Hi, this will be easier if you can ask your setting or work placement for a copy of their staff appraisal form as it ought to contain the aspects that this criteria needs you to evaluate. If you've had a recent appraisal you'll be able to use that document to evidence your practice and show how you evaluated it with a member of your setting.
If not check with your tutor or assessor to see if they have an example sheet you can use or if this one would be suitable -
example staff appraisal form
Best wishes xx