Teen Name: Ohio 4-H Work-Based Learning Performance Appraisal TEEN SELF-ASSESSMENT
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1 (To be added by county) Due Date: ID# Teen Name: Ohio 4-H Work-Based Learning Performance Appraisal TEEN SELF-ASSESSMENT The following statements describe skills or competencies of teens in a work-based learning program. For Teens: Please complete the two columns labeled Teen by reading each sentence and circling the number that best explains your skills before and after participating in the camp counselor program. Write comments that apply to these skills in the Comments space provided. Remember that your participation as a camp counselor includes everything from the application and interview, training and planning, and actually being a counselor at camp. We estimate it will take you approximately 20 minutes to complete this assessment. Your responses will be added together with those of other participants in order to evaluate the success of this program in achieving its goals. However, the responses you share will be between you and your supervisor. Your responses will be kept private, and no one else will know how you responded. Please return by the due date above. Your 4-H professional will schedule a time to meet with you to discuss your performance. Response Scale 1 = I need to significantly improve this skill. 2 = I need to show some improvement in this skill. 3 = I demonstrate basic understanding of this skill. 4 = I sometimes excel at this skill. 5 = I consistently excel at this skill. N = This skill is not applicable to my experience. Teen Back before I participated in this program Teen Now after I have participated in this program 1. I make good decisions. 2. I think through difficulties and solve problems. 3. I am creative. 4. I express thoughts clearly to others. 5. I am comfortable speaking in front of a group. 6. I am a good listener. 7. I am a good writer.
2 8. I work well with others to achieve a goal or complete a project. 9. I work well with others to resolve disagreements in a way that is fair and respectful. 10. I lead others to achieve a goal. 11. I can organize people around an idea, problem, or cause. 12. I encourage and support others. 13. I take the initiative for getting things done. 14. I set goals and work hard to meet them. 15. I ask for help when needed. 16. I have the motivation to complete work or project tasks without needing reminders. 17. I manage time well. 18. I have good work habits (being punctual, honest, and responsible). 19. I have a positive attitude about work. 20. I dress appropriately for the job. 21. I work well with people from diverse backgrounds (different ages, races, genders, religions, cultures, lifestyles, and viewpoints). 22. I meet scheduled deadlines. 23. I offer suggestions for improvements for the program. 24. I am respectful of others. -continued on next page-
3 If necessary, please use additional space to answer the following questions. 25. The most important thing(s) I gained being in this program is 26. What did you like best about the program? 27. What did you like least? 28. Is there anything that you feel should be changed about the program?
4 Teen Name: ID# Ohio 4-H Work-Based Learning Performance Appraisal SUPERVISOR ASSESSMENT The following statements describe skills or competencies of teens in a work-based learning program. For Supervisors: Please circle the number that best matches your thoughts about the skills of this teen at two different points in time: at the beginning of the program and after participating in the program. Use the Comments section to provide specific details about strengths and growth areas as appropriate. Remember that participation as a camp counselor includes everything from the application and interview, training and planning, and actually being a counselor at camp. After you have completed your evaluation, please schedule a time to meet with each teen. The teen should bring the Teen Self-Assessment portion of the evaluation on the same items. Make a copy of this assessment for your records. Provide a copy of the Supervisor Assessment to the teen, review the form and how you rated him or her on each item, and discuss specific areas of strength or growth and any major discrepancies between your ratings. You, or someone from your program, will enter the data into an electronic survey at a later date to meet program evaluation reporting requirements. We estimate it will take approximately 20 minutes for you to complete this assessment. Your assessment is to share between you and the teen, otherwise the assessment will be confidential. Response Scale 1 = The teen needs to significantly improve this skill. 2 = The teen needs to show some improvement in this skill. 3 = The teen demonstrates basic understanding of this skill. 4 = The teen sometimes excels at this skill. 5 = The teen consistently excels at this skill. N = This skill was not observed in this experience. Supervisor When this participant began the program Supervisor Now after the participant has completed the program 1. Makes good decisions. 2. Thinks through difficulties and solves problems. 3. Is creative. 4. Expresses thoughts clearly to others. 5. Is comfortable speaking in front of a group. 6. Is a good listener. 7. Is a good writer.
5 8. Works well with others to achieve a goal or complete a project. 9. Works well with others to resolve disagreements in a way that is fair and respectful. 10. Leads others to achieve a goal. 11. Can organize people around an idea, problem, or cause. 12. Encourages and supports others. 13. Takes the initiative for getting things done. 14. Sets goals and works hard to meet them. 15. Asks for help when needed. 16. Has motivation to complete work or project tasks without needing reminders. 17. Manages time well. 18. Has good work habits (being punctual, honest, and responsible). 19. Has a positive attitude about work. 20. Dresses appropriately for the job. 21. Works well with people from diverse backgrounds (different ages, races, genders, religions, cultures, lifestyles, and viewpoints). 22. Meets scheduled deadlines. 23. Offers suggestions for improvements for the program. 24. Is respectful of others.
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