21st Century Community Learning Centers
Summer 2013/School Year 2013-14
Pa Grantee Report Question Guide
Grantees may use this guide to prepare answers for entry into the web-based Pa Grantee
Report for summer 2013 and school year 2013-14 21st Century Community Learning Centers
programs. Narrative answers may be copied and pasted from this document. Do not turn
this Question Guide in as your report. You must complete your report online. Grantees will
receive login information when the online system opens, typically in June.
Complete ONE (1) report per grantee, per cohort. The report should address program and
implementation information for all centers operated by the grantee through 21st Century
funds for summer 2013 and school year 2013-14. If your program/organization receives
funds through more than one funding cycle (cohort), you must complete one report that represents the programming and students
supported by that cohort’s funds. If you are not sure how to split your programming or students by cohort, please refer to the Pa
21st Century Evaluation Handbook located at www.aiu3.net/evaluations and follow the link for 21st Century.
The purpose of this report is to collect results and program information from grantees that is required by Pennsylvania, but not
addressed in the federal reporting system. Additionally, some optional reporting areas are provided due to grantee requests for
opportunities to report beyond the required components.
This Question Guide is provided for those grantees who want to work on their report without having to work on a draft within the
online reporting system. This Guide will allow users to see all questions and prepare answers in advance. This is especially useful
when compiling responses from multiple centers. The results of all grantees’ entries will be provided to PDE in a summary report
format. Be sure to review the directions and helpful hints for the Pa Grantee Report in the Evaluation Handbook. This Question
Guide is a tool to help grantees complete the web-based report.
Grantees are strongly encouraged to review this entire Question Guide before beginning reporting in the online
system in order to identify the data elements and reporting format that apply to the grantee.
If you need a username and password to access your account in the Pa Grantee Report system, please email
Leslie.McConnell@aiu3.net. AIU will only issue login information to contact individuals on file with PDE for each grantee.
The supported answer format is provided in brackets [ ] to assist you in selecting and preparing your response. Character limits
are also provided. Keep in mind that answers to certain questions will cause the respondent to skip entire sections that do not
apply to the grantee. If a question skips, note the next section number in red text. No grantee will answer all questions in
the Pa Grantee Report.
You must download/save this Guide to your local network or hard drive in order to work within it.
To check character counts:
a. Highlight text to be counted.
b. Select the ‘Review’ (Word 2007 and later) or ‘Tools’ menu at the top of your Word window.
c. Select Word Count.
d. Determine text length using the ‘Characters (with spaces)’ count.
Helpful Definitions
Complete Data/Sufficient Data for Analysis – an individual has appropriate, correct, and useful data that could be
analyzed. A count of students having complete data DOES NOT include students for which you were unable to collect data for a
particular indicator. In most cases, complete data means having two “data points” from consistent sources from which to
determine change over time. Depending on the data source, this may mean having both fall/pre and spring/post assessment data
or prior year and participating year attendance or discipline data.
Example 1: Your 21st CCLC program enrolls 100 students who attended regularly (30+ days). Your program attempted to collect
attendance data and 4Sight Assessment Data for each child, but you were not successful in getting data for everyone. You were
able to collect:
12-13 ONLY attendance data for 35 of the students
11-12 AND 12-13 attendance data for 57 of the students
12-13 ONLY attendance data for 8 of the students
Fall AND Spring 4Sight Reading data for 82 of the students
Fall ONLY 4Sight Reading data for 6 of the students
Spring ONLY 4Sight Reading data for 12 of the students
Given this, you would have complete attendance data for 57 students and complete 4Sight reading assessment data for 82
students.
21st CCLC PA Grantee Report Question Guide 2013-14
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Unduplicated – A count of individuals in a category in which a student is counted only once. Within a category, all sub-counts
must add up to the category total. In other words, if you were to list each student by name, you would have a unique,
unduplicated list of the students who participated, and each student would only show up in the list once. Here are some examples:
Students A, B, C, D, E, F, and G are enrolled in the same 21st CCLC program. Given this list, we could say that the unduplicated
number of students enrolled is 7.
Example 1: Of these students, we might be able to say that in total, over the program term, 3 students attended 1-29 days and 4
attended 30-59 days. In this reporting area, a student could only be counted in one attendance category, as the same student
could not attend a total of 29 days and a total of 59 days during the same reporting period.
3 (students attending 1-29 days) + 4 (students attending 30-59 days) = 7 (total # of students enrolled)
Example 2: Of this same list of students, for the 4 regular attendees, 2 students improved in reading, 1 student showed no change
in reading, and 1 student did not need to improve in reading, according to the grantee’s data source/analysis method.
2 (improved) + 1 (no change) + 1 (did not need to improve) = 4 (regular attendees)
Regular attendee/Regularly attending – PPICS defines a regularly attending student as one who attends the program for 30 or
more days over the course of the program year, which includes summer and the following school year. A student may be
considered a regular attendee if they attend the program for 30+ days during summer only, 30+ days during the school year only,
or 30+ days between both summer and school year; however, some student outcomes data apply only to students who attended
the program one day or more during the school year.
Improvement – Students counted in this outcome category are those students who showed improvement or gains in the specified
area based on the data source and analysis method.
Decline – Students counted in this outcome category are those students who showed a decline in the specified area based on the
data source and analysis method.
No change – Students counted in this outcome category are those students who had a need to improve but did not show change
(maintained the same level) in the specified area based on the data source and analysis method. This category may also include
students who may have improved in prior years and needed to maintain, but still are not achieving at the highest level(s).
Did Not Need to Improve – Students counted in this outcome category are those students who were already achieving at the
highest level(s), had achieved proficiency, did not have a need in this area, or were performing at grade level in the specified area
based on the data source and analysis method. This category may also include students who may have improved to the highest
levels in prior years and needed to maintain their level(s) or students who had needs in other areas, but not this one.
Grantees having large populations of students who needed to maintain their level may want to provide such an explanation in the
open-ended comments section at the end of the appropriate section.
Reminder: You must complete one (1) report per grantee. If you have more than one center or site, you will need to compile
results for all centers into one (1) report that represents the grantee.
Reminder: The PA Grantee Report (and PPICS) follow the federal program year of summer 2013 and school year 2013-14,
regardless of dates. This is a different timeframe than the QPR, which follows the fiscal year (C6, C6A: Oct. 1 – Sept. 30; C5: July
1-June 30).
Bold questions are required.
The question type is provided in brackets [ ]. For [text] questions, the character limit will also be specified
Section 1. Implementation
If your program is known by another name (other than the grantee/school
name), please provide it here. [text, 500 characters]
Which counties does your program serve? [text, 500 characters]
What was your 2013-14 Fiscal Year allocation? [text, 100 characters]
Please provide your grant contract number. [text, 50 characters]
FC#41000_________
21st CCLC PA Grantee Report Question Guide 2013-14
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Please describe the strategies/protocol your staff uses to encourage regular and repeated student attendance at
your program. [select all that apply]
Answer options:
Program has an attendance policy
Program offers incentives for regular attendance
Program staff contact parents of students who are absent from the program
Regular attendance is required for continued enrollment
Regular attendance is required for participation in field trips or special activities
Program does not use any particular strategies to encourage repeated
attendance
Other, please specify [text, 300 characters]
In what ways does the program collaborate with the schools the students attend to develop and implement the
21st Century program? [select all that apply]
Answer options:
Program maintains ongoing communication with school administrators
Program maintains ongoing communication with school-day teachers
School representatives contributed to the grant application
School representatives serve on the Advisory Board
Teachers from the school(s) are also the program staff
Other, please specify [text, 300 characters]
Which of the following student groups, if any, does your program specifically target? In other words, which
student groups do you actively recruit? [select all that apply]
This question is not asking if students from these groups participate in your program. It is asking if your program is specifically
designed for or actively pursuing or recruiting students who fall into certain demographic categories.
Answer options:
Academically at-risk
English Language Learners (ELL)/ESL
Homeless
Low-income
Migrant
Refugee
Special education or students with disabilities
Students with behavior, social skill, or discipline concerns
Truant, chronically absent, or students with school attendance concerns
The program does not target/recruit any particular student group.
Other, please specify [text, 300 characters]
What strategies or information do you use to identify students to enroll? [select all that apply]
Answer options:
Academic assessment data (i.e. 4Sight, PSSA, DIBELS, etc.)
Demographic elements as indicated in the prior question
Parent referral
Program does not use a formal process to identify students for enrollment
Program has open enrollment
Referral from social services/community agency
Report card grades
Siblings of already enrolled students
Teacher/school recommendation
Other, please specify [text, 500 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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What difficulties or challenges, if any, have you experienced related to identification and recruitment of students? Pennsylvania
uses this information to plan training and professional development, support grantees, and anticipate needs. [select all that apply]
Answer options:
Building awareness of program
Competition with other programs/activities
Extended day more difficult for younger students
Parent commitment to consistent attendance
Parent involvement and awareness
Student responsibilities at home or after-school job
Student transience
Transportation
None/Not aware of any challenges
Other, please specify [text, 500 characters]
What strategies or information do you use to identify students' needs? [select all that apply]
Answer options:
Assessment data (i.e. PSSA, 4Sight, DIBELS)
Intake assessment
Observation
Parent feedback
Program does not formally identify student needs
Report card grades
Teacher/school recommendation
Other, please specify [text, 500 characters]
Please explain how the grantee provides services or interventions to students based upon their needs. [select all
that apply]
Answer options:
All students receive the same menu of services
Program connects individual student needs to services for academics only
Student choice
Students are identified for specific needs and provided one-on-one support
Students are identified for specific needs and provided small group support with
students with like needs
Students with academic needs are grouped according to skills and needs
Other, please specify [text, 500 characters]
What assistance, training, or information does your program need (or anticipate
needing) related to student identification or recruitment? [text, 1000
characters]
What information or qualities does the grantee consider most important when selecting an intervention (program,
activity, curriculum, etc.)? Please select no more than three options. [select three]
Answer options:
Complements/matches district programming
Demonstrated program success with specific student groups
Other program recommendation
Prior experience using the model/program
Research
Other, please specify [text, 300 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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Please indicate the typical number of hours per week each of the following activities was provided to EACH
student during school year 2013-14 programming. Enter zero (0) if the program does not include this activity type.
[number]
Academic enrichment
Academic instruction/tutoring
Character education/social skill-building
Exercise/physical activities
Field trips
Homework help
Recreation
Service learning/community service
Other, please specify [text, 300 characters]
The following program types are identified in 21st Century program guidance. Please indicate the types of
programming or services that your program offers by selecting the program types that apply. [select all that apply]
Answer options:
Remedial education activities and academic enrichment learning programs,
including those which provide additional assistance to students to improve
academic achievement
Mathematics and science education activities (STEM Activities)
Arts and music education activities
Entrepreneurial education programs
Tutoring services, including those provided by senior citizen volunteers, and
mentoring programs
Programs that provide after-school activities for limited English proficient (LEP)
students and that
emphasize language skills and academic achievement
Recreational activities (includes physical activity, nutrition education and
nutritional snacks)
Telecommunications and technology education programs
Expanded library service hours
Programs that promote parental involvement and family literacy
Programs that provide assistance to students who have been truant, suspended,
or expelled to allow
them to improve their academic achievement
Drug and violence prevention programs
Counseling programs
Character education programs
Service learning
How does the program provide transportation for students? [select all that apply]
Answer options:
Schools/districts provide transportation
Students take public transportation
Program provides transportation during school year programming
Program provides transportation during summer programming
Program provides transportation for field trips and special events
Program provides transportation on weekdays
Program provides transportation on weekends
Program does not provide transportation
Most students live within walking distance of their center
Other, please specify [text, 300 characters]
How does the program coordinate 21st Century programming with
other initiatives to ensure the programs complement (not compete
with or supplant) each other? [text, 2000 characters]
What assistance, training, or information does your program need (or anticipate
needing) related to program operations or activities? [text, 1000 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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Section 2. Academics
What models or pre-packaged programs, if any, is the grantee using for
academics? [text, 500 characters]
How does the program integrate the school day curricula into its
activities; and how do the educational activities offered support
regular school-day learning? [text, 2000 characters]
What assistance, training, or information does your program need (or anticipate
needing) related to academic support or intervention? [text, 1000 characters]
When did the program operate during the 2013-14 program year?
[select one]
Answer options:
Summer 2013 only (Cohort 5 grantees only)
School year 2013-14 only
BOTH Summer 2013 and School year 2013-14
What difficulties, if any, did your program or evaluator experience in collecting, managing, or interpreting academic data (reading,
math, etc.)? 21st Century evaluators use this information to plan training and professional development, support grantees, and
develop resources. [select all that apply]
Answer options:
Classroom teachers did not complete/return the PPICS Teacher Survey
Collecting data from multiple schools/districts
Delays receiving data from students' home school/district
Lack of formal data sharing agreements
Lack of student data permission form
No system in place to efficiently collect, manage, analyze data
State assessment data availability timeline
Relied on students/parents to turn in data to program
School(s) use a grading scale that PPICS does not recognize
Student transience
Students' home school/district unresponsive to data requests
Unanticipated data needs
None/Not aware of any challenges
Other, please specify [text, 500 characters]
Section 2A. Reading
Grantees are required to include reading report card grades and reading state assessment data (PSSA, Keystone
Exam) in the federal PPICS reporting system. In your application for 21st CCLC funds, did you indicate you would
be collecting other reading data (local reading assessments such as 4Sight, DIBELS, Study Island, etc.) in addition
to those data that are reported in PPICS? [select one]
Answer options:
Yes, we included local reading assessment data in our application and we were
able to collect these data.
We included local reading assessment data in our application, but we were
unsuccessful collecting these data.
If you choose this answer option, please skip to section 2B.
No, we did not include local reading assessment data in our application.
If you choose this answer option, please skip to section 2B. We may confirm this
answer with your application.
21st CCLC PA Grantee Report Question Guide 2013-14
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Which of the following local reading assessment data sources did your program use? Do not include state assessments (PSSA,
PASA, Keystone Exams). [select all that apply]
Answer options:
4Sight Benchmark Assessments
DIBELS
DRA
GRADE
ScanTron
STAR Reading
Study Island
Terra Nova
Other, please specify [text, 300 characters]
For which grade levels were local reading assessment data available? [select all that apply]
Answer options:
Pre-K
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
In the following section, grantees should report on the number of individual students who experienced change within each
applicable change and program attendance category based on the local assessment data collected. An individual student should
only be counted once in this section. All students should be combined here, regardless of the assessment data source. If a
student has assessment data from more than once assessment source, the grantee should choose the result (one data source)
that is most representative of the student’s change. For example, if a student has both 4Sight and DIBELS reading assessment
data, the grantee may want to choose to report the student’s DIBELS result – discarding the 4Sight result for state reporting – if
program implementation is more closely aligned with the concepts DIBELS measures, or vice versa. If the grantee has several
assessment data sources and some students have data from more than once source, these outcomes should be reported in the
grantee’s local evaluation report.
Grantees should not report any data here that is reported in PPICS (i.e. PSSA, PASA, Keystone Exams, reading report card
grades).
Grantees with summer-only programs can also report summer academic assessment results in this section. Please be sure to
explain how the grantee administered and analyzed local assessment data for summer.
The optional comparison group results sections of this report have been eliminated. If you have comparison group results, this
information should be included in your local evaluation report.
Please explain how the grantee defined improvement, decline, no
change, and no need to improve for READING assessment data. If you
used more than one measurement method or assessment, you must
indicate how change was determined for each assessment method and
for which grade(s) the assessment was used. [text, 1000 characters]
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated IMPROVEMENT in reading/language arts according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
21st CCLC PA Grantee Report Question Guide 2013-14
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Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated NO CHANGE in reading/language arts according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated a DECLINE in reading/language arts according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who DID
NOT NEED TO IMPROVE in reading/language arts according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
If there is anything else that you want to share related to student outcomes or
results in READING, please use this space: [text, 2000 characters]
Section 2B. Math
Grantees are required to include math report card grades and math state assessment data in the federal PPICS
reporting system. In your application for 21st CCLC funds, did you indicate you would be collecting other math
data (local reading assessments such as 4Sight, GMADE, Study Island, etc.) in addition to those data that are
reported in PPICS? [select one]
Answer options:
Yes, we included local math assessment data in our application and we were
able to collect these data.
We included local math assessment data in our application, but we were
unsuccessful collecting these data.
If you choose this answer option, please skip to section 3.
No, we did not include local math assessment data in our application.
If you choose this answer option, please skip to section 3. We may confirm this
answer with your application.
Which of the following local math assessment data sources did your program use? Do not include state assessments (PSSA, PASA,
Keystone Exams). [select all that apply]
Answer options:
4Sight Benchmark Assessments
GMADE
ScanTron
STAR Math
Study Island
Terra Nova
Other, please specify [text, 300 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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For which grade levels were local math assessment data available? [select all that apply]
Answer options:
Pre-K
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
In the following section, grantees should report on the number of individual students who experienced change within each
applicable change and program attendance category based on the local assessment data collected. An individual student should
only be counted once in this section. All students should be combined here, regardless of the assessment data source. If a
student has assessment data from more than once assessment source, the grantee should choose the result (one data source)
that is most representative of the student’s change. For example, if a student has both 4Sight and GMADE math assessment
data, the grantee may want to choose to report the student’s 4Sight result – discarding the GMADE result for state reporting – if
program implementation is more closely aligned with the concepts 4Sight measures, or vice versa. If the grantee has several
assessment data sources and some students have data from more than once source, these outcomes should be reported in the
grantee’s local evaluation report.
Grantees should not report any data here that is reported in PPICS (i.e. PSSA, Keystone Exams, math report card grades).
Grantees with summer-only programs can also report summer academic assessment results in this section. Please be sure to
explain how the grantee administered and analyzed local assessment data for summer.
The optional comparison group results sections of this report have been eliminated. If you have comparison group results to
share, please report this information in your local evaluation report.
Please explain how the grantee defined improvement, decline, no
change, and no need to improve for MATH assessment data. If you
used more than one measurement method or assessment, you must
indicate how change was determined for each assessment method and
for which grade(s) the assessment was used. [text, 1000 characters]
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated IMPROVEMENT in math according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated NO CHANGE in math according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated a DECLINE in math according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
21st CCLC PA Grantee Report Question Guide 2013-14
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Please provide the unduplicated number of students served by the grantee during this reporting period who DID
NOT NEED TO IMPROVE in math according to local assessment data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
If there is anything else that you want to share related to student outcomes or
results in MATH, please use this space: [text, 2000 characters]
Section 3. Social Skills, Behavior, and School Attendance
Please describe the strategies/protocol your program uses or plans to use to influence positive student behavior
(for students with such a need). [select all that apply]
Answer options:
Character education activities
Communication with parents
Communication with school/teachers/administrators
Community service or service learning
Counseling
Home visits
Individualized intervention strategies
Mentoring
Rewards/incentives
Student Code of Conduct/discipline protocol
No specific strategies are planned/used.
Behavior and discipline are not a focus of the program.
Other, please specify [text, 500 characters]
Please describe the strategies/protocol your staff uses to improve student social
skills, self-confidence, attitude toward school, classroom behavior, and
interpersonal skills (for students with such a need). If the program is not
focusing on these issues, please provide an answer to that effect. [text, 1000
characters]
Please describe the strategies/protocol your staff uses to positively influence student attendance at school (for
students with a need). [select all that apply]
Answer options:
Character education activities
Communication with parents
Communication with school/teachers/administrators
Established school attendance policy
Home visits
Immediate follow-up with students absent from the program
Individualized intervention strategies
Reinforcement with students of the benefits of attending school
Required school-day attendance for program attendance
Rewards/Incentives
No specific strategies are planned/used.
School attendance is not a focus of the program.
Other, please specify [text, 500 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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What difficulties, if any, did your program or evaluator experience in collecting, managing, or interpreting attendance, discipline,
or other behavior data? [select all that apply]
Answer options:
Classroom teachers did not complete/return the PPICS Teacher Survey
Collecting data from multiple schools/districts
Delays receiving data from students' home school/district
Inconsistency in how schools/districts track behavior/discipline
Lack of formal data sharing agreements
Lack of student data permission form
No system in place to efficiently collect, manage, analyze data
Relied on students/parents to turn in data to program
Student transience
Students' home school/district unresponsive to data requests
Unanticipated data needs
None/Not aware of any challenges
Other, please specify [text, 500 characters]
What assistance, training, or information does your program need (or anticipate
needing) related to student behavior and attendance intervention? [text, 1000
characters]
Section 3A. School Attendance
In your application for 21st CCLC funds, did you indicate you would be collecting school attendance data? [select
one]
Answer options:
Yes, we included school attendance data in our application and we were able to
collect these data.
We included school attendance data in our application, but we were
unsuccessful collecting these data.
If you choose this answer option, please skip to section 3B.
No, we did not include school attendance data in our application.
If you choose this answer option, please skip to section 3B. We may confirm this
answer with your application.
Please explain how the grantee defined improvement, decline, no
change, and no need to improve for school attendance data. [text, 1000
characters]
In the following section, grantees should report on the number of individual students who experienced change within each
applicable change and program attendance category based on the data collected. An individual student should only be counted
once in this section.
School attendance is different than class attendance, as measured on the PPICS Teacher Survey. Do not report any PPICS
Teacher Survey data here.
The optional comparison group results sections of this report have been eliminated. If you have comparison group results to
share, please include this information in your local evaluation report.
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated IMPROVEMENT in school attendance. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated NO CHANGE in school attendance. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
21st CCLC PA Grantee Report Question Guide 2013-14
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Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated a DECLINE in school attendance. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who DID
NOT NEED TO IMPROVE in school attendance. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
If there is anything else that you want to share related to student outcomes or
results related to school attendance, please use this space: [text, 2000
characters]
Section 3B. School Discipline
In your application for 21st CCLC funds, did you indicate you would be collecting school discipline data? [select
one]
Answer options:
Yes, we included school discipline data in our application and we were able to
collect these data.
We included school discipline data in our application, but we were unsuccessful
collecting these data.
If you choose this answer option, please skip to section 4.
No, we did not include school discipline data in our application.
If you choose this answer option, please skip to section 4. We may confirm this
answer with your application.
Please explain how the grantee defined improvement, decline, no
change, and no need to improve for school discipline data. [text, 2000
characters]
In the following section, grantees should report on the number of individual students who experienced change within each
applicable change and program attendance category based on the data collected. An individual student should only be counted
once in this section.
Do not report any PPICS Teacher Survey data here.
The optional comparison group results sections of this report have been eliminated. If you have comparison group results to
share, please report this information in your local evaluation report.
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated IMPROVEMENT in behavior as measured by school discipline data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated NO CHANGE in behavior as measured by school discipline data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
Please provide the unduplicated number of students served by the grantee during this reporting period who
demonstrated a DECLINE in behavior as measured by school discipline data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
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Please provide the unduplicated number of students served by the grantee during this reporting period who DID
NOT NEED TO IMPROVE in behavior as measured by school discipline data. [number]
1-29 days (optional) Enter zero if you wish to skip this optional category.
30-59 days
60-89 days
90+ days
If there is anything else that you want to share related to student outcomes or
results related to behavior or discipline, please use this space: [text, 2000
characters]
Section 4. Stakeholder Involvement and Feedback
Please describe how the grantee communicates with parents, students, and the community. [select all that apply]
Answer options:
Advisory Board meetings
Family/student handbooks
Fliers/promotional materials/newsletters
Informal feedback/communication
Letters sent to students' home
Media (i.e. newspapers, TV, radio)
Meetings/events
Open houses/family nights
Parent meetings
Phone calls
Social media
Surveys, questionnaires, focus groups
Website
Other, please specify [text, 500 characters]
What kinds of parent/family activities did your program offer during the 2013-14 program year? [select all that
apply]
Answer options:
Adult ESL services
Adult education opportunities and/or GED classes
Career/job training
Computer/technology training
Cultural events
Family literacy nights
Open House
Parent/Center staff meetings
Parenting skills classes
Parent training on how to help their children with schoolwork
Parent training on post-secondary options and planning
Parent reinforcement of the importance of school and education
Parent volunteering at the program
Structured family recreation
Other, please specify [text, 500 characters]
Section 4A. Parent Feedback
Did your program (grantee or local evaluator) collect feedback from parents? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 4B.
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Please indicate the number of parents indicating each level of satisfaction with the following items. If you did not ask questions
like these, leave the answer fields blank.
How many parents reported their satisfaction with the program OVERALL within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many parents reported their satisfaction with the program’s COMMUNICATION within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many parents reported their satisfaction with the program’s ACADEMICS within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many parents reported their satisfaction with the program’s RECREATION within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
Please indicate the number of parents indicating each level of agreement with the following statements. If you did not ask
questions like these, leave the answer fields blank.
The program addressed my child’s specific needs. [number]
Strongly Agree
Agree
Disagree
Strongly Disagree
I had opportunities to visit the program. [number]
Strongly Agree
Agree
Disagree
Strongly Disagree
The program offered my child a variety of academic and enrichment activities. [number]
Strongly Agree
Agree
Disagree
Strongly Disagree
If you did not ask questions like these, leave the answer fields blank.
How many parents reported that their child IMPROVED in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
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How many parents reported that their child showed NO CHANGE in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
How many parents reported that their child DECLINED in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
How many parents reported that their child DID NOT NEED TO IMPROVE in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
Please provide the number of parents who reported that the parent activities offered: [number]
If you did not ask questions like these, leave the answer fields blank.
Met their needs
Did not meet their needs
Indicated that they did not participate in the parent activities
Indicated that parent activities were not offered to them
How does your program collect feedback from parents about parent activities? [select all that apply]
Informal or unprompted parent sharing with staff
Interviews or focus groups
Parent survey (specific questions about parent activities)
We have not collected parent feedback this year on parent activities
Other, please specify [text, 500 characters]
What did parents report as the most positive results of their child’s participation
in the 21st Century program? [text, 1000 characters]
What did parents report as areas where the program could be improved? [text,
1000 characters]
If there were other parent comments or results that you would like to share that
did not fit into the above categories, please provide a brief explanation: [text,
2000 characters]
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Section 4B. Student Feedback
Did your program (grantee or local evaluator) collect feedback from students? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 4C.
If you did not ask questions like these, leave the answer fields blank.
How many students reported their satisfaction with the program OVERALL within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many students reported their satisfaction with the program’s ACADEMICS within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many students reported their satisfaction with the program’s RECREATION within each satisfaction level below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many students reported that they IMPROVED in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
How many students reported that they showed NO CHANGE in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
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How many students reported that they DECLINED in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
How many students reported that they DID NOT NEED TO IMPROVE in these academic and behavioral categories? [number]
Reading
Math
Science
Social Studies
Technology
Homework completion
Self-confidence
Attitude toward school/learning
Attendance at school
Behavior at school
If there were other students comments or results that you would like to share
that did not fit into the above categories, please provide a brief explanation:
[text, 2000 characters]
Section 4C. Partner Feedback
Did your program (grantee or local evaluator) collect feedback from community partners? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 4D.
Please provide a brief summary or explanation of partner comments or
feedback: [text, 2000 characters]
Section 4D. School Administrator Feedback
Did your program (grantee or local evaluator) collect feedback from school/district administrators? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 5.
If you did not ask questions like these, leave the answer fields blank.
How many school administrators reported their satisfaction with the program OVERALL within each satisfaction level below?
[number]
Very satisfied
Somewhat satisfied
Not satisfied
How many school administrators reported their satisfaction with the program’s COMMUNICATION within each satisfaction level
below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
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How many school administrators reported their satisfaction with the program’s ACADEMICS within each satisfaction level below?
[number]
Very satisfied
Somewhat satisfied
Not satisfied
How many school administrators reported their satisfaction with the program’s COLLABORATION within each satisfaction level
below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
If there were other school administrator comments or results that you would like
to share that did not fit into the above categories, please provide a brief
explanation: [text, 2000 characters]
Section 5. Staff & Professional Development
What is the program's typical student to staff ratio? (Staff refers to those
individuals providing direct services to students.) If it is different for summer and
school year, you may provide both, but please label each accordingly. [text, 300
characters]
What type(s) of professional development is/are available to your staff? [select all that apply]
Answer options:
Health & safety training
Peer networking
Staff orientations
State/national afterschool conferences
Training on implementation of academic models/interventions/purchased
programs
Training on implementation of attendance & discipline
models/interventions/purchased programs
Training on implementation of social & behavioral
models/interventions/purchased programs
Grantee does not offer professional development to staff
Other, please specify [text, 500 characters]
Who typically provides professional development/training? [select all that apply]
Answer options:
Contractors/vendors
Grantee staff
Partners
Presenters at conferences
School District/LEA
Other, please specify [text, 500 characters]
Please describe how information, materials, resources, and program requirements are shared with program staff,
especially information collected at state-level grantee meetings and trainings? [select all that apply]
Answer options:
Email communication
Informal conversations
Newsletters
Phone calls
Staff meetings
Training/professional development
Other, please specify [text, 500 characters]
What assistance, training, or information does your program need (or anticipate
needing) related to staff or professional development? [text, 1000 characters]
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Section 5A. Staff Feedback
Did your program (grantee or local evaluator) collect feedback from center/program staff? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 6.
If you did not ask questions like these, leave the answer fields blank.
How many center/program staff reported their satisfaction with the program OVERALL within each satisfaction level below?
[number]
Very satisfied
Somewhat satisfied
Not satisfied
How many center/program staff reported their satisfaction with the program’s COMMUNICATION within each satisfaction level
below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
How many center/program staff reported their satisfaction with the program’s ACADEMICS within each satisfaction level below?
[number]
Very satisfied
Somewhat satisfied
Not satisfied
How many center/program staff reported their satisfaction with the program’s COLLABORATION within each satisfaction level
below? [number]
Very satisfied
Somewhat satisfied
Not satisfied
Which staff types are included in the above results? [select all that apply]
Answer options:
Aides
Program coordinators/administrators
Site coordinators/administrators
Teachers/instructional staff
Support staff
Volunteers
Other, please specify [text, 300 characters]
If there were other center/program staff comments or results that you would
like to share that did not fit into the above categories, please provide a brief
explanation: [text, 2000 characters]
21st CCLC PA Grantee Report Question Guide 2013-14
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Section 6. Course/Credit Recovery
Did your program include a credit/course recovery component during the 2013-14 program year? [select one]
Answer options:
Yes
No
If you choose this answer option, please skip to section 7.
How many students participated in credit/course recovery programming during
this program year? [number]
How many students recovered one or more credits/courses during this program
year? [number]
How many students recovered literacy-related courses/credits in the following categories? [number]
Recovered 1 course
Recovered 2 courses
Recovered 3 courses
Recovered 4 courses
Recovered 5 or more courses
How many students recovered math-related courses/credits in the following categories? [number]
Recovered 1 course
Recovered 2 courses
Recovered 3 courses
Recovered 4 courses
Recovered 5 or more courses
How many students recovered other courses/credits in the following categories? [number]
Recovered 1 course
Recovered 2 courses
Recovered 3 courses
Recovered 4 courses
Recovered 5 or more courses
How long did it typically take students to recover one course during school year programming? [select one]
Answer options:
Less than one month
Less than a semester
Less than a full school year
A full program year
Course or credit recovery was not a component of the school year program
How long did it typically take students to recover one course during summer programming? [select one]
Answer options:
Less than the length of the summer program
The full term of the summer program
We did not operate a summer program/Course or credit recovery was not a
component of the summer program
What volume of program operation time do you estimate course/credit recovery made up of all 21st CCLC activities? [select one]
Answer options:
Less than a quarter of program operational time
A quarter to half of program operational time
Half to three quarters of program operational time
More than three quarters of program operational time
How was course/credit recovery typically delivered? [select one]
Answer options:
Primarily face-to-face
Primarily computer-based
Blend of face-to-face and computer-based instruction
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Of the students who participated in course/credit recovery activities, how many attended the program in each of
the following program attendance categories? [number, 50 characters each]
1-29 days
30-59 days
60-89 days
90+ days
Did students who participated in course/credit recovery activities typically participate in other 21st Century
activities? [select one]
Answer options:
Yes
No
If you answered "no" to the previous question, why did course/credit recovery students not typically participate in non-credit
recovery 21st CCLC activities? [select all that apply]
Answer options:
Course/credit recovery activities targeted a different population than the regular
21st CCLC activities/program.
Students had other school-related obligations that prevented them from
participating.
Students had other family, home, or work obligations that prevented them from
participating.
Students had so many courses/credits to recover that there was not an
opportunity for them to participate in other 21st CCLC activities.
The program only offered course/credit recovery activities.
Other, please specify [text, 500 characters]
If there is anything else you want to share related to course/credit recovery,
please use this space: [text, 1000 characters]
Section 7. Program Evaluation and Reporting
Please share the name(s) of your external evaluator or evaluation
team and that person’s or team’s organization affiliation. Enter
“independent evaluator” after the person’s name if the evaluator is not part of
an organization or business. [text, 1000 characters]
Please explain the evaluator's skills, capacity, or qualifications to effectively
manage the evaluation of your program. [text, 1000 characters]
Does this evaluator/evaluation team have prior experience (before this year) evaluating 21st Century Community
Learning Centers programs? [select one]
Answer options:
Yes
No
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Please indicate the services the external evaluator is providing to your program. [select all that apply]
Answer options:
Data analysis and interpretation
Data entry
Data collection from students’ school(s)
Development of data collection/management instruments
Evaluation planning
Information entry into state and federal reporting systems
Local report preparation/writing/production
Ongoing evaluation and data-related support
Preparation of evaluation findings/reports for stakeholders (i.e. newsletters,
articles, communications, etc.)
Preparation of federal summative/program year report (PPICS)
Preparation of periodic program reports (i.e. QPR)
Preparation of state summative/program year report (PA Grantee Report)
Program recommendations based on evaluation findings
Site observations
Stakeholder feedback collection (surveys, focus groups, interviews, etc.)
Support to program in using evaluation findings for program improvement
Train program staff to collect data or carry out program-related evaluation tasks
Other, please specify [text, 500 characters]
Please indicate the program’s role in evaluation. [select all that apply]
Answer options:
Activities tracking
Daily student attendance tracking
Data analysis and interpretation
Data entry
Data collection from students’ school(s)
Develop and implement program changes based on evaluation findings
Development of data collection/management instruments
Evaluation planning
Information entry into state and federal reporting systems
Preparation of evaluation findings/reports for stakeholders (i.e. newsletters,
articles, communications, etc.)
Preparation of federal summative/program year report (PPICS)
Preparation of periodic program reports (i.e. QPR)
Preparation of state summative/program year report (PA Grantee Report)
Site observations
Stakeholder feedback collection (surveys, focus groups, interviews, etc.)
Train program staff to collect data and/or carry out program-related evaluation
tasks
Other, please specify [text, 500 characters]
Does the grantee have a formal data access/provision/sharing agreement in place with the LEA(s) from which
students enroll? [select one]
Answer options:
Yes
No
Grantee is a school/district and only serves its own students
What assistance, training, information, or tools does your program need (or
anticipate needing) related to program evaluation or data collection? [text, 1000
characters]
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How did you meet the goals and objectives set forth in your original application during the 2013-14 funding year?
Your response should be approximately 2-3 pages long, or 3,000-5,000 characters. [text, 5000 characters]
What results were achieved as a result of receiving funds from the 21st CCLC program and how did those funds
contribute to the success of your program? Your response should be approximately 2-3 pages long, or 3,000-5,000
characters. [text, 5000 characters]
Section 8. Grantee Information
Your name: [text, 300 characters]
What is your role in this program? [select all that apply]
Answer options:
Program manager
Site coordinator
Program support staff
Local evaluator
Other, please specify [text, 300 characters]
How can we get in touch with you in case we have a question about your responses? [text]
Phone [text, 300 characters]
Email [text, 300 characters]
Please share anything else that you think the Pennsylvania 21st Century Program
state team (PA Department of Education, Center for Schools and Communities,
Allegheny Intermediate Unit) should know. Feel free to share challenges, needs,
suggestions, or successes. [text, 2000 characters]
*IMPORTANT* - In addition to the Pa Grantee Report, grantees are also required to complete and submit the following by
October 31, 2014, if you have not done so already:

PPICS Grantee Profile (complete or update as needed)

PPICS Annual Performance Report

Local evaluation report

21st Century Equipment Inventory Form
If you have questions about any of these required reports, please contact the 21st Century evaluation team at Allegheny
Intermediate Unit or refer to the evaluation website (www.aiu3.net/evaluations, click on 21st Century link).
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