On-Site Evaluator Peer Evaluation Survey

	N/A	1	2	3	4
Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure.	Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. N/A	Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 1	Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 2	Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 3	Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 4
Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation.	Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. N/A	Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 1	Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 2	Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 3	Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 4
Demonstrated no apparent conflicts of interest during the On-Site Evaluation.	Demonstrated no apparent conflicts of interest during the On-Site Evaluation. N/A	Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 1	Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 2	Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 3	Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 4
Maintained confidentiality regarding program information.	Maintained confidentiality regarding program information. N/A	Maintained confidentiality regarding program information. 1	Maintained confidentiality regarding program information. 2	Maintained confidentiality regarding program information. 3	Maintained confidentiality regarding program information. 4
Demonstrated an appropriate level of professionalism.	Demonstrated an appropriate level of professionalism. N/A	Demonstrated an appropriate level of professionalism. 1	Demonstrated an appropriate level of professionalism. 2	Demonstrated an appropriate level of professionalism. 3	Demonstrated an appropriate level of professionalism. 4
Avoided being unduly influenced by non-team members during the On-Site.	Avoided being unduly influenced by non-team members during the On-Site. N/A	Avoided being unduly influenced by non-team members during the On-Site. 1	Avoided being unduly influenced by non-team members during the On-Site. 2	Avoided being unduly influenced by non-team members during the On-Site. 3	Avoided being unduly influenced by non-team members during the On-Site. 4
Did not impose personal values, opinions, philosophies, or biases.	Did not impose personal values, opinions, philosophies, or biases. N/A	Did not impose personal values, opinions, philosophies, or biases. 1	Did not impose personal values, opinions, philosophies, or biases. 2	Did not impose personal values, opinions, philosophies, or biases. 3	Did not impose personal values, opinions, philosophies, or biases. 4
Did not accept solicitations, recruitment, or encourage future contact by the program officials.	Did not accept solicitations, recruitment, or encourage future contact by the program officials. N/A	Did not accept solicitations, recruitment, or encourage future contact by the program officials. 1	Did not accept solicitations, recruitment, or encourage future contact by the program officials. 2	Did not accept solicitations, recruitment, or encourage future contact by the program officials. 3	Did not accept solicitations, recruitment, or encourage future contact by the program officials. 4
Demonstrated objectivity in the evaluation of the program evaluated.	Demonstrated objectivity in the evaluation of the program evaluated. N/A	Demonstrated objectivity in the evaluation of the program evaluated. 1	Demonstrated objectivity in the evaluation of the program evaluated. 2	Demonstrated objectivity in the evaluation of the program evaluated. 3	Demonstrated objectivity in the evaluation of the program evaluated. 4
Used effective verbal communication skills.	Used effective verbal communication skills. N/A	Used effective verbal communication skills. 1	Used effective verbal communication skills. 2	Used effective verbal communication skills. 3	Used effective verbal communication skills. 4
Used effective written communication skills when needed.	Used effective written communication skills when needed. N/A	Used effective written communication skills when needed. 1	Used effective written communication skills when needed. 2	Used effective written communication skills when needed. 3	Used effective written communication skills when needed. 4
Represented the ARC/STSA & CAAHEP in a positive manner.	Represented the ARC/STSA & CAAHEP in a positive manner. N/A	Represented the ARC/STSA & CAAHEP in a positive manner. 1	Represented the ARC/STSA & CAAHEP in a positive manner. 2	Represented the ARC/STSA & CAAHEP in a positive manner. 3	Represented the ARC/STSA & CAAHEP in a positive manner. 4
Demonstrated tact and sensitivity.	Demonstrated tact and sensitivity. N/A	Demonstrated tact and sensitivity. 1	Demonstrated tact and sensitivity. 2	Demonstrated tact and sensitivity. 3	Demonstrated tact and sensitivity. 4
Consistently performed with efficiency as a team member.	Consistently performed with efficiency as a team member. N/A	Consistently performed with efficiency as a team member. 1	Consistently performed with efficiency as a team member. 2	Consistently performed with efficiency as a team member. 3	Consistently performed with efficiency as a team member. 4
Demonstrated positive On-Site Evaluation teamwork skills.	Demonstrated positive On-Site Evaluation teamwork skills. N/A	Demonstrated positive On-Site Evaluation teamwork skills. 1	Demonstrated positive On-Site Evaluation teamwork skills. 2	Demonstrated positive On-Site Evaluation teamwork skills. 3	Demonstrated positive On-Site Evaluation teamwork skills. 4
Made no references to other programs, to evaluator’s own program or to products, services or	Made no references to other programs, to evaluator’s own program or to products, services or N/A	Made no references to other programs, to evaluator’s own program or to products, services or 1	Made no references to other programs, to evaluator’s own program or to products, services or 2	Made no references to other programs, to evaluator’s own program or to products, services or 3	Made no references to other programs, to evaluator’s own program or to products, services or 4

N/A

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure.

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. N/A

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 1

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 2

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 3

Demonstrated knowledge of the Standards/Guidelines and ARC/STSA - CAAHEP programmatic accreditation policy and procedure. 4

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation.

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. N/A

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 1

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 2

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 3

Was knowledgeable of the material submitted/provided to the team prior to the On-Site Evaluation. 4

Demonstrated no apparent conflicts of interest during the On-Site Evaluation.

Demonstrated no apparent conflicts of interest during the On-Site Evaluation. N/A

Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 1

Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 2

Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 3

Demonstrated no apparent conflicts of interest during the On-Site Evaluation. 4

Maintained confidentiality regarding program information.

Maintained confidentiality regarding program information. N/A

Maintained confidentiality regarding program information. 1

Maintained confidentiality regarding program information. 2

Maintained confidentiality regarding program information. 3

Maintained confidentiality regarding program information. 4

Demonstrated an appropriate level of professionalism.

Demonstrated an appropriate level of professionalism. N/A

Demonstrated an appropriate level of professionalism. 1

Demonstrated an appropriate level of professionalism. 2

Demonstrated an appropriate level of professionalism. 3

Demonstrated an appropriate level of professionalism. 4

Avoided being unduly influenced by non-team members during the On-Site.

Avoided being unduly influenced by non-team members during the On-Site. N/A

Avoided being unduly influenced by non-team members during the On-Site. 1

Avoided being unduly influenced by non-team members during the On-Site. 2

Avoided being unduly influenced by non-team members during the On-Site. 3

Avoided being unduly influenced by non-team members during the On-Site. 4

Did not impose personal values, opinions, philosophies, or biases.

Did not impose personal values, opinions, philosophies, or biases. N/A

Did not impose personal values, opinions, philosophies, or biases. 1

Did not impose personal values, opinions, philosophies, or biases. 2

Did not impose personal values, opinions, philosophies, or biases. 3

Did not impose personal values, opinions, philosophies, or biases. 4

Did not accept solicitations, recruitment, or encourage future contact by the program officials.

Did not accept solicitations, recruitment, or encourage future contact by the program officials. N/A

Did not accept solicitations, recruitment, or encourage future contact by the program officials. 1

Did not accept solicitations, recruitment, or encourage future contact by the program officials. 2

Did not accept solicitations, recruitment, or encourage future contact by the program officials. 3

Did not accept solicitations, recruitment, or encourage future contact by the program officials. 4

Demonstrated objectivity in the evaluation of the program evaluated.

Demonstrated objectivity in the evaluation of the program evaluated. N/A

Demonstrated objectivity in the evaluation of the program evaluated. 1

Demonstrated objectivity in the evaluation of the program evaluated. 2

Demonstrated objectivity in the evaluation of the program evaluated. 3

Demonstrated objectivity in the evaluation of the program evaluated. 4

Used effective verbal communication skills.

Used effective verbal communication skills. N/A

Used effective verbal communication skills. 1

Used effective verbal communication skills. 2

Used effective verbal communication skills. 3

Used effective verbal communication skills. 4

Used effective written communication skills when needed.

Used effective written communication skills when needed. N/A

Used effective written communication skills when needed. 1

Used effective written communication skills when needed. 2

Used effective written communication skills when needed. 3

Used effective written communication skills when needed. 4

Represented the ARC/STSA & CAAHEP in a positive manner.

Represented the ARC/STSA & CAAHEP in a positive manner. N/A

Represented the ARC/STSA & CAAHEP in a positive manner. 1

Represented the ARC/STSA & CAAHEP in a positive manner. 2

Represented the ARC/STSA & CAAHEP in a positive manner. 3

Represented the ARC/STSA & CAAHEP in a positive manner. 4

Demonstrated tact and sensitivity.

Demonstrated tact and sensitivity. N/A

Demonstrated tact and sensitivity. 1

Demonstrated tact and sensitivity. 2

Demonstrated tact and sensitivity. 3

Demonstrated tact and sensitivity. 4

Consistently performed with efficiency as a team member.

Consistently performed with efficiency as a team member. N/A

Consistently performed with efficiency as a team member. 1

Consistently performed with efficiency as a team member. 2

Consistently performed with efficiency as a team member. 3

Consistently performed with efficiency as a team member. 4

Demonstrated positive On-Site Evaluation teamwork skills.

Demonstrated positive On-Site Evaluation teamwork skills. N/A

Demonstrated positive On-Site Evaluation teamwork skills. 1

Demonstrated positive On-Site Evaluation teamwork skills. 2

Demonstrated positive On-Site Evaluation teamwork skills. 3

Demonstrated positive On-Site Evaluation teamwork skills. 4

Made no references to other programs, to evaluator’s own program or to products, services or

Made no references to other programs, to evaluator’s own program or to products, services or N/A

Made no references to other programs, to evaluator’s own program or to products, services or 1

Made no references to other programs, to evaluator’s own program or to products, services or 2

Made no references to other programs, to evaluator’s own program or to products, services or 3

Made no references to other programs, to evaluator’s own program or to products, services or 4

Question Title

* 6. What is the background of the team member being evaluated?[Please check all applicable boxes]

First time serving as an On-Site Evaluator

Novice On-Site Evaluator (less than 4 visits)

Experienced On-Site Evaluator (more than 4 visits)

First time serving as an On-Site Chair

Experienced On-Site Chair (2 or more visits as a Chair)

Question Title

* 7. What recommendations do you have regarding this team member? [Please check all applicable boxes]

Reconsider using this individual as an On-Site Evaluator in the future (Please explain below)

Acceptable as future On-Site Evaluator but requires additional training (Please explain below)

Recommend as an On-Site Evaluator, but do not recommend as Chair (Please explain below)

Exceptionally skilled as on On-Site Evaluator, but desires not to be a Chair

Recommend as future On-Site Evaluator Chair.

Skilled as an On-Site Evaluator Chair (consistently performs leadership task)

Exceptionally skilled as On-Site Evaluator Chair (exceeds normal expectations as a leader)

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* 8. If any of the first 3 boxes were checked, please explain further:

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* 9. Please provide additional comments or observations:

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* 10. Please enter your contact information:

Name

Date

Question Title

* 11. Experience level as an evaluator

First time serving as an On-Site Evaluator

Novice On-Site Evaluator (less than 4 visits)

Experienced On-Site Evaluator (more than 4 visits)

First time serving as an On-Site Chair

Experienced On-Site Chair (2 or more visits as a Chair)

On-Site Evaluator Peer Evaluation

Question Title

* 1. Team Member Evaluated

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* 2. Program Evaluated

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* 3. Date(s) of Visit (Please enter as MM/DD-MM/DD/YYYY)

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* 4. Type of Evaluation

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* 5. Please use the following scale to select the best response to each statement (4 is the best)

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* 6. What is the background of the team member being evaluated?[Please check all applicable boxes]

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* 7. What recommendations do you have regarding this team member? [Please check all applicable boxes]

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* 8. If any of the first 3 boxes were checked, please explain further:

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* 9. Please provide additional comments or observations:

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* 10. Please enter your contact information:

Question Title

* 11. Experience level as an evaluator