District Healthy and Safe School Environment

Health and Safety Coordinator

Form Approved

OMB No: 0920-0445

Expiration Date: xx/xx/xxxx

Healthy and Safe School Environment
District Questionnaire

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Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, Mailstop D-74, Atlanta, GA 30333; Attention PRA (0920-0445).

Healthy and Safe School Environment
District Questionnaire

Questions

MODULE 1

General School Environment 1–29

Elementary Schools 1–9

Middle Schools 10–19

High Schools 20–29

Transportation 30–32

Joint Use Agreements 33–35

Violence Prevention 36–43

Tobacco Use Prevention 44–61

Student Drug Testing 62–63

Injury Prevention and Safety 64–71

MODULE 2

Physical School Environment 72–105

MODULE 3

Crisis Preparedness, Response, and Recovery 106–117

MODULE 4

Community Service and Service-Learning 118–120

Foods and Beverages Available Outside of the School Meal Programs 121–130

Professional Development 131

School Health Coordination 132–141

MODULE 5

Health and Safety Coordinator 142–151

THIS QUESTIONNAIRE WILL BE ADMINISTERED USING WEB-BASED INTERVIEW TECHNOLOGY. AS THE RESPONDENT TYPES RESPONSES TO THE QUESTIONS INTO THE COMPUTER, THE INTERVIEW PROGRAM WILL 1) DISPLAY THE CORRECT TENSE OF VERBS, 2) PROVIDE ALTERNATE ANSWERS TO QUESTIONS (E.G., NOT APPLICABLE, “I DON’T KNOW”), 3) NAVIGATE COMPLEX SKIP PATTERNS, AND 4) PERFORM OTHER USEFUL FUNCTIONS. COMMENTS APPEARING IN THE MARGIN REPRESENT ADDITIONAL CLARIFICATION ON THE QUESTION OR THE SPECIFIC TERMINOLOGY USED. THIS TEXT WILL APPEAR ON-SCREEN UNDER THE MAIN QUESTION TEXT. THE PROGRAMMING SPECIFICATIONS FOR THE INTERVIEW ARE NOT INCLUDED IN THIS PRINTED VERSION OF THE QUESTIONNAIRE.

1. This questionnaire focuses on your district’s policies and practices regarding school policy and environment.

2. For the purposes of this questionnaire, “policy” means any law, rule, regulation, administrative order, or similar kind of mandate issued by the local school board or other local agency with authority over schools in your district. SHPPS is most interested in what is required by the district, not what is recommended or contained in non-binding guidance documents, unless the question specifically asks about recommendations.

3. For the purposes of this questionnaire, “adopted a policy” means either that the district has its own policy or that the district follows a policy established at the state level, including any law, rule, regulation, administrative order, or similar kind of mandate.

4. If a district policy is worded in such a way that it requires schools to develop and adopt their own policies on a given topic, for the purposes of this questionnaire please consider it the same as a district-wide requirement.

5. Districts may sometimes grant policy exceptions or waivers, but please answer each question based on what is considered the general policy and standard practice in your district.

6. Please do not consider school practices or policies when answering the questions. This information is gathered during data collection from schools across the country.

7. For the purposes of this questionnaire, “elementary school” refers to a school that contains any of grades K–5. “Middle school” refers to a school that contains any of grades 6–8. Some jurisdictions may refer to these schools as “junior high schools.” “High school” refers to a school that contains any of grades 10–12. Some jurisdictions may refer to these schools as “senior high schools.”

ANSWER Q1–Q9 IF DISTRICT CONTAINS ELEMENTARY SCHOOLS. OTHERWISE, SKIP TO INSTRUCTIONS BEFORE Q10.

The first questions ask about policies affecting elementary schools in your district.

1. Has your district adopted a policy stating that elementary schools will maintain closed campuses, meaning that students are not allowed to leave school during the school day, including during lunchtime?

Yes 1

No 2

2. Has your district adopted a policy stating that elementary schools will assign staff or adult volunteers to monitor…

Yes No

1. School halls during classes? 1 2

2. School halls between classes? 1 2

3. Restrooms? 1 2

4. School grounds? 1 2

3. Has your district adopted a policy requiring students at the elementary school level to wear school uniforms?

Yes 1 SKIP TO Q5

No 2

4. Has your district adopted a policy stating that elementary schools will enforce a student dress code?

Yes 1

No 2

5. Has your district adopted a policy requiring that…

Yes No

1. Students at the elementary school level wear
   identification badges? 1 2

2. Faculty and staff in elementary schools wear
   identification badges? 1 2

3. Visitors to elementary schools wear
   identification badges? 1 2

6. Has your district adopted a policy stating that elementary schools will use…

Yes No

1. Security or surveillance cameras, either inside or
   outside the building? 1 2

2. Metal detectors, including wands? 1 2

3. Communication devices such as cell phones, 2-way
   radios, walkie-talkies, or intercoms for security purposes? 1 2

7. Has your district adopted a policy requiring elementary school students to refrain from using personal communication devices, such as cell phones, during the school day?

Yes 1

No 2

8. Has your district adopted a policy stating that elementary schools will use police, school resource officers, or security guards during the regular school day?

Yes 1

No 2

9. What is the standard distance elementary school students must live from a school to be eligible for riding a school bus? Do not include students with special needs or those eligible for hazard busing.

More than ½ mile 1

More than ¾ mile 2

More than 1 mile 3

More than 1½ miles 4

More than 2 miles 5

No minimum distance 6

ANSWER Q10–Q19 IF DISTRICT CONTAINS MIDDLE SCHOOLS. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q20.

The next questions ask about policies affecting middle schools in your district.

10. Has your district adopted a policy stating that middle schools will maintain closed campuses, meaning that students are not allowed to leave school during the school day, including during lunchtime?

Yes 1

No 2

11. Has your district adopted a policy stating that middle schools will assign staff or adult volunteers to monitor…

Yes No

1. School halls during classes? 1 2

2. School halls between classes? 1 2

3. Restrooms? 1 2

4. School grounds? 1 2

12. Has your district adopted a policy stating that middle schools will routinely conduct locker searches?

Yes 1

No 2

13. Has your district adopted a policy requiring students at the middle school level to wear school uniforms?

Yes 1 SKIP TO Q15

No 2

14. Has your district adopted a policy stating that middle schools will enforce a student dress code?

Yes 1

No 2

15. Has your district adopted a policy requiring that…

Yes No

1. Students at the middle school level wear
   identification badges? 1 2

2. Faculty and staff in middle schools wear
   identification badges? 1 2

3. Visitors to middle schools wear
   identification badges? 1 2

16. Has your district adopted a policy stating that middle schools will use…

Yes No

1. Security or surveillance cameras, either inside
   or outside the building? 1 2

2. Metal detectors, including wands? 1 2

3. Communication devices such as cell phones, 2-way
   radios, walkie-talkies, or intercoms for security purposes? 1 2

17. Has your district adopted a policy requiring middle school students to refrain from using personal communication devices, such as cell phones, during the school day?

Yes 1

No 2

18. Has your district adopted a policy stating that middle schools will use police, school resource officers, or security guards during the regular school day?

Yes 1

No 2

19. What is the standard distance middle school students must live from a school to be eligible for riding a school bus? Do not include students with special needs or those eligible for hazard busing.

More than ½ mile 1

More than ¾ mile 2

More than 1 mile 3

More than 1½ miles 4

More than 2 miles 5

No minimum distance 6

ANSWER Q20–Q29 IF DISTRICT CONTAINS HIGH SCHOOLS. OTHERWISE, SKIP TO THE INTRODUCTION TO Q30.

The next questions ask about policies affecting high schools in your district.

20. Has your district adopted a policy stating that high schools will maintain closed campuses, meaning that students are not allowed to leave school during the school day, including during lunchtime?

Yes 1

No 2

21. Has your district adopted a policy stating that high schools will assign staff or adult volunteers to monitor…

Yes No

1. School halls during classes? 1 2

2. School halls between classes? 1 2

3. Restrooms? 1 2

4. School grounds? 1 2

22. Has your district adopted a policy stating that high schools will routinely conduct locker searches?

Yes 1

No 2

23. Has your district adopted a policy requiring students at the high school level to wear school uniforms?

Yes 1 SKIP TO Q25

No 2

24. Has your district adopted a policy stating that high schools will enforce a student dress code?

Yes 1

No 2

25. Has your district adopted a policy requiring that…

Yes No

1. Students at the high school level wear
   identification badges? 1 2

2. Faculty and staff in high schools wear
   identification badges? 1 2

3. Visitors to high schools wear identification badges? 1 2

26. Has your district adopted a policy stating that high schools will use…

Yes No

1. Security or surveillance cameras, either inside
   or outside the building? 1 2

2. Metal detectors, including wands? 1 2

3. Communication devices such as cell phones, 2-way
   radios, walkie-talkies, or intercoms for security purposes? 1 2

27. Has your district adopted a policy requiring high school students to refrain from using personal communication devices, such as cell phones, during the school day?

Yes 1

No 2

28. Has your district adopted a policy stating that high schools will use police, school resource officers, or security guards during the regular school day?

Yes 1

No 2

29. What is the standard distance high school students must live from a school to be eligible for riding a school bus? Do not include students with special needs or those eligible for hazard busing.

More than ½ mile 1

More than ¾ mile 2

More than 1 mile 3

More than 1½ miles 4

More than 2 miles 5

No minimum distance 6

The next questions ask about transportation to and from school.

30. Has your district adopted a policy that supports or promotes walking or biking to and from school?

Yes 1

No 2

31. Does your district support or promote the use of public transportation for its students to travel to and from school?

Yes 1

No 2

No public transportation available 3

32. Does your district support or promote the use of public transportation for its faculty and staff to travel to and from school?

Yes 1

No 2

No public transportation available 3

The next questions ask about joint use agreements.

A joint use agreement is a formal agreement, such as a memorandum of agreement or understanding, between the school district and another public or private entity to jointly use or share either school facilities or community facilities to share costs and responsibilities. For example, joint use agreements might be designed to increase access to spaces for recreation and physical activity, library services, school health centers, preschool programs, child care centers, before- or after-school programs, adult education, or other programs that benefit students and the community. These could be indoor or outdoor education or recreational facilities.

33. Does your district have such an agreement for shared use of school or community property? Do not include situations where the community can use school property but no formal agreement with another entity exists.

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q36

34. Does this formal agreement apply to the use of facilities for…

Yes No

1. Indoor recreation or physical activity? 1 2

2. Outdoor recreation or physical activity? 1 2

3. Library services? 1 2

4. Preschool or infant child care programs? 1 2

5. Before- or after-school programs for school-aged children? 1 2

6. Adult education programs? 1 2

7. Healthcare services? 1 2

8. Other activities or programs? 1 2

35. Does your school district have a formal joint use agreement with…

Yes No

1. A local parks or recreation department? 1 2

2. A local youth organization, such as the YMCA,
   Boys or Girls Clubs, or the Boy Scouts or Girl Scouts? 1 2

3. A local faith-based organization? 1 2

4. A local health club? 1 2

5. A local healthcare facility? 1 2

6. A local library system? 1 2

7. Any other public or private entity? (Specify) 1 2

The next questions ask about policies affecting all schools in your district. The first question asks about your district’s policies regarding gang activity.

36. Has your district adopted a policy prohibiting gang activity, such as recruiting or wearing gang colors, symbols, or other gang attire?

Yes 1

No 2

The next questions ask about bullying. For the purposes of these questions, “bullying” means when one or more students tease, threaten, spread rumors about, hit, shove, or hurt another student repeatedly. 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.

37. Has your district adopted a policy prohibiting bullying on school property?

Yes 1

No 2

38. Has your district adopted a policy prohibiting bullying at off-campus, school-sponsored events?

Yes 1

No 2

The next questions ask about electronic aggression, sometimes called cyber-bullying. For the purposes of these questions, “electronic aggression” means when students use a cell phone, the Internet, or other communication devices to send or post text, pictures, or videos intended to threaten, harass, humiliate, or intimidate other students or staff.

39. Has your district adopted a policy prohibiting electronic aggression or cyber-bullying on school property?

Yes 1

No 2

40. Has your district adopted a policy prohibiting electronic aggression or cyber-bullying at off-campus, school-sponsored events?

Yes 1

No 2

41. Has your district adopted a policy prohibiting any electronic aggression or cyber-bullying that interferes with the educational environment, even if it does not occur on school property or at school-sponsored events?

Yes 1

No 2

42. Has your district adopted a policy stating that schools will have a plan for the actions to be taken when a student at risk for suicide is identified?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q44

43. Does the policy require that…

Yes No

1. The student’s family will be informed? 1 2

2. The student will be referred to a mental health provider? 1 2

3. A visit with a mental health provider will be
   documented before the student returns to school? 1 2

The next questions ask about your district’s policies regarding tobacco use.

44. Has your district adopted a policy prohibiting cigarette smoking by students?

Yes 1

No 2 SKIP TO Q46

45. Does that policy specifically prohibit cigarette smoking by students…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

46. Has your district adopted a policy prohibiting cigar or pipe smoking by students?

Yes 1

No 2

47. Has your district adopted a policy prohibiting smokeless tobacco use by students?

Yes 1

No 2 SKIP TO Q49

48. Does that policy specifically prohibit smokeless tobacco use by students…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

49. Has your district adopted a policy prohibiting tobacco advertisements…

Yes No

1. In the school building? 1 2

2. Outside, on school grounds, including on the outside
   of the school building, on playing fields, or other areas
   of the campus? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. In school publications? 1 2

50. Has your district adopted a policy that prohibits students from wearing tobacco brand‑name apparel or carrying merchandise with tobacco company names, logos, or cartoon characters on it?

Yes 1

No 2

51. Has your district adopted a policy prohibiting tobacco advertising through sponsorship of school events?

Yes 1

No 2

52. Has your district adopted a policy prohibiting cigarette smoking by faculty and staff during any school-related activity?

Yes 1

No 2 SKIP TO Q54

53. Does that policy specifically prohibit cigarette smoking by faculty and staff…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

54. Has your district adopted a policy prohibiting cigar or pipe smoking by faculty and staff during any school-related activity?

Yes 1

No 2

55. Has your district adopted a policy prohibiting smokeless tobacco use by faculty and staff during any school-related activity?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q57

56. Does that policy specifically prohibit smokeless tobacco use by faculty and staff…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

The next question asks about your district’s policy regarding cigarette smoking by school visitors. For the purposes of these questions, “visitors” means anyone other than students or faculty and staff, including family members, community members, contractors, and repair workers. These people might visit school during or outside of school hours.

57. Has your district adopted a policy prohibiting cigarette smoking by school visitors?

Yes 1

No 2 SKIP TO Q59

58. Does that policy specifically prohibit cigarette smoking by school visitors…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

59. Has your district adopted a policy prohibiting cigar or pipe smoking by school visitors?

Yes 1

No 2

60. Has your district adopted a policy prohibiting smokeless tobacco use by school visitors?

Yes 1

No 2 SKIP TO THE INSTRUCTIONS BEFORE Q62

61. Does that policy specifically prohibit smokeless tobacco use by school visitors…

Yes No

1. In school buildings? 1 2

2. Outside on school grounds, including parking lots and
   playing fields? 1 2

3. On school buses or other vehicles used to
   transport students? 1 2

4. At off-campus, school-sponsored events? 1 2

ANSWER Q62 IF DISTRICT CONTAINS MIDDLE OR HIGH SCHOOLS. OTHERWISE, SKIP TO THE INTRODUCTION TO Q64.

The next questions ask about your district’s policies regarding student drug testing.

62. Has your district adopted a student drug-testing policy?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q64

63. The next questions ask about how students are chosen for drug testing under your district’s policy.

Yes No

1. Is student drug testing conducted randomly among
   members of specific groups of students, such as
   athletes, students who participate in other
   extracurricular activities, or student drivers? 1 2

2. Is student drug testing conducted when it is suspected
   that a student is using drugs at school, that is, for cause? 1 2

3. Is student drug testing voluntary for all students or
   specific groups of students? 1 2

4. Are students chosen for drug testing using any
   other criteria? 1 2

The next questions ask about your district’s policies regarding injury prevention and safety.

64. Has your district adopted a policy on the inspection or maintenance of…

Yes No

ANSWER A IF DISTRICT CONTAINS ELEMENTARY SCHOOLS. OTHERWISE, SKIP TO B.

1. Playground facilities and equipment, such as playing
   surfaces, benches, monkey bars, and swings? 1 2

2. Indoor athletic facilities and equipment, such as playing
   surfaces, benches, tumbling mats, and weight lifting
   equipment? 1 2

3. Outdoor athletic facilities and equipment, such as
   playing fields and bleachers? 1 2

4. Special classroom areas, such as chemistry labs,
   workshops, and art rooms? 1 2

5. Other school areas, such as halls, stairs, and
   regular classrooms? 1 2

6. Smoke alarms? 1 2

7. Fire extinguishers? 1 2

8. Sprinkler systems? 1 2

9. Lighting inside school buildings? 1 2

10. Lighting outside school buildings? 1 2

11. Automated external defibrillators (AEDs)? 1 2

65. Has your district adopted a policy requiring that students wear appropriate protective gear when engaged in…

Yes No N/A

1. Classes such as wood shop or metal shop? 1 2 3

2. Lab activities for photography, chemistry,
   biology, or other science classes? 1 2 3

66. Has your district adopted a policy requiring that students use hearing protection devices during classes or activities where they are exposed to potentially unsafe noise levels, such as industrial arts classes or marching band? A hearing protection device is any piece of equipment or apparatus that is made to reduce the loudness of sound, such as earplugs or earmuffs.

Yes 1

No 2

ASK Q67–69 ONLY IF DISTRICT CONTAINS ELEMENTARY SCHOOLS. OTHERWISE, SKIP TO Q70.

67. Has your district adopted a policy that addresses the following issues related to playground safety?

Yes No

1. Ratio of playground monitors to students 1 2

2. Criteria for selecting playground monitors 1 2

3. Duties of playground monitors 1 2

4. Training for playground monitors 1 2

5. A discipline procedure for students who are not
   following the rules 1 2

6. A procedure for what to do in case of an injury 1 2

7. Criteria for the selection, placement, and installation of
   playground surfacing materials 1 2

8. Criteria for the selection, placement, and installation of
   playground equipment 1 2

9. The posting of rules for the safe use of specific types of
   equipment, such as swings, slides, or climbing structures 1 2

10. The identification of an individual responsible
    for enforcing the policy 1 2

68. During the past two years, has your district provided training for playground monitors?

Yes 1

No 2

69. Has your district adopted a policy requiring schools to use the safety checklist and equipment guidelines published in the Handbook for Public Playground Safety by the U.S. Consumer Product Safety Commission?

Yes 1

No 2

70. Has your district ever been sued because of an injury that occurred on school property or at an off-campus, school-sponsored event? Please include any claim filed with a court, regardless of the outcome.

Yes 1

No 2

The next question asks about sun safety.

71. Does your district require or recommend that schools will…

Require Recommend Neither

1. Schedule outdoor activities to avoid times
   when the sun is at peak intensity during
   the school day? 1 2 3

2. Allow students to apply sunscreen while
   at school? 1 2 3

3. Encourage students to wear protective
   clothing (such as long sleeve shirts or
   long pants) when in the sun during the
   school day? 1 2 3

4. Encourage students to wear hats or visors
   when in the sun during the school day? 1 2 3

5. Encourage students to wear sunglasses
   when in the sun during the school day? 1 2 3

The next section asks about the physical school environment, such as building maintenance, indoor air quality, pest control, chemicals, siting, and campus design.

72. Has your district adopted a policy requiring that schools conduct periodic inspections…

Yes No

1. For condensation in and around the school facilities? 1 2

2. Of the building foundation, walls, and roof for cracks,
   leaks, or past water damage? 1 2

3. For mold? 1 2

4. Of the plumbing system? 1 2

5. Of the heating, ventilation, and air conditioning (HVAC)
   system? 1 2

6. That test drinking water outlets for lead? 1 2

7. For clutter that prevents effective cleaning and
   maintenance? 1 2

73. Do any schools in your district have a main instructional building that was constructed before 1980?

Yes 1

No 2 SKIP TO Q77

74. Has your district adopted a policy requiring that schools constructed before 1980 inspect for lead in cracked or peeling paint?

Yes 1

No 2

Lead paint previously identified and
remediated 3

The next questions ask about inspection for PCBs. PCBs, or polychlorinated biphenals, are man‑made chemicals that are harmful to humans. They were commonly used in light ballasts, caulking, and a variety of other products before being banned in 1979.

75. Has your district adopted a policy requiring that schools constructed before 1980 inspect for PCBs in caulking around windows and doors?

Yes 1

No 2

PCBs in caulking previously identified and
remediated 3

76. Has your district adopted a policy requiring that schools constructed before 1980 inspect for PCBs in fluorescent light ballasts?

Yes 1

No 2

PCBs in fluorescent light ballasts previously
identified and remediated 3

77. How often are schools in your district required to conduct a campus-wide inspection for pests such as ants, roaches, bees, mice, or rats? For the purposes of this question, “campus‑wide” means inside the buildings and on the school grounds.

Weekly 1

Monthly 2

Quarterly 3

Every 6 months 4

Once per year 5

Only as needed 6

Other time frame 7

78. How often are schools in your district required to notify staff, students, and families prior to the application of pesticides?

Never 1

Each time 2

Once per year 3

Other time frame 4

Schools do not apply pesticides 5

79. Does your district require that schools….

Yes No

1. Seal openings in walls, floors, doors, and windows
   with caulk or weather stripping? 1 2

2. Keep vegetation, shrubs, and wood mulch at least
   1 foot away from buildings to control pests? 1 2

3. Allow eating only in designated areas to control pests? 1 2

4. Store food waste in plastic, glass, or metal containers
   with tight lids so that it is inaccessible to pests? 1 2

5. Repair cracks in pavement and sidewalks? 1 2

6. Remove infested or diseased plants? 1 2

7. Use spot treatments and baiting rather than widespread
   applications of pesticides? 1 2

8. Mark indoor and outdoor areas that have been treated
   with pesticides? 1 2

9. Store food in plastic, glass, or metal containers with
   tight lids so that it is inaccessible to pests? 1 2

80. Does your district use an outside company for pest management?

Yes 1

No 2 SKIP TO Q82

81. Is this company third-party certified for practices that reduce the use or risk of pesticides (i.e., integrated pest management)? For the purposes of this question, “third-party certified” means that the pest control company was trained by an organization such as the National Pest Management Association or Integrated Pest Management of North America in ways to limit the use and risk of pesticides.

Yes 1

No 2

82. Has your district adopted a policy regarding how schools should address mold problems?

Yes 1

No 2

83. Has your district adopted a policy stating that schools will respond to moisture-related issues, such as floods, leaks, or condensation within 48 hours or less?

Yes 1

No 2

84. Does your district have an indoor air quality (IAQ) management program?

Yes 1

No 2 SKIP TO Q86

85. Is your program based on the Environmental Protection Agency’s (EPA) Indoor Air Quality Tools for Schools?

Yes 1

No 2

86. Has your district adopted a policy requiring that schools be tested for radon?

Yes 1

No 2

87. Do any schools in your district have a school-operated water system, in which the school obtains drinking water from its own well, spring, or small reservoir?

Yes 1 SKIP TO Q89

No 2

88. Has your district adopted a policy requiring schools to do the following at least once a year?

Yes No

1. Test drinking water for bacteria 1 2

2. Test drinking water for coliforms 1 2

3. Test drinking water for other contaminants 1 2

89. Has your district adopted a policy requiring schools to flush drinking water outlets after periods of non-use, such as after weekends or school vacations?

Yes 1

No 2

The next questions ask about school buses and other vehicles.

90. Has your district implemented an engine idling reduction program for…

District does
not have
Yes No school buses

1. School buses? 1 2 3

2. Commercial vehicles, such as delivery
   trucks? 1 2

3. Personal vehicles, such as cars? 1 2

IF Q90A IS NO OR N/A, SKIP TO THE INTRODUCTION TO Q92.

91. During the past two years, has your district provided bus drivers with training related to the engine idling reduction program?

Yes 1

No 2

The next question asks about low-emitting products. Many commonly used products, such as floor coverings, furniture, paint, cleaners, markers, textiles, or adhesives emit chemical fumes or vapors. Some of these types of products are designed to give off little or no chemical fumes or vapors and are called low-emitting products.

92. Has your district adopted a policy to purchase low-emitting products for use in and around the school and school grounds, including in common areas, art classes, industrial art classes, and science laboratories?

Yes 1

No 2

93. Is district approval of the following products required before they are used by teachers, administrative or custodial staff, or contractors at a school in your district?

Yes No

1. Cleaning and maintenance products, such as
   disinfectants, air fresheners, polishes, or waxes 1 2

2. Pesticides 1 2

3. Chemicals or other potentially hazardous materials
   used in science labs, vocational education, art, or
   other classes 1 2

94. During the past two years, has your district provided funding for or offered training to custodial or maintenance staff on…

Yes No

1. Use of hazardous materials? 1 2

2. Labeling of hazardous materials? 1 2

3. Storage of hazardous materials? 1 2

4. Disposal of hazardous materials? 1 2

5. How to reduce the use of hazardous materials? 1 2

6. How to address mold problems? 1 2

7. Indoor air quality? 1 2

8. School drinking water quality? 1 2

9. Pest management practices that limit the use
   of pesticides? 1 2

10. Green cleaning products and practices? 1 2

The next questions ask about green building design. Green building design is a way of designing a building so that it minimizes impact on the environment. For example, the design of such a building conserves resources such as energy and water, protects the existing landscape, and provides healthy indoor air.

95. Has your district adopted a policy to include green design when building new school buildings or renovating existing buildings?

Yes 1

No 2 SKIP TO THE INTRODUCTION TO Q97

96. Buildings constructed or renovated under a green building policy may be inspected by an independent or third party, and rated, certified, or labeled as meeting certain green building conditions. Examples of third party rating or labeling systems include Collaborative for High Performance Schools (CHPS), LEED for Schools from the U.S. Green Building Council, and Green Globes. Does your district’s policy on green building design require the use of a third party green building certification, labeling, or rating system?

Yes 1

No 2

97. Has your district adopted a policy that addresses the following practices for new school campuses or renovations?

Yes No

1. Use of natural light for visual comfort or energy
   conservation 1 2

2. Use of energy efficient lighting and electrical systems 1 2

3. Use of renewable energy, such as solar or wind power 1 2

4. Conservation of water, such as using rainwater or
   plumbing fixtures that conserve water 1 2

5. Implementation of recycling programs 1 2

6. Orienting buildings to optimize energy conservation,
   use of daylight, and noise reduction 1 2

7. Use of landscaping that includes only native
   planting materials 1 2

8. Use of alternative transportation including
   public transportation, walking, or biking 1 2

9. Creating a system for managing arrivals and departures
   of pedestrians and bicycles 1 2

10. Preservation of green space or protection of the
    existing landscape 1 2

11. Use of building materials such as floor and wall
    coverings, paints, sealants, caulk, adhesives, or furniture
    that are low- or no-volatile organic compound (VOC)
    emitting materials 1 2

12. Use of procedures or systems to protect indoor air quality 1 2

13. Use of radon resistant new construction practices 1 2

98. During the past five years, has your school district initiated the construction of a school facility on a new school site?

Yes 1

No 2 SKIP TO Q101

99. Consider only the most recent new school facility built on a new site. How influential were the following factors in the district’s decision to build a new school facility rather than renovate an existing facility?

Not a Somewhat Very
factor influential influential

1. Need to accommodate population growth 1 2 3

2. School consolidation policy 1 2 3

3. Need to support current or future
   educational programs 1 2 3

4. Ease of obtaining funding to construct
   a new school than to renovate an
   existing school 1 2 3

5. Ease of obtaining approvals to construct
   a new school than to renovate an
   existing school 1 2 3

6. Cost of repairing existing facility 1 2 3

7. Desire to have a more energy-efficient
   facility 1 2 3

8. Desire to accommodate community use of
   the school facility or campus, such as an
   auditorium, classrooms, or athletic fields 1 2 3

100. How influential were the following factors in deciding where to build the new school? Again, please consider only the most recent new school construction built on a new site in the past five years.

Not a Somewhat Very
Factor Influential Influential

1. Local government officials’ input 1 2 3

2. Need for athletic facilities 1 2 3

3. Need for parking 1 2 3

4. Availability or design of existing roads
   and infrastructure 1 2 3

5. Land prices 1 2 3

6. Site donated 1 2 3

7. Site already owned 1 2 3

8. Ability for students to walk or bike to school 1 2 3

9. Demographic characteristics of students
   who would attend that school, such as
   race, ethnicity, and poverty status 1 2 3

10. Compatibility with local community
    growth plan related to future residential
    development 1 2 3

11. Environmental concerns related to on-site
    contamination or potential nearby sources
    of pollution 1 2 3

12. Potential clean up costs of contaminated sites 1 2 3

13. Desire to accommodate community use of
    the school facility or campus, such as an
    auditorium, classrooms, or athletic fields 1 2 3

101. Has your district adopted a policy that requires formal consultation or input from the following groups on whether to construct a new school?

1. The public

Yes 1

No 2

2. Local government transportation officials

Yes 1

No 2

No local government transportation
officials 3

3. Local government land use or community planning officials

Yes 1

No 2

No local government land use or
community planning officials 3

4. Public health or environmental health officials

Yes 1

No 2

No local public health or environmental
health officials 3

5. State government officials

Yes 1

No 2

102. Has your district adopted a policy that requires formal consultation or input from the following groups on where to construct a new school?

1. The public

Yes 1

No 2

2. Local government transportation officials

Yes 1

No 2

No local government transportation
officials 3

3. Local government land use or community planning officials

Yes 1

No 2

No local government land use or
community planning officials 3

4. Public health or environmental health officials

Yes 1

No 2

No local public health or environmental
health officials 3

5. State government officials

Yes 1

No 2

103. Has your district adopted a policy that requires formal consultation or input from the following groups on environmental review of candidate sites?

1. The public

Yes 1

No 2

2. Local government transportation officials

Yes 1

No 2

No local government transportation
officials 3

3. Local government land use or community planning officials

Yes 1

No 2

No local government land use or
community planning officials 3

4. Public health or environmental health officials

Yes 1

No 2

No local public health or environmental
health officials 3

5. State government officials

Yes 1

No 2

The next question asks about Phase I environmental site assessments. Phase I environmental site assessments can include a physical survey of the property and surrounding properties to assess general land use and occupants of the area, an on-site visual inspection of the site to identify environmental concerns, an assessment of current and past uses of the property particularly if any hazardous materials were stored or disposed of at the site, a review of owner records, and a review of local, state, and federal regulatory agency records maintained for the site.

104. Has your district adopted a policy requiring Phase I environmental site assessments prior to constructing a new school facility?

Yes 1

No 2

No new facilities planned 3

The next question asks about formal training for a newly hired person who oversees custodial, maintenance, and environmental issues, such as hazardous materials and pest management, for schools in your district. For the purposes of this question, “formal training” means college classes, including community college; workshops; seminars; conferences; or any other kind of in-service or pre-service.

105. In your district, is a newly hired person who oversees custodial, maintenance, and environmental issues required to have any formal training in issues related to the physical environment of buildings and health hazards likely to be encountered in schools?

Yes 1

No 2

The next questions ask about crisis preparedness, response, and recovery in the event of a natural disaster or other emergency situation.

106. Has your district used any materials from the U.S. Department of Education, such as Practical Information on Crisis Planning: A Guide for Schools and Communities, to develop policies or plans related to crisis preparedness, response, and recovery?

Yes 1

No 2

107. Does your district have a comprehensive district-level plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation?

Yes 1

No 2 SKIP TO Q109

108. Does your district’s crisis preparedness, response, and recovery plan include…

Yes No

1. Evacuation protocols for crises involving more than
   one school? 1 2

2. Protocols for communicating with building-level
   managers during a crisis? 1 2

3. Plans for supplying food, water, and medical supplies
   to schools in extended shelter-in-place? 1 2

4. Requirements to conduct district-level crisis-response drills? 1 2

5. Plans for training school staff, for example in triage or
   first aid skills? 1 2

6. Plans for serving as a community shelter or coordinating
   center during a community-wide crisis? 1 2

7. Plans to resume normal activities after buildings or
   facilities have been damaged? 1 2

8. Mechanisms for evaluating outside offers of assistance
   during or after a crisis? 1 2

9. Provision of mental health services for students, faculty,
   and staff after a crisis has occurred, for example to treat
   post-traumatic stress disorder? 1 2

10. Establishment of an incident command system? 1 2

11. Mechanisms for communicating with school personnel? 1 2

12. Procedures for responding to media inquiries? 1 2

(Q108 continued)

Yes No

13. Requirements to periodically review and revise
    emergency response plans? 1 2

14. Procedures for responding to pandemic influenza (flu)
    or other infectious disease outbreaks? 1 2

15. Procedures for implementing unplanned school dismissal
    or school closure? 1 2

109. Has your district adopted a policy requiring that schools have a comprehensive plan to address crisis preparedness, response, and recovery in the event of a natural disaster or other emergency or crisis situation?

Yes 1

No 2 SKIP TO THE INSTRUCTIONS BEFORE Q111

110. Has your district adopted a policy requiring schools’ crisis preparedness, response, and recovery plans to include…

Yes No

1. Evacuation plans? 1 2

2. Procedures to stop people from leaving or entering school
   buildings, that is, lock down plans? 1 2

3. Procedures to control the exterior of the building and
   school grounds? 1 2

4. Plans to seek immediate shelter and remain in that area
   during a chemical, biological, or radiological emergency
   rather than evacuating, or shelter-in-place plans? 1 2

5. Requirements to conduct regular emergency drills,
   other than fire drills? 1 2

6. Family reunification procedures? 1 2

7. Provisions for students and staff with special needs? 1 2

8. Plans to resume normal activities after buildings or
   facilities have been damaged? 1 2

9. Provision of mental health services for students, faculty,
   and staff after a crisis has occurred, for example to treat
   post-traumatic stress disorder? 1 2

(Q110 continued)

Yes No

10. Mechanisms for communicating with school personnel? 1 2

11. Establishment of an incident command system? 1 2

12. Procedures for responding to media inquiries? 1 2

13. Mechanisms for communicating the plan to students’
    families? 1 2

14. Requirements to periodically review and revise
    emergency response plans? 1 2

15. Procedures for responding to pandemic influenza (flu)
    or other infectious disease outbreaks? 1 2

16. Procedures for implementing unplanned school
    dismissal or school closure? 1 2

IF Q107 AND Q109 ARE BOTH “NO,” SKIP TO Q112.

111. During the past two years, has your district provided funding for or offered training on the crisis preparedness, response, and recovery plan to…

Yes No

1. School faculty and staff? 1 2

2. Students? 1 2

3. Students’ families? 1 2

112. During the past two years, has your district offered education on crisis preparedness, response, and recovery to students’ families?

Yes 1

No 2

IF Q107 AND Q109 ARE BOTH “NO,” SKIP TO Q115.

113. In developing the crisis preparedness, response, and recovery plans, did your district work with…

Yes No N/A

1. Staff from individual schools within
   your district? 1 2

2. Students or their families? 1 2

3. A local fire department? 1 2

4. A local law enforcement agency? 1 2

5. Local emergency medical services? 1 2

6. The local public transportation department? 1 2 3

7. A local health department? 1 2

8. A local mental health or social services
   agency? 1 2

9. A local hospital? 1 2

10. A local homeland security office or
    emergency management agency? 1 2 3

11. Other community members? 1 2

114. During the past 12 months, has your district’s crisis preparedness, response, and recovery plan been evaluated or assessed?

Yes 1

No 2

115. Some communities have a group of local agencies that coordinates crisis preparedness, response, and recovery efforts. Such a group might be called a local emergency planning committee, an emergency management team, or something else. Is your district a member of such a group?

Yes 1

No 2

No such group 3

116. Are any of the schools in your district designated to serve as staging areas or community shelters during local emergencies?

Yes 1

No 2

117. Has your district adopted a policy that all schools must have a National Oceanic and Atmospheric Administration (NOAA) weather radio?

Yes 1

No 2

The next questions ask about community service and service-learning. For the purposes of these questions, “community service” is unpaid work that helps the community, and “service-learning” is a particular type of community service that is designed to meet specific learning objectives for a course.

118. Has your district adopted a policy requiring students at any school level to participate in community service?

Yes 1

No 2

119. Does your district require or recommend that schools provide service-learning opportunities to students?

Require 1

Recommend 2

Neither 3

ANSWER Q120A IF DISTRICT CONTAINS ELEMENTARY SCHOOLS. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q120B.

120a. Has your district adopted a policy stating that elementary schools will participate in programs in which family or community members serve as role models to students or mentor students, such as the Big Brothers Big Sisters program?

Yes 1

No 2

ANSWER Q120B IF DISTRICT CONTAINS MIDDLE SCHOOLS. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q120C.

120b. Has your district adopted a policy stating that middle schools will participate in programs in which family or community members serve as role models to students or mentor students, such as the Big Brothers Big Sisters program?

Yes 1

No 2

ANSWER Q120C IF DISTRICT CONTAINS HIGH SCHOOLS. OTHERWISE, SKIP TO THE INTRODUCTION TO Q121.

120c. Has your district adopted a policy stating that high schools will participate in programs in which family or community members serve as role models to students or mentor students, such as the Big Brothers Big Sisters program?

Yes 1

No 2

The next questions ask about foods and beverages available outside of the school meal programs.

Junk foods are foods or beverages that have low nutrient density, that is, they provide calories primarily through fats or added sugars and have minimal amounts of vitamins and minerals.

121. Does your district require or recommend that schools prohibit advertisements for junk food or fast food restaurants on school property?

Require 1

Recommend 2

Neither 3

ANSWER Q122 IF DISTRICT CONTAINS ELEMENTARY SCHOOLS. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q123.

120. Does your district require or recommend that elementary schools prohibit student access to vending machines for at least part of the school day?

Require 1

Recommend 2

Neither 3

ANSWER Q123 IF DISTRICT CONTAINS MIDDLE SCHOOLS. OTHERWISE, SKIP TO THE INSTRUCTIONS BEFORE Q124.

121. Does your district require or recommend that middle schools prohibit student access to vending machines for at least part of the school day?

Require 1

Recommend 2

Neither 3

ANSWER Q124 IF DISTRICT CONTAINS HIGH SCHOOLS. OTHERWISE, SKIP TO Q125.

122. Does your district require or recommend that high schools prohibit student access to vending machines for at least part of the school day?

Require 1

Recommend 2

Neither 3

123. Does your district require or recommend that schools restrict the distribution of products promoting junk food, fast food restaurants, or soft drinks to students, such as t-shirts, hats, or book covers?

Require 1

Recommend 2

Neither 3

124. Does your district allow schools to sell soft drinks, such as sports drinks, soda pop, or fruit drinks that are not 100% juice to students in any venue?

Yes 1

No 2 SKIP TO Q130a

125. Does your district receive a specified percentage of the soft drink sales receipts?

Yes 1

No 2 SKIP TO Q129

126. Does your district receive incentives, such as cash awards or donations of equipment, supplies, or other donations, once receipts total a specified amount?

Yes 1

No 2

127. Is your district prohibited from selling soft drinks produced by more than one company?

Yes 1

No 2

130a. Are soft drink companies allowed to advertise soft drinks, such as sports drinks, soda pop, or fruit drinks that are not 100% juice in school buildings?

Yes 1

No 2

130b. What about on school grounds, including on the outside of school buildings, on playing fields, or other areas of campuses?

Yes 1

No 2

The next questions are about professional development, which might include workshops, conferences, continuing education, graduate courses, or any other kind of in-service.

131. During the past two years, has your district provided funding for or offered professional development for school faculty and staff on how to implement school-wide policies and programs related to…

Yes No

1. Classroom management? 1 2

2. Electronic aggression or cyber-bullying prevention? 1 2

3. Other bullying prevention? 1 2

4. Dating violence prevention? 1 2

5. Other violence prevention? 1 2

6. Injury prevention and safety? 1 2

7. Sun safety? 1 2

8. Tobacco use prevention? 1 2

9. Alcohol use prevention? 1 2

10. Illegal drug use prevention? 1 2

11. Crisis preparedness, response, and recovery? 1 2

12. Indoor air quality? 1 2

13. Drinking water quality? 1 2

14. Integrated pest management? 1 2

15. Green cleaning products and practices? 1 2

16. Radon testing and mitigation? 1 2

17. Faculty and staff health promotion? 1 2

The next questions ask about school health coordination.

128. Is there one or more than one group—for example, a school health council, committee, or team—at the district level that offers guidance on the development of policies or coordinates activities that are health-related?

Yes 1

No 2 SKIP TO Q138

129. Do any of these groups address…

Yes No

1. Tobacco use prevention? 1 2

2. Alcohol or other drug use prevention? 1 2

3. Food service or nutrition? 1 2

4. Physical education or physical activity? 1 2

5. Pregnancy prevention? 1 2

6. Human immunodeficiency virus (HIV) prevention? 1 2

7. Other sexually transmitted disease (STD) prevention? 1 2

8. Violence prevention, for example bullying, fighting, or
   dating violence prevention? 1 2

9. Injury prevention and safety? 1 2

10. Health education? 1 2

11. Health services? 1 2

12. Mental health or social services? 1 2

13. The psychological and social environment, or school
    climate? 1 2

14. Faculty and staff health promotion? 1 2

15. Family and community involvement in school
    health programs? 1 2

16. Physical school environment? 1 2

17. Crisis preparedness, response, and recovery? 1 2

18. Management of chronic health conditions, such as
    asthma or diabetes? 1 2

19. Management of infectious diseases, such as influenza (flu)? 1 2

20. Management of foodborne illnesses? 1 2

21. Management of food allergies? 1 2

22. Local wellness policies? 1 2

130. Do any of the district school health councils, committees, or teams include…

No such staff
Yes No in this district

1. Health education teachers? 1 2 3

2. Physical education teachers? 1 2 3

3. Health services staff (e.g., school nurses)? 1 2 3

4. Nutrition or food service staff? 1 2 3

5. Mental health and social services staff? 1 2 3

6. Maintenance staff? 1 2 3

7. Transportation staff? 1 2 3

8. Technology staff? 1 2 3

9. Library or media center staff? 1 2 3

10. District administrators? 1 2

11. School-level administrators? 1 2

12. Students? 1 2

13. Students’ parents or families? 1 2

131. Do any of the district school health councils, committees, or teams include representatives from any of the following local agencies or organizations?

Yes No

1. Health department 1 2

2. Mental health or social services agencies 1 2

3. Healthcare providers, such as pediatricians or dentists 1 2

4. Health organizations, such as the local Red Cross chapter 1 2

5. Youth organizations, such as the Boys and Girls Clubs 1 2

6. Businesses 1 2

7. Hospitals 1 2

8. Service clubs, such as the Rotary Club 1 2

9. Public safety agencies, such as police, fire, or
   emergency services 1 2

10. Faith-based organizations 1 2

11. Other local government agencies 1 2

132. Do any of these groups…

Yes No

1. Identify student health needs based on a review of
   relevant data, such as Youth Risk Behavior Survey data? 1 2

2. Recommend new or revised health and safety policies and
   activities to district administrators or the school board? 1 2

3. Seek funding or leverage resources to support health and
   safety priorities for students and staff? 1 2

4. Review health-related curricula or instructional materials? 1 2

5. Communicate the importance of health and safety policies
   and activities to the school board, district administrators,
   school administrators, or community members? 1 2

For the next question, please think about the school health council, committee, or team that met the most during the past 12 months.

133. During the past 12 months, how many times did this group meet?

0 times 1

1 or 2 times 2

3 or 4 times 3

5 or 6 times 4

More than 6 times 5

134. During the past two years, has your district provided any funding for or offered to help schools establish a group—for example, a school health council, committee, or team—that offers guidance on the development of policies or coordinates activities that are health‑related?

Yes 1

No 2

135. Has your district ever used a self-assessment tool, such as the Healthy Schools Report Card or the Healthy Schools Builder, to assess your district’s health and safety policies and activities?

Yes 1

No 2

The next questions ask about a district-level school improvement plan. Such plans are developed to improve the district’s overall instructional and environmental policies and activities.

136. Does your district-level school improvement plan include health and safety objectives?

Yes 1

No 2

The district does not have a district-level
school improvement plan 3

137. The Elementary and Secondary Education Act requires certain schools to have a written School Improvement Plan (SIP). Many states and school districts also require schools to have a written SIP. Does your district require schools to include health and safety objectives in their written SIP?

Yes 1

No 2

Schools in this district do not have SIPs 3

The next questions ask about the person responsible for overseeing or coordinating your district’s health and safety policies and activities.

138. Currently, is there one person in your district who oversees or coordinates the district’s health and safety policies and activities, for example a district health coordinator?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

139. Are you this person?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

140. Are the following activities included in your responsibilities as coordinator of your district’s health and safety policies and activities?

Yes No N/A

1. Developing or assisting in the development
   of school health and safety policy language,
   policy guidance, or other policy materials 1 2

2. Securing funding or other resources
   to support health and safety policies and
   activities 1 2

3. Communicating health and safety priorities
   to district-level decision-makers, such as
   the Superintendent, school board, or other
   district-level administrators 1 2

4. Linking community-based health-related
   resources to the district 1 2

5. Facilitating collaboration among
   district-level staff responsible for the health
   and safety of students and staff 1 2

6. Serving as a liaison between the district
   office and those who oversee or implement
   health and safety policies and activities
   at the school level 1 2

7. Convening district school health council,
   committee, or team meetings 1 2 3

8. Coordinating school health-related
   professional development 1 2 3

141. Counting this year as a full year, how many years have you been responsible for coordinating health and safety policies and activities at the district level?

Years

The last questions ask about your educational background.

142. Do you have an undergraduate degree?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

143. What did you major in?
     MARK ALL THAT APPLY

Health education 1

Physical education 2

Other education 3

Kinesiology, exercise physiology, or
exercise science 4

Nursing 5

Nutrition 6

Public health 7

Biology or other science 8

Home economics or family and
consumer science 9

Other (Specify) 10

144. Did you have an undergraduate minor?

Yes 1

No 2 SKIP TO Q150

145. What did you minor in?
     MARK ALL THAT APPLY

Health education 1

Physical education 2

Other education 3

Kinesiology, exercise physiology, or
exercise science 4

Nursing 5

Nutrition 6

Public health 7

Biology or other science 8

Home economics or family and
consumer science 9

Other (Specify) 10

146. Do you have a graduate degree?

Yes 1

No 2 That is the last question. Thank you very much for taking the time to complete this questionnaire.

147. In what area or areas was your graduate work?
     MARK ALL THAT APPLY

Health education 1

Physical education 2

Education administration 3

Other education 4

Kinesiology, exercise physiology, or
exercise science 5

Nursing 6

Nutrition 7

Public health 8

Biology or other science 9

Home economics or family and
consumer science 10

Other (Specify) 11

Thank you very much for taking the time to participate in this study.

If you would like more information about this study or would like clarification of any questions in this questionnaire, please call 800-287-1815.

Healthy and Safe School Environment District Questionnaire—Public Use Version 0