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Candidate’s Name Whitney Miller. Pre-service Performance Assessment for Practicum/Practicum Equivalent Professional Standards for Teachers: See 603 CMR 7.08 Please use this assessment in conjunction with the Pre-service Performance Assessment for Teachers guidelines: the rating scale; ev aluation questions relating to the standards; and the license-specific questions per standard (b)2c. Candidates must complete the Evidence column for evaluation by the program supervisor and supervising Standard A - Plans Curriculum and Instruction Indicators ience 1 Draws on content standards of the relevant curriculum frameworks to plan sequential units of study, individual lessons, and learning activities that make learning cumulative and advance students’ level of content knowledge. (Specify Curriculum Framework title, learning standards, and concept and skills used [attach list if rnecessary]). MA-CF and SHAPE standards are cited in all LP's (Lesson Plan Section) Content standards stated in Non-Manipulative Unit Pian (Unit Plan Section) ‘SP Midterm Evaluation: “follows the Springfield Public Schoot's Physical Education Pacing Guide” (Observation Section) Draws on results of formal and informal assessments as well as knowledge of human development to identify teaching strategies and learning activities appropriate to the specific discipline, age, level of English language proficiency, and range of cognitive levels being taught. CS Midterm Evaluation: “lesson activities are designed around standards that extend learning fora wide variety of individual students.” (Observation Section) SP Observation Form 01/29/15: “Lessons included strategies for ELU’s needs and disabilities.” (Observation Section) Identifies appropriate reading materials, other resources, and writing activities for promoting further learning by the full range of students within the classroom, Cognitive Assessment on Jumping and Landing during Non-Manipulative Unit (Assessment Section) Word Wall is presented with key words in Unit objectives for Non-Manipulative Unit (Unit and Other Section) Identifies prerequisite skils, concepts, and vocabulary needed for the learning activities and design lessons that strengthen student reading and writing skill. Non-Manipulative Unit Pian Assessments Students record different information every day (Assessment Section) All Lesson Plans include students reading the white board objectives for each lesson (Lesson Plan Section) Lesson Plan #7 Reflection 03/02/15: “Students had to read the white board and learn what volleying meant.” (Lesson Plan Reflection} Candidate's Name Whitney Miller | 5. Plans lessons with clear objectives and relevant measurable outcomes. AIILP’s have measurable objectives in all3 domains (Lesson Plan Section) ‘SP Midterm Evaluation: “shows clear objectives for each lesson.” (Observation Section) CS Observation 03/05/15: “Lesson objectives clear to students from the beginning.” (Observation Section) 6. Draws on resources from colleagues, families, and the community to enhance learning. Utilized SP’s “Ladder Training Manual” book to plan Ladder LP (Lesson Plan Section) Utilized SP’s “Climbing the Wall Everlast Climbing Industries” book to plan Traverse Wall LP (Lesson Plan Section) Sat in on a teacher parent meeting: 03/03/2015 (Other Section) 7. Incorporates appropriate technology and media in lesson planning. Uses computer to write all lesson plans (Lesson Plan Section) Lesson #11 02/23/15: Teacher used music during dance lesson. (Lesson Plan Section) 8 Uses information in Individualized Education Programs (IEPs) to plan strategies for integrating students with disabilities into general education classrooms. Lesson #1 01/20/15- Accommodations include partner work and constant strategizing (Lesson Plan Section) Lesson #5 01/30/2015: Students were allowed to choose whom they wanted to work with for partners. (Lesson Plan Section) Alllesson plans have modified activities and ‘extensions up or down. (Lesson Plan Section) 9. Uses instructional planning, materials, and student engagement approaches that support students of diverse cultural and linguistic backgrounds, strengths, and challenge: Unit Outcomes and Benchmark Rules are used to display focus of each lesson (Other Section) Journal #22 02/26/15: “Deals very well with the ‘many distractions that occur as well as helping those students that are challenged in some way, especially ELL students.” (Journal Section) Demonstrations used before each activity in each lesson (Lesson Plan Section) Candidate's Name Whitriey Miller. Explanation of Rating for Standard A - Plans Curriculum and Instruction: Plans are well thought out, build on one another, and are aligned with MA Curriculum Frameworks and national physical education standards Engages in informal assessment and adjusts lesson appropriately to match abilities of learners. Ensures that students lean appropriate vocabulary, concepts and skill cues, for each lesson taught. Draws on a variety of resources to enhance planning. Very conscientious about adjusting lessons to meet the needs of students with disabilities. Continue to improve ability to put all of your good thinking regarding your plans in writing, Tating Sener T=Does Not Me he Standard eet the Standard, Intends te Standarg; WANT ARDICADE: Candidate’s Name: ANhduey Wau c License: Program Supervisor (initial): Bw Date: S-4047 oe ‘Supervising Practitioner (initial): = (7-7. Date: ot. J . LIS Candidate's Name Whitney Miller, Pre-service Performance Assessment for Practicum/Practicum Equivalent Professional Standards for Teachers: See 603 CMR 7.08 Standard B — Delivers Effective Instruction Indicators Evidence 4. Communicates high standards and expectations when beginning the lesson. Makes learning objectives clear to students. Alllesson plans have objectives written on white board (Lesson Plan Section) CCP Observation 01/29/2015: “Explanation of skills {s excellent” (Observation Section) ‘SP Observation 02/06/2015: “Good explanation of the activity” (Observation Section) ‘SP Observation: 01/21/2015: "Nice and calm gym voice. Good emphasis with your tone.” b. Communicates clearly in writing, speaking and through | YOr®, S2e the use of appropriately designed visual and Cee ne aie CP Observation 01/29/2015: “Demonstration of skills fs excellent and uses all resources avaiable” (Observation Section) Word Wallis used with a variety of new words for students to focus on (Other Section) c. Uses engaging ways to begin a new unt of study or lesson. Unit Outcomes are posted for each unit and what the outcomes for each grade level are (Other Section) S Midterm Evaluation: “Builds on prior knowledge and she asks her students questions so they can explain their ideas” (Observation 2, Bullds on students’ prior knowledge and experience. | Section) LP #3 01/22/15: Demonstrated the leap jump and asked students what it was called (Lesson Plan Section) 2. Communicates high standards and expectations when carrying out the lesson, Uses a balanced approach to teaching skills and concepts of elementary reading and writing, All assessments are developmentally appropriate for all students (Assessment Section) Lessons Plans 1-6: Informing Section have students read the White Board Objectives (Lesson Plan Section) Employs a variety of content-based and content= oriented teaching techniques from more teacher- directed strategies such as direct instruction, practice, and Socratic dialogue, to less teacher-directed approaches such as discussion, problem solving, ‘cooperative learning, and research projects (among ‘ll lessons contain a teacher directed activator: Mighty Milers (Lesson Plan Section) Lesson #4 1/23+1/29: Teaching by invitation by allowing students to choose how they wanted to jump rope (Lesson Plan Section) Candidate's Name Whitney Mille. others) Lesson #5 01/30/15: Students were able to choose if they wanted to work individually or with 2 partner for traverse wall. (Lesson Plan Section) Demonstrates an adequate knowledge of and approach to the academic content of lessons. (See attached documentation that demonstrates license-specific questions were used to evaluate candidate knowledge) ‘CS Midterm Evaluation: “Demonstrates an ‘adequate knowledge of all content” (Observation Section) SP Midterm Evaluation: “Whitney is quite knowledgeable of the lessons that she teaches.” (Observation Section) Physical Education license-specific questions: 1. Demonstrates an adequate knowledge of the principles of health-related fitness and nutrition. ‘Mighty Milers Program is performed every week (Lesson Plan Section) Lesson #4 1/29/15: Closure section asked students what fitness component jump roping is. (Lesson Plan Section) 2. Uses knowledge of motor development (growth and evelopment) when developing and modifying lessons. ‘AllLP’s are written at a developmentally appropriate level for students. (Lesson Plan Section} CS Midterm Evaluation: “Provides students with a ‘number of options so all students can succeed.” {Observation Section) 3. Demonstrates an adequate knowledge ofthe history and foundations of physical ‘education/kinesiology (e.., exercise physiology, biomechanics, psycho-social aspects of play and spor, history of physical education) Lesson Plan #4 01/23+-1/29: Asked why students heart beat increases when jump roping (Lesson Plan Section) Lesson Plan #7: 03/03/15: States the skill cues Used for the body when rowing. (Lesson Plan Section) Lesson Plan #8: 03/04/15: tates the skill cues used forthe ifferent body parts when volleying | (Lesson Plan Section) 4, Demonstrates an adequate knowledge of ‘movement concepts, skill themes, and sports concepts. (C5 Midterm Evaluation: “Demonstrates a solid knowledge of all content, as is evidenced by ‘observations and journaling.” (Observation Section) CS Observation 03/05/15: “Knowledge of content is excellent.” (Observation Section) ‘5. Demonstrates an adequate knowledge of a range of ‘appropriate play and sports for PreK-12 and the relevant motor skills, Volleying Unit Outcomes posted for each grade level during unit. (Other Section) CS Midterm Evaluation: “Provides her students with a number of options so that most, if not all, of students can succeed.” (Observation Section) Candidate's Name Whitney Miller. 6. Demonstrates knowledge of appropriate physical ‘and safety limitations, legal standards, tort liability, first aid and Cardiac Pulmonary Resuscitation (CPR) when conducting a lesson. CPR Certified (Other Section) CS Observation 01/29/15: “Lesson was safe and appropriate forall learners.” Alllesson plans state safety rules and regulations (Lesson Plan Section) 7, Demonstrates an adequate knowledge of ‘adaptations for students with disabilities. ‘Adaptions on lesson plansin “Special Considerations” for students to be successful, (Lesson Pian Section) Lesson #8 03/04/15: Modifications made for student with disabilities. (Lesson Plan Section) 4. Refers to appropriate learning standards in the Comprehensive Health Curriculum Framework in developing a lesson. Journal #17: Reflects on the UMASS Extension Center coming in to talk to the students about ‘nutrition. lournal Section) Journal #12: Reflects on “My Plate” that was taught by UMASS Extension Center. (Journal Section} Employs a variety of reading and writing strategies for addressing learning objectives. Cognitive Pre-Test Assessment given to students before Rowing Unit (Assessment Section) Non-Manipulative Unit Plan Cognitive ‘Assessments. (Assessment Section) Uses questioning to stimulate thinking and encourages all students to respond. ‘SP Midterm Observation: “Poses thought provoking questions which require the students to think about their responses before answering.” (Observation Section) ‘SP Observation 03/02/15: “Good questions for rowing.” (Observation Section) Uses instructional technology appropriately. Lesson Plan #7 03/03/2015: Monitors on ergs ‘were used while performing rowing. (Lesson Plan Section) Lesson Plan #7 03/03/2015: Smart board was Used to show visuals and instructions (Lesson Plan Section) Uses effective strategies and techniques for making content accessible for English language learners. CS Observation 01/25/15: “Delivers effective instruction to all levels of learners.” (Observation Section) CS Observation 01/29/15: “Demos/Explanations of skills are excellent.” (Observation Section) — —_ Candidate's Name Whitney Mille. hh. Demonstrates knowledge of the difference between social and academic language and the importance of ‘this difference in planning, differentiating and delivering effective instruction for English language learners at various levels of English language proficiency and literacy. Lesson Plan #7 Rowing: Demonstrations used to Geliver effective instruction and student. =. understanding. (Lesson Plan Section) Journal #22: Reflects on an ELL student that was paired with a bi-lingual student to understand lesson. Journal Section) 3. Communicates high standards and expectations when extending and completing the lesson. 2. Assigns homework or practice that furthers student learning and checks it Post Test Rowing Assessment was a take home assignment (Assessment Section) ‘Students assigned homework to write down a healthy recipe snack that could easily be made, (Assessment Section) b. Provides regular and frequent feedback to students on their progress. ‘CS Midterm Evaluation: “Provides regular and positive feedback to as many student as possible and it should be noted that her feedback s not only positive, but, specific.” (Observation Section) SP Midterm Evaluation: “Whitney also provides reat, positive feedback to many students.” (Observation Section) 5 Evaluation 03/05/15: “Specific and positive feedback.” (Observation Section) Provides many and varied opportunities for students to achieve competence. Extensions in each lesson plan for students to be successful. (Lesson Plan Section) CS Observation 03/05/15: “All students fully ‘engaged, participating and challenged.” {Observation Section) 4. Communicates high standards and expectations when evaluating student learning. a. Accurately measures student achievement of, and progress toward, the learning objectives with a variety of formal and informal assessments, and uses results to plan further instruction. CS Observation 03/05/15: “Excellent closure in both classes. Covered skill cues taught as well as objectives.” (Observation Section) CS Observation 03/05/15: "Checked for understanding.” (Observation Section} Checking for understanding applied throughout | alllesson plans (Lesson Plan Section) 'b. Translates evaluations of student work into records ‘that accurately convey the level of student achievement to students, parents or guardians, and school personnel. Feedback given to students for Non-Manipulative assessments: “Nice work” (Assessment Section) Skils sheet used during Non-Manipulative to assess students psychomotor ability (Assessment Section} Candidate's Name Whitney Miller. Rating: Explanation of Rating for Standard B — Delivers Effective Instruction: Observations continue to provide evidence of this area as an area of strength. Clear and engaging as physical education teacher. Humor and enthusiasm make all lessons come alive. Provides regular, specific instruction to individual learners and clear extensions and modifications to luals and to the group as a whole. Highly skilled at asking questions that make students think and engaging them in both guided discovery reflection and Socratic dialogue. Student achievement measured through both formal and informal assessments (e.g. peer assessment, worksheets and quizzes). Tating Sales T=Does Not oe The Standard P=Micts the Standard SHExceeds the Standard; NAN ARBAB care (huey (Miler Program Supervisor (init Dae So 0. PE ‘Supervising Practitioner (initial): CL PM Seis Candidate's Name Whitney Miller Pre-service Performance Assessment for Practicum/Practicum Equivalent Professional Standards for Teachers: See 603 CMR 7.08 | Standard C - Manages Classroom Climate and Operation Indicators Evidence - (CS Midterm Evaluation: "Provides an 1. Creates and maintains a safe and collaborative learning | environment that is conductive to learning.” environment that values diversity and motivates students. | (Observation Section) to meet high standards of conduct, effort and performance. ‘SP Midterm Evaluation: "Strives to provide an ‘atmosphere that is conductive for learning,” (Observation Section) CS Midterm Evaluation: “The physical | ervironment works well with the activites that have been selected for the cas.” (Observation 2. Creates physical environment appropriate to arange of | Soran) | learning activities. S Observation 1/29/15: “All students fully engaged and participating.” (Observation Section) CS Midterm Evaluation: * Rules and routines have been clearly established and are posted.” (Observation Section) 3. Maintains appropriate standards of behavior, mutual respect, and safety. AILP’s have standards for the class (Lesson Plan Section) Lesson Plan #5 1/30/15: Affective objective: “show respect.” ‘SP Observation 01/21/15: “Good idea to stop lesson when students are not doing correct 4, Manages classroom routines and procedures without loss_| task.” (Observation Section) of significant instructional time. SP Observation 01/26/15: “Great redirecting ‘when someone says something that doesn’t | pertain to the lesson.” (Observation Section) Explanation of Rating for Standard C - Manages Classroom Climate and Operation: Very positive, sets high standards for learning and behavior and reinforces desired behaviors. Good attention to safety, respect for all. Lessons flow, loss of practice time mi id. Knows names of over 300 students, is very dynamic and engaging, motivates students in a variety of ‘ways. Overall provides an environment that is positive and conductive to learning for all. 10 Ee Canididate’s Name Whitney Miller. ating Sale Candidate's Name: Program Supervisor (initial): ial ‘Supervising Practitioner (initial): WYofes— Pre-service Performance Assessment for Practicum/Practicum Equivalent Professional Standards for Teachers: See 603 CMR 7.08 Standard D ~ Promotes Equity Indicators Evidence 1. Encourages all students to believe that effort isa key to, achievement. ‘CS Midterm Evaluation: “All students are encouraged to play hard, play fair and work as a team.” (Observation Section) 2. Works to promote achievement by all students without exception. ‘SP Midterm Evaluation: “Gives great individual attention to students who lack the skil ability ‘to complete a task.” (Observation Section) CS Midterm Evaluation: “Evidence that Whitney pays attention to all students and works hard to ‘meet the needs of everyone in her classes.” (Observation Section) ‘Assesses the significance of student differences in home ‘experiences, background knowledge, learning skills, learning pace, and proficiency in the English language for learning the curriculum at hand and uses professional judgment to determine if instructional adjustments are necessary. LP 6 02/23/15: Reflection: reflected on ELL student and how to make the class more accessible to him. (Lesson Pian Section) Journal #20 02/23/15: “Nice modifications for ELL student.” (Journal Section) n —— Candidate’s Name Whitney Mille. Lesson Plan #1: 01/30/15: Affective Domai 4. Helpsall students to understand American civic culture, | "..demonstrate working cooperatively and \ its underiying ideals, founding political principles and | show respect." (Lesson Plan Section) | political institutions, and to see themselves as members | of a local, tate, national, and international civic Benchmark Rules are posted and state the rules community and regulations of the classroom (Other ____| section) Alice Beal Newsletter is given to parents (Other 5. Collaborates with families, ecognizing the significance of | Section) native language and culture to create and implement strategies for supporting student learning and ‘SP Midterm Evaluation: “Whitney works with all development both at home and at school. | students and tres to adapt to all needs.” | (Observation Section) Rating: Explanation of Rating for Standard D- Promotes Equity: Has consulted with other professionals in the school including specialists and classroom teachers. Hard work and practice are values that are articulated and positively reinforced on a regular basis. Has consulted with individual pupil aides to ensure the greatest success by a range of learners with diverse styles, perspectives, experiences and needs, including students with special needs and English language learners. Good evidence that she provides for the needs of visual, auditory and kinesthetic learners. Candidate is a role model for American ci culture and its underlying ideals in her conduct at all times. She is effective in reinforcing these values as they are articulated in the PE environment — play safe, play fair, play hard, have fun, Tang cae Does NOt Wet Te Sanda ts he Sardar, the Standard WAIN Appeal, When Millar — | Program Supervisor (hi pater Qe Oe Candidate’s Name: | Supervising Practitioner (init Date: Sys s- Pre-service Performance Assessment for Practicum/Practicum Eq! Professional Standards for Teachers: See 603 CMR 7.08 Candidate's Narie Whitney Miller. Standard E - Meets Professional Responsil Indicators Evidence Understands his or her legal and moral responsi ‘SHAPE Standards, MA CF Physical Health ‘Standards, and safety considerations cited in all LP's (Lesson Plan Section) ‘SP Midterm Evaluation: “Very professional from her clean and appropriate attire to her exceptional work habits.” (Observation Section} Conveys knowledge of and enthusiasm for his/her academic discipline to students. CS Midterm Evaluation: “Enthusiasm for ‘teaching is clear and students know it.” (Observation Section) ‘SP Midterm Observation: "Her positive, upbeat, and polite manner clearly shows her enthusiasm for teaching.” (Observation Section) Maintains interest in current theory, research, and developments in the academic discipline and exercises judgment in accepting implications or findings as valid for application in classroom practice. C5 Observation 01/29/15: ” Uses all resources available to her.” (Observation Section) Uses a variety of resources in LP’s (Lesson Plan Section) SP Midterm Observation: “Able to take professional criticism and quickly turn it around, showing that she is clearly understands what is asked of her.” (Observation Section) Collaborates with colleagues to improve instruction, assessment, and student achievement. 'P Midterm Evaluation: “Works well with all staff members in the building.” (Observation Section) All Journal Entries (Journal Section) Journal #1 01/30/15: “Classes are well controlled thus the learning environment is suitable for all who want to pay attention and. learn.” (Journal Section) ‘Works actively to involve parents in thelr child’s ‘academic activities and performance, and communicates clearly with them, (03/03/15: Attended a parent/teacher conference (Other Section) (03/04/15: Wrote in agenda for parents to sign (Other Section) Journal Reflection #24: ‘Parental contact plus ‘the circumstances under which you met the parent or guardian.” (Journal Section) 3 Candidate’s Name Whitney Mille. ‘SP Midterm Evaluation: “She has a strong work ethic and is slways willingly steps into any task 6. Reflects critically upon his or her teaching experience, | 7's steng» (Observation Section) identifies areas for further professional development as, part of a professional development plan that is linked | to grade level, school, and district goals, and is receptive to suggestions for growth. Reflects upon lessons every day through all journal entries. ournal Section) All LP's have reflections and clearly state how to adjust each lesson. (Lesson Plan Section) LP's are cited with references from the internet, textbooks, and colleagues (Lesson Plan Section) 7. Understands legal and ethical issues as they apply to responsible and acceptable use of the Internet and other resources. CS Midterm Observation: “Professionalism is clearly a strength.” (Observation Section) Rating: Explanation of Rating for Standard E ~ Meets Professional Responsibilities: Very professional, punctual, works hard, inquisitive and caring. Her knowledge and enthusiasm are documented in lesson plans and in ‘observations. D ly collaborates with colleagues and uses resources to plan lessons and make adjustments. Refers to published work of noted professionals, engages in critical reflection and is open to input and feedback. She is growing in the understanding that teaching is both an art and a science that the best practitioners will never be fully satisfied. She shows every indication that she will always be striving to improve. Tang Scales T=Uoes Nok Meet the andar, taste andar, (ideaeey Miller Program Supervisor (intial): Date: ceeds the Sandor NASWOX APSHA. [ Candidate’s Name: License: ‘Supervising Practitioner (initial): Sere Date: Yoyys 4 an Candidate's Name Whitney Miller. Pre-service Performance Assessment for Practicum/Practicum Equivalent Professional Standards for Teachers: See 603 CMR 7.08 Summary Decision for Pre-service Performance Assessment To be completed and agreed upon by both the supervising practitioner and the program supervisor Teacher candidate's Pre-service Performance Assessment in the practicum/practicum equivalent meets the Professional Standards for Teachers: [| Yes [_]No Candidate (sign): | L f [= d Md LL iO . MEPID: or License #: Program Supervisor (sign): Ofte fe Date: eS - fet& ‘Supervising Practit ny: V Date: GE | BAZs— | Teaching Ability (“on eon Gdarn Grade_ 4 Final Practicum Grade (superising Practitioner & College Supervisor callaberate) (cludes all writen assigns CS determines nal rade] Standard Rating Standard A- Plans Curriculum and Instruction 3 Standard B- Delivers Effective Instruction 3 Standard C- Manages Classroom Climate and Operation 3 Standard D- Promotes Equity 3 Standard E- Meets Professional Responsibilities 3 Rating Scale: IsOoes Not Meet the Standard, 2sMeste the Standard, 3-Exceede the Standard; NACNot AppCaBe ‘Summary Assessment of Performance (include phrases that could be used in a letter of recommendation): Areas of strength: Students are a good judge of people and they quickly became very fond of Whitney. Whitney’s great, calm voice led students to trust her and her doting manner made each child feel very special. Whitney's ability to quickly think on her feet allowed her the option to expand her lessons to meet the need of her students, or to change it in mid activity, when she felt the students were struggling with a skill. That is a wonderful attribute to have as a teacher! Whitney's enthusiasm for teaching shines through in her professional mannerisms, punctuality and her attention to detail 15 Candidate's Name Whitney Miller Areas in need of improvement: Like any new teacher Whitney struggles a bit with classroom management. She does work hard to be firm with students so that they are safe and follow her directions. In time, classroom management will come to Whitney. It’s difficult for anyone to | come into a situation as an authoritative figure, not truly knowing the students, and commanding respect. 16 Pre-service Pi Profes: Candidate's Name Whitney Miller. erformance Assessment for Practicum/Practicum Equivalent nal Standards for Teachers: See 603 CMR 7.08 Standard (b)2c Demonstrates adequate knowledge of and approach to the academic content of lessons. Evidence Found v mw Physical Education (PreK-8)(5-12) Pvigencs Nol License-Specific Evaluation Questions Found Does the candidate demonstrate an adequate knowledge of the principles of health-related fitness and nutrition? oO Does the candidate use knowledge of motor development (growth and development) when developing and modifying lessons? Does the candidate demonstrate an adequate knowledge of the g history and foundations of physical education/kinesiology (e.., exercise physiology, biomechanics, psycho-social aspects of play and sport, history of physical education)? Does the candidate demonstrate an adequate knowledge of, w a g Ww movement concepts, skill themes, and sports concepts? Does the candidate demonstrate an adequate knowledge of a range of appropriate play and sports for PreK-12 and the relevant motor skis? Does the candidate demonstrate knowledge of appropriate physical and safety limitations, legal standards, tort lability, first aid and Cardiac Pulmonary Resuscitation (CPR) when conducting a lesson? o Does the candidate demonstrate an adequate knowledge of adaptations for students with disabilities? Does the candidate refer to appropriate learning standards in the Comprehensive Health Curriculum Framework in developing a lesson? nian Program Supervisor (ini Date: bidueed Willer vo AV 2 fos ‘Supervising Practitioner (init Date: REZ Lom v SS

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