ECLS-K:2011 Pilot Tests of the Third-, Fourth-, and Fifth-Grade Direct Child Assessment, Child Questionnaire, and Online School Administrator Questionnaire

Appendix C:
School Administrator Questionnaire (SAQ)

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Spring 2013
School Administrator Questionnaire
Questionnaire B
Prepared for the U.S. Department of Education
National Center for Education Statistics by:
Westat
Rockville, Maryland
Use a black or blue ball point pen to complete this questionnaire.

RETURN THIS COMPLETED QUESTIONNAIRE 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.

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 information collection is 18500750. Approval expires 10/31/2015. The time required to complete this
information collection 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 information requested.
If you have any comments concerning the accuracy of the time estimate or
suggestions for improving the survey instrument, please write to: U.S.
Department of Education, Washington, D.C. 20202-4537. If you have
comments or concerns regarding the status of your individual response to this
survey, write directly to: National Center for Education Statistics, 1990 K
Street, N.W., Room 9086, Washington, D.C. 20006-5574.

1

The collection of information in this survey is authorized by 20 U.S.
Code, Section 9541. Participation is voluntary. You may skip questions
y
ou 
do 
not

wi
s
h 
t
o 
ans
wer
;

howev
er
,

we 
hope 
t
hat

y
ou 
wi
l
l

ans
wer

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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2

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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. You have received this questionnaire because one
or more of the children in your school are participants in this study.
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 (if applicable)
f ) Staffing and teacher characteristics
g) School administrator characteristics
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)
.

I
nf
or
mat
i
on 
f
r
om 
mul
t
i
pl
e 
i
ndi
vi
dual
s

wi
l
l

be 
combi
ned 
t
o 
pr
oduce 
s
t
at
i
s
t
i
cal

r
epor
t
s
;

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 6) or by writing your responses in the space provided. Your best estimates are acceptable
answers.

3

15265

DEFINITIONS
For the purposes of this study, the following definitions apply:
Special programs. Reference is made in this questionnaire to Title I and Title III programs, individualized
education programs (IEP), individualized family service plans (IFSP), 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 or an IFSP.
Individualized Family Service Plan (IFSP): A written statement of the educational program and other
services designed to enhance the family's capacity to meet the developmental needs of an infant or
toddler (preschool-aged) with a disability. The plan includes a description of the appropriate services
needed to assist transition into elementary school.
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.
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.

4

15265
1

TYPES OF LANGUAGE INSTRUCTION EDUCATIONAL PROGRAMS (LIEPs)
Programs that focus on developing students' literacy in two languages

Two-way immersion program (TWI) or two-way bilingual program: The goal of these programs is to
develop strong skills and proficiency in both students' home language and English. These programs may
also be called dual language programs. These programs include students whose native language is not
English (but who all speak the same non-English language) and students whose native language is English.
Instruction is provided in both languages, typically starting with a smaller proportion of instruction in
English, and gradually moving to half of the instruction in each language. Students typically stay in these
programs throughout elementary school.
Developmental bilingual program, late exit transitional program, or maintenance bilingual education
program: The goal of these programs is to develop some skills and proficiency in students' home language
and strong skills and proficiency in English. Content is taught in both languages by teachers fluent in both
languages. These programs may also be called dual language programs. Instruction at lower grades is in
the students' home language with a gradual transition to English. Students typically transition into
mainstream classrooms with their English-speaking peers. The programs can vary in the focus placed on
acquiring literacy in students' home language, but students generally do continue to receive some degree
of support in their home language after the transition to English classrooms.
Transitional program, early exit bilingual program, or early exit transitional program: The goal of these
programs is to develop English proficiency skills as soon as possible, without delaying learning of
academic core content. Instruction begins in students' home language but rapidly moves to English.
Students typically are transitioned into mainstream classrooms with their English-speaking peers as soon
as possible.
Heritage language program or indigenous language program: The goal of these programs is to develop
literacy in two languages. Content is taught in both languages by teachers fluent in both languages.
These programs typically target non-English speakers with weak literacy skills in their home language.
Programs that focus on developing students' literacy solely in English
Sheltered English instruction or content-based English as a Second Language (ESL) program: The goal of
these programs is to develop proficiency in English while learning content in an all-English setting.
Students from various linguistic and cultural backgrounds can be in the same class. Instruction is adapted
to students' proficiency in English and is supported by visual aids and support in the students' home
languages as available. Fully developed prototypes of this program include Sheltered Instruction
Observational Protocol (SIOP) and Specially Designed Academic Instruction in English (SDAIE).
Structured English Immersion (SEI): The goal of SEI is to develop fluency in English. This program usually
serves only English language learners. All instruction is in English, though the instruction is adjusted to the
English proficiency level of students so subject matter is comprehensible. Teachers may have some
receptive skills in the students' home language(s) and generally use sheltered instructional techniques.
Pull-out English as a Second Language (ESL) or English Language Development (ELD): The goal of
these programs is to develop fluency in English. ELL students leave their mainstream classroom for part
of the day to receive ESL instruction, which generally focuses on grammar, vocabulary, and
communication skills, not academic content. There typically is no support provided for students' home
languages.
Push-in English as a Second Language (ESL) program: The goal of push-in ESL is to develop fluency in
English. Students receive ESL instruction in a mainstream classroom, with instruction in English with some
native language support if needed. The ESL teacher or an instructional aide provides clarification,
translation if needed, and uses ESL strategies.

THANK YOU VERY MUCH FOR YOUR HELP.
1

National Clearinghouse for English Language Acquisition. (n.d.). Types of language instruction educational programs (LIEPs).
Retrieved [January 6, 2012] from http://www.ncela.gwu.edu/files/uploads/5/Language_Instruction_Educational_Programs.pdf.

5

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6

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SECTION A. SCHOOL CHARACTERISTICS
A1.

How many days are children required to attend school this academic year? WRITE IN NUMBER
BELOW.
Number of school days

A2.

What are the start and end dates for this school for the 2012-2013 school year? WRITE IN MONTH
AND DAY.
START

2 0 1 2
MONTH

DAY

YEAR

END

2 0 1 3
MONTH

A3.

DAY

YEAR

School enrollment. WRITE IN THE APPROXIMATE NUMBER OF CHILDREN FOR EACH OF THE
FOLLOWING. IF NO CHILDREN HAVE LEFT OR ENROLLED IN YOUR SCHOOL DURING THE
SCHOOL YEAR, WRITE "0" ON THE APPLICABLE LINE.
Number of
children
a. Total enrollment in your school around October 1, 2012, or the date
nearest to that for which data are available
b. Number of children who have enrolled in your school since October 1, 2012
c. Number of children who have left your school since October 1, 2012, and
have not returned

A4.

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.
% Average Daily Attendance
That is,

number of students attending on an average day
number of students enrolled

OR
Average Number Attending Daily

7

X 100

15265

A5.

Approximately 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%.
Number
OR
Percent
of children
a. Hispanic/Latino of any race

%

b. American Indian or Alaska Native, not Hispanic or
Latino

%

c. Asian, not Hispanic or Latino

%

d. Black or African American, not Hispanic or Latino

%

e. Native Hawaiian or Other Pacific Islander, not
Hispanic or Latino

%

f.

%

White, not Hispanic or Latino

%

g. Two or more races, not Hispanic or Latino

1 0 0 %

h. Total school enrollment (sum of a through g)

A6.

If your school is a private, magnet, or charter school, please check here and SKIP TO Q A8.

A7.

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."
Percent

A8.

Don't know

a. They have special needs (gifted and talented, children with
disabilities, etc.) and attend to receive a specialized program
or service?

%

b. 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.)

%

c. 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)?

%

About what percentage of the children enrolled in this school are eligible for free or reducedprice lunch? WRITE IN PERCENTAGE BELOW. IF NONE, WRITE "0."
Percentage of children

8

15265

A9.

What time does school officially start in the morning? WRITE IN TIME BELOW.
:
HH

AM
MM

9

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SECTION B. SCHOOL-FAMILY-COMMUNITY CONNECTIONS
B1.

Are any of the following programs available for second-grade children and their families at your
school site? Please include programs run by the school and those run by outside groups. MARK
YES OR NO ON EACH ROW.
Yes
No
a. Before-school child care
b. After-school child care
c. Hearing screening
d. Vision screening

B2.

Please indicate how often each of the following activities is provided by your school. MARK ONE
RESPONSE ON EACH ROW.

Never
a. PTA, PTO, or Parent-Teacher-Student
organization meetings
b. Reports (report cards) of child's
performance provided to parents
c. Information on the child's standardized
assessment scores provided to parents
d. Teacher-parent conferences
e. School performances to which parents
are invited
f.

Classroom programs like class plays,
book nights, or family math nights

10

Once
a year

2 to 3
times
a year

4 to 6
times
a year

7 or more
times
a year

15265

B3.

Indicate how much you agree or disagree with the following statements about the school's
community and parents. MARK ONE RESPONSE ON EACH ROW.
Neither
Strongly
agree nor
disagree Disagree disagree

Agree

Strongly
agree

a. Parents are actively involved in
this school's programs.
b. The community served by this
school is supportive of its goals
and activities.
c. Parents of children in this school
are welcome to observe classes
any time they are in session.

B4.

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 Happens
at least
at least Happens
Happens once a
once a
on
Never
daily
week
month occasion happens
a. Children bringing weapons to school
b. Theft
c. Physical conflicts among students
d. Children bringing in or using alcohol at
school
e. Children bringing in or using illegal
drugs at school
f.

Vandalism of school property

g. Student bullying
h. Widespread disorder in classrooms
i.

Class cutting

11

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B5.

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

a. Student tardiness
b. Student absenteeism
c. Student aggressive or disruptive behavior
d. Teacher absenteeism
e. Teacher turnover
f.

B6.

Overcrowding

During the past year, to what extent did any of the following changes occur at your school?
MARK ONE RESPONSE ON EACH ROW.
Not
at all
a. Funding levels decreased
b. Enrollment increased
c. Enrollment decreased
d. The number of students receiving free
or reduced-price lunch increased
e. Student mobility increased (that is, the
number of students transferring in and
out of the school increased)
f.

There has been a reduction in staffing

g. Class sizes increased
h. Class sizes decreased
i.

Salaries increased

j.

Salaries decreased

k. Number of English language learners
increased

12

Small
extent

Moderate
extent

Large
extent

15265

B7.

During the past year, did any of the following changes occur at your school? MARK YES OR
NO ON EACH ROW.
Yes
a. Salaries were frozen
b. Changes were made to the school's assigned
attendance area (IF YOURS IS A PRIVATE, CHARTER,
OR MAGNET SCHOOL, PLEASE SKIP ITEM b.)

13

No

15265

SECTION C. SCHOOL POLICIES AND PRACTICES
C1.

How many first-grade children were retained at their current grade level last school year?
WRITE NUMBER BELOW. IF NONE, WRITE "0."
Number of first-grade children retained last year

C2.

How many second-grade children were retained at their current grade level last school year?
WRITE NUMBER BELOW. IF NONE, WRITE "0."
Number of second-grade children retained last year

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

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C4.

For each of the following statements about READING and MATH, indicate how strongly you agree
or disagree. MARK ONE RESPONSE ON EACH ROW.

For READING

Neither
Strongly
agree nor
disagree Disagree disagree

a. 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.
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.
For 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 MATH.

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.

15

Agree

Strongly
agree

Don't
know

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C5.

Is Response to Intervention (RtI) currently used at your school in second grade, either partially
or fully implemented? MARK ONE RESPONSE.
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.
Yes
No (SKIP TO Q D1)

C6.

Is RtI currently implemented at your school in second grade in the following areas? MARK
ONE RESPONSE ON EACH ROW.
Yes, fully
Yes, partially
No, not
implemented
implemented
implemented
in second grade in second grade in second grade
a. Math
b. Reading
c. Writing
d. Behavior/Social skills

C7.

Approximately how many years ago did your school begin implementing RtI in second 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 2012-2013 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 ALL THAT APPLY.
a. Communication through written materials such as letters, email, school website, or
newsletters
b. Communication through workshops, discussion groups, or other meetings such as
PTA meetings
c. Communication through individual meetings with parents or phone calls
d. Information is not distributed on this topic

16

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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)

D2.

What percentage of children in this school and in second grade are English language learners
(ELL)?
SEE PAGES 4 AND 5 FOR DEFINITIONS RELATED TO LANGUAGE. WRITE IN THE PERCENTAGES
BELOW.

D3.

%

ELL among all students in school

%

ELL among all students in second grade

Please indicate what type(s) of specialized language instruction is provided to second-grade
English language learners in your school. MARK ALL THAT APPLY.
EXAMPLES OF THE PROGRAMS INCLUDED IN EACH CATEGORY ARE PROVIDED BELOW.
SEE PAGE 5 FOR DEFINITIONS OF THESE EXAMPLES.
Programs that focus on developing students' literacy in two languages. For example:






Two-way immersion program or two-way bilingual program
Developmental bilingual program, late exit transitional program, or
maintenance bilingual education program
Transitional program, early exit bilingual program, or early exit transitional program
Heritage language program or indigenous language program

Programs that focus on developing students' literacy solely in English. For example:


Sheltered English instruction or content-based English as a Second
Language (ESL) program



Structured English Immersion (SEI)



Pull-out English as a Second Language (ESL) or English Language Development (ELD)
Push-in ESL program



Other program(s) (PLEASE SPECIFY)

No specialized language program is provided to second-grade English language learners or
there are no second-grade English language learners in this school.

17

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Children with Special Needs
D4.

Since the beginning of this school year (2012-2013), how many students have been NEWLY
evaluated at your school to determine if they are eligible for an IEP? WRITE NUMBER IN BOX.
Total number of newly evaluated students at your school

D5.

Of those students who have been NEWLY evaluated at your school this school year (20122013), 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 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.
Yes

No

a. IQ-achievement discrepancy model which shows whether
there is a discrepancy between expected performance and
actual performance
b. Response to Intervention (RtI) model

D7.

Approximately what percentage of your second-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 SECOND GRADE OR IN ANY GRADE IN YOUR SCHOOL.
Not offered
in second grade

Percent
a. Special education with an
Individualized Education Program
(IEP)

%

b. Receive accommodations through a
504 plan

%

c. Reading instruction for students
performing below grade level in
reading

%

d. Math instruction for students
performing below grade level in math

%

e. A gifted and talented program

%

18

Not offered
in any grade

15265

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

1

The following items pertain to public schools only.
IF YOURS IS A PRIVATE SCHOOL CHECK HERE. (SKIP TO Q F1)

Title I Funding and Programs
E1.

Did your school receive Federal Title I funds for this school year? MARK ONE RESPONSE.
Yes
No (SKIP TO Q E4)

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.

E2.

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

1

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.

19

15265

E3.

Does your school use Title I funds for any of the following purposes? MARK YES OR NO ON
EACH ROW.
Yes
No
a. To serve children in a pull-out setting
b. To serve children in an in-class setting
c. To reduce class sizes
d. To provide extended time learning opportunities before and/or
after school for children
e. To provide professional development activities
f.

To provide family literacy services

g. To provide summer learning opportunities
h. To serve children in preschool

Title III Funding and Programs
E4.

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 (SKIP TO Q E6)

E5.

Does your school use Title III funds for any of the following purposes? MARK YES OR NO ON
EACH ROW.
Yes
a. To serve children in a pull-out setting for second language
instruction
b. To serve children in an in-class setting for second language
instruction
c. To provide extended time learning opportunities before
and/or after school for children
d. To improve the entire educational program through a
schoolwide program
e. To provide professional development activities for teachers who
serve English language learners
f. To provide family literacy services (usually done out of Title III
immigrant funds)
g. To provide summer learning opportunities
h. To provide student support in the student's home language for
second language instruction

20

No

15265

Federal Requirements
E6.

At the end of the LAST school year (2011-2012), 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.
Yes (SKIP TO Q E9)
No
Not applicable (SKIP TO Q E9)

E7.

At the end of the LAST school year (2011-2012), 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.
Yes
No (SKIP TO Q E9)

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15265

E8.

Please indicate in part 1 whether any of the following actions have taken place in your school
in the past three years. For each action that you mark as having taken place, please indicate
in part 2 whether the action took place at your school in response to being identified for
improvement due to AYP requirements. MARK ONE RESPONSE ON EACH ROW FOR PART 1.
IF YES IS MARKED IN PART 1, MARK ONE RESPONSE IN PART 2 FOR THAT ROW.

PART 1

PART 2

Action taken place in
the past three years?
Yes

No

a. Developed or revised a two-year
school improvement plan
b. Offered students the choice to
transfer to another public school
c. Offered supplemental educational
services to students from low-income
families
d. Replaced school staff
e. Implemented a new curriculum based
on scientifically based research
f.

Extended the school day or school
year

g. Appointed an outside expert to advise
the school on its progress toward
making AYP
h. Reorganized the school (that is,
significant changes were made to
both the school's staffing and
governance)
i.

E9.

Offered professional development

Does this school have grade 3 students? MARK ONE RESPONSE.
Yes
No (SKIP TO Q F1)

22

If yes to part 1, was action
in response to being
identified for improvement?
Yes

No

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E10.

Based on recent state assessments, what percentage of the grade 3 students in your school in
the PRIOR school year (2011-2012) scored "proficient" or above in the subjects in this table?
Please also indicate the percentage of students scoring proficient or above that was needed to
meet your AYP (Adequate Yearly Progress) goals for that school year. WRITE PERCENTAGES
BELOW. IF THE AYP COLUMN IS NOT APPLICABLE FOR YOUR SCHOOL OR IF GRADE 3
STUDENTS IN YOUR SCHOOL DO NOT TAKE A STATE ASSESSMENT, WRITE "NA" IN THE
APPROPRIATE COLUMN.
Percentage
of students whose
achievement level was
"proficient" or above in
2011-2012

Percentage required by
AYP goals in
2011-2012

a. Reading/Language Arts

%

%

b. Mathematics

%

%

c. Science
(WRITE NA IF NO STUDENTS
WERE ASSESSED IN SCIENCE)

%

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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 
I
N 
ONLY 
ONE 
STAFF 
CATEGORY;

I
F 
A 
STAFF 
MEMBER 
FI
TS
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."

a. Regular classroom teachers
b. ESL/bilingual education/language immersion/ELL
instruction teachers
c. Drama, music, or art teachers
d. Gym/PE or health teachers
e. Special education teachers and related service
providers (for example, speech therapist, physical
therapist, adaptive physical education, etc.)
f.

Teachers of gifted/talented students

g. Reading teachers, specialists, and interventionists
h. Math teachers, specialists, and interventionists
i.

School nurses or health professionals

j.

School psychologists or social workers

k. Guidance counselors
l.

Paraprofessionals (for example, classroom aides)

m. Library media specialists/librarians
n. Computer/technology teachers or support staff

24

(1)

(2)

Number who
work full time in
your school

Number who
work part time
in your school

15265

F2.

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.
Yes

No

a. A school staff member who provides ongoing training or support to
classroom teachers in the delivery of effective READING instruction
b. A school staff member who provides ongoing training or support to
classroom teachers in the delivery of effective MATH instruction
c. A school staff member who provides ongoing training or support to
classroom teachers in the delivery of effective behavioral supports
d. A school staff member who supports teachers in collecting,
organizing, and managing assessment data
e. A school staff member who supports teachers in the interpretation
and use of assessment data to guide instruction

F3.

Teacher mobility. WRITE IN THE APPROXIMATE NUMBER OF REGULAR CLASSROOM
TEACHERS FOR EACH OF THE FOLLOWING. IF NO TEACHERS HAVE LEFT OR STARTED AT
YOUR SCHOOL DURING THE SCHOOL YEAR, WRITE "0" ON THE APPLICABLE LINE.
Number
of teachers
a. Number of regular classroom teachers who have begun teaching in your
school since October 1, 2012
b. Number of regular classroom teachers who have left your school since
October 1, 2012, and have not returned
c. Number of regular classroom teachers for whom this school year is their
first year of teaching
d. Number of regular classroom teachers for whom this school year is their
first year teaching in this school

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F4.

What percentage of your part-time and full-time teachers, including regular classroom,
ESL/bilingual, remedial, special education, art, music, and physical education teachers, belongs
to each of the following racial/ethnic groups?
COMPLETE EITHER THE NUMBER OR PERCENT COLUMN. ENTER "0" IF YOUR SCHOOL HAS NO
TEACHERS IN THAT RACIAL/ETHNIC GROUP. THE NUMBER COLUMN SHOULD ADD TO YOUR
TOTAL NUMBER OF TEACHERS OR THE PERCENT COLUMN SHOULD ADD TO 100%.
Number of
teachers

OR

Percent

a. Hispanic/Latino of any race

%

b. American Indian or Alaska Native, not Hispanic or Latino

%

c. Asian, not Hispanic or Latino

%

d. Black or African American, not Hispanic or Latino

%

e. Native Hawaiian or Other Pacific Islander, not Hispanic
or Latino

%

f.

%

White, not Hispanic or Latino

g. Two or more races, not Hispanic or Latino

%

1 0 0 %

h. Total number of teachers (sum of a through g)

F5.

Indicate how much you agree or disagree with the following statements about your school and
staff. MARK ONE RESPONSE ON EACH ROW.
Strongly
disagree
a. There is a consensus among
administrators and teachers
on goals and expectations.
b. We have an active professional
development program for
teachers.
c. Teachers are very active in
planning staff development
activities in this school.
d. There is adequate time for teacher
professional development.

26

Disagree

Neither
agree nor
disagree

Agree

Strongly
agree

15265

F6.

Are monetary incentives such as cash bonuses, salary increases, or different steps on the salary
schedul
e 
used 
i
n 
your

school

t
o 
r
ewar
d 
t
eacher
s 
f
or
… 

MARK YES OR NO ON EACH ROW.
Yes

No

a. Improved student performance on state tests?
b. Reaching target goals on state tests?

F7.

If a person other than the school principal has completed the previous sections, please provide
the following information for the individual who completed them, or if more than one
individual for the individual who completed the majority of the sections: PLEASE PRINT

LAST NAME

FIRST NAME

MIDDLE INITIAL

TITLE
F8.

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

YEAR(S) MONTH(S)

The school principal or headmaster 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 headmaster.

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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.

1 9
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.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

G5.

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
a. Years as a teacher before becoming a principal
b. Total number of years as a principal
c. Number of years as principal at this school

28

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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.
Yes

No

a. Traditional university-based training and certification program
b. District-based training program (for example, the Boston Principal
Fellowship, New York City Leadership Academy's Aspiring
Principals Program, Chicago's LAUNCH program)
c. City-based training program (for example, Cleveland's First Ring
Leadership Academy)
d. State-based training program (for example, New Jersey EXCEL)
e. Training and/or certification program run by a national non-profit
organization (for example, KIPP School Leadership Program,
New Leaders for New Schools)
f.

G7.

Another school administration preparation program

What is the highest level of education you have completed? MARK ONE RESPONSE.
High school diploma or equivalent/GED
Associ
at
e’
s 
degr
ee
Bachel
or
’
s 
degr
ee
At

l
east

one 
y
ear

of

cour
sewor
k 
bey
ond 
a 
Bachel
or
’
s 
degr
ee 
but

not

a 
gr
aduat
e 
degr
ee
Mas
t
er
’
s 
degr
ee
Education specialist or professional diploma based on at least one year of coursework past a
Master's degree level
Doctorate or an advanced professional degree beyond a Master's degree (for example, MD)

G8.

What was your major field(s) of study in the highest degree you completed? MARK YES OR NO
ON EACH ROW.
Yes
a. Early childhood education
b. Elementary education
c. Education administration/management
d. Special education
e. Other education-related major (such as secondary
education, educational psychology, science education,
music education, etc.)
f.

Non-education major (such as history, English, etc.)

29

No

15265

G9.

Please estimate how many hours you spend on average per week in the following activities.
WRITE IN NUMBER OF HOURS BELOW. IF NONE, WRITE "0."
Hours
per week
a. Working with teachers on instructional issues
b. Internal school management (weekly calendars, vendors, office, memos, etc.)
c. Student discipline/attendance
d. Monitoring hallways, playground, lunchroom
e. Teaching
f.

Talking and meeting with parents

g. Meeting with students
h. Paperwork required by local, state, or federal authorities

G10.

What is your best estimate of the number 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

G11.

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

30

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G12.

Do you speak a language other than English with students' families whose native language is
not English? MARK ONE RESPONSE.
Yes
No

G13.

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 G15.

G14.

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
A Filipino language
Arabic
Other (PLEASE SPECIFY)

G15.

Date Questionnaire Completed:

2 0 1 3
MONTH

DAY

YEAR

Questionnaire completed by:

LAST NAME

FIRST NAME

MIDDLE INITIAL

THANK YOU FOR YOUR COOPERATION!

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For Office Use Only
C - No DR

C - DR Comp

C - DR Ref

Ref

RETURNING

35

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