Exit this survey

1. Section 1

 
 6% of survey complete.
Please complete one application for each site – the physical location where early care and education services are provided. If you have questions, please contact your lead agency or Ola Friday at (212) 652-2067.

Applications are due by February 19, 2010.

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1. Name of school or agency

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2. District or agency contact person

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3. Telephone and e-mail address of district or agency contact

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4. Name of program or classroom site

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5. Site contact person

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6. Telephone and e-mail address of site contact person

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7. Physical location of program or classroom site

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8. Mailing address of program or classroom site

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9. Hours program or classroom is open to serve children

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10. Types of sessions offered (please check all that apply.) If the program is in a school, do not included kindergarten or other grade sessions.

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11. Organization operating program or classroom site (please check one).

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12. NY regulating agency

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13. License number(s) if applicable

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14. License capacity

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15. Total number of children enrolled (if a program is in a school, do not included kindergarten or other grades).

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16. Total number of classrooms (if a program is in a school, do not included kindergarten or other grades).

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17. Type of educational services offered (please check all that apply.)

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18. Total number of teachers (if the program is in a school, do not included kindergarten or other grade teachers.)

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19. Total number of assistant teachers, aides, or other classroom staff (if the program is in a school, do not included kindergarten or other grade teachers.)

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20. Estimated percent of children whose home language is not English

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21. Estimated percent of children with special educational or medical needs

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22. Estimated percent of children who have an IEP or ISFP

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23. Types of need-based financial assistance used by enrolled families to pay program fees (please select all that apply)

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24. Estimated percent of children receiving any need-based financial assistance

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25. Years in operation at this site

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26. Program affiliation, if any (please check all that apply)

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27. Accreditation status

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28. Primary language(s) used by most of program staff

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29. Other information about this program site relevant to participation in the QUALITYstarsNY field test

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