Intentional Program Design: Needs Assessment and
Understanding Data

Feedback Form

You for Youth (Y4Y)

May 4, 2020

Question Title

* 1. What is your primary role with 21st CCLC?

State Coordinator

Project Director

Site Coordinator

Program Staff

Other (please specify)

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* 2. What grade levels does your program serve? Select all that apply.

Pre-K

Elementary

Middle

High

Other (please specify)

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* 3. Please rate today's session on the following criteria

	Limited	Average	Good	Excellent
Clarity of the information presented	Clarity of the information presented Limited	Clarity of the information presented Average	Clarity of the information presented Good	Clarity of the information presented Excellent
Relevance of the information	Relevance of the information Limited	Relevance of the information Average	Relevance of the information Good	Relevance of the information Excellent
Helpfulness of the information	Helpfulness of the information Limited	Helpfulness of the information Average	Helpfulness of the information Good	Helpfulness of the information Excellent
Conciseness of the presentation	Conciseness of the presentation Limited	Conciseness of the presentation Average	Conciseness of the presentation Good	Conciseness of the presentation Excellent
Questions were answered	Questions were answered Limited	Questions were answered Average	Questions were answered Good	Questions were answered Excellent

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* 4. We are always seeking ways to improve our technical assistance and training. Please feel free to provide our Y4Y team with constructive feedback.

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* 5. Please rate the following statements on a scale of 1 to 4. (1=limited, 2=average, 3=good, 4=excellent)

	Before today	After today
My knowledge of and ability to conduct a comprehensive needs assessment.	My knowledge of and ability to conduct a comprehensive needs assessment. Before today menu	My knowledge of and ability to conduct a comprehensive needs assessment. After today menu
My knowledge and understanding of the three levels of data.	My knowledge and understanding of the three levels of data. Before today menu	My knowledge and understanding of the three levels of data. After today menu
My confidence in my ability to develop program SMART goals.	My confidence in my ability to develop program SMART goals. Before today menu	My confidence in my ability to develop program SMART goals. After today menu

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* 6. List three (3) things you learned in today's training (your take-aways):

1

2

3

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* 7. List two (2) concepts or strategies you learned today that you will share with a colleague:

1

2

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* 8. Identify one (1) strategy you learned today that you will use in your own training or practice: