Parent Community School Survey

Part I: What is happening at your school?

This brief questionnaire (developed by the Coalition for Community Schools) is intended to help individual schools assess where they are in their effort to become a community school.

Following are examples of what community schools are doing across the country for students, families and community residents. Activities will vary based on need and circumstances. A fully developed community school will be doing work in each of the areas listed. We have organized possible activities by the core results that community schools should strive for.

Question Title

* 1. Listed below are some possible activities that might go on in your child’s school to ensure that s/he is ready to enter school. Please rate the school’s implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
Early learning and development opportunities	Early learning and development opportunities Not at all	Early learning and development opportunities Needs Work	Early learning and development opportunities Somewhat	Early learning and development opportunities Area of Strength	Early learning and development opportunities N/A
Headstart/Educare	Headstart/Educare Not at all	Headstart/Educare Needs Work	Headstart/Educare Somewhat	Headstart/Educare Area of Strength	Headstart/Educare N/A
On‐Site health clinic	On‐Site health clinic Not at all	On‐Site health clinic Needs Work	On‐Site health clinic Somewhat	On‐Site health clinic Area of Strength	On‐Site health clinic N/A
Transition services from early childhood to school	Transition services from early childhood to school Not at all	Transition services from early childhood to school Needs Work	Transition services from early childhood to school Somewhat	Transition services from early childhood to school Area of Strength	Transition services from early childhood to school N/A
Parent education	Parent education Not at all	Parent education Needs Work	Parent education Somewhat	Parent education Area of Strength	Parent education N/A
Teacher home visits	Teacher home visits Not at all	Teacher home visits Needs Work	Teacher home visits Somewhat	Teacher home visits Area of Strength	Teacher home visits N/A
Childcare	Childcare Not at all	Childcare Needs Work	Childcare Somewhat	Childcare Area of Strength	Childcare N/A
Pre‐K	Pre‐K Not at all	Pre‐K Needs Work	Pre‐K Somewhat	Pre‐K Area of Strength	Pre‐K N/A
Prenatal care	Prenatal care Not at all	Prenatal care Needs Work	Prenatal care Somewhat	Prenatal care Area of Strength	Prenatal care N/A

Question Title

* 2. Please describe any additional activities not listed above.

Question Title

* 3. Overall, I feel that my school helps ensure that my child is ready to enter school.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength

Question Title

* 4. Listed below are some possible activities that might go on in your child's school to ensure that young people succeed academically. Please rate their implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
High quality reading and math instruction	High quality reading and math instruction Not at all	High quality reading and math instruction Needs Work	High quality reading and math instruction Somewhat	High quality reading and math instruction Area of Strength	High quality reading and math instruction N/A
College and Career Readiness	College and Career Readiness Not at all	College and Career Readiness Needs Work	College and Career Readiness Somewhat	College and Career Readiness Area of Strength	College and Career Readiness N/A
Enriched/extended learning (after school clubs)	Enriched/extended learning (after school clubs) Not at all	Enriched/extended learning (after school clubs) Needs Work	Enriched/extended learning (after school clubs) Somewhat	Enriched/extended learning (after school clubs) Area of Strength	Enriched/extended learning (after school clubs) N/A
Active family involvement (parent conferences, volunteering, PTA)	Active family involvement (parent conferences, volunteering, PTA) Not at all	Active family involvement (parent conferences, volunteering, PTA) Needs Work	Active family involvement (parent conferences, volunteering, PTA) Somewhat	Active family involvement (parent conferences, volunteering, PTA) Area of Strength	Active family involvement (parent conferences, volunteering, PTA) N/A
Opportunities for learning in the real world and community problem solving	Opportunities for learning in the real world and community problem solving Not at all	Opportunities for learning in the real world and community problem solving Needs Work	Opportunities for learning in the real world and community problem solving Somewhat	Opportunities for learning in the real world and community problem solving Area of Strength	Opportunities for learning in the real world and community problem solving N/A
Mentoring	Mentoring Not at all	Mentoring Needs Work	Mentoring Somewhat	Mentoring Area of Strength	Mentoring N/A

Question Title

* 5. Please describe any additional activities not listed above.

Question Title

* 6. Overall, I feel that my child's school helps ensure that my child succeeds academically.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength

Question Title

* 7. Listed below are some possible activities that might go on in your school to ensure that your child is engaged and motivated to learn, and involved in their community. Please rate the school’s implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
Mentoring/tutoring	Mentoring/tutoring Not at all	Mentoring/tutoring Needs Work	Mentoring/tutoring Somewhat	Mentoring/tutoring Area of Strength	Mentoring/tutoring N/A
High quality reading and math instruction	High quality reading and math instruction Not at all	High quality reading and math instruction Needs Work	High quality reading and math instruction Somewhat	High quality reading and math instruction Area of Strength	High quality reading and math instruction N/A
Family involvement activities (literacy or math nights)	Family involvement activities (literacy or math nights) Not at all	Family involvement activities (literacy or math nights) Needs Work	Family involvement activities (literacy or math nights) Somewhat	Family involvement activities (literacy or math nights) Area of Strength	Family involvement activities (literacy or math nights) N/A
Home visits	Home visits Not at all	Home visits Needs Work	Home visits Somewhat	Home visits Area of Strength	Home visits N/A
Youth leadership development (scouting, student council, safety patrol)	Youth leadership development (scouting, student council, safety patrol) Not at all	Youth leadership development (scouting, student council, safety patrol) Needs Work	Youth leadership development (scouting, student council, safety patrol) Somewhat	Youth leadership development (scouting, student council, safety patrol) Area of Strength	Youth leadership development (scouting, student council, safety patrol) N/A
Opportunities for learning in the real world and community problem solving	Opportunities for learning in the real world and community problem solving Not at all	Opportunities for learning in the real world and community problem solving Needs Work	Opportunities for learning in the real world and community problem solving Somewhat	Opportunities for learning in the real world and community problem solving Area of Strength	Opportunities for learning in the real world and community problem solving N/A
School as center for community problem solving	School as center for community problem solving Not at all	School as center for community problem solving Needs Work	School as center for community problem solving Somewhat	School as center for community problem solving Area of Strength	School as center for community problem solving N/A
Enriched/extended learning (after school clubs)	Enriched/extended learning (after school clubs) Not at all	Enriched/extended learning (after school clubs) Needs Work	Enriched/extended learning (after school clubs) Somewhat	Enriched/extended learning (after school clubs) Area of Strength	Enriched/extended learning (after school clubs) N/A

Question Title

* 8. Please describe any additional activities not listed above.

Question Title

* 9. Overall, I feel that my school helps ensure that my child is engaged and motivated to learn, and involved in his/her community.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength

Question Title

* 10. Listed below are some possible activities that might go on in your school to ensure that your child lives, learns and thrives in stable and supportive environments. Please rate their implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
Mentoring	Mentoring Not at all	Mentoring Needs Work	Mentoring Somewhat	Mentoring Area of Strength	Mentoring N/A
Health education	Health education Not at all	Health education Needs Work	Health education Somewhat	Health education Area of Strength	Health education N/A
Peer mediation/conflict resolution	Peer mediation/conflict resolution Not at all	Peer mediation/conflict resolution Needs Work	Peer mediation/conflict resolution Somewhat	Peer mediation/conflict resolution Area of Strength	Peer mediation/conflict resolution N/A
Vision/hearing screening	Vision/hearing screening Not at all	Vision/hearing screening Needs Work	Vision/hearing screening Somewhat	Vision/hearing screening Area of Strength	Vision/hearing screening N/A
Violence prevention	Violence prevention Not at all	Violence prevention Needs Work	Violence prevention Somewhat	Violence prevention Area of Strength	Violence prevention N/A
Mental health services	Mental health services Not at all	Mental health services Needs Work	Mental health services Somewhat	Mental health services Area of Strength	Mental health services N/A
Crisis intervention (food, clothing, housing)	Crisis intervention (food, clothing, housing) Not at all	Crisis intervention (food, clothing, housing) Needs Work	Crisis intervention (food, clothing, housing) Somewhat	Crisis intervention (food, clothing, housing) Area of Strength	Crisis intervention (food, clothing, housing) N/A
Case management	Case management Not at all	Case management Needs Work	Case management Somewhat	Case management Area of Strength	Case management N/A
On‐site health clinic	On‐site health clinic Not at all	On‐site health clinic Needs Work	On‐site health clinic Somewhat	On‐site health clinic Area of Strength	On‐site health clinic N/A
Social and emotional learning opportunities	Social and emotional learning opportunities Not at all	Social and emotional learning opportunities Needs Work	Social and emotional learning opportunities Somewhat	Social and emotional learning opportunities Area of Strength	Social and emotional learning opportunities N/A

Question Title

* 11. Overall, I feel my school helps ensure that my student lives, learns, and thrives in stable and supportive environments.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength

Question Title

* 12. Listed below are some possible activities that might go on in your school to ensure that families are actively involved in your child’s education. Please rate their implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
Parent leadership development	Parent leadership development Not at all	Parent leadership development Needs Work	Parent leadership development Somewhat	Parent leadership development Area of Strength	Parent leadership development N/A
Community events and organizing (block party, voting poll, neighborhood meetings)	Community events and organizing (block party, voting poll, neighborhood meetings) Not at all	Community events and organizing (block party, voting poll, neighborhood meetings) Needs Work	Community events and organizing (block party, voting poll, neighborhood meetings) Somewhat	Community events and organizing (block party, voting poll, neighborhood meetings) Area of Strength	Community events and organizing (block party, voting poll, neighborhood meetings) N/A
Teacher home visits	Teacher home visits Not at all	Teacher home visits Needs Work	Teacher home visits Somewhat	Teacher home visits Area of Strength	Teacher home visits N/A
Family involvement activities (literacy or math nights, carnivals, bingo chili)	Family involvement activities (literacy or math nights, carnivals, bingo chili) Not at all	Family involvement activities (literacy or math nights, carnivals, bingo chili) Needs Work	Family involvement activities (literacy or math nights, carnivals, bingo chili) Somewhat	Family involvement activities (literacy or math nights, carnivals, bingo chili) Area of Strength	Family involvement activities (literacy or math nights, carnivals, bingo chili) N/A

Question Title

* 13. Please describe any additional activities not listed above.

Question Title

* 14. Overall, I feel that my school creates the conditions to ensure that I am actively involved in my child’s education.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength

Question Title

* 15. Listed below are some possible activities that might go on in your child’s school to ensure that communities are desirable places to live. Please rate their implementation or choose N/A if not applicable.

	Not at all	Needs Work	Somewhat	Area of Strength	N/A
On‐site health clinic	On‐site health clinic Not at all	On‐site health clinic Needs Work	On‐site health clinic Somewhat	On‐site health clinic Area of Strength	On‐site health clinic N/A
Counseling/mental health services	Counseling/mental health services Not at all	Counseling/mental health services Needs Work	Counseling/mental health services Somewhat	Counseling/mental health services Area of Strength	Counseling/mental health services N/A
Health education	Health education Not at all	Health education Needs Work	Health education Somewhat	Health education Area of Strength	Health education N/A
Adult education (English language, GED)	Adult education (English language, GED) Not at all	Adult education (English language, GED) Needs Work	Adult education (English language, GED) Somewhat	Adult education (English language, GED) Area of Strength	Adult education (English language, GED) N/A
Violence prevention	Violence prevention Not at all	Violence prevention Needs Work	Violence prevention Somewhat	Violence prevention Area of Strength	Violence prevention N/A
Job training	Job training Not at all	Job training Needs Work	Job training Somewhat	Job training Area of Strength	Job training N/A
Crisis intervention (food, clothing, housing)	Crisis intervention (food, clothing, housing) Not at all	Crisis intervention (food, clothing, housing) Needs Work	Crisis intervention (food, clothing, housing) Somewhat	Crisis intervention (food, clothing, housing) Area of Strength	Crisis intervention (food, clothing, housing) N/A
Community events and organizing (block party, neighborhood meetings, voting poll)	Community events and organizing (block party, neighborhood meetings, voting poll) Not at all	Community events and organizing (block party, neighborhood meetings, voting poll) Needs Work	Community events and organizing (block party, neighborhood meetings, voting poll) Somewhat	Community events and organizing (block party, neighborhood meetings, voting poll) Area of Strength	Community events and organizing (block party, neighborhood meetings, voting poll) N/A
Community leadership development	Community leadership development Not at all	Community leadership development Needs Work	Community leadership development Somewhat	Community leadership development Area of Strength	Community leadership development N/A
Youth leadership development	Youth leadership development Not at all	Youth leadership development Needs Work	Youth leadership development Somewhat	Youth leadership development Area of Strength	Youth leadership development N/A
School as center for community problem solving	School as center for community problem solving Not at all	School as center for community problem solving Needs Work	School as center for community problem solving Somewhat	School as center for community problem solving Area of Strength	School as center for community problem solving N/A

Question Title

* 16. Please describe any additional activities not listed above.

Question Title

* 17. Overall, I feel that my school creates the conditions to ensure that communities are desirable places to live.

Not at all

Needs work

Somewhat

Area of strength

Not at all

Needs work

Somewhat

Area of strength