Parent Survey about Providers/Teachers

OMB No.: 0970-0420
Expiration Date: 1/31/2015

Family and
Early Care and
Education Provider
Relationship Study

Parent Survey

R

OMB No.: 0970-0420
Expiration Date: 1/31/2015

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:
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.

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

Rarely

Sometimes

Very often

a.

Your

chi
l
d’
s 
exper
i
ences 
i
n 
t
he 
educat
i
on
and care setting

b.

Your

chi
l
d’
s 
abi
l
i
t
i
es

c.

Your

chi
l
d’
s 
gener
al

behavi
or

d.

Your child's learning

e.

Goals you have for your child

f.

What to expect at each stage of your child's
development

g.

Your vision for your child's future

2.

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

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

Rarely

Sometimes

Very often

58769

3

OMB No.: 0970-0420
Expiration Date: 1/31/2015

3.

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

Comfortable

Very
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

4.

If you had a problem with your childcare 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

58769

4

OMB No.: 0970-0420
Expiration Date: 1/31/2015

5.

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

a.

Share information with you about your
child's day?

b.

Offer you books or materials on parenting?

c.

Suggest activities for you and your child to
do together?

d.

Ask you about the cultural values and
beliefs you want him/her to communicate
to your child?

6.

How often does your childcare provider or teacher:

Rarely

Sometimes

Very often

Rarely

Sometimes

Very often

[MARK ONE BOX IN EACH ROW.]
Never

a.

Ask about your family?

b.

Work with you to develop strategies you can
use at home to support your child's learning
and development?

c.

Listen to your ideas about ways to change
or improve the care and education your
child receives?

d.

Offer you ideas or suggestions about
parenting?

e.

Provide you with opportunities to make
decisions about your child's education and
care?

f.

Provide you with opportunities to give
feedback on his or her performance?

g.

Remember personal details about your
family when speaking with you?

h.

Contradict you in front of your child?

58769

5

OMB No.: 0970-0420
Expiration Date: 1/31/2015

7.

How much are the following statements like your childcare provider or teacher?
My 
chi
l
dcar
e 
pr
ovi
der

or

t
eacher
…
[MARK ONE BOX IN EACH ROW.]
Not at all like A little like my A lot like my
my provider
provider
provider

a.

Respects me as a parent

b.

Is flexible in response to my work or
school schedule

c.

Treats me like an expert on my child

d.

Tells me how my child is progressing
towards goals or developmental milestones

e.

Uses my feedback to adjust the education
and care provided to my child

f.

Encourages me to be involved in all aspects
of my child's care and education

g.

Asks me questions to show he/she cares
about my family

h.

Reflects the cultural diversity of students
in activities

i.

Shows respect for different ethnic heritages

j.

Is respectful of religious beliefs

k.

Encourages parents to provide feedback on
the way he/she cares for and teaches
children

l.

Communicates the cultural values and
beliefs I want my child to have

Exactly like
my provider

58769

6

OMB No.: 0970-0420
Expiration Date: 1/31/2015

8.

Please indicate how much you agree or disagree with the following statements.
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

Disagree

Agree

Strongly
agree

a.

My childcare provider or teacher is open to
learning new ways to teach and care for
my child

b.

My provider and I work together to make
sure my child has the best care and
support

9.

Please indicate how much the following words are like your childcare provider or
teacher.
My 
chi
l
dcar
e 
pr
ovi
der

or

t
eacher

i
s…
[MARK ONE BOX IN EACH ROW.]
Not at all like A little like my A lot like my
my provider
provider
provider

a.

Caring

b.

Understanding

c.

Rude

d.

Flexible

e.

Dependable

f.

Trustworthy

g.

Impatient

h.

Unfriendly

i.

Respectful

j.

Judgmental

k.

Available

Exactly like
my provider

58769

7

OMB No.: 0970-0420
Expiration Date: 1/31/2015

10.

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

11.

How much do you agree or disagree with the following statements?
I 
t
r
ust

t
hat

my 
chi
l
dcar
e 
pr
ovi
der

or

t
eacher
…
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

Disagree

Agree

a.

Can maintain a safe environment for my
child

b.

Has my child's best interest at heart

12.

How strongly do you agree or disagree with the following statements?

Strongly
agree

[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

a.

My childcare provider or teacher judges my
family because of our faith and religion

b.

My childcare provider or teacher judges my
family because of our culture and values

c.

My childcare provider or teacher judges my
family because of our race/ethnicity

d.

My childcare provider or teacher judges my
family because of our financial situation

Disagree

Agree

Strongly
agree

58769

8

OMB No.: 0970-0420
Expiration Date: 1/31/2015

13.

How easy or difficult is it for you to reach your childcare 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

14.

On 
a 
scal
e 
of

1–5,

wher
e 
1 
i
s 
t
he 
wor
st

you 
can 
i
magi
ne 
and 
5 
i
s 
t
he 
best

you 
can
imagine, how would you describe your relationship with your childcare provider or
teacher?
[MARK THE BOX NEXT TO THE NUMBER THAT BEST DESCRIBES YOUR RELATIONSHIP.]
Worst
1

Best
2

3

4

5

The next set of questions ask about the age of your child, your experience with childcare
providers, and your background.
15.

How old is your child?
[MARK ONLY ONE BOX.]
Less than 1 year old
1-2 years old
3-4 years old
5 years or older

16.

For how long has your current childcare 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

58769

9

OMB No.: 0970-0420
Expiration Date: 1/31/2015

17.

Thinking about all of your children, how many childcare providers have you ever
worked with?
[MARK ONLY ONE BOX.]
1
2-3
4-5
More than 5

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.

Are you of Hispanic or Latino origin?
Yes
No

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
58769

10

OMB No.: 0970-0420
Expiration Date: 1/31/2015

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

22.

What would you say was your household's income last year, before taxes?
[MARK ONLY ONE BOX.]
Less than $25,000
$25,000-$34,999
$35,000-$44,999
$45,000-$54,999
$55,000-$74,999
$75,000 or more

Thank you for helping us with this important study!

58769

11

OMB No.: 0970-0420
Expiration Date: 1/31/2015

Place Label OR Print ID in This Box

[E for English, S for Spanish]

Version

58769

12