<p> INTERNSHIP ACTION PLAN SPED 565: INTERNSHIP IN SPECIAL EDUCATION II KEENE STATE COLLEGE Spring 2005</p><p>Student Teacher Mentor/Cooperating Teacher </p><p>School Site District </p><p>Mentor Signature Intern Signature </p><p>Rating Scale For Intern Performance 5= Outstanding Demonstrates excellent understanding and application of professional skills and concepts. 4=High Competence Demonstrates strong understanding and application of professional skills and concepts. 3=Satisfactory Demonstrates acceptable understanding and application of professionals skills and concepts. 2=Minimal Competence Demonstrates competence in some areas of understanding and application of processional skills and concepts, but has received feedback as to a number of areas in need of improvement. 1=Standards Not Met Demonstrates inadequate competence in areas of understanding and application professional skills and concepts. N=Not Observed No documentation of the identified competence</p><p>Guidelines In order to meet state certification guidelines and program competencies there are required outcomes for each Danielson domain area (these are identified on the Special Education Internship Competency Rating Form). The Action Plan for the Post-Bac Special Education Internship II is designed so that the Intern and the Mentor can work together to design an individualized plan for final demonstration of competence. The focus of the plan is on the products/artifacts needed to demonstrate competence. Each intern will have a different plan based on Internship I performance.</p><p>The Intern is required to draft the action plan and schedule a meeting with the Mentor to review. The Intern will examine portfolio self-assessments, KSC Supervisor evaluation, and Internship I Special Education Internship Competency Rating Form to determine the course of action for the semester. After the plan is completed, the Intern will schedule a meeting with the KSC Supervisor to review and discuss. As artifacts are completed, the Mentor and College Supervisor will rate performance (additional scoring guides for assignments are in the Internship Handbook or will be provided). At the end of the Internship the Mentor/KSC Supervisor will complete the Special Education 2</p><p>Internship Competency Rating Form and complete the Final Evaluation Narrative based information provided on tasks related to the action plan. In consultation with the mentor a final grade for the Internship I will be determined by the KSC Supervisor.</p><p>3</p><p>INTERNSHIP II ACTION PLAN DOCUMENTATION OF ACTIVITIES AND OUTCOMES Planning, Preparation, and Assessment</p><p>TO BE COMPLETED BY Propose Complet MENTOR AND KSC Outcomes/Artifacts for Portfolio d ed SUPERVISOR *Required unless an alternative is negotiated with KSC Supervisor, see notes Complet (check ion Date below) Standards Not Met Outstanding PLANNING, PREPARATION, AND ASSESSMENT*  Formal and informal test data and report 1 2 3 4 5</p><p> Goals, objectives, and accommodation plan for case study student (if 2/4/05 2/4/05 1 2 3 4 5 did not complete in Internship I, submit to KSC supervisor)</p><p> IEP for one student 1 2 3 4 5</p><p> Access Plan 1 2 3 4 5</p><p> Transition Plan (done with the Transition Planning course) SPED 525 SPED 1 2 3 4 5 525  Instructional plans (model lesson materials, lesson plans, unit plans, Ongoing Ongoing 1 2 3 4 5 etc.)</p><p>CLASSROOM ENVIRONMENT*  Functional Behavioral Assessment 1 2 3 4 5</p><p> Behavioral Intervention Plan 1 2 3 4 5</p><p> Written observations of classroom environment issues (mentor and KSC Ongoing Ongoing 1 2 3 4 5 observations) 4</p><p> Written reflections on classroom environment (develop with Mentor) Ongoing Ongoing 1 2 3 4 5 5</p><p>INSTRUCTION*  Systematic plan for monitoring and evaluating instruction 1 2 3 4 5</p><p> Instructional plans and written observation of instruction (mentor and Ongoing Ongoing 1 2 3 4 5 KSC observations)</p><p> Written reflections on instruction (develop with Mentor) Ongoing Ongoing 1 2 3 4 5</p><p>PROFESSIONAL RESPONSIBILITIES*  Internship II Action Plan 1/31 1/31 1 2 3 4 5</p><p> Documentation of the facilitation of an IEP meeting 1 2 3 4 5</p><p> Documentation of full-time responsibility (1-2 weeks, non-Alt IV only) Week(s) Week(s) 1 2 3 4 5</p><p> Updated Danielson reflections May May 1 2 3 4 5</p><p> Action research documentation TBA TBA 1 2 3 4 5 6</p><p>ADDITIONAL OUTCOMES/ ARTIFACTS BASED ON PROFESSIONAL DEVELOPMENT TARGETS FROM INTERNSHIP I (AT LEAST 3 REQUIRED)  1 2 3 4 5</p><p>Rationale:</p><p> 1 2 3 4 5</p><p>Rationale:</p><p> 1 2 3 4 5</p><p>Rationale:</p><p> 1 2 3 4 5</p><p>Rationale:</p><p> 1 2 3 4 5</p><p>Rationale: 7</p><p>Notes regarding action plan</p>