Grades 1 & 2 Assessment

SCHOOL: ___________________________________
STUDENT: _________________________GRADE:___
TEACHER: __________________________________
COUNSELOR: ______________________________
CIS: ________________________________________

When I am at school, I feel:

1. I belong.  Yes  No

2. I am safe.  Yes  No

3. I am safe coming to and from school.  Yes  No

4. I have fun learning.  Yes  No

5. I have friends at school.  Yes  No

6. I have school supplies and all I need for school.  Yes  No

When I am at home, I feel:

7. I am loved.  Yes  No

8. I am safe.  Yes  No

9. I have food and all I need at home.  Yes  No

10. I like being at my home.  Yes  No