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APPENDIX 5: FIELD SUPERVISOR REPORT

KENYATTA UNIVERSITY
DEPARTMENT OF POPULATION, REPRODUCTIVE HEALTH AND COMMUNITY
RESOURCE MANAGEMENT
SUPERVISING ATTACHMENT OFFICER
ASSESSMENT FORM
PERFORMANCE EVALUATION OF STUDENTS ON ATTACHMENT
(STRICTLY TO BE FILLED BY ATTACHMENT FIELD SUPERVISOR-IN-CHARGE)

STUDENT’SNAME___________________________________________________________

EVALUATION PERIOD ______________________________________________________

ORGANIZATION ___________________________________________________________

Please rate the student’s performance by ticking in the appropriate box.


S.No Unsatisfactory Needs Satisfactory Above Superior
1 improvement 3 average 5
2 4
Quality of work
1. Accuracy
2. Neatness
3. Work organization
Quantity of work
4. Amount of work performed
5. Completion of work ontime
6. Consistency of work
produced
Following directions
7. Compliance with work
instructions
8. Observance of rules and
regulations
9. Use/care of resources and
equipment
10. Report writing skills
Leadership
11. Use of initiative
12. Decision making skills
13. Teamwork skills
14. Adapting to new
situations/emergencies
Attendance
15. Punctuality
16. Regularity of attendance
Interpersonal relations
17. Getting along with others
18. Meeting and handling of the
public
19. Personal appearance –
appropriate dressing and
cleanliness
20. Communication & advocacy
skills
General Comments about the student
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
How do you compare this student with students (from other institutions) you have worked with
on previous attachments?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Are there any recommendations that you would make regarding our program that may be
beneficial for the preparation of future students for practicum?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Do you recommend that we continue sending more students to your organization?


_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
NAME OFSUPERVISOR __________________________________________________
DESIGNATION ____________________________________________________________
SIGNATURE & STAMP _______________________________________________________________
DATE ______________________________________________________________________

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