Jones County School District
Instructional Supervision Checklist
Teacher
Date
Subject
Grade
Drop in 
Time of Observation
Objectives Evident
Formal 
Lesson Plans Reviewed
Dominant Teacher Activity:
Class Discussion
Question/Answer Session
Working w/ Individual(s)
Reading to Students
Leading in Group Center(s)
Sitting at Desk
Demonstrating/Modeling
Administering Test
Whole Group Instruction
Use of Manipulatives
Use of Audiovisual Equipment
Proximity Utilized
Positive Reinforcement
Lecture
Primary Student Activity:
Question/Answer Session
Taking Notes
Class Discussion
Reading (Silently/Orally)
Individual Seat Work
Group Work
Taking Test
Technology in Use
Instructional Games
Board Work
Task-Oriented
High Quality Classroom Instruction and Management
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
Yes
Yes
Yes
Yes
No
No
No
No
Does the room arrangement support effective instruction?
Is the classroom climate built upon mutual respect?
Does the teacher have clear procedural routines posted?
Are the students on task and engaged?
Are clear expectations and learning goals established and visible in the classroom?
Is it evident that the various DOK levels and Bloom’s Taxonomy are being utilized?
Is instructional time maximized for student success?
Does the teacher use a variety of teaching strategies to individualize instruction based on students’ needs
and tier placement?
Is the teacher implementing scientifically-based research strategies?
Is differentiated instruction evident?
Are assessments varied and appropriate with meaningful feedback?
Is classroom teaching reflective of curriculum map?
Cognitive Level:
 Knowledge  Comprehension
Depth of Knowledge Level:
 DOK 1
 DOK 2
 Application  Analysis
 DOK 3
 Synthesis
 Evaluation
 DOK 4
Comments:
Teacher’s Signature
Date
Principal’s Signature
Date
(Three-Minute Walk Through and Tier I Documentation Form – 9/08)