Delaware 21ST Century Community Learning Centers



Delaware 21ST Century Community Learning Centers

Site Visit Documentation

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|General Program Information |

Visit Date:

Cohort #:

Lead Agency Name:

Servicing School or School District:

Site Name/Location:

School Principal:

Program Director:

Site Coordinator:

Number of Staff Total in Budget Current Total Total Present

21st CCLC Part Time: __________ _______ ________

21st CCLC Full Time: __________ _______ ________

Other: __________ _______ ________

Total: __________ _______ ________

Number of Proposed Current Total Proposed Average Current Average

Participants Enrollment Enrollment Present Daily Attendance Daily Attendance

Funded by 21st CCLC: _______ _______ _______ _______ _______

Other: _______ _______ _______ _______ _______

Total: _______ _______ _______ _______ _______

Staff attendance at professional development in last 4 months

Environment/Climate /Health Academic Alignment/Achievement

Youth Participation/Engagement Program Sustainability/Growth

Parent/Family/Community Partnerships Relationships

Administration/Organization 21st CCLC Funding

Measuring Outcomes/Evaluation Programming/Activities

Other None

Notes:

Time spent developing lesson plans

None Monthly Weekly Daily Other

Notes:

Describe arrival process:

Describe Dismissal process:

Describe method of tracking attendance:

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #

Description:

Activity Leader:

Adult Staff Total: Certified Teacher: Specialist, Other:

Young Adult: HS Student: Volunteer: Other:

Activity Type:

1. Homework assistance 12.Study skills/test prep.

2. Reading/language art enrichment 13.Tutoring

3. Math/science enrichment puter skill building

4. Recreational reading/listening to puter games

5. Sports (competitive & non comp) 16.Sports: practice/drills /skill-building

6. Service/civic (in comm. or program) 17.Cultural awareness club/projects

7. Arts and/or crafts 18.Performing arts rehearsal/instruction

8. Boards/table/card games or puzzle 19.Health/well being

9. Fitness/exercise class 20. Snack, Dinner/Lunch

10. Arrival/dismissal 21. Higher Education or Career Orient.

/video watching 22.Other (specify)

Type of Space

Classroom Specialized studio/lab Games/club room

Gym Auditorium Cafeteria

Library Computer room Hallways

Outside playground/field Other (specify):

Participants Total: Girls: Boys:

Grades K 1 2 3 4 5

6 7 8 9 10 11 12

Knowledge/ Skill Areas

Interpersonal Physical/athletic Math/numeracy

Other Academic Artistic Problem-solving/decision-making

Reading/language arts None Other:

Materials used

Computers Art supplies Sports equipment Games

Trade, reference, research books Text books & workbooks

Writing materials Electronics media

Musical instruments None Other (specify):

Observation Time

10-15 minutes 16-25 minutes 26-30 minutes 31 or more minutes

Grouping Patterns

Large Group (15+) Medium Group (6-14) Small Group (2-5) Individual Working Alone

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #:

Description:

Activity Descriptions/Comments: Use the space below to describe the practices observed,

list any concerns about quality, overall affective, youth engagement, instructional process etc…

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #

Description:

Activity Leader:

Adult Staff Total: Certified Teacher: Specialist, Other:

Young Adult: HS Student: Volunteer: Other:

Activity Type:

1. Homework assistance 12.Study skills/test prep.

2. Reading/language art enrichment 13.Tutoring

3. Math/science enrichment puter skill building

4. Recreational reading/listening to puter games

5. Sports (competitive & non comp) 16.Sports: practice/drills /skill-building

6. Service/civic (in comm. or program) 17.Cultural awareness club/projects

7. Arts and/or crafts 18.Performing arts rehearsal/instruction

8. Boards/table/card games or puzzle 19.Health/well being

9. Fitness/exercise class 20. Snack, Dinner/Lunch

10. Arrival/dismissal 21. Higher Education or Career Orient.

/video watching 22.Other (specify)

Type of Space

Classroom Specialized studio/lab Games/club room

Gym Auditorium Cafeteria

Library Computer room Hallways

Outside playground/field Other (specify):

Participants Total: Girls: Boys:

Grades K 1 2 3 4 5

6 7 8 9 10 11 12

Knowledge/ Skill Areas

Interpersonal Physical/athletic Math/numeracy

Other Academic Artistic Problem-solving/decision-making

Reading/language arts None Other:

Materials used

Computers Art supplies Sports equipment Games

Trade, reference, research books Text books & workbooks

Writing materials Electronics media

Musical instruments None Other (specify):

Observation Time

10-15 minutes 16-25 minutes 26-30 minutes 31 or more minutes

Grouping Patterns

Large Group (15+) Medium Group (6-14) Small Group (2-5) Individual Working Alone

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #:

Description:

Activity Descriptions/Comments: Use the space below to describe the practices observed,

list any concerns about quality, overall affective, youth engagement, instructional process etc…

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #

Description:

Activity Leader:

Adult Staff Total: Certified Teacher: Specialist, Other:

Young Adult: HS Student: Volunteer: Other:

Activity Type:

1. Homework assistance 12.Study skills/test prep.

2. Reading/language art enrichment 13.Tutoring

3. Math/science enrichment puter skill building

4. Recreational reading/listening to puter games

5. Sports (competitive & non comp) 16.Sports: practice/drills /skill-building

6. Service/civic (in comm. or program) 17.Cultural awareness club/projects

7. Arts and/or crafts 18.Performing arts rehearsal/instruction

8. Boards/table/card games or puzzle 19.Health/well being

9. Fitness/exercise class 20. Snack, Dinner/Lunch

10. Arrival/dismissal 21. Higher Education or Career Orient.

/video watching 22.Other (specify)

Type of Space

Classroom Specialized studio/lab Games/club room

Gym Auditorium Cafeteria

Library Computer room Hallways

Outside playground/field Other (specify):

Participants Total: Girls: Boys:

Grades K 1 2 3 4 5

6 7 8 9 10 11 12

Knowledge/ Skill Areas

Interpersonal Physical/athletic Math/numeracy

Other Academic Artistic Problem-solving/decision-making

Reading/language arts None Other:

Materials used

Computers Art supplies Sports equipment Games

Trade, reference, research books Text books & workbooks

Writing materials Electronics media

Musical instruments None Other (specify)

Observation Time

10-15 minutes 16-25 minutes 26-30 minutes 31 or more minutes

Grouping Patterns

Large Group (15+) Medium Group (6-14) Small Group (2-5) Individual Working Alone

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #:

Description:

Activity Descriptions/Comments: Use the space below to describe the practices observed,

list any concerns about quality, overall affective, youth engagement, instructional process etc…

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #

Description:

Activity Leader:

Adult Staff Total: Certified Teacher: Specialist, Other:

Young Adult: HS Student: Volunteer: Other:

Activity Type:

1. Homework assistance 12.Study skills/test prep.

2. Reading/language art enrichment 13.Tutoring

3. Math/science enrichment puter skill building

4. Recreational reading/listening to puter games

5. Sports (competitive & non comp) 16.Sports: practice/drills /skill-building

6. Service/civic (in comm. or program) 17.Cultural awareness club/projects

7. Arts and/or crafts 18.Performing arts rehearsal/instruction

8. Boards/table/card games or puzzle 19.Health/well being

9. Fitness/exercise class 20. Snack, Dinner/Lunch

10. Arrival/dismissal 21. Higher Education or Career Orient.

/video watching 22.Other (specify)

Type of Space

Classroom Specialized studio/lab Games/club room

Gym Auditorium Cafeteria

Library Computer room Hallways

Outside playground/field Other (specify):

Participants Total: Girls: Boys:

Grades K 1 2 3 4 5

6 7 8 9 10 11 12

Knowledge/ Skill Areas

Interpersonal Physical/athletic Math/numeracy

Other Academic Artistic Problem-solving/decision-making

Reading/language arts None Other:

Materials used

Computers Art supplies Sports equipment Games

Trade, reference, research books Text books & workbooks

Writing materials Electronics media

Musical instruments None Other (specify):

Observation Time

10-15 minutes 16-25 minutes 26-30 minutes 31 or more minutes

Grouping Patterns

Large Group (15+) Medium Group (6-14) Small Group (2-5) Individual Working Alone

21ST CCLC After School Program Evaluation

Description of Activity Observed Activity #:

Description:

Activity Descriptions/Comments: Use the space below to describe the practices observed,

list any concerns about quality, overall affective, youth engagement, instructional process etc…

21st CCLC Afterschool Program Evaluation Measure

Note to the monitors/observers: If an observed measure scores less than 3 or more than 5 please explain it under notes.

Human Relationships:

1) Staff greet children effectively and consistently N/A

a. QUANTITY

1 2 3 4 5 6

|Little or no greeting to children. |Some children were greeted |All or almost all children were |

| | |greeted. |

Notes:

b. QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Indifferent or neutral reaction to children during |Moderate respect and attention; some attempts to make|Children were greeted individually;|

|arrival. |children feel welcome. |effectively, respectfully and |

| | |consistently. Staff appear |

| | |genuinely interested in each child.|

Notes:

2) Staff relate to children and youth. N/A

a. QUANTITY

1 2 3 4 5 6

|Virtually no interaction; hardly ever speak to |Some interactions; sometimes listen to them. |Often interact through talk or |

|children. | |behavior. |

Notes:

b. QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Very negative; poor listening, interactions seldom |Moderate respect and attention; some attempts to make|Very positive and engaged |

|indicate any respectful or positive reaction to |children feel welcome and accepted when relating to |relations; treat them with respect |

|needs of child. |them. |and react positively according to |

| | |individual needs. |

Notes:

3) Staff responds to the individual needs of children and youth. N/A

a) QUANTITY

1 2 3 4 5 6

| Never responds to needs and requests of children. |Some interactions; sometimes react to them in regard |Almost always responds to child’s |

| |to specific needs and requests. |requests and needs. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Very inappropriate; responses indicate almost no |Somewhat appropriate; occasionally relate to them in |Very good fit between responses and|

|relationship with the personal needs of the |a way that acknowledges their personal temperament |needs of children; able to react to|

|children. |and needs. Sometimes provide support when child needs|range of feelings, temperaments, |

| |extra attention. |and specific requests. |

Notes:

4) Staff provide opportunity to foster positive self-esteem N/A

c) QUANTITY

1 2 3 4 5 6

|Few opportunities for children to successfully learn|Some opportunities for children to develop and some |Many different opportunities to |

|activities and little or no positive adult |positive adult recognition. |appropriately challenge students and |

|recognition/ praise. | |staff provide positive |

| | |acknowledgment. |

Notes:

d) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| Very discouraging; never indicate appreciation for |Moderate degree of encouragement; sometimes give |Very encouraging and responsive |

|students’ choices. May go to other extreme and |children chances to choose and control their |guidance; offer choices to control |

|overwhelm child with too many choices for their |activities, sometimes do not seem to be able to react|activities without overwhelming |

|personal needs. |to students’ desire to control their choices. |child or inaccurately assessing |

| | |child’s ability to lead. |

Notes:

4) Staff encourage children and youth to make choices and to become more responsible.

N/A

a) QUANTITY

1 2 3 4 5 6

|Little or no opportunities to make choices. |Some opportunities to make choices; sometimes |Frequently allow children to have |

| |encourage children to take leadership roles. |choices in what they do, how they |

| | |do it, and with whom. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| Very discouraging; never indicate appreciation for |Moderate degree of encouragement; sometimes give |Very encouraging and responsive |

|students’ choices. May go to other extreme and |children chances to choose and control their |guidance; offer choices to control |

|overwhelm child with too many choices for their |activities, sometimes do not seem to be able to react|activities without overwhelming |

|personal needs. |to students’ desire to control their choices. |child or inaccurately assessing |

| | |child’s ability to lead. |

Notes:

5) Staff interact with children and youth to help them learn. N/A

a) QUANTITY

1 2 3 4 5 6

|Very low degree of interaction for learning; |Some sharing of skills and resources; occasional |Often interact with children in |

|children are largely left on their own and are |conversations with them during lessons. |learning opportunities. |

|subject to one approach to learning only. | | |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Never encourage conversation to practice skills; |Somewhat attentive to students’ need for interaction;|Very fitting interaction with |

|either converse in a way that shuts down learning or|sometimes vary approach to learning according to |children: conversations help |

|effectively does it for the children instead of |child, sometimes do not share resources available |facilitate learning and allow for |

|letting them use their skills. |with children who need them. |children to solve problems for |

| | |themselves when they are able. |

Notes:

7) Children and youth generally interact with one another. N/A

c) QUANTITY

1 2 3 4 5 6

|Very little opportunity for peer interaction. |Some occurrence of interactions. |Frequent interactions between |

| | |children. |

Notes:

d) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Negative interactions are the norm; children seem |Some room for positive and appropriate interaction |Very positive interactions; |

|tense and atmosphere is either under- or |between children; children are sometimes given a |children are able to relax and seem|

|over-controlled so that positive peer interactions |chance to work out conflicts for themselves and solve|to respect one another and can |

|are not facilitated. |problems together. |usually cooperate successfully. |

Notes:

Indoor Environment:

8) The program’s indoor space meets the needs of children and youth. N/A

a) QUANTITY

1 2 3 4 5 6

|There is not enough room for all program activities:|Space is somewhat sufficient; sometimes there seems |Indoor space is quite sufficient to|

|areas are frequently overcrowded and resources are |to be room to move around and arrange materials, but |meet the needs of the children: |

|inaccessible to children. |sometimes it seems too chaotic or crowded. |there is plenty of room for |

| | |activities and to display relevant |

| | |materials. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Very poor; indoor activities often interfere with |Space is appropriate in some ways; sometimes shared |Very good; space allows maximum |

|each other, or space does not allow for all program |space is maximized and things can go on at the same |access to resources, it appears |

|activities; there is no indoor space for active play|time without disruption. Other times the space |that all areas as useable and space|

|during bad weather, and the area is uncomfortable |restricts the students’ activities or noise levels. |allows for a range of activities. |

|and inappropriately arranged. | | |

Notes:

9) The indoor space allows children and youth to take initiative explore and their interests.

N/A

a) QUANTITY

1 2 3 4 5 6

| Little or no room for unstructured activities or |Some room for children to “do their own thing”; some |Plenty of room for varied |

|exploration outside of planned activities. |parts of area allow for exploration without |activities; no areas being avoided |

| |disruption of others in shared space. |by children, and there is room to |

| | |arrange the materials to suit their|

| | |needs. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Very poor; space is not comfortable and does not |Some opportunities to explore; some areas facilitate |Extremely flexible and useful |

|invite independent choice of activities. Children do|students’ movement and provide easy access to |space; room for usage and storage |

|not have access to resources available unless they |materials, but some parts of space are not supportive|of materials, and ability for |

|are part of a planned activity. |of anything unplanned. |children to manipulate resources |

| | |without aid. |

Notes:

10) The indoor space displays program rules and children’s work. N/A

a) QUANTITY

1 2 3 4 5 6

|Little or no displays of rules or students’ works. |Some displays of rules and students’ works. |Plenty of displays of program rules|

| | |and students’ works. |

Notes:

b) QUALITY &APPROPRIATENESS

1 2 3 4 5 6

|Space does not indicate attention to displays; rules|Some students’ work is displayed, and there are some |Good use of display space; rules |

|for behavior are not posted, virtually no students’ |up-to-date bulletin boards, but not all of it is up |are clearly displayed, students’ |

|work is displayed, and there are no displays related|to date or appears to be updated regularly. |work is prominently displayed, and |

|to current class activities. | |there are up to date, attractive |

| | |bulletin boards. |

Notes:

11) The program provides functional building facilities for children and youth. N/A

c) QUANTITY

1 2 3 4 5 6

|Little or no areas with adequate facilities; broken |Some suitable qualities to environment; may have some|Adequate or excellent facilities; |

|or missing bathroom components, lights, temperature |bathroom access or limited control of heat and light.|plenty of bathroom access, easily |

|control. | |controlled heat and light sources. |

Notes:

d) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Facilities are unclean and uncomfortable, with |Facility is somewhat healthy; some areas are clean |Facility is healthy for children; |

|inadequate hand washing equipment. |and comfortable, and there may be limited access to |area is clean, comfortable, and |

| |hand washing areas. |provides adequate and accessible |

| | |supplies for hand washing. |

Notes:

Activities:

12) Today’s schedule is flexible and attentive to needs of all children and youth. N/A

a) QUANTITY

1 2 3 4 5 6

|Little or no schedule of activities evident. |Some evidence of scheduled activities; at least part |Schedule is clear and evident to |

| |of schedule seems known. |children |

Notes:

b) QUALITY & APPROPRIATENESS

|1 2 6Very rigid schedule; does not | 3 4 | 5 6 |

|allow for individual needs of children, nor for them| |Many opportunities for flexibility |

|to move through activities at their own pace. |Some opportunities for flexibility and attention to |and the addressing of individual |

| |individual needs; some activities allow children |needs; children can be as |

|There are no regular opportunities for choice. |individual room to set their own pace. |independent as they like without |

| | |derailing the schedule for |

| | |everyone. |

Notes:

13) Children and youth can choose from a wide variety of activities N/A

a) QUANTITY

1 2 3 4 5 6

|Very few activities. |Some different activities. |Wide variety of activities. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| There are no regular opportunities for choice; It |Some range of activities available, children don’t |Variety of quality choices |

|is overly controlled or overly chaotic, and there is|always get to choose (e.g., physical play, creative |available; children may often |

|little to no variability. |play, quiet time, etc. may be available but only by |decide what they want to do. |

| |assignment). | |

Notes:

Safety, Health & Nutrition:

14) Children and youth are carefully supervised. N/A

a) QUANTITY

1 2 3 4 5 6

| Little or no supervision evident; staff is often |Some supervision; staff are occasionally present |Staff are always present during |

|unaware of location and activity of children. |during students’ activities. |students’ activities. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Students are seldom supervised properly; may be |Students are somewhat supervised, but there are times|Students are well supervised; staff|

|unmonitored during potentially dangerous activity, |when some of them are unaccounted for or receiving |takes action according to needs of |

|supervision is not tailored to needs of child, and |inappropriate supervision according to their ages, |child and monitors potentially |

|no one keeps track of comings and goings of |needs or abilities. |harmful situations very carefully. |

|children. | | |

Notes:

Materials:

15) There are materials to support program activities. N/A

a) QUANTITY

1 2 3 4 5 6

|Very few or no materials available to staff and |Some limited access to materials; may only have |Plenty of materials for program |

|children. |enough for some of the children or some of the |activities; enough for all children|

| |activities. |and activities. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

|Materials are in poor repair, incomplete, or |Materials are somewhat functional and available; |Materials are complete and in good |

|missing; there are not enough to go around or they |there may be some broken things, or some times when |working order; there are enough for|

|are not appropriate to today’s program activities. |there are not enough materials for all children to |the children in the program, and |

| |participate in an activity, or children have to wait |they are developmentally |

| |to use them. |appropriate. There are varied |

| | |materials for children with |

| | |differing abilities and interests. |

Notes:

Teaching Performance:

16) Staff guide the behavior of children and youth. N/A

a) QUANTITY

1 2 3 4 5 6

|No guidance evident. |Some guidance, but not consistent across all |Adequate amount of consistent |

| |situations or children. |guidance. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| Extremely low or high behavioral limits set; either|Occasionally suitable guidance; some limits |Guidance consistently appropriate, |

|no rules or discipline, or total control without |reasonable, but not necessarily all of them. |no harsh discipline; children are |

|allowing children to resolve their own conflicts | |encouraged to work out their own |

|when possible. | |conflicts, with staff intervention |

| | |only if needed to work things out. |

Notes:

17) Staff/child ratios permit staff to meet the needs of children and youth. N/A

a) QUANTITY

1 2 3 4 5 6

| Ratios are insufficient; less than 1:15 for |Sometimes optimal ratios; other times inadequate |Staff ratios are optimal: between |

|children 6 and older, and less than 1:12 for |ratios. |1:10 to 1:15 for children age 6 and|

|children under age 6. | |over, and between 1:8 and 1:12 for |

| | |those under six. |

Notes:

b) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| Inadequate staff for types and complexity of the |Some students’ needs are met; some group’s have |Staff coverage varies according to |

|group’s activities. |acceptable ratios, but some groups do not appear to |activities and needs of children. |

| |have enough coverage for the activity they are doing.| |

Notes:

18) Staff works together to meet the needs of children and youth. N/A

c) QUANTITY

1 2 3 4 5 6

|Staff members work independently. |Staff works together at some times. |Staff works together most or all of|

| | |the time; always appear to be a |

| | |team. |

Notes:

d) QUALITY & APPROPRIATENESS

1 2 3 4 5 6

| Staff does not appear to be cohesive or act |Staff sometimes appears cooperative and |Staff works very well together; |

|professional and respectful with one another; they |communicative; at other times they may not keep |they are cooperative, respectful, |

|are poor role models of positive adult |interactions professional or check with one another |communicative, and model positive |

|relationships. |to make sure all needs are met. |verbal and non-verbal interaction. |

Notes:

21st CCLC After School Program Evaluation Measure

Date: Site/Program:

|Observations by: |N/A |* Quantity |* Quality & |

| | | |Appropriateness |

|Human Relationships: | | | |

|Staff greet children effectively and consistently. | | | |

|Staff relate to children and youth. | | | |

|Staff respond to the individual needs of children and youth. | | | |

|Staff provide opportunity to foster positive self-esteem | | | |

|Staff encourage children and youth to make choices and to become more responsible. | | | |

|Staff interact with children and youth to help them learn. | | | |

|Children and youth generally interact with one another. | | | |

|Indoor Environment: | | | |

|The program’s indoor space meets the needs of children and youth. | | | |

|The indoor space allows children and youth to take initiative and explore their | | | |

|interests. | | | |

|The indoor space displays program rules and students’ work. | | | |

|The program provides functional building facilities for children and youth. | | | |

|Activities: | | | |

|Today’s schedule is flexible and attentive to needs of all children and youth. | | | |

|Children and youth can choose from a wide variety of activities | | | |

|Safety, Health & Nutrition: | | | |

|Children and youth are carefully supervised. | | | |

|Materials: | | | |

|There are materials to support program activities. | | | |

|Teaching Performance: | | | |

|Staff guide the behavior of children and youth. | | | |

|Staff/child ratios permit staff to meet the needs of children and youth. | | | |

|Staff works together to meet the needs of children and youth. | | | |

Monitor-Were other activities available to the program participants that you have not described?

Yes No

If so, please list:

Please share the procedures you use to ensure the security of the 21st CCLC expendable and

non-expendable 21st CCLC property e. g. inventory list, tag, written policies etc.

2010-2011 After-School Program Schedule

Starting Date:

Ending Date:

Hours:

Additional Comments:

|Monitor Information |

Date of Observation:

Observer(s) Name (s):

Length of Visit:

Travel Time:

Travel Distance: miles

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