CF Supervision Requirements: The 18 Activities Explained

Clinical fellowship supervision is the requirement most likely to derail an otherwise complete CCC application. Hours are easy to count; supervisory activities are easy to under-document. Here's the exact standard, in mentor and fellow terms.

Who can be a CF mentor

• Holds a current, active CCC-SLP for the entire fellowship — not just at the start.
• Has completed 2 hours of professional development in clinical instruction/supervision under current ASHA standards.
• Is licensed in the state where the fellowship occurs, where required.
• Can be replaced mid-fellowship if necessary — but the replacement must meet all the same criteria, and the transition should be documented.

Verify your mentor's certification status independently at the beginning and again at the end. A lapse mid-fellowship can invalidate that segment.

The 18 supervisory activities

Across the fellowship, the mentor must complete at least 18 supervisory activities:

• 12 monitoring activities minimum, of which at least 6 are direct observations — real-time observation of the fellow delivering clinical services (in person or live video).
• 6 indirect activities — chart/record review, reviewing written reports, case conferences, phone or video consultation, staff meetings about specific clients.

The distribution rule people miss

The fellowship divides into three segments (thirds by hours). Each segment must contain at least 6 supervisory activities: 2 direct observations and 2 indirect activities minimum. You cannot satisfy the requirement by cramming observations into the final month — the distribution is the point.

For a 36-week full-time fellowship, that's roughly one direct observation every 6 weeks at minimum. In practice, mentors who do monthly observations never have a problem.

What counts as direct observation

• Mentor physically present during your session.
• Live synchronous video observation of your session.
• Observation of your evaluation, treatment, or family/team conference where you're providing clinical service.

Not direct observation:

• Reviewing a recorded session after the fact (that's an indirect activity).
• Being in the same building.
• Discussing a case afterward.

The 80% direct contact rule

At least 80% of your 1,260 hours must be direct clinical contact: assessment, intervention, and consultation with clients, families, and teams about specific clients. The remaining 20% can be documentation, program planning, training, and administrative work.

Risk settings: school placements with heavy IEP paperwork, roles that include supervising SLP assistants, and positions with significant scheduling/administrative duties. Track the split monthly, not at the end.

Documentation that survives review

Log each supervisory activity with:

• Date and duration
• Type (direct observation vs. indirect)
• Setting and client population (no identifiers)
• Skills addressed and feedback given
• Mentor initials or signature

A simple shared spreadsheet, updated the same week, is enough. Reconstructing nine months of activities from memory is where fellowships fall apart.

The Clinical Fellowship Skills Inventory

At the end, your mentor rates you on core skills across evaluation and intervention. You need a rating of 3 or higher on every item. If a skill is rated below 3, the fellowship extends until it's remediated and re-rated — which is why mid-fellowship feedback conversations matter. Ask for the inventory at the start so you know the rubric you're being measured against.

Questions to ask before accepting a CF position

• Who is my mentor, and is their CCC active?
• Have they completed the supervision professional development requirement?
• How will direct observations be scheduled — and is that time protected?
• What's my expected productivity, and does it leave room for documentation?
• What percentage of my role is direct clinical contact?
• Is supervision written into the offer letter?

Related paperwork

Everything here funnels into the CF Report and Rating Form, submitted with your CCC application alongside your transcript and Praxis score. See the full clinical fellowship guide for hours, timelines, and placement selection.