School Climate Survey (Student version)

1. Elementary School Student Report

This set of questions asks you to tell about your school and things that may or may not have happened to you at school. There are no right or wrong answers. Please answer the questions to show what you think about your school.

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* 1. During the past month, has this happened to you?

	Never	Less than 1 time per week	1 time per week	2-4 times per week	5 or more times per week
I was hit, pushed, or kicked by other kids	I was hit, pushed, or kicked by other kids Never	I was hit, pushed, or kicked by other kids Less than 1 time per week	I was hit, pushed, or kicked by other kids 1 time per week	I was hit, pushed, or kicked by other kids 2-4 times per week	I was hit, pushed, or kicked by other kids 5 or more times per week
Other kids said mean things, teased me, or called me names	Other kids said mean things, teased me, or called me names Never	Other kids said mean things, teased me, or called me names Less than 1 time per week	Other kids said mean things, teased me, or called me names 1 time per week	Other kids said mean things, teased me, or called me names 2-4 times per week	Other kids said mean things, teased me, or called me names 5 or more times per week
Other kids told stories about me that were not true	Other kids told stories about me that were not true Never	Other kids told stories about me that were not true Less than 1 time per week	Other kids told stories about me that were not true 1 time per week	Other kids told stories about me that were not true 2-4 times per week	Other kids told stories about me that were not true 5 or more times per week
Other kids did not let me join in what they were doing	Other kids did not let me join in what they were doing Never	Other kids did not let me join in what they were doing Less than 1 time per week	Other kids did not let me join in what they were doing 1 time per week	Other kids did not let me join in what they were doing 2-4 times per week	Other kids did not let me join in what they were doing 5 or more times per week
Other kids took things that belong to me	Other kids took things that belong to me Never	Other kids took things that belong to me Less than 1 time per week	Other kids took things that belong to me 1 time per week	Other kids took things that belong to me 2-4 times per week	Other kids took things that belong to me 5 or more times per week
Other kids threatened to hurt me or take things	Other kids threatened to hurt me or take things Never	Other kids threatened to hurt me or take things Less than 1 time per week	Other kids threatened to hurt me or take things 1 time per week	Other kids threatened to hurt me or take things 2-4 times per week	Other kids threatened to hurt me or take things 5 or more times per week

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* 2. If any of the above things happened to you, what did you do? (check all that apply):

I got help from an adult at school

I ignored it or walked away

I told the kid to stop

I said things to myself to help myself feel better

I got help from my parents

I hit, kicked, or pushed the kid

I tried to stop the kid by saying or doing something funny

I avoided the kid so I would not get hurt or teased again

I got help from another kid

I said mean things, teased, or called the kid names

I told the kid I agreed with what he or she said about me

I did nothing

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* 3. Who bullied you? (check all that apply):

a girl

a boy

a group

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* 4. Where did it happen? (check all that apply):

Classroom

Going to and from school

Playground

Bathroom

Hallways/lunchroom

before or after school activity

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* 5. Who did you tell? (check all that apply):

no one

a parent

a friend

a bus driver

an adult at school

other

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* 6. During the past month, have you seen this happen?

	Never	Less than 1 time per week	1 time per week	2-4 times per week	5 or more times per week
I saw someone get hit, pushed, or kicked by other kids	I saw someone get hit, pushed, or kicked by other kids Never	I saw someone get hit, pushed, or kicked by other kids Less than 1 time per week	I saw someone get hit, pushed, or kicked by other kids 1 time per week	I saw someone get hit, pushed, or kicked by other kids 2-4 times per week	I saw someone get hit, pushed, or kicked by other kids 5 or more times per week
I heard kids say mean things, tease, or call someone names	I heard kids say mean things, tease, or call someone names Never	I heard kids say mean things, tease, or call someone names Less than 1 time per week	I heard kids say mean things, tease, or call someone names 1 time per week	I heard kids say mean things, tease, or call someone names 2-4 times per week	I heard kids say mean things, tease, or call someone names 5 or more times per week
I heard kids tell stories about someone that were not true	I heard kids tell stories about someone that were not true Never	I heard kids tell stories about someone that were not true Less than 1 time per week	I heard kids tell stories about someone that were not true 1 time per week	I heard kids tell stories about someone that were not true 2-4 times per week	I heard kids tell stories about someone that were not true 5 or more times per week
I saw kids not let someone join in what they were doing	I saw kids not let someone join in what they were doing Never	I saw kids not let someone join in what they were doing Less than 1 time per week	I saw kids not let someone join in what they were doing 1 time per week	I saw kids not let someone join in what they were doing 2-4 times per week	I saw kids not let someone join in what they were doing 5 or more times per week
I saw or heard that kids took things that belong to someone else	I saw or heard that kids took things that belong to someone else Never	I saw or heard that kids took things that belong to someone else Less than 1 time per week	I saw or heard that kids took things that belong to someone else 1 time per week	I saw or heard that kids took things that belong to someone else 2-4 times per week	I saw or heard that kids took things that belong to someone else 5 or more times per week
I heard kids threaten to hurt someone or take things	I heard kids threaten to hurt someone or take things Never	I heard kids threaten to hurt someone or take things Less than 1 time per week	I heard kids threaten to hurt someone or take things 1 time per week	I heard kids threaten to hurt someone or take things 2-4 times per week	I heard kids threaten to hurt someone or take things 5 or more times per week

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* 7. If you heard or saw any of these things happen, what did you do? (Check all that apply):

I did nothing

I stood up to the kid who was teasing or hurting the kids

I helped the kid come up with ideas about how to handle the problem

I got help from an adult at school

I helped the kid who was hurt/teased/left out to get away

I talked to the kid who was hurt/teased/left out about he/she felt

I asked the kid who was hurt/teased/left out to play with me

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* 8. Who was it done by? (check all that apply):

a Girl

a Boy

a Group

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* 9. Where did it happen? (check all that apply):

Classroom

Going to and from school

Playground

Bathroom/locker room

Hallways/Lunchroom

Before or after school activity

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* 10. Who did you tell? (check all that apply):

No one

a Parent

a friend

Bus Driver

An Adult at school

Other

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* 11. How safe do you feel?
During the past month, this is how I felt in each of these places:

	Very unsafe & scared	Unsafe & scared	Kind of unsafe	Kind of safe	Safe	Very Safe
In My Classroom	In My Classroom Very unsafe & scared	In My Classroom Unsafe & scared	In My Classroom Kind of unsafe	In My Classroom Kind of safe	In My Classroom Safe	In My Classroom Very Safe
On the Playground	On the Playground Very unsafe & scared	On the Playground Unsafe & scared	On the Playground Kind of unsafe	On the Playground Kind of safe	On the Playground Safe	On the Playground Very Safe
In the Hallways	In the Hallways Very unsafe & scared	In the Hallways Unsafe & scared	In the Hallways Kind of unsafe	In the Hallways Kind of safe	In the Hallways Safe	In the Hallways Very Safe
Lunchroom	Lunchroom Very unsafe & scared	Lunchroom Unsafe & scared	Lunchroom Kind of unsafe	Lunchroom Kind of safe	Lunchroom Safe	Lunchroom Very Safe
Going to and from school	Going to and from school Very unsafe & scared	Going to and from school Unsafe & scared	Going to and from school Kind of unsafe	Going to and from school Kind of safe	Going to and from school Safe	Going to and from school Very Safe
Bathroom	Bathroom Very unsafe & scared	Bathroom Unsafe & scared	Bathroom Kind of unsafe	Bathroom Kind of safe	Bathroom Safe	Bathroom Very Safe
At, before, or after school activities	At, before, or after school activities Very unsafe & scared	At, before, or after school activities Unsafe & scared	At, before, or after school activities Kind of unsafe	At, before, or after school activities Kind of safe	At, before, or after school activities Safe	At, before, or after school activities Very Safe

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* 12. What is our school like?

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* 13. What Grade are you in?

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* 14. I am a:

Boy

Girl

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* 15. I usually go to and from school by:

Walking

Bike

Car

Bus

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* 16. I am: (Check all that apply)

Asian America

African American

Hispanic/Latino American

Native American

White American

Other

	never/hardly ever true	sometimes true	often true	almost always/always true
The other kids help if they see someone being bullied or picked on	The other kids help if they see someone being bullied or picked on never/hardly ever true	The other kids help if they see someone being bullied or picked on sometimes true	The other kids help if they see someone being bullied or picked on often true	The other kids help if they see someone being bullied or picked on almost always/always true
The other kids tell an adult if they see someone being bullied or picked on	The other kids tell an adult if they see someone being bullied or picked on never/hardly ever true	The other kids tell an adult if they see someone being bullied or picked on sometimes true	The other kids tell an adult if they see someone being bullied or picked on often true	The other kids tell an adult if they see someone being bullied or picked on almost always/always true
If someone is alone at lunch or recess, others will invite them to join in	If someone is alone at lunch or recess, others will invite them to join in never/hardly ever true	If someone is alone at lunch or recess, others will invite them to join in sometimes true	If someone is alone at lunch or recess, others will invite them to join in often true	If someone is alone at lunch or recess, others will invite them to join in almost always/always true
Kids at this school encourage other kids to do the best they can at their schoolwork	Kids at this school encourage other kids to do the best they can at their schoolwork never/hardly ever true	Kids at this school encourage other kids to do the best they can at their schoolwork sometimes true	Kids at this school encourage other kids to do the best they can at their schoolwork often true	Kids at this school encourage other kids to do the best they can at their schoolwork almost always/always true
There are clear rules at our school	There are clear rules at our school never/hardly ever true	There are clear rules at our school sometimes true	There are clear rules at our school often true	There are clear rules at our school almost always/always true
The teachers and staff help if they see someone being bullied or picked on	The teachers and staff help if they see someone being bullied or picked on never/hardly ever true	The teachers and staff help if they see someone being bullied or picked on sometimes true	The teachers and staff help if they see someone being bullied or picked on often true	The teachers and staff help if they see someone being bullied or picked on almost always/always true
Kids who misbehave take a lot of my teacher's time	Kids who misbehave take a lot of my teacher's time never/hardly ever true	Kids who misbehave take a lot of my teacher's time sometimes true	Kids who misbehave take a lot of my teacher's time often true	Kids who misbehave take a lot of my teacher's time almost always/always true
Adults at this school care that the students do the best schoolwork they can	Adults at this school care that the students do the best schoolwork they can never/hardly ever true	Adults at this school care that the students do the best schoolwork they can sometimes true	Adults at this school care that the students do the best schoolwork they can often true	Adults at this school care that the students do the best schoolwork they can almost always/always true
My school tries to make everyone feel included	My school tries to make everyone feel included never/hardly ever true	My school tries to make everyone feel included sometimes true	My school tries to make everyone feel included often true	My school tries to make everyone feel included almost always/always true
I usually play with someone at recess	I usually play with someone at recess never/hardly ever true	I usually play with someone at recess sometimes true	I usually play with someone at recess often true	I usually play with someone at recess almost always/always true
When I'm upset other kids try to comfort me or cheer me up	When I'm upset other kids try to comfort me or cheer me up never/hardly ever true	When I'm upset other kids try to comfort me or cheer me up sometimes true	When I'm upset other kids try to comfort me or cheer me up often true	When I'm upset other kids try to comfort me or cheer me up almost always/always true
I like going to school	I like going to school never/hardly ever true	I like going to school sometimes true	I like going to school often true	I like going to school almost always/always true
I'm afraid to go to school	I'm afraid to go to school never/hardly ever true	I'm afraid to go to school sometimes true	I'm afraid to go to school often true	I'm afraid to go to school almost always/always true
Most people in school are kind	Most people in school are kind never/hardly ever true	Most people in school are kind sometimes true	Most people in school are kind often true	Most people in school are kind almost always/always true

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* 1. During the past month, has this happened to you?

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* 2. If any of the above things happened to you, what did you do? (check all that apply):

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* 3. Who bullied you? (check all that apply):

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* 4. Where did it happen? (check all that apply):

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* 5. Who did you tell? (check all that apply):

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* 6. During the past month, have you seen this happen?

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* 7. If you heard or saw any of these things happen, what did you do? (Check all that apply):

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* 8. Who was it done by? (check all that apply):

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* 9. Where did it happen? (check all that apply):

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* 10. Who did you tell? (check all that apply):

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* 11. How safe do you feel?During the past month, this is how I felt in each of these places:

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* 12. What is our school like?

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* 13. What Grade are you in?

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* 14. I am a:

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* 15. I usually go to and from school by:

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* 16. I am: (Check all that apply)

* 11. How safe do you feel?
During the past month, this is how I felt in each of these places: