Baby FACES: HOME VISITOR INTERVIEW

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Staff Demographics

Question Item
What language or languages do you speak?
ROWS

Question Response
MARK ALL THAT APPLY
1 ENGLISH
2 SPANISH
3 CREOLE
4 MANDARIN
5 CANTONESE
6 JAPANESE
7 VIETNAMESE
8 OTHER (SPECIFY)
9 OTHER (SPECIFY)

Staff Demographics

FOR EACH LANGUAGE SELECTED:
How fluent are you in this language?
COLUMN

Staff Demographics

What languages are used for instruction in
your class?

1. Fluent
2 Not fluent but can speak the language
3 Can't speak the language but can understand when someone
else is speaking
4 Can neither speak nor understand the language
"MARK ALL THAT APPLY
1. ENGLISH
2. SPANISH
3. VIETNAMESE
4. CHINESE
5. JAPANESE
6. KOREAN
7. A FILIPINO LANGUAGE
8. OTHER LANGUAGE (SPECIFY) Please tell me what
other languages are used for instruction in this classroom?"

Staff Demographics

What is the highest level of school you have MARK ONE
completed?
1 Some high school
2 High school graduate or GED
If you are still in school or no longer in
3 Some college courses, but no degree
school: Please tell us about the last year of 4 Two year college degree
schooling you finished.
5 Four year college degree
6 Some graduate school
7 Graduate degree

D.33

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver and EHSREP
Home Visitor CAPI

Primary Caregiver and New
Home Visitor CAPI

Primary Caregiver and FACES 2006
Home Visitor CAPI

Primary Caregiver and EHSREP
Home Visitor CAPI

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Staff Demographics

Question Item
Have you had any of the following special
child care training?

Staff Demographics

Are you currently enrolled in any of the
following special child care trainings?

Primary Caregiver or
Question Response
Home Visitor
Used in prior Study
a. A Graduate degree in Early Childhood Education or a
Primary Caregiver and SEHSP
related field
Home Visitor CAPI
b. A Baccalaureate degree in Early Childhood Education or a
related field
c. Associate degree in Early Childhood Education or a related
field
d. Child Development Associate (CDA) credential
e. State-awarded preschool, infant/toddler, family child care or
home-based certification, credential, or licensure that meets or
exceeds CDA requirements
a Currently enrolled in an Early Childhood Education at an
accredited institution of higher education
b. Currently enrolled in CDA training at an accredited
institution of higher education
c. Currently enrolled in a course of early childhood training
from some other organization (not an accredited college or
university) that leads toward a state infant-toddler credential,
the CDA, a family child care certificate, or other credential
recognized in your state

D.34

Primary Caregiver and SEHSP
Home Visitor CAPI

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Staff Demographics

Question Item
Are you of Spanish, Hispanic, or Latino
origin?
Which one of these best describes you

What is your race? You may name more
than one if you like.

Question Response
Yes; No

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver and FACES 2006
Home Visitor CAPI

1 Mexican, Mexican American, Chicano, Puerto Rican,
2 Cuban, or
3 another Spanish/Hispanic/Latino group? (SPECIFY)
MARK ALL THAT APPLY
1. WHITE
2. BLACK OR AFRICAN AMERICAN
3. AMERICAN INDIAN OR ALASKA NATIVE (SPECIFY)
4. ASIAN INDIAN
5. CHINESE
6. FILIPINO
7. JAPANESE
8. KOREAN
9. VIETNAMESE
10. ASIAN (NOT FURTHER SPECIFIED)
11. NATIVE HAWAIIAN
12. GUAMANIAN OR CHAMORRO
13. SAMOAN
14. OTHER PACIFIC ISLANDER (SPECIFY)
15. ANOTHER RACE
16. DON’T KNOW
17. REFUSED
18. OTHER (SPECIFY) “Please tell me what is your race?”

Staff Demographics

INTERVIEWER CODE WITHOUT
ASKING

Male; Female

Primary Caregiver and EHSREP
Home Visitor CAPI

Program
Implementation

How many times a year do your managers or Never; _Times per year
staff supervisors conduct staff trainings?

D.35

Primary Caregiver and SEHSP
Home Visitor CAPI

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Program
Implementation

Question Item
Question Response
Does your Early Head Start program or
Yes; No
grantee agency provide any of the following:
a. Tuition reimbursement for relevant college
courses
b. Workshop fees or other costs for outside
training
c. Time during work hours for staff
development activities such as attending
courses or workshops
FOR EACH YES ASK:
Who is eligible to receive [FILL IN EACH
BENEFIT OFFERED]?

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver and SEHSP
Home Visitor CAPI

Yes; No

Program
Implementation

Do you have an individual development
plan?

Yes; No

Primary Caregiver and New
Home Visitor CAPI

Program
Implementation

1. One-on-one supervision
2. Group supervision
3. Both
Yes; No

Primary Caregiver
CAPI

Program
Implementation

Do you have one-on-one supervision
meetings, group supervision meetings or
both?
Are supervision meetings scheduled
regularly?

Program
Implementation

How frequently do you have supervision
meetings?

1. Once a month
2. Once every 1-3 months
3. Once every 4-6 months
4. Once a year
5. Never

Program
Implementation

Do you need to submit written lesson plans? Yes; No
1. Once a month
IF YES:
2. Two times a month
How often do you submit written lesson
3. Three times a month
plans?
4. More than three times a month

D.36

New

Primary Caregiver and New
Home Visitor CAPI
Primary Caregiver and New
Home Visitor CAPI

Primary Caregiver and New
Home Visitor CAPI

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Program
Implementation

Question Item
Have you been assigned a mentor?

Question Response
Yes; No

Program
Implementation

As part of your employment in this Early
Head Start program do you have the
following?

Yes; No

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver and FACES 2006
Home Visitor CAPI
Primary Caregiver and EHSREP
Home Visitor CAPI

A. Educational stipends to cover workshops?
B. Retirement/pension plan?
C. Life insurance?
D. Paid maternity/paternity leave?
E. Paid health insurance?
F. Dental insurance?
G. Paid sick leave?
H. Paid holidays?
I. Paid vacations?
Program
Implementation

Please tell me the extent to which you agree 1. Strongly disagree, 2. Disagree, 3. Neutral, 4. Agree, 5.
or disagree with the following statements:
Strongly Agree, NA, DK
1. Overall, our Early Head Start program has
high morale
2. Our Early Head Start program allows
primary caregivers/ home visitors input into
planning curriculum.
3. Our Early Head Start program helps
primary caregivers/ home visitors to work
effectively with children with disabilities.
4. Our Early Head Start program helps
primary caregivers/ home visitors to work
effectively with families from different
cultural groups.

D.37

Primary Caregiver and SEHSP Work Climate
Home Visitor CAPI
Survey (Modified)

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Physical Health

Question Item
Now, let’s talk about your health. Would
you say your health in general is . . .

Question Response
Excellent, very good, good, fair, or poor?

Physical Health

Do you have any health concerns that
interfere with your job?

Yes, specify ; No

Mental Health/ Well
Being

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver and FACES 2006/EHSREP
Home Visitor CAPI
Primary Caregiver and New
Home Visitor CAPI

IF YES: What heath concerns interfere with
your work?
CES-D Short Form (20 items)
Rarely or never, some or a little of the time, occasionally or a Primary Caregiver and EHSREP
moderate amount of time, or most or all of the time
Home Visitor CAPI
Radloff, L. S. (1977). The CES-D scale: A
self-report depression scale for research in
the general population. Applied
Psychological Measurement, 1, 385-401

Sleep Individualization During home visits, do encourage parents to Yes; No
provide adequate sleep for their
infants/toddlers?
Sleep Individualization Are there sleep routines in place at your
Yes; No
(center-based only)
center?

Home Visitor CAPI

New

Primary Caregiver
CAPI

New

Sleep Individualization IF YES: Do children take naps other than at
(center-based only)
the routine nap times?

Yes; No

Primary Caregiver
CAPI

New

Sleep Individualization How many naps do the children take in a
(center-based only)
typical day?

Number

Primary Caregiver
CAPI

New

Sleep Individualization How long does a typical nap usually last?
(center-based only)

hh:mm, child does not nap

Primary Caregiver
CAPI

New

Primary Caregiver
CAPI

FACES 2006

Primary Caregiver/
Home Visitor Ratings

Do you have any parents of current or former Yes; No
Head Start children employed in your center?

D.38

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Primary Caregiver/
Home Visitor Ratings

Question Item
During this year and the past Early Head
Start year, have parent volunteers in your
center helped . . .

Question Response
Yes; No

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver
FACES 2006
CAPI

a. as classroom aides, or bus monitors or
drivers?
b. with screening or child assessment?
c. as consultants or workshop leaders?
d. home visitors?
e. as interpreters for non-English speaking or
limited English-speaking families?
f. in recruiting families?
g. mentor or encourage other families to
participate?
Primary Caregiver/
Home Visitor Ratings

What percent of the children in your center
have parents who participate in
any of the following ways?

Number- Percentage

Primary Caregiver
CAPI

ECLS-B

Home Visitor CAPI

New

a. As classroom
volunteers................................
b. As members of a parent council or other
governing bodies..............................
c. By doing maintenance, chores, or
shopping for the
center............................................................
d. By helping at special events or
activities...................................................
e. By attending special events or activities,
such as a children's performance, holiday
party, etc.....................
Primary Caregiver/
Home Visitor Ratings

In general, how often do families typically
1. Often
attend home visits as scheduled? Would you 2. Sometimes
say…
3. Rarely
4. Never

D.39

PRIMARY CAREGIVER/ HOME VISITOR INTERVIEW

Survey Section
Primary Caregiver/
Home Visitor Ratings

Question Item
In general, how often do families typically
attend center based visits as scheduled?
Would you say...

Use of data

Do you have access to a computer?

Use of data

Do you have laptops for use during home
visits?
Does your Early Head Start program have
internet access?

Use of data

Question Response
1. Often
2. Sometimes
3. Rarely
4. Never
Yes; No
Yes; No
Yes; No

Primary Caregiver or
Home Visitor
Used in prior Study
Primary Caregiver
New
CAPI

Primary Caregiver
CAPI
Home Visitor CAPI

New
New

Primary Caregiver and New
Home Visitor CAPI

D.40