75 PDE 430 Form Student/Candidate’s Information: First Name: Last Name: Beginning Date of Evaluation Period: End Date of Evaluation Period: Academic Year: Semester:� Grade Level(s) & Subject(s) Taught: Certification Area� Student Teaching Location(s) (Including district and building): Evaluator’s Information:� Last Name: First Name: �ecommending Institution�Educator Pre�aration Program (EPP):� This forms serves as the (select one):� Interim Evaluation� This confidential evaluation serves as a permanent record of a candidate’s professional performance evaluation during a defined timeframe, based on specific criteria, prior to being considered for Pennsylvania certification. The criteria are based upon the PDE Educator Effectiveness Observation & Practice: Framework for Evaluation and aim to measure a pre-service candidate prior to certification. Please visit the Pennsylvania Department of Education website to obtain the most up-to-date versions of documents related to educator effectiveness. Instructions for the Evaluator: Final Evaluation 1. Examine all sources of evidence and input furnished by the Candidate, Evaluator, and Cooperating Teacher. 2. Based on the aforementioned sources, refer to Framework for Evaluation: Pre- �ervi�e �ea��er�to assess each domain (commencing on page 2). Consider the Components of Practice outlined for each domain. 3. Once the domains have been scored, the Overall Evaluation section �i�� dis��a� the� �ina� ratin� score� ��ease veri�� �or acc�rac��� 4. �rovide a concise ��sti�cation �or the overa�� ratin� in the area �rovided�� 5. Complete the Recommended Actions section, retaining evidence to support your recommendations. 6. Discuss the completed evaluation with the Candidate. 7. Sign the evaluation as the Evaluator and obtain the Candidate’s signature. 1
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