SOWK: Performance & Verification of Experience - SOWK Candidate

Millersville University
School of Social Work

Performance and Verification of Experience
School Social Worker Candidate

STUDENT INFORMATION

P ID#

Student Last Name

Student First Name

Academic Year

Beginning Date of Evaluation Period

End Date of Evaluation Period

Select Evaluation Timeframe

Mid-Evaluation (7.5 weeks)

Final Evaluation (15 weeks)

CERTIFICATION AREA:

Site Supervisor First Name

Site Supervisor Last Name

Placement School

Placement District

Instructions: Please rate the applicant by selecting the rating that corresponds to the learning objectives and characteristics.

1. Integrate and apply NASW school social work Standards, Code of Ethics, and ethical decision-making models in social work practice

2. Demonstrates professional conduct and demeanor

3. Demonstrate management skills

4. Integrate and apply social work modalities across client systems

5. Integrate and apply theories of human behavior and development to practice

6. Understanding of the needs of vulnerable and at-risk diverse pupil populations

7. Conduct a strength based clinical assessment focused on diagnoses, assessment, and treatment across diverse client systems

8. Utilize and apply interdisciplinary and multidisciplinary approaches

9. Understanding of federal and state laws including PA educational policies and local policies affecting services and students

10. Demonstrate proficiency working with diverse student learners

11. Demonstrate proficiency working with English Learners

12. Demonstrate system record keeping (documentation)

13. Communicate professionally (oral, written, and electronically)

14. Ability to adapt to situations

In the space provided below, please provide the following information. The spaces provided do not have a minimum/maximum word count.

Is this field placement?

Yes

Is this employment?

Yes

Description of agency or school setting.

Description of field placement or employment experience (if field placement, indicate semester/year and hours completed).

Hours earned

Description of the following:
1. Core assignments or job responsibilities

2. Specific pupil population served

3. Models of Social Work practice

4. Intervention modalities used

Overall assessment of the applicant.

Recommended Action:

As the candidate's site supervisor, I am recommending the selection noted below based on my assessment of their performance and verification of their relevant experience.

Satisfactory completion of placement

Unsatisfactory completion of placement

Date of Evaluation Meeting:

Required Signatures:

Site Supervisor’s Signature & Credentials:

Click to Sign...

Site Supervisor Email

I hereby affirm that the information in this document is correct and true to the best of my knowledge.

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SOWK: Performance & Verification of Experience - SOWK Candidate

Millersville University School of Social Work

Performance and Verification of Experience School Social Worker Candidate

Millersville University
School of Social Work

Performance and Verification of Experience
School Social Worker Candidate