Fast Response Survey System (FRSS) 105: Condition of Public School Facilities: 2012 – Feasibility Calls

Attachment 3: FRSS 105 Questionnaire

U.S. DEPARTMENT OF EDUCATION NATIONAL CENTER FOR EDUCATION STATISTICS WASHINGTON, D.C. 20006–5651 CONDITION OF PUBLIC SCHOOL FACILITIES FAST RESPONSE SURVEY SYSTEM

FORM APPROVED O.M.B. No.: 1850–0733 EXPIRATION DATE: XX/XXX Draft 04-27-12

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).

Please provide information only about the school that is indicated on the front of this survey.

This survey is designed to be completed by district-level personnel who are very familiar with the school facilities in this district. You may wish to consult with other district-level personnel or with school-level personnel, such as the principal of the selected school, in answering some questions. Please respond about the selected school for the current 2012-13 school year, even if the selected school is new.

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

Name of person completing this form:

Title/position:

Telephone number: E-mail:

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

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

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: Debbie Alexander (8599.13.13.02) Debbie Alexander at Westat

Westat 800-937-8281, Ext. 2088 or 301-294-2088

1600 Research Boulevard E-mail: XXXXXX@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 30 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. 105, XX/2012

2. Does this school have the following types of onsite buildings? (Indicate yes or no for each type of building.)

	Yes	No		If the answer to question 1 for a type of building is “no,” leave the columns for that type of building blank in questions 2 and 8.
a. Permanent buildings	1	2
b. Portable (temporary) buildings	1	2

Use the following rating scale to indicate the condition of building systems/features in question 2 and outdoor features in question 3:

Not applicable means that a building system/feature does not exist within that type of building. This rating can only be applied to those building systems/features or outdoor features where a “0” appears in the “not applicable” column.

Excellent means that a particular feature or system meets all the reasonable needs of the school pertaining to that item, yet goes well beyond adequate. Relatively minor enhancements may be necessary.

Good means a feature or system meets all the reasonable needs of the school, is most often in good condition, and generally meets some, but not all, of the characteristics of an excellent system/feature.

Fair means that a feature or system meets minimal conditions but is not dependable, breaks down frequently, or has other limitations. It is a feature or system that would require some upgrading to be considered in good condition.

Poor means that a particular feature or system as it exists is inadequate to meet even the minimal needs of the school.

3. What is the condition of each building system/feature for the permanent and portable (temporary) onsite buildings at this school?

• In Part A, circle one rating on each line to indicate the condition of each system/feature for the permanent buildings at this school. Leave Part A blank if this school does not have any permanent buildings.

• In Part B, circle one rating on each line to indicate the condition of each system/feature for the portable (temporary) buildings at this school. Leave Part B blank if this school does not have any portable (temporary) buildings.

Building system/feature	Part A. Permanent buildings					Part B. Portable (temporary) buildings
	Not appli-cable	Excel-lent	Good	Fair	Poor	Not appli-cable	Excel-lent	Good	Fair	Poor
Roofs	----	1	2	3	4	----	1	2	3	4
Framing, floors, foundations	----	1	2	3	4	----	1	2	2	4
Exterior walls, finishes, windows, doors	----	1	2	3	4	----	1	2	3	4
Interior finishes, trim	----	1	2	3	4	----	1	2	3	4
Plumbing/lavatories	----	1	2	3	4	0	1	2	3	4
Heating system	0	1	2	3	4	0	1	2	3	4
Air conditioning system	0	1	2	3	4	0	1	2	3	4
Ventilation/filtration system	----	1	2	3	4	----	1	2	3	4
Electrical system	----	1	2	3	4	----	1	2	3	4
Interior lighting	----	1	2	3	4	----	1	2	3	4
Exterior lighting	----	1	2	3	4	0	1	2	3	4
Life safety features (e.g., sprinklers, fire alarms)	----	1	2	3	4	0	1	2	3	4
Technology infrastructure	----	1	2	3	4	0	1	2	3	4

4. What is the condition of the following outdoor features at this school? (Circle one rating on each line.)

Outdoor feature	Not applicable	Excellent	Good	Fair	Poor
a. School parking lots and roadways	0	1	2	3	4
b. Bus lanes and drop-off areas	0	1	2	3	4
c. School sidewalks and walkways	0	1	2	3	4
d. Outdoor play areas/playgrounds	0	1	2	3	4
e. Outdoor athletic facilities	0	1	2	3	4

Use the following rating scale to indicate the overall condition of each type of onsite building at this school:

Not applicable means that the school does not have that type of building.

Excellent means that the facility meets all the reasonable needs for normal school performance, yet goes well beyond adequate. Relatively minor enhancements may be necessary.

Good means that the facility meets all the reasonable needs for normal school performance, is most often in good condition, and generally meets some, but not all, of the characteristics of an excellent facility.

Fair means that the facility meets minimal needs for normal school performance but requires frequent maintenance or has other limitations. It requires some upgrading to be considered in good condition.

Poor means that the facility does not meet minimal requirements for normal school performance.

5. What is the overall condition of the permanent and portable (temporary) onsite buildings at this school? (Circle one on each line.)

Building type	Not applicable	Excellent	Good	Fair	Poor
a. Permanent buildings	0	1	2	3	4
b. Portable (temporary) buildings	0	1	2	3	4

6. What would probably be the total cost of all repairs/renovations/modernizations required to put this school’s onsite buildings in good overall condition? (Give your best estimate. If this school’s onsite buildings are already in good or excellent overall condition, enter zero.)

$________________

7. On which of the sources listed below is this cost estimate based? (Circle all that apply.)

a. Does not apply – already in good or excellent overall condition 1

b. Facilities inspection(s)/assessment(s) performed within the last 3 years by licensed professionals 2

c. Repair/renovation/modernization work already being performed and/or contracted for 3

d. Capital improvement/facilities master plan, schedule, or budget 4

e. My best professional judgment 5

f. Opinions of other district or school administrators 6

g. Other (specify) 7

8. What would be the total cost to replace this school’s existing onsite buildings with new school buildings of the same size at the same location?

$________________

9. How satisfactory is each environmental factor in the permanent and portable (temporary) onsite buildings at this school?

• In Part A, circle one rating on each line to indicate the overall satisfaction with each environmental factor for the permanent buildings at this school. Leave Part A blank if this school does not have any permanent buildings.

• In Part B, circle one rating on each line to indicate the overall satisfaction with each environmental factor for the portable (temporary) buildings at this school. Leave Part B blank if this school does not have any portable (temporary) buildings.

Environmental factor	Part A. Permanent buildings					Part B. Portable (temporary) buildings
	Not appli-cable	Very satis-factory	Satis-factory	Unsatis-factory	Very unsatis-factory	Not appli-cable	Very satis-factory	Satis-factory	Unsatis-factory	Very unsatis-factory
a. Artificial lighting	----	1	2	3	4	----	1	2	3	4
b. Natural lighting	0	1	2	3	4	0	1	2	3	4
c. Heating	0	1	2	3	4	0	1	2	3	4
d. Air conditioning	0	1	2	3	4	0	1	2	3	4
e. Ventilation	----	1	2	3	4	----	1	2	3	4
f. Indoor air quality	----	1	2	3	4	----	1	2	3	4
g. Water quality	----	1	2	3	4	0	1	2	3	4
h. Acoustics or noise control	----	1	2	3	4	----	1	2	3	4

10. In what year was this school’s main instructional building constructed? ____________

11. In what year was the last major renovation of the main instructional building? ____________

12. In what year was the last major renovation/addition/replacement made to this school? ____________

13. Is any major repair/renovation/modernization work currently being performed at this school?

    Yes 1

    No 2

14. Is any major repair/renovation/modernization work for this school currently under contract, but not yet begun?

    Yes 1

    No 2

15. Which of the following construction projects, if any, are planned for this school in the next 2 years? (Indicate yes or no for each item.)

Yes No

a. Build new permanent buildings or permanent additions to buildings
(e.g., a new classroom wing or gymnasium) 1 2

b. Major repairs, renovations, or modernization of existing permanent buildings 1 2

c. Install new portable (temporary) buildings 1 2

16. Which of the following building systems or features at this school, if any, have major repairs, renovations, or replacements planned for the next 2 years? What is the main reason for the planned major repair, renovation, or replacement?

• In Part A, circle one response on each line to indicate major repair, renovation, or replacement plans for each building system or feature. Do not include preventive maintenance or minor repairs.

• In Part B, circle one response to indicate the main reason for any planned major repairs, renovations, or replacements for a building system or feature. Leave Part B blank for any building system or feature for which no major repair, renovation, or replacement is planned.

Building system/feature	Part A. Plans for major repair, renovation, or replacement			Part B. Main reason for planned major repair, renovation, or replacement
	No major repair, renovation, or replacement planned	Major repair or renovation planned	Replacement planned	Functional problem in existing system or feature	Improved operational or energy efficiency	Replacement cycle or capital investment	Other reason
Roofs	1	2	3	1	2	3	4
Framing, floors, foundations	1	2	3	1	2	3	4
Exterior walls, finishes, windows, doors	1	2	3	1	2	3	4
Interior finishes, trim	1	2	3	1	2	3	4
Plumbing/lavatories	1	2	3	1	2	3	4
Heating system	1	2	3	1	2	3	4
Air conditioning system	1	2	3	1	2	3	4
Ventilation/filtration system	1	2	3	1	2	3	4
Electrical system	1	2	3	1	2	3	4
Interior lighting	1	2	3	1	2	3	4
Exterior lighting	1	2	3	1	2	3	4
Life safety features (e.g., sprinklers, fire alarms)	1	2	3	1	2	3	4
Technology infrastructure	1	2	3	1	2	3	4

17. Is there a written long-range educational facilities plan for this school?

    Yes 1 (Continue with question 17.)

    No 2 (Skip to question 18.)

18. Are the following included in the long-range educational facilities plan? (Indicate yes or no for each item.)

Yes No

1. Improving energy efficiency 1 2

2. Improving environmental conditions(e.g., air quality, acoustics) 1 2

3. Creating a Green School or Green Classrooms 1 2

19. Has this school had the following performed by licensed professionals within the last 3 years? (Indicate yes or no for each item.)

Yes No

1. A facility inspection/assessment 1 2

2. Energy review walk-through 1 2

3. Evaluation of the indoor air quality 1 2

20. Have any of the following been done within the last 3 years to improve energy efficiency at this school? (Indicate yes or no for each item.)

Yes No

1. Replaced lighting fixtures or bulbs, or installed motion-sensors for lighting 1 2

2. Replaced windows and/or doors 1 2

3. Replaced insulation, outer walls, and/or siding 1 2

21. Does the school district in which this school is located have the ability to issue bonds or increase levies for school construction?

    Yes 1

    No 2

22. Are there state funds available for school construction?

    Yes 1

    No 2

23. Are there significant problems with the facilities at this school that are not covered in this survey?

Yes 1

No 2

If yes, please briefly describe those problems below: