Title Page
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School Name
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Site Visit Date
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Prepared by
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Start Time:
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End Time
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School Personnel Involved
Site Visit Review Items for the Month
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Site Visit Review Items
Comments and Documentation
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Other Items Discussed
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Stakeholder Data to be Collected
- Governing Authority Members
- Students
- Parents
- Staff
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Stakeholder Interviews
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Technical Assistance Provided
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Areas of Strength
Areas of Improvement Identified This Month
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Area of Improvement
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Action Steps Required
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Timeframe for Completetion
Follow- Up on Previously Identified Areas for Improvement
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Area for Improvement
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Progress of Required Action Steps
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Timeframe for Completion
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Improvement Progress
- Unmet
- Progressing
- Met