Formative 1_x___

Formative 2__x. _
Formative 3_____
Summative _____

CANDIDATE NAME: Dain Leytem COHORT: Urban Purple 2017 DATE: 12/4/17

Candidate Instructions:
1. Make a COPY of this document​ and ​RENAME​! ​Example: JIM JOHNSON FORMATIVE ASSESSMENT.
2. Share w/your Mentor and Field Supervisor via Google using YOUR uni.edu account.

Mentor Instructions:
1. Complete assessment of Candidate’s knowledge and experience in each of the following 35 ISSL criteria. If the student has not had the
opportunity to demonstrate knowledge or experience in a particular skill area, please check (None) in the appropriate circle.
2. Invite Candidate and Field Supervisor to a meeting at which time this assessment is discussed. ​Meeting may be virtual!

Student, Mentor, Field Supervisor Instructions:

1. Check and date at bottom of this Assessment when discussion is complete.
2. Candidate downloads as Word document and ​immediately​ uploads to Student Management System.
Evaluation Scale:
HD (high degree) SD (some degree) LD (low degree) None

HD SD LD None
Standard 1: Visionary Leadership
The student has demonstrated knowledge or understanding of:
A. Uses Data for Establishment of Achievement Goals X ○ ○ ○
Worked with AP to compute Parent/Teacher Conference attendance data (1Hr.)
AP Task Force
B. Uses best practice in Program Improvement ○ X ○ ○
Dan Butler discussion (survey data) 1 hour
STUCO election turnout and inclusion (2 hours)
C. Articulates/Promotes high Expectations for teaching/learning ○ ○ X ○
Seeking input from student leaders about announcements (1Hr.)
D. Aligns educational programs w/ District Vision and Goals X ○ ○ ○
Assist in organizing Freshman Orientation to facilitate engagement with clubs/sports/TAG (3 Hr.)
E. Provides leadership for Major Initiatives & Change Efforts X ○ ○ ○
Organizing Homecoming activities and school-wide blood drive. (10 Hr.)
F. Communicates effectively w/Various Stakeholders on progress X ○ ○ ○
Communicates details and logistics of Homecoming/Blood Drive with staff, parents, district and community (5 Hr.)

Standard 2: Instructional Leadership

The student has demonstrated knowledge or understanding of:
A. Provides leadership for Assessing/Developing/Improving Climate/Culture X ○ ○ ○
Homecoming/Teacher Appreciation/Ram Fam Week/Covers of Comfort/Blood Drive? (8 Hr.)
B. Systematically/Fairly Recognizing/Celebrating Staff/St. Accomplishment ○ ○ X ○
Working with SS Dept. to create Student of the Month criteria
C. Encourages design of more effective learning experiences for students X ○ ○ ○
Talented and Gifted Program Study (4 Hr.)
D. Monitors/Evaluates Effective Curriculum/Instruction/Assessment ○ ○ X ○
Created a classroom visit log (1 Hr.)
E. Evaluates Staff and Provides ongoing coaching for improvement ○ X ○ ○
Meets weekly with new teacher to provide instructional coaching and guidance
F. Ensures professional development that enhances teaching/learning X ○ ○ ○
AP Breakfast/AP Task Force
G. Uses research/theory to develop/revise professional growth plan X ○ ○ ○
ITPDP / TAG Study (8 Hr.)
 H. Promotes collaboration with all stakeholders ○ X ○ ○
Calendar Meeting (Cook and Lawler) 2 Hours
I. Accessible and approachable to all stakeholders X ○ ○ ○
Chaperone Homecoming Dance (4 Hr.)
J. Visible and engaged in the community X ○ ○ ○
Organize Blood Drive/Covers of Comfort/Presentation of school statue (10 Hr.)
Soccer Game Supervision (3 hours)
K. Articulates and reinforces desired school culture, showing evidence X ○ ○ ○
Homecoming Week that encompassed schools core values (8 Hr.)

Standard 3: Organizational Leadership

The student has demonstrated knowledge or understanding of:
A. Complies with state and federal mandates and local board policies ○ X ○ ○
Share Table correspondence with Americorps, cafe staff and school board policies (2 hours)
B. Recruiting, selection, induction, and retention of staff for quality instruction X ○ ○ V
Interview Committees (Registar, School Counselor, Student Needs Facilitator) 16 hours
C. Addresses current and potential issues in a timely manner X ○ ○ ○
Weekly STUCO Meeting (5 Hr.) Created a Task Tracker (1Hr.)
Lawler Basketball Meeting
Administration Meeting in regards to Dance Protocol - Snowcoming (1hr) *5A
D. Effectively/efficiently manages fiscal and physical resources X ○ ○ ○
Student Council Budget / Prom budget
E. Protects instructional time X ○ ○ ○
Created Homecoming schedule
8 Period Schedule Meeting in AUD (1 hour)
F. Uses effective communication w/internal & external audiences about
school operations X ○ ○ ○
Student ​Council communications (letter home, Remind, staff emails) (1 Hr.)
Lawler Basketball Meeting

HD SD LD None
Standard 4: Collaborative Leadership
The student has demonstrated knowledge or understanding of:
A. Engages families and community and promotes shared
responsibility for student learning and education ○ X ○ ○
Community Conversation in STUCO about dancing/8th period day + AUD meeting (2 hrs.)
B. Promotes/supports structure for family/community involvement ○ X ○ ○
XC Service Trip - Mines of Spain (8 hr.s)
Parent Advisory Meeting
C. Facilitates connections of students/families to health/social services
that support focus on learning X ○ ○ ○
Project KIDS (5 Hr.)
D. Collaboratively establishes culture that welcomes & honors families and
community and seeks ways to engage them in student learning X ○ ○ ○
Student Council Induction Ceremony (3 hours)

Standard 5: Ethical Leadership

The student has knowledge or understanding of the need to act with integrity, fairness and in an ethical manner as related to:
A. Demonstrates ethical and professional behavior ○ X ○ ○
Administration Meeting in regards to Dance Protocol - Snowcoming (1hr) *3C
Frisk Student (1 Hour)
B. Demonstrates values, beliefs, and attitudes that will inspire others to
higher levels of performance X ○ ○ ○
TAG Advisor Group
Caleb Student Council
AP Task Force (10 hrs.)
C. Fosters and maintains caring, professional relationships with staff ○ X ○ ○
Created an Excel Tracker to keep a tally on corresponce with staff members
D. Demonstrates appreciation for and sensitivity to diversity in
the school community ○ X ○ ○
Worked with AP to create plan for a special needs student to be enrolled in extracurricular activity (Caleb) (1 Hr.)
Met with Dr. Johnson to discuss equity and relationship building (3/15/18) 2 hours
E. Demonstrates respect for divergent opinions ○ X ○ ○
Department Meetings
AP Access Force / Student Council

Standard 6: Political Leadership

The student has knowledge and understanding of:
A. Collaborates with service providers/decision-makers to improve
teaching and learning ○ X ○ ○
Discussion with School Board Rep about community engagement - Sachi (1Hr.)
B. Advocates for the welfare of all members of the learning community ○ X ○ ○
Letter to representative about school funding (2 hrs.)
C. Designs and implements appropriate strategies to reach desired goals X ○ ○ ○
AP Task Force data collection and discussions (3 hours)
Dan Butler discussions (2 hours)

UNI Educational Leadership Contextual Framework

To what degree this semester has the student engaged in leadership experiences allowing him/her to function as a:
Leader of Learning ○ X ○ ○
Leader of Service X ○ ○ ○
Leader of Change X ○ ○ ○

Mentor Summary
What leadership experiences were especially successful for the student this semester?
AP Access Task Force was tremendously successful.

What leadership experiences fell below your expectations for the student this semester?
None.

What has been the main focus or topic of reflections and conversations with the student this semester?
Leading change, importance of building and maintaining relationships, developing other leaders.

Overall Evaluation:
Please rate the overall quality of your student’s clinical internship​ ​performance​ ​for this semester using a scale of 1-10 (low to high)
9 (AP Access Task Force was a very successful leadership opportunity)

What are your recommendations for improvement?

One thing I would like to see as we move forward is having Dain as a developing leader be more intentional about sharing ideas on change and
how to implement change. Engage more in those discussions to help develop concepts. The CTE Access Task Force and Business Access Task
Force are all upcoming opportunities.

Student Summary:
How many Field-Based Clinical Internship hours did you complete this semester? _146___
How many reflections have you uploaded into the Student Management System this semester? __20___
Verification:
Please check and date signifying you have participated in a discussion of this Assessment instrument

___DjL_______Student _6/8/18_________Date
__DJ________Mentor ______6/8/18____Date
____JmV_Field Supervisor ___6/18/18____Date