Teacher Self Assessment Form A Page 2
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22Domain I: Planning
Indicators
Standard 2
Performance Level 1
Performance Level 2
Performance Level 3
Performance Level 4
The teacher does not use data
The teacher inconsistently or
The teacher frequently and
The teacher consistently and
Plans lessons that meet the
diversity of students’
(formal or informal) about the
inappropriately uses data
appropriately uses data
appropriately uses multiple
backgrounds, cultures,
prior experiences, language
(formal and informal) about
(formal and informal) about
and varied data sources
skills, learning levels,
proficiencies, achievement
the prior experiences,
the prior experiences,
(formal and informal) about
levels, and special needs of
language proficiencies,
language proficiencies,
the prior experiences,
language proficiencies,
interests, and special needs.
the class.
achievement levels, and
achievement levels, and
language proficiencies,
special needs of the class.
special needs of the class.
achievement levels, and
special needs of the class.
Plans lessons that meet the
The teacher does not
The teacher inconsistently
The teacher frequently and
The teacher consistently and
diversity of students’
incorporate the class’s
and/or ineffectively
effectively incorporates the
effectively incorporates the
incorporates the class’s
class’s questions and interests
class’s questions and interests
questions and interests by
backgrounds, cultures,
skills, learning levels,
collaborating with students to
questions and interests by
by collaborating with students
by collaborating with students
language proficiencies,
design and implement relevant
collaborating with students to
to design and implement
to design and implement
interests, and special needs.
learning experiences.
design and implement relevant
relevant learning experiences.
relevant learning experiences
learning experiences.
while leveraging family and
community resources in the
process.
Plans lessons that meet the
The teacher does not design
The teacher inconsistently or
The teacher frequently and
The teacher consistently and
diversity of students’
instruction to build on the
inappropriately designs
appropriately designs
appropriately designs
class’s prior knowledge,
instruction to build on the
instruction to build on the
instruction to build on the
backgrounds, cultures,
class’s prior knowledge,
class’s prior knowledge,
class’s prior knowledge,
experience, and/or cultural
skills, learning levels,
language proficiencies,
background; does not allow
experience, and/or cultural
experience, and/or cultural
experience, and/or cultural
interests, and special needs.
learners to accelerate as they
background; does not allow
background; however,
background; allows learners to
demonstrate their
learners to accelerate as they
inconsistently allows learners
accelerate as they demonstrate
understanding.
demonstrate their
to accelerate as they
their understanding.
understanding.
demonstrate their
understanding.
2
August 2013
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