4Cs R&R Update Question Title * 1. First and last name Question Title * 2. What is your facility number? Question Title * 3. What is the best phone number for you to be reached at? Question Title * 4. What is your email address? Question Title * 5. What are the ages that you serve? Minimum Age Maximum Age Child's Age Newborn 1 month 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years Child's Age Minimum Age menu Newborn 1 month 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 years 17 years Child's Age Maximum Age menu Other (please specify) Question Title * 6. How many current openings do you have? Infant (0-2) Toddler (2-5) School Age (5+) # of Openings 0 1 2 3 4 # of Openings Infant (0-2) menu 0 1 2 3 4 5 6 7 8 9 10 11 12 # of Openings Toddler (2-5) menu 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 # of Openings School Age (5+) menu Other (please specify) Question Title * 7. What are your scheduled days and hours of operation? Days Hours Question Title * 8. Do you take in children for full-time, part-time or both? Full-time Only Part-time Only Both (Full-time & Part-time) Question Title * 9. What are your full-time rates? (Fill in all that apply) Infants (Weekly) Infants (Monthly) Toddlers (Weekly) Toddlers (Monthly) School Age (Weekly) School Age (Monthly) Question Title * 10. Do you have any special needs experience? Yes No If yes, please specify Question Title * 11. Do you provide transportation for the children? To school From school To child's home From child's home Specify which schools Done