Safe Schools Design Team
Educational Services Center
4700 South Yosemite Street
Greenwood Village, Colorado 80111
720.554.4289
Cherry Creek School District
Climate, Safety, and Wellness Survey
Parent Report
My child is a:
Boy
Girl
My child’s grade: _______
My child’s school: __________________________________
My child is Hispanic/Latino or from Spanish origin: Yes
No
He or she is (check all that apply):
North, Central or South American Indian or Alaska Native
Asian
Black or African American
White
Native Hawaiian or Other Pacific Islander
Other
Have you volunteered at your child’s school either in the classroom, with an extracurricular group or activity,
on a school committee (for example, accountability or safety), or through the PTCO
Yes
No
The following set of questions asks about factors related to the safety of your child’s school.
Please answer the questions to the best of your knowledge.
In general, during the past month, how safe have you felt your child is at school?
very unsafe
unsafe
& scared
& scared


kind of
unsafe
kind of
safe


very
safe
safe


Definition of Bullying: Bullying/harassment happens when one person (or a group of people) hurt or try to
hurt another person on purpose. Bullying/harassment can be hurting another person physically (hitting,
kicking, pushing), with words (saying mean things, teasing, calling names), by leaving them out of the
group, or another way of hurting them. It is NOT bullying when people of the same strength or power fight or
disagree.
During the past month, has your child been bullied at school?
never

less than
1 time
per week

1 time
per week

2-4 times
per week

5 + times
per week

If your child was bullied, who was the bully (check all that apply)?
one student
a group of students
several different students
other
a teacher or other adult at school
1
2016
Please rate the degree to which each of the following statements is true for your child’s school:
not
true
somewhat
true
true
very
true
don’t
know
After school activities with adult supervision are available for my child
My child’s school has sufficient programming and/or curricula related to
citizenship and personal character
Students at this school are encouraged to/given opportunities to
participate in volunteerism/community service
Students at my child’s school typically behave in an orderly and respectful
manner
My child’s school lets me know when my child has done something well
The rules at my child’s school are clear, everyone knows what students
can and cannot do
The rules at my child’s school are fair and consistently applied
The teachers at my child’s school treat students fairly
The adults at my child’s school are respectful toward parents
The adults at my child’s school respect and/or care about the students
Students of different races, backgrounds, and interests get along with
each other at my child’s school
The students at my child’s school respect and/or care about each other
My child’s school offers the same opportunities for success to all students regardless of:
race/cultural background
gender
learning abilities/learning differences
income level
The students at my child’s school are respected and valued regardless of:
race/cultural background
gender
learning abilities/learning differences
income level
As compared to other schools in the district, this school receives enough
support and/or recognition from the district
My child’s school actively seeks ideas from parents on school-related
issues (e.g., changes to curriculum, safety procedures, new programs)
Parental involvement is valued by my child’s school
As a parent, I feel welcomed and included by my child’s school
The teachers at my child’s school are easily accessible and easy to talk to
2
2016
Please rate the degree to which each of the following statements is true for your child’s school:
not
true
somewhat
true
true
very
true
don’t
know
My child’s school tries to schedule parent meetings (e.g., parent-teacher
conferences, PTCO meetings, accountability meetings) at a variety of
times in order to accommodate parent schedules
The expectations of parental support at my child’s school are realistic and
appropriate
My child’s school lets me know what is expected of me/what I need to do
to support my child with their schoolwork
The principal and/or other administrators at my child’s school are easily
accessible and easy to talk to
Teachers at my child’s school provide lessons that:
are relevant to our family’s cultural background
introduce cultures that are different from our family’s cultural
background
The teachers in my child’s school reflect our family’s cultural background
When there is a problem with bullying/harassment at school, the school
staff know how to handle it and the situation improves
My child’s school has adequate crisis and emergency response plans in
place
My child would know what to do or would be instructed what to do in the
event of a crisis or emergency at school
My child’s school has plans for helping students feel better in the
aftermath of a crisis or emergency at school
I would call or email the CARE line if I had a concern about safety
My child’s school has adequate:
Measures to create a positive school environment
Acknowledgment for positive student behaviors
Procedures in place for monitoring visitors in the building
Safety/security personnel
Alcohol and drug prevention programs
Consequences for violation of the CCSD drug and alcohol policy
Consequences for violation of the CCSD weapons policy
3
2016
Please rate the degree to which each of the following statements is true for your child’s school:
not
true
My child’s school has adequately communicated to parents about:
somewhat
true
true
very
true
don’t
know
The process for visitor sign-in
Lockdown/secure perimeter procedures for parents
Lockdown/secure perimeter procedures for students
The number and type of security staff in the building
What parents should do if they have a safety-related concern
The school’s plans to help students following a crisis in the
school/community
The consequences for student violation of the CCSD drug and
alcohol policy
The consequences for student violation of the CCSD weapons policy
Please rate the degree to which you think each of the following is a problem for students who attend your
child’s school:
not a
problem
somewhat yes, a very much
a problem problem a problem
don’t
know
Bullying/harassment
Physical fighting/aggression
Weapons being brought to school
Alcohol use
Marijuana use
Use of drugs other than marijuana and alcohol
Gangs
Depression
Self-injury
Suicide
Stress/anxiety
Not enough sleep
Limited opportunities for physical activity at school
Nutritional choices at school
Internet safety (cyberbullying/ inappropriate
content/online predators)
Sexting (sending nude or partially nude pictures)
Do you have any comments about safety or the learning environment at your child’s school
(comments may be reviewed by the school):
4
2016