dividual Evaluation Mariana Hall OCCT 526A at University Medical Center of Southern Nevada OCCT 526A - Fall 2013 (1/13/2014 to 2/7/2014) | (01/13/2014 - 02/07/2014) Evaluation Type: Educator Evaluation of Level I Fieldwork - Student Evaluator: Aesa Jackson 001.0 Fieldwork Educator: ‘Aesa Jackeon OTRIL 002.0 Type of Fieldwork: (Specialty/Practice Area) [111 maven Acute [1112 matent Rena 1115 SNF) sub-Acuto Acut Long-Term Gare 1114 General Rehab Outpatient (115 outpatient Hands [x] 16 Pediatric Hospitalunt (1117 Pacitnic Hospital Oupatant [D1 tmPationt Psych [E121 Pedate Communty [2] 22 Banaveral Heath Community [512 Oto Adult Community Ling (E24 oie Adult Day Program (1125 Outpatientiand privet action [51.26 Aduit Day Program or 00 (2127 Home Heath (B20 eaane Oupatent cine (2131 eat intervention (32 scroot Totter (soe boi) 004.0 Organization xpanizaton Consider ability to set priate, be dependable, be organized, fellow through with responsibilities NA Excoeds Standards Moots Standards Below Standards Well Below Standards rT a 004.0 Engagement in the Fieldwork Experience NA Excouds Standards Moos Standards Below Standards Woll Bolaw Standards Cs ja) 004.0 Sel-Directed Learning SeitDrected Learning Consider tty to take responsibilty for own leaming; demonstrate motivation; aware of ow strengths and areas for improvement NA Exceeds Standards Meets Standards Below Standards Well Below Standards a) ariana Hall OCCT 5268 at Unters Mesa Cee of Scher Nevada Page t004.0 Self-Directed Learning - Comments, SeltDirected Learning| Consider abit o take responsibilty for wn lamning, domonstrate motivation, aware of ovm strengths and areas for improvement does her research regarding topies idlagnoses 004.0 Reasoning/Problem Solving ReasoningyProblem Solving Consider ably 1 use Seeflecton, wslingness to ask questions; abity fo analyze, syninesize and intorprt information, understand the OT process; damonstrates inquy SKIES appropriate fo the student's stage of edueation and raining NA Exceeds Standards Meets Standards Bolow Standards Well Boiow Standards re 004.0 Written Communication Written Communication Consider grammar, speling legibly, successful compat of witen assignments, documentation ski NA Exceeds Standards Meets Standards Bolow Standards Well Boiow Standards [Om | 004.0 Initiative Initiative Consider intiatve, ably to Seek and acquire information from a vaney of sources NA Exceeds Standards ‘Meets Standards Bolow Standards Well Below Standards [a 004.0 Observation Skills, (Opservation Skis Consider abity to observe relevant behaviors for performance areas and performance components and to verbalize peroeptions and observations: NA Exceeds Standards Meets Standards Bolow Standards Wall Below Standards TTT ESS 004.0 Verbal Communication and Interpersonal Skis, Na Exoeeds Standaras Moots Standards Solow Standaras et seiow Stancaras Ca) 004.0 Professional and Personal Boundaries NA Exceeds Standards Meets Standards Bolow Standards Wall Below Standards [Om | 004.0 Use of Professional Terminology Na Exoeeds Standaras Moots Standards Solow Standaras et seiow Stancaras ra 004.0 Attitude and Professional Appearance - Comments nleelyipromptly clad Majiana Hal OCCT £208 at UniverstyMical Contr of Souther Nevada Page 2(004.0 Attitude and Professional Appearance NA Exoveds Standards Moots Standards Below Standards Wel Below Standards Le ee (004.0 Time Management Skills “Time Menagement Skis Consider ability to be prompt, anve on time, complete assignments on time NA Excaeds Standards Moots Standaras Below Standards Well Below Standards Ss) 004.0 Time Management Skills - Comments ‘Time Menogement Skis Consider ability to be prompt, anve on time, complete assignments on time always prompt 004.0 Participation in the Supervisory Process NA Excaeds Standards Moots Standaras Below Standards Well Below Standards 005.0 Date Completed = 1 1 owierzo14 005.0 Student Learning Objectives - 1 1 Observelparticipate with child engaged in occupation based activity and discuss with fleld work educator at least one method Inwhich activity could be eartied out with family outsed of the treatment sessions. 005.0 Date Completed - 2 2 ovesre01a (005.0 Student Learning Objectives - 2 2 ‘Observe and partciparte in client evaluation or re assessment 005.0 Date Completed - 3 3 2in6r2014 (005.0 Student Learning Objectives - 3 a Marianna to be more proficient in writing goss "Maan Hall OCCT 526A at University Mekal Center of Southern Nevada Page 3006.0 Fieldwork Educator Comments: Marianna demonstrates promise in her field makes revisions as needed. Looking forward "OT. she puts in time and effort in her homework and ensures that she cing my colleague soon. 007.0 We have both reviewed the Educator Evaluation of Student, Student E valuation of Educator, and Student Evaluation of Facility, Ld) ves Lino "Mariana Hal OCCT 5268 at Unversity Medial Cente of Saute Neva PageStudent Fieldwork Contact Information Course #630A Student Name: Mariana Hall Student Street Address: 2298 Florence Ave City, State, Zip Las Vegas, NV, 89119 Student Cell Phone: 702-340-0895 Home Phone: 702-340-0895 Emergency Contact Name: Ashley J. Hall Il Emergency Contact Phone: 702-340-0894 Field Educator Name: Irene Burke (This is may NOT be the initial contact provided by “Touro—please provide your actual on-site FE's name) Field Educator Credentials: Mental Health Worker (OTAVL, OTR/L, PT, PAC, etc) Field Educator Street Address: 1391 S. Jones Blvd. City, State, Zip: Las Vegas, NV, 89146 Field Educator Facility Phone: 702-486-6354 Field Educator Cell Phone: 702-486-6354 Field Educator Fax: Field Educator Email: iburke@dre@nv.gov {Either personal, facity or both “Inform them that this is for the purpose of sending CEU certificates) Fridays 9am-Spm_ Fieldwork Schedule: Touro Uniform Important Info: (Oress code, requirements, ete) If you do not have accurate information for your fieldwork educator, please submit the form noting “TBA” where necessary. Then contact your fieldwork site and try to expedite this information. The updated form must be re-submitted to the Touro fieldwork office by the end of your first week of fieldwork. TO SAVE THIS FILE: FILE-SAVE AS-STUDENT NAME AND COURSE #.pdfTe INAC UE Lm Aes Lbes Le) Subject: Mariana Hall Activity/Site: OCCT 630A at Desert Regional Center Time Frame/Partic: OCCT 630A - Spring 2014 (4/21/2014 to 5/16/2014) / (04/21/2014 - 05/16/2014) Evaluation Type: Educator Evaluation of Level | Fieldwork « Student Evaluator: Irene Burke (002.0 Type of Fieldwork: (Specialt/Practice Avea) (11 inpatient Acute ta inpatient Rena [E13 SNF) sup-seute/ Acute Long-Term Care (14 General Rehab Outpatient [18 Outpatient Hands (1s Peciatre Hesptavunit 17 Pediatric Hospital Outpatient (18 Inpatient Psych (24 Pediatrie Community (22 Behavioral Health Community [1123 Older Adutt Community Living (24 Older duit Oay Program [5125 Outpatientinand private practice: (126 Aut Day Program for 0 (127 Home Health [B28 Pesiatre Outpatient cine (31 Eenly intervention (22 Scheot [x] other (s20 below) 003.0 Other Other was selec for Type of Fieldwork, please spect Intermediate Care Facility 004.0 Organization Organization | consider blty to sot priorities, be dependable, be organized, follow through with responsibilies NA Exceeds Standards Meets Stendares Below Standards Wall Beiow Standards a 004.0 Engagement in the Fieldwork Experience NA Exoseds Standards este Standarse Below Standards Wall Be.ow Stancards a A 004.0 Self-Directed Learning ‘Set-Directes Learning Conse abit to take responsibilty for ovn learning: demonstate motivation: avare of evn aengtns and areas for improvement Na Exceeds Standards Meets Standards Below Standards Well Below Stancards Ss) Monane Hal OCCT E304 at Desert Regional Cntr Pose!004.0 Reasoning/Problem Solving Reasoning/Problem Salving Consider abilty to use seitrefection, wilingness to ask questions; ably to analyze, synthesize and interpret information; understand the OT process; demonstrates inquiry sklls appropriate to the student's stage of education and training Na Exceeds Standards Meets Standards Below Standards ‘Well Below Standards SS) 004.0 Written Communication ‘wrtten Communication Consider grammar, speling legiity, successful completion of witten assignments, documentation skils Na Exceeds Standards Meets Standards Below Standards ‘Well Below Standards a 004.0 Initiative Initiate Consider iniatve, ability to seek and acquire information from a varity of sources NA Exceeds Standards Meets Standards Below Standards ‘Well Below Standards LS 004.0 Observation Sills ‘Observation Skis CConsidar ablty to observe relevant behaviors for performance araas and performance components and to verbalize perceptions and ‘observations Na Excoods Standards Meets Standards Below Standares ‘Well Below Standards a ee ee 004.0 Verbal Communication and interpersonal Skills Na Exceeds Stancards Meets Standards Below Standares ‘Well Below Standards 004.0 Professional and Personal Boundaries NA Exceeds Standards Mels Stondards Below Standards Well Below Standards LS 004.0 Use of Professional Terminology Na Exceeds Standards Meets Stoncards Below Standares Well Below Standards a ee ee 004.0 Attitude and Professional Appearance Na Exceeds Standards Meets Standards Below Standards ‘Well Below Standards 004.0 Time Management Skills “Time Management St CConsier abilty tobe prompt, ative on time, complete assignments on time Na Exceeds Standards Mats Standards Below Standards ‘Wall Below Standards a) ovina Hall OCCT 620A at Desert Regional Cant Page2004.0 Participation in the Supervisory Process Na Exceeds Standards Meets Standards Below Standards Well Below Stancards a 005.0 Date Completed - 1 1 saris (005.0 Student Learning Objectives - 1 1 1. Complete one documentation note per facility standards based on the client observed / seen for treatment. The note ‘should be co-signed by the clinical supervisor 005.0 Date Completed - 2 2 sit3i15 005.0 Student Learning Objectives - 2 2 2. _ Observe the evaluation/assessment process of one client per facility standards. Discuss your observations and recommendations for treatment planning to address the psychosocial needs ofthe client and discuss this with your clinical ‘supervisor 005.0 Date Completed - 3 3 sitsit4 (005.0 Student Learning Objectives - 3 3 3.__ Review research conducted on Sensory ntegration/Processing Interventions for clients with Autism Spectrum Disorder (ASD) to find interventions that have shown to be effective specitically for selfanjurious behavior (SIB) and aggression. Fieldwork Educator Comments: Mariana was a bright, professional, and empathic intern. She was a pleasure to work with and to Introduce tothe people who live on DRC campus.’ Mariana provided the staff on campus with useful information to improve the quality of life for the people we serve. She was inquisitive, compassionate, and provided me with useful information, 007.0 We have both reviewed the Educator Evaluation of Student, Student Evaluation of Educator, and Student Evaluation of Facility, Oves [x] No Nonna Hall OCCT 620A at Desert Regional Cente PageIndividual Evaluatio fs Subject: Mariana Hall Activity/Site: OCCT 681A at Progressive Hospit Time FrameiPartic: OCCT 651A - Summer 2014 (7/28/2014 to 8/29/2014) | (07/28/2014 - 08/29/2014) Evaluation Type: Educator Evaluation of Level | Fieldwork - Student Evaluator: Caroline Smith 001.0 Fiekiwork Educator Caroline Smith 002.0 Type of Fieldwork (Specialty/Practice Area) (1 impotent cate 112 inpatient Rena [13 snr? sub-cute! Acute Long-term care 2114 General Reab Ouipatent Cts outpatient Hanes T1168 Pedic HspasUnt 17 Pedane Hospal Cupatent (C1 18 In-Patient Psycn (let peda Conunty 5) 22 senaverl ean community 15128 older adult Commun Lng 24 cise aut 02) -rogam E5]25 outpateninara pate practice [)26 aauoay ream tx 00 27 ame Hea [E26 mediane oupatent cine [5181 earyinenenton (hae sere Homer (se bow) 004.0 Organization Organization Consider abiltyo set proties, be dependable, be organized flow through wih responsibilies, NA Exceeds Stanaares Meets standaras Below Standaras ‘Wet Below Standards Ly 004.0 Oraanization - Comments Organization | Consider abilty to set pronties, be dependable be organized flow through with responsibilities (on time and witing to assist as needed (004.0 Engagement in the Fieldwork Experience NA Exceeds Standards Meets Standards Below Standards ‘Well Below Standards as) ‘eva Hall OCCT 6518 at Progressive Hosa Page 1004.0 Engagement in the Fieldwork Experience — Comments ‘though somewhat nervous she was very involved and took instruction well 004.0 Self-Directed Learning SeftDirected Learning Consider abi 10 lake responsibly for own learning, demonstrate mativation, aware of evn stiengihs and areas fr provement NA Exceeds Standards ‘Meats Standaras Bolow Standaras ‘Well Below Standards EE) 004.0 Self-Directed Learning - Comments, SeftDirected Leaning CConeider alii 0 lake responsibly for wm leaming, demonstrate mativation, aware of evn strengths and areas fr provement asked great questions and is self aware of limitations, 004.0 Reasoning/Prablem Solving ReasoningiProblem Solving Consider abi 0 use self-reflection, witingness to ask questions; ably to analyze, synthesize and interpret information; understand ‘he OT process: demonstrates inquiry skils appropriate to the students Stage of edueaton and traning Na Exceeds Standards ‘Meets stangaras Below Stanaares ‘Well Below Stancaras OO 004.0 Reasoning/Problemn Solving - Comments ReasoningiProblem Solving CConsicer ality use Sei-fefection, wisingness to ask questions; abiy to analyze, syninesize and interpret information; understand ‘he OT process; demonstrates inquiry skils appropriate 1o the students stage of edeaton and traning very appropriate for currant stage of learning 004.0 Written Communicatio ‘writen Communication Consider grammar, speaing, egy, suecesstul completion of writen assignments, cocumentation skits ‘omments rice handwriting, needs more review of medical terminology and documentation 004.0 Written Communication ‘Wntten Communication Consider grammar, speaing, egy, successful completion of writin assignments, documentation skits NA Exceeds Standards ‘Meets Standards Below Standaras ‘Well Below Standards a 004.0 Initistive tnivatve Consider intatve, abit to seek and acquire information ftom a vary of sources NA Exceeds Standards ‘Meets Standords| Below Standards Well Below Standards Ee) avian Hal OCCT 6814 at Progressive Hosa Page 2004.0 Observation Skills (Observation Skis (004.0 Observation Skills - Comments ‘Oncervation Skis | ‘Consider aby to observe relevant behaviors for performance areas and perfomance components and to verbalize perceptions ang observations ‘more practice with skilled tc will improve observation and evaluation skis (004.0 Verbal Communication and Interpersonal Skills Na Exceeds Standards Meets Stancaras Below Standaras| EE) (004.0 Verbal Communication and Interpersonal Skils - Comments, very soft spoken, however she is sware of this trait (004.0 Professional and Personal Boundaries - Comments 004.0 Professional and Personal Boundaries NA Exceeds Standards Meets Standards Below Standards 004.0 Uso of Professional Terminology Na Exceeds Standards Meets Stancaras Below Standaras| 004.0 Use of Professional Terminology - Comments, ‘continue to refine documentation and language skills 004.0 Attitude and Professional Appearance NA Exceeds Stanaards Meets Stancaras Below Standaras: | ee ee ee eee 004.0 Time Management Ski “Time tanagement Skate Cansiger aby 1 be prompt, ave on tme, complete assignments on time NA Exceeds Stanaards Meets Stancaras Below Standaras: ao) ‘Marana Hal OCCT 6618 at Promsiv Hosta Pages004.0 Participation in the Supervi NA Exceeas Stancaras Meets Stancaras Below Standaras Well Betow Stancaras Ea) (004.0 Participation in the Supervisory Process - Comments ‘900d for level one! 006.0 Date Completed - 1 1 anatig ang erra 006.0 Student Leamnina Objectives - 1 1 ‘observer and complete sn assessment or evaluation 006.0 Student Learning Objectives 2 2 ‘compelete one documentation note 008.0 Date Completed - 2 2 asia 008.0 Date Completed - 3 3 anang 006.0 Student Learning Objectives - 3 8 PPE and restraints correctly jeldwork Educator Comments Mariana was a pleasure to have 2s a student, She was intelligent, willing and involved in her own leaming process. (007.0 We have both reviewed the Educator Evaluation of Student, Student Evaluation of Educator. and Student ‘Marana Hal OCCT ES1A at Progossiv Hosp PageAOTA §AOTA CONFERENCES Crom aa nN anno 2014 AOTA Annual Conference & Expo 4/1/14 - 416/14 Conference Report This certificate of completion is verification of continuing education credit for the sessions you attended. Ifyou have specific questions related to the information in this document, please direct them to. conference@aota.org. Name: Mariana Hall Date | Contact | CEUs | PDUs Session Name ‘Hours rari 15 | 015 | 15 [Sc 149 Assembling a Successful Aging-in-Place Home Modifications Team: OT and Remodeler Collaboration for Best Client Outcomes iat 15 | 015 | 15 [SC215 Chemo Brain: What Is It? How Can Occupational Therapy Help? iat 075 | 0075 | 075 [Presidential Address Attitude, Authenticity, and Action: Building Capacity for Occupational Therapy lesan 02 (0.02 | G2 [PO 4065 Occupational Therapy for Panie Disorders and Anxiety Disorders: faiarta 15 | 015 | 15 [Sc 221(SIS) SISIS Annual Program: Identification and intervention of Sensory lasues in the Binh to 3 Years Population isi 15 | 015 | 15 [S313 (AOTA) Occupational Therapy Practice Guideline for Adults With Neurodegenerative Diseases ist 15 | 045 | 15 [SC330 Lessons From the Field: Occupational Therapy in Hespice asia 15 [045 | 15 [5C341 Animal-Assisted Therapy: A Practical Application Within the Context of Gccupational Therapy Total Contact Hours: 9.95 Frank E. Gainer, MHS, OTA/L, FAOTA, CAE Director of Conferences ‘American Occupational Therapy Association | 4720 Montgomery Lane | Bethesda, MD 20814 | Phone: 301.652.6611 | Fax: 301.656.3218 Please Note: Additional information, such as a description of the session and learning objectives, may be required for certain types of professional development activities, such as certification, Please save appropriate informaton from the conference program guide, in addition to this letter, a part of your portfolio