Parent Survey about Providers/Teachers

Appendix A-4:
Parent Survey about Providers/Teachers

Family and
Early Care and
Education Provider
Relationship Study

Parent Survey About Teachers and
Child Care Providers

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

Parent 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 child’s care and early education. This survey is about your child’s main child
care provider or teacher. Please only think about this person when answering the following questions.
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 parent 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
3. As a token of our appreciation for your time and effort, you will receive a check for $25 within 2-3
weeks of our receipt of your completed questionnaire.

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.

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

1. Since September, how often have you talked to your child care provider or teacher about the
following?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Your child’s experiences in the education
and care setting ...........................................
b. Your child’s abilities ..................................
c. Your child’s general behavior ....................
d. Goals you have for your child ....................
e. What to expect at each stage of your
child’s development ...................................
f. Your vision for your child’s future .............

2. Since September, how often have you talked to your child care provider or teacher about the
following?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Your provider’s expectations for your
child ............................................................
b. The rules your provider has for children in
his or her care ...........................................
c. How you feel about the care and
education your child receives .....................

3. How often do you have difficulty communicating with your child care provider or teacher
because he or she has a strong accent or speaks a different language than you?
[MARK ONLY ONE BOX.]
Never .........................................................................................................
Rarely ........................................................................................................
Sometimes .................................................................................................
Very often ..................................................................................................

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

4. How comfortable do you feel sharing the following information with your child care provider or
teacher?
[MARK ONE BOX IN EACH ROW.]
Very
uncomfortable

Uncomfortable

Comfortable

a. If your child has siblings ............................
b. If you have other adult relatives living in
your household ...........................................
c. Your household schedule .........................
d. Your marital status .....................................
e. Your personal relationship with a spouse
or partner ..................................................
f.

Your employment status ...........................

g. Your financial situation ............................
h. Your family life .......................................
i.

The role that faith and religion play in
your household ........................................

j.

Your family’s culture and values ............

k. What you do outside of the education and
care setting to encourage your child’s
learning ....................................................
l.

How you discipline your child ................

m. Problems your child is having at home ...
n. Changes happening at home ....................
o. Health issues your child has such as food
allergies or asthma ....................................

5. How often does your child care provider or teacher ask about your family?
[MARK ONLY ONE BOX.]
Never .........................................................................................................
Rarely ........................................................................................................
Sometimes .................................................................................................
Very often ..................................................................................................

3

Very
comfortable

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

6. If you had a problem with your child care provider or teacher, how comfortable would you feel
talking to him or her about it?
[MARK ONLY ONE BOX.]
Very uncomfortable ...................................................................................
Uncomfortable ...........................................................................................
Comfortable ...............................................................................................
Very comfortable .......................................................................................

7. How often does your child care provider or teacher:
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Help you say goodbye to your child when
you drop him or her off?............................
b. Share information with you about your
child’s day?................................................
c. Offer you books or materials on
parenting? ..................................................
d. Suggest activities for you and your child
to do together? ...........................................

8. How often does your child care provider or teacher:
[MARK ONE BOX IN EACH ROW.]
Never

a. Work with you to develop strategies you
can use at home to support your child’s
learning and development? ..........................
b. Listen to your ideas about ways to change
or improve the education and care your
child receives? ............................................
c. Offer you ideas or suggestions about
parenting? ...................................................
d. Provide you with opportunities to make
decisions about your child’s education and
care? ............................................................
e. Provide you with opportunities to give
feedback on your provider’s performance? .
f.

Remember personal details about your
family when speaking with you? .................

g. Contradict you in front of your child? .........

4

Rarely

Sometimes

Very often

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

9.

How much are the following statements like your child care provider or teacher?
[MARK ONE BOX IN EACH ROW.]
Not at all like
my provider

a.

My child care provider or teacher uses my
feedback to adjust the education and care
provided to my child .................................

b.

My child care provider or teacher is
flexible in response to my work or school
schedule ....................................................

A little like my
provider

A lot like my
provider

Exactly like my
provider

10. How much do you agree or disagree with the following statement?
My child care provider or teacher is open to learning new ways to teach and care for children.
[MARK ONLY ONE BOX.]
Strongly disagree .......................................................................................
Disagree .....................................................................................................
Agree .........................................................................................................
Strongly agree............................................................................................
11.  Please indicate how much the following words are like your childcare provider or teacher.
My child care provider or teacher is…
[MARK ONE BOX IN EACH ROW.]
Not at all like
my provider

a. Caring ..........................................................
b. Understanding .............................................
c. Rude ............................................................
d. Flexible ........................................................
e. Dependable ..................................................
f.

Trustworthy .................................................

g. Impatient......................................................
h. Unfriendly ..................................................
i.

Respectful ...................................................

j.

Judgmental..................................................

k. Available ....................................................

5

A little like my
provider

A lot like my
provider

Exactly like my
provider

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

12. How strongly do you agree or disagree with the following statement?
My child care provider or teacher sees this job as just a paycheck.
[MARK ONLY ONE BOX.]
Strongly disagree .....................................................................................
Disagree ...................................................................................................
Agree........................................................................................................
Strongly agree ..........................................................................................

13. How strongly do you agree or disagree with the following statements? 
I trust that my child care provider or teacher …
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

a.

Can maintain a safe environment for my
child ..........................................................

b.

Has my child’s best interest at heart .........

Disagree

Agree

Strongly agree

Agree

Strongly agree

14. How strongly do you agree or disagree with the following statements?
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

a.

My child care provider or teacher judges
my family because of our faith and
religion .......................................................

b.

My child care provider or teacher judges
my family because of our culture and
values ........................................................

c.

My child care provider or teacher judges
my family because of our race/ethnicity ...

d.

My child care provider or teacher judges
my family because of our financial
situation.....................................................

6

Disagree

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

15. How easy or difficult is it for you to reach your child care provider or teacher during the day if
you have a question or if a problem comes up?
[MARK ONLY ONE BOX.]
Very difficult ........................................................................................
Difficult ................................................................................................
Easy ......................................................................................................
Very easy ..............................................................................................

16.

On a scale of 1-5, where 1 is the worst you can imagine and 5 is the best you can imagine, how
would you describe your relationship with your child care provider or teacher?
[MARK THE BOX NEXT TO THE NUMBER THAT BEST DESCRIBES YOUR RELATIONSHIP.]
Worst
1

17.

Best
2

3

4

5

For how long has your current child care provider or teacher been teaching or caring for this
child?
[MARK ONLY ONE BOX.]
Less than 6 months .................................................................................
6 months-less than 1 year .......................................................................
1 year-less than 2 years ..........................................................................
2 years or more .......................................................................................

18.  What language do you most speak at home?
[MARK ONLY ONE BOX.]
English ...................................................................................................
Spanish ...................................................................................................
English and Spanish equally ..................................................................
English and another language equally ....................................................
Other language .......................................................................................
19.

Thinking about all of your children, how many child care providers have you
ever worked with?
[MARK ONLY ONE BOX.]
1 ..............................................................................................................
2-3 ..........................................................................................................
4-5 ..........................................................................................................
More than 5 ............................................................................................
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OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

20.

What is your race?
[MARK ALL THAT APPLY.]
White ......................................................................................................
Black or African American ....................................................................
American Indian or Alaska Native .........................................................
Asian Indian ...........................................................................................
Chinese ...................................................................................................
Filipino ...................................................................................................
Japanese .................................................................................................
Korean ....................................................................................................
Vietnamese .............................................................................................
Other Asian ............................................................................................
Native Hawaiian .....................................................................................
Guamanian or Chamorro ........................................................................
Samoan ...................................................................................................
Other Pacific Islander .............................................................................

21.

What is the highest level of education you have completed?
[MARK ONLY ONE BOX.]
Less than a high school diploma ............................................................
High school diploma or GED .................................................................
Some college, no degree ........................................................................
Associate’s degree ..................................................................................
Bachelor’s degree ...................................................................................
Graduate school degree ..........................................................................

END: THANK YOU FOR COMPLETING THIS SURVEY

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