MVCS-YRRS

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Implied Consent

Filling in the form below affirms that you are over 18 years of age and that you consent to have your group-level responses to this questionnaire included in related technical assistance processes, research, and/or technical reports.

If you have any questions or concerns, please contact: Dr. Joseph P. Martinez at info@nmcpp.com

For more information and assistance, please visit positivepractices.com/tsas/

Thank you!

THANK YOU for taking the time to fill out this self-assessment questionnaire. Your responses will be held in strict confidence and your name/identity is NOT requested and will NOT be included in any related reports provided to the project sponsor or the public. Only the Center for Positive Practices (CPP) project staff and the project sponsor are allowed to see any individual entries, and only group-level data may be seen and used by schools, districts, and the public for research, planning and implementing services, and for assessing program effectiveness.

INSTRUCTIONS. Below are several questions designed to help you express your level of confidence for successfully completing the designated tasks. The tasks-related questions are derived from the upper levels of the NMTEACH Classroom Observation Protocol/Rubric. Keep in mind, this questionnaire is fully confidential, and we need to know the true feelings of all participants, so please be as honest as you can.

Any reference to "all students" includes culturally and linguistically diverse students, English learners (ELs), and students with disabilities (SWD). Any reference to New Mexico adopted standards includes the 2012 Amplification of WIDA English Language Development (ELD) Standards when serving English language learners (ELL), and Individualized Education Program (IEP) goals when serving students with disabilities.

Each question is based on a scale of 1 to 100, with 1 being no confidence and 100 being complete confidence. If you enter a zero, it may be counted as a blank, or non-response. Similarly, simply entering 90 or 100 across the board may cause the statistical system to discard the entire set of responses as not sufficiently variable.

Each question is preceded by the stem 'I feel confident that I can demonstrate to observers…' which is not necessarily an assessment of your future potential but rather your own self-assessment of your confidence to successfully demonstrate to observers the specified tasks at this point in time.

    1. I feel safe in school.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    2. I feel safe around other students before and after school.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    3. I eat breakfast in the morning.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    4. I eat a full meal at night.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    5. My teacher cares about me.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    6. I like riding the bus, or how I get to and from school each day.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    7. I want to get good grades.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    8. I like coming to school.
    • Never
    • Rarely
    • Sometimes
    • Often
    • Always
    This is a required question
    9. Grade:
      Please enter the number of your present grade (for example, K 1 2 3…)
    • Pre-K
    • K
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
    • 7
    • 8
    • 9
    • 10
    • 11
    • 12
    • Other:
    This is a required question
    10. SCHOOL:

    This is a required question
    11. NAME:

    This is a required question
    12. DATE:

    This is a required question
    13. Entered by (initials)

    This is a required question
    14. Project Specific Question #1
      This is a project specific question. If you know the question and have an answer, you can enter it here; otherwise, please go back to your project-specific form and answer it there.

    This is a required question
    15. Project Specific Question #2
      This is a project specific question. If you know the question and have an answer, you can enter it here; otherwise, please go back to your project-specific form and answer it there.

    This is a required question
    16. Project Specific Question #3
      This is a project specific question. If you know the question and have an answer, you can enter it here; otherwise, please go back to your project-specific form and answer it there.

    This is a required question
    17. Human -vs- Robot Question:
      Most fast-food joints sell a round sandwich called a… (hint: not a hotdog)

    Must contain burger
    This is a required question