Fill - Free fillable 2016 17ASSIST Student Performance Review Instructional Packet Supervisors (Southern College) PDF form

2016-2017 ASSIST Student Performance Review Instructions

for Student Supervisors

How to Complete Your Portions

Please read before attempting to have your students and parents complete their performance

reviews:

There are four sections to the 2016-17 PFE Student Performance review—the student’s

section, the Program Administrator or Student Supervisor’s section, the Facility

Administrator’s and the Senior Mentor’s section. Please distribute the instructions for students

before they fill anything out. Once the student portion is submitted, they will receive a

confirmation email and you will receive a notification email. In your notification email, there will

be a link to access their portion of the review.

It will be helpful to have the questions for the Facility Administrator and Senior Mentor

sections ahead of time so that the Senior Mentor Liaison and Student Supervisor may conduct

interviews to obtain the answers before this review is completed. They are attached to the end

of these instructions.

For your knowledge, the link to the performance review is on the front page of our

website, www.southern.edu/assistpfe, and is in the “ASSIST – Academy Students” section above

the application and visitation reflection links (see snapshot below)—

STEP #1

1. When a student completes their portion of the performance review, you will receive an

email that looks like the picture below, with “[Student’s} 2016-17 PFE Student

Performance Review Has Been Submitted”.

2. Click on the link that says “Edit Submission”. You also have the option of downloading a

PDF of the student’s responses before you complete the rest of the review.

STEP #2

1. The student’s performance review will open. Switch the “Person currently

submitting/reviewing this form” to “Program Administrator/Student Supervisor”.

2. Review the student’s information, making sure all is correct; but be sure to leave the

student’s candid answers untouched.

3. Click “Next”.

STEP #3

1. You will be taken to a page that asks for a “Program Administrator Password”. Use the

same password that you use to approve visitation reflections. This should be formatted

as “assist*[schoolname]” to access the “Program Administrator or Student Supervisor

Feedback Section”. I entered in “assist*sau” to illustrate—you must enter in at least the

“assist*” portion to access the next sections.

2. The “Program Administrator or Student Supervisor Feedback Section” will come up. Fill

in your answers then click “Next”.

STEP #4

1. Next is the “Facility Administrator Feedback Section”. You will need to have conducted

an interview with or given your student’s facility administrator the questions to fill out

before this section can be completed online. Please fill in this person’s answers honestly

and candidly. You may always go back through the link you receive in your email to fill in

this person’s answers. The questions for this sections are attached.

2. When you are finished, click “Next”.

STEP #5

1. You will see the “Senior Mentor Feedback Section” next. You will need to fill in the

answers that the student’s senior mentor has given during their interview (questions are

attached). Please fill this section in honestly and candidly.

2. We have included two additional “Senior Mentor Feedback Sections” in case the

student has multiple senior mentors. If he/she has more than three, you are only

required to obtain answers from three individuals.

3. If you need to add a senior mentor’s answers, select “Yes” to the “Do you have another

senior mentor’s feedback to add?” question.

4. When you are finished, click “Next”.

STEP #6

1. The last page will ask you, “What is the status of this performance review?” We have

created the review in such a way that if you need to go back to enter in any information

in any section, particularly the Facility Administrator’s or Senior Mentor’s, then you may

select “Still in Progress”. If you have collected all of your information ahead of time and

have entered it all in, select “All Sections are Finished” to notify us of the review’s

completion.

2. After you have selected

the status, click

“Submit”. If you

submitted the review as

“Still in Progress”, be

sure to go back,

complete it, and submit

again as “All Sections

are Finished”.

3. On the Thank You page, you will have the option of going back into the review to edit or

download a PDF of your completed review. We suggest downloading PDFs when the

reviews are finished for the benefit of your program. These reviews are beneficial in

growing your program, making changes, and giving out praise/thanks where merited.

You are finished!

Facility Administrator Feedback Section

Questions for Interview

1. This student is engaged with his/her senior mentor(s) (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

2. This student and his/her senior mentor(s) interact and learn from each other (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

3. This student is aware of the needs of his/her senior mentor(s) (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

4. This student is an advocate for his/her senior mentor(s) (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

5. This student is respectful and considerate of staff members (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

6. This student engages in one-to-one activities with his/her senior mentor over group activities (choose

one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

7. Would you like to provide any additional comments? (short answer)

Senior Mentor Feedback Section

Questions for Interview

1. My student mentee is engaged with me when he/she is visiting (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

2. My student mentee takes initiative (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

3. My student mentee is thoughtful and considerate (choose one):

a. Always

b. Frequently

c. Sometimes

d. Seldom

e. Never

4. Would you say you have developed a personal relationship with your student?

a. Yes

b. No

5. What are some of the activities you and your student do together? (short answer)

6. What are some things your student does for you? (short answer)

7. What do you appreciate most about your student? (short answer)

8. Did a representative from the school visit you to explain the expectations of the visits? (short answer)

9. Would you like to discuss any areas your student could improve or additional comments? (short answer)

Person currently submitting/reviewing this form:

Student

Program Administrator/Student Supervisor

Student Name

First Name Last Name

Student ASSIST ID#

Student Email

Current Grade Level

EXAMPLE

THIS EXAMPLE IS NOT TO BE USED TO TURN IN, HARD COPY, TO

SOUTHERN'S PFE OFFICE. USE THE ONLINE FORM. THANK YOU.

❍

Grade 9

Grade 10

Grade 11

Grade 12

Number of Semesters Worked in ASSIST (including the current semester)

Academy Name

Academy ASSIST Email

In each of the settings listed below, indicate how many senior mentors you were partnered with:

1 2 3 4 5 6+

Nursing Home

Individual Residence

Assisted Living Facility

Retirement Community

Other

Please answer each of the below questions, indicating either Strongly Agree, Agree, Unsure, Disagree, or

Strongly Agree:

Strongly

Agree

Agree Unsure Disagree Strongly

Disagree

I am aware senior citizens in my community are in need of company.

I know what is expected of me when I am working with my senior mentors.

The online reflection profess is easy to understand.

I typically receive approved or denied feedback within two days of submitting my

reflections.

My senior mentor(s) and I enjoy each other's company.

My senior mentor(s) and I learn from each other.

I am making a positive impact with the senior mentor(s) I am partnered with.

I am meeting a need in the community.

Without this job I would most likely not be able to attend my school or academy.

The mission or purpose of the ASSIST Program makes me feel my job is

important.

EXAMPLE

Andrews Academy, MI

Atlanta Adventist

Academy, GA

Bass Memorial

Academy, MS

Battle Creek Academy,

Blue Mountain

Academy, PA

Campion Academy, CO

Collegedale Academy,

Columbia Adventist

Academy, WA

Fletcher Academy, NC

Gem State Adventist

Academy, ID

Georgia-Cumberland

Academy, GA

Great Lakes Adventist

Academy, MI

Greater Atlanta

Adventist Academy, GA

Greater Miami

Adventist Academy, FL

Greeneville Academy,

Gurnee Christian

School, IL

Higher Ground Mission

School, NM

Highland Academy, TN

Highland Adventist

School, WV

Highland View

Academy, MD

Hinsdale Adventist

Academy, IL

Indiana Academy, IN

Jefferson Christian

Academy, TX

Madison Academy, TN

Maplewood Academy,

Midland Adventist

Academy, KS

Mile High Academy, CO

Milo Adventist

Academy, WA

Mount Ellis Academy,

Mount Pisgah Academy,

Ozark Adventist

Academy, AR

Pine Forge Academy,

Pine Tree Academy, ME

Portland Adventist

Academy, OR

Puget Sound Adventist

Academy, WA

Richmond Academy, VA

Rio Lindo Adventist

Academy, CA

Riverview Memorial

School, ME

Rogue Valley Adventist

Academy, OR

Savannah Adventist

Christian School, GA

Shenandoah Valley

Academy, VA

Skagit Adventist

Academy, WA

Spring Valley Academy,

Takoma Academy, MD

Upper Columbia

Academy, WA

Vienna Adventist

Academy, VA

Vine Haven Adventist

School, NJ

TEST ACADEMY (do

not choose)

❍

What have you learned from visiting with your senior mentor?

What is one (or more) area in which you could improve on regarding your work in the ASSIST Program?

Do you think you would be interested in a career working in the senior care industry? Examples: Working

as a nurse, activities director, nursing home/assisted living manager, or other job in which seniors live.

Yes

Is there anything you would like to say to the people who fund the ASSIST Program?

Do you have any suggestions, experiences, or thoughts you would like to let us know about?

EXAMPLE

❍

Program Administrator Password

Please answer the following questions as truthfully and accurately as possible:

Always Frequently Sometimes Seldom Never N/A

This student shows up for work on time.

This student takes initiative and is engaged with their senior mentor.

This student represents the school well.

This student is committed to interacting and learning from their senior

mentor.

This student demonstrates a genuine care for his/her senior mentor.

This student submits their visitation reflections on-time.

Please include any other feedback or information, including any praises or concerns pertaining to this

student's work in ASSIST:

EXAMPLE

Submit

❍

Please answer the following questions as truthfully and accurately as possible:

Always

Frequently Sometimes Seldom Never

This students is engaged with the senior mentor(s).

This student and his/her senior mentor(s) interact and learn from each other.

This student is aware of the needs of his/her senior mentor(s).

This student is an advocate for his/her senior mentor(s).

This student is respectful and considerate of staff members.

This student engages in one-to-one activities with his/her senior mentor over group

activities.

Would you like to provide any additional comments?

Please answer the following questions as truthfully and accurately as possible:

Always Frequently Sometimes Seldom Never

My student mentee is engaged with me when he/she is visiting.

My students mentee takes initiative.

My student mentee is thougtful and considerate.

Would you say you have developed a personal relationship with your student?

Yes

EXAMPLE

❍

What are some of the activities you and your student do together?

What are some things your student does for you?

What do you appreciate most about your student?

Did a representative from the school visit you to explain the expectations of the visit?

Yes

Would you like to discuss any areas your student could improve or additional comments?

Do you have another senior mentor's feedback to add?

Yes

Please answer the following questions as truthfully and accurately as possible:

AlwaysFrequentlySometimesSeldomNeverMy student mentee is engaged with me when he/she is visiting.My students mentee takes initiative.My student mentee is thougtful and considerate.

Would you say you have developed a personal relationship with your student?

YesNo

What are some of the activities you and your student do together?What are some things your student does for you?What do you appreciate most about your student?Did a representative from the school visit you to explain the expectations of the visit?

YesNo

Would you like to discuss any areas your student could improve or additional comments?Do you have another senior mentor's feedback to add?

YesNo

Please answer the following questions as truthfully and accurately as possible:

AlwaysFrequentlySometimesSeldomNeverMy student mentee is engaged with me when he/she is visiting.My students mentee takes initiative.My student mentee is thougtful and considerate.

Would you say you have developed a personal relationship with your student?

YesNo

Would you like to discuss any areas your student could improve or additional comments?

What is the status of this performance review?

Still in Progress

All Sections are Finished

EXAMPLE

❍

EXAMPLE

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