For site visitors: Please provide brief notes for the sections applicable to the initiative you are assessing. Each section contains suggestions for things to look for when assessing the environment.
Initiative Name |
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Location Observed (building address if applicable) |
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Date |
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Time |
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Occupancy (estimated number of people served in facility, number of customers present, etc.) |
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Building Assessment Describe the building that houses the initiative.
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Indoor Facilities If initiative-related activities take place indoors, describe the facilities where the activities take place.
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Outdoor Facilities If initiative-related activities take place outdoors, described the grounds where the activities take place.
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Food Environment For initiatives with a healthier foods and beverages component, describe what you observe.
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Participants If you are observing participants engaging in initiative-related activities, describe what you observe.
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Neighborhood Assessment Describe the neighborhood the initiative is located in or targets.
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Other Describe anything else that was observed that has not been mentioned above that may have an impact (positive or negative) on the initiative. |
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File Type | application/msword |
Author | Kari Cruz |
Last Modified By | arp5 |
File Modified | 2011-08-19 |
File Created | 2011-06-14 |