Anexa 1

CARACTERIZARE
privind activitatea n perioada de practic
a studentului/ei ..
anul/ grupa
Apreciem activitatea desfurat n perioada de practic n unitatea noastr, confirmat
prin pontajul alaturat, de ctre studentul/a de mai sus, astfel:

.............
....................................................................................
i acordm CALIFICATIVUL:
foarte bine, bine,
satisfacator,
nesatisfacator .(se taie ce nu corespunde)

FIA DE PONTAJ
privind prezena la practic
Anul: ..
DATA
luna/zi
Ore

DIRECTOR
(Nume, prenume,
semntura, tampila)
L.S.

Total

ndrumtor de practic
(Nume, prenume, semntura)

Anexa 2
FORMULAR DE EVALUARE
STUDENT1
Acordati o nota de la 1(minim) pana la 5(maxim) pentru fiecare caracteristica enuntata:
I.CRITERII DE EVALUARE BAZATE PE TRASATURI: Caracteristici personale ale
studentului:
- capacitate de comunicare
1
;2
;
3;
4;
5
-capacitate empatica
1
;2
;
3;
4;
5
-spirit inovator
1
;2
;
3;
4;
5
II.CRITERII DE EVALUARE AXATE PE COMPORTAMENT:
Caracteristici comportamentale ale studentului:
-Capacitate de inter-relationare cu beneficiarii directi si indirecti
1
;2
;
3;
4;
5
-Capacitate de observare directa,indirecta
1
;2
;
3;
4;
5
-Comportament proactiv manifest
1
;2
;
3;
4;
5
III.CRITERII DE EVALUARE AXATE PE OBIECTIVELE PRACTICII DE
SPECIALITATE:
a)urmarirea de catre student a obiectivelor practicii:
1
;2
;
3;
4;
5
b)indeplinirea de catre student a obiectivelor practicii
1
;2
;
3;
4;
5
IV.CRITERII DE EVALUARE AXATE PE OBIECTIVELE LOCULUI DE PRACTICA :
1

a)familiarizarea studentului cu obiectivele locului de practica

;2
;
3;
4;
5

b)respectarea de catre student a obiectivelor locului de practica

;2
;
3;
4;
5

V.OBSERVATII:

Nume prenume indrumator practica

Data

Formularul se va completa de catre indrumatorul specialist de la locul de practica al studentului

Anexa 2
AUTOEVALUAREA ACTIVITILOR PRACTICE23
1.Numele si prenumele___________________________
2. Locul de practic______________________________
3.Perioada de practic___________________________
4..Cadru didactic coordonator______________________
5 Indrumator de practica__________________________
5. Ai participat la instruirea initial privind practica?
Da

Nu

6. Vi s-au prezentat caracteristicile locului de practic?

Da

Nu

7. In ce msur cunoastei acum locul de practic?

Deloc n mic msur Acceptabil Bine

Foarte bine

8. Definii obiectivele locului de practic

_____________________________________________________________________
__________________________________________________________
9.n ce msur este realizat ?
Deloc

Foarte puin

Puin

Bine

Foarte bine

10. Care sunt beneficiarii ,,locului de practic?

_____________________________________________________________________
___________________________________________________________
11. Ce probleme ale beneficiarilor trebuie s rezolve ,,locul de practic?
_____________________________________________________________________
___________________________________________________________
12. Ce probleme sunt n realitate rezolvate ?
_____________________________________________________________________
__________________________________________________________
13. V intereseaz problemele ,,locului de practic?
Da
2

Nu

Fisa de autoevaluare va trebui completata de catre student , fiind parte integranta din portofoliul de practica ce va
fi predat la sfarsitul activitatii practice de catre student
3
Formularul de autoevaluare este preluat ca model din Dimensiuni ale asistentei sociale, coordonator Miftode V.,
pg.387

14. Dac da, ai reusit s le cunoastei si s le ntelegei?

Da Nu Deloc Foarte puin Puin Mult Foarte mult
15. Dac nu ai reuit, care sunt cauzele ?
_____________________________________________________________________
___________________________________________________________
16. Ai cooperat cu personalul ,,locului de practic ?
ntr-o mic msur ntr-o oarecare msur ntr-o mare msur
17. Evaluai :
a). Atmosfera ntlnit la ,, locul de practic :
Foarte tensionat Tensionat Armonioas Foarte armonioas
b). Utilitatea i eficacitatea timpului de practic ( acordai o not de la 1 la 10 ) :
1; 2; 3; 4; 5; 6; 7; 8; 9; 10;
c). Gradul de libertate de cunoastere, cercetare si actiune ( acordati o not de la 1 la
10 ) :
1; 2; 3; 4; 5; 6; 7; 8; 9; 10;
18. Ce v-a plcut cel mai mult la ,,locul de practic
_____________________________________________________________________
___________________________________________________________
19. Ce v-a deranjat cel mai mult la ,, locul de practic ?
_____________________________________________________________________
___________________________________________________________
20. Ce schimbri de urgent ati propune ?
_____________________________________________________________________
___________________________________________________________
21. Cum v apreciati activitatea practic ?
a).Prezena (notai procentul orelor frecventate)
_____________________________________________
b).Interesul manifestat zilnic pentru problemele specifice ( acordai-v o not de la 1
la 10 )
1; 2; 3; 4; 5; 6; 7; 8; 9; 10;
c). Atenia cu care ai urmrit ,,problemele( acordai-v o not de la 1 la 10 ) :
1; 2; 3; 4; 5; 6; 7; 8; 9; 10;
d). Portofoliul de practic scris ( analiza, sinteza); acordati-v o not de la 1 la 10 :
1; 2; 3; 4; 5; 6;

7; 8; 9; 10;

22. Mentionati cauzele eventualelor nereusite ( absente de la practic, lipsa de interes,

atentie, etc. )
_____________________________________________________________________
___________________________________________________________
23. Cum apreciati rolul ndrumtorului dvs. de practic ?
Acordati o not de la 1 la 10 urmtoarelor variante :
a). n ce msur v-a ajutat : 1; 2; 3; 4; 5; 6; 7; 8; 9;
10;
b). n ce msur v-a nteles : 1; 2; 3; 4; 5; 6; 7; 8;
9; 10;
c). n ce msur v-a ncurajat : 1; 2; 3; 4; 5; 6; 7; 8; 9; 10;
d). n ce msur ati avut cu el ,, schimb de idei : 1; 2; 3; 4; 5; 6; 7; 8;
9; 10;
Ce sugestii aveti pentru mbunttirea practicii ?
_____________________________________________________________________
__________________________________________________________
Alte comentarii privind practica desfsurat:
_____________________________________________________________________
___________________________________________________________
Informatiile din acest formular sunt exacte din punctul meu de vedere si-mi apartin n
ntregime.
Semntura titularului

Data

Anexa 3
Fia sintez
CENTRALIZATOR AL ACTIVITII PRACTICE
Studentul/a ...
Specializarea: Asisten social
Denumire
activitate

Rol
ndeplinit

Avizat, ndrumator practic,

Calitati utilizate

Data
desfurrii
activitii

Durata

Observaii

Anexa 4
JURNALUL ACTIVITILOR PRACTICE4
Instituia de profil_______________________________
1. Principalele activiti derulate n cadrul instituiei:
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________
2. Principalele activiti prestate de mine n cadrul instituiei (pe intervale orare):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
__________________________________
3. Persoanele cu care am intrat n contact (specialiti, beneficiari):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________________________

4. Ce am nvat din aceast experien:

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________________________

Aceast fi este parte component a portofoliului de practic al studentului, fiind preluat dupa modelul prezentat
n Caietul de practic elaborat de A. Geleriu, Universitatea din Sibiu

_____________________________________________________________________
_____________________________________________________________________
______________________________________________________
5. Dac mine a relua activitile de astzi ce a schimba:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
____________________________________________
6. Alte observaii:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_________________________________________________
Studentul............................................................................
Data..............
Ora intrrii n instituie...........Ora prsirii instituiei..........
Numele si semntura specialistului care certific prezena studentului n instituie

Anexa 5
Fia de prezentare a instituiei5
Denumirea complet a instituiei
______________________________________
Reprezentant legal_______________________
Scurt istoric (data nfiinrii, momente importante n funcionarea ei)
_____________________________________________________________________
___________________________________________________________
_____________________________________________________________________
___________________________________________________________
Structura instituiei:guvernamentala/nonguvernamentala
Obiectivele instituiei
________________________________________________________________
_____________________________________________________________________
___________________________________________________________
_____________________________________________________________________
___________________________________________________________
Descrierea pe scurt a serviciilor/activitilor instituiei :
_______________________________________________________________
_____________________________________________________________________
___________________________________________________________
Beneficiarii instituiei
________________________________________________________________
_____________________________________________________________________
__________________________________________________________
Metodologia utilizat _______________________________________________
5

Aceast fi este parte component a portofoliului de practic al studentului

_______________________________________________________________
________________________________________________________________

Resurse utilizate :
Financiare_____________________________________________________________
___________________________________________________________
Umane________________________________________________________________
__________________________________________________________
Materiale______________________________________________________________
___________________________________________________________
Rezultate nregistrate
_____________________________________________________________________
___________________________________________________________
________________________________________________________________
Observaii_____________________________________________________________
_____________________________________________________________________
_______________________________________________________

Anexa 6
STUDIU DE CAZ 6
I.DATE BENEFICIAR
INIIALE..
VRSTA

II.ISTORICUL SOCIAL AL BENEFICIARULUI

.........................
III.NEVOI IDENTIFICATE

IV.ACIUNI NTREPRINSE

Aceast fi este parte component a portofoliului de practic al studentului


...................................

.................
V.METODOLOGIE UTILIZAT

..............................................
...................................................................................
VI.DESFURAREA INTERVENIEI
*STABILIREA RELAIEI CU BENEFICIARUL-descriere

...............................
..................................................................................................
*IDENTIFICAREA IPOTEZELOR SOCIALE

.......................................
..........................................................................................
*FAZELE INTERVENIEI SOCIALE
*FAZA INIIAL
.....................
........................................

.........................................................
....................................
*FAZA INTERMEDIAR

.........................................................
.........................................................................................
*FAZA FINAL

.......................................
..........................................................................................
VII.REZULTATE OBINUTE

....................................................................................................
.................................................................................................
VIII.CONCLUZII/OBSERVAII

.................

Anexa 7
PLANUL DE INTERVENIE
Familia _____________________________________
Domiciliul ____________________________________
Tipul familiei: Normal Monoparental Uniune consensual
Numr copii _______
Obiective

Aciuni/Durat/Resurse
Data ntocmirii __/__/____

Asistent Social
Beneficiar
Supervizor