Kindergarten Assessment Form

Student Name: __________________________________ Date of Assessment: __________________________ Assessor's Name: ____________________________

Academic Skills

Literacy

• Recognizes all uppercase letters: (Circle one) Yes / No

• Recognizes all lowercase letters: (Circle one) Yes / No

• Identifies 10+ letter sounds: (Circle one) Yes / No

• Recognizes own name in print: (Circle one) Yes / No

• Attempts to write own name: (Circle one) Yes / No

• Identifies rhyming words: (Circle one) Yes / No

Numeracy

• Counts to 20: (Circle one) Yes / No

• Recognizes numbers 1-10: (Circle one) Yes / No

• Identifies basic shapes (circle, square, triangle): (Circle one) Yes / No

• Sorts objects by color, size, or shape: (Circle one) Yes / No

• Identifies simple patterns: (Circle one) Yes / No

Social-Emotional and Motor Skills

Social-Emotional

• Follows 2-step directions: (Circle one) Yes / No

• Shares and takes turns: (Circle one) Yes / No

• Interacts positively with peers: (Circle one) Yes / No

• Expresses needs and feelings appropriately: (Circle one) Yes / No

• Separates from parent/caregiver with ease: (Circle one) Yes / No

Fine Motor

• Holds pencil/crayon with a tripod grasp: (Circle one) Yes / No

• Cuts with scissors along a straight line: (Circle one) Yes / No

• Draws a simple human figure (head, body, arms, legs): (Circle one) Yes / No

• Completes simple puzzles (4-6 pieces): (Circle one) Yes / No

Gross Motor

• Jumps with both feet together: (Circle one) Yes / No

• Hops on one foot: (Circle one) Yes / No

• Runs without falling: (Circle one) Yes / No

Assessor Notes and Observation