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.
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                                                                     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.
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                                                             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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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.
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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.
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