Initial Report Last Modified:

07/27/2021

1. Intern's Full Name

Text Response

Taylor Mair

Statistic Value

Total Responses 1

2. Intern's Email Address

Text Response

taylor_mair@msn.com

Statistic Value

Total Responses 1

3. Internship Supervisor's Full Name

Text Response

Lauren “Eljay” Johnson

Statistic Value

Total Responses 1
 4. Internship Supervisor's Email Address

Text Response

ljohnson@slco.org

Statistic Value

Total Responses 1

5. Agency

Text Response

Salt lake county parks and Recreation

Statistic Value

Total Responses 1
 6. Part One: Performance Criteria Professional Relationships and Responsibilities

1 - Does Not Meet 2- Needs improvement in 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations meeting expectations expectations expectations expectations introduced Responses

1. Establish/maintain effective working

1 0 0 0 1 0 0 1 4.00
relationships

2. Create/maintain a safe and therapeutic

2 0 0 0 0 1 0 1 5.00
environment
3 3. Maintain CTRS/required state credential(s) 0 0 0 0 1 0 1 5.00

4. Participate in in-service training/staff

4 0 0 0 1 0 0 1 4.00
development
5. Maintain knowledge of current TR/RT
5 0 0 0 1 0 0 1 4.00
trends

6. Enhance professional
6 0 0 0 0 1 0 1 5.00
competence/additional credentials

7 7. Enhance professional competence 0 0 0 0 1 0 1 5.00

8. Support the development of evidence-

8 0 0 0 0 1 0 1 5.00
based practices

9. Adhere to professional standards of

9 0 0 0 0 1 0 1 5.00
practice and code of ethics

10. Participate in quality improvement

10 0 0 0 1 0 0 1 4.00
process

11. Participate in agency/professional

11 0 0 0 0 1 0 1 5.00
committees

2. 9. Adhere to
1. 3. Maintain 4. Participate in 5. Maintain 6. Enhance 8. Support the 10. Participate
Create/maintain a 7. Enhance professional 11. Participate in
Establish/maintain CTRS/required in-service knowledge of professional development of in quality
Statistic safe and professional standards of agency/professional
effective working state training/staff current TR/RT competence/additional evidence-based improvement
therapeutic competence practice and code of committees
relationships credential(s) development trends credentials practices process
environment ethics

Min Value 4 5 5 4 4 5 5 5 5 4 5
Max Value 4 5 5 4 4 5 5 5 5 4 5

Mean 4.00 5.00 5.00 4.00 4.00 5.00 5.00 5.00 5.00 4.00 5.00
Variance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Deviation

Total
1 1 1 1 1 1 1 1 1 1 1
Responses
 7. Part One: Performance Criteria Assessment

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

1 12. Request/secure referrals/orders 0 0 0 0 0 0 0 0.00

13. Obtain/review pertinent

2 0 0 0 0 0 0 0 0.00
information
14. Select/develop assessment
3 0 0 0 0 0 0 0 0.00
methods/setting

15. Establish therapeutic

4 0 0 0 0 0 0 0 0.00
relationship
5 16. Conduct assessments 0 0 0 0 0 0 0 0.00

6 17. Analyze/interpret results 0 0 0 0 0 0 0 0.00

18. Integrate/record/disseminate
7 0 0 0 0 0 0 0 0.00
results

18.
12. Request/secure 13. Obtain/review pertinent 14. Select/develop assessment 15. Establish therapeutic 16. Conduct 17. Analyze/interpret
Statistic Integrate/record/disseminate
referrals/orders information methods/setting relationship assessments results
results

Min Value - - - - - - -

Max Value - - - - - - -

Mean 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Standard
0.00 0.00 0.00 0.00 0.00 0.00 0.00
Deviation

Total
0 0 0 0 0 0 0
Responses
 8. Part One: Performance Criteria Plan Interventions and/or Programs

1 - Does Not Meet 2- Needs improvement in 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations meeting expectations expectations expectations expectations introduced Responses

1 19. Discuss results of assessment 0 0 0 0 0 0 0 0.00

2 20. Develop/document intervention plan 0 0 0 0 0 0 0 0.00

21. Develop/select
3 0 0 0 0 0 0 0 0.00
interventions/approaches

4 22. Develop/select protocols 0 0 0 0 0 0 0 0.00

5 23. Utilize activity/task analysis 0 0 0 0 0 0 0 0.00
24. Select
6 adaptations/modifications/assistive 0 0 0 0 0 0 0 0.00
technology

19. Discuss results of 20. Develop/document 21. Develop/select 22. Develop/select 23. Utilize activity/task 24. Select adaptations/modifications/assistive
Statistic
assessment intervention plan interventions/approaches protocols analysis technology

Min Value - - - - - -

Max Value - - - - - -
Mean 0.00 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00
Deviation
Total
0 0 0 0 0 0
Responses
 9. Part One: Performance Criteria Implement Interventions and/or Programs

1 - Does Not Meet 2- Needs improvement in 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations meeting expectations expectations expectations expectations introduced Responses

25. Explain the purpose/outcomes of the

1 0 0 0 0 0 0 0 0.00
intervention/program

2 26. Implement individual/group sessions(s) 0 0 0 0 0 0 0 0.00

27. Use leadership/facilitation/adaption
3 0 0 0 0 0 0 0 0.00
techniques

4 28. Monitor/address safety 0 0 0 0 0 0 0 0.00

29. Observe for response to
5 0 0 0 0 0 0 0 0.00
intervention/program

30. Monitor effectiveness of

6 0 0 0 0 0 0 0 0.00
intervention/program

27. Use 28.

25. Explain the purpose/outcomes of the 26. Implement individual/group 29. Observe for response to 30. Monitor effectiveness of
Statistic leadership/facilitation/adaption Monitor/address
intervention/program sessions(s) intervention/program intervention/program
techniques safety

Min Value - - - - - -

Max Value - - - - - -

Mean 0.00 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00
Deviation
Total
0 0 0 0 0 0
Responses
 10. Part One: Performance Criteria Evaluate Outcomes of the Interventions/Programs

1 - Does Not Meet 2- Needs improvement in 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations meeting expectations expectations expectations expectations introduced Responses

1 31. Evaluate changes in functioning 0 0 0 0 0 0 0 0.00

32. Determine effectiveness of individual

2 0 0 0 0 0 0 0 0.00
intervention plan
3 33. Revise individualized intervention plan 0 0 0 0 0 0 0 0.00

34. Evaluate for

4 0 0 0 0 0 0 0 0.00
additional/alternative/discharge of services
35. Determine effectiveness of
5 0 0 0 0 0 0 0 0.00
protocols/programs

31. Evaluate changes in 32. Determine effectiveness of individual 33. Revise individualized 34. Evaluate for additional/alternative/discharge 35. Determine effectiveness of
Statistic
functioning intervention plan intervention plan of services protocols/programs

Min Value - - - - -

Max Value - - - - -

Mean 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00
Deviation

Total
0 0 0 0 0
Responses

11. Part One: Performance Criteria Document Intervention Services

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

36. Document participation/adherence

1 0 0 0 0 0 0 0 0.00
to intervention

2 37. Document behavioral observations 0 0 0 0 0 0 0 0.00

38. Document occurrences related to
3 0 0 0 0 0 0 0 0.00
risk management
4 39. Document protocols/modalities 0 0 0 0 0 0 0 0.00
5 40. Document program effectiveness 0 0 0 0 0 0 0 0.00

36. Document participation/adherence to 37. Document behavioral 38. Document occurrences related to risk 39. Document 40. Document program
Statistic
intervention observations management protocols/modalities effectiveness

Min Value - - - - -

Max Value - - - - -
Mean 0.00 0.00 0.00 0.00 0.00
Variance 0.00 0.00 0.00 0.00 0.00
Standard
0.00 0.00 0.00 0.00 0.00
Deviation
Total Responses 0 0 0 0 0
 12. Part One: Performance Criteria Treatment Teams and/or Service Providers

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

41. Identify the treatment

1 0 0 0 0 0 0 0 0.00
team/community partners

42. Provide information to

2 0 0 0 0 0 0 0 0.00
team/community partners
3 43. Communicate information 0 0 0 0 0 0 0 0.00

44. Coordinate/integrate intervention

4 0 0 0 0 0 0 0 0.00
plan
45. Develop/provide collaborative
5 0 0 0 0 0 0 0 0.00
services

41. Identify the treatment team/community 42. Provide information to team/community 43. Communicate 44. Coordinate/integrate intervention 45. Develop/provide collaborative
Statistic
partners partners information plan services

Min Value - - - - -

Max Value - - - - -

Mean 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00
Deviation
Total Responses 0 0 0 0 0
 13. Part One: Performance Criteria Develop and Maintain Programs

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

46. Maintain equipment/supply

1 0 0 0 0 0 0 0 0.00
inventory

47. Plan/coordinate support

2 0 0 0 0 0 0 0 0.00
services
48. Maintain program
3 0 0 0 0 0 0 0 0.00
budget/expense records

4 49. Develop/distribute schedules 0 0 0 0 0 0 0 0.00

5 50. Identify funding sources 0 0 0 0 0 0 0 0.00

13 51. Conduct needs assessment 0 0 0 0 0 0 0 0.00

52. Conduct ongoing program

14 0 0 0 0 0 0 0 0.00
evaluation

53. Follow risk management

15 0 0 0 0 0 0 0 0.00
practices

46. Maintain
47. Plan/coordinate 48. Maintain program 49. Develop/distribute 50. Identify 51. Conduct needs 52. Conduct ongoing 53. Follow risk
Statistic equipment/supply
support services budget/expense records schedules funding sources assessment program evaluation management practices
inventory

Min Value - - - - - - - -
Max Value - - - - - - - -

Mean 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Deviation

Total
0 0 0 0 0 0 0 0
Responses
 14. Part One: Performance Criteria Managing TR/RT Services

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

1 54. Comply with standards/regulations 0 0 0 0 0 0 0 0.00

2 55. Prepare/update written plan of operation 0 0 0 0 0 0 0 0.00

56. Confirm programs are consistent with agency

3 0 0 0 0 0 0 0 0.00
mission

4 57. Recruit/train/educate/supervise/evaluate staff 0 0 0 0 0 0 0 0.00

5 58. Provide staff development/mentorship 0 0 0 0 0 0 0 0.00

13 59. Develop/implement/maintain internship program 0 0 0 0 0 0 0 0.00

60. Prepare/implement/evaluate/monitor annual
14 0 0 0 0 0 0 0 0.00
budget
15 61. Support research programs/projects 0 0 0 0 0 0 0 0.00
16 62. Develop/conduct quality improvement plan 0 0 0 0 0 0 0 0.00
17 63. Write summary reports of TR/RT services 0 0 0 0 0 0 0 0.00

18 64. Identify/obtain/manage supplemental funding 0 0 0 0 0 0 0 0.00

56.
Confirm
62. 63. Write
55. programs
57. 59. 60. 61. Support Develop/conduct summary 64.
54. Comply with Prepare/update are 58. Provide staff
Statistic Recruit/train/educate/supervise/evaluate Develop/implement/maintain Prepare/implement/evaluate/monitor research quality reports Identify/obtain/manage
standards/regulations written plan of consistent development/mentorship
staff internship program annual budget programs/projects improvement of TR/RT supplemental funding
operation with
plan services
agency
mission

Min Value - - - - - - - - - - -
Max Value - - - - - - - - - - -
Mean 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Variance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Deviation
Total
0 0 0 0 0 0 0 0 0 0 0
Responses

15. Part One: Performance Criteria Awareness and Advocacy

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds N/A - Job task has not be Total
# Question Mean
Expectations expectations expectations expectations expectations introduced Responses

65. Establish/maintain network with

1 0 0 0 0 0 0 0 0.00
organizations/advocates
2 66. Advocate for rights of person(s) served 0 0 0 0 0 0 0 0.00
67. Provide education to the internal/external
3 0 0 0 0 0 0 0 0.00
stakeholders
4 68. Promote marketing/public relations 0 0 0 0 0 0 0 0.00
5 69.. Monitor legislative/regulatory changes 0 0 0 0 0 0 0 0.00

Statistic 65. Establish/maintain network with organizations/advocates 66. Advocate for rights of person(s) served 67. Provide education to the internal/external stakeholders 68. Promote marketing/public relations 69.. Monitor legislative/regulatory changes

Min Value - - - - -

Max Value - - - - -
Mean 0.00 0.00 0.00 0.00 0.00
Variance 0.00 0.00 0.00 0.00 0.00
Standard Deviation 0.00 0.00 0.00 0.00 0.00
Total Responses 0 0 0 0 0
 16. Part Two: Personal and Developmental Criteria The Therapeutic Recreation Intern Demonstrates:

1 - Does Not Meet 2- Needs improvement in meeting 3 - Meets 4 - Frequently exceeds 5 - Consistently exceeds
# Question N/A - Job task h
Expectations expectations expectations expectations expectations

1 1. Positive Attitude 0 0 0 0 0

2 2. Enthusiasm 0 0 0 0 0
3 3. Self-confidence 0 0 0 0 0
4 4. Empathy 0 0 0 0 0

5 5. Flexibility 0 0 0 0 0
19 6. Willingness to learn 0 0 0 0 0
20 7. Judgment 0 0 0 0 0
21 8. Initiative 0 0 0 0 0

22 9. Respect and courtesy 0 0 0 0 0

23 10. Cooperation 0 0 0 0 0

24 11. Ability to evaluate personal strengths and weakness 0 0 0 0 0

25 12. Ability to accept constructive criticism 0 0 0 0 0

26 13. Professional dress according to setting 0 0 0 0 0

27 14. Work habits (timeliness, completeness, consistent quality of work 0 0 0 0 0

28 15. Planning and organizational skills (time management, management of space and materials) 0 0 0 0 0

29 16. Interpersonal relationships (with supervisor, staff, customers) 0 0 0 0 0

30 17. Effective verbal communication skills (assertiveness, clarity, organization) 0 0 0 0 0

31 18. Effective written communication (skills grammar, spelling, legibility) 0 0 0 0 0

33 19. Uses available computer 0 0 0 0 0

35 20. Use of medical terminology and abbreviations 0 0 0 0 0

36 21. Maintenance of professional boundaries (personal space, relationships, language) 0 0 0 0 0

37 22. Ability to seek direct and indirect supervision 0 0 0 0 0

38 23. Ability to accept direct and indirect supervision 0 0 0 0 0

15. Planning
11. Ability 14. Work 16. 17. Effective 18. Effective
and
to 13. habits Interpersonal verbal written 20. Use o
9. 12. Ability organizational
1. 6. evaluate Professional (timeliness, relationships communication communication 19. Uses medical
2. 3. Self- 4. 5. 7. 8. Respect 10. to accept skills (time
Statistic Positive Willingness personal dress completeness, (with skills (skills available terminolog
Enthusiasm confidence Empathy Flexibility Judgment Initiative and Cooperation constructive management,
Attitude to learn strengths according to consistent supervisor, (assertiveness, grammar, computer and
courtesy criticism management
and setting quality of staff, clarity, spelling, abbreviatio
of space and
weakness work customers) organization) legibility)
materials)

Min Value - - - - - - - - - - - - - - - - - - - -
Max Value - - - - - - - - - - - - - - - - - - - -

Mean 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Variance 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Standard
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Deviation
Total
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Responses

17. Part Three: Supervisor Comments1. In what areas does the intern excel?

Text Response

Statistic Value

Total Responses 0

18. 2. In what areas does the intern need further development?

Text Response

Statistic Value
Statistic Value

Total Responses 0
 19. Please identify any questions or concerns that need to be addressed by the academic supervisor.

Text Response

Statistic Value

Total Responses 0

20. Indicating projected completion status on the Mid-Term Evaluation Please indicate if the student is on target for successful completion or if there are
notable concerns. This will allow the academic supervisor to provide the necessary support for the student and internship supervisor as needed. It is better
to address these concerns early so that the student can set goals to aim for successful completion by the end of the internship. Please select one of the
following: Successful Completion: The student passes the internship experience, has met all requirements from the agency in addition to
gaining exposure to all items on the NCTRC Task Analysis. Incomplete: The student has not successfully met the agency's requirements for a successful
internship. The university supervisor will meet with the agency supervisor, to outline with the student the specific tasks on the NCTRC Job Analysis that the
student needs additional experience and training to achieve “Successful Completion” for the internship. Together an individualized plan for the student will
be developed that includes specific outcomes and additional hours required. The student will receive a “T” for a grade in the course, which indicates the
internship is still in progress. Unsatisfactory: The student has not met the agency requirements for a successful internship. If an agency supervisor
records an “Unsatisfactory” on the student’s Final Agency Evaluation of Student-TRIE the agency supervisor is stating the student is not able to meet the
required competencies of the agency's internship. The agency has met with the student throughout the internship documenting concerns regarding the
student’s abilities and performance, the university supervisor was notified of concerns, and the student and university supervisor have discussed the
performance issues. When given an unsatisfactory the agency supervisor is stating the internship experience is over and the student has not met the stated
guidelines of the agency's internship thus receiving an “Unsatisfactory”. Additionally, the agency supervisor cannot verify that the student meets the
minimum competencies as outlined on the student evaluation, which references the NCTRC Job Analysis. If a student receives an “Unsatisfactory” the
student will not be able to receive a higher than C- grade and will need to repeat RECTH 5828 Recreational Therapy Internship. The university supervisor
and the student will meet to discuss the student’s options.

# Answer Bar Response %

1 Successful Completion 1 100%

2 Incomplete 0 0%

3 Unsatisfactory 0 0%

Total 1

Statistic Value

Min Value 1
Max Value 1

Mean 1.00
Variance 0.00

Standard Deviation 0.00

Total Responses 1
 21. Please provide any additional information that you would like to include regarding this evaluation.

Text Response

We are grateful for Taylor’s positive presence on the team and her drive to always do and be better! This drive will prove for full success at the end of her internship, as she works on and meets these goals :) I’m excited to support her in the process!!

Statistic Value

Total Responses 1