Universrry of Norr CAROLINA PEMBROKE esw eon Cee a Peranes rain Sludsne) | Jeannette Feivey ‘Semester Fal 2078 Field Supanieor | Rachel Unas (SW) or Task Iinsiructor. SN Cock | 716 06-6357 Fie HOOT Sedat Ena | mnie onopods | | ruhas@aullemsociety- ncorg Field Practicum Schedule Wonday | Tossday | Wedhesday | Thursday | —Fiday | Salurday | Sunday ‘aft ‘Bam-ipm —[Sam-ipm — | Class@UNCP |Gam-spm — | Sam-épm | off ‘Supaniion Day and Time Instructions for Completion foniract and Performance Evaluation form serves 65 the guiding document Tor social work slodenis in the field. Students and Field id work together to develop this document and review it troughout the semoster. Students are responsible for scheduling time for this a Supervisor, Sudan are also responsible fr composing a draft, making revisions and submiting three times over the semester. ‘and cognitive & affective processes that ars Spores fore dpre the ers scking, Numbers on scare dort comesponé recy wih ae grade Evaluation Seale "T= Nol Competent wi naulfciont Progress = Not Competent w/ Suffclant Progress ‘F Emerging Competence - 4= Competent ‘5= Exceptional Competence ‘la= Not Observed Poge t ofUniversity of Norrii Canouina PEMBROKE Department of Social Work BSW Leaming Contract and Perfomance Evaluation Sludant “eannatie Fevey ‘Semester Fall 2018 Field Supervisor | Rachel Unas (GSW) orTask Instructor. ‘Student Contact | 216 926-6457 Practicum ‘Autism Society NC | Field Supervisor] 810-307-0 o ‘Number: Organization: | ‘Contact Number: ‘Student Email | jnf028@bravemai unop edu | Practicum "1047 Murchison RA Field Supervisor | ruhas@auismeodehy- ‘Organization | Fayottevile, NC 28301 | mai: neorg Physical Address: Z| Thursday | Friday | Saturday | Sunday Monday [Tuesday Tam-ipm_—Sam-pm ‘Supervision Day and Time: Instructions for Completion This Leaming Contract and Performance Evaluation form serves a ‘Supervisors should work together to develop this document and raviow process with ther Field Supervisor. Students ae also responsible for comy Definitions ‘Competencies: The Counc on Social Work Educaiion thei sock work eck knowledge, values, Evaluation Scale "F= Not Competent wi Ineuficient Progress 2 Not Competent wi Sufficient Progress ‘3 Emerging Compelance = Competent '5= Exceptional Competence ‘vas Not Observed Page t of‘Competency 1; Demonstrate Ethical and Professional Behavior [(Dimensions: Knowledge & Values) ‘Behaviors Related to This Competency Relevant Activities or Tasks ‘Mid-Term Eval Final Evat 1-1 Make ethical decisions by applying the laws and regulations, models for ethical decision- ‘making, ethical conduct of research, and addiional codes of ethics as appropriate to context. Waintain confidentially and professionalism. Ensure proper storage and destruction of unused cllent information. Apply Medicaid guidelines for dally services. i 1.2 Use refiecion and self-regulation to manage personal values and maintain professionalism in Practice situations Teeniify personal bias and work to overcome them. 7.3 Demonstrate professional demeanor in ‘behavior; appearance; and ora, written, and ‘electronic communication Tahara to dress coda. Maintain professionalism with chents and caregivers. 7-4 Use technology elhicaly and appropriately to ‘faciitate practice outcomes. ‘Use double encrypted computers for files and cient Information. 75 Use supervision and consultation to guide professional judgment and behavior. ‘Weekly meeting with fieid supervisor te assess behaviors and concems from previous week. Page 2 of 8