Palomar College CHDV Department Lesson Plan Format and Instructions
***THE FOLLOWING PORTION SHOULD ONLY BE COMPLETED FOR THOSE CHDV ASSIGNMENTS
REQUIRING IMPLEMENTATION OF THE LESSON PLAN***
(Print this page and take with you when you implement the activity.)
EVALUATION BY SUPERVISING TEACHER AT CENTER
Student’s Name:
Activity:
Palomar Professor’s Name:
Class Name/#:
STUDENT RESPONSIBILITIES FOR THE ACTIVITY
(Please complete on a scale of 1 to 5, 1 being poor/not met, and 5 being outstanding/fully met)
ACTIVITY DESCRIPTION
RATING
1
2
3
4
5
Student contacted you in advance of the activity.
Set up on the day of the activity.
Activity was appropriate to the center & age of the children.
Interaction with the children was appropriate, i.e. eye contact,
amount and type of communication, vocabulary…
Student showed responsiveness and sensitivity to the individual
needs of the children.
Appropriate limits were set and maintained.
Student demonstrated creative effort.
Clean up was planned and carried through.
Overall evaluation of the activity and presentation.
COMMENTS
Please list ways you felt the activity went well:
Please list suggestions for the student in regards to future lesson plans/interactions with children:
Other comments:
Signature of Supervising Teacher:
Supervising Teacher (printed name):
Phone or email:
Date:
Appendix A – Rev. 11.14.11
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