State Trend Survey PDF

(Although not identical to the online interactive trend survey, the content is the same.)

Part I: The following survey includes questions about the school climate assessment that was administered at your school during the 2012-13 school year.

We encourage that the following questions be completed soon after the school climate assessment instrument is administered for your school and no later than July 19, 2013.

This survey should take about 30-40 minutes to complete.

  1. GENERAL INFORMATION
  1. Please enter the district and school ID for which you are reporting:

District ID: _ _ _ School ID _ _
  1. What is the name of the districtwide School Climate Coordinator for your school district?

Name:
E-mail:
Please include phone number: (work) (Fax)
  1. What is the name of the safe School Climate Specialist for your school?

Name:
E-mail:
Please include phone number: (work) (Fax)
  1. The following questions are about the Connecticut State Department of Education (CSDE)School Climate Assessment Instrument (SCAI) that was administered at your school. In answering the following questions, please note that these questions are to be completed at the SCHOOLLEVEL (NOT THE DISTRICT LEVEL).

Also, please note that every question must be answered in order to move on to the next question.

  1. WhichSCAI were administered at your school? (Select ALL that apply.)

○YES ○NO 4A. Did you administer the SCAI developed by CSDE?

○YES ○NO ○NA 4B. If you answered YES to the previous question (4A), did you modify the survey in any way(e.g., changing words, adding questions, omitting questions, changing the scale)?

4C. If you answered YESto the previous question (4B), please specify which surveys were modified.

NA / Students / Parents/
Guardians / Teachers/Staff / Not Applicable / Other
○ / ○ / ○ / ○ / ○ / ○

4D. If you modified the survey in any way, please describe these modifications in the spaces below, where appropriate (for example, “We modified language so that the survey could meet the literacy level of students.”). If this question is not applicable, please select NA on the left-hand side.

If NA,click below. /
  1. Student Survey: If modifications were made to the studentSCAI, please describe the reason for the modification(s) and a general description of the modification. (Note: You do not have to describe the actual question and the exact change that was made; this can be general.)

○
If NA,click below. /
  1. Parent Survey: If modifications were made to the parentSCAI, please describe the reason for the modification(s) and a general description of the modification. (Note: You do not have to describe the actual question and the exact change that was made; this can be general).

○
If NA,click below. /
  1. Teacher/Staff Survey: If modifications were made to the teacher/staffSCAI, please describe the reason for the modification(s) and a general description of the modification. (Note: You do not have to describe the actual question and the exact change that was made; this can be general).

○

○YES ○NO○NA4E. Did you administer any alternative School Climate Assessment Instruments [not the Connecticut SCAI]at your school? (If yes, please specify the name of the assessment instrument that was used and the name of the organization in the space below.)

If NA,click below. / Instrument Name: Below, please specify the name of the alternative school climate assessment instrument that was used.
○
If NA,click below. / Organization Name: Below, please specify the name of the organization to which this assessment instrument pertains.
○
  1. Below, please select all grade levelsthat received the corresponding SCAIthat is listed in the left-hand column.

If NA,click below. / PreK / K / 1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10 / 11 / 12 / Adult Ed
The CSDE School Climate Assessment Instrument / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○
The modified CSDE School Climate Assessment Instrument / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○
An alternative School Climate Assessment Instrument / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○ / ○
  1. Below, please enter the total number of students and the total number of staff (certified and uncertified) at your school.

If NA,
click below. / Total Students / Total Staff (certified and uncertified)
○ / ___ / ___
○ / ___ / ___
  1. Below, please specify the total number of students, staff (certified and uncertified), and parents/guardians at your school who completed the corresponding SCAI listed on the left-hand side.

Students / Staff / Parents/Guardians
If NA,click below / Total # of students who completed school climate assessment instrument / Total # of staff
(certified and uncertified) who completed school climate assessment instrument / Total # of parents/guardians who completed school climate assessment instrument
The CSDE School Climate Assessment Instrument / ○ / ___ / ___ / ___
The modified CSDE School Climate Assessment Instrument / ○ / ___ / ___ / ___
An alternative School Climate Assessment Instrument / ○ / ___ / ___ / ___
  1. YOUR FEEDBACK

For these next few questions, we are interested in your feedback.

  1. Based on the school climate assessment results for your school, what are some ofyour school’s strengths? (List up to three strengths for each version of the SCAI.)

If NA,click below. / Student Survey: Based on the SCAI that was administered to students, what are some of your school’s strengths (name up to three strengths).
○
If NA,click below. / Parent Surveys: Based on the SCAI that was administered to parents/guardians, what are some of your school’s strengths (name up to three strengths).
○
If NA,click below. / Teachers/Staff Surveys: Based on the SCAI that was administered to teachers/staff, what are some of your school’s strengths (name up to three strengths).
○
  1. Based on the school climate assessment results for your school, what are some of your school’s discrepancies? Be sure to quantify the discrepancies. [NOTE: In this case, discrepancies refer to differences between populations at the school.]

The following are just a few examples of quantified discrepancies: “75% of girls view the school positively as compared to 25% of boys”;“84% of students in lower grade levels say they have a connection with an adult at the school as compared to 61% of students in upper grades”;“54% of teachers believe the school is safe as compared to 42% of students.” List up to three discrepancies.

If NA,click below. /
  1. Discrepancy 1 (be sure to include percent):

○
If NA,click below. /
  1. Discrepancy 2 (be sure to include percent):

○
If NA,click below. /
  1. Discrepancy 3 (be sure to include percent):

○
  1. Please tell us about any challenges that were experienced at your school in regard to the SCAI. List up to three for each.

If NA,click below. / Student Survey: Please tell us about any challenges that were experienced at your school with the implementation of the student SCAI. (List up to three challenges.)
○
If NA, click below. / Parent Survey: Please tell us about any challenges that were experienced at your school with the implementation of the parentSCAI. (List up to three challenges.)
○
If NA,click below. / Teacher/Staff Surveys: Please tell us about any challenges that were experienced at your school with the implementation of the teacher/staffSCAI. (List up to three challenges.)
○
  1. Based on theSCAIresults for your school, what are the areas that will be targeted for improvement? (List up to three for each.)

If NA,click below. / Student Survey: Based on the SCAI that was administered to students at your school,what are the areas that will be targeted for improvement? (List up to three.)
○
If NA,click below. / Parent Survey: Based on the SCAI that was administered to parents/guardians atyour school,what are the areas that will be targeted for improvement? (List up to three.)
○
If NA,click below. / Teachers/Staff Survey: Based on the SCAI that was administered to teachers/staff at your school,what are the areas that will be targeted for improvement? (List up to three.)
○
  1. Does your school have a School Climate Improvement Plan based on the School Climate Assessment data that wasgathered at your school?

○YES

○NO

○In progress

13. If you answered YES to question 12, briefly describe any existing or anticipated barriers that you think would prevent the implementation of school climate improvements at your school.

If NA,click below. / Briefly, please describe any existing or anticipated barriers that you think would inhibit the implementation of school climate improvement at your school.
○

PART II:

As required by Public Act 11-232, each local and regional board of education shall collect the school climate assessments for each school in the district and submit school climate assessments to the Department. In order to comply with this requirement, the following includes questions regarding school climate data collected at your school during the 2012-13 school year.

  1. Based on the results of the SCAI that was administered at yourschool, what percentage of students, parents/guardians, and faculty/staff believe the school has an overall positive school climate? (Note: “Positive school climate” can be defined on your own terms.)

NA / Students / Parents/
Guardians / Faculty/Staff
The CSDE School Climate Assessment Instrument / ○ / __% / __% / __%
The modified CSDE School Climate Assessment Instrument / ○ / __% / __% / __%
An alternative School Climate Assessment Instrument / ○ / __% / __% / __%
  1. Please select the responsive consequence(s) to any of the verified acts of bullying at your school? Select all that apply.

Expulsion
Suspension – In-School
Suspension – Out-of-School
Detention
CounselingReassignment / Community service
Adult mediation
Peer mediation
Restorative actions
Police action
Other (please specify)

  1. Does your school have grade-appropriate (K-12) Bullying Prevention/Positive School Climate
program(s)/curricula?
Yes
No
NA
If Yes, name of program(s)/curricula

  1. On or before January 1, 2013, for which of the following groups have you provided school climate
improvement/bullying prevention training? Select all that apply.
Parents/guardians
Teachers
School Administrators
Superintendents
Certified Staff
Non-Certified Staff
Substitute Teacher
Guidance Counselor
Nurse
Social Worker
School Psychologist
Nurse
Paraprofessionals
Coach
Bus Drivers
Food Service Providers or any other individual who has contact with students on a regular basis.
Other
(Specify)

  1. Does your school’s improvement effort include school climate improvement?
Yes
No
N/A
  1. Does your school have a safe school climate committee?
Yes
No
  1. Does this safe school climate committee include at least one parent?
Yes
No
  1. Does this safe school climate committee include any students?
Yes
No
  1. How can the CSDE support you in your school climate improvement efforts(only list up to
three in the space below)?
If NA,click below. / Recommendations(only list up to three)
○
  1. Do you have any recommendations for the CSDE? (Only list up to three in the space below.)
If NA,click below. / Recommendations(only list up to three)
○

This plan requires superintendent certification. Please include the Superintendent’s certification in the space below prior to submission.

Thank you for your time!