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Currency [0]/Explanatory TextG5Explanatory Text % 0Good;Good  a%1 Heading 1G Heading 1 I}%O2 Heading 2G Heading 2 I}%?3 Heading 3G Heading 3 I}%234 Heading 49 Heading 4 I}% 5InputuInput ̙ ??v% 6 Linked CellK Linked Cell }% 7NeutralANeutral  e%3Normal % 8Noteb Note   9OutputwOutput  ???%????????? ???:$Percent ;Title1Title I}% <TotalMTotal %OO= Warning Text? Warning Text %XTableStyleMedium9PivotStyleLight16`mq Instructions9 Cover pageٙSummary input formDistrict summary sheet\Charts  ;*  ;G  ;'* );;4h,  3 A@@  I|]9School Self-Assessment for Culturally Responsive PracticeC. Behavior Management SubdomainsB. School Climate Domain TotalIB. School ClimateII. Family InvolvementIII. CurriculumIVA. Teaching & Learning#IVB. Classroom Achievement & Assmt.IVC. Behavior Management)VA. Pre-Referral and Referral Procedures Score (%)%A. School Governance, Org. & Policy $A. Pre-Referral/Referral Procedures!B. Classroom Achievement & AssmtB. Assessment & InterventionA. Teaching & Learning%IA. School Governance, Org., & PolicyDomain/ SubdomainAvg DOMAIN TOTALS OVERALL SCOREIB. School ClimateIII - CurriculumDomains and Subdomains Cover PageDistrict Name:Superintendent: Facilitator:Team Leader Name!District Summary Sheet and ChartsSummary Input Form@Instructions for Completing the District Self-Assessment SummarygThe district summary should be prepared after all participating schools have completed their individualI. Domain TotalIV. Domain TotalV. Domain TotalVB. Assessment & Intervention Score (#) # Possible:District Summary Scores Across All Domains and Sub-Domains0District Primary Domain Scores and Overall Score!School Building Summary Results**XNote: A score at or above 75% (the green line) indicates a relative strength. A scorecschool building summaries and submitted them to the District Facilitator. Prior to completing this-Enter information into the yellow cells only.d the icon in the top right corner of this worksheet, immediately to the left of the "X" icon).=Domain I - School Governance, Organization, Policy, & ClimateDomain II - Family InvolvementDomain III - Curriculum%Domain IV - Organization of Learning ;Domain V - Special Education Referral Process and Programs 5Domain I - School Governance, Org., Policy, & ClimateB at or below 50% (the red line) indicates a relative weakness.U2. Enter the names of the school district, superintendent, and district facilitator.c1. Click on the tab below to navigate to the "Summary input form" worksheet. This is the form you/Aq1. Click on the tab below to navigate to the "Cover page" worksheet (if you are unable to see the tabs, click on/9E^2. Using the "Building summary sheet" from each school, enter in the summary number score for%3complete these two pages - no input is necessary. a4. The Cover Page also provides space for you to provide additional information and/or feedback.**Note - the numbers in row 5 of this worksheet do not have to correspond to the school building's number from the "Cover Page".t ~School Building Namef3. Enter the full names of the school buildings participating in the self-assessment (i.e. - FranklinY Elementary, Cascade High), as well as the name of the team leader for each building.g will use to enter the individual building summary results from each participating school building.e3. Each building's summary results should be placed in a separate column - the results for the firstb building should be entered into the column marked "1", the second into column "2", etc. The b4. The column marked "Avg" will automatically calculate the average for each domain and use these5 averages to calculate your district's summary. fThese two sheets show the results of your district's questionnaires. The worksheet will automatically` rows on the input form are in the same order as the items on the "Building summary sheet". G]>Instructions for Completing the District Questionnaire Summaryvcopy). Note - it may be helpful to print a hard copy of these instructions for reference as you complete the summary.hsummary, the Facilitator should obtain each school's Building Questionnaire Summary (electronic or hard 5?S.Schools Participating in the Self-Assessment: +DISTRICT QUESTIONNAIRE SUMMARY - COVER PAGEa each building (not the percentage score). These numbers are found on the "Building summary   P1 sheet", in the column labeled "Score (#)".  $ - District Summary Charts:District Summary Sheet+District Questionnaire Summary - Input Form3Domain V - Special Ed. Referral Process & Programs 'IA. School Governance, Org., & Policy %IVB. Class. Achievement & AssessmentIVC. Behavior ManagementVA. Pre-Referral Procedures&I - School Gov, Org, Policy, & ClimateII - Family InvolvementIV - Organization of LearningV - Special Education ReferralIn the box below, please provide any additional information that you would like to share. This could include: (1) the Facilitator's response to the self-study results, (2) actions/improvement activities that the district intends to implement based on the results of the self-study, or (3) additional information that might assist the district's self-study team in developing an appropriate plan of action.The results of the district's self-assessment can be a valuable tool in identifying the strengths and weaknesses in the educational services that your district provides. There are many ways in which this instrument might be used to assist your district in providing the best opportunities possible for culturally and linguistically diverse students. 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