CUYAHOGA COMMUNITY COLLEGE

HUMAN SERVICES PROGRAM

PRACTICUM EVALUATION

STUDENT: Briana Young SEMESTER: Spring Year: 2020

COURSE: HS # 2860 INSTRUCTOR: Joyce Jordan

PRACTICUM SITE: Ohio Guidestone

ADDRESS: 3500 Carnegie Ave

CITY/ZIP CODE: Cleveland 44115

PHONE NUMBER: 216-906-9575

SUPERVISOR NAME: Cynthia Holtzman

NUMBER OF TERMS THE STUDENT HAS BEEN IN, AT YOUR PRACTICUM

SITE: 4

PRACTICUM DATES: FROM: 01/13/20 – 05/04/20

STUDENT SPECIALIZATION: __X___GENERALIST _____CHEMICAL DEP.

DESCRIBE THE TYPE OF AGENCY: (e.g. group home, treatment center, mental
health center, etc.)____Mental
Health___________________________________________________

_______________________________________________________________________

FUNDING SOURCE: ___Private non-profit, _X__ Public non-profit, ___For profit

If the student is assigned to a specific program within the Agency, please identify the
name and address._______________________________________________________

________________________________________________________________________
 CLIENT CHARACTERISTICS

Indicate the age, gender and socio-cultural background of the clients served by the
student:

AGE: ___Pre-school ___ Pre-teen _X__ Adolescent ___ Adult ___ Seniors

GENDER: __X__ Male __X__Female

PROBLEM AREAS OF THE CLIENT POPULATION SERVED BY THE

STUDENT: (check all that apply)

_X___ Abuse ____ Income Maintenance

____ Aging __X__ Learning Problems
____ AIDS __X__ Legal Systems
____ Alcoholism ____ Marital Problems/divorce
_X__ Anti-social Behavior _X___ Mental Health
_X___ Chemical Dependency _X___ Parent/Child Problems
__X__ Child Protection ____ Physical Disability
_X___ Crisis Intervention __X__ Poverty
____ Domestic Violence ____ Other (Specify)
____ Developmental Challenges
____ Employment
_X__ Family Problems
____ Homelessness

SOCIO-CULTURAL BACKGROUND

Please identify the racial, ethnic and socio-economic background of the clients served by
the student: __Clients typically are inner-city or suburban youth who are living
below poverty level. Clients are enrolled in mental health services with Ohio
Guidestone. Goals include reducing mental health symptoms by gaining an
understanding of how mental health affects functioning, and developing coping
skills to manage symptoms and improve functioning. Some youth are receiving
psychotropic interventions.
____________________________________________________________

________________________________________________________________________

________________________________________________________________________

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 I. QUALITY OF PROFESSIONAL DEVELOPMENT

EVALUATION CRITERIA: Using the following criteria, please rate the student on
Professional Development. Using the same form, students will be evaluated at mid-
semester and the end of each semester. During the mid –semester evaluation, students
may score a 1 or 0 in an area. By the end of the semester, students must perform at a
rating of 2 or better to successfully complete the course.
_________________________________________________________________
Performance meets or exceeds the agency standards =3
Performance is satisfactory/average =2
Performance needs improvement =1
Performance is unsatisfactory (CCC Instructor has been notified) =0
________________________________________________________________
RATINGS

MID-SEMESTER END SEMESTER

A.) Organization and Planning: Organizes and manages time

efficiently; completes tasks within a specified time frame; provides
accurate information about work and services completed. ______3________ ______3______

B.) Decision Making: Recognizes problems/potential problems;

makes sound decisions under pressure; exercises good judgment,
demonstrates progress toward independence. _____3_________ ______3______

C.) Dependability: Follows through with assignments; arranges

personal schedule to avoid interfering with professional obligations;
prompt, meets professional commitment /obligations as agreed with others____3_______ _____3_____

D.) Initiative: Acts promptly; willing to take independent action;

Consistently attains goals; volunteers enthusiastically; self motivated _____3________ ______3_____

E.) Resourcefulness: Readily determines an alternative course of plan/

action in event of change; seeks additional learning experiences to improve
areas of knowledge; thinks outside the box. ______3_______ _____3_____

F.) Adaptability: Flexible; demonstrates a positive “attitude” to new

assignments, change, and adversity ______3_______ ______3_____

G.) Enthusiasm: Maintains a positive outlook; demonstrates

confidence; displays interest and curiosity ____3_____ ____3___

H.) Interpersonal Skills: Conducts self in a tactful, professional

and positive manner, accepts criticism; is cooperative and respectful
of clients and staff; is able to work as a team member ______3______ _____3_____

I.) Professional Values and Ethical Conduct: Adheres to

policies and procedures of the institution and practicum program; conducts
self with honesty, integrity, and fairness; accepts and respects supervision
and guidance; respects and maintains the confidentiality of clients and personnel __3_____ ___ 3______

J.) Verbal and Nonverbal Communication: Listens and follows

directions as given; actively participates in discussions and meetings;

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 demonstrates a positive attitude towards workload, preceptors, peers and clients___3_____ ____3______

K.) Written Communication: Written work is well organized, clear,

concise, professional and consistent with the documentation policies and
procedures of the agency ___2_____ 3________

L.) Professional Development: Knows and uses educational resources and

references appropriately; is aware of personal/professional strengths and
weaknesses; integrates classroom learning at practicum; utilizes supervision at
the practicum; completes self assessment and develops appropriate plans for
professional development ___3_____ _3_______

II. QUALITY OF PRACTICE/COMPETENCY SKILLS

Students are expected to develop skills in each of the competency areas, throughout
their 3 semesters of practicum. Please complete the following:

1.) Identify the competency skills the student has on their goal sheet for this
semester, by checking the space next to the skills.
2.) Provide a rating of performance (using the scale identified above) for each
competency skill, at mid-semester and the end of semester.
3.) Document comments on student performance for each competency skill,
addressing the extent that each goal was met, were there modifications
required, student’s strengths and areas of weakness.

Students may also continue to demonstrate additional competencies not identified on

their goal sheet, in the performance of their duties at the agency. Please evaluate students
on these competencies as well, by providing comments in the space provided.

Check here if chosen as # RATING:

a semester competency MIDSEMESTER END SEMESTER

1.) INTAKE: ________ ___________ _____________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

2.)ASSESSMENT: _______ ___________ _____________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

3.) SCREENING: ________ ___________ _____________

COMMENTS:___________________________________________________________
________________________________________________________________________

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________________________________________________________________________
________________________________________________________________________

4.) REFERRAL:________ ___________ _____________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
5. CRISIS INTERVENTION:____X____ ____________
______3______

COMMENTS:__Briana has participated in family mediation sessions and assisted

clients in de-escalation which resulted in them continuing to participate in session.
Briana assisted clients in the use of emotional regulation skills and positive
communication skills. Briana has learned to manage client’s in mental health crisis
and follow up with requirements.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________

6. CASE MANAGEMENT:___X____ _____________

_____3________

COMMENTS:__Briana currently provides case management services for 3 clients.

Briana communicates regularly with other service providers and adjusts
interventions to meet the identified needs of the
clients.__________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________

7. RECORD KEEPING:___X____ ____________

______3______

COMMENTS:__Briana has developed her professional language and writing case

notes according to agency standards. Briana has learned to use therapeutic language
in her written communication.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_________________________________________________________

8. COMMUNITY SUPPORT:___X____ ___________

_____3_______

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COMMENTS:__Briana has learned about community resources and linkages.
Briana has assisted clients with obtaining employment and job readiness skills.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_________________________________________________________

9. OUTREACH:__________ ____________ ___________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

10. CO-THERAPY_________ ____________ ____________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
11. GROUP FACILITATION:________ ___________ _________
( CO-FACILITATION)
COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

12. FACILITATION OF FAMILIES:_______ __________ ________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________

13. ADVOCACY:_______ __________ ________

COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

14. ORIENTATION, EDUCATION:________ __________ ________

PREVENTION
COMMENTS:___________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

15. BEHAVIOR CHANGER:________ __________ ________

COMMENTS:___________________________________________________________
________________________________________________________________________

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________________________________________________________________________
________________________________________________________________________

For the areas of practice that have a numeric rating, compute a mean score.( add
scores together and divide by the number of scores for mean rating)
RATING=__3__

Cynthia A. Holtzman, M.E.d., LPC

__04/27/2020___________________________________
____________________________
Supervisor Signature at Evaluation Student Signature at Midterm
/Date Evaluation /Date

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 END OF THE SEMESTER SUMMARY STATEMENT

STUDENT’S PROFESSIONAL ABILITIES:__Briana has developed professionally

during her time with Ohio Guidestone.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
___________________________________________________________

AREAS OF STRENGTH:
_Briana does a wonderful job with client engagement and building rapport with
clients.__________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_____

AREAS NEEDING IMPROVEMENT:

_
___None________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
____

ADDITIONAL AREAS NEEDED FOR STUDENT DEVELOPMENT:

_ Briana was involved with providing services for adolescents and working with families.
She can further develop as a professional with increased opportunities for younger and
older clients.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________

IF STUDENT IS GRADUATING, PLEASE COMMENT ON STUDENT’S

PREPAREDNESS FOR EMPLOYMENT AND SPECIFIC AREAS OF
EXPERTISE:__Briana has been an exemplary intern with Ohio Guidestone. We would
very much like to add her as an employee in the future. Briana has learned the skill set
necessary to provide top quality service to clients. Although Briana’s internship kept her
working with the adolescent population, Briana is bright and a quick learner. I have
confidence that she will be able to adapt her skill set to working with clients in other
populations.______________________________________________________________
________________________________________________________________________
________________________________________________________________________
___________________________________________________________________

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 I HAVE READ AND PARTICIPATED
IN THIS EVALUATION:

_Cynthia A. Holtzman, M.E.d., LPC____________________________________

_____04/27/2020___________________________
SIGNATURE OF SUPERVISOR/DATE

SIGNATURE OF STUDENT/DATE

________________________________________

________________________________________
SIGNATURE OF CCC INSTRUCTOR/DATE

Rev. ID 2001