Site Visit Implementation Checklist

FAP Outreach Project Site Visit Implementation Checklist
Date of Observation: ___________________		Observer Name: ­­­­­­­­­­­­­­­­­­_____________________________________
Installation Name/ID: ______________________________ Campaign for Observation:  Domestic Violence Awareness  Child Abuse Prevention *Please note: This checklist will need to be filled out for each material or event observed. Accessibility and translation for different languages will be an important consideration.		Service Branch:  Army  Navy  Air Force  Marine Corps
MATERIALS
Item	Response		Notes
1. Did you observe campaign messages or materials (e.g., posters, flyers, announcements via screen/display/verbal advertisement)?	Yes No [If “No”, skip to item 2]
What type of material did you observe?	Poster, flyer, or banner Display Announcement on a screen or display Brochure Other ____________________
How would you describe the display of the material? (Check all that apply)	Readily visible Partially visible Hidden Large and eye-catching Small and difficult to see Other _______________
Item	Response		Notes
c. Where did you observe the material? (Check all that apply)	Installation main gate Family Support Centers Medical Facilities (Hospital, pharmacy, urgent care) Commissary Child Development Centers Base Exchange Childcare Center Dental Clinic Family Advocacy Program Office Gymnasium/Fitness Center Library Personnel Support Office Public restroom Welcome/Visitors Center Religious facility or place of worship Restaurant Off-installation _____________________ Other ______________________ Other ______________________		Provide more details here about the location of the material (i.e., foyer, hallway, bulletin board, etc.)
d. Approximately how many materials did you observe?	1 – 5 6 – 10 11 – 20 21+
e. Take a photo of the campaign material.
EVENTS
Item	Response		Notes
Were any campaign events happening when you visited the installation?	Yes No [If “No”, skip to item 3]
a. Where did the event occur?	Family Support Centers Medical Treatment Facilities Commissary Base Exchange Family Advocacy Program Office Gymnasium/Fitness Center Library Personnel Support Office Welcome/Visitors Center Other ______________________
b. Describe the events. Include a description of activities, perceived level of engagement, and purpose.
Item	Response		Notes
c. Approximately how many people attended the event?	1 to 20 21-50 51 to 100 101 to 150 151 +
d. Who attended the event? (Select all that apply)	Service members Family members and significant others Leadership Other ____________________
e. Take a photo of event activities, signage, or advertising materials.

OTHER

Item	Response	Notes
Did you overhear or have any conversations about the campaigns?	Yes No [If “No”, skip to item 4]
a. Describe the content of the conversations.
Is there anything else you observed related to the campaigns that may be helpful? If yes, please describe.