Evaluations

One Level I fieldwork performance evaluation and two lab class professional behavior evaluations. Each document is available for download.

Level I Fieldwork Performance Evaluation

Integrity House, 4/20 – 4/27/2026, 32 fieldwork hours

Supervisor: Lenka Capkova, BS, COTA/L, CBIS, FW Faculty, SAC

Pass: the student meets standards Total: 38 / 48

Supervisor’s comments

During her L1 FW placement at IH, Zita demonstrated the ability to build effective therapeutic relationships with members and participated in all activities of the clubhouse as needed. She planned and implemented meaningful, member-centered one-on-one interventions. Zita’s overall active engagement and a positive attitude contributed to her successful performance. Well done!

Ratings

Exceeds Standards (4 points each): Engagement in fieldwork experience; Verbal communication and interpersonal skills with clients, staff, and caregivers
Meets Standards (3 points each): Ethics; Safety; Values and beliefs of occupational therapy; Evaluation process; Client centered and occupation-based interventions; Initiative; Observation skills; Time management skills; Organization; Diversity

First page of the Level I Fieldwork Performance Evaluation form

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Professional Behavior Development, 1st semester

Santa Ana College OTA Program, class OTA 101L, 12/03/25

Faculty: Yovana G. Harris

Rated “Always” in all five areas

Area	Rating	Faculty comment
Time Management	Always	Zita arrives on time and is present for all class sessions. All assignments are submitted on time. Her time management during professional presentations is always within the expected time frame.
Organization	Always	Zita is well organized in the classroom, including when having to manage materials and peers during professional presentations. Her assignments are well written and organized.
Engagement	Always	Zita is engaged during all class discussions and group lab activities. She asks relevant questions to better understand the material, and provides real world experience feedback when appropriate from her previous experience as an OTP in Ukraine.
Communication	Always	Zita maintains open and appropriate communication with instructor and peers. Written assignments utilize appropriate and professional terminology and adequately demonstrate an understanding of course materials.
Professional and Personal Boundaries	Always	Zita is professional at all times, she is respectful of peers and maintains appropriate boundaries at all times.

First page of the 1st semester professional behavior feedback form

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Professional Behavior Development, 2nd semester

Santa Ana College OTA Program, class 102 L, 06/02/2026

Faculty: Elizabeth Medina

Rated “Always” in all five areas

Area	Rating	Faculty comment
Time Management	Always	Arrives punctually, has consistent attendance and completes assignments on time.
Organization	Always	She is very dependable and follows through with all responsibilities.
Engagement	Always	Zita contributes to class discussions with valuable input, exercises good judgement and demonstrated flexibility.
Communication	Always	Uses appropriate body language and is tactfully in her shared perspective during class discussions and when working with her peers.
Professional and Personal Boundaries	Always	Works cooperatively, demonstrates sensitivity to diverse views and contributes to the success of others.

First page of the 2nd semester professional behavior feedback form

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