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pdfOMB No.: 0970-0420
Expiration Date: 1/31/2015
Family and
Early Care and
Education Provider
Relationship Study
Director Survey
R
OMB No.: 0970-0420
Expiration Date: 1/31/2015
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:
Family and Early Care and Education Provider Relationship Study
Westat
1600 Research Boulevard, Room RC B16
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 #0970-0420. 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.
OMB No.: 0970-0420
Expiration Date: 1/31/2015
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
1 year-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.
DO NOT INCLUDE CHILDREN THAT ARE ENROLLED IN A KINDERGARTEN 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 and teaching assistants are employed in the program?
aides and teaching assistants
5.
How many child care providers and teachers are employed in the program?
providers and teachers
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OMB No.: 0970-0420
Expiration Date: 1/31/2015
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
8.
a.
Website
b.
Newsletter
c.
Calendar
d.
Bulletin Boards
e.
Email
f.
Text message
g.
Telephone
h.
Parent-teacher conferences
i.
In-person discussions
No
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.
Women, Infants, and Children (WIC)?
d.
Child care subsidies or vouchers?
e.
Temporary Assistance for Needy Families (TANF)?
f.
Adult education, GED classes, ESL classes, or continuing education?
g.
Housing assistance?
h.
Energy or fuel assistance?
i.
Immigration or legal services?
j.
Domestic violence programs?
k.
Substance abuse programs?
l.
Health insurance?
No
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OMB No.: 0970-0420
Expiration Date: 1/31/2015
9.
Since September, has your program provided referrals for the following services:
[MARK ONE BOX IN EACH ROW.]
Yes
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?
No
10. Since September, has your program offered the following to any family:
[MARK ONE BOX IN EACH ROW.]
Yes
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?
No
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
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OMB No.: 0970-0420
Expiration Date: 1/31/2015
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:
No
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
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OMB No.: 0970-0420
Expiration Date: 1/31/2015
Place Label OR Print ID in This Box
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File Type | application/pdf |
File Modified | 2013-11-14 |
File Created | 2013-11-13 |