Local Facilator Log of Activities

APPENDIX D

LOCAL FACILATOR LOG OF ACTIVITIES

NWREL Experimental Study of Project CRISS

NOTE: The intent is to show the content of the questionnaire. This questionnaire will be reformatted into a data entry screen that the Local Facilitator will be able to access on-line.

Local Facilitator Log (Questionnaire)¹

(TREATMENT Schools Only)

This monthly log is part of an experimental study being conducted by Northwest Regional Educational Laboratory (NWREL) under contract with the U.S. Department of Education. Your answers are critically important and will be used to better understand your role as a school Local Facilitator for Project CRISS. Please be candid in your answers. Responses to this data collection will be used only for statistical purposes. The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific district, school, or individual. We will not provide information that identifies you or your district or school to anyone outside the study team, except as required by law.

Please answer questions with regard to the current calendar month only.

Month/Year: (pull down menu) School: (pull down menu)

1. Did the Project CRISS trainer visit your school this month?

____ Yes

____ No

IF YES, PLEASE PROVIDE THE INFORMATION BELOW:

Number of days trainer was on site: __________

Activities conducted: (pull down menu of typical workshops/TA)

Other help provided by Project CRISS trainer: (open text box)

2. Did you hold any formal meetings this month with groups of teachers participating in Project CRISS?

____ Yes

____ No

IF YES, PLEASE PROVIDE THE INFORMATION BELOW:

Number of meetings: __________

Average attendance: __________

Content area teachers who attended: (pull down menu with core content areas)

Activities conducted: (pull down menu of typical CRISS meeting topics)

Other group help I provided: (open text box)

3. Did you work one-on-one with any teachers this month who are participating in Project CRISS?

____ Yes

____ No

IF YES, PLEASE PROVIDE THE INFORMATION BELOW:

Number of consultations: __________

Content areas I worked with: (pull down menu with core content areas)

Activities conducted: (pull down menu of typical CRISS one-on-one activities)

Other individual help I provided: (open text box)

4. Did you work with the principal in any way to help her/him support Project CRISS with teachers?

____ Yes

____ No

IF YES, PLEASE DESCRIBE:

(open text box)

5. About how many hours did you spend facilitating Project CRISS this month by working with teachers and/or the principal?

Note: Do not include hours attending workshops provided by the Project CRISS trainer.

(pull down menu)

____ Less than one hour ____ 1 to 5 hours ____ 6 to 10 hours ____ 11 to 15 hours

____ 16 to 20 hours ____ 21 to 25 hours ____ 26 to 30 hours ____ More than 30

6. To what extent was the Project CRISS trainer available and willing to help you—by phone or email—to answer questions or help with Project CRISS?

_____ Was generally available and tried to help when I needed her

_____ Was generally not available or willing to help when I tried to contact her

_____ I really didn’t have the need to contact her for help

7. I spent approximately _______ hours this month conferring with the trainer via telephone/email.

Background Questionnaire for LF

The background questions 1-3 below will be asked once through an initial set-up call to acquaint the LF with the on-line log and how to use it. If the LF changes during the course of the two years, the new person will also be asked these questions. Question 4-6 can change from year to year and will be asked once per year over the two-year intervention.

1. How many years (including this year) of middle or high school teaching experience do you have?

_____ years

2. How many years (including this year) have you been teaching at this school?

_____ years

3. What is your highest educational degree completed?

____ Bachelor (B.S. or B.A.)

____ Masters (M.S., M.A, M.Ed.)

____ Doctorate (Ph.D, Ed.D, J.D)

____ Other: _____________________

4. Which of the following core content subjects do you currently teach? (check all that apply, and write in other subjects under Other, if applicable)

____ Language Arts

____ Science

____ Mathematics

____ Social Studies

____ Other: ___________________________

5. Are you certified by your state to teach Reading?

____ Yes

____ No

6. Aside from Project CRISS, have you had any other formal training or professional development to help prepare you as a literacy coach for other teachers?

____ Yes

____ No

IF YES, PLEASE DESCRIBE: (open text box)

rev.10/11/07

1 According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.  The valid OMB control number for this information collection is xxxx-xxxx, expiration date xx-xx-xx.  The time required to complete this information collection is estimated to average 10 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(s) or suggestions for improving this form, please write to:  U.S. Department of Education, Washington, D.C. 20202-4700.  If you have comments or concerns regarding the status of your individual submission of this form, write directly to:  Gil Garcia, U.S. Department of Education, 555 New Jersey Avenue, N.W., Room 506E, Washington, D.C. 20208.

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