APPENDIX F

FOURTH-GRADE

SCHOOL ADMINISTRATOR QUESTIONNAIRES

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 

(ECLS-K:2011)

Spring Fourth-Grade National Data Collection

and Fifth-Grade Recruitment

OMB Clearance Package

#1850-0750 v.16
1

Westat

Spring 2015

School Administrator Questionnaire

Questionnaire A

RETURN THIS COMPLETED QUESTIONNAIRE IN THE SEALED

TYVEK® ENVELOPE DIRECTLY TO YOUR SCHOOL COORDINATOR

OR AN ECLS‐K:2011 STAFF MEMBER. DO NOT MAIL THIS

QUESTIONNAIRE UNLESS YOU ARE ASKED TO DO SO BY STUDY

STAFF AND ARE PROVIDED WITH AN ENVELOPE FOR MAILING.

Use a black or blue ball point pen to complete this questionnaire.

Rockville, Maryland

National Center for Education Statistics by:

Prepared for the U.S. Department of Education

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survey is estimated to average 60 minutes per response, including the time to 

review instructions, search existing data resources, gather the data needed, 

and complete and review the survey. If you have any comments concerning 

the accuracy of the time estimate or suggestions for improving this survey, or 

any comments or concerns regarding the status of your individual submission 

of this survey, please write to: Early Childhood Longitudinal Study, National 

Center for Education Statistics, 1990 K Street, N.W., Washington, D.C. 20006‐

5574.

The collection of information in this survey is authorized by 20 U.S. 

Code, Section 9543. Participation is voluntary. You may skip questions 

you do not wish to answer; however, we hope that you will answer as 

many questions as you can. Your responses are protected from 

disclosure by federal statute ﴾20 U.S. Code, Section 9573﴿. All 

responses that relate to or describe identifiable characteristics of 

individuals may be used only for statistical purposes and may not be 

disclosed, or used, in identifiable form for any other purpose except as 

required by law. Data will be combined to produce statistical reports. 

No individual data that links your name, address, telephone number, 

or identification number with your responses will be included in the 

statistical reports. 

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Dear School Administrator,

This questionnaire is an important part of a major longitudinal study of children's early educational experiences

beginning with kindergarten and continuing through grade 5. The Early Childhood Longitudinal Study,

Kindergarten Class of 2010‐2011 ﴾ECLS‐K:2011﴿ is collecting information from schools attended by children

who are in the study to investigate the relationship between children's academic progress and various school,

classroom, teacher, and child characteristics. You have received this questionnaire because one or more of the

children in your school are participants in this study.

For the purposes of this study, the following definitions apply:

 Kindergarten: Traditional year of school primarily for 5‐year‐olds prior to first grade.

 Transitional ﴾or readiness﴿ kindergarten: Extra year of school for kindergarten‐age eligible children who

are judged not ready for kindergarten.

 Transitional first ﴾or prefirst﴿ grade: Extra year of school for children who have attended kindergarten but 

have been judged not ready for first grade.

 Ungraded: A classroom containing children with an age span of two or more years, not formally identified

by grade﴾s﴿.

This information is vital to the study. Please feel free to ask other knowledgeable members of your staff to

provide the information necessary to complete various sections of the questionnaire. However, we ask that you,

yourself, please complete the final section, which is about your own background and characteristics. Taking part

in the study is voluntary. You may stop at any time or choose not to answer a question you do not want to

answer. Although we realize you are very busy, we urge you to complete this questionnaire as completely and

accurately as possible. The information you provide is being collected for research purposes only and will be

protected from disclosure to the fullest extent allowable by law ﴾Education Sciences Reform Act of 2002, 20 U.S.C.

§ 9573﴿. Information from multiple individuals will be combined to produce statistical reports; no information

that identifies you will be included in any reports or provided to students, their parents, or other school staff.

Please record your answers directly on the questionnaire by marking the appropriate answer ﴾as described in the

instructions on page 5﴿ or by writing your responses in the space provided. Your best estimates are acceptable

answers.

DEFINITIONS

This questionnaire contains several brief sections:

a﴿ School characteristics

b﴿ School‐family‐community connections

c﴿ School policies and practices

d﴿ School programs for particular populations

e﴿ Federal programs: Title I, Adequate Yearly Progress ﴾AYP﴿, and Title III

 Staffing and teacher characteristics

g﴿ School administrator characteristics

f﴿

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Special programs. Reference is made in this questionnaire to Title I and Title III programs, individualized

education programs ﴾IEP﴿, Section 504 plans, and Response to Intervention ﴾RtI﴿. For this study, the following

definitions apply:

 Title I: "Improving the Academic Achievement of the Disadvantaged." Title I is a program of the

Elementary and Secondary Education Act ﴾ESEA﴿ of 1965, as reauthorized under the No Child Left

Behind Act of 2001. The purpose of this program is to ensure that all children have a fair, equal, and

significant opportunity to obtain a high‐quality education and reach, at a minimum, proficiency on

state academic achievement standards and state academic assessments.

 Title III: "Language Instruction for Limited English Proficient and Immigrant Students." Title III is a

program of the Elementary and Secondary Education Act ﴾ESEA﴿ of 1965, as reauthorized under the

No Child Left Behind Act of 2001. One of the main purposes of this program is to help ensure that

children who have limited proficiency in English, including immigrant children and youth, attain

English proficiency, develop high levels of academic attainment in English, and meet the same state

academic content and student academic achievement standards as all students are expected to meet.

 Individualized Education Program ﴾IEP﴿: A written statement of the educational program designed to

meet the individual needs of a school‐aged child with a disability that is judged to affect the child's

educational performance. Children who receive special education services under the Individuals with

Disabilities Education Act ﴾IDEA﴿ are expected to have an IEP.

 Section 504 plan: A written plan to provide appropriate services to a child with a disability, whether or 

not the disability is judged to affect the child's educational performance. Speech therapy services may 

often be specified as part of a Section 504 plan.

 Response to Intervention ﴾RtI﴿: A multi‐step approach to providing early and progressively intensive

intervention and monitoring within the general education setting. In principle, RtI begins with

research‐based instruction and behavioral support provided to students in the general education

classroom, followed by screening of all students to identify those who may need systematic progress

monitoring, intervention, or support. Students who are not responding to the general education

curriculum and instruction are provided with increasingly intensive interventions through a "tiered"

system, and they are regularly monitored to assess their progress and inform the choice of future

interventions, including possibly special education for students determined to have a disability.

THANK YOU VERY MUCH FOR YOUR HELP.

Language. Reference is made to English language learners ﴾ELL﴿, as well as to instructional programs for ELL

students in this questionnaire. For this study, the following definitions apply:

 Language‐minority ﴾LM﴿ student: A student in whose home a non‐English language typically is spoken.

This group includes students whose English is fluent enough to benefit from instruction in academic

subjects offered in English as well as students who are English language learners.

 English language learner ﴾ELL﴿: A student whose native language is one other than English and whose

skills in listening, speaking, reading, or writing English are such that he or she has difficulty

understanding school instruction in English.

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SECTION A. SCHOOL CHARACTERISTICS

A2. School enrollment. WRITE IN THE APPROXIMATE NUMBER OF CHILDREN FOR EACH OF THE

FOLLOWING. IF NO CHILDREN HAVE LEFT OR ENROLLED IN YOUR SCHOOL SINCE OCTOBER 1, WRITE

"0" ON THE APPLICABLE LINE.

Number of

children

a. Total enrollment in fourth grade in your school around October 1, 2014,

or the date nearest to that for which data are available

b.

c.

A1. How many instructional days will this school provide during this academic year? WRITE IN NUMBER

BELOW. IF THIS IS A YEAR‐ROUND SCHOOL, PLEASE PROVIDE THE NUMBER OF INSTRUCTIONAL DAYS A

GIVEN CHILD WOULD ATTEND.

Number of instructional days

Total enrollment in your school ﴾across all grades﴿ around October 1, 2014,

or the date nearest to that for which data are available

d. Number of children who have left your school since October 1, 2014, and

have not returned

Number of children who have enrolled in your school since October 1, 2014

Approximately what is the Average Daily Attendance for your school this year? WRITE IN PERCENT

OR NUMBER BELOW. TO CALCULATE PERCENT, DIVIDE THE NUMBER OF STUDENTS ATTENDING ON AN

AVERAGE DAY BY THE NUMBER OF STUDENTS ENROLLED AND THEN MULTIPLY BY 100.

A3.

% Average Daily Attendance

OR

Average Number Attending Daily

That is, number of students attending on an average day

 number of students enrolled

X 100

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A6. In what year did this school start providing instruction as a public CHARTER school? WRITE IN

YEAR BELOW.

YEAR

Mark all grade levels included in your school. PLEASE SEE PAGE 3 OF THIS QUESTIONNAIRE FOR

DEFINITIONS OF DIFFERENT TYPES OF CLASSES AND GRADE LEVELS.

A4.

Ungraded

Prekindergarten

Transitional ﴾or readiness﴿ kindergarten

Kindergarten

Transitional first ﴾or prefirst﴿ grade

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

A5. Which of the following characterizes your school? MARK ALL THAT APPLY.

Regular public school ﴾not including magnet school﴿

Public magnet school

Charter school

Catholic school

Diocesan

Parish

Private order

Other private school, religious affiliation

Private school affiliated with NAIS, no religious affiliation

Other private school, no religious or NAIS affiliation

Early Childhood Center ﴾school/center includes preschool and/or early grades﴿

Special education school – primarily serves children with disabilities

Year‐round school

Bureau of Indian Education ﴾BIE﴿ or tribal school

IF YOU MARKED "CHARTER SCHOOL" IN Q A5, GO TO Q A6.

IF YOU DID NOT MARK "CHARTER SCHOOL," THEN SKIP TO Q A8.

A7. Which of the following characterizes your public CHARTER school? MARK ONE RESPONSE.

For profit

Not for profit

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Approximately how many or what percentage of the children in your school belongs to each of the

following racial/ethnic groups? COMPLETE EITHER THE NUMBER OR PERCENT COLUMN. ENTER "0" IF

YOUR SCHOOL HAS NO CHILDREN IN THAT RACIAL/ETHNIC GROUP. THE NUMBER COLUMN SHOULD

ADD TO YOUR TOTAL SCHOOL ENROLLMENT OR THE PERCENT COLUMN SHOULD ADD TO 100%.

A8.

Percentage of children

A10. About what percentage of the children enrolled in this school attend from outside of this school's

assigned attendance area because... WRITE IN PERCENTAGES BELOW. IF NONE, WRITE "0."

A11. About what percentage of the children enrolled in this school are eligible for free or reduced‐

price lunch? WRITE IN PERCENTAGE BELOW. IF NONE, WRITE "0."

A9. If your school is a private, magnet, or charter school, please check here and SKIP TO Q A11.

%

Number

 of children OR Percent

a. Hispanic/Latino of any race

b.

c.

d.

e.

f.

g.

h.

American Indian or Alaska Native, not Hispanic or

Latino

%

Asian, not Hispanic or Latino %

Black or African American, not Hispanic or Latino %

Native Hawaiian or Other Pacific Islander, not Hispanic

or Latino %

White, not Hispanic or Latino %

Two or more races, not Hispanic or Latino

Total school enrollment ﴾sum of a through g﴿

%

1 0 0 %

Percent

%

a.They have special needs ﴾gifted and talented, children with

disabilities, etc.﴿ and attend to receive a specialized program or

service?

%

They transferred into the school because their previous school

did not make adequate yearly progress ﴾AYP﴿? ﴾Adequate yearly

progress is your state's measure of yearly progress toward

achieving state academic standards.﴿

b.

%

They attend this school under public school choice for reasons

other than their assigned school did not make AYP ﴾that is,

excluding those who are reported in b﴿?

c.

Don't know

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SECTION B. SCHOOL‐FAMILY‐COMMUNITY CONNECTIONS

B1. Please indicate how often each of the following activities is provided by your school. MARK ONE

RESPONSE ON EACH ROW.

a.

b.

c.

d.

e.

f.

PTA, PTO, or Parent‐Teacher‐Student

organization meetings

Reports ﴾report cards﴿ of child's

performance provided to parents

Information on the child's standardized

assessment scores provided to parents

Teacher‐parent conferences

School performances to which parents

are invited

Classroom programs like class plays,

book nights, or family math nights

Never

Once

 a year

2 to 3

times

a year

4 to 6

times

a year

7 or more

times

a year

B2. During this school year, how often has your school used the following ways to communicate with

all parents? MARK ONE RESPONSE ON EACH ROW.

a.

b.

Electronic communication to all parents,

such as group emails, electronic

newsletters, website postings,

"robocalls" ﴾mass automated phone

calls﴿, text alerts, or other electronic

notices for all parents

Non‐electronic communication to all

parents, such as letters, newsletters,

phone calls, or other non‐electronic

messages for all parents

More

than

once a

week

Once a

week

Several

times a

month

Once a

month

Less than

once a

month

or never

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B6. How much of a problem are the following in the neighborhood where this school is located? MARK

ONE RESPONSE ON EACH ROW.

f. Violence in the neighborhood

Big

problem

Somewhat of

a problem

No

problem

a.

b.

c.

d.

e.

Tensions based on racial, ethnic, or

religious differences

Selling or using drugs or excessive

drinking in public

Gangs

Vacant houses and buildings

Crime in the neighborhood

Don't

know

Yes

No

During this school year, has your school used an online tool or website that is available to the

general public and that parents can access without a login or password? MARK ONE RESPONSE.

B3.

B5. Have the following types of information been provided in the online tool or website that parents

can only access with a login and password? MARK YES OR NO ON EACH ROW.

Classroom‐specific assignments, including homework

Child‐ or parent‐specific information, such as progress reports

between grading periods

a.

b.

Yes No

During this school year, has your school ﴾or any teacher﴿ used an online tool or website that parents

can only access with a login and password to get information about their child, the child's class, or

the school? MARK ONE RESPONSE.

Yes

No

B4.

﴾SKIP TO Q B6﴿

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B8. Does your school take any of the following measures to ensure the safety of children? MARK YES

OR NO ON EACH ROW.

a. Security guards, unarmed

Security guards, armed

c. Metal detectors

Locked doors during the school day

A requirement that visitors sign in

Intercoms or telephones in classrooms

b.

d.

e.

f.

B7. To the best of your knowledge how often do the following types of problems occur at your school?

MARK ONE RESPONSE ON EACH ROW.

Happens

daily

Happens

at least

once a

week

Happens

at least

once a

month

Happens

on

occasion

Never

happens

Children bringing weapons to school

Theft

Physical conflicts among students

Children bringing in or using alcohol at

school

Children bringing in or using illegal

drugs at school

Vandalism of school property

Student bullying

Widespread disorder in classrooms

a.

b.

c.

d.

e.

f.

g.

h.

i. Class cutting

g. Other ﴾PLEASE SPECIFY﴿

Yes No

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B10. During the past year, to what extent did any of the following changes occur at your school? MARK

ONE RESPONSE ON EACH ROW.

Funding levels decreased

Enrollment increased

Enrollment decreased

The number of students receiving free

or reduced‐price lunch increased

Student mobility increased ﴾that is, the

number of students transferring in and

out of the school increased﴿

There has been a reduction in staffing

a.

b.

c.

d.

e.

f.

g. Class sizes increased

h. Class sizes decreased

i. Salaries increased

j. Salaries decreased

k. Number of English language learners

increased

Not

at all

Small

extent

Moderate

extent

Large

extent

B9. To what extent is each of the following matters a problem in this school? Indicate whether each is

a SERIOUS problem, a MODERATE problem, a MINOR problem, or NOT a problem in this school.

MARK ONE RESPONSE ON EACH ROW.

Serious

problem

Moderate

problem

Minor

problem

Not a

problem

Student tardiness

Student absenteeism

Student aggressive or disruptive behavior

Teacher absenteeism

Teacher turnover

Overcrowding

a.

b.

c.

d.

e.

f.

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B11.

Yes

No

During the past year, were salaries frozen at your school? MARK ONE RESPONSE.

Yes

No

During the past year, were changes made to your school's assigned attendance area? MARK ONE

RESPONSE.

B12.

IF YOUR SCHOOL IS A PRIVATE, MAGNET, OR CHARTER SCHOOL, SKIP TO Q C1.

IF YOUR SCHOOL IS NOT A PRIVATE, MAGNET, OR CHARTER SCHOOL, GO TO Q B12.

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SECTION C. SCHOOL POLICIES AND PRACTICES

Not applicable

C1. How many third‐grade children were retained at their current grade level last school year? WRITE

NUMBER BELOW. IF NONE, WRITE "0." IF YOUR SCHOOL DOES NOT HAVE THIRD‐GRADE STUDENTS, MARK

THE "NOT APPLICABLE" BOX.

C2. How many fourth‐grade children were retained at their current grade level last school year? WRITE

NUMBER BELOW. IF NONE, WRITE "0." IF YOUR SCHOOL DOES NOT HAVE FOURTH‐GRADE STUDENTS, MARK

THE "NOT APPLICABLE" BOX.

Number of fourth‐grade children retained last year

Number of third‐grade children retained last year

C4. For each of the following statements about READING and MATH, indicate how strongly you agree or

disagree. MARK ONE RESPONSE ON EACH ROW.

Strongly

disagree Disagree

Neither

agree nor

disagree Agree

Strongly

agree

Don't

know For READING

For MATH

This school has a set of clear,

predetermined, grade‐level benchmarks

﴾that is, cut scores, goals/targets, or

percentiles﴿ that are used to determine

which students are struggling or at risk

of failure in MATH.

c.

This school has a set of clear,

predetermined, grade‐level benchmarks

﴾that is, cut scores, goals/targets, or

percentiles﴿ that are used to determine

which students are struggling or at risk

of failure in READING.

a.

C3. Is a school‐wide positive behavioral intervention and support program ﴾for example, Positive Behavioral

Support, Positive Behavioral Intervention System﴿ implemented at your school? MARK ONE RESPONSE.

Yes

No

b. At this school, we use data from

screening tests to determine if core

instruction in READING is meeting the

needs of most of our students.

d. At this school, we use data from

screening tests to determine if core

instruction in MATH is meeting the

needs of most of our students.

Not applicable

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C5. Is Response to Intervention ﴾RtI﴿ currently used at your school in fourth grade, either partially or

fully implemented? MARK ONE RESPONSE.

C6. Is Rtl currently implemented at your school in fourth grade in the following areas? MARK ONE

RESPONSE ON EACH ROW.

RESPONSE TO INTERVENTION (RTI) IS A MULTI‐STEP APPROACH TO PROVIDING EARLY AND

PROGRESSIVELY INTENSIVE INTERVENTION AND MONITORING WITHIN THE GENERAL EDUCATION

SETTING. SEE PAGE 4 FOR A COMPLETE DEFINITION OF RTI.

C7. Approximately how many years ago did your school begin implementing RtI in fourth grade in any

subject? MARK ONE RESPONSE.

Less than 1 year ago

1 to 2 years ago

More than 2 years ago

C8. For the 2014‐2015 school year, how has your school made information available to parents/

guardians to help them understand how RtI is being implemented in your school? MARK YES OR NO

ON EACH ROW.

Yes

No ﴾SKIP TO Q C9﴿

Math

Reading

Writing

a.

b.

c.

d. Behavior/Social skills

Yes, fully

implemented

in fourth grade

Yes, partially

implemented

in fourth grade

No, not

implemented

in fourth grade

Communication through written materials such as letters, email,

school website, or newsletters

Communication through workshops, discussion groups, or other

meetings such as PTA meetings

Communication through individual meetings with parents or phone

calls

a.

b.

c.

d. Information is not distributed on this topic

Yes No

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C11. Approximately how many years ago did your school begin implementing the Common Core

State Standards in any grade or subject? MARK ONE RESPONSE.

Less than 1 year ago

1 to 2 years ago

More than 2 years ago

C9. Has your school implemented the Common Core State Standards at any grade﴾s﴿? MARK ONE

RESPONSE.

Yes

No ﴾SKIP TO Q D1﴿

C10. Are the Common Core State Standards currently implemented at your school in fourth grade in the

following areas? MARK ONE RESPONSE ON EACH ROW.

Reading and Language Arts

Mathematics

a.

b.

Yes, fully

implemented

in fourth grade

Yes, partially

implemented

in fourth grade

No, not

implemented

in fourth grade

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SECTION D. SCHOOL PROGRAMS FOR PARTICULAR POPULATIONS

Language‐Minority Students and Families

D1. Do any of the children in this school come from a home where a language other than English is

spoken? MARK ONE RESPONSE.

Yes

No ﴾SKIP TO Q D5﴿

D4. Are any of the following services provided to families of children from households where a

language other than English is spoken? MARK YES OR NO ON EACH ROW.

Translators are made available to parents for parent/teacher and

parent/school staff meetings and/or meetings are conducted in

the parents' non‐English language.

Translations of written communications are provided to these

families.

Home visits are made to families of these children.

a.

b.

c.

Yes No

PLEASE NOTE THE FOLLOWING DEFINITION

THAT IS RELEVANT TO QUESTIONS D2 & D3 BELOW:

English language learners ﴾ELL﴿ are children whose native language is one other

than English and whose skills in listening, speaking, reading, or writing English are

such that they have difficulty understanding school instruction in English.

% ELL among all students in fourth grade

What percentage of children in fourth grade are English language learners? WRITE IN THE

PERCENTAGE BELOW. IF NONE, WRITE "0."

D3.

%

What percentage of children in this school are English language learners ﴾ELL﴿? WRITE IN THE

PERCENTAGE BELOW. IF NONE, WRITE "0."

D2.

ELL among all students in school

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Children with Special Needs

D7. What method﴾s﴿ are used in your school to determine special education ELIGIBILITY for students

with learning disabilities? MARK YES OR NO ON EACH ROW. IF A COMBINATION OF THESE METHODS

IS USED AT YOUR SCHOOL, MARK YES FOR BOTH A AND B.

D5. Since the beginning of this school year ﴾2014‐2015﴿, how many students have been NEWLY

evaluated at your school to determine if they are eligible for an IEP? WRITE NUMBER IN BOX.

D6. Of those students who have been NEWLY evaluated at your school this school year ﴾2014‐ 2015﴿,

how many were found eligible for an IEP, including those who may have an IEP for speech only?

WRITE NUMBER IN BOX.

Total number of newly evaluated students at your school

Total number of newly evaluated students found eligible at your school

IQ‐achievement discrepancy model which shows whether there

is a discrepancy between expected performance and actual

performance

Response to Intervention ﴾RtI﴿ model

a.

b.

Yes No

RESPONSE TO INTERVENTION (RTI) IS A MULTI‐STEP APPROACH TO PROVIDING EARLY AND

PROGRESSIVELY INTENSIVE INTERVENTION AND MONITORING WITHIN THE GENERAL EDUCATION

SETTING. SEE PAGE 4 FOR A MORE COMPLETE DEFINITION OF RTI.

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D8. Approximately what percentage of your fourth‐graders are in each of the following instructional

programs? WRITE PERCENTAGES IN BOXES. IF NONE, WRITE "0" AND INDICATE IF THE PROGRAM IS

NOT OFFERED IN FOURTH GRADE OR IN ANY GRADE IN YOUR SCHOOL.

Where are children with Individualized Education Programs ﴾IEPs﴿ typically served in this school?

MARK ONE RESPONSE.

D9.

Children with IEPs are not served in this school.

Children with IEPs typically spend most of their day in separate classes.

Children with IEPs typically spend most of their day in the regular classroom.

Percent

Not offered

in fourth grade

Not offered

in any grade

Special education with an Individualized

Education Program ﴾IEP﴿

Receive accommodations through a 504

plan

Reading instruction for students

performing below grade level in reading

Math instruction for students

performing below grade level in math

a.

b.

c.

d.

%

%

%

%

e. A gifted and talented program %

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SECTION E. FEDERAL PROGRAMS: TITLE I, ADEQUATE YEARLY PROGRESS, AND TITLE III

The following items pertain to public schools only.

E1. Did your school receive Federal Title I funds for this school year? MARK ONE RESPONSE.

1

E2. Is your school operating a Title I targeted assistance or schoolwide program? MARK ONE RESPONSE.

Targeted assistance program

Schoolwide program

Yes

No ﴾SKIP TO Q E3﴿

IF YOURS IS A PRIVATE SCHOOL CHECK HERE. ﴾SKIP TO Q F1﴿

PLEASE NOTE THE FOLLOWING DEFINITIONS

THAT ARE RELEVANT TO QUESTION E2 BELOW:

A targeted assistance program uses Title I funds to provide supplemental

academic services ﴾usually in reading and/or math﴿ to specific students, sometimes

referred to as "Title I students," who have been identified as low achieving.

A schoolwide program may use Title I funds to improve the quality of educational

programs and services throughout the school. A school may use Title I funds for a

schoolwide program if at least 40 percent of its students are from low‐income

families, or if it receives a waiver permitting it to operate a schoolwide program.

E3. Did your school receive Federal Title III funds for this school year? ﴾Title III is "Language Instruction

for Limited English Proficient and Immigrant Students."﴿ MARK ONE RESPONSE.

Yes

No

Title I and Title III and their accompanying requirements are programs of the Elementary and Secondary Education Act of 1965 ﴾ESEA﴿, as

reauthorized by the No Child Left Behind Act of 2001. See the introductory section of this questionnaire for more information on these

programs.

1

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21

Federal Requirements

E4. At the end of the LAST school year ﴾2013‐2014﴿, did this school make Adequate Yearly Progress

﴾AYP﴿? ﴾Adequate Yearly Progress is your state's measure of yearly progress toward achieving

state academic standards.﴿ MARK ONE RESPONSE.

E5. At the end of the LAST school year ﴾2013‐2014﴿, was this school identified for improvement due to

Adequate Yearly Progress ﴾AYP﴿ requirements? ﴾A school is identified for improvement if it does

not make Adequate Yearly Progress for two consecutive years or more in the same content area.﴿

MARK ONE RESPONSE.

﴾SKIP TO Q F1﴿

﴾SKIP TO Q F1﴿

Yes

No

Not applicable

Yes

No

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SECTION F. STAFFING AND TEACHER CHARACTERISTICS

F1. Approximately how many staff members does your school currently have in the following

categories?

PLEASE PROVIDE RESPONSES IN COLUMN (1) FOR STAFF MEMBERS WHO WORK FULL TIME AT YOUR

SCHOOL AND IN COLUMN (2) FOR STAFF WHO WORK PART TIME AT YOUR SCHOOL. IF A STAFF

MEMBER IS SHARED WITH OTHER SCHOOLS, COUNT THAT PERSON AS "PART TIME" IN YOUR SCHOOL.

PLACE EACH STAFF MEMBER IN ONLY ONE STAFF CATEGORY; IF A STAFF MEMBER FITS MORE THAN

ONE CATEGORY, PICK THE CATEGORY MOST DESCRIPTIVE OF HIS/HER WORK.

WRITE NUMBERS IN BOXES. IF THERE ARE NO STAFF IN YOUR SCHOOL IN A CATEGORY, WRITE "0."

﴾1﴿ ﴾2﴿

 Number who

work full time in

your school

Number who

work part time

in your school

Regular classroom teachers

Drama, music, or art teachers

Special education teachers and related service

providers ﴾for example, speech therapist, physical

therapist, adaptive physical education, etc.﴿

ESL/bilingual education/language immersion/ELL

instruction teachers

a.

b.

c.

d.

e.

Gym/PE or health teachers

f. Paraprofessionals ﴾for example, classroom aides﴿

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F2. Does your school currently have any staff members ﴾full‐ or part‐time﴿ in the following

categories? MARK YES OR NO ON EACH ROW. INCLUDE THOSE WHO ARE FULL‐ OR PART‐TIME STAFF

MEMBERS AT YOUR SCHOOL.

F4. Please indicate the number of regular classroom teachers who have joined or left your school

since October 1, 2014. WRITE IN THE APPROXIMATE NUMBERS FOR EACH OF THE FOLLOWING. IF

NO TEACHERS HAVE LEFT OR STARTED AT YOUR SCHOOL SINCE OCTOBER 1, WRITE "0" ON THE

APPLICABLE LINE.

F3. Does your school currently have any staff members who do the following as their primary role or

one of their primary roles? MARK YES OR NO ON EACH ROW. INCLUDE THOSE WHO ARE FULL‐ OR

PART‐TIME STAFF MEMBERS AT YOUR SCHOOL.

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective READING instruction

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective MATH instruction

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective behavioral supports

A school staff member who supports teachers in collecting,

organizing, and managing assessment data

a.

b.

c.

d.

e. A school staff member who supports teachers in the interpretation

and use of assessment data to guide instruction

Number

of teachers

Number of regular classroom teachers who have begun teaching in your

school since October 1, 2014

Number of regular classroom teachers who have left your school since

October 1, 2014, and have not returned

a.

b.

b. Reading specialists and interventionists

c. Math specialists and interventionists

d. School nurses or health professionals

e. School psychologists or social workers

f. Guidance counselors

g. Library media specialists/librarians

h. Computer/technology teachers or support staff

a. Teachers of gifted/talented students

Yes No

Yes No

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F5. Are monetary incentives such as cash bonuses, salary increases, or different steps on the salary

schedule used in your school to reward teachers for... MARK YES OR NO ON EACH ROW.

Improved student performance on state tests?

Reaching target goals on state tests?

a.

b.

Yes No

F6. Did this school's principal ﴾or head administrator﴿ complete the majority of the previous sections

or was the majority completed by someone else? MARK ONE RESPONSE.

Principal ﴾SKIP TO Q G1﴿

Someone else

F7. If a person other than the school's principal ﴾or head administrator﴿ has completed the previous

sections, please write in the name and title of the person who completed the majority of the

sections. PLEASE PRINT.

TITLE

LAST NAME FIRST NAME MIDDLE INITIAL

How long has the individual listed above been employed at this school? WRITE YEARS AND MONTHS

BELOW.

F8.

YEAR﴾S﴿ MONTH﴾S﴿

The principal or head administrator should complete the remainder of

this questionnaire. If a designee is chosen to complete this in his or her

place, please be sure that the background and education characteristics

provided are about the school's principal or head administrator.

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SECTION G. SCHOOL ADMINISTRATOR CHARACTERISTICS

G1. What is your gender? MARK ONE RESPONSE.

Male

Female

G2. In what year were you born? WRITE IN YEAR BELOW.

YEAR

G3. Are you Hispanic or Latino? MARK ONE RESPONSE.

Yes

No

G4. Which best describes your race? MARK ONE OR MORE RESPONSES TO INDICATE WHAT YOU CONSIDER

YOURSELF TO BE.

G5.

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

1 9

How many years of experience do you have in each of the following positions, including years in

which you worked part time? WRITE THE NUMBER OF YEARS TO THE NEAREST FULL SCHOOL YEAR. IF

THIS IS YOUR FIRST YEAR, WRITE "1."

Number

of years

Years as a teacher before becoming a school administrator

Total number of years as a school administrator

Number of years as school administrator at this school

a.

b.

c.

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G6. Through which, if any, of the types of training programs below did you receive preparation for

fulfilling your role as a school administrator? MARK YES OR NO ON EACH ROW.

G7. What is the highest level of education you have completed? MARK ONE RESPONSE.

High school diploma or equivalent/GED

Associate’s degree

Bachelor’s degree

At least one year of coursework beyond a Bachelor’s degree but not a graduate degree

Master’s degree

Education specialist or professional diploma based on at least one year of coursework past a

Doctorate or an advanced professional degree beyond a Master's degree ﴾for example, MD, EdD﴿

Master's degree level

G8. What was your major field﴾s﴿ of study in the highest degree you completed? MARK YES OR NO ON

EACH ROW.

Traditional university‐based training and certification program

District‐based training program ﴾for example, the Boston Principal

Fellowship, New York City Leadership Academy's Aspiring Principals

Program, Chicago's LAUNCH program﴿

City‐based training program ﴾for example, Cleveland's First Ring

Leadership Academy﴿

State‐based training program ﴾for example, New Jersey EXCEL﴿

Training and/or certification program run by a national non‐profit

organization ﴾for example, KIPP School Leadership Program, New

Leaders for New Schools﴿

Another school administration preparation program

a.

b.

c.

d.

e.

f.

Early childhood education

Elementary education

Education administration/management

Special education

Other education‐related major ﴾such as secondary

education, educational psychology, science education,

music education, etc.﴿

Non‐education major ﴾such as history, English, etc.﴿

a.

b.

c.

d.

e.

f.

Yes No

Yes No

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G9. What is your best estimate of the percentage of children in your school you know by name?

MARK ONE RESPONSE.

Nearly every child

76% or more

51% to 75%

26% to 50%

25% or less

G10. During school hours, do you speak a language other than English with students at your school

whose native language is not English? MARK ONE RESPONSE.

Yes

No

G11. Do you speak a language other than English with students' families whose native language is not

English? MARK ONE RESPONSE.

Yes

No

G12. If you do not speak a language other than English with EITHER students OR students'

families whose native language is not English, mark here and SKIP TO Q G14.

G13. What language﴾s﴿ other than English do you speak with students at your school or with their

families? MARK ALL THAT APPLY.

Spanish

Vietnamese

A Chinese language

Japanese

Korean

Other ﴾PLEASE SPECIFY﴿

Arabic

A Filipino language

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G14. Date Questionnaire Completed:

Questionnaire completed by:

LAST NAME FIRST NAME MIDDLE INITIAL

MONTH DAY YEAR

2015

THANK YOU FOR YOUR COOPERATION!

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For Office Use Only

C ‐ No DR C ‐ DR Comp

 C ‐ DR Ref Ref

NEW

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Westat

Spring 2015

School Administrator Questionnaire

Questionnaire B

RETURN THIS COMPLETED QUESTIONNAIRE IN THE SEALED

TYVEK® ENVELOPE DIRECTLY TO YOUR SCHOOL COORDINATOR

OR AN ECLS‐K:2011 STAFF MEMBER. DO NOT MAIL THIS

QUESTIONNAIRE UNLESS YOU ARE ASKED TO DO SO BY STUDY

STAFF AND ARE PROVIDED WITH AN ENVELOPE FOR MAILING.

Use a black or blue ball point pen to complete this questionnaire.

Rockville, Maryland

National Center for Education Statistics by:

Prepared for the U.S. Department of Education

S_ID

According to the Paperwork Reduction Act of 1995, no persons are required 

to respond to a collection of information unless it displays a valid OMB 

control number. The valid OMB control number for this voluntary survey is 

1850‐XXXX. Approval expires XX/XX/XXXX. The time required to complete this 

survey is estimated to average 60 minutes per response, including the time to 

review instructions, search existing data resources, gather the data needed, 

and complete and review the survey. If you have any comments concerning 

the accuracy of the time estimate or suggestions for improving this survey, or 

any comments or concerns regarding the status of your individual submission 

of this survey, please write to: Early Childhood Longitudinal Study, National 

Center for Education Statistics, 1990 K Street, N.W., Washington, D.C. 20006‐

5574.

The collection of information in this survey is authorized by 20 U.S. 

Code, Section 9543. Participation is voluntary. You may skip questions 

you do not wish to answer; however, we hope that you will answer as 

many questions as you can. Your responses are protected from 

disclosure by federal statute ﴾20 U.S. Code, Section 9573﴿. All 

responses that relate to or describe identifiable characteristics of 

individuals may be used only for statistical purposes and may not be 

disclosed, or used, in identifiable form for any other purpose except as 

required by law. Data will be combined to produce statistical reports. 

No individual data that links your name, address, telephone number, 

or identification number with your responses will be included in the 

statistical reports. 

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Dear School Administrator,

This questionnaire is an important part of a major longitudinal study of children's early educational experiences

beginning with kindergarten and continuing through grade 5. The Early Childhood Longitudinal Study,

Kindergarten Class of 2010‐2011 ﴾ECLS‐K:2011﴿ is collecting information from schools attended by children

who are in the study to investigate the relationship between children's academic progress and various school,

classroom, teacher, and child characteristics. You have received this questionnaire because one or more of the

children in your school are participants in this study.

For the purposes of this study, the following definitions apply:

 Kindergarten: Traditional year of school primarily for 5‐year‐olds prior to first grade.

 Transitional ﴾or readiness﴿ kindergarten: Extra year of school for kindergarten‐age eligible children who

are judged not ready for kindergarten.

 Transitional first ﴾or prefirst﴿ grade: Extra year of school for children who have attended kindergarten but 

have been judged not ready for first grade.

 Ungraded: A classroom containing children with an age span of two or more years, not formally identified

by grade﴾s﴿.

This information is vital to the study. Please feel free to ask other knowledgeable members of your staff to

provide the information necessary to complete various sections of the questionnaire. However, we ask that you,

yourself, please complete the final section, which is about your own background and characteristics. Taking part

in the study is voluntary. You may stop at any time or choose not to answer a question you do not want to

answer. Although we realize you are very busy, we urge you to complete this questionnaire as completely and

accurately as possible. The information you provide is being collected for research purposes only and will be

protected from disclosure to the fullest extent allowable by law ﴾Education Sciences Reform Act of 2002, 20 U.S.C.

§ 9573﴿. Information from multiple individuals will be combined to produce statistical reports; no information

that identifies you will be included in any reports or provided to students, their parents, or other school staff.

Please record your answers directly on the questionnaire by marking the appropriate answer ﴾as described in the

instructions on page 5﴿ or by writing your responses in the space provided. Your best estimates are acceptable

answers.

DEFINITIONS

This questionnaire contains several brief sections:

a﴿ School characteristics

b﴿ School‐family‐community connections

c﴿ School policies and practices

d﴿ School programs for particular populations

e﴿ Federal programs: Title I and Title III

 Staffing and teacher characteristics

g﴿ School administrator characteristics

f﴿

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4

Special programs. Reference is made in this questionnaire to Title I and Title III programs, individualized

education programs ﴾IEP﴿, Section 504 plans, and Response to Intervention ﴾RtI﴿. For this study, the following

definitions apply:

 Title I: "Improving the Academic Achievement of the Disadvantaged." Title I is a program of the

Elementary and Secondary Education Act ﴾ESEA﴿ of 1965, as reauthorized under the No Child Left

Behind Act of 2001. The purpose of this program is to ensure that all children have a fair, equal, and

significant opportunity to obtain a high‐quality education and reach, at a minimum, proficiency on

state academic achievement standards and state academic assessments.

 Title III: "Language Instruction for Limited English Proficient and Immigrant Students." Title III is a

program of the Elementary and Secondary Education Act ﴾ESEA﴿ of 1965, as reauthorized under the

No Child Left Behind Act of 2001. One of the main purposes of this program is to help ensure that

children who have limited proficiency in English, including immigrant children and youth, attain

English proficiency, develop high levels of academic attainment in English, and meet the same state

academic content and student academic achievement standards as all students are expected to meet.

 Individualized Education Program ﴾IEP﴿: A written statement of the educational program designed to

meet the individual needs of a school‐aged child with a disability that is judged to affect the child's

educational performance. Children who receive special education services under the Individuals with

Disabilities Education Act ﴾IDEA﴿ are expected to have an IEP.

 Section 504 plan: A written plan to provide appropriate services to a child with a disability, whether or 

not the disability is judged to affect the child's educational performance. Speech therapy services may 

often be specified as part of a Section 504 plan.

 Response to Intervention ﴾RtI﴿: A multi‐step approach to providing early and progressively intensive

intervention and monitoring within the general education setting. In principle, RtI begins with

research‐based instruction and behavioral support provided to students in the general education

classroom, followed by screening of all students to identify those who may need systematic progress

monitoring, intervention, or support. Students who are not responding to the general education

curriculum and instruction are provided with increasingly intensive interventions through a "tiered"

system, and they are regularly monitored to assess their progress and inform the choice of future

interventions, including possibly special education for students determined to have a disability.

THANK YOU VERY MUCH FOR YOUR HELP.

Language. Reference is made to English language learners ﴾ELL﴿, as well as to instructional programs for ELL

students in this questionnaire. For this study, the following definitions apply:

 Language‐minority ﴾LM﴿ student: A student in whose home a non‐English language typically is spoken.

This group includes students whose English is fluent enough to benefit from instruction in academic

subjects offered in English as well as students who are English language learners.

 English language learner ﴾ELL﴿: A student whose native language is one other than English and whose

skills in listening, speaking, reading, or writing English are such that he or she has difficulty

understanding school instruction in English.

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SECTION A. SCHOOL CHARACTERISTICS

A2. School enrollment. WRITE IN THE APPROXIMATE NUMBER OF CHILDREN FOR EACH OF THE

FOLLOWING. IF NO CHILDREN HAVE LEFT OR ENROLLED IN YOUR SCHOOL SINCE OCTOBER 1, WRITE

"0" ON THE APPLICABLE LINE.

Number of

children

a. Total enrollment in fourth grade in your school around October 1, 2014,

or the date nearest to that for which data are available

b.

c.

A1. How many instructional days will this school provide during this academic year? WRITE IN NUMBER

BELOW. IF THIS IS A YEAR‐ROUND SCHOOL, PLEASE PROVIDE THE NUMBER OF INSTRUCTIONAL DAYS A

GIVEN CHILD WOULD ATTEND.

Number of instructional days

Total enrollment in your school ﴾across all grades﴿ around October 1, 2014,

or the date nearest to that for which data are available

d. Number of children who have left your school since October 1, 2014, and

have not returned

Number of children who have enrolled in your school since October 1, 2014

Approximately what is the Average Daily Attendance for your school this year? WRITE IN PERCENT

OR NUMBER BELOW. TO CALCULATE PERCENT, DIVIDE THE NUMBER OF STUDENTS ATTENDING ON AN

AVERAGE DAY BY THE NUMBER OF STUDENTS ENROLLED AND THEN MULTIPLY BY 100.

A3.

% Average Daily Attendance

OR

Average Number Attending Daily

That is, number of students attending on an average day

 number of students enrolled

X 100

Percentage of children

A4. About what percentage of the children enrolled in this school are eligible for free or reduced‐

price lunch? WRITE IN PERCENTAGE BELOW. IF NONE, WRITE "0."

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SECTION B. SCHOOL‐FAMILY‐COMMUNITY CONNECTIONS

B1. Please indicate how often each of the following activities is provided by your school. MARK ONE

RESPONSE ON EACH ROW.

a.

b.

c.

d.

e.

f.

PTA, PTO, or Parent‐Teacher‐Student

organization meetings

Reports ﴾report cards﴿ of child's

performance provided to parents

Information on the child's standardized

assessment scores provided to parents

Teacher‐parent conferences

School performances to which parents

are invited

Classroom programs like class plays,

book nights, or family math nights

Never

Once

 a year

2 to 3

times

a year

4 to 6

times

a year

7 or more

times

a year

During this school year, how often has your school used the following ways to communicate with

all parents? MARK ONE RESPONSE ON EACH ROW.

a.

b.

Electronic communication to all parents,

such as group emails, electronic

newsletters, website postings,

"robocalls" ﴾mass automated phone

calls﴿, text alerts, or other electronic

notices for all parents

Non‐electronic communication to all

parents, such as letters, newsletters,

phone calls, or other non‐electronic

messages for all parents

More

than

once a

week

Once a

week

Several

times a

month

Once a

month

Less than

once a

month

or never

B2.

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8

B6. To the best of your knowledge how often do the following types of problems occur at your school?

MARK ONE RESPONSE ON EACH ROW.

Happens

daily

Happens

at least

once a

week

Happens

at least

once a

month

Happens

on

occasion

Never

happens

a. Children bringing weapons to school

b. Physical conflicts among students

c. Student bullying

d. Widespread disorder in classrooms

Yes

No

During this school year, has your school used an online tool or website that is available to the

general public and that parents can access without a login or password? MARK ONE RESPONSE.

B3.

B5. Have the following types of information been provided in the online tool or website that parents

can only access with a login and password? MARK YES OR NO ON EACH ROW.

Classroom‐specific assignments, including homework

Child‐ or parent‐specific information, such as progress reports

between grading periods

a.

b.

Yes No

During this school year, has your school ﴾or any teacher﴿ used an online tool or website that parents

can only access with a login and password to get information about their child, the child's class, or

the school? MARK ONE RESPONSE.

Yes

No

B4.

﴾SKIP TO Q B6﴿

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9

B7. Does your school take any of the following measures to ensure the safety of children? MARK YES

OR NO ON EACH ROW.

a. Security guards, unarmed

Security guards, armed

c. Metal detectors

Locked doors during the school day

A requirement that visitors sign in

Intercoms or telephones in classrooms

b.

d.

e.

f.

g. Other ﴾PLEASE SPECIFY﴿

Yes No

B8. To what extent is each of the following matters a problem in this school? Indicate whether each is

a SERIOUS problem, a MODERATE problem, a MINOR problem, or NOT a problem in this school.

MARK ONE RESPONSE ON EACH ROW.

Serious

problem

Moderate

problem

Minor

problem

Not a

problem

Student tardiness

Student absenteeism

Student aggressive or disruptive behavior

Teacher absenteeism

Teacher turnover

Overcrowding

a.

b.

c.

d.

e.

f.

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B9. During the past year, to what extent did any of the following changes occur at your school? MARK

ONE RESPONSE ON EACH ROW.

a. Funding levels decreased

Not

at all

Small

extent

Moderate

extent

Large

extent

The number of students receiving free

or reduced‐price lunch increased

There has been a reduction in staffing

b.

c.

d. Class sizes increased

e. Class sizes decreased

f. Salaries increased

g. Salaries decreased

Yes

No

B10. During the past year, were salaries frozen at your school? MARK ONE RESPONSE.

Yes

No

During the past year, were changes made to your school's assigned attendance area? MARK ONE

RESPONSE.

B11.

IF YOUR SCHOOL IS A PRIVATE, MAGNET, OR CHARTER SCHOOL, SKIP TO Q C1.

IF YOUR SCHOOL IS NOT A PRIVATE, MAGNET, OR CHARTER SCHOOL, GO TO Q B11.

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SECTION C. SCHOOL POLICIES AND PRACTICES

C4. For each of the following statements about READING and MATH, indicate how strongly you agree or

disagree. MARK ONE RESPONSE ON EACH ROW.

Strongly

disagree Disagree

Neither

agree nor

disagree Agree

Strongly

agree

Don't

know For READING

For MATH

This school has a set of clear,

predetermined, grade‐level benchmarks

﴾that is, cut scores, goals/targets, or

percentiles﴿ that are used to determine

which students are struggling or at risk

of failure in MATH.

c.

This school has a set of clear,

predetermined, grade‐level benchmarks

﴾that is, cut scores, goals/targets, or

percentiles﴿ that are used to determine

which students are struggling or at risk

of failure in READING.

a.

C3. Is a school‐wide positive behavioral intervention and support program ﴾for example, Positive

Behavioral Support, Positive Behavioral Intervention System﴿ implemented at your school? MARK

ONE RESPONSE.

Yes

No

b. At this school, we use data from

screening tests to determine if core

instruction in READING is meeting the

needs of most of our students.

d. At this school, we use data from

screening tests to determine if core

instruction in MATH is meeting the

needs of most of our students.

Not applicable

C1. How many third‐grade children were retained at their current grade level last school year? WRITE

NUMBER BELOW. IF NONE, WRITE "0." IF YOUR SCHOOL DOES NOT HAVE THIRD‐GRADE STUDENTS, MARK

THE "NOT APPLICABLE" BOX.

C2. How many fourth‐grade children were retained at their current grade level last school year? WRITE

NUMBER BELOW. IF NONE, WRITE "0." IF YOUR SCHOOL DOES NOT HAVE FOURTH‐GRADE STUDENTS, MARK

THE "NOT APPLICABLE" BOX.

Number of fourth‐grade children retained last year

Number of third‐grade children retained last year

Not applicable

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C5. Is Response to Intervention ﴾RtI﴿ currently used at your school in fourth grade, either partially or

fully implemented? MARK ONE RESPONSE.

C6. Is Rtl currently implemented at your school in fourth grade in the following areas? MARK ONE

RESPONSE ON EACH ROW.

RESPONSE TO INTERVENTION (RTI) IS A MULTI‐STEP APPROACH TO PROVIDING EARLY AND

PROGRESSIVELY INTENSIVE INTERVENTION AND MONITORING WITHIN THE GENERAL EDUCATION

SETTING. SEE PAGE 4 FOR A COMPLETE DEFINITION OF RTI.

C7. Approximately how many years ago did your school begin implementing RtI in fourth grade in any

subject? MARK ONE RESPONSE.

Less than 1 year ago

1 to 2 years ago

More than 2 years ago

C8. For the 2014‐2015 school year, how has your school made information available to parents/

guardians to help them understand how RtI is being implemented in your school? MARK YES OR NO

ON EACH ROW.

Yes

No ﴾SKIP TO Q C9﴿

Math

Reading

Writing

a.

b.

c.

d. Behavior/Social skills

Yes, fully

implemented

in fourth grade

Yes, partially

implemented

in fourth grade

No, not

implemented

in fourth grade

Communication through written materials such as letters, email,

school website, or newsletters

Communication through workshops, discussion groups, or other

meetings such as PTA meetings

Communication through individual meetings with parents or phone

calls

a.

b.

c.

d. Information is not distributed on this topic

Yes No

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C11. Approximately how many years ago did your school begin implementing the Common Core

State Standards in any grade or subject? MARK ONE RESPONSE.

Less than 1 year ago

1 to 2 years ago

More than 2 years ago

C9. Has your school implemented the Common Core State Standards at any grade﴾s﴿? MARK ONE

RESPONSE.

Yes

No ﴾SKIP TO Q D1﴿

C10. Are the Common Core State Standards currently implemented at your school in fourth grade in the

following areas? MARK ONE RESPONSE ON EACH ROW.

Reading and Language Arts

Mathematics

a.

b.

Yes, fully

implemented

in fourth grade

Yes, partially

implemented

in fourth grade

No, not

implemented

in fourth grade

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SECTION D. SCHOOL PROGRAMS FOR PARTICULAR POPULATIONS

Language‐Minority Students and Families

D1. Do any of the children in this school come from a home where a language other than English is

spoken? MARK ONE RESPONSE.

Yes

No ﴾SKIP TO Q D4﴿

PLEASE NOTE THE FOLLOWING DEFINITION

THAT IS RELEVANT TO QUESTIONS D2 & D3 BELOW:

English language learners ﴾ELL﴿ are children whose native language is one other

than English and whose skills in listening, speaking, reading, or writing English are

such that they have difficulty understanding school instruction in English.

% ELL among all students in fourth grade

What percentage of children in fourth grade are English language learners? WRITE IN THE

PERCENTAGE BELOW. IF NONE, WRITE "0."

D3.

%

What percentage of children in this school are English language learners ﴾ELL﴿? WRITE IN THE

PERCENTAGE BELOW. IF NONE, WRITE "0."

D2.

ELL among all students in school

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Children with Special Needs

D4. Since the beginning of this school year ﴾2014‐2015﴿, how many students have been NEWLY

evaluated at your school to determine if they are eligible for an IEP? WRITE NUMBER IN BOX.

D5. Of those students who have been NEWLY evaluated at your school this school year ﴾2014‐ 2015﴿,

how many were found eligible for an IEP, including those who may have an IEP for speech only?

WRITE NUMBER IN BOX.

Total number of newly evaluated students at your school

Total number of newly evaluated students found eligible at your school

D6. What method﴾s﴿ are used in your school to determine special education ELIGIBILITY for students

with learning disabilities? MARK YES OR NO ON EACH ROW. IF A COMBINATION OF THESE METHODS

IS USED AT YOUR SCHOOL, MARK YES FOR BOTH A AND B.

IQ‐achievement discrepancy model which shows whether there

is a discrepancy between expected performance and actual

performance

Response to Intervention ﴾RtI﴿ model

a.

b.

Yes No

RESPONSE TO INTERVENTION (RTI) IS A MULTI‐STEP APPROACH TO PROVIDING EARLY AND

PROGRESSIVELY INTENSIVE INTERVENTION AND MONITORING WITHIN THE GENERAL EDUCATION

SETTING. SEE PAGE 4 FOR A MORE COMPLETE DEFINITION OF RTI.

D7. Approximately what percentage of your fourth‐graders are in each of the following instructional

programs? WRITE PERCENTAGES IN BOXES. IF NONE, WRITE "0" AND INDICATE IF THE PROGRAM IS

NOT OFFERED IN FOURTH GRADE OR IN ANY GRADE IN YOUR SCHOOL.

Percent

Not offered

in fourth grade

Not offered

in any grade

Special education with an Individualized

Education Program ﴾IEP﴿

Receive accommodations through a 504

plan

Reading instruction for students

performing below grade level in reading

Math instruction for students

performing below grade level in math

a.

b.

c.

d.

%

%

%

%

e. A gifted and talented program %

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SECTION E. FEDERAL PROGRAMS: TITLE I AND TITLE III

The following items pertain to public schools only.

E1. Did your school receive Federal Title I funds for this school year? MARK ONE RESPONSE.

1

E2. Is your school operating a Title I targeted assistance or schoolwide program? MARK ONE RESPONSE.

Targeted assistance program

Schoolwide program

Yes

No ﴾SKIP TO Q E3﴿

IF YOURS IS A PRIVATE SCHOOL CHECK HERE. ﴾SKIP TO Q F1﴿

PLEASE NOTE THE FOLLOWING DEFINITIONS

THAT ARE RELEVANT TO QUESTION E2 BELOW:

A targeted assistance program uses Title I funds to provide supplemental

academic services ﴾usually in reading and/or math﴿ to specific students, sometimes

referred to as "Title I students," who have been identified as low achieving.

A schoolwide program may use Title I funds to improve the quality of educational

programs and services throughout the school. A school may use Title I funds for a

schoolwide program if at least 40 percent of its students are from low‐income

families, or if it receives a waiver permitting it to operate a schoolwide program.

E3. Did your school receive Federal Title III funds for this school year? ﴾Title III is "Language Instruction

for Limited English Proficient and Immigrant Students."﴿ MARK ONE RESPONSE.

Yes

No

Title I and Title III and their accompanying requirements are programs of the Elementary and Secondary Education Act of 1965 ﴾ESEA﴿, as

reauthorized by the No Child Left Behind Act of 2001. See the introductory section of this questionnaire for more information on these

programs.

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SECTION F. STAFFING AND TEACHER CHARACTERISTICS

F1. Approximately how many staff members does your school currently have in the following

categories?

PLEASE PROVIDE RESPONSES IN COLUMN (1) FOR STAFF MEMBERS WHO WORK FULL TIME AT YOUR

SCHOOL AND IN COLUMN (2) FOR STAFF WHO WORK PART TIME AT YOUR SCHOOL. IF A STAFF

MEMBER IS SHARED WITH OTHER SCHOOLS, COUNT THAT PERSON AS "PART TIME" IN YOUR SCHOOL.

PLACE EACH STAFF MEMBER IN ONLY ONE STAFF CATEGORY; IF A STAFF MEMBER FITS MORE THAN

ONE CATEGORY, PICK THE CATEGORY MOST DESCRIPTIVE OF HIS/HER WORK.

WRITE NUMBERS IN BOXES. IF THERE ARE NO STAFF IN YOUR SCHOOL IN A CATEGORY, WRITE "0."

﴾1﴿ ﴾2﴿

 Number who

work full time in

your school

Number who

work part time

in your school

Regular classroom teachers

Drama, music, or art teachers

Special education teachers and related service

providers ﴾for example, speech therapist, physical

therapist, adaptive physical education, etc.﴿

ESL/bilingual education/language immersion/ELL

instruction teachers

a.

b.

c.

d.

e.

Gym/PE or health teachers

f. Paraprofessionals ﴾for example, classroom aides﴿

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F2. Does your school currently have any staff members ﴾full‐ or part‐time﴿ in the following

categories? MARK YES OR NO ON EACH ROW. INCLUDE THOSE WHO ARE FULL‐ OR PART‐TIME STAFF

MEMBERS AT YOUR SCHOOL.

F4. Please indicate the number of regular classroom teachers who have joined or left your school

since October 1, 2014. WRITE IN THE APPROXIMATE NUMBERS FOR EACH OF THE FOLLOWING. IF

NO TEACHERS HAVE LEFT OR STARTED AT YOUR SCHOOL SINCE OCTOBER 1, WRITE "0" ON THE

APPLICABLE LINE.

F3. Does your school currently have any staff members who do the following as their primary role or

one of their primary roles? MARK YES OR NO ON EACH ROW. INCLUDE THOSE WHO ARE FULL‐ OR

PART‐TIME STAFF MEMBERS AT YOUR SCHOOL.

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective READING instruction

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective MATH instruction

A school staff member who provides ongoing training or support to

classroom teachers in the delivery of effective behavioral supports

A school staff member who supports teachers in collecting,

organizing, and managing assessment data

a.

b.

c.

d.

e. A school staff member who supports teachers in the interpretation

and use of assessment data to guide instruction

Number

of teachers

Number of regular classroom teachers who have begun teaching in your

school since October 1, 2014

Number of regular classroom teachers who have left your school since

October 1, 2014, and have not returned

a.

b.

b. Reading specialists and interventionists

c. Math specialists and interventionists

d. School nurses or health professionals

e. School psychologists or social workers

f. Guidance counselors

g. Library media specialists/librarians

h. Computer/technology teachers or support staff

a. Teachers of gifted/talented students

Yes No

Yes No

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F5. Are monetary incentives such as cash bonuses, salary increases, or different steps on the salary

schedule used in your school to reward teachers for... MARK YES OR NO ON EACH ROW.

Improved student performance on state tests?

Reaching target goals on state tests?

a.

b.

Yes No

F6. Did this school's principal ﴾or head administrator﴿ complete the majority of the previous sections

or was the majority completed by someone else? MARK ONE RESPONSE.

Principal ﴾SKIP TO Q G1﴿

Someone else

F7. If a person other than the school's principal ﴾or head administrator﴿ has completed the previous

sections, please write in the name and title of the person who completed the majority of the

sections. PLEASE PRINT.

TITLE

LAST NAME FIRST NAME MIDDLE INITIAL

How long has the individual listed above been employed at this school? WRITE YEARS AND MONTHS

BELOW.

F8.

YEAR﴾S﴿ MONTH﴾S﴿

The principal or head administrator should complete the remainder of

this questionnaire. If a designee is chosen to complete this in his or her

place, please be sure that the background and education characteristics

provided are about the school's principal or head administrator.

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SECTION G. SCHOOL ADMINISTRATOR CHARACTERISTICS

G1. What is your gender? MARK ONE RESPONSE.

Male

Female

G2. In what year were you born? WRITE IN YEAR BELOW.

YEAR

G3. Are you Hispanic or Latino? MARK ONE RESPONSE.

Yes

No

G4. Which best describes your race? MARK ONE OR MORE RESPONSES TO INDICATE WHAT YOU CONSIDER

YOURSELF TO BE.

G5.

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

1 9

How many years of experience do you have in each of the following positions, including years in

which you worked part time? WRITE THE NUMBER OF YEARS TO THE NEAREST FULL SCHOOL YEAR. IF

THIS IS YOUR FIRST YEAR, WRITE "1."

Number

of years

Years as a teacher before becoming a school administrator

Total number of years as a school administrator

Number of years as school administrator at this school

a.

b.

c.

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21

G6. Through which, if any, of the types of training programs below did you receive preparation for

fulfilling your role as a school administrator? MARK YES OR NO ON EACH ROW.

G7. What is the highest level of education you have completed? MARK ONE RESPONSE.

High school diploma or equivalent/GED

Associate’s degree

Bachelor’s degree

At least one year of coursework beyond a Bachelor’s degree but not a graduate degree

Master’s degree

Education specialist or professional diploma based on at least one year of coursework past a

Doctorate or an advanced professional degree beyond a Master's degree ﴾for example, MD, EdD﴿

Master's degree level

G8. What was your major field﴾s﴿ of study in the highest degree you completed? MARK YES OR NO ON

EACH ROW.

Traditional university‐based training and certification program

District‐based training program ﴾for example, the Boston Principal

Fellowship, New York City Leadership Academy's Aspiring Principals

Program, Chicago's LAUNCH program﴿

City‐based training program ﴾for example, Cleveland's First Ring

Leadership Academy﴿

State‐based training program ﴾for example, New Jersey EXCEL﴿

Training and/or certification program run by a national non‐profit

organization ﴾for example, KIPP School Leadership Program, New

Leaders for New Schools﴿

Another school administration preparation program

a.

b.

c.

d.

e.

f.

Early childhood education

Elementary education

Education administration/management

Special education

Other education‐related major ﴾such as secondary

education, educational psychology, science education,

music education, etc.﴿

Non‐education major ﴾such as history, English, etc.﴿

a.

b.

c.

d.

e.

f.

Yes No

Yes No

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G9. What is your best estimate of the percentage of children in your school you know by name?

MARK ONE RESPONSE.

Nearly every child

76% or more

51% to 75%

26% to 50%

25% or less

G10. During school hours, do you speak a language other than English with students at your school

whose native language is not English? MARK ONE RESPONSE.

Yes

No

G11. Do you speak a language other than English with students' families whose native language is not

English? MARK ONE RESPONSE.

Yes

No

G12. If you do not speak a language other than English with EITHER students OR students'

families whose native language is not English, mark here and SKIP TO Q G14.

G13. What language﴾s﴿ other than English do you speak with students at your school or with their

families? MARK ALL THAT APPLY.

Spanish

Vietnamese

A Chinese language

Japanese

Korean

Other ﴾PLEASE SPECIFY﴿

Arabic

A Filipino language

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G14. Date Questionnaire Completed:

Questionnaire completed by:

LAST NAME FIRST NAME MIDDLE INITIAL

MONTH DAY YEAR

2015

THANK YOU FOR YOUR COOPERATION!

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For Office Use Only

C ‐ No DR C ‐ DR Comp

 C ‐ DR Ref Ref

RETURNING

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