Violence Prevention Program Assessment Tool - Student Services ...

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Elementary Violence Assessment ToolSchool District:___________Building:_____________A. School Environment(Assesses policies/procedures and practicesrelated to violent/aggressive behavior)3. The school (or district) has a team trained andprepared to conduct a threat assessment of anystudent, or other member of the school communitywho demonstrates behaviors or communicationsthat may indicate the potential for violence. (U)School Environment Component SummaryWe’re doing well in these areas (rating of 2).2 1 0Don'tKnow1.___________________________________________________________2.___________________________________________________________We’ve done some work in these areas, but they need more attention (rating of 1).1.___________________________________________________________2.___________________________________________________________We have the following gaps in the School Environment Component (rating of 0).1.___________________________________________________________2.___________________________________________________________We will focus on the following over the next 2 year planning cycle: (Leave blank if youplan to focus on another Component).1.___________________________________________________________2.___________________________________________________________3.___________________________________________________________Please give examples of policies, procedures and practices related to violent/aggressivebehavior in place in your school:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________2
Elementary Violence Assessment ToolSchool District:___________Building:_____________B. Curriculum/Instruction(Assesses violence prevention curricula andinstructional strategies for evidence-basedpractices/approaches)Universal (U) = Programs, strategies, andpractices for all studentsSelected (S) = Programs, strategies, and practicesfor students at risk of demonstrating aggressivebehaviorIndicated (I) = Programs, strategies, and practicesfor students demonstrating aggressive behavior1. School’s violence prevention curricula use thefollowing learning strategies:2 1 0Don'tKnow1a. teacher guided discussion (U)1b. teacher skill modeling (U)1c. supervised practice (U)1d. role playing (U)2. School’s violence prevention curricula use avariety of culturally appropriate examples and theactivities include:2a. people of various ethnic/social backgrounds (U)2b. not stereotyping or stigmatizing any groups (U)3. School’s violence prevention curricula includethe following:3a. dangerous or risky behaviors that may lead toviolence (U)3
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