Page 2 - Parenting Assessments

Code Sheet for Parenting

Assessment Survey

Parent Name: ______________________________________ Date: ___________

Case Manager: ______________________________________

Instructions:
The Parent Assessment is used to determine which pamphlets are especially needed by each parent.

 The Parent Assessment has two questions related to each pamphlet, and four questions
related to general parenting issues.
 Code the parent’s answer onto this form in the corresponding column. You will only track
specific responses that indicate an immediate need.
 Indicate in the Code column which pamphlets you will prioritize for this parent.

For Evaluation Only
The parent needs immediate
Code ©2022 Learnovation®, LLC
assistance with this topic if they
Pamphlet
Questions
answered…
P General Parenting Issues 1 28 1 - SD or D 28 - SA or A
P General Parenting Issues 26 27 26- SD or D 27 - SA or A
P1 Life With Kids 3 5 3 - SD or D 5 - SD or D
P2 What to Expect as Kids Grow 6 8 6 - SD or D 8 - SA or A

P3 Being a Good Parent 10 12 10 - SA or A 12 - SD or D
Talking and Connecting with 14 16 14 - SA or A 16 - SA or A
P4
Kids
P5 Disciplining Kids 18 20 18 - SD or D 20 - SA or A
P6 Conflict in the Family 22 24 22 - SA or A 24 - SD or D
P7 Kids and Divorce 2 4 2 - SD or D 4 - SA or A

Single Parenting and Step 7 9 7 - SD or D 9 - SA or A
P8
Families
P9 Keeping Kids Healthy 11 13 11 - SA or A 13- SD or D
P10 Kids and School 15 17 15 - SD or D 17- SD or D
P11 When Your Kids Are in Trouble 19 21 19 - SA or A 21 - SA or A

Finding Help in Your 23 25 23 - SA or A 25 - SA or A
P12
Community

Parent Pre-Assessment Answer Sheet Parenting Pamphlet Series
©2022 Learnovation®, LLC