as part of our classroom. Chase is organized and flexible-willing to take on any task and
work with any student(s) I need him for additional support. Chase is a natural born leader
and easily commands the room and has learned to keep student's attention focused on
the lesson at hand. Chase is adept at taking direction and modifying his strategies to
ensure all learner's needs are being met. Chase is fun, yet sets the necessary
boundaries between himself and the students. Chase would be an excellent teacher and
welcomed additiona to the field of education if that is the route he chooses to take.

Template Developed by the California Department of Education


May 2021 Page 3 of 10
Scoring Guide to the Employer Evaluation of Student Intern Form
This document is a companion piece to the above Employer Evaluation of Student Intern form. It describes each rating
component.

Category A – Foundational Skills


Does Not Meet Partially Meets
Foundational Skills Meets Expectations Above Expectations
Expectations Expectations
The student has
The student has
minimal ability to
moderate ability to The student has the The student
locate,
locate, ability to locate, demonstrates an
understand and
understand and understand and advanced ability to
Locating, evaluate
evaluate evaluate information, locate, understand and
Comprehending, information,
and Evaluating information, including, if relevant, evaluate information,
including, if
Information including, if ability to interpret including, if relevant,
relevant, ability
relevant, ability to charts or graphs or ability to interpret charts
to interpret
interpret charts or identify trends in or graphs or identify
charts or graphs
graphs or identify data. trends in data.
or identify trends
trends in data.
in data.
The student usually The student is attentive;
The student appears attentive and retains delivered
The student is occasionally retains most of the information, as evidenced
inattentive and appears delivered information, through subsequent
does not retain inattentive, but as evidenced through performance; takes notes
as necessary;repeats
delivered retains most of subsequent
back keyideas,
Listening information, as the delivered performance; the
demonstrating that
evidenced information, as student knows to take information was heard;
through evidenced notes if necessary to and asks questions to
subsequent through remember important develop a deeper
performance. subsequent information; and asks knowledge and
performance. clarifying questions as understanding of the
needed. work.

Template Developed by the California Department of Education


May 2021 Page 4 of 10
Does Not Meet Partially Meets
Foundational Skills Meets Expectations Above Expectations
Expectations Expectations

The student has a keen


The student has
The student has awareness of the
awareness of the The student has
minimal awareness surroundings, always
surroundings but awareness of the
Workplace Safety of the surroundings follow safety protocols, and
does not surroundings and always
and does not follow takes the time and initiative
consistently follow follow safety protocols.
safety protocols. to identify and prevent
safety protocols.
workplace hazards.

The student
The student has a
exercises a The student exercises a The student exercises a
minimal level of
moderate level of satisfactory level of high level of reasoning and
Problem-Solving/ reasoning or
Troubleshooting reasoning and reasoning and analytical analytical thinking to
analytical thinking
analytical thinking to thinking to problem- problem-solve and
to problem-solve or
problem-solve and solve and troubleshoot. troubleshoot.
troubleshoot.
troubleshoot.

The student articulates


The student The student does ideas clearly and
does not not consistently The student effectively, including
Oral
Communication articulate ideas articulate ideas articulates ideas the use of right
clearly and clearly and clearly and effectively. language and
effectively. effectively. terminology to the
audience.

Template Developed by the California Department of Education


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May 2021
Does Not Meet Partially Meets
Foundational Skills Meets Expectations Above Expectations
Expectations Expectations
The student’s
The student’s
written
written The student’s written
communication is
communication is The student’s written communication is
unclear (e.g., poor
occasionally unclear communication is clear consistently clear (e.g.,
choice of words
(e.g., poor choice of (e.g., good word choice proper word choice, good
and sentence
words, sentences and sentence structure, sentence structure, well
structure,
Written are sometimes well organized, proper organized, proper tone,
Communication disorganized,
fragmented, and/or tone, and the message selects the right form of
incorrect tone,
the message is is clear based on the communication, and the
and/or the message
sometimes not clear communication method message is clear based on
is not clear based
based on the used [e.g., email, text, the communication method
on the
communication report]). used [e.g., email, text,
communication
method used [e.g., report]).
method used [e.g.,
email, text, report]).
email, text, report]).

The student is not The student is fairly The student is detailed The student is detailed
attentive to detail attentive to detail oriented and has oriented and identifies
Attention to Detail
and has multiple and has errors in the minimal errors in the errors to correct before
errors in the work. work. work. moving forward.

The student is able to


The student is able grasp concepts in a timely
The student is able The student is able to
Ability to Grasp to grasp concepts manner and has learned
Concepts to occasionally grasp concepts in a
but not in a timely the concepts well enough
grasp concepts. timely manner.
manner. to be able to teach them to
someone else.

Template Developed by the California Department of Education


May 2021 Page 6 of 10
Does Not Meet Partially Meets
Foundational Skills Meets Expectations Above Expectations
Expectations Expectations
The student has The student has The student has a keen
minimal awareness awareness of The student has awareness of workplace
Following of workplace workplace awareness of workplace procedures and guidelines
Workplace procedures and procedures and procedures and and always follows them,
Guidelines guidelines and guidelines but does guidelines and always and takes the time and
does not follow not consistently follows them. initiative to identify areas in
them. follow them. need of improvements.

Category B – Applied Workplace Skills

Applied Workplace Does Not Meet Partially Meets


Skills Meets Expectations Above Expectations
Expectations Expectations
The student understands
their role and how it
The student has The student has a
The student supports the
Understanding the minimal moderate
understands their organization, along with
Organizational understanding of their understanding of
Structure and role and how it a clear understanding of
role and how it their role and how it
Processes supports the other roles within the
supports the supports the
organization. organization and how it
organization. organization.
all connects to
productivity.
The student has The student has the
The student has
moderate skills to skills to use, operate, The student has the
minimal skills to use,
Information use, operate, or run or run the technology skills to use, operate, or
operate, or run the
Technology the technology necessary to run the technology to
Application technology necessary
necessary to complete assigned complete assigned work
to complete assigned
complete assigned work the majority of at all times.
work.
work. the time.

Template Developed by the California Department of Education


May 2021 Page 7 of 10
Applied Workplace Does Not Meet Partially Meets
Skills Meets Expectations Above Expectations
Expectations Expectations
The student
The student does not The student builds
occasionally builds The student builds
build collaborative collaborative
collaborative collaborative
relationships with relationships with
relationships with relationships with
Teamwork colleagues and has colleagues, works well
colleagues and can colleagues and
difficulty working within a team structure,
sometimes work works well within a
within a team and is respectful of
within a team team structure.
structure. various viewpoints.
structure.
The student provides
The student is rarely The student is able The student provides
support, assistance,
able to provide to provide limited support, assistance,
and/or advice to
Customer Service support, assistance support, assistance, and/or advice to
customers, and
and/or advice to and/or advice to customers, and exceeds
meets their
customers. customers. their expectations.
expectations.
The student The student can respond
The student does not The student has
Responsiveness to responds positively to positively to change,
Change respond well to mixed reactions to
change and adjust adjust plans accordingly,
change. change.
plans accordingly. and can motivate others.
*

Ethical Behavior/Integrity: This item questions whether the student demonstrated ethical behavior/integrity.

Template Developed by the California Department of Education


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May 2021
Category C – Self-Management and Personal Responsibility
Self-Management
Does Not Meet Partially Meets
and Personal Meets Expectations Above Expectations
Responsibility Expectations Expectations
The student is rarely The student is rarely
absent and sometimes absent and always
The student is The student is informs management informs management of
Absenteeism
frequently absent. occasionally absent. of planned absences planned absences (i.e.,
(i.e., approved time off) approved time off) in a
in a timely manner. timely manner.
The student is The student is The student is on time to
frequently tardy to occasionally tardy to The student is on time work and/or returns from
Punctuality work and/or work and/or to work and/or returns breaks on time, and
frequently returns occasionally returns from breaks on time. informs employer ahead
from breaks tardy. from breaks tardy. of time of tardiness.
The student
The student completes
The student rarely occasionally does
The student completes assignments in a timely
Time Management completes not complete
assignments on time. and can adjust when
assignments on time. assignments on
deadlines change.
time.
The student rarely The student
The student takes The student takes
takes initiative and occasionally takes
Self-Directed; initiative, requires initiative, is easily able to
the student requires initiative but requires
Takes Initiative; minimal supervision, work independently, and
Resourceful ongoing supervision some supervision to
and asks for support requires very little
to maintain maintain
as needed supervision.
productivity. productivity.
The student
The student rarely The student actively
hesitates to seek out The student seeks out
Takes seeks out new seeks out new knowledge
new knowledge and new knowledge and
Responsibility for knowledge and skills, and skills, learns from
Learning; Seeks to skills, and skills, and usually
and rarely learns his/her mistakes, and
Learn sometimes learns learns from his/her
from his/her rarely repeats the same
from his/her mistakes.
mistakes. mistake.
mistakes.

Template Developed by the California Department of Education


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May 2021
Self-Management
Does Not Meet Partially Meets
and Personal Meets Expectations Above Expectations
Expectations Expectations
Responsibility
The student expresses
The student is The student shows The student shows interest and motivation to
disinterested and interest and interest and motivation complete all
Motivation lacks motivation to motivation to to complete the tasks/projects/work, and
complete complete some majority of demonstrates willingness
tasks/projects/work. tasks/projects/work. tasks/projects/work. to work beyond given
roles.

Template Developed by the California Department of Education


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May 2021

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