<p> OFFICE OF FIELD SERVICES PRACTICUM RECORD AND EVALUATION FORM</p><p>INTERN:______EXP: ST EST PR EST 371 371 SCHOOL______SEMESTER/YEAR______</p><p>GRADE LEVEL/SUBJECT______</p><p>This form is to inform intern, mentor and supervisor of Intern’s progress on assignments and observations throughout semester. Supervisor is to returned Completed Form to OFS at end of semester. </p><p>Rubrics in Taskstream DRFs are used to determine Scores on assignments. Final scores are to be recorded here. **OBR Modules are not scored by supervisor A DESCRIPTION TASKSTREA SCORE SS (A SCORE OF “2” IS CONSIDERED PROFICIENT) M (0-3) DRF IG Context for Learning OFS N Student Profiles: Students as Learners OFS M Instructional Videotaping LICENSUR E E N Teacher Work Sample LICENSUR TS E Post-observation reflections OFS See Below * SPA Requirements Above OB 4 MODULE Quizzes** All submitted to Student Completed R (PRACTICUM) Manager, Cleveland State YES NO Taskstream OFS DRF</p><p>Complete information for each Observation O Taskstream BS DATE/TIME Walk LESSON PLAN COMMENTS 1 Last Revised : 8/19/16 ER Through OR Score Completed Observation Met/ Not Met V OBS Met Not Met Met Not AT Met IO OBS Met Not Met Met Not N Met S OBS Met Not Met Met Not Met OBS Met Not Met Met Not Met W/T OBS Met Not Met Met Not Met W/T OBS Met Not Met Met Not Met</p><p>TR DATE OF MEDIATED SCORE</p><p>IA TRIAD Midte DS rm Final</p><p>Please circle type of letter completed for intern by Mentor and Supervisor</p><p>MENTOR LETTER SUPERVISOR LETTER RECOMMENDATION Letter or RECOMMENDATION Letter or COMPLETION Letter COMPLETION Letter</p><p>SIGNATURES:</p><p>INTERN:______(DATE)</p><p>MENTOR:______(DATE)</p><p>SUPERVISOR:______2 (DATE) Description GRADE % of Final Grade FINAL ASSIGNMENTS 40% GRAD E CANDIDATE PRE-SERVICE ASSESSMENT 40% TOTA OF LS STUDENT TEACHING (CPAST) C.O.E.H.S./SPA 20% Final Grade for Semester Grade Calculator can be found on OFS website </p><p>GRADE KEYS ASSIGNMENTS GRADE KEY OBSERVATIONS AND FINAL GRADE Grade Points or% A >1.64 A- 1.63-1.52 B+ 1.51-1.40 B 1.39-1.28 B- 1.27-1.16 C+ 1.15-1.04 C 1.03-0.92 D 0.91-0.80 F 0.79></p><p>Grade Points or % A >2.14 A- 2.13-2.02 B+ 2.01-1.90 B 1.89-1.78 B- 1.77-1.66 C+ 1.65-1.54 C 1.53-1.42 D 1.41-1.30 F 1.29 ></p><p>3 Last Revised : 8/19/16 4</p>