• Reason for phone call:

  • Were you able to conduct a program site visit without interruptions from another school site?

  • What is the plan of action?


  • Was the Site Coordinator on campus?

  • Were all employees following proper dress code?

  • Was there inappropriate Physical Interaction?

  • Does the program meet the recommended number of student to staff ratio?

  • Does the Activity Leader use appropriate Classroom Safety Awareness (i.e., scanning classroom, court vision, facing the students, setting expectations, follow through, etc.)

  • Were release time procedures handled properly?


  • Did the Activity Leader engage all students?

  • In reviewing the Activity Leaders lesson plans, were the lesson plans current and appropriate?

  • Were transitions fluid?

  • Does the site have bathroom and water fountain usage procedures and are they followed?

  • Are attention getters used?

  • Is student discipline clear, consistent and fair?

  • Did you observe the use of Positive Re-Direction when needed?


  • Are all staff members arriving on time daily?

  • Are time sheet logs prepared daily?

  • Are all staff members wearing district issued vests?

  • Did staff members follow the non-use of personal cell phone policy at the site?

  • Were activity leaders using allocated prep time appropriately?

  • Did staff members follow their lesson plan?

  • Was proper walkie talkie etiquette used?

  • Was there effective communication with program staff?


  • During this visit was school administration available to meet?

  • What are your commendations or suggestions for improvement?

  • Were there any Site Celebrations?

  • Any other notes:

  • Add signature

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