Form 2 CPTED Student Survey

APPENDIX G

CPTED Student Survey

Form Approved

OMB No. 0920-XXXX

Exp. Date:

CPTED STUDENT SURVEY

School ID: [ ] [ ] [ ] Classroom: [ ] [ ] Grade Level: [ ] [ ]

Thank you for agreeing to complete this survey. We want to learn about your feelings about your school, and how safe you feel in your school. Please be honest in your answers, and tell us what you really think. Your responses will help us understand what makes school a better place to be, and how changes may be made to improve it. You may choose not to answer any question. No one will be able to know how you answered because there are no names attached to the survey.

Again thank you for your help. If you have any questions during the survey, please feel free to ask the survey administrator who will explain the purposes of the survey, provide instructions for completing the survey, and be in the room to assist.

Background

1. First, we would like you to answer a few questions about you and your family. Your answers will help us understand who goes to your school and how they feel about it.

1. Are you a…

	Boy
	Girl

2. How old are you?

	9 years old
	10 years old
	11 years old
	12 years old
	13 years old
	14 years old
	15 years old
	16 years old
	Other ________________

1.3 Which grown-ups live in your house?

(You can pick more than one)

	Mother
	Father
	Stepmother/Father’s girlfriend
	Stepfather/Mother’s boyfriend
	Foster Mother/Guardian
	Foster Father/Guardian
	Grandmother
	Grandfather
	Aunt
	Uncle
	Other relatives or friends

1.4 Do you get or are you eligible for a free or reduced-price lunch at your school?

	Yes, I get or am eligible for free lunches
	Yes, I get or am eligible for reduced-price lunches
	No, I do not get and am not eligible for free or reduced-price lunches

1.5 Do you receive special education services?

	Yes
	No
	I prefer not to answer

1.6 Are you Hispanic or Latino/Latina?

	Yes
	No

1.7 How do you describe yourself?

	American Indian or Alaska Native
	Asian
	Black or African American
	Native Hawaiian or Other Pacific Islander
	White
	Other: ________________________________

1.8 What language is spoken most often in your home?

	English
	Spanish
	Another language

1.9 Were your parents born in the United States?

	Yes, my mother
	Yes, my father
	Yes, both my mother and father
	No

1.10 Do you take ESOL (English for Speakers of Other Languages) classes?

	Yes
	No

How You Feel About Your School

2. Now, we would like you to give us some of your general feelings about your school. Please mark the box that indicates how true each of the following statements is for you.

Check one box for each statement.	Not At All True	Not Really True	Sort of True		True	Very True
Students in my school don’t really care about each other.						
I feel safe outside around the school.						
I worry about crime and violence in my school.						
Students in my school like to put each other down.						
I feel safe in the hallways and bathrooms of my school.						
Students at my school are often teased or picked on.						
I feel safe when security is present at my school.						
Students at my school don’t get along together very well.						
Students at my school are often threatened or bullied.						
When students are caught bullying, they know what kind of punishment will follow.						
The teachers and other adults at my school stop bullying when it happens.						
My school has a required program to prevent violence or bullying						
I feel safe in my classes.						
I sometimes stay home because I don’t feel safe at school						
Students at my school just look out for themselves.						
Students at my school treat each other with respect.						
My classmates often bother me.						
I like pretty much all of the other kids in my grade.						
I like working with my classmates.						
I get along well with the other kids in my class.						
I am liked by my classmates.						
I rarely fight or argue with other kids.						
I work hard at school.						
I enjoy being at school.						
I get bored at school a lot.						
I do well in school.						
I feel good about myself when I am at school.						
Doing well in school is important to me.						
I like the way my school looks.						
There are good places to hang out with my friends at school.						
My school is crowded and hard to get around in.						
There are lots of places at school where I really feel at home.						
My school is bright and cheery.						
We are watched way too closely at my school.						
At my school, everyone knows what the school rules are.						
The rules at my school are fair.						
The rules at my school are strictly enforced.						
If the rules at my school are broken, students know what kind of punishment will follow.						
The punishment for breaking school rules is that same no matter who you are.						
Teachers at my school treat students with respect.						
Teachers at my school treat other staff members with respect.						

Fear of Violence

3. Thinking about your life at school over the past month, please answer each of the following questions.

	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
a) How often were you afraid that someone would attack or harm you in the school building or on school property?					
b) How often were you afraid that someone would attack or harm you on a school bus or on the way to and from school?					
c) Besides the times you were in the school building, on school property, on a school bus, or going to or from school, how often were you afraid that someone would attack or harm you?					

Bullying

Bullying is when one or more students tease, threaten, spread rumors about, hit, shove, or hurt another student over and over again. It is not bullying when two students of about the same strength or power argue or fight or tease each other in a friendly way.

4.1 Thinking about your life at school over the past month, how often has any student bullied you by…?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
Making fun of you, calling you names, or insulting you?					
Spreading rumors about you?					
Threatening you with harm?					
Pushing you, shoving you, tripping you, or spitting on you?					
Trying to make you do things you did not want to do, for example, give them money or other things?					
Excluding you from activities on purpose?					
Destroying your property on purpose?					

Feelings of Safety

5. Thinking about your life at school over the past month, how SAFE did you feel in each of these places?

Check one box for each statement.	Not At All Safe	Not Really Safe	Sort of Safe	Safe	Very Safe
School parking lots					
School grounds (sidewalks and gathering areas such as outside courtyards and bike rack areas, or any outdoor areas within school boundaries).					
Student entries and exits.					
Corridors/hallways and locker areas.					
Stairs, stair areas and balconies.					
Restrooms.					
Classrooms.					
Gym locker rooms.					
Inside recreation and/or athletic areas such as gyms or practice areas.					
Outside recreation and/or athletic areas such as playing fields or courts.					
Cafeteria and vending areas.					
Portables and other non-attached buildings.					
School bus waiting areas.					

Places Where Threats Are Made

6. Thinking about the past month, how often do you think students have been THREATENED in each of these places?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
School parking lots					
School grounds (sidewalks, gathering areas such as outside courtyards and bike rack areas, or any other outdoor area within school boundaries).					
Student entries and exits.					
Corridors/hallways and locker areas.					
Stairs, stair areas and balconies.					
Restrooms.					
Classrooms.					
Gym locker rooms.					
Inside recreation and/or athletic areas such as gyms or practice areas.					
Outside recreation and/or athletic areas such as playing fields or courts.					
Cafeteria and vending areas.					
Portables and other non-attached buildings.					
School bus waiting areas.					

Places Where Fights Happen

7. Thinking about the past month, how often do you think students have been in PHYSICAL FIGHTS in each of these places?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
School parking lots					
School grounds (sidewalks and gathering areas such as outside courtyards and bike rack areas, or any other outdoor areas within school boundaries).					
Student entries and exits.					
Corridors/hallways and locker areas.					
Stairs, stair areas and balconies.					
Restrooms.					
Classrooms.					
Gym locker rooms.					
Inside recreation and/or athletic areas such as gyms or practice areas.					
Outside recreation and/or athletic areas such as playing fields or courts.					
Cafeteria and vending areas.					
Portables and other non-attached buildings.					
School bus waiting areas.					

Places Where Tobacco, Alcohol or Drugs Are Used

8. Thinking about the past month, how often do you think students have USED TOBACCO, ALCOHOL or DRUGS in each of these places?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
School parking lots					
School grounds (sidewalks and gathering areas such as outside courtyards and bike rack areas).					
Student entries and exits.					
Corridors/hallways and locker areas.					
Stairs, stair areas and balconies.					
Restrooms.					
Classrooms.					
Gym locker rooms.					
Inside recreation and/or athletic areas such as gyms or practice areas.					
Outside recreation and/or athletic areas such as playing fields or courts.					
Cafeteria and vending areas.					
Portables and other non-attached buildings.					
School bus waiting areas.					

Avoiding Unsafe Places

9. Thinking about your life at school over the past month, how often did you AVOID each of these places because you felt unsafe?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)
School parking lots					
School grounds (sidewalks and gathering areas such as outside courtyards and bike rack areas).					
Student entries and exits.					
Corridors/hallways and locker areas.					
Stairs, stair areas and balconies.					
Restrooms.					
Classrooms.					
Gym locker rooms.					
Inside recreation and/or athletic areas such as gyms or practice areas.					
Outside recreation and/or athletic areas such as playing fields or courts.					
Cafeteria and vending areas.					
Portables and other non-attached buildings.					
School bus waiting areas.					

Ability to Avoid Violence

10. How sure are you that you can…..?

Check one box for each statement.	Not At All Sure	Not Really Sure	Sort of Sure	Sure	Very Sure	Don’t know
Stay out of fights						
Avoid being bullied or threatened						
Avoid being insulted?						
Avoid being in an argument						

Aggression in School

11. During the past month, how many times did you do the following things on school property?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)	Prefer not to answer
I teased students.						
I encouraged other students to fight.						
I pushed or shoved other students.						
I physically attacked someone but did not injure them. .						
I slapped or kicked someone.						
I called other students bad names.						
I threatened to hurt or hit someone.						
I started an argument.						
I threatened someone with a weapon.						
I physically attacked someone and injured them enough to see a doctor or nurse.						
I bullied another kid because of his/her sexual orientation, appearance, religion, or some other reason.						

Being a Victim in School

12. During the past month, how many times did the following things happen to you on school property?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)	Prefer not to answer
I was teased.						
I was pressured to fight someone.						
I was pushed or shoved.						
I was physically attacked but not injured.						
I was slapped or kicked.						
I was called bad names.						
Someone threatened to hurt or hit me.						
Someone picked an argument with me.						
I was threatened with a weapon.						
I was attacked and injured enough to see a doctor or nurse.						

Hearing About Violence in School

13. During the past month, about how many times did you hear that the following things happen to another student on school property?

Check one box for each statement.	Never	Seldom (1-2 times)	Sometimes (3-5 times)	Often (6-15 Days)	Frequently (16+ Days)
A student was teased.					
A student was pressured to fight someone.					
A student was pushed or shoved.					
A student was in a physical fight but not injured.					
A student was slapped or kicked.					
A student was called bad names.					
Someone threatened to hurt or hit another student.					
Someone picked an argument with another student.					
Another student was threatened with a weapon.					
Another student was attacked and injured enough to see a doctor or nurse.					
Another student was sexually assaulted.					
Another student had a gun or explosive at school.					
Another student had a weapon other than a gun or explosive (like a knife or club) at school.					

Ways to Avoid Violence

14. To avoid being bullied, attacked or insulted, how useful would you consider each of the following actions …?

Check one box for each statement.	Not at all useful	Not really useful	Sort of Useful	Useful	Very Useful	Don’t know
Avoiding unsafe places in school						
Avoiding certain students in school						
Being with as many people as possible						
Using my social skills						

Substance Use

15. During the past month, how many days did you do the following on school property?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)	Prefer not to answer
Smoke cigarettes.						
Have at least one drink of alcohol, other than a few sips.						
Use marijuana.						
Use inhalants.						
Use any other illegal drug						
Use prescription drugs without doctor’s permission.						

Personal Norms Concerning Aggression

16. How “ok” do you think it is for a kid in your school to …?

Check one box for each statement.	Not At All Okay	Not Really Okay	Sort of Okay	Okay	Completely Okay
Hit someone who said something mean?					
Yelled at someone who said something mean?					
Threatened someone who said something mean?					
Hit someone who hit first?					
Hit someone for no reason?					
Threatened someone because that person yelled first?					
Yelled at someone for no reason?					
Yelled at someone who yelled first?					
Threatened someone for no reason?					
Threatened someone who hit first?					

School Norms Concerning Aggression

17. How “ok” would the kids in your school think it was if a kid in your school…?

Check one box for each statement.	Not At All Okay	Not Really Okay	Sort of Okay	Okay	Completely Okay
Hit someone who said something mean?					
Yelled at someone who said something mean?					
Threatened someone who said something mean?					
Hit someone who hit first?					
Hit someone for no reason?					
Threatened someone because that person yelled first?					
Yelled at someone for no reason?					
Yelled at someone who yelled first?					
Threatened someone for no reason?					
Threatened someone who hit first?					

Grades and School Attendance

Please answer the following questions about your activities at school.

18. On your last report card, how many of each of the following grades did you get?

Mostly A’s
	Mostly A’s and B’s
	Mostly B’s
	Mostly B’s and C’s
	Mostly C’s
	Mostly C’s and D’s
	Mostly D’s
	Mostly D’s and F’s
	Mostly F’s I prefer not to answer

19. In the last month, how many whole days have you not gone to school WITH parents’ permission…?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)	Prefer not to answer
Because of illness.						
Because I felt I would be unsafe at school.						
Because I felt I would be unsafe on the way to or from school.						
Because I had something else to do.						
Because I was suspended or expelled						
For other Reasons.						

20. In the last month, how many whole days of school have you skipped or cut WITHOUT parents’ permission…?

Check one box for each statement.	Never	Seldom (1-2 Days)	Sometimes (3-5 Days)	Often (6-15 Days)	Frequently (16+ Days)	Prefer not to answer
Because of illness.						
Because I felt I would be unsafe at school.						
Because I felt I would be unsafe on the way to or from school.						
Because I had something else to do.						
For other reasons.						