COUNSELORAN-TRAINING CHECKLIST SITE SUPERVISOR EVALUATION Student's Name: Erin Sonnessa Date: December 6" 2016 (CHECKLIST COMPLETED BY SITE SUPERVISOR: Name of On-site Supervisor: Chadwick Cox ‘Agency or School Name: Blacksburg High School Period Covered: From: August 15 2016 To: December 15 2016 Final Evaluation This evaluation is intended to help the student, agency, and university assess the student's progress in the development of the knowledge, values, and skills necessary for the practice of counseling. ‘The evaluation guide presented here is a tool to assist in that process, Feel free to include additional areas or criteria, which you believe, are important. Core Requirements ‘The student has successfully demonstrated: (Please inital) yes No {A total of 300 hours of work on-site this semester (FINAL ONLY) Beat ‘total of 120 DIRECT hours with students/clients (FINAL ONLY) = __X__ Skills with individual counseling Skills with at least two long-term client contacts Skill with group counseling - At least one group with a ees minimum of four members fora series of sessions. Skills in consultation x. Skills in testing/assessment Skills in making referrals, Skills in training and development x. ign Polyecnicstve and Ste Unrest ‘on Sie Supers’ Evaluten f Coursing har 2003ra UNIVERSITY On-Site Supervisor Eval Counselor Education Program School of Educati VIRGINIA POLYTECHNIC INSTITUTE AND STATE luation of Counseling Intern Intem’s Name: Erin Sonnessa Date 12/06/2016 Name of On-Site Chadwick Cox Supervisor. “Ageney or School Name Blacksburg High School Dates Evaluation Covers From, August 15, 2016 To: December 15, 2016 This evaluation is intended to help the intern, on-site supervisor, and university supervisor assess the intem’s progress in the development of the knowledge, values, and skills necessary for the practice of counseling. The evaluation quide presented here is a tool to assist in that process. Please complete this form to the best of your ability, share it with the intem, sign and date the form, and forward the completed signed form to the university supervisor. Feel free to include additional areas or criteria that you believe are important. contact the university supervisor If @ conference to discuss this evaluation is needed, please Thank you for your time in completing the evaluation ofthe intem’s performance. Directions: Indicate competency by placing a check mark in the appropriate column, Rating Scale: ‘Atea needing improvement ‘Adequate 3= Area of strength NA = Not applicable; no opportunity to observe 11.213 [NA Personal and Professional Competencies 1._| Punctuality x 2._| Attendance x 3.__| Ability to follow through and complete tasks x 4._| Ability to meet deadlines x 5._| Responsibility for actions, x 6. | Commitment to the helping profession. x 7.__| Initiative and wilingness to become involved x 8._| Adherence to professional and ethical practices x ‘9, _ | Professional judgment x Use of Supervision 10._| initiative in seeking help from supervisor x 11._| Openness to new ideas x 12. | Receptivity to feedback x ise of Resot 13._| Skill in accessing and using resources within the internship communi x 14._ | Knowledge of community programs/resources, x 15,_| Awareness of client requested resources: x 16._| Skill in using a variety of resources, x 17__| Skill in making referals x ‘Sell-Organization Skill 18._| Ability to organize and carry out a work pian x Virgina Posetnichstuie and Sate Unersty Cn Sie Super’ Evalaten of Courslnglien 2018,78._| Abily to keep appropriate documentation x 20._| Professional discipline in use of time x 21.__| Iiliatve for involving self in learning activities x 22._| Completion of assigned tasks x Counseling Skills and Knowledge 23. | Establishing of rapport with student/cient x 24,_| Goal setting with client/student Xx 25._| Use of effective and appropriate counseling strategies and techniques x 26._| Assessment of client's/student's progress x 27._| Effective termination with studenticlient x 28._| Effective group counseling skills x 29._| Accurate assessment of client students needs, x '30._| Knowledge of counseling theory and research x '31.__| Knowledge of developmental theories x 32._| Appropriate application of multicultural perspective x '33.__| Effective classroom guidance andlor psycho-eduoational skills x ‘Communication Skis 34._| Writing skills x 35._| Oral skills x 36. | Ability to effectively collaborate with other professionals x all Evaluation 37. | Overall evaluation of inter x Comments 38, In your opinion, what are this intern’s areas of strength? Initiative and willingness to help out with all aspects of the position as it pertains to the high school environment. Has a very strong level of intuition and does not hesitate to act on it. ‘She is patient in a new environment and very hard working, 39, What areas do you believe the intern should focus on to enhance his/her competence as a professional counselor? Continue to leam more about the field of counseling enhance skills. Also work on specialization skills and local agencies for referrals and outreach options. Keeping working towards certification ideas in specializations; work towards these skills and ‘expand them. 40. Has the administrative support from the university supervisor been adequate? If no, please indicate suggestions. Yes and we have had no issues or problems. Additional Comments: Erin has been a great intem with our group and | hope she will have a chance to work in our school system, Signatures: On-site Date: t/ b A | Supervisor Chad Cox Che — l v (signature) Intern Erin Sonnessa in \ anneson_ | Date: | 12 -e- 201y nature) University Dr. Jonathan Ricks Date: Supervisor Vigna Polenichstuie and Sate Unersty (on Sie Superior Evaluator of Coursing nen 2013