Director Survey

Appendix A-2:
Director Survey

Family and
Early Care and
Education Provider
Relationship Study

Director Survey

R

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

Director Survey
Thank you for agreeing to participate in the Family and Early Care and Education Provider Relationship
Study. The results will help us develop surveys that teachers, child care providers, and policymakers can
use to improve children’s care and education.
This survey asks about your early education and child care program. We will ask general questions about
the education or care environment, and the parents and families of children enrolled in your program.
All information obtained from this study will be kept private. The report summarizing the findings will
not contain any names or identifying information.
Please follow these steps:
1. Complete the director survey. It takes approximately 10 minutes.
Please use a black or blue pen to complete this form.
Mark

to indicate your answer.

If you change your answer, mark
right answer.

on the wrong answer, and mark

to indicate the

2. Use the self-addressed, postage-paid envelope, to mail the survey back to:
XXXXX XXXXXX
Westat
1600 Research Boulevard
Rockville, Maryland
20850-3129

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for
reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
number.
The office of Management and Budget has approved the data collection under OMB #XXXX-XXXX. OPRE is authorized to conduct
this study under Section 649 of the Head Start Act, as amended by the Improving Head Start for School Readiness Act of 2007,
codified at 42 United States Code (U.S.C.) 9844.

1

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

1.

How many children ages 0-5 are currently enrolled in your program?
[IF YOUR PROGRAM HAS MORE THAN ONE PROGRAM ONLY REPORT ABOUT THE
PROGRAM YOU ARE DIRECTLY RESPONSIBLE FOR. DO NOT INCLUDE CHILDREN THAT
ARE ENROLLED IN A KINDERGARTEN PROGRAM.]
________children

2.

What are the ages of children you will accept into your program?
[MARK ALL THAT APPLY]
Less than 6 months .......................................
6 months-less than 1 year .............................
1year-less than 2 years..................................
2 years-less than 3 years ...............................
3 years-less than 4 years ...............................
4 years-less than 5 years ...............................
5 years or more .............................................

3.

Approximately how many of the children in your program belong to each of the following
racial/ethnic groups?
[THE COLUMNS SHOULD ADD TO THE TOTAL ENROLLMENT IN YOUR PROGRAM.]
a. White, not Hispanic or Latino ..................................................................
b. Black or African American, not Hispanic or Latino .................................
c. Hispanic/Latino of any race ......................................................................
d. Two or more races, not Hispanic or Latino ..............................................
e. Asian, not Hispanic or Latino ...................................................................
f.

Native Hawaiian or Other Pacific Islander, not Hispanic or Latino .........

g. American Indian or Alaska Native, not Hispanic or Latino .....................
Total enrollment (sum of a through g) ............................................................

4.

How many aides or teaching assistants are employed in the program?
_______ aides or teaching assistants

5.

How many child care providers or teachers are employed in the program?
_______ providers or teachers

2

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

6.

How many family service workers are employed in the program?
_______ family service workers

7.

Which of the following methods are used to communicate with families?
[MARK ONE BOX IN EACH ROW.]
Yes

No

a. Website.......................................................................................................
b. Newsletter ..................................................................................................
c. Calendar .....................................................................................................
d. Bulletin Boards ..........................................................................................
e. Email ..........................................................................................................
f.

Text message ..............................................................................................

g. Telephone ...................................................................................................
h. Parent-teacher conferences.........................................................................
i.
8.

In-person discussions .................................................................................

Since September has your program given any family information about the following:
[MARK ONE BOX IN EACH ROW.]
Yes
a. Employment or job training? .....................................................................
b. Food pantries? ............................................................................................
c. Child care subsidies or vouchers? ..............................................................
d. Temporary Assistance for Needy Families (TANF)? ................................
e. Adult education, GED classes, ESL classes, or continuing education? .....
f.

Housing assistance? ...................................................................................

g. Energy or fuel assistance? ..........................................................................
h. Immigration or legal services? ...................................................................
i.

Domestic violence programs? ....................................................................

j.

Substance abuse programs?........................................................................

3

No

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

9.

Since September has your program provided referrals for the following services:
[MARK ONE BOX IN EACH ROW.]
Yes

No

Yes

No

a. Health screening (medical, dental, vision, hearing, or speech)? ................
b. Developmental assessments? .....................................................................
c. Psychological counseling services for children? ........................................
d. Psychological counseling services for parents? .........................................
e. Social services such as housing assistance, food stamps, financial aid, or
medical care?..............................................................................................
10.

Since September has your program offered the following to any family:
[MARK ONE BOX IN EACH ROW.]

a. Sick care? ...................................................................................................
b. Extended hours? .........................................................................................
c. Flexibility to drop off early or pick up late as needed? ..............................
d. Flexibility to pay for child care services after the payment due date? .......
e. Help getting transportation to and/or from the care setting? ......................
11.

Since September, has your program received funding from any of the following?
[MARK ALL THAT APPLY.]
State pre-kindergarten ..................................................
Head Start .....................................................................
Child Care and Development Fund (CCDF) ................
Title 1 ...........................................................................
Local or community organizations (e.g., United Way)
Other .............................................................................

12.

Do you ask parents to provide you feedback about your program?
[MARK ONLY ONE BOX.]
Yes ...................................
No ....................................

GO TO QUESTION 14

4

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

13.

How often do you use the feedback you receive from parents to make changes to your
program?
[MARK ONLY ONE BOX.]
Never ............................................................................
Rarely ...........................................................................
Often .............................................................................
Very often .....................................................................

Listed below are some questions about the environment of your child care program.
[MARK ONE BOX IN EACH ROW.]
At your program:
Yes
14. Parents can visit the care setting anytime during care hours .......................................
15. There are a variety of opportunities for parent involvement, including:
a. volunteering in program/care activities ..................................................................
b. bringing in materials such as arts and crafts ...........................................................
c. participating in a parent committee ........................................................................
d. observing their own children in the care setting .....................................................
16. Parents are invited to shape the planning of the program ............................................
17. The program has suggestion boxes or surveys for family members to give
feedback about the program ........................................................................................
18. The program offers special activities just for fathers or other male members of the
family ...........................................................................................................................
19. Written information and materials provided to families are in all languages spoken
by families ...................................................................................................................
20. Written information and materials provided to families are at the appropriate
literacy level ................................................................................................................
21. The program provides opportunities for family events ...............................................
22. There are opportunities for parents to get together ......................................................
23. The program provides parenting information through: ...............................................
a. parenting workshops/classes ..................................................................................
b. bulletin boards ........................................................................................................
c. newsletters ..............................................................................................................
d. resource library with books and/or videos..............................................................
e. pamphlets ...............................................................................................................

END: THANK YOU FOR COMPLETING THIS SURVEY

5

No