SOP 107.07-att-4: Problem Solving Skills in Action (PSSIA) Facilitator Competency Evaluation Form

SOP 107.07
Attachment 4

5/2/22
Page 1 of 2
# The Georgia Department of Corrections Office of Reentry Services Problem Solving Skills in Action (PSSIA) Facilitator Competency Evaluation Form

|Site:|Col2|Evaluation Date:|Col4|Col5|Col6|Col7|
|---|---|---|---|---|---|---|
|Facilitator:|Facilitator:|Initial Enrollment:|Initial Enrollment:|Initial Enrollment:|Initial Enrollment:|Initial Enrollment:|
|Date group started:|Date group started:|Current Enrollment:|Current Enrollment:|Current Enrollment:|Current Enrollment:|Current Enrollment:|
|Class Time:|Class Time:|Attendance:|Attendance:|Attendance:|Attendance:|Attendance:|
|Session:|Session:|Gender:|Gender:|Gender:|Gender:|Gender:|
|Evaluator:|Evaluator:|Evaluator:|Evaluator:|Evaluator:|Evaluator:|Evaluator:|
| SCORE: ___ /100| SCORE: ___ /100| SCORE: ___ /100| SCORE: ___ /100| SCORE: ___ /100| SCORE: ___ /100| SCORE: ___ /100|
|A |Class Control / Preparation|Class Control / Preparation|Yes|No|NA|Pts|
|1|Did the facilitator keep the class on task and redirect the group as needed?|Did the facilitator keep the class on task and redirect the group as needed?||||3|
|2|Did the facilitator have rules and sanctions regarding missing group meetings, tardiness and classroom
behavior?|Did the facilitator have rules and sanctions regarding missing group meetings, tardiness and classroom
behavior?||||3|
|3|Is the classroom set up in a circular formation?|Is the classroom set up in a circular formation?||||3|
|4|Did the facilitator have ability to deal with difficult participants (e.g. hostile, angry, disrespectful, non-
participating members in a professional manner)?|Did the facilitator have ability to deal with difficult participants (e.g. hostile, angry, disrespectful, non-
participating members in a professional manner)?||||3|
|5|Were group rules written and posted in the room?|Were group rules written and posted in the room?||||3|
|6|Did the facilitator always model pro-social behavior?|Did the facilitator always model pro-social behavior?||||3|
|7|Did the facilitator greet the offenders as they entered the room?|Did the facilitator greet the offenders as they entered the room?||||3|
|8|Did class start and end on time?|Did class start and end on time?||||5|
| SUBTOTAL: /26 | SUBTOTAL: /26 | SUBTOTAL: /26 | SUBTOTAL: /26 | SUBTOTAL: /26 | SUBTOTAL: /26 ||
|Comments:|Comments:|Comments:|Comments:|Comments:|Comments:||

|B|Facilitator/Group Process|Yes|No|NA|Pts|
|---|---|---|---|---|---|
|9|Did the facilitator review key points from the previous lesson?||||3|
|10|Did all of the participants have assigned homework?||||4|
|11|Did the facilitator adhere to the lesson plan for the day?||||4|
|12|Did the facilitator model the skill step correctly to the class prior to allowing them to role play skill step?||||3|
|13|Did each of the participants model the new skill as the main actor?||||3|
|14|Were the participants corrected if they did not model the skill correctly?||||3|
|15|Did the facilitator use clear examples, illustrations, explained definitions relative to the offender’s
experiences?||||3|
|SUBTOTAL: /23|SUBTOTAL: /23|SUBTOTAL: /23|SUBTOTAL: /23|SUBTOTAL: /23||
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|C|Delivery and Response to Participant's Use of Skills|Yes|No|NA|Pts|
|---|---|---|---|---|---|
|16|Did the facilitator ensure that the group understood the skill/concepts being taught?||||3|
|17|Was the facilitator able to motivate participants to learn and practice new skill?||||3|
|18|Did the participants have group discussions?||||4|

Retention Schedule: Upon completion, this competency evaluation form should be kept on file, for review by Office of Reentry
Services, for one (1) year.

SOP 107.07
Attachment 4

5/2/22
Page 2 of 2

|19|Did the facilitator allow participants to work in their workbooks when needed during lesson?|Col3|Col4|Col5|4|
|---|---|---|---|---|---|
|20|Did all the participants have a workbook to work on?||||3|
|21|Did the facilitator keep the participant safe from ridicule from other participants?||||3|
|22|Did the facilitator answer participant questions?||||3|
|23|Did the facilitator use positive reinforcement?||||3|
|24|Did the facilitator engage all participants in discussion of workbooks?||||4|
|SUBTOTAL: /30|SUBTOTAL: /30|SUBTOTAL: /30|SUBTOTAL: /30|SUBTOTAL: /30||
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|D|Paperwork Review|Yes|No|NA|Pts|
|---|---|---|---|---|---|
|24|Did the facilitator use the correct supplements/handouts for modeling and classroom assignments?||||4|
|25|Does the facilitator have a copy of the Breakfast Club Movie?||||4|
|26|Is the facilitator correctly using the Class Sign in Sheet?||||2|
|27|Were participants given a pre-test prior to the beginning of class and a post test at the termination of class?||||2|
|28|Are the Pre- and Post-tests are being scored onsite and entered into SCRIBE?||||2|
|29|Are participant feedback forms being utilized when the participant is terminated from class?||||2|
|30|Are Program Data forms correctly completed and submitted timely for entry into SCRIBE?||||2|
|31|Did all participants have an assessed need for DETOUR?||||3|
|SUBTOTAL: /21|SUBTOTAL: /21|SUBTOTAL: /21|SUBTOTAL: /21|SUBTOTAL: /21||
|Overall Score: ___/100 |Overall Score: ___/100 |Overall Score: ___/100 |Overall Score: ___/100 |Overall Score: ___/100 |
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Retention Schedule: Upon completion, this competency evaluation form should be kept on file, for review by Office of Reentry
Services, for one (1) year.