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  5. Goal Tracking: Neolani Marshall 1/27/2016
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Dear Teachers:

Please fill out this Goal/Behavioral Tracking Survey on Neolani Marshall for 1/27/16.

Please remember you are evaluating her on today's behaviors. This should only take you approximately 5-10 minutes. If you are in a co-taught class, I only need one survey per class.

I created a box to comment on any behaviors (positive or negative) from the last two weeks that need to be addressed.

Your participation in this survey is valuable to track behavioral trends. This data can be used to head off possible behavioral problems along with providing the opportunity to reward good behavior.

Thank you

Mrs. DuRant
 
 
Please rate the student listed above in the following areas for 1/27/2016. 1 being the lowest and 5 being the highest.
* Prepared for Class
* On Task Behavior
* Appropriate Behavior
* Peer Relationships
* Adult Relationships
* Participation
* Responded to authority figure appropriately and respectfully
* Student appeared happy
 
 
 
Please explain how the student did or did not respond to authority figure in an appropriate and respectful manner AND if you have noticed the student appeared angry or depressed today?
   
 
 
 
* How often did Neolani start an assignment without asking for help right away.
 
Not observed
 
1 out of 5 times
 
2 out of 5 times
 
3 out of 5 times
 
4 out of 5 times
 
5 out of 5 times
 
 
 
* When Neolani became frustrated, how many times did she remove herself for a cool down period. (Pick the best answer. If there were only 3 times observed and she did all three please pick 5 because it equals 100%)
 
Not needed
 
1 out of 5 times
 
2 out of 5 times
 
3 out of 5 times
 
4 out of 5 times
 
5 out of 5 times
 
 
 
After one prompt, how many prompts did Neolani need to refocus her attention to the task at hand.
   
 
 
 
Any other positive or negative comments about the student in behavior TODAY? (Please indicate if you have seen out of character behavior.)
   
 
 
 
Any other positive or negative comments about the student in behavior in the last TWO WEEKS? (Please indicate if you have seen out of character behavior.)
   
 
 
 
Do you wish to speak to me in person?
Yes
No
 
 
 
Name, Class, Period
   
 
Thank you for filling out this survey!