Positive Action Lesson Checklist
To be completed at least twice a month, or at most once a week.
OK
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1.
Session Leader Name
(Required.)
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2.
Date
(Required.)
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3.
Unit & Lesson taught
(Required.)
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4.
Percentage of students that received lesson
(Required.)
*
5.
Grade level
(Required.)
2
3
4
5
6
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6.
At what time of day was the Positive Action lesson administered?
(Required.)
Early morning
Mid-morning
Late morning
Early afternoon
Late afternoon
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7.
Was the lesson adapted from the original plan and instructions?
(Required.)
Yes
No
8.
If Yes, how was the lesson adapted?
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9.
Were there lesson specific posters in the classroom?
(Required.)
Yes
No
Not Applicable
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10.
Were activity sheets, booklets, or journals used in the lesson?
(Required.)
Yes
No
Not Applicable
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11.
Were there other items the lesson instructions called for that were used?
(Required.)
Yes
No
Not Applicable
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12.
Have you seen students applying concepts learned from past Positive Action materials?
(Required.)
Yes
No
13.
If Yes, in what ways have you noticed students applying Positive Action concepts?
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14.
Between the past lesson and now, how often did you help students to understand that doing positive actions helps them feel good about themselves?
(Required.)
Never
A few times
Many times
Most of the time
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15.
Between the past lesson and now, how often did you recognize student’s positive actions in the classroom?
(Required.)
Never
A few times
Many times
Most of the time
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16.
Between the past lesson and now, how often did you reinforce students’ positive actions/behaviors when you observed them?
(Required.)
Never
A few times
Many times
Most of the time
*
17.
Between the past lesson and now, how often did you encourage your students to do positive actions/behaviors outside the classroom?
(Required.)
Never
A few times
Many times
Most of the time
Current Progress,
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