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Section V:

Verification of Program Completion

Name: _____________________________________________________ Local Program: ____________________________

I. PORTFOLIO CONTENTS: Place documents listed below in a digital portfolio in the Learning Management
System. The portfolio is reviewed by Leadership Coach, Local Program Coordinator and .

Section I: Coaching Agreement

Section I: Professional Experience & Work Context
Section II: Collaborative Summary (minimum of 3)
Section II: Coaching Hours (40 hours per year)
Section II: CPSEL Self-Assessment: Initial, Benchmark and Final
Section III: Leadership Learning Goal
Section IV: Professional Development Reflection (minimum of 2)
Section IV: Professional Development Hours (20 hours per year)
Section V: End of Year One Progress Check
Section V: Verification of Program Completion

Section V: Candidate Data Sheet (hard copy handed in at time of exit


II. CPSEL Standard Elements: Select at least one element from each CPSEL to demonstrate competency for
program completion. Checkmark where documentation of CPSEL competencies are located in portfolio.
Learning Goal
Work Context


Experience &


California Professional Standard for



Education Leader (CPSEL) Other

Standard 1:
Shared Vision of Learning
Standard 2:
Instructional Leadership
Standard 3:
Management & Learning Environment
Standard 4:
Family & Community Engagement
Standard 5:
Ethics & Integrity
Standard 6:
External Context and Policy

*Association of California School Administrators* July 2018

Name: _____________________________________________________

III. Exit Interview: Respond to the following three questions. Use a a separate piece of paper if needed.

a) Of the six CPSEL for which you documented competency in your portfolio, which two elements did you
select for the exit presentation or interview? Please provide examples and/or evidence of CPSEL
knowledge, skills, behaviors and/or dispositions for each.

b) Reflecting on the CPSEL and your induction experience, describe your growth and how you have
made an impact as a leader.

c) Discuss future learning goals and intended actions toward achieving them.

IV. Exit Confirmation of Program Completion

Candidate Signature Print Name Date

Leadership Coach Signature Print Name Date

Local Program Coordinator Signature Print Name Date

ACSA CACP Director Signature Print Name Date

Signature indicates, to the best of your knowledge, that the candidate has demonstrated competency in the CPSEL and
completed the all requirement components for a Clear Administrative Services Credential program.
All signatures must be present prior to the recommendation by the CACP office for a
Clear Administrative Services Credential.

*Association of California School Administrators* July 2018