ESBD_520882_1779973981563_Attachment 07-VR2923 Orientation & Mobility Internship.pdf
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- Solicitation number
- 3202600155
- Issued by
- Texas
About this file
This is a performance evaluation form for the Orientation and Mobility (O&M) Internship program administered by the Texas Workforce Commission Vocational Rehabilitation Services. The form is designed to assess intern performance across multiple competency areas during their internship placement at an agency or facility. The evaluation covers a comprehensive range of performance metrics including teaching effectiveness, professional conduct, communication skills, and personal development. The form accommodates evaluation periods with designated spaces for the intern name, evaluation dates, supervising O&M instructor, and host agency or facility information. The assessment utilizes a five-point rating scale (Poor, Below Average, Average, Above Average, and Excellent) to evaluate 30 distinct performance criteria, with space for an overall performance evaluation and additional supervisor comments.
The evaluation form requires signatures from both the O&M supervisor and the intern, indicating acknowledgment and discussion of the assessment results. The form includes performance criteria spanning instructional competency (lesson planning, subject matter knowledge, teaching techniques), student interaction (rapport building, feedback provision, goal establishment), professional standards (punctuality, appearance, confidentiality, ethics), workplace behavior (initiative, attitude toward procedures, staff relations), and administrative responsibilities (report timeliness, meeting attendance, written communication). This evaluation instrument serves as a critical tool for monitoring intern development, documenting performance for the vocational rehabilitation program, and ensuring quality standards for orientation and mobility instruction services provided to students and customers with visual impairments or other disabilities.
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Text version
VR2923 (10/17) Orientation and Mobility (O&M) Internship Performance Evaluation Page 1 of 2
Texas Workforce Commission Vocational Rehabilitation Services
Orientation and Mobility (O and M) Internship Performance Evaluation
General Information
Intern name:
Date:
Agency or Facility:
O and M Supervisor name:
Inclusive Dates of Evaluation:
Performance Results
Teaching performance: Poor=1, Below Average=2, Average=3, Above Average=4, Excellent=5
1 2 3 4 5
1. Punctual to work and lessons.
2. Plans appropriate lessons.
3. Establishes and maintains rapport with student or customer.
4. Clarity when explaining lessons to students or customers.
5. Knowledgeable in subject area taught.
6. Mutually establishes goals and objectives with students or customers.
7. Uses a variety of teaching techniques and activities.
8. Plans lessons to achieve goals and objectives.
9. Keeps accurate daily lessons.
10. Remains alert and cautious on lessons.
11. Maintains proper position on lessons.
12. Provides effective feedback and support to student or customer.
13. Drives safely and courteously where appropriate.
14. Organizes and uses preparation time wisely.
15. Communicates effectively in written reports and evaluations.
16. Turns in reports and other assignments in timely manner.
17. Appropriate attendance and reporting at meetings.
18. Shows initiative in presenting and developing new ideas.
19. Handles special assignments appropriately.
20. Neat and appropriate appearance.
SAMPLE
VR2923 (10/17) Orientation and Mobility (O&M) Internship Performance Evaluation Page 1 of 2
21. Consults with supervisor for assistance when needed.
22. Seeks and accepts constructive criticism.
23. Expresses opinions in supervisory conferences.
24. Follows through on suggestions.
25. Observes the ethics of confidentiality.
26. Relates well with other staff and/or teachers.
27. Accepts professional responsibility.
28. Appropriate attitude toward policies and procedures.
29. Willingness to keep abreast of current professional literature.
30. Overall evaluation of intern’s performance.
Additional Comments:
O and M Supervisor signature:
X
O and M Intern signature:
X
SAMPLE
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