Supplemental Modules - Series 2

Grade 5

Elementary Module

Grade 7 & Above

Core Module

Supplemental Modules - Series 1 (Original)

Supplemental Modules - Series 2

Gang Risk Awareness Module (supplemental fee)

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 GRAM Module

Elementary School Version:

English (pdf)
Spanish (pdf)

Middle and High School Version:

English (pdf)
Spanish (pdf)

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

For more information about this module contact Leslie Poynor at lpoynor@wested.org or (510) 302.4241.

Service Learning Module

In collaboration with the CDE Counseling Student Support and Service Learning Office, WestEd has developed a new module, specifically for schools that conduct service learning.

The six-question module collects information from students on the quality of their service learning activities and the impact of service learning on a number of domains measured by the CHKS.

Download Service Learning Module

Elementary School Version:

English (pdf)
Bilingual (pdf)

Middle School Version:

English (pdf)
Spanish (pdf)

High School Version:

English (pdf)
Spanish (pdf)

Note: If you are doing more than one Service Learning Module, please contact your Cal-SCHLS Regional Center. For general information about this module contact Kiku Annon at kannon@wested.org or (562) 799.5127.

Closing the Achievement Gap (CTAG) Module

For the CHKS, a short 10-question supplementary CTAG Module was developed that assesses student perceptions concerning extra help with school work, academic rigor, the cultural relevance of lessons, equity in opportunities, and fair and respectful treatment of all students. These questions align with new CTAG-related questions on the California School Climate Survey (CSCS), so that staff and student perceptions can be compared. These new questions greatly enhance the value of both the CHKS and the CSCS as tools to guide school-improvement efforts for all students.

Download CTAG Module

Middle and High School Versions:

English (PDF)
Spanish (PDF)

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 Military Connected School Module

Elementary School Version (25 items):

English (pdf)
Spanish (pdf)

Middle School & High School Version (39 items):

English (pdf)
Spanish (pdf)

School Climate Module

To assess school climate more extensively, this module assesses in more depth issues of academic rigor and supports, respectful relationships and cultural sensitivity, the relevance of classroom lessons, student learning motivation and classroom involvement, discipline and enforcement of rules, and the quality of facilities maintenance. Developed for use in California’s Safe and Supportive Schools Project Survey, this module enhances the ability of users to make comparisons of Cal-SCHLS student, staff, and parent survey data on school climate in order to guide school improvement efforts.

Download School Climate Module

High School Version (16 items):

English (pdf)
Spanish (pdf)

After School Program Module

The After-School Intake and Exit Modules are part of California’s 21st Century Community Learning Centers (21st CCLC) focus on helping children and youth in schools serving high-poverty areas succeed academically through the use of scientifically-based practice and extended learning time. These surveys are designed to look at the how an after school program is impacting their participants in the areas of youth development reducing participant risk behaviors and in enhancing resilience, safety, school connectedness, and several key educational outcomes.

Download After School Program Module

Grades 4-6:

Intake (pdf)
Exit (pdf)

Grades 7-12:

Intake (pdf)
Exit (pdf)

Building Healthy Communities (BHC) Module

Building Healthy Communities Grants. These grants provide services to schools as part of an ongoing effort to help children grow up in healthy, strong, supportive environments.

Download BHC Module

High School Version (39 items):

English (pdf)
Spanish (pdf)

School Health Center (SHC) Module

The School Health Center module looks at student access to and use of school based health centers.

Download SHC

High School Version (23 items):

English (pdf)

California Student Survey (CSS) Module

The California Student Survey (CSS) is a voluntary, anonymous, and confidential self-report survey of substance use, school safety, harassment and violence, youth resilience factors, and health-related behaviors. California law requires that the survey be conducted every two years among a representative statewide sample of students in grades 7, 9, and 11 in order to monitor and prevent adolescent risk behaviors and promote positive youth development, health, and well-being.

Download CSS Module

Middle School Version (12 items):

English (pdf)
Spanish (pdf)

High School Version (23 items):

English (pdf)
Spanish (pdf)

Drug Free Communities (DFC) Module

Approved for Drug Free Communities (DFC) and Sober Truth on Preventing Underage Drinking Act (STOP ACT) grantees, this 11 question supplemental module (for middle & high school) is approved by ICF for meeting their reporting requirements with CSAP/ONDCP.

Download DFC Module

Middle and High School Version (11 items):

English (pdf)
Spanish (pdf)