NSCCSD Design Phase Feasibility Test
In-Person Provider Questionnaire – REVISED 12/17/08
This protocol will be used for qualitative interviews with various staff members within selected providers. Individuals will be asked to report for their job areas, so that teachers may talk only of their classrooms or themselves, while a school financial staff person will answer only the administrative questions. Interviewers will probe as needed.
General Characteristics and Market Definition
M3a. Is your program for profit, not for profit, or is it run by a government agency?
1. for profit (ask M4)
2. not for profit
3. run by a government agency
4 OTHER (SPECIFY: _______________)
M3b. Is your program independent or is it sponsored by another organization?
1 Independent (SKIP TO M5)
2 Sponsored (ask M3c)
3 DK/Ref (SKIP TO M5)
M3c. What organization sponsors your program? CIRCLE ALL THAT APPLY, READ CATEGORIES ONLY TO PROBE CORRECTLY.
1 Head Start
2 social service organization or agency
3 church or religious group
4 public school/board of education
5 private school, religious
6 private school, nonreligious
7 college or university
8 private company or individual employer
9 non-government community organization
10 state government
11 local government, not including school district
12 Federal government or military
13 other (specify ________________)
SKIP TO M5.
M4. Is your program part of a local chain, a national chain, or is it independently owned and operated?
1 Local chain
2 National chain
3 Independent
M5. What age groups of children participate in your program at this site? (1) IF R GIVES AGE GROUP NAME (E.G., TODDLER), ASK FOR APPROXIMATE AGES IN MONTHS. (2) IF R PROVIDES BROAD RANGE (E.G., UNDER AGE 12), ASK IF PROGRAM CLASSIFIES CHILDREN IN FINER AGE GROUPINGS. (3) IF R MENTIONS SCHOOL-AGE CHILDREN AGE 13 OR OLDER, SAY, “This study focuses on children under age 13, so I am going to ask you to separate that age group from any children age 13 or older whom you may also serve.
Age group (e.g., 18-35 months, 36-59 months, etc.)
1.__________________________
2.__________________________
3.__________________________
4.__________________________
M7. About how far do most of the children in your program travel to come to your program? IF NEEDED: ABOUT HOW LONG DOES IT TAKE TO GET FROM THE CHILDREN’S HOME TO YOUR LOCATION?
___________ miles
___________ minutes of travel time
M8a. Please tell me the names of up to three programs or providers in your area that you consider to be similar to your own:
Name: _______________ Location: __________________
Name: _______________ Location: __________________
Name: _______________ Location: __________________
M10. Think about the last time you changed the standard prices you charge parents for your program. How important were each of the following in your decision, very important, somewhat important, not very important, not at all important?
VImp SWIm NVImp NotImp
1 Covering increasing costs 1 2 3 4
2 Increasing profitability 1 2 3 4
3 Being affordable to parents 1 2 3 4
4 Matching the competition 1 2 3 4
5 Changes in gov’t reimbursement rates 1 2 3 4
6 Other (__________________________) 1 2 3 4
Schedule
S3. What is your program’s policy for parents who pick up children after your official closing time?
________________________________________________________
S4. (If no policy or no penalties in S3, skip to S5) In the last 3 months, when parents were late to pick up their children, how often have you enforced this policy?
1 all of the time
2 most of the time
3 some of the time
4 almost never
S5. How often do parents request additional hours or days outside of what your program usually provides?
1 Often
2 Sometimes
3 Rarely
4 Never (skip to S8)
S6. Does your program ever make exceptions for parents based on these requests?
1 Often
2 Sometimes
3 Rarely
4 Never (SKIP TO S8)
S7. Do parents pay extra for these exceptions?
1 Yes
2 No
S10. Do you permit parents to use care on schedules that vary from week to week?
1 Yes (ask S10a)
2 No (Skip to S10c)
3 DK/REF (skip to S10c)
S10a. How many of the children in your program have schedules that vary from week to week?
__________ Number of children
S10b. How far in advance do parents need to let you know when they will be needing care?
__________ Number of 1 Hours
2 Days
3 Weeks
S10c. Do you permit parents to pay for and use varying numbers of hours of care each week?
1 Yes, at their convenience
2 Yes, from a set of schedule options (ASK S10C1)
3 Yes, beyond a minimum number of hours (ASK s10c2)
4 No (Skip to S11)
5 DK/REF (skip to S11)
S10c1. How many schedule options do you offer? ________ Options (skip to s10d)
S10c2. What is the minimum number of hours? _________ Hours
S10d. How many of the children in your program have variation in the number of paid hours of care each week?
__________ Number of children
S10e. How far in advance do parents need to let you know when they will be needing care?
__________ Number of 1 Hours
2 Days
3 Weeks
Enrollment
E2. Approximately how many of children under age 13 were absent yesterday? IF NEEDED: Please tell me about the last regular school day. IF NEEDED: You can give me the percentage who were absent. Your best estimate is fine.
____________ CHILDREN or ___________ % absent
d. Is this rate of absence about the usual, higher than usual, or lower than usual?
1 usual
2 higher than usual
3 lower than usual
E3. For these next questions, please think about the [NUMBER from E1b] children that your program regularly provides care for. How many of these children are boys?
_______ Boys
E4. Question omitted.
E5. How many of the children have a physical condition that affects the way you provide care for them?
_______ Number of children
E6. How many of the girls have an emotional, developmental or behavioral condition that affects the way you provide care for them? And of the boys?
E6_1. _______ Number of girls
E6_2. _______ Number of boys
E7. About how many of the children are of Hispanic or Latino origin?
_______ Number of children
E8. As far as you know, how many of the children are….
a. White _______ Number of children
b. Black or African-American _______ Number of children
c. Asian _______ Number of children
d. Native Hawaiian or Other
Pacific Islander _______ Number of children
e. American Indian or Alaska
Native _______ Number of children
f. IF VOLUNTEERED: MIXED
RACE _______ Number of children
g. OTHER: ________________ _______ Number of children
E9. Do you have any children that you usually care for…
a. 4 hours or less each week? Y N
b. 5 to 20 hours each week? Y N
c. 21 to 39 hours each week? Y N
d. 40 hours or more each week? Y N
E9e. How many hours per week do you consider full-time enrollment in your program?
_________ Number of hours
E10. How many of your children do not speak English at home? IF NEEDED: What percent of your children do not speak English at home?
_____________ Number of children
OR _________% of children
E10a. Do you have any parents who have difficulty communicating with their child’s teacher because of a language barrier? IF NEEDED: For example, are their parents who need the help of an interpreter or a child to speak with their child’s teacher?
1 Yes (ask E10b)
2 No (skip to E11)
E10b. How many of your families have difficulty communicating with their child’s teacher because of a language barrier? IF NEEDED: Please tell me the percentages of families who need the help of an interpreter or a child to speak with their child’s teacher.
____________ Number of families
____________ % of children
E10c.What languages do these families speak?
______________________________________________________________
E11. What languages are spoken by your program staff when working directly with children? CODE ALL THAT APPLY.
1 English
2 Spanish
3 Other (specify: ____________________)
IF ENGLISH AND ANOTHER LANGUAGE SELECTED, ASK E11A.
E11a. What percentage of the time is English spoken? _______ %
E12. Does a federal, state or local agency such as a human services agency, an education department, welfare or an employment or training program pay part or all of the cost for any of the children you care for?
1 Yes
2 No (go to E15)
E12a. How many children are paid for partially or fully by a government agency?
_________ Number of children
E12b. Do the agencies pay you….
1. directly for slots Y N
2. pay you for vouchers or certificate received from parents Y N
3. pay the parents in cash Y N
4. some other way (___________________)
E12c. For how many of the children in your program do you receive payment or partial payment through a voucher? IF NEEDED: Vouchers are certificates that parents may receive from a social service or educational agency to give to a program so that the program can receive payment for care from the agency. The program may also provide attendance records or other information in order to receive payment. IF NEEDED: Your best estimate is fine.
________________ Number of children.
E12d. Some agencies contract directly with providers to provide subsidized care or ‘slots’ to needy families. Do you have a contract with a federal, state or local agency to provide a certain number of slots for subsidized care for low-income families?
1 Yes
2 No (go to E13)
E12e. How many children are partially or fully paid for through contracts with governmental agencies?
__________ Number of children
E12f. What agencies do you have contracts with? RECORD NAME & CODE.
________________________________________
1 Federal
2 State
3 Local, other than public school districts
4 Local public school district
Admissions/Marketing
A1. During January through March of this year, how many children did you stop caring for? IF NEEDED: Include children whose parents withdrew their children from care as well as children you didn’t want to care for anymore.
_________
A2. During January through March of this year, how many new children did you start taking care of?
_________
A6. The last time you had an opening, how long did it take you to find another child to care for?
________ Number of 1 Days (skip to A7)
2 Weeks (skip to A7)
3 Months (skip to A7)
4 STILL HAVE OPENING (ask A6a)
5 CHILD TAKEN FROM WAITING LIST (skip to A7)
A6a. How long have you had this opening so far?
________ Number of 1 Days
2 Weeks
3 Months
A7. In the past year, have you turned away children who wanted to enroll because you did not have an empty slot?
1 yes
2 no
3 CHILDREN ARE PLACED ON A WAITING LIST
A7_. In the past three months, have you told a parent that you won’t care for a child anymore because of…
a. problems with the child’s behavior Yes No
b. problems getting paid Yes No
c. other issues with the parent Yes No
d. you wanted to reduce your program’s size Yes No
A8a. How often in the last three months have you or someone else on your staff raised any of the following with a parent …
1. parenting issues? Never Monthly Weekly Daily
2. payment of program fees? Never Monthly Weekly Daily
3. coming late to pick up a child? Never Monthly Weekly Daily
A8b. In the last three months, how often has a parent talked with you or someone else on your staff about any of the following…
1. Something the child’s teacher/caregiver is doing with the child or group
Never Monthly Weekly Daily
2. The child’s behavior
Never Monthly Weekly Daily
3. The child’s development
Never Monthly Weekly Daily
4. The child’s health
Never Monthly Weekly Daily
5. How parents can support children’s learning at home
Never Monthly Weekly Daily
6. How parents can discipline the child at home
Never Monthly Weekly Daily
7. Recent family activities or events
Never Monthly Weekly Daily
A9. How important is it to you that your lead teachers:
a. Value their relationships with parents?
1 Very Important
2 Somewhat Important
3 Not very Important
4 Not at all Important
b. Understand what parents’ schedules are like?
1 Very Important
2 Somewhat Important
3 Not very Important
4 Not at all Important
c. Are flexible in working with parents’ schedules?
1 Very Important
2 Somewhat Important
3 Not very Important
4 Not at all Important
d. Pay attention to suggestions parents make about caring for their children?
1 Very Important
2 Somewhat Important
3 Not very Important
4 Not at all Important
A10. The care that a child receives can vary for many reasons. The environment they’re in, the money and other resources available to the person providing care, the how the parent works with the care provider, etc.
IF R CARES FOR CHILDREN UNDER AGE 3, ASK:
A10a. If 1 means ‘the best possible care there is’ and 5 means ‘not as good as I’d like it to be,’ please tell me how you would rate the care you provide to children under age 3. In terms of:
a. having a safe environment ______ N/A
b. being warm and nurturing ______ N/A
c. helping them learn so they can do well in school ______ N/A
d. helping them learn how to get along with others ______ N/A
e. helping them with their physical skills ______ N/A
f. teaching them your program’s values ______ N/A
IF R CARES FOR CHILDREN AGE 3 TO 5, ASK:
A10b. [If 1 means ‘the best possible care there is’ and 5 means ‘not as good as I’d like it to be,’ please tell me how you would rate/How about] the care you provide to children aged 3 to 5. In terms of:
a. having a safe environment ______ N/A
b. being warm and nurturing ______ N/A
c. helping them learn so they can do well in school ______ N/A
d. helping them learn how to get along with others ______ N/A
e. helping them with their physical skills ______ N/A
f. teaching them your program’s values ______ N/A
IF R CARES FOR SCHOOL_AGE CHILDREN, ASK:
A10c. . If 1 means ‘the best possible care there is’ and 5 means ‘not as good as I’d like it to be,’ please tell me how you would rate the care you provide to school-age children. In terms of:
a. having a safe environment ______ N/A
b. being warm and nurturing ______ N/A
c. helping them learn so they can do well in school ______ N/A
d. helping them learn how to get along with others ______ N/A
e. helping them with their physical skills ______ N/A
f. teaching them your program’s values ______ N/A
A11. The following questions are about various services that children and their families might require outside of the child-care setting.
a. Are any of the following available to children on-site at your program? Health screening: medical, dental, vision, hearing, or speech?
1 Yes Does your program pay for this service? 1 Yes 2 No
2 No -> Does your program provide referrals to this service? 1 Yes 2 No
b. Are development assessments available to children on-site at your program?
1 Yes Does your program pay for this service? 1 Yes 2 No
2 No -> Does your program provide referrals to this service? 1 Yes 2 No
c. Are therapeutic services such as speech therapy, occupational therapy, or services for children with special needs available to children on-site at your program?
1 Yes Does your program pay for this service? 1 Yes 2 No
2 No -> Does your program provide referrals to this service? 1 Yes 2 No
d. Are counseling services for children or parents available on-site at your program?
1 Yes Does your program pay for this service? 1 Yes 2 No
2 No -> Does your program provide referrals to this service? 1 Yes 2 No
e. Are any of the following available to children on-site at your program? Social services to parents such as housing assistance, food stamps, financial aid, or medical care.
1 Yes Does your program pay for this service? 1 Yes 2 No
2 No -> Does your program provide referrals to this service? 1 Yes 2 No
A11e. [if yes to A11e1 or A11e2] In the last year, how many parents have you provided with social services assistance, including referrals?
__________ Number of parents
A12. In the past 3 months, have you provided financial aid or reduced the fees that you charge a family because of a change in their personal circumstances?
1 Yes (ask A12a)
2 No (skip to A13)
A12a. About how many families have you done this for?
__________ Number of families
Staffing
T1. What is the total number of staff employed by your program at this site who work directly with children. Please include full-time and part-time workers.
___________
T2. Thinking only about staff who work directly with children, how many such individuals have left the program in the last 12 months?
_______
T2a. [if T2>0] In the last year, have you asked a staff member who worked directly with children to leave your program because of concerns about that person’s caregiving or instructional quality?
1 Yes
2 No
T3. What is the total number of staff who do not work directly with children? Include full-time and part-time workers, administrators, support staff, drivers, cooks, and anyone else on your program’s payroll at this site.
____________
T5. These next questions are about supervision in your program.
a. In the past year have you or someone else observed each of the groups in your program? Y N
b. Was feedback provided to the staff observed based on these observation(s)?
Y N
c. Do salary decisions take into account what is observed or how staff respond to feedback provided?
Y N
Care Provided
C1. How many groups of children do you have? Please include all groups in all of the programs or sessions that you offer for children under age 13. IF NEEDED: By group, we mean children who are together for most of the [day/session] with an assigned staff member or group of staff members. If children change groups frequently during the day, please tell me about your groups during a typical activity period.
_________ Number of groups [if only one group, skip to C3]
C2. [ASK ABOUT AGE GROUPS FROM M5, AGES OF CHILDREN SERVED.] How many of these groups serve [AGE GROUP FROM M5] children?
Age group from M5
1.__________________________ _______ number of groups
a1. what are the names of these groups?
1. ________________________ 2. ______________________
3. ________________________ 4. ______________________
5. ________________________ 6. ______________________
7. ________________________ 8. ______________________
2.__________________________ _______ number of groups
a1. what are the names of these groups?
1. ________________________ 2. ______________________
3. ________________________ 4. ______________________
5. ________________________ 6. ______________________
7. ________________________ 8. ______________________
3.__________________________ _______ number of groups
a1. what are the names of these groups?
1. ________________________ 2. ______________________
3. ________________________ 4. ______________________
5. ________________________ 6. ______________________
7. ________________________ 8. ______________________
4.__________________________ _______ number of groups
a1. what are the names of these groups?
1. ________________________ 2. ______________________
3. ________________________ 4. ______________________
5. ________________________ 6. ______________________
7. ________________________ 8. ______________________
[RANDOMLY SELECT TWO GROUPS. DO NOT LET R SELECT GROUP.]
C3. I’m going to ask you some detailed questions about two of your groups. This helps reduce the number of questions I need to ask you, but still gives us a sense overall of the range of offerings that providers have. Please do not worry if the groups I select are not typical of your program.
[First,] let’s talk about [FIRST/SECOND SELECTED GROUP]. ASK C3A THROUGH C7 FOR FIRST GROUP, THEN ASK ENTIRE SET FOR GROUP FROM NEXT AGE CATEGORY UNTIL ALL AGE CATEGORIES ARE COMPLETE.
INFANT-TODDLER
C3a. How old is the youngest child in []?
_______ Years and _______ Months
C3b. How old is the oldest child in []?
_______ Years and _______ Months
C3c. How many children are currently enrolled in []? ___________ Number of children
C3d. How many more children would you be able and willing to accept in this group? _______ Number of additional children
C3e. How many hours per day are most of the children in this group at your program?
__________ Hours per day
C3f. During a typical activity period, how many assistant teachers or aides help with this group?
__________ Number of assistants/aides
C3g. During a typical activity period, how many lead teachers and other teachers are with this group?
__________ Number of teachers
C3h. During a typical activity period, how many volunteers help with this group?
__________ Number of volunteers
C4. Please tell me the names or initials of the lead teachers, other teachers, assistants or aides who work with this group.
C4a. Is [NAME] a lead teacher, other teacher, assistant teacher or aide?
C4b. Is [] male or female?
C4c. How old is []? IF NEEDED: your best guess is fine.
C4d. Approximately how many hours per week does [] usually work?
C4e. Is [] of Hispanic or Latino origin?
C4f. Which of the following is []…READ CATEGORIES?
C4g1. [Does []/Do you] have a CDA?
1 Yes
2 No
C4g2. [Does []/Do you] have a 2 year college degree?
1 Yes
2 No
C4g3. [Does []/Do you] have a 4-year college degree?
1 Yes
2 No
C4g4. [if c4g2=1 or c4g3=1] [Does []/Do you] have a college degree in…
a. child development or early care and education?
1 Yes
2 No
b. special education?
1 Yes
2 No
c. elementary education?
1 Yes
2 No
C4g5. [Does []/Do you] have some form of certification to teach young children?
1 Yes
2 No
C4g6. [Does []/Do you] have some form of certification as a special education teacher or elementary school teacher?
1 yes
2 No
C4h. Does [] have any training outside of higher education in child development or early care and education?
C4i. As far as you know, has [] received any professional development or other training on working with young children in the past 12 months?
C4j. How long has [] worked in your program?
C4k. How many years of experience does [] have working with children under age 13? Please do not count any experience raising (his/her) own children.
C4l. How much is [] paid? RECORD AMOUNT AND TIME UNIT. PROBE FOR BEST ESTIMATE IF NEEDED.
C4m. Please tell me if [] receives any of the following benefits: READ ALL CATEGORIES
1 reduced tuition at your program 2 funds for (him/her) to receive training
3 retirement/IRA/SEP/Keogh 4 life or disability insurance
5 health insurance 6 paid parental leave
7 other paid time off
C4 Please tell me the names or initials of the lead teachers, other teachers, assistants or aides who work with this group.
Name/initials |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
C4a. Role |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
1 Lead 2Teacher 3 Asst 4 Aide 5 Other |
C4b. Gender |
1 Male 2 Female |
1 Male 2 Female |
1 Male 2 Female |
1 Male 2 Female |
1 Male 2 Female |
1 Male 2 Female |
1 Male 2 Female |
C4c. Age |
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C4d. Hours per week |
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C4e. Hispanic/Latino |
1 Yes 2 No |
1 Yes 2 No |
1 Yes 2 No |
1 Yes 2 No |
1 Yes 2 No |
1 Yes 2 No |
1 Yes 2 No |
C4f. Race |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
1 White 2 Black 3 Asian 4 NHOPI 5 AI/AN 6 OTHER |
C4g. College Degree |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
C4h. Education or Child Dev Training |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
C4i. Prof Dev past 12 months |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
1 Yes 2 No 3 DK |
C4j. Yrs w/pgm |
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C4k. Years in field |
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C4l. Wage rate |
$ ______ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$______ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$______ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$ _____ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$ _____ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$ _____ per 1 hour 2 day 3 week 4 month 5 year 6 other |
$ _____ per 1 hour 2 day 3 week 4 month 5 year 6 other |
C4m. Benefits received |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
1 reduced tuition 2 training funds 3 rtrmt 4 life insurance 5 health insurance 6 paid parental leave 7 paid time off |
ASK 4A-M FOR NEXT STAFF PERSON UNTIL ALL STAFF PERSONS ASKED ABOUT FOR THIS GROUP.
C5. [IF group is younger than school-age] Thinking about a typical day for children in this group, what percentage of time do children spend doing such things as physical activities, creative activities, instructional activities, other group activities and free choice activities. IF NEEDED: Just tell me the typical amount of time on this activity.
a. Physical activities led by an adult. ___________ % or minutes
b. Creative activities led by an adult, such
as music, block building, arts and crafts,
or dramatic play. ___________ % or minutes
c. Teacher-directed instruction such as [learning
animals or colors/numbers or letters/reading
or mathematics] ___________ % or minutes
d. Other teacher-directed group activities,
such as reading aloud or [storytelling/discussion] ___________ % or minutes
e. Activities chosen by the child. ___________ % or minutes
C5a. [IF GROUP IS SCHOOL-AGE] Next, I’ll ask you about how children in this group spend a typical day. I’ll ask about academic activities, arts or cultural enrichment, recreational activities, social activities, community service, technology, or supervised free time. What percentage of time do children spend on…? IF NEEDED: Just tell me the typical amount of time on this activity.
Activity |
Time |
% /minutes |
Academic activities (tutoring, homework help, college prep, etc.) |
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Arts/Cultural enrichment (arts, music, cooking, going to museums, multicultural awareness, etc.) |
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Physical or Athletic activities (sports, free swimming, active play, etc.) |
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Social or Recreational activities (focused on behavioral and interpersonal skills) |
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Community service/civic engagement |
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Technology (computer programming/web site design) |
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Supervised free time |
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C5b. [IF GROUP IS SCHOOL-AGED] 1. Indicate the extent to which the management and staff of this Center consider each of the following to be an objective or goal of their program. Indicate whether each is (1) a major objective, (2) a minor objective, or (3) not an objective of this Center:
A __ Provide a safe environment for kids after school
B __ Help kids to improve academic performance (e.g., grades, test scores)
C __ Help kids to develop socially
D __ Provide cultural opportunities for kids
E __ Provide physical or recreational activities for kids
F __ Prevent risky behavior
G __ Other (describe)
C6. How often do children in this group watch educational programs on television or DVDs?
1 every day
2 2-3 times per week
3 2-4 times per month
4 very rarely
5 never
C6. How often do children in this group watch other programming?
1 every day
2 2-3 times per week
3 2-4 times per month
4 very rarely
5 never
C7. How often do children in this group use computers?
1 every day
2 2-3 times per week
3 2-4 times per month
4 very rarely
5 never
END REPRESENTATIVE GROUP QUESTIONS.
C11. Would you say that you and your staff feel overwhelmed by the concerns parents share with you…?
1 Often
2 Occasionally
3 Rarely
4 Never?
Finances
F1. Now I will be asking you some questions about your program’s finances for the last completed financial reporting year.
What would be the starting and ending dates of that financial reporting year?
Start Date _______
End Date _______ (END DATE MUST PRECEDE INTERVIEW DATE)
IF NO FORMAL FINANCIAL REPORTING YEAR. Please answer the following questions about the calendar year 2008.
F2. For that year, approximately what were the total revenues of your at this site? Your best guess will be fine. INTERVIEWER: IF R IS ABLE, PLEASE COLLECT NUMBERS FOR PROGRAMS FOR CHILDREN UNDER AGE 13 ONLY. ELSE, COLLECT NUMBERS FOR ENTIRE PROGRAM AND INDICATE INCLUSION OF CHILDREN OVER AGE 13 IN ITEM F2A.
$ _____________________
F2A. [if r provides care for children age 13 or older, ask] Just to confirm, do the total revenues you reported to me include revenues from children age 13 or older as well as those under age 13?
1 Yes
2 No
F3. Please tell me your revenues for the year ending (END DATE) for your program at this site. Your best guess will be fine.
Revenue Category |
Amount (If Amount DK/Ref, ask rec’d) |
Received at all? |
a. Tuitions and fees paid by parents - including parent fees and additional fees paid by parents such as registration fees, transportation fees from parents, late pick up/late payment fees.
|
|
1 Yes 2 No |
b. Tuitions paid by state government (vouchers/certificates, state contracts, transportation, Pre-K funds, grants from state agencies)
|
|
1 Yes 2 No |
c. Local government (e.g. Pre-K paid by local school board or other local agency, grants from county government)
|
|
1 Yes 2 No |
d. Federal government(e.g., Head Start, Title I)
|
|
1 Yes 2 No |
d2.Community organizations (e.g., United Way, local charities, or other service organizations) |
|
1 Yes 2 No |
e. Grant revenues (not including anything you’ve mentioned above)
|
|
1 Yes 2 No |
f. Child and Adult Care Food Program
|
|
1 Yes 2 No |
g. Investment income
|
|
1 Yes 2 No |
h. Revenues from fund raising activities, cash contributions, gifts, bequests, special events. |
|
1 Yes 2 No |
i. Other (please specify: _______________)
|
|
1 Yes 2 No |
F3k. [if r provides care to children age 5 or under AND receives government money (F3b or F3c or F3d greater than 0 or marked ‘yes’ in the received column)]:
Does your program receive funds from:
1. Head Start, Early Head Start, or
a partnership with a Head Start program? Y N
2. a state or local pre-kindergarten program? Y N
3. Title I Y N
Costs
F4. What would you estimate was the total cost of running your program during your last financial year? Please do not include the value of donated services, space, or materials. Again, your best guess will be fine.
$ _________________
F5. Altogether, did your program’s revenues exceed expenses, expenses exceed revenues, or did you break even during the last financial reporting year
1 REVENUES EXCEEDED EXPENSES
2 EXPENSES EXCEEDED REVENUES
3 BROKE EVEN
F6. First, I will ask you about labor costs, then about other costs. Then I will ask you about in-kind donations your program may receive.
Labor Costs Please include all people who work in this child care program at this site, either full or part time. |
Amount last year |
a. Salaries and wages for all staff (not just teachers). (Put taxes in b.)
|
|
b. Fringe benefits and payroll taxes (incl. FICA, unemployment, health insurance benefits)
|
|
c. Total Labor Costs (sum of a. and b.)
|
|
F7. What proportion of your total direct costs is made up of labor costs, including wages and fringe benefits? By total direct costs I mean labor costs, other direct costs, excluding facility costs & the value of donated time & other items. ______________ %
F8. Other than labor, what would you say are your three largest expenses? Please provide the amount of these expenses for your last financial reporting year if you have that information available. CODE BASED ON VERBATIM RESPONSE, READ CATEGORIES ONLY TO PROBE INTO CORRECT CATEGORY.
0. Facility costs, including utilities and insurance for the facility
1. Costs of food and related goods for meals & snacks served to children (not cook's wages)
2. Educational materials & expenditures, program supplies (e.g. books, supplies, field trips), program equipment including program equipment depreciation.
3. Office supplies and office equipment, postage, office equipment depreciation
4. Telephone, printing, copying, duplicating, advertising, recruiting
5. Liability insurance
6. Other insurance (DO NOT INCLUDE HEALTH INSURANCE FOR EMPLOYEES OR FACILITY-RELATED INSURANCE)
7. Transportation of children: vehicle expenses, gas and drivers if not listed with labor costs above.
8. Subcontractors (fees for professional services, e.g. accountants, consultants, attorneys, auditing, payroll services; other services paid via contract, e.g. janitorial services, etc.)
9. Training / Professional development expenses (e.g., trainer coming to program, fees for staff to attend courses, conferences)
10. Staff mileage or travel
11. Supplemental services for children (e.g., health screenings, speech therapy)
12. Administrative Allocation, Overhead, Indirect Costs (paid to sponsoring agency or parent organization). (This is only relevant for programs that have a parent/sponsoring agency, or are part of a larger organization, not a single stand-alone business.)
13. Miscellaneous/other
|
Category of Expense |
Dollar Cost in 2008/Last Year |
F8a. LARGEST NON-LABOR EXPENSE: |
|
|
F8b. 2nd LARGEST NON-LABOR EXPENSE |
|
|
F8c. 3RD LARGEST NON-LABOR EXPENSE |
|
|
F9. These next questions are about in-kind services or goods your program may have received last year. First, please tell me if your program received any of the following services free or at reduced cost [that year/during 2008]? [IF R IS PART OF A NETWORK OR SPONSORING ORGANIZATION, READ: You might have received some of these services from your network or sponsoring organization.]
a. Volunteers working with the children in the classroom, on field trips, or in the playground
|
1 Yes 2 No 1 Yes 2 No
|
b. Accounting/bookkeeping
|
1 Yes 2 No
|
c. Legal services
|
1 Yes 2 No
|
d. Special learning activities provided: music, art, sports, etc.
|
1 Yes 2 No
|
e. Repairs/maintenance (labor and parts)
|
1 Yes 2 No
|
f. Clerical
|
1 Yes 2 No
|
g. Grant writer
|
1 Yes 2 No
|
h. Administrative, professional, contractual & support services provided
|
1 Yes 2 No
|
i. Professional development provided (e.g., trainer provides services at no cost or reduced cost to your program)
|
1 Yes 2 No
|
j. Supplemental services provided (speech & language therapist, physical therapist, health services)
|
1 Yes 2 No
|
k. "Other" in-kind services donated free or at a reduced rate
|
1 Yes 2 No
|
F10. During the last financial year, did you receive any in-kind donations?
1 Yes (ask F10a)
2 No (F11)
F10a. What was the most important donation you received, and what would you estimate as its market value?
a. Reduced or no rent/no fee for classroom(s), administrative space, outdoor space
|
b. Utilities free or at reduced rate
|
c. Donated food for children.
|
d. Educational expenditures provided (e.g. books, supplies, equipment, field trips)
|
e. Financial aid, scholarships for children provided by a group or individual other than your program.
|
f. Office supplies and office equipment provided
|
g. Telephone, printing, copying, advertising
|
h. Liability and/or other insurance provided
|
i. Professional development provided (e.g., fees for staff to attend courses)
|
j. Transportation for children provided
|
k. "Other" in-kind goods donated free or at a reduced rate
|
Most important donation received:
Category ______________
Estimated market value: _____________
F12. And may I record your title? _____________________________________
Those are all of the questions I have for you today. We appreciate your taking the time to talk with us about your program.
File Type | application/msword |
File Title | Schedule |
Author | datta-atreyee |
Last Modified By | DHHS |
File Modified | 2008-12-17 |
File Created | 2008-12-17 |