HEALTHY SCHOOL CHAMPIONS RECOGNITION PROGRAM
APPLICATION AND SCORING RUBRIC
2015-2016
Name of School:
Date:
Directions: The following questions are to be completed by applicants. Please input
responses in the text box below each question. The text box will expand as you type. Note
the word limit for each question – portions of responses that exceed the assigned word
limits will not be read or scored by reviewers! Please reference the rubric below each text
box for further clarification into how each question will be scored by reviewers.
To submit: Please save your responses to the Healthy School Champions application and
upload completed applications and three signed letters here by 11:59 p.m. Monday, January
18, 2016. NOTE: Please make sure you have all materials completed and ready to submit before
accessing the link above. Additionally, please note that CEI will be closed on Monday, January
18, 2016 and no technical assistance will be available. We encourage you to submit your
application by January 15, 2016 if you need assistance from CEI staff.
1. Identify how you are incorporating best practices in each of the component areas of school health.
(750 word limit)
Component areas include: Nutrition; Physical Education/Physical Activity; Health Education; Health
Services; Counseling, Psychological, and Social Services; Healthy and Safe School Environments; Family,
Community, and Student Involvement; Staff Health Promotion
Excellent
17-20
The implementation of
best practices related to
school health is
demonstrated in ALL 8
component areas and best
practices in each of those
areas are specified.
Good
12-16
The implementation of
best practices related to
school health is
demonstrated in at least 6
of 8 component areas and
best practices in those
areas are specified.
Activities that are not
considered best practice
may be specified.
Fair
6-11
The implementation of
best practices related to
school health is
demonstrated in at least 4
of 8 component areas and
best practices in those
areas are specified. Best
practices in all of these
area are not necessarily
included but activities that
are not considered best
practice are noted.
Poor
0-5
The implementation of
best practices related to
school health is
demonstrated in fewer
than 3 of 8 component
areas and minimal
references to best
practices in those areas
are specified.
OR
The implementation of
best practices is not
demonstrated or the
questions is not answered.
Activities that are not
considered best practice
may be noted.
REVIEWER CONSIDERATIONS:
 In order to be eligible for an ‘Excellent’ score, all component areas must be addressed with the
implementation of best practices demonstrated in each area.
 Activities that are not considered best practice (i.e. one-time wellness activity or event) may be
included in the application and can be considered for scoring in the ‘Good’, ‘Fair’ and ‘Poor’
categories but should not be a consideration for scoring in the ‘Excellent’ category. For more
information on best practices, please see the Best Practices Guide for Healthy Schools here.
 Do not read or score text beyond 750 words.
2. Identify the ways your school administrators help to lead and/or support your healthy school
efforts. (350 word limit)
Examples of administrative support include: participating on the wellness team, supporting the
development and implementation of healthy school initiatives; supporting staff time and efforts focused
on healthy school initiatives; soliciting support from the broader school community and being an
outspoken proponent of integrating health into the overall school’s mission, systems, i.e., Unified
Improvement Plans, and environment.
Excellent
9-10
School administrators are
champions or changemakers for health and
wellness. They participate
on the wellness team and
often lead efforts, and
support innovation in the
development of healthy
school initiatives. They
encourage the use of staff
time toward healthy school
efforts. They solicit support
for health and wellness
from the broader school
community and are
outspoken proponents of
integrating health into
school systems.
Good
6-8
School administrators are
active supporters of
health and wellness
efforts. They participate in
wellness team events and
programs, and provide
ample support to the
wellness team to develop
healthy school policy
initiatives and delegate
staff or provide the
time/space for healthy
school efforts.
REVIEWER CONSIDERATIONS:
 Do not read or score text beyond 350 words.
Fair
3-5
School administrators are
passive supporters of
health and wellness efforts.
They are permissive of
health and wellness efforts,
particularly when they do
not require additional
resources or capacity,
conflict with another
directive, or affect systems.
They participate
occasionally in programs
and events.
Poor
0-2
School administrators’
involvement in healthy
school efforts is minimal,
and/or administrators do
not support the use of
staff time to focus on
healthy school efforts,
nor do they allow health
and wellness a voice at
the table during school
improvement planning.
OR
Administrator support is
non-existent or
adversarial, or the
question is not
answered.
3. Describe the dynamic of your wellness team that supports healthy school efforts. Include your
members’ titles, meeting frequency, and any major tasks completed or decisions made. (350 word
limit)
Schools can have a team specifically convened to address healthy school efforts. This team should
include a diverse group of stakeholders and plan/implement healthy school strategies and policies.
Excellent
9-10
Membership includes all
of the following:
administrators, parents,
students, community
members and school staff.
They meet at least
monthly. Includes more
than one example of a
major task completed or
decision made that had a
lasting, systemic effect on
students, staff, or the
school culture.
Good
6-8
Membership includes 3-4
of the following:
administrators, parents,
students, community
members and school staff.
They meet at least 5-6
times in a school year. At
least one example of a
major task completed or
decision made that had
positive effect on students,
staff, or school culture.
REVIEWER CONSIDERATIONS:
 Do not read or score text beyond 350 words.
Fair
3-5
Membership is limited to
school staff and/or missing
the voice of parents,
students, community
members, and
administrators. They meet
at least 3-4 times
throughout the school
year. May cite specific tasks
or decisions but does not
demonstrate how those
tasks or decisions have had
a positive effect on
students, staff, or school
culture.
Poor
0-2
Membership is lacking
and meetings are
infrequent or
inconsistent. Efforts to
build or improve team
and impact are unclear.
OR
Wellness team is nonexistent, is not
addressed, or question is
not answered.
4. What are the data sources you use? Show how those data have helped your school identify and
implement priority areas for healthy school efforts. (500 word limit)
Consider your student and school-level data sources such as Healthy Kids Colorado Survey, climate
surveys, needs and interest surveys, Smart Source, attendance records, discipline and referral records,
etc. and show that you’ve used these data to: identify student/staff needs, prioritize areas of
improvement, implement strategies to make improvements, and garner support/buy-in from the
broader school community.
Excellent
13-15
Multiple data sources are
used to assess needs and
gaps at the school and
student level. Illustrated
through multiple examples,
there is a systematic
process in place for
identifying, prioritizing,
implementing, and
garnering support for
health strategies, with a
clear connection
established between what
the data show and the
resulting healthy school
efforts. Data are used to
integrate health and
wellness into the overall
school system and
environment.
Good
9-12
More than one data
source is used to assess
needs and gaps at the
school and student level.
Results of these data
sometimes inform the
healthy school efforts that
are implemented, or there
is evidence of a link
between data and efforts.
Process for interpreting
and applying the data
exists, but may not
necessarily establish a
direct link between data
and overall healthy school
efforts.
Fair
4-8
At least one data source is
used to assess needs and
gaps. Some attempt is
made to identify priority
areas for healthy school
efforts based on data, but
does not establish a direct
link between data and
overall school health
efforts. Application may
demonstrate improving
the connection where it is
lacking.
Poor
0-3
A data source may be
cited, but data is not
actually used to inform
healthy school efforts, or
the process for
interpreting/applying data
is limited to non-existent,
and there is little evidence
of work to improve the
link.
OR
Data sources are not used,
data is not addressed, or
question is not answered.
REVIEWER CONSIDERATIONS:
 Assessment process and instruments are specified.
 Assessment is used to target gaps and opportunities for improvement.
 Staff, parent and student input are sought to identify priorities.
 Implementation of school health efforts directly links to priorities identified in data.
 Do not read or score text beyond 500 words.
5. How are community partners, parents, and students involved in the design and implementation of
healthy school efforts? (500 word limit)
Excellent
13-15
All three groups are at the
table as co-creators of
healthy school efforts.
Multiple examples of
partnerships and
contributions (ideas, time,
in-kind or monetary
support) from all three
groups are included.
Good
9-12
Two of these groups are
involved. Examples show
how their input and or
support is sought and
incorporated into design
and implementation of
healthy school efforts.
More than one example of
partnerships and
contributions (ideas, time,
in-kind or monetary
support) from at least two
of the three groups are
included.
REVIEWER CONSIDERATIONS:
 Do not read or score text beyond 500 words.
Fair
4-8
At least one of these
groups is involved.
Examples show that their
input and/or support has
been sought and
incorporated at least once
in the past, and a plan to
increase involvement is
evident. At least one
example of a partnership
and/or contribution (ideas,
time, in-kind or monetary
support) from at least one
of the three groups is
included.
Poor
0-3
Involvement from these
groups is minimal, or
application of their input
is unclear. Plan to
increase involvement is
not evident.
OR
Involvement is nonexistent, or question is
not answered.
6. Describe the ways you are working to sustain your healthy school efforts. (500 word limit)
Sustainability efforts include: evaluating the effectiveness of efforts, developing and/or enforcing
policies; securing ongoing funding support; securing in-kind support from the broader school
community; working to institutionalize healthy school efforts.
Excellent
13-15
A clear process is in place
to evaluate efforts, with
the goal of moving toward
continuous quality
improvement. Policies are
developed and enforced.
Examples of securing
funding and in-kind
support are provided. The
school community is
committed to creating a
culture of health. Progress
in institutionalizing health
efforts is specified.
Good
9-12
Examples of evaluating
efforts are provided with
the goal of moving toward
continuous improvement,
but process may not be
consistent. Some policies
are in place, and there
have been attempts to
pursue funding or in-kind
support. Work is
happening to
institutionalize healthy
school efforts.
Fair
4-8
Attempts have been made
to sustain healthy school
efforts through evaluation,
securing support, gaining
commitment from school
community, or developing
policies. However the
follow-through or results of
said attempts are unclear.
Poor
0-3
There have been minimal
attempts to evaluate
effectiveness of, or
sustain, efforts. “Fly by
night” programs or
initiatives, with no clear
plan to improve
sustainability.
OR
There have been no
attempts to sustain
efforts, or question is
unanswered.
REVIEWER CONSIDERATIONS:
• Narrative highlights how programs, activities, policies are evaluated and how results of that
evaluation inform future improvements.
• Narrative details the ways in which policies are developed and enforced.
• Progress in institutionalizing health and wellness efforts is specified.
• Details are provided regarding the sources and amounts of financial and in-kind support that
have been secured to support health programming.
• Do not read or score text beyond 500 words.
7. Explain how your healthy school efforts are integrated into your school systems and culture.
(500 word limit)
Excellent
13-15
Health and wellness is
foundational to the
school’s policies,
environment, and systems
(e.g., UIP process). Efforts
are consistently messaged
to the broader school
community, evidence of
the commitment of
teachers, parents, and
students toward creating
a culture of health is
provided, and the
importance of health is
spotlighted in the school’s
overall mission/vision.
Good
9-12
Health and wellness has a
voice at the table when it
comes to the school’s
development of policies,
environment, and
systems. Efforts are
sometimes messaged to
the broader community,
and the importance of
health and wellness is
emphasized but it may not
be apparent in the
school’s overall
mission/vision or the
school’s culture.
REVIEWER CONSIDERATIONS:
 Do not read or score text beyond 500 words.
Fair
4-8
Steps are being taken to
integrate health and
wellness into the school’s
policies, environment, and
systems. Examples of how
those steps lead to overall
systemic or cultural
changes are limited or not
addressed. Efforts may be
messaged to the broader
community but it is not
apparent in the school’s
overall mission/vision or
the school’s culture.
Poor
0-3
Healthy school efforts that
do occur can be
characterized as “extra”,
and in general, health and
wellness is marginalized.
No seat at the table for
school improvement
planning, and efforts are
not messaged to the
broader community.
OR
Health and wellness is
completely lacking in the
school systems and
culture, or question is
unanswered.
Thank you for completing the
Healthy School Champions Application!
As a reminder, please save your responses to the Healthy School Champions
application and upload completed applications and three signed letters here by
11:59 p.m. Monday, January 18, 2016. NOTE: Please make sure you have all
materials completed and ready to submit before accessing the link above.
HEALTHY SCHOOL CHAMPIONS RECOGNITION PROGRAM
APPLICATION CHECKLIST (completed by reviewer)
 Completion of Smart Source tool by Dec 31, 2015
 Three letters of support from your choice of the following: administrator,
teacher, parent, student, and/or community member
 Healthy School Champions Application
REVIEWER SCORING RUBRIC (completed by reviewer)
COMPONENTS
1. Identify how you are incorporating best practices
in each of the component areas of school health.
(750 word limit)
2. Identify the ways your school administrators help
to lead and/or support your healthy school efforts.
(350 word limit)
3. Describe the dynamic of your wellness team and
how it supports healthy school efforts. Include your
members’ titles, meeting frequency, and any major
tasks completed or decisions made. (350 word limit)
4. What are the data sources you use? Share how
those data have helped your school identify priority
areas for healthy school efforts. (500 word limit)
5. How are community partners, parents, and
students involved in the design and implementation
of your healthy school efforts? (500 word limit)
6. Describe the ways you are working to sustain
your effective healthy school efforts. (500 word
limit)
7. Explain how your healthy school efforts are
integrated into your school systems and culture.
(500 word limit)
TOTAL POINTS FROM ALL COMPONENTS
TOTAL POSSIBLE
POINTS
20
10
10
15
15
15
15
100
ACTUAL
POINTS