## 1 **TEACHER AND COUNSELOR SURVEY**

**Survey Instructions** The Corporation for National and Community Service (CNCS), with its contractor [TBD] , is conducting a study of the School Turnaround AmeriCorps program, a partnership between CNCS and the Department of Education. The purpose of the study is to learn about how School Turnaround AmeriCorps programs are being implemented and how they are hel ping schools improve. You have been selected to complete a survey as part of the study. Your perspective is very important, so please answer honestly. Your participation in this study is completely voluntary. Refusing to participate will not involve any penalty or affect your [AmeriCorps status ] [ employment ] in any way. It also will have no effect on your relationship with your school. It should take you approximately 30 minutes to complete the survey. We understand that your school may have interactions with multiple AmeriCorps programs. Answer the questions based only on your experience with the School Turnaround AmeriCorps program at your school this year. All responses are anonymous and your responses will be kept confidential to the extent provided by law. Under no circumstances will anyone from your AmeriCorps program/school have access to any information that can be attributable to you. The information you provide in the survey will be summarized with the information from other respondents and incl uded in a report that will be shared with your School Turnaround AmeriCorps program and with CNCS. Please contact XXXX of XXXX, at XXX

-XXX

-XXXX or XXXX, if you have any questions regarding this research.

[Note: Most questions will be asked at both grantee and comparison schools, though questions asking specifically about School Turnaround AmeriCorps will only be asked at grantee schools. Most, but not all, questions will be asked at both the beginning and the end of the school year.]

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**1. What is your current position at the school? _______________________** 

**_______________________________ 2.**  **W hich subjects**  **do you teach ?**  **(Check all that apply.)** 

___ Math ematics ___ Reading

___ English Language A rts ___ Science, e.g. Biology, Chemistry, Physics, Environmental Science ___ Social Studies ___ Foreign languages ___ Computer Science ___ Elective (art, music, computer technology/literacy, home economics, shop, etc. )

___ Physical Education /Health ___None: I am a counselor ___ Other, please specify :

**_______________________ ____________________________________________** **____________ 3.**  **What grades do you work with? (Check all that apply.)**  ___K ___1 ___2 ___3 ___4 ___5 ___6 ___7 ___8 ___9 ___10 ___11 ___12 **4. How many years total have you worked at this school, including this year?** 

_____ (If this is your first year at this school, enter 1.) **5. Across all your responsibilities, approximately how many students did you work with this year?** 

_____

**6. What is your average classroom size?** 

_____ (If not applicable, enter NA) **7. Approximately h**  **ow many of the students you worked with**  **were involved in Schoo**  **l Turnaround AmeriCorps**  **programming ?**  **Please enter the percentage OR number of students, of all the students you worked with.** Percentage of students: _____% OR Number of students: _____ If you don’t know, check here: ___
**8. To the best of your knowledge,**  **w hat mechanisms**  **did the school use to identify students for activities led by**  **School Turnaround**  **AmeriCorps members ?**  **( Check all that apply.**  **)**

___ Teacher recommendation

___ Counselor recommendation

___ P arent request

___ Studen t request

___ Standardized test scores

___ G rades __ Other, please specify: ________________________________________________________________________________ **9. To the best of your knowledge,**  **what are the reasons**  **that students were identified**  **to participate School Turnaround**  **AmeriCorps programming? (**  **Check all that apply. )** 

__ I mprove academic achievement (standardized test scores and/or grades) __ Improve academic engagement (attendance, interest in school) __ Assist students at risk for dropping out __ Improve self

- esteem or socio

-emotional health __ Improve behavior __ Sustain performance __ Other, please specify: ________________________________________________________________________________

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**10. To the best of your knowledge, did**  **School Turnaround AmeriCorps m**  **embers provide direct services to individual students or to the**  **whole classroom or school?**  **(Check all that apply.)** __ AmeriCorps programming was targeted to individual students __ AmeriCorps programming supported the whole classroom __ AmeriCorps programming supported all students in the school
**11. Do you know which students were served by**  **School Turnaround AmeriCorps members?**  Yes : _____ No: _____ Sometimes but not always: _____
**12. What**  **do you consider to be the most important**  **sc hool turnaround**  **outcomes for students over the next two years**  **? (Check all that apply** **. )**  ___ Enhanced academic achievement

___ Improved grades

___ Improved completion of assignments

___ Increased motivation

___ Increased self

-esteem

___ Improved attendance

___ Improved socio

-emotional health

___ Improved behavior

___ Other : ___________________________________________________________________________________________

**13. Please fill in the following table about school improvement outcomes for students.**  Was there improvement in this area for one or more of your students at your school this year ? If you marked “Yes,” what were the outcomes with the greatest degree of improvement, across students ? Rank, with 1=Greatest improvement. Do not rank outcomes whe re you marked “No.” Enhanced academic achievement, as measured by interim progress or unit assessments ___Yes ___No
Improved grades ___Yes ___No Improved completion of assignments ___Yes ___No Increased motivation ___Yes ___No Increased self

- esteem ___Yes ___No Improved attendance ___Yes ___No Improved socio

- emotional health ___Yes ___No Improved behavior ___Yes ___No Other: __________________________ ___Yes ___No

**14. P**  **lease indicate the level of agreement/disagreement**  **with the following statements about teacher relationships with**  **School Turnaround AmeriCorps members.**  **(Mark one response in each row.) Strongly**  **Disagree Disagree**  **Agree Strongly**  **Agree Not** 

**Applicable a.**  Teachers in this school are supportive of the AmeriCorps program. **b.** Teachers in this school share and discuss instructional practices with AmeriCorps members. **c.** Teachers in this school share and discuss behavioral management strategies with AmeriCorps members.

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**d.** Teachers in this school discuss their expectations for st udents with AmeriCorps members. **e.** Teachers and AmeriCorps members successfully collaborate to support students.

**15. Please indicate your level of**  **agreement/disagreement with the following statements about your school this year. (Mark one response in each row.)**  **My school ... Strongly**  **Disagree Disagree**  **Agree Strongly**  **Agree Don’t** 

**Know Not** 

**Applic able**  **a.** Offers students a supportive and inviting environment within which to learn

. **b.** Sets high standards for academic performance for all students. **c.** Prompts academic success for all students. **d.** Emphasizes helping students academically when they need it. **e.** Provides adequate counseling and support services for students. **f.** Emphasizes teaching lessons in ways relevant to students. **g.** Offers staff a supportive and inviting environment within which to work. **h.** Promotes trust and collegiality among staff. **i.** Provides the materials, resources, and training (professional development) needed to do your job effectively. **j.** Provides the materials, resources, and training (professional development) needed to work with special education (IEP) students. **k.** Encourages opportunities for students to decide things like class rules. **l.** Gives all students equal opportunity to participate in classroom discussions or activities. **m.** Gives all students equal opportunity to participate in a variety of extracurricular activities. **n.** Gives all students equal opportunity to participate in a variety of enrichment activities. **o.** Gives students opportunities to “make a difference” by helping other people, the school, or the community (e.g., service learning). **p.** Encourages students to enroll in rigorous courses (such as honors and AP), regardless of race, ethnicity, or nationality. **q.** Emphasizes using instructional materials that reflect the culture or ethnicity of our students. **r.** Has staff examine their own cultural biases through professional development. **s.** Considers closing the racial/ethnic achievement gap a high priority. **t.** Fosters an appreciation of student diversity and respect for one an other. **u.** Emphasizes showing respect for all students’ cultural beliefs and practices.

## 5 **My school ... Strongly**  **Disagree Disagree**  **Agree Strongly**  **Agree Don’t** 

**Know Not** 

**Applic able**  **v.** Clearly communicates to students the consequences of breaking school rules. **w.** Handles discipline problems fairly. **x.** Effectively handles student discipline and behavioral problems. **y.** Is a safe place for students. **z.** Is a safe place for staff. **aa.** Is welcoming to and facilitates parent involvement. **bb.** Makes information and resources available to parents/guardians about how they can support their children’s education

. **cc.** Has clean and well

- maintained facilities and property **dd.** Has sufficient teaching staff to meet the needs of students. **ee.** Has sufficient support staff to meet the needs of students. **16. Please indicate**  **the level of agreement/disagreement with the following statements about community involvement and**  **partnerships with your school. (Mark one response in each row.) This school w** **orks with organizations in the community to ...**  **Strongly Disagree**  **Disagree Agree**  **Strongly Agree**  **Not**

**Applicable a.**  Provide academic enrichment, extended learning time or other academic supports to students. **b.** Make appropriate support service s available to students with special needs

. **c.** D eliver wraparound services and non -academic (social/emotional ) supports to students. **d.** Increase awareness about and access to health resources/services (e.g. targeting drug use, mental health, teen pregnancy)

. **e.** Expose students to post

-secondary education opportunities and increase student interest in and knowledge about college

. **f.** Connect parents/guardians to information and resources to help them support their children’s education.

**17. Please indicate whether the following topics represent challenges in your school this year.**  **(Mark one response in each row.)**  **Not a challenge Moderate**  **Challenge Severe**  **Challenge**

**a.** Student academic performance **b.** Student behavior and discipline **c.** Student engagement in school **d.** Student attendance **e.** Student safety **f.** Student aspirations for college and/or career **g.** Student fatigue/lack of sleep **h.** Student alcohol and drug use **i.** Student tobacco use **j.** Harassment or bullying among students **k.** Physical fighting between students

## 6 **Not a challenge Moderate** 

**Challenge Severe**  **Challenge l.**  Disruptive student behavior **m.** Racial/ethnic conflict among students **n.** Student depression or other mental health problems **o.** Lack of respect of staff by students **p.** Cutting classes or being truant **q.** Gang

- related activity **r.** Weapons possession **s.** Vandalism (including graffiti) **t.** Theft

**18. Please indicate**  **the level of agreement/disagreement with the following statements about your school. (Mark one**  **response in each row.) Strongly**  **Disagree Disagree**  **Agree Strongly**  **Agree Not** 

**Applicable a.**  Students take their school work seriously. **b.** Students treat each other with respect. **c.** Students treat teachers with respect. **d.** Students treat AmeriCorps members with respect. **e.** There is communication and collaboration between teachers and other school staff. **f.** Families play an active role in our school. **g.** AmeriCorps members offer supports that are beneficial to the teachers in this school. **h.** AmeriCorps members provide helpful support to the students in this school. **i.** AmeriCorps activities occur frequently enough to be valuable. **j.** AmeriCorps members are important partners in improving student outcomes.

**19. For this school year, please indicate**  **the level of satisfaction/dissatisfaction with each of the elements listed below:**  **Very Dissatisfied**  **Dissatisfied Satisfied**  **Very Satisfied**  **Not**

**Applicable a.**  Overall quality of AmeriCorps programming. **b.** Communication and collaboration between teachers and AmeriCorps members. **c.** Implementation of the roles and responsibilities outlined in the school partnership agreements **d.** Placement of members in meaningful service activities

**e.** Referral of students to receive services offered by AmeriCorps members **f.** Matching of members to students in need of academic strengthening and social/emotional supports

**20. In your opinion, how successful was the**  **School Turnaround AmeriCorps program in the following areas**  **this year ?**  **(Mark one response in each row.)**  **Very Unsuccessful**  **Somewhat**

**Unsuccessful Somewhat** 

**Successful Very** 

**Successful**

## 7 **g.** Overall success of the AmeriCorps program **h.** AmeriCorps program’s success in improving student academic achievement **i.** AmeriCorps program’s success in improving student socio

emotional health **j.** AmeriCorps program’s success in improving school climate **k.** AmeriCorps program’s success in improving the school’s capacity to implement its turnaround model

## 8 **TEACHER EVALUATION OF IMPROVEMENT Thinking about the student whose last name is closest to the beginning of the alphabet, and the student whose last name is**  **closest to the end of the alphabet, please complete the following for those two students.**  **21. Since b**  **eginning to work with a School Turnaround AmeriCorps member** **( s**  **) , t** **o what extent has your student changed his**  **or her behavior in terms of:**  **Student #1:** Significant

Decline Moderate

Decline No Change Moderate Improvement Significant

Improvement Did not Need

to Improve a. Turning in his/her homework on time. b. Completing homework to your satisfaction. c. Participating in class. d. Volunteering (e.g., for extra credit or more responsibilities). e. Attending class regularly. f. Being attentive in class. g. Coming to school motivated to learn. h. Getting along well with other students. **Student#2:** Significant Decline Moderate

Decline No Change Moderate Improvement Significant

Improvement Did not Need

to Improve a. Turning in his/her homework on time. b. Completing homework to your satisfaction. c. Participating in class. d. Volunteering (e.g., for extra credit or more responsibilities). e. Attending class regularly. f. Being attentive in class. g. Coming to school motivated to learn. h. Getting along well with other students.