Teacher School Safety Checklist

Teacher School Safety Checklist
This survey asks about your views on safety and crime on your campus. The answers you give will be kept private. Check off only one answer for each question, unless you are given other instructions.

Campus (required)
1. Sex	Male Female
2. Race or Ethnicity	White, non-Hispanic African-American, non-Hispanic Native American or Alaskan Native Hispanic Asian or Pacific Islander Other
3. Grade Level(s) or Course Level(s) you teach. (Select all that apply - Hold the ctrl or command key to make multiple selections)	PreK K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
4. How safe do you feel at school?	very safe safe unsafe
5a. Are there particular places at school where you don't feel safe? If so, where are they? (Select all that apply.)	classrooms lunchroom playground parking lot restrooms school bus other
5b. Are there certain times of day when these places are unsafe? (Select all that apply.)	Before school During class During lunch After school Entire school day Other
6. This school year, have you had something stolen from your desk, locker, or other place at school?	never one or two times three to four times more than four times
7. This school year, has someone taken money or things directly from you by using force, weapons or threats?	never one or two times three to four times more than four times
8. This school year, has your personal property been damaged while on school property or at school-sponsored events?	never one or two times three to four times more than four times
9. This school year, has someone physically threatened, attacked, or hurt you at school?	never one or two times three to four times more than four times
10. This school year, have you been verbally abused at school?	never one or two times three to four times more than four times
11a. This school year, has someone made sexual advances or attempted to sexually assault you at school?	never one or two times three to four times more than four times
11b. This school year, has someone sexually assaulted you at school?	never one or two times three to four times more than four times
12a. Is there a process in place for students to report alleged physical, psychological, or sexual abuse?	Yes No
12b. Does the campus follow-up on reports of alleged abuse?	Yes No
13. Do gangs cause trouble at your school?	Yes Sometimes No Don't Know No Gangs at my School
14a. Have you even seen a student carrying a weapon at school?	Yes No
14b. If yes, please specify what kind of weapon you saw. (Select all that apply.)	gun knife scissors other
15. During this school year, how many fights have you witnessed at your school?	none one to two three to five more than five
16. In your opinion, how serious are the following problems at school: Vandalism	don't know no problem small problem serious problem
Gangs	don't know no problem small problem serious problem
Alcohol Use	don't know no problem small problem serious problem
Tobacco Use	don't know no problem small problem serious problem
Drug Use	don't know no problem small problem serious problem
Drug Selling	don't know no problem small problem serious problem
Carrying Weapons	don't know no problem small problem serious problem
Racial Conflict	don't know no problem small problem serious problem
Other
17. In your opinion, what are the three major problems at school right now?
Thank you for completing the survey.