_________________________________ TOTALS
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PART I: OPPORTUNITIES
KEY: Degree to which the following supports needed for youth developments are provided 3=Sometimes 5=Almost Always NA=Not Applicable Adult Youth Total
1=Rarely
A. Exploration and Reflection
Opportunity for youth to learn and practice new skills, talents and abilities. 1. Do activities and experiences encourage curiosity, questioning, experimentation and exploration? _____ _____ _____ 2. Are activities based on an interactive “hands on” approach to experiential learning? Opportunity for youth to explore, discuss and reflect on ideas and choices. 3. Do organized activities enable youth to explore different life situations, viewpoints, and cultures? 4. Is there time for participants to discuss learning experiences? 5. Is the learning sequence and level of instruction appropriate to youths’ abilities?
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B. Expression and Creativity
Opportunity for youth to express themselves through different mediums. 6. Does the experience involve the visual arts, music, drama, creative writing, public speaking or another active form of self-expression? Opportunity for youth to be heard and taken seriously by others. 7. Are there opportunities for youth to make choices and decisions about the things they want to do? 8. Are youth able to express their ideas, concerns and opinions publicly (through committees, forums, research programs, etc.)? _____ _____ _____
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C. Group Membership
Opportunity to contribute and participate in the responsibilities of belonging to a group. 9. Do youth and adults work together to plan and implement group programs and activities? 10. Do youth contribute ideas and suggestions for projects, programs and activities which are accepted and implemented? 11. Are youth encouraged to play an active leadership role?
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Adult Youth Total
12. Are youth aware of how the program is funded and participate in fund-raising and advocacy activities? Opportunity to be an accepted and important member of a group. 13. Are youth encouraged to cooperate with one another to build a spirit of camaraderie and teamwork within the group? 14. Has the group created symbols (tee shirts, caps, slogans, etc.) to build a sense of group identity? 15. Are youth able to participate in the program without fear of being excluded, harassed, or intimidated? _____ _____ _____
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D. Contribution and Service
Opportunity for youth to volunteer their time, interest or skills in order to have a positive influence on others. 16. Are youth encouraged to use their time and energies for the benefit of others in their school, club or organization? 17. Are youth encouraged to “give back to the community” through activities, such as teen mentoring, “adopt a highway,” etc.? Opportunity for youth to participate and contribute to the welfare of the community. 18. Does the activity emphasize ongoing relationships with schools, businesses, and/or other community organizations? 19. Are there opportunities for civic involvement, such as letter writing campaigns, committee membership, voter registration drives, etc.?
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E. Part Time Employment
Opportunity to earn income and be part of the workforce. 20. Does the program include paid employment or stipend work? 21. Is there an opportunity for youth to develop and practice jobrelated skills? _____ _____ _____
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Notes/Reflections
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PART II: SUPPORTS KEY: Degree to which the following supports needed for youth development are provided 1=Rarely 3=Sometimes 5=Almost Always NA=Not Applicable
Adult Youth Total
A. Nurturance and Friendship
Caring relationships with adults and peers. 1. Are caring adults available to provide guidance and support? 2. Does the program have specific strategies for building trust and caring relationships among staff, volunteers and youth? 3. Is peer interaction positive for youth who participate? Adults in positions of power and authority are affirming and responsive to youth. 4. Do adults listen to and respond supportively to feedback from youth about their needs and interests? 5. Do adults refrain from ordering, commanding or threatening youth in order to make them comply with adult expectations? 6. Do adult staff members get acquainted with youth by learning their names and interacting with them? Opportunities exist for youth and adult program staff to come together for collective celebrations. 7. Are there opportunities for adults and youth to celebrate and recognize successes and achievements? _____ _____ _____
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B. Emotional Safety
Youth are encouraged to respond appropriately to difficult emotions. 8. Has the program established clear rules dealing with bullying and other forms of physical violence and verbal abuse? 9. Do adults model appropriate ways of dealing with anger, frustration, conflict and other negative emotions? 10. Are youth encouraged to try out new activities without fear of being criticized if they fail or make mistakes? _____ _____ _____
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C. High Expectations
The program provides opportunities, encouragement and recognition to encourage youth to reach their potential. 11. Are there consistent messages about how to participate and succeed in the program?
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Adult Youth Total
12. Do youth set goals, action plans and benchmarks for success? 13. Are high expectations set for all young people, with different options to succeed? _____ _____ _____ _____ _____ _____
D. Standards and Boundaries
There are established rules and norms regarding appropriate and non-appropriate behavior. 14. Are youth given clear messages about rules, behavior expectations and the consequences for not following them? 15. Are youth and adult staff provided with orientation information including program guidelines and behavior expectations? 16. Are program guidelines, rules, and disciplinary consequences fairly and consistently enforced? Opportunities to discuss and modify boundaries when appropriate. 17. Do youth provide input about program policy and structure, the reason for rules and the consequences for not following them?
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E. Strategic Support
Adult assistance in helping youth learn to assess options, make decisions and solve problems. 18. Are there opportunities for youth to grow by taking on new responsibilities and broader roles within the program? 19. Do adults provide guidance through coaching, feedback and discussion, rather than by telling youth what to do? 20. Do adults help youth set goals and monitor and assess progress? 21. Is support provided to help youth deal with changes in their roles or with changes in the program itself?
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F. Access to Resources
Youth have access to people, services and materials needed in order to participate fully and succeed in a variety of settings. 22. Are youth provided with additional information, instruction or help when it’s needed? 23. Are resources available to youth after they leave the program?
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Notes/ Reflections:
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PART III: ORGANIZATION
KEY: Degree to which the following supports needed for youth development are provided 1=Rarely 3=Sometimes 5=Almost Always NA=Not Applicable Adult Youth Total
A. Organizational Support
The program is implemented by trained staff. 1. Is staff screened? 2. Is staff provided with information about the program’s philosophy and objectives? 3. Do training opportunities provide volunteer staff with information about opportunities and supports youth need for development? 4. Does staff have opportunities to discuss strategies for promoting youth development? Partnerships and collaborations exist. 5. Does the program encourage partnerships and collaborations with other agencies and organizations in order to reach all youth? 6. Have efforts been made to reach youth who traditionally have not been involved in these kinds of programs? Evaluation and assessment of the program occurs. 7. Are there specific strategies in place for assessing the impact and value of the program? 8. Do youth provide evaluation feedback about the program? 9. Does the program conduct a peer review process as a means of improving quality?
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Notes/Reflections:
(most recently revised:4/15/09)
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