Sample Form

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Event:
Location:
Date:
MM slash DD slash YYYY
Observer Name:
First Last
1. Creative Placemaking:
Project uses creativity (e.g., art, culture, design) to promote cultural heritage, animate public and private spaces, rejuvenate structures and streetscapes, improve local business viability and public safety, and most importantly brings diverse people together.
1a. Creativity promotes cultural heritage:
Select appropriate choice.
- Observed that this was a primary attribute
  Art, design, and creativity are a major part of what is observed. Cultural heritage (i.e. storytelling, personal history, what makes people unique) is being shared.
- Observed Moderately
  There are some clear examples of art and creativity that clearly promote cultural heritage.
- Observed Rarely
  There are a few examples of art, and creativity but not clear how they relate to cultural heritage.
- Not Observed
  There are no observable creative components and no signs of cultural heritage.
Supporting Notes:
1b. Animate public and private spaces, rejuvenate structures and streetscapes:
Select appropriate choice.
- Observed that this was a primary attribute
  There are many more people in public and private spaces. They are conversing and laughing. People are saying hello as they pass. There is plenty of foot traffic and the space is active.
- Observed Moderately
  There are more people than usual. People are smiling at each other as they pass. People are engaged in conversation.
- Observed Rarely
  Public spaces are slightly more animated. People are speaking to each other and smiling rather than just doing their business and leaving.
- Not Observed
  Public spaces appear unchanged. Streets and structures also appear unchanged. People do not speak to each other. No one makes eye contact or smiles.
Supporting Notes:
1c. Improve local business viability and public safety:
Select the appropriate choice:
- Observed that this was a primary attribute
  This is an environment where local businesses can thrive. There is more foot traffic. People are learning job skills. Strangers are chatting with each other. There are eyes on the street.
- Observed Moderately
  Local business are more likely to succeed in this environment. People are sticking around with others to spend time here. The space is more active than usual.
- Observed Rarely
  Local businesses are slightly more viable/likely to succeed. People are spending a little more time here than usual.
- Not Observed
  Local businesses are not any more viable or likely to succeed than before. Public safety appears unchanged.
Supporting Notes:
1d. Bring diverse people together:
Select the appropriate choice:
- Observed that this was a primary attribute
  People are sharing experiences that have not been around each other before. There are multiple languages spoken. People are learning about other cultures. People are celebrating cultural expression. There is plenty of interaction, dialogue, and exchange of ideas or values.
- Observed Moderately
  There is some diversity in race, age, nationality, and perspective. I hear people speaking languages other than English. Some people are sharing ideas or values.
- Observed Rarely
  There is little diversity. Participants are diverse in one way (i.e. age) but not in others (i.e. race, culture)
- Not Observed
  There is no diversity in age, race, sex, nationality, language, or socio-economic factors. Everyone looks the same.
Supporting Notes:
2. Health:
The project improves access to healthy, affordable food within low-income communities and build social cohesion.
2a. Access to healthy, affordable food within low income communities
Select the appropriate choice:
- Observed that this was a primary attribute
  Healthy and affordable food is major part of what is observed.
- Observed Moderately
  There are some clear examples of healthy, affordable food.
- Observed Rarely
  There are few healthy food options but they aren’t affordable enough or vice versa.
- Not Observed
  There are no affordable, healthy food options present.
Supporting Notes:
2b. Build social cohesion:
Select the appropriate choice:
- Observed that this was a primary attribute
  People are helping each other and working together to achieve a task. There is a clear way to get involved and unite the community.
- Observed Moderately
  People are gathering in a common space. People are smiling at each other and talking.
- Observed Rarely
  There are a few examples of people chatting with each other.
- Not Observed
  No observable social cohesion exists. People aren’t talking to each other. There is no place to gather.
Supporting Notes:
3. Economic Development:
The project creates living wage jobs, expands micro-enterprise development, promotes enterprise-level training, and contributes to neighborhood revitalization.
3a. Creates living wage jobs:
Select the appropriate choice:
- Observed that this was a primary attribute
  There is a clear path to living wage job creation and job training / workforce development is a major part of what is observed.
- Observed Moderately
  There are some clear examples of job training that could lead to a living wage job.
- Observed Rarely
  There are a few examples of skills development but it’s not clear how they will translate into a living wage job.
- Not Observed
  There are no observable job training/skills development opportunities and there is no observable path to job creation.
Supporting Notes:
3b. Expands small business development and promotes workforce training:
Select the appropriate choice:
- Observed that this was a primary attribute
  There is a network of support for small business development. There are opportunities to take business classes, do market research, and grow one’s small business. There are clear ways to get business support. There are training opportunities to prepare for the workforce.
- Observed Moderately
  There are some clear examples of support for small business development. There are clear examples of workforce training.
- Observed Rarely
  There is little small business development support. There are a few examples of workforce training.
- Not Observed
  There is no observable small business development. There is no observable workforce training.
Supporting Notes:
3c. Contributes to neighborhood revitalization:
Select the appropriate choice:
- Observed that this was a primary attribute
  There are clear contributions to the neighborhood’s quality of life, streetscapes. There are clear ways for residents to take action to improve their community. There are positive changes in the streetscape and structures.
- Observed Moderately
  There are some examples of neighborhood revitalization. Some improvements in beautification, safety, streetscapes, or other quality of life factors are occurring.
- Observed Rarely
  There is little evidence of neighborhood revitalization.
- Not Observed
  The neighborhood appears unchanged. Streets and structures appear unchanged. The quality of life appears unchanged.
Supporting Notes:
4. Equity:
The project expands opportunities for everyone to participate and prosper, particularly those communities that have historically been excluded from such opportunities.
4a. Expands opportunities for everyone to participate and prosper:
Select the appropriate choice:
- Observed that this was a primary attribute
  There are clear ways for everyone to participate and have ownership. There are clear paths for people who have been historically excluded from opportunities to prosper. There is evidence that decision making is shared and that everyone can lead or take ownership of the process.
- Observed Moderately
  There are some clear examples of opportunities for everyone to participate and prosper.
- Observed Rarely
  There are a few examples of opportunities for everyone to participate and prosper.
- Not Observed
  There are no observable opportunities for everyone to participate and prosper.
Supporting Notes:

Sample Form

1. Creative Placemaking:

2. Health:

3. Economic Development:

4. Equity: