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Elementary Module (Grade 5)


Core Elementary Module

The single (non-modular) elementary school survey is built around CHKS Core and Resilience & Youth Development items. It is intended for use in grade 5, but it is also appropriate for grades 4 and 6.

The elementary survey contains many of the same or similar items as the middle school version, so that cross-survey comparisons can be made. For these items, the wording is simpler and developmentally appropriate.

Download Core Elementary Survey

Social Emotional Health Module

The Social Emotional Health Module is enhances the value of the CHKS as a strength-based assessment of youth empathy, self-efficacy, self-awareness, persistence, emotional self-regulation, behavioral self-control.

Download Social Emotional Health Elementary Module

Cal-Well Module

This module assesses students’ mental health, the availability of adult and peer social supports, access to mental health services, and students’ openness to utilizing mental health supports and services.

Supplemental Health Module

The Supplemental Health Module contains items on weight perception, exercise, seat belt and helmet use, neighborhood safety and cyber-bullying.

Download Health Elementary Module

District After-School Module (DASM)

District After-School Module for districts with After-School Programs (ASPs)

The items in this module are for schools and districts that have students attending an after-school program. This may be a program run in conjunction with the school or as a separate entity. The questions assess how students spend their time after school, if they attend an ASP and issues related to safety.

Note: This module is part of the regular CHKS given in school. It is not the After-School Program Survey, which is administered in after-school programs.

Download Elementary School Module

Gang Risk Awareness Module

Developed in conjunction with Sonoma County and the City of Santa Rosa, the Gang Risk Assessment Module (GRAM) gathers information on gang involvement, perceptions, knowledge, attitudes, and risk factors, as well as related, and alternative activities among youth grades 5 and up. The GRAM includes questions recommended by the US Office of Juvenile Justice and Delinquency Prevention.

Download Elementary School Module

To sign up please go to Sign Up or call (888) 841.7536.

Military Connected School Module

The military module will allow schools to gather anonymously the views of students about their schools and their educational needs. The voices of students will be used to establish sustainable military-friendly school climates that improve social, behavioral, and academic outcomes.

Download Elementary School Module

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