Sample Evidence Forms
Sample Evidence Forms
Sample Evidence Forms
Remember: 1) Notify the teacher you are visiting at least 72 hours prior to your visit. 2)
Your visit should last a minimum of 30 minutes. 3) Do not put the name of the teacher
visited anywhere on the form. 4) Remember to give feedback after the visit through
personal contact or memo. 5) Return form to your Discipline Chair.
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
Course____________________________
Date__________________
Topic covered________________________________________________
2. Activities:
6. Classroom set-up:
1. _______________________________
2. _______________________________
3. _______________________________
4. _______________________________
12. What was the best evidence of learning observed in this class?
Focus on Learning Peer Visit Form – Observation
Remember: 1) Notify the teacher you are visiting at last two days prior to your visit 2)
Your visit should be at least 30 minutes 3) Do not put the name of the teacher visited
anywhere on the form 4) Give feedback after the visit be personal contact or memo
F. What did you see or observe about student learning in this visit?
Peer Observation Form
“You can observe a lot by just watching”
Yogi Berra
Circle: First or Second Observation of Fall or Spring Semester Name of Person Observed_________________
Are CA State Standards posted for lesson? Yes No Are Student Outcomes posted for lesson? Yes No
Comments:______________________________________________________________________
Comments: ______________________________________________________________________
Identify the Student Outcomes exhibited by the students during the observation.
Description of Assignment:
So you plan to revise this assignment to help student mastery? If so, how?
What conclusions can you draw from this evidence of student work?
STUDENT OBSERVATION
ESLRs
PERSONAL RESPONSIBILITY
TECHNOLOGY
Note: This interview form is not a judgment of students or teachers; it is just an informational tool used
to determine what is actually being learned here at the school.
Date: _________________
Can something you learned from this activity/lesson be applied to your life or your other classes in the
future? If yes, explain:
Has this lesson/activity improved or reinforced your personal or academic skills? If yes, explain:
Did you have an opportunity today to get help, ask questions, or possibly redo an assignment for
improvement? If so, explain:
Could anything have been done differently to help you understand better through this lesson/activity?
Could you have done something differently, so more learning would take place? Explain.
Other comments?
Possible questions for student interview
6. name something you are very good at (or) name something you know
very well.
12. If you could change anything that goes on in your classroom what
would it be?
Focus on Learning – Evidence Collection Label
Briefly explain HOW the attached evidence relates to the Learner Outcome(s):
Researcher:_______________________________ Topic:______________________________
Briefly explain HOW the attached evidence relates to the Learner Outcome(s) (ESLRs) or other analysis:
Focus on Learning
Description of Evidence:
Nature of this assignment in the department (type of work, developmental levels, connection with
framework?)
Frequency – how often is this type of work being done; how often should it be done; it is being done
with all students (a-level, b-level, LEP, Chpt. 1, AVID, ESL, AP, RSP, migrant, etc.)?