STAFF SKILLS INVENTORY
(To be conducted annually)

Name:  _______________________________________________ Room #  ________

Please check any of the following in which you have expertise or training:

Emergency response:

___ First aid   ___ Search and Rescue   ___ Emergency Management

___ CPR   ___ Law Enforcement Source  ___ CISD (Critical Incident
                 Stress Debriefing)

___ EMT    ___ CB Radio    ___ Ham Radio

___ Firefighting  ____ Other (specify):  ________________________________
 

___ Cellular Phone which could be used in an emergency:  PH #   _____________________

Bi/multilingual Language(s):  ___________________________________________________________________________

___________________________________________________________________________

SURVEY OF STUDENTS/STAFF WHO NEED SPECIAL ASSISTANCE IN EDUCATION
(To be conducted each semester)

  Name     Grade/Location   Type of Assistance Needed

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________

___________________________  _____________  ______________________
 

CRISIS RESPONSE TEAM REPORT TO SUPERINTENDENT
REQUIRED REPORT (Due within 5 days of incident)

School:  ______________________________  Date of Report:  ___________________

Description of incident (include date, time, place):
 
 
 

Immediate actions by Crisis Response Team:
 
 

Describe assistance provided by Emergency Services:
 
 

Describe assistance provided by other community agencies/organizations:
 
 

Follow-up which has occurred/is occurring:

· With students:
 

· With faculty/staff:
 

· With parent(s)/guardian(s) of student(s) involved:
 

· With community:
 

Recommendations to improve responses to such crises in the future:
 
 

Principal Signature:  ______________________________  Date:  _______________

* Attach a list of students directly involved in the incident including their grade levels and
parents� names, addresses, and phone numbers.
 

EVALUATION OF CRISIS RESPONSE TEAM INTERVENTION
 

The Crisis Response Team (CRT), consisting of both the school guidance staff and the area school student services staff, seeks your input to help us assess the effectiveness of the intervention during the recent crisis at your school. We would appreciate your taking a few minutes of your time to complete this form as soon as possible and return it to the Crisis Response Team Coordinator.

Please indicate with an �X� the response which most closely reflects your evaluation of the following:

   (Use a scale of 1 - 5 with 1 being the lowest and 5 the highest)

1. Speed of CRT�s response to the crisis:
        very delayed - adequate - very timely:  _____

2. Comprehensiveness of CRT�s response:
        very limited - adequate - exceptional:  _____

3. Effectiveness of team�s responses in meeting students� needs:
         not helpful - adequate - very helpful:  _____

4.  Assistance to teachers in the classroom:
        not supportive - adequate - very supportive:  ____

5.  Quality of communication with the school faculty and staff:
        not informative - adequate - very explanatory:  _____

6.  Support and guidance to individual teachers and staff:
        ineffectual - adequate - very empathic:  _____

7.  Assistance to the administrative staff:
        limited - adequate - comprehensive:  _____

8.  Amount of time allocated for intervention:
        insufficient - adequate - very sufficient:  _____

9. Support to families in need:
        lacking - adequate - outstanding:  _____

10.  Communication of information to parents:
        minimal - adequate - thorough:  _____
 

II.  Please circle all the adjectives which best describe the students� reactions to the CRT�s intervention:

     satisfied      positive     negative     angry       ambivalent

     receptive     grateful      hostile      relieved      apathetic
 

III.  Please describe any significant reactions the students had to the CRT intervention which should be considered in future interventions.
 
 
 
 
 
 
 
 
 
 
 
 
 

IV.  Please comment on any aspects of the intervention you found particularly helpful or areas which you think should be modified.
 
 
 
 
 
 
 
 
 
 
 
 
 

School:   _________________________________________

Signature (optional):  ____________________________________________________

Return to: Crisis Response Team Coordinator

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