IMPAQ International, LLC 6. TA Recipient Survey 

### APPENDIX E

6. TECHNICAL ASSISTANCE RECIPIENT SURVEY

Thank you for taking the time to complete this survey. The US Department of Education

supports 22 Comprehensive Technical Assistance Centers to help increase State Education

Agencies’ capacity to assist districts and schools in meeting student achievement goals. As part

of an external evaluation of the national Comprehensive Centers program, IMPAQ International

is surveying recipients of technical assistance like you about your experience with the program

and related capacity

‐ building outcomes. Your responses will help assess outcomes and inform

improvement of the Comprehensive Centers program.

The focus of this survey is on technical assistance in two areas identified by the Department of

Education as priorities:

1. Identifying, recruiting, developing, and retaining highly effective teachers and leaders

2. Ensuring school readiness and success of preschool

‐ age children and their successful

transition to kindergarten.

The survey should take no more than 15 minutes to complete.

Information collected for this study comes under the confidentiality and data protection

requirements of the Institute of Education Sciences (The Education Sciences Reform Act of

2002, Title I, Part E, Section 183). Responses to this data collection will be used only for

research purposes. The reports prepared for this study from the survey findings will

be summarized and aggregated and should not associate responses with a specific district,

school, or individual. However, respondents’ roles and the CC they work with may be identified

in the report, which may lead to individuals’ being identified. Other than this situation that we

have made respondents aware of, we will not provide information that identifies you to anyone

outside the study team, except as required by law.

This survey is voluntary. You can decide not to participate, or you can discontinue participation

at any time without consequence. You do not have to answer any questions you do not want

to, but we encourage you to answer as many as you can.

If you have any questions, please contact Michaela Gulemetova at 443

‐ 367

‐ 0088 extension

2335 or NCCEvaluation@impaqint.com.

Thank you for your help!IMPAQ International, LLC 6. TA Recipient Survey

2 The OMB Control Number for this information collection is <insert number> and the expiration date is <insert

date>.

According to the Paperwork Reduction Act of 1995, persons are not required to respond to this collection of

information unless it displays a currently valid OMB control number and expiration date. Responding to this

interview is voluntary. Public reporting burden for this collection of information is estimated to average 15

minutes per response. Send comments regarding this burden estimate or any other aspect of this collection of

information to XXXXXXXXXXXXXXX at XXXXXXXXXXXXX@ed.gov.IMPAQ International, LLC 6. TA Recipient Survey

3 

### Technical assistance from [Center]

1. To what extent do you agree with the following statements about your relationship with

the [Center]? (Select ONE response in each row)

Strongly

Disagree Disagree Neither

Disagree

Nor

Agree Agree Strongly

Agree

a. We have frequent

communication. ⃝  ⃝  ⃝  ⃝  ⃝

b. Our relationship is

collaborative. ⃝  ⃝  ⃝  ⃝  ⃝

c. They understand my

organization’s needs. ⃝  ⃝  ⃝  ⃝  ⃝

d. They provide technical

assistance in timely manner. ⃝  ⃝  ⃝  ⃝  ⃝

Next, we will ask you questions about specific technical assistance (TA) you have received

during the last 12 months in the Department of Education’s priority areas related to Identifying,

recruiting, developing, and retaining highly effective teachers and leaders (great teachers and

leaders) and ensuring the school readiness and success of preschool

‐ age children and their

successful transition to kindergarten (early childhood learning).

2. Have you personally received the any of following specific TA from [Center or Centers]

during the last 12 months? (Select ONE response in each row)

Yes No Don’t know

a. Workshop #1 ⃝  ⃝  ⃝

b. Webinar #2 ⃝  ⃝  ⃝

c. Consultation #3 ⃝  ⃝  ⃝

d. Product #4 ⃝  ⃝  ⃝

e. Lit review #5 ⃝  ⃝  ⃝

f. Toolkit #6 ⃝  ⃝  ⃝

g. Other (Please specify)___________ ⃝  ⃝  ⃝

3. To what extent do you agree with the following statements about the technical assistance

(TA) you received from [Center] during the last 12 months? (Select ONE response in each

row)

Strongly

Disagree Disagree Neither

Disagree

Nor Agree Agree Strongly

Agree

a. Overall, the TA content

was of high quality

. ⃝  ⃝  ⃝  ⃝  ⃝

b. Overall, the TA delivery

was of high quality. ⃝  ⃝  ⃝  ⃝  ⃝IMPAQ International, LLC 6. TA Recipient Survey

4 Strongly

Disagree Disagree Neither

Disagree

Nor Agree Agree Strongly

Agree

c. Overall, the TA was

relevant to my work. ⃝  ⃝  ⃝  ⃝  ⃝

d. Overall, the TA was

useful. ⃝  ⃝  ⃝  ⃝  ⃝

4. After receiving technical assistance last year, have you engaged in any of the following

activities? (Check ALL that apply)

⃝ a. Reviewed the materials/resources/handouts provided by the [Center]

⃝ b. Looked up references provided by the [Center]

⃝ c. Researched additional materials on the topic

⃝ d. Used the information in drafting internal memos/plans/reports

⃝ e. Used the information in developing new processes/projects/programs

⃝ f. Used the information to overcome a barrier or challenge

⃝ g. Made recommendations to SEA leadership or staff

⃝ h. Other:_____________

⃝ i. I have not yet engaged in any activities related to the TA, but have made plans to do

so ⃝ j. No, I have not engaged in any activities related to the TA I received from the [Center]

5. Have you discussed the information you received through the TA with any of the

following? (Check ALL that apply)

⃝ a. [Center] staff/event organizers

⃝ b. Other technical assistance recipients from outside our organization (e.g., other SEAs)

⃝ c. LEA staff

⃝ d. Other staff within your organization

⃝ e. Other:_____________

⃝ f. No, I have not discussed the information

6. To what extent do you agree that the technical assistance you received during last 12

months helped you in the following ways? (Select ONE response in each row)

To what extent did the TA you

received help you.... Not at all Very little To some

extent To a great

extent Not

Applicable

a. Solve a problem? ⃝  ⃝  ⃝  ⃝  ⃝

b. Access the information

you wanted? ⃝  ⃝  ⃝  ⃝  ⃝

c. Increase your knowledge

and expertise in the

topic? ⃝  ⃝  ⃝  ⃝  ⃝

d. Identify additional

training events, webinars,

and seminars of interest? ⃝  ⃝  ⃝  ⃝  ⃝IMPAQ International, LLC 6. TA Recipient Survey

5 e. Build collaborations with

professional experts

outside your

organization? ⃝  ⃝  ⃝  ⃝  ⃝

f. Access useful information

or ideas from other

states? ⃝  ⃝  ⃝  ⃝  ⃝

g. Learn about or obtain

new tools that you can

use in your work? ⃝  ⃝  ⃝  ⃝  ⃝

h. Learn new strategies that

you can use in your work? ⃝  ⃝  ⃝  ⃝  ⃝

i. Perform your job in a

more informed and

efficient way? ⃝  ⃝  ⃝  ⃝  ⃝

7. To what extent do you agree that the technical assistance you received during the last 12

months helped your organization in the following ways? (Select ONE response in each

row)IMPAQ International, LLC 6. TA Recipient Survey

6 To what extent did the TA you

received help your

organization.... Not at all Very

little To some

extent To a

great

extent Not

Applicable

a. Develop and implement

internal staff trainings? ⃝  ⃝  ⃝  ⃝  ⃝

b. Incorporate the new

information into internal

procedures and processes? ⃝  ⃝  ⃝  ⃝  ⃝

c. Redesign state agency

structures, teams and

departments? ⃝  ⃝  ⃝  ⃝  ⃝

d. Improve communication

channels across state

agencies? ⃝  ⃝  ⃝  ⃝  ⃝

e. Improve communication

channels with LEAs? ⃝  ⃝  ⃝  ⃝  ⃝

f. Partner more with external

experts? ⃝  ⃝  ⃝  ⃝  ⃝

g. Shape new and existing

programs and policies in the

area of great teachers and

leaders? ⃝  ⃝  ⃝  ⃝  ⃝

h. Provide better support to

LEAs in the area of great

teachers and leaders? ⃝  ⃝  ⃝  ⃝  ⃝

i. Shape new and existing

programs and policies in the

area of early learning? ⃝  ⃝  ⃝  ⃝  ⃝

j. Provide better support to

LEAs in the area of early

learning? ⃝  ⃝  ⃝  ⃝  ⃝

k. Identify other needs for

information? ⃝  ⃝  ⃝  ⃝  ⃝

l. Other:_______

___________ ⃝  ⃝  ⃝  ⃝  ⃝

8. Do you have specific plans to use the information you received from the Center in the

upcoming 12 months? (Select ONE)

⃝ a. Yes  if yes, please elaborate how:________

_______________ ⃝ b. No

9. Has the [Center]’s technical assistance enabled you to accomplish what you may not have

otherwise accomplished?

⃝ a. YesIMPAQ International, LLC 6. TA Recipient Survey

7 ⃝ b. No

Please explain:

______________ _________

10. Please describe the aspects of the services and/or resources that have been most helpful

and why:

___________________

11. Please describe the aspects of the services and/or resources that have been least helpful

and why:

___________________

12. Please describe if you have any needs that were not met by the services and/or resources:

__________ _________

13. What challenges have you encountered in your experience with the [Center] during the

last 12 months? (Check ALL that apply)

⃝ a. Lack of understanding of our needs by [Center] staff

⃝ b. Delay in receiving needed TA

⃝ c. Staff turnover at our organization

⃝ d. Staff turnover at the [Center]

⃝ e. Difficulty scheduling time for our staff to participate

⃝ f. Difficulty in communication with the [Center]

⃝ g. Lack of skills/expertise by [Center] staff to address our needs

⃝ h. Lack of alignment between my organization’s needs and [Center] priorities

⃝ i. Insufficient number of in

‐ person meetings with the [Center]

⃝ j. Unclear understanding of the role of the [Center] and what it can offer

⃝ k. Other_____________

14. Please provide any additional comments about your experience with the

[Center]:

__________



### Demographic background

15. Please identify your organization: (Select ONE)

⃝ a. State Education Agency

⃝ b. Local Education Agency/School District

⃝ c. School

⃝ d. Comprehensive Center

⃝ d. Other_____________

16. What is your role in your organization?

__________ _________

17. How long have you been in your current role? (Select ONE)

⃝ a. 0

– 1 yearsIMPAQ International, LLC 6. TA Recipient Survey

8 ⃝ b. 2

– 3 years ⃝ c. 4 or more years

18. How long have you been with your organization? (Select ONE)

⃝ a. 0

– 1 years ⃝ b. 2

– 3 years ⃝ c. 4

‐ 10 years ⃝ d. 11 or more years



### Thank you!