Official Legal Form

Parent Education Self Evaluation

Published by Virginia Courts — Forms. Mirrored here in its unmodified, original form for free public access.

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Parent Education Program Self Evaluation
  Developed from recommendations of the Model Parent Education Curriculum Committee
                      as presented in House Document 26 (2000)

Organization name _______________________________            Date: ____________
Address ____________________________________________________________________
City ___________________ State ________ Zip ____________
Phone (_____)_________________
Contact person ________________________________
E-mail _____________________________ Web site _________________________________
Name of program ______________________________________________________________


FACILITIES
  accessible through public transportation
  ample off street parking
  handicap access
  child care available on site
  on duty security
  other sites where your program is conducted:

STAFF
  pre-class intake to determine special needs
   one person     co-trainers    total number of trainers _____
Trainer qualifications: undergraduate degree: ______________________________________
  post grad. degree        no education requirement      equivalent life experience

PROGRAM DETAILS
Type            national program     curriculum developed by our agency   combination
Localities Served ______________________________________________________________
Cost            under $35 per person     $35-$50 sliding scale scholarships available
Class size      limited to 10   limited to 20    limited to 30   no limit

Sessions         one session    multiple sessions option:______________________________
  weekdays       week nights weekends          weekly     monthly other ______________
  less than 2 hours     2- 4 hours       5 - 6 hours      more than 6 hours

Presentation    lecture    discussion    video     role-play   written hand outs
                visual and auditory teaching tools Manual: included additional charge
                other _______________________________________
Special needs   foreign language interpreters     sign language interpreters
PROGRAM CONTENT
[Check all which are included in your program]

DISPUTE RESOLUTION ALTERNATIVES
 Understanding the effect of parental conflict on their children
 How to reduce parental conflict
 What triggers anger or conflict
 Techniques in problem solving and negotiation

SKILLS
  Increase parents’ communication skills
  Parenting skills and co-parenting techniques to increase the effectiveness of parenting from
two homes
  Skills to identify and meet developmental needs of their children
  Skills on how to keep children out of the middle

EMOTIONAL AND FINANCIAL SUPPORT
  Emotional, cognitive and behavioral components of parental separation
  Information that will help parents recognize when a child is experiencing emotional problems
  Increase parents’ understanding of the importance of providing emotional and financial
support to children.

PSYCHOLOGICAL IDENTITY AND RELATIONSHIPS
  Increase parents’ understanding of why children need and want a healthy, meaningful
relationship with both of their parents and offer ideas on how to successfully share in the
parenting of their children
  Increase awareness of parental roles and their impact on child development
  Encouragement of positive involvement of both parents in the lives of their children
  Development of a personal action plan related to their co-parenting.
  How parents recognize the signs of children at risk
  Enhance the safety, stability, consistency, and security of the child’s environment

EXTENDED FAMILY AND COMMUNITY
   Data on what is normal in their past, present, and future situation including changes in family
structure such as remarriage, blended families, step and half siblings
   Validation of the many things parents have already done or are doing that support children
during the divorce / separation process
   Make parents aware where to seek professional help, support, and where they can access
community resources available to them
LEGAL INFORMATION

  Mediation alternatives
  When and what court may have jurisdiction
  Grounds for divorce
  Types of divorce
  Equitable distribution of marital property
  Paternity establishment
  Options for parenting arrangements
  Persons with a legitimate interest
  Factors a judge must consider in awarding custody or visitation
  When and by whom child support may be awarded
  How child support is calculated
  Factors to rebut the presumption of child support calculated
  Requirements for notification of relocation
  Rights of access to child's records
  Tax consequences
  Enforcement of a court order
  Penalties for violation of a court order
  Social services available


COMPLETION AND FOLLOW UP

Does your program conduct an exit survey?              Yes    No

Do you award certificates of completion?               Yes    No

Do you conduct post follow up calls or surveys?        Yes    No
      If so, when? ______________________

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Parent Education Self Evaluation
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