Supervisor Evaluation of Student

Palomar College
Alcohol and Other Drug Studies/Psychological and Social Services Program
Supervisor Evaluation of Student's Performance

This form is to be completed at the end of the semester by the internship supervisor. The supervisor and intern should
use this evaluation as an exit interview for the student's learning.

Student's Name: Semester Year

AODS/PSYC/SOC: (Check one) 140 298 299

Agency/Program: Date form completed:

I. EXPERIENCES/SKILLS

1. Briefly describe the kinds of learning experiences made available to the student. Include
any special orientation or training the student attended.

II. EVALUATION/ASSESSMENT: Please rate the student on the following characteristics
representing the student's professionalism, personal characteristics, and practice skills.

	Outstanding	More than Acceptable	Average	Below Average	Not Acceptable	Not Applicable
Punctuality/attendance
Behavior & Work Attitudes
Adherence to basic ethical standards & values of the profession
Effectiveness in planning & arranging work responsibilities
Ability to assume responsibilities for own learning
Ability to work within the purpose, structure, and constraints of the agency
Verbal communication skills
Written communication skills
Ability to develop and maintain professional relationships with clients/consumers/co-workers from various cultural/ethnic backgrounds
Ability to identify and use community resources
Competency in providing helping skills to clients.
Competency in providing helping skills to clients.	Comments

III. SUPERVISION:

Did supervisory sessions take place on a regular basis? Yes or No

How much time was provided for the sessions?

IV. GENERAL ASSESSMENT:

1. What were/are the student's primary strengths?

2. In what areas do you think the student needs improvement?

3. Taking this entire evaluation into consideration, how would you rate the students
    performance overall? Check one:
Outstanding    Above Average    Average    Below Average    Unsatisfactory

Internship Supervisor's Signature _________________________ Date: ____________

V. STUDENT REVIEW OF EVALUATION

        My internship supervisor and I have discussed this evaluation.

I agree with the overall rating given above

        I do not agree with the overall rating above

Student's Signature _____________________________________ Date: _____________

If student disagrees with this evaluation, he/she should explain in writing and submit copy
to the Internship Supervisor and Palomar College Instructor.