General Questions

The Delta Foundation for Jefferson County School District's 21st Century Community Learning Center Program would like you to respond to a few general questions and also to share your thoughts and ideas about the out-of-school-time activities and services being provided in our community. What do you think of your child’s 21st Century Program in your school district? Your answers will help make the program better for future students and families.

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* 1. Parent/Guardian Name:

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* 2. Please enter the following:

Date

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* 3. Please enter your name(s) of your students in the program.

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* 4. What school(s) do your children attend?

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* 5. Please select the grade your child was in the current school year. (Please select only one.)

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* 6. How many years has your child been in the 21st Century program at this school?

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* 7. Please identify any activities or services that you participated in at the community learning center.

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* 8. Please select Yes or No to respond to the following questions.

  Yes No
Did you feel that the services/activities offered were helpful and/or worthwhile for you?
Were you comfortable working with the community learning center staff?
Did the facility have adequate resources and meet your needs?
Did you get the help you were looking for?
Did you feel the services and activities offered for your children were worthwhile?
Has the center had a positive impact on any or all of your children?
Did you feel that there was good communication between the regular school staff and the out-of-school-time program?
Have you talked to your children about the program and about school in general?

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* 9. How would you rate your child’s out-of-school time program in the following areas?
Select one answer per question.

  Poor Fair Good Excellent Don’t Know
The overall 21st Century program
The safety of your child while he/she is at the 21st Century program
The atmosphere and comfort of the room(s) in which the 21st Century program operates
The snacks that are served to your child on a daily basis
The hours of operation
The transportation provided, if any

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* 10. Was transportation provided?

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* 11. To what extent do you agree or disagree with the following statements about the program? (Select one answer per question.)

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
I am satisfied with the kinds of programs and activities offered at the 21st Century program.
There is adequate quiet time for my child to complete homework.
The 21st Century program has helped my child get his/her homework done on time.
There is adequate opportunity for physical activity.

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* 12. How many days per week of after-school would be ideal for your child?

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* 13. To what extent do you agree or disagree with the following statements describing your child’s experience in the 21st Century Program? (Select one answer per question.)

My child...

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
Enjoys attending the 21st Century program.
Feels comfortable with the 21st Century staff.
Seems happier or less stressed since participating in the 21st Century program.
Has friends in the 21st Century program.
Completes homework with greater ease.
Has a better attitude towards school.

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* 14. To what extent do you agree or disagree with the following statements about the afterschool staff? (Select one answer per question.)

  Strongly Disagree Disagree Agree Strongly Agree Don’t Know
I am comfortable talking with the staff.
The staff welcomes suggestions from parents.
The staff keeps me informed about my child’s day at the 21st Century program.
The staff welcomes parents who wish to observe.
I am comfortable with how the staff handles discipline problems.
The staff encourages positive interactions among the children.
I am satisfied with the number of adult staff available to work with the students.
I am satisfied with the manner adult staff interact with the students.
The staff has clearly informed me about how to contact them during the afterschool program.
I am satisfied with the overall performance of the 21st Century staff.

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* 15. Why does your child attend the 21st Century Program? (Please check all that apply.)

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* 16. What would your child be doing after school if he/she were not attending this program? (Please check all that apply.)

Please give us your comments on the 21st Century Community Learning Centers Program.

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* 17. What do you like best about the 21st Century Program?

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* 18. What are some things you would like to see changed?

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* 19. How many times did you go to the afterschool program?

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* 20. Have you been involved as a volunteer in the 21st Century program?

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* 21. If you would like to make additional comments, suggestions, or ask questions about the 21st Century Community Learning Center Program, please use the space below.

Please provide answers to the following COVID-19 related questions as they pertain to the last school year.

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* 22. Did you participate in the 21st CCLC program in-person (at school) or virtually (at home) this school year?

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* 23. How would you rate your 21stCCLC program access to digital learning platforms and materials during the COVID-19 pandemic (Chromebooks, iPads, online learning, Zoom, learning platforms iReady, Study Island, iXL, etc.)?

Rate from 1-5 with 1 being the lowest level of access to 5 being the highest level of access.

Thank you for taking the time to complete the survey and for any comments or suggestions you may have included.

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