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Allen County Schools Instructional Specialist - Post-Observation Conference Form

Instructional Specialist
School
Grade Level(s)
Evaluator
Date of Conference

Evaluator’s Formative Observation Rating: Other professionals may request the evaluator provide
examples of evidence used to support the rating

Domain 2: The Environment	Rating	Domain 3: Delivery of Service	Rating
A: Creating an Environment of / Trust and Respect		A: Collaborating with Teachers in the Design of Instructional Units
B. Establishing a Culture for Ongoing Instructional Improvement		B. Engaging Teachers in Learning New Instructional Skills
C. Establishing Clear Procedures for Teachers to Gain Access to the Instructional Support		C: Sharing Expertise with Staff
D: Establishing and Maintaining Norms of Behavior for Professional Interactions		D: Locating Resources for Teachers to Support Instructional Improvement
E. Organizing Physical Space for Workshops or Training		E: Demonstrating Flexibility and Responsiveness

I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA

I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA
I	D	A	E	NA

Domain 1: Planning and Preparation	Comments / Ratings:

Domain 4: Professional Responsibilities	Comments / Ratings:

_____________________________________ _____________________ _____________________________________ _____________________
Instructional Specialist’s Signature Date Evaluator’s Signature Date
*Denotes sharing of results, not necessarily agreement with the formative rating. The instructional specialists may submit a response in writing to all ratings by the evaluator.

Opportunities for an appeal are part of the Allen County School District evaluation plan
A copy of the completed form must be provided to the instructional specialist