Head Start Safe Families-Safe Homes Training Curriculum Survey

Safe Families Safe Homes Evaluation
Survey Instructions

OMB Control No: xxxx­xxxx 
Expiration Date: xx/xx/xxxx 
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104­13) 

Public reporting burden for this collection of information is estimated to average .25 hours per response, including the time for reviewing 
instructions, gathering and maintaining the data needed, and reviewing the collection of information. 

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid 
OMB control number. 

About You

Between April and October 2011, you and other Head Start staff from your state participated in a training session on Safe Families­Safe Homes: A 
Collaborative Approach to Responding to and Preventing Domestic Violence. The following questions relate to these trainings and to activities you 
have undertaken since the training. 

*1. Please provide your month and year of birth.

*2. Gender
j Female
k
l
m
n
j Male
k
l
m
n

*3. At the time of the training, what was your official job title at your Head Start program?
c Family Service Worker
d
e
f
g
c Home­Based Visitor
d
e
f
g

c Home­Based Supervisor
d
e
f
g
c Teacher
d
e
f
g

c Assistant Teacher
d
e
f
g

c Health Service Manager
d
e
f
g

c Family & Community Partnerships Manager
d
e
f
g
c Head Start Director
d
e
f
g
c Other
d
e
f
g

Please specify. 

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Safe Families Safe Homes Evaluation

*4. At the time of the training, how long had you worked in that position at the Head Start

program?

Number of years

*5. Before you started working with Head Start, did you have any work or volunteer

experience working directly with families seeking services (e.g., social worker, case
worker)?
j No (skip to #7)
k
l
m
n

j Yes
k
l
m
n

6. How many years experience did you have with such programs before you joined Head
Start?
Number of years

*7. At the time of the training, what was the last or highest grade of school (or highest

level of education) you had completed?
6  

*8. At the time of the training, did you have any professional certifications or state or

industry licenses? (Select all that apply.)
c No, no professional certifications or licenses
d
e
f
g
c Yes, Child Development Associate (CDA)
d
e
f
g

c Yes, Family Development Credential (FDC)
d
e
f
g

c Yes, Registered Nurse (RN) or Licensed Practical/Vocational Nurse (LPN/LVN)
d
e
f
g
c Yes, Other
d
e
f
g

Please specify. 

*9. Prior to this Safe Families­Safe Homes training, had you ever had training on

domestic violence/family violence?
j No (skip to #12)
k
l
m
n

j Yes
k
l
m
n

10. Prior to this Safe Families­Safe Homes training, how many hours of training do you
estimate you have had on domestic violence/family violence?
Number of hours

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Safe Families Safe Homes Evaluation
11. Prior to this Safe Families­Safe Homes training, what types of training have had you
had related to domestic violence/family violence? (Select all that apply.)
c Training sessions or workshops held within your Head Start agency
d
e
f
g

c Training sessions or workshops held within a domestic violence program
d
e
f
g
c Training sessions or workshops held within any other agency
d
e
f
g

c Courses or classes made available at a community or four­year college
d
e
f
g

*12. Prior to this Safe Families­Safe Homes training, had you ever worked or volunteered

with a domestic violence/family violence program?
j No (skip to #14)
k
l
m
n

j Yes
k
l
m
n

13. How many years experience did you have with such programs?
Number of years

About Your Community and Head Start Families

*14. What term best describes the location of your program?
c Urban
d
e
f
g

c Suburban
d
e
f
g
c Rural
d
e
f
g

*15. Does your program have an Early Head Start program?
j No
k
l
m
n

j Yes
k
l
m
n

*16. Is your program a Migrant/Seasonal Head Start program?
j No
k
l
m
n

j Yes
k
l
m
n

*17. Is your program an American Indian/Alaska Native Head Start program?
j No
k
l
m
n

j Yes
k
l
m
n

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Safe Families Safe Homes Evaluation

*18. On average, approximately what percentage of the families you work with

predominately speak a language other than English?
% of families speaking 
Spanish
% of families speaking other 
languages
(Please specify)

*19. On average, approximately what percentage of the families you work with are...
American Indian or Alaska 
Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other 
Pacific Islander
White

*20. In terms of the families you work with, to what degree do they need your help with

personal problems (e.g., family relations, marital stress, substance abuse, domestic
violence)? (Choose the one statement that best describes the needs of the families.)
j Families do not need my help at all with their personal problems.
k
l
m
n

j Some families need my help with personal problems, but not as much as with other issues.
k
l
m
n
j Personal problems are the main concern for some, but not all, of the families I work with.
k
l
m
n
j Personal problems are the main concern for many of the families I work with.
k
l
m
n

*21. To the best of your knowledge, at any given time how many of the families that you

work with have household members who are the victims of domestic violence?
Number of families

About the Safe Families­Safe Homes Training Session

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Safe Families Safe Homes Evaluation

*22. Please rate the following statements about the Safe Families­Safe Homes training,

using this rating scale:
The training helps 

Strongly Disagree

Somewhat Disagree

Somewhat Agree

Strongly Agree

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
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m
n

j
k
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m
n

j
k
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m
n

j
k
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n

j
k
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n

j
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n

j
k
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n

j
k
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n

j
k
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n

j
k
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n

j
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n

j
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n

j
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n

j
k
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m
n

j
k
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m
n

j
k
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m
n

participants understand the 
CAUSES, 
CHARACTERISTICS and 
IMPACTS of domestic 
violence on families.
The training helps 
participants understand the 
CONNECTIONS between 
domestic violence and 
other issues families face 
(e.g., substance abuse and 
child abuse and neglect).
The training prepares Head 
Start staff to RESPOND 
appropriately to disclosures 
of domestic violence and 
support families 
experiencing domestic 
violence.
The training prepares Head 
Start staff to quickly 
CONNECT families to 
domestic violence services 
in their local communities 
and increase family safety.
The training prepares Head 
Start staff to ENGAGE in 
local collaborative efforts 
aimed at prevention and 
intervention of domestic 
violence.

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Safe Families Safe Homes Evaluation

*23. Which of the following components of the Safe Families­Safe Homes training

contributed to improvements in your understanding of the CAUSES, CHARACTERISTICS
and IMPACTS of domestic violence?
Very helpful

Helpful

Somewhat helpful

Not at all helpful

N/A

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Training materials

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Self assessments

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Films

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Group activities and 

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Small­group discussions

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Role playing

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Other

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Collaborative delivery 
model (i.e., trainings 
delivered by trainers from 
different disciplines)

exercises

Please specify. 

5
6

*24. Which of the following components of the Safe Families­Safe Homes training

contributed to improvements in your understanding of the CONNECTIONS between
domestic violence and other issues families face (e.g., substance abuse and child abuse
and neglect)?
Very helpful

Helpful

Somewhat helpful

Not at all helpful

N/A

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Training materials

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Self assessments

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Films

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Group activities and 

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Small­group discussions

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Role playing

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Other

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Collaborative delivery 
model (i.e., trainings 
delivered by trainers from 
different disciplines)

exercises

Please specify. 

5
6

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Safe Families Safe Homes Evaluation

*25. Which of the following components of the Safe Families­Safe Homes training

contributed to improvements in your PREPARATION to ASSIST families in obtaining
needed services and increase family safety?
Very helpful

Helpful

Somewhat helpful

Not at all helpful

N/A

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Training materials

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Self assessments

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Films

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Group activities and 

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Small­group discussions

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Role playing

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Other

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Collaborative delivery 
model (i.e., trainings 
delivered by trainers from 
different disciplines)

exercises

Please specify. 

5
6

*26. Which of the following components of the Safe Families­Safe Homes training

contributed to improvements in your PREPARATION to ENGAGE in local collaborative
efforts aimed at response to domestic violence?
Very helpful

Helpful

Somewhat helpful

Not at all helpful

N/A

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Training materials

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Self assessments

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Films

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Group activities and 

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Small­group discussions

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Role playing

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Other

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

j
k
l
m
n

Collaborative delivery 
model (i.e., trainings 
delivered by trainers from 
different disciplines)

exercises

Please specify. 

5
6

Activities Since the Safe Families­Safe Homes Training Session

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Safe Families Safe Homes Evaluation
Each participant in the Safe Families­Safe Homes training identified his or her own action steps to be taken upon returning to work. The next three 
questions ask about activities that you may have completed since participating in the Safe Families­Safe Homes training, reasons that might have 
contributed to any successes you may have had, and challenges you may have encountered in completing these activities. 

*27. Which, if any, of the following activities have you completed since participating in the

Safe Families­Safe Homes training? (Check all that apply.)
c Enrolled in additional training related to helping families deal with domestic violence.
d
e
f
g

c Investigated the policies and procedures related to domestic violence that are in place at your Head Start program.
d
e
f
g

c Changed (or suggested changes to) the policies and procedures related to domestic violence that are in place at your Head Start 
d
e
f
g
program. 

c Investigated the laws and regulations related to domestic violence that are in place in the community in which you work.
d
e
f
g
c Identified resources in your community, such as local domestic violence victim service agencies.
d
e
f
g

c Contacted potential community partner(s) to improve local efforts aimed at prevention and intervention of domestic violence (please 
d
e
f
g
specify agency below). 

c Developed a formal partnership agreement with a community partner to improve local efforts aimed at prevention and intervention of 
d
e
f
g
domestic violence (please specify agency below). 

c Referred a family for social or community services.
d
e
f
g

c Assisted a family with accessing domestic violence services.
d
e
f
g
c No follow­up activities completed (skip to Question #29).
d
e
f
g
c Other activity (specify below).
d
e
f
g

Please specify involved agencies and/or other activities: 

5
6

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Safe Families Safe Homes Evaluation
28. What are the reasons that might have contributed to any successes you have
experienced in follow­up activities related to the Safe Families­Safe Homes training?
(Check all that apply.)
c The Safe Families­Safe Homes training provided us with the necessary skills and information to respond appropriately to disclosures of 
d
e
f
g
domestic violence. 

c The Safe Families­Safe Homes training provided us with the necessary skills and information to connect families directly to domestic 
d
e
f
g
violence services. 

c The Safe Families­Safe Homes training provided us with the necessary skills and information to increase family safety.
d
e
f
g
c The Head Start Collaboration Director and/or other state trainers facilitated follow­up activities.
d
e
f
g
c Our Head Start program’s Director was supportive of the initiative.
d
e
f
g

c We had the resources to devote to additional training opportunities or collaborative efforts.
d
e
f
g

c Domestic violence prevention and intervention was a priority of our program’s Policy Council, Governing Board, or other advisory 
d
e
f
g
committee. 

c Before the training, our program was involved in collaborative efforts with community partners related to other issues (e.g., substance 
d
e
f
g
abuse). 

c Before the training, our program was already involved in collaborative efforts related to domestic violence prevention and intervention.
d
e
f
g
c Does not apply.
d
e
f
g
c Other
d
e
f
g

Please specify. 

5
6

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Safe Families Safe Homes Evaluation

*29. What are the challenges you have encountered in follow­up activities since the Safe

Families­Safe Homes training session you attended? (Check all that apply.)

c The Safe Families­Safe Homes training did not provide us with the necessary skills and information to respond appropriately to 
d
e
f
g
disclosures of domestic violence. 

c The Safe Families­Safe Homes training did not provide us with the necessary skills and information to connect families directly to 
d
e
f
g
domestic violence services. 

c The Safe Families­Safe Homes training did not provide us with the necessary skills and information to increase family safety.
d
e
f
g
c I do not have the authority to institute or change policies and procedures related to domestic violence.
d
e
f
g
c I do not have the authority to contact potential community partners.
d
e
f
g

c I do not have the authority to establish formal agreements with community partners.
d
e
f
g
c I do not have the time to devote to additional training or collaborative efforts.
d
e
f
g

c We did not have the resources to devote to additional training opportunities or collaborative efforts.
d
e
f
g
c Our Head Start program’s Director was not supportive of the initiative.
d
e
f
g

c Domestic violence prevention and intervention was not a priority of our program’s Policy Council, Governing Board, or other advisory 
d
e
f
g
committee. 

c No challenges encountered.
d
e
f
g

c No follow­up activities attempted.
d
e
f
g
c Other
d
e
f
g

Please specify. 

5
6

30. Are there things that you wish you had learned or practiced at your Safe Families­Safe
Homes training? Are there any changes you would make to the training? Please describe.
5
6  

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