Attachment 1 – Survey Instrument

Fast Response Survey System (FRSS) 106: 

School Safety and Discipline: 2013–14

OMB# 1850-0733 v. 29

November 27, 2013

National Center for Education Statistics

U.S. Department of Education
U.S. DEPARTMENT OF EDUCATION 

NATIONAL CENTER FOR EDUCATION STATISTICS

WASHINGTON, D.C. 20006–5651

SCHOOL SAFETY AND DISCIPLINE: 2013–14

FAST RESPONSE SURVEY SYSTEM

FORM APPROVED 

O.M.B. No.: 1850–0733

EXPIRATION DATE: 05/2015

Draft 11-25-13

This survey is authorized by law (Education Sciences Reform Act of 2002, 20 U.S.C. § 9543). While participation in this 

survey is voluntary, your cooperation is critical to make the results of this survey comprehensive, accurate, and timely.

Your answers may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any 

other purpose unless otherwise compelled by law (Education Sciences Reform Act of 2002, 20 U.S.C. § 9573).

 This survey is designed to be completed by the person(s) most knowledgeable about safety and 

discipline at your school. 

 Please respond for the current 2013–14 school year to date.

 Please use the definitions on the Instructions and Definitions Page for words that appear in the 

questionnaire bolded and marked by an asterisk.

NAME AND ADDRESS OF SAMPLED SCHOOL HERE

IF ABOVE SCHOOL INFORMATION IS INCORRECT, PLEASE UPDATE DIRECTLY ON LABEL.

Grades taught at this school: Low grade taught ________ High grade taught ________

Name of person completing this form: ___________________________________________________________________

Title/position: ______________________________________________________________________________________

Telephone number: ___________________________________ E-mail:______________________________________

Best days and times to reach you (in case of questions): ___________________________________________________

THANK YOU. PLEASE KEEP A COPY OF THIS SURVEY FOR YOUR RECORDS.

PLEASE RETURN COMPLETED FORM TO: IF YOU HAVE ANY QUESTIONS OR COMMENTS, CONTACT:

Mail: Cindy Gray (6197.01.02.02) Cindy Gray at Westat

Westat 800-937-8281, Ext. 4336 or 301-251-4336

1600 Research Boulevard E-mail: SafetySurvey@westat.com

Rockville, Maryland 20850-3195

Fax: 800-254-0984

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 information collection is 1850–0733. The time required to complete this information collection is 

estimated to average 20 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and 

complete and review the information collection. If you have any comments concerning the accuracy of the time estimate or suggestions for improving 

this form, please write to: U.S. Department of Education, Washington, DC 20202–4537. If you have any comments or concerns regarding the status of 

your individual submission of this form, write directly to: National Center for Education Statistics, 1990 K Street, NW, Washington, DC 20006.

FRSS Form No. 106, 02/2014
Instructions and Definitions Page

 Please respond for the current 2013–14 school year to date.

 The following words are bolded and marked by an asterisk (*) wherever they appear in the questionnaire. 

Please use these definitions as you respond.

At school/at your school – activities happening in school buildings, on school grounds, on school buses, and at 

places that hold school-sponsored events or activities. Unless otherwise specified, this refers to normal school 

hours or to times when school activities/events were in session.

Physical attack or fight – an actual and intentional touching or striking of another person against his or her will, or 

the intentional causing of bodily harm to an individual.

Rape – forced sexual intercourse (vaginal, anal, or oral penetration). This includes penetration from a foreign 

object. Both male and female students can be victims of rape.

Robbery (taking things by force) – the taking or attempting to take anything of value that is owned by another 

person or organization, under confrontational circumstances by force or threat of force or violence and/or by putting 

the victim in fear. A key difference between robbery and theft/larceny is that robbery involves a threat or battery.

For this survey, you will be asked to report incidents of robbery, but not theft/larceny).

Sexual battery – an incident that includes threatened rape, fondling, indecent liberties, child molestation, or 

sodomy. Both male and female students can be victims of sexual battery. Classification of these incidents should 

take into consideration the age and developmentally appropriate behavior of the offender(s).

Sexual harassment – conduct that is unwelcome, sexual in nature, and denies or limits a student’s ability to 

participate in or benefit from a school’s education program. The conduct can be carried out by school employees, 

other students, and non-employee third parties. Both male and female students can be victims of sexual 

harassment, and the harasser and the victim can be of the same sex. The conduct can be verbal, nonverbal, or 

physical.

Theft/larceny (taking things worth over $10 without personal confrontation) – the unlawful taking of another 

person’s property without personal confrontation, threat, violence, or bodily harm.

(For this survey, you will be asked to report incidents of robbery, but not theft/larceny).

Violence – actual, attempted, or threatened fight or assault.

Weapon – any instrument or object used with the intent to threaten, injure, or kill. This includes look-alikes if they 

are used to threaten others.
1. During the 2013–14 school year, was it a practice of your school to do the following? (If your school changed its 

practices during the school year, please answer regarding your most recent practice. Indicate yes or no for each 

item.)

Yes No

a. Require visitors to sign or check in ....................................................................................................

b. Control access to school buildings during school hours (e.g., locked or monitored doors)...............

c. Control access to school grounds during school hours (e.g., locked or monitored gates)................

d. Require students to pass through metal detectors each day.............................................................

e. Perform one or more random metal detector checks on students.....................................................

f. Require that all or most students stay on campus during lunch ........................................................

g. Use one or more random dog sniffs to check for drugs.....................................................................

h. Perform one or more random sweeps for contraband (e.g., drugs or weapons*), but not

including dog sniffs.............................................................................................................................

i. Require drug testing for athletes........................................................................................................

j. Require drug testing for students in extra-curricular activities other than athletics ...........................

k. Require drug testing for any other students.......................................................................................

l. Require students to wear uniforms ....................................................................................................

m. Enforce a strict dress code.................................................................................................................

n. Provide school lockers to students ....................................................................................................

o. Require clear book bags or ban book bags on school grounds.........................................................

p. Provide an electronic notification system that automatically notifies parents in case of a 

school-wide emergency .....................................................................................................................

q. Provide a structured anonymous threat reporting system (e.g., online submission, 

telephone hotline, or written submission via drop box)......................................................................

r. Require students to wear badges or picture IDs................................................................................

s. Require faculty and staff to wear badges or picture IDs ....................................................................

t. Use one or more security cameras to monitor the school .................................................................

u. Provide telephones in most classrooms ............................................................................................

v. Provide two-way radios to any staff ...................................................................................................

w. Limit access to social networking websites (e.g., Facebook, Twitter) from school 

computers ..........................................................................................................................................

x. Prohibit use of cell phones and text messaging devices during school hours...................................

2. During the 2013–14 school year, did your school or school district provide any of the following for classroom teachers 

or aides? (Indicate yes or no for each item.)

Yes No

a. Training in classroom management for teachers...............................................................................

b. Training in school-wide discipline policies and practices related to violence*..................................

c. Training in school-wide discipline policies and practices related to bullying .....................................

d. Training in school-wide discipline policies and practices related to alcohol and/or drug use............

e. Training in safety procedures (e.g., how to handle emergencies) ....................................................

f. Training in recognizing early warning signs of students likely to exhibit violent behavior .................

g. Training in recognizing physical, social, and verbal bullying behaviors.............................................

h. Training in recognizing signs of students using/abusing alcohol and/or drugs..................................

i. Training in positive behavioral intervention strategies .......................................................................

j. Training in crisis prevention and intervention.....................................................................................
3. Please indicate in part 1 whether your school has a written plan that describes procedures to be performed in the 

following crises. For items a–e, if your school has a written plan, please indicate in part 2 whether your school drilled 

students on the use of this plan during the 2013–14 school year.

Crisis

Part 1. Have a 

written plan?

Part 2. If “Yes,” 

have you drilled 

students on the plan 

this school year?

a. Shootings/Active shooters Yes No Yes No

b. Natural disasters (e.g., earthquakes or tornadoes) Yes No Yes No

c. Hostages Yes No Yes No

d. Bomb threats or incidents Yes No Yes No

e. Chemical, biological, or radiological threats or incidents (e.g., 

release of mustard gas, anthrax, smallpox, or radioactive materials) Yes No Yes No

f. Suicide threat or incident Yes No

g. An “imminent threat alert” is issued by the Department of Homeland 

Security’s National Terrorism Advisory System Yes No

h. Pandemic flu Yes No

4. During the 2013–14 school year, did you have any security guards, security personnel, or sworn law enforcement 

officers present at your school* at least once a week?

Yes (Continue with question 5.) No (Skip to question 7.)

5. How many of the following were present in your school at least once a week? (If an officer works full time across 

various schools in the district, count this officer as “part time at your school.*” Please answer all items. If none, check 

the “None” box.)

Type of personnel (Answer all items. If none, check the “None” box) Number at your school*

a. Security guards or security personnel (not law enforcement)

i. Full time at your school* ................................................................................................ ______ or None

ii. Part time at your school*................................................................................................ ______ or None

b. School Resource Officers (Include all career law enforcement officers with arrest 

authority, specialized training, and are assigned to work with school organizations.)

i. Full time at your school* ................................................................................................ ______ or None

ii. Part time at your school*................................................................................................ ______ or None

c. Sworn law enforcement officers who are not School Resource Officers

i. Full time at your school* ................................................................................................ ______ or None

ii. Part time at your school*................................................................................................ ______ or None

6. Did these security guards, security personnel, or sworn law enforcement officers participate in the following activities 

at your school*? (Indicate yes or no for each item.)

Yes No

a. Security enforcement and patrol .......................................................................................................

b. Maintaining school discipline ............................................................................................................

c. Coordinating with local police and emergency team(s) ....................................................................

d. Identifying problems in the school and proactively seeking solutions to those problems..................

e. Training teachers and staff in school safety or crime prevention.......................................................

f. Mentoring students.............................................................................................................................

g. Teaching a law-related education course or training students (e.g., drug-related education, 

criminal law, or crime prevention courses).........................................................................................
Please refer to the Instructions and Definitions Page for words in bold and marked by an asterisk.

7. To the best of your knowledge, how often do the following types of problems occur at your school*? (Check one box 

on each line.)

Problem

Happens 

daily

Happens 

at least 

once a 

week

Happens 

at least 

once a 

month

Happens 

on 

occasion

Never 

happens

a. Student racial/ethnic tensions...................................

b. Student bullying ........................................................

c. Student sexual harassment* of other students.......

d. Student harassment of other students based on 

sexual orientation or gender identity (i.e., lesbian, 

gay, bisexual, transgender, questioning)..................

e. Widespread disorder in classrooms..........................

f. Student verbal abuse of teachers .............................

g. Student acts of disrespect for teachers other than 

verbal abuse ............................................................

8. During the 2013–14 school year, have any of your school’s students, faculty, or staff died as a result of a homicide 

committed at your school*?

Yes No 

9. Record the number of incidents that occurred at school* during the 2013–14 school year for the offenses listed below.

Please provide information on: 

 The number of incidents, not the number of victims or offenders.

 Recorded incidents, regardless of whether any disciplinary action was taken.

 Recorded incidents, regardless of whether students or non-students were involved.

 Incidents occurring before, during, or after normal school hours.

Please answer all items. If none, check the “None” box.

Type of incident

Total number of 

recorded incidents

a. Rape* or attempted rape*................................................................................................ ______ or None

b. Sexual battery* other than rape* (include threatened rape*)................................ ______ or None

c. Robbery* (Report robbery,* which is taking things by force or threat.

Do not report theft,* which is taking things without personal confrontation.)

i. With a weapon*................................................................................................______ or None

ii. Without a weapon*................................................................................................ ______ or None

d. Physical attack or fight*

i. With a weapon*................................................................................................______ or None

ii. Without a weapon*................................................................................................ ______ or None

e. Threats of physical attack*

i. With a weapon*................................................................................................______ or None

ii. Without a weapon*................................................................................................ ______ or None