Professional Documents
Culture Documents
Personal Quality Checklist
Personal Quality Checklist
I. Directions: Use the following scale to rate the students behavior in your class.
SOMETIMES 1 ALWAYS 3
_____1. Makes appropriate use of free time (e.g., performs homework & other assignments)
_____2. Remains on task for required length of time
_____3. Follows directions
_____4. Makes responsible decisions
_____5. Is organized
_____6. Is dependable
_____7. Demonstrates initiative in absence of directions
_____8. Demonstrates problem-solving skills
_____9. Pays attention
_____10. Responds appropriately to authority figures/is respectful
_____11. Demonstrates respect to peers
_____12. Follows rules
II. Directions: Please list strengths and weaknesses concerning the student in your class.
STRENGTHS: ________________________________________________________________________
________________________________________________________________________
WEAKNESSES: ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
III. Directions: Please list accommodations or modifications you feel were beneficial to this student in your class.
ACCOMMODATIONS: ________________________________________________________________________
(curriculum is NOT changed)
________________________________________________________________________
MODIFICATIONS: ________________________________________________________________________
(works on different curriculum)
________________________________________________________________________
IV. Utilize the space provided below to list other concerns you may have that were not addressed in sections I, II, and III.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
IEP Data
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Other: __________________________________________
__________________________________________
__________________________________________
__________________________________________
Personal Qualities Checklist
(Pamela Russell, December, 1999)
Name: _____________________________________________________ Date: ___________________
Directions: Rate the student based on his /her current level of competence for each behavior listed. A
score of one would be the lowest score and five would be the highest score.
BEHAVIORS 1 2 3 4 5
Poor Fair Average Good Excellent
1. Demonstrate self-advocacy skills.
A. Expressing feelings of self-worth
A. Personal relationships
B. Race
C. Ability/Interest
D. Language
E. Tolerance/acceptance
5. Develop awareness of independent behaviors.
A. Self-advocacy
B. Self-organization
B. Anticipate consequences
COMMENTS:
CIRCLE THE APPROPRIATE PERSON DOING THE RATING: (1) Parent (2) Student (3) Employer (4) Teacher
Directions: Use the following scale to rate the students work related behaviors, interpersonal relations, and social/community
expectations.
SOMETIMES 1 ALWAYS 3
Work Related
_____1. Makes appropriate use of free time (e.g., performs homework assignments, studies,
etc.)
_____2. Remains on task for required length of time
_____3. Follows directions
_____4. Makes responsible decisions
_____5. Is organized
_____6. Is dependable
_____7. Demonstrates initiative in absence of directions
_____8. Demonstrates problem-solving skills
_____9. Pays attention
_____10. Is persistent in seeking success (e.g., will stay on task)
_____11. Takes responsibility for his/her own actions
_____12. Learns from mistakes
_____13. Recognizes consequences of inappropriate behavior and responds appropriately
Interpersonal Relations
_____1. Responds appropriately to peers
_____2. Cares for personal appearance (e.g., grooming, clothing, etc.)
_____3. Demonstrates the ability to resolve conflict situations appropriately
_____4. Responds appropriately to authority figures
_____5. Adjusts easily to new situations (e.g., works with individuals he/she does not know,
adjusts to new surroundings, etc.)
_____6. Maintains consistent patterns of acceptable behavior and emotions
_____7. Is loyal to friends, family, and work associates
Social/Community Expectations
_____1. Is responsible for appropriate care of personal property
_____2. Follows rules
_____3. Obeys laws
_____4. Behaves appropriately in the absence of supervision
_____5. Demonstrates appropriate care and handling of others property
_____6. Is honest
_____7. Follows safety guidelines
_____8. Demonstrates ability to control temper