Supervisor' comments

Good attendance

Comments

Punctual

Comments

Well presented

Comments

Shows interest

Comments

Works well as part of a team

Comments

Able to follow instructions

Comments

Works well under own initiative

Comments

Interacts well with client/children

Comments

Completes tasks required

Comments

Applies care value base

Comments

Respectful at all times

Comments

Able to deal with problems

Comments

Asks for help and advice

Comments

Accepts constructive criticism

Comments

Listens to others

Comments

Supervisor' comments

Strengths

Weaknesses

Observation details (If carried out)

Supervisor's signature

Student Experience

Interim report done

Health and safety checklist completed

Attendance record up to date

Ten key themes added to

Number of Witness Statements completed.

Comments from Student

Action Plan

Personal Development

College Paperwork to complete

Comments from work-placement coordinator

Authentication

Student
Work Placement Coordinator
Date of observation
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.