CHILD CARE QUESTIONNAIRE 1.Do you currently require child care for your family ? YesNo 2.How many children age 12 or under live in your home? 3.What are their ages? 4. What kinds of child care arrangements are you currently using or looking for? Please answer the following questions for each child ages 12 years old and under. family member or friend : c1c2c3c4 nanny : c1c2c3c4 license-not-required family child care * : c1c2c3c4 licensed family child care * : c1c2c3c4 group day care * : c1c2c3c4 preschool program * :c1c2c3c4 out-of-school care * :c1c2c3c4 childminding * :c1c2c3c4 other, specify :c1c2c3c4 Please add other specification 5.Are your current child care arrangements full-time, part-time, weekend or other? full time : c1c2c3c4 part-time :c1c2c3c4 weekend : c1c2c3c4 other, specify :c1c2c3c4 6.How satisfied are you with your child(ren)’s current child care arrangements? very satisfied :c1c2c3c4 somewhat satisfied :c1c2c3c4 dissatisfied :c1c2c3c4 very dissatisfied : c1c2c3c4 7.How important is it that your child(ren) be able to continue/stay within the same facility as they age? very importantsomewhat importantnot important 8. How much are you currently paying per month for you child care arrangements?
