Independence Charter School Independence Charter School Complete the survey below. Question Title * 1. Please choose your grade level: Kindergarten 1 2 3 4 5 6 7 8 9 10 11 12 Question Title * 2. For Breakfast Out of 5 school days each week, on average how many days do you do each of the following for breakfast? Your total must add to 5. Get breakfast at school Buy breakfast on your way to school Bring breakfast form home to eat at school Eat breakfast at home Skip Breakfast Question Title * 3. From the list below, please select up to 3 top reasons why you don't get breakfast at school more often. Too expensive School doesn't offer breakfast food I like Not enough time before class to get breakfast Cafeteria's location is not convenient I am not hungry I'd rather spend the time with my friends; they don't eat breakfast at school School breakfast isn't healthy fresh School breakfast doesn't look good Other (please specify) Question Title * 4. How many days a week do you eat breakfast at the school? 0 1-2 3-4 5 Question Title * 5. If you never eat breakfast at the school, or only eat it 1-2 times a week, why? I bring my breakfast/I eat breakfast at home I do not eat breakfast My bus is always late I do not like what the cafeteria offers Question Title * 6. For Breakfast select the statement that fits each type of food. I would like to see MORE of these items offered I would like to see LESS of these items offered Hot breakfast sandwiches Hot breakfast sandwiches I would like to see MORE of these items offered Hot breakfast sandwiches I would like to see LESS of these items offered Cold Cereal Cold Cereal I would like to see MORE of these items offered Cold Cereal I would like to see LESS of these items offered Hot Cereal Hot Cereal I would like to see MORE of these items offered Hot Cereal I would like to see LESS of these items offered Bagels Bagels I would like to see MORE of these items offered Bagels I would like to see LESS of these items offered Fruit Fruit I would like to see MORE of these items offered Fruit I would like to see LESS of these items offered Eggs Eggs I would like to see MORE of these items offered Eggs I would like to see LESS of these items offered Pancakes Pancakes I would like to see MORE of these items offered Pancakes I would like to see LESS of these items offered Waffles Waffles I would like to see MORE of these items offered Waffles I would like to see LESS of these items offered French Toast French Toast I would like to see MORE of these items offered French Toast I would like to see LESS of these items offered Turkey Bacon, Sausage, etc Turkey Bacon, Sausage, etc I would like to see MORE of these items offered Turkey Bacon, Sausage, etc I would like to see LESS of these items offered Granola bars Granola bars I would like to see MORE of these items offered Granola bars I would like to see LESS of these items offered Yogurt Yogurt I would like to see MORE of these items offered Yogurt I would like to see LESS of these items offered Other (please specify) Question Title * 7. If breakfast items you like the most were offered, how many days per week would you get breakfast at school? Question Title * 8. Please answer the following about the different locations where breakfast may be available at your school: Breakfast is available at this location I would get breakfast at this location if it was available In School Cafeteria In School Cafeteria Breakfast is available at this location In School Cafeteria I would get breakfast at this location if it was available Breakfast in classroom Breakfast in classroom Breakfast is available at this location Breakfast in classroom I would get breakfast at this location if it was available Grab-n-go cart at theentrance or otherlocation Grab-n-go cart at theentrance or otherlocation Breakfast is available at this location Grab-n-go cart at theentrance or otherlocation I would get breakfast at this location if it was available Question Title * 9. What is your favorite fruit? (Check all that apply) Apple Orange Grape Pear Banana Peach Plum Question Title * 10. For Lunch Out of 5 school days each week, on average, how many days do you do each of the following for lunch? Your total must add to 5. Get lunch at school cafeteria Bring lunch from home toeat at school Leave school to buy lunch Skip Lunch Question Title * 11. How many days a week do you eat at the lunch served at school? 0 1-2 3-4 5 Question Title * 12. If you never eat lunch served at school, or only eat it 1-2 times a week, why? I bring my lunch from home I skip lunch I do not like what the cafeteria offers Question Title * 13. When you decide whether or not to get lunch at school, how important are each of the following to your decision? 5- Very Important 4- Important 3- Somewhat Important 2- Not Very Important 1- Not Important At All Menu variety Menu variety 5- Very Important Menu variety 4- Important Menu variety 3- Somewhat Important Menu variety 2- Not Very Important Menu variety 1- Not Important At All Salad and sandwichoptions Salad and sandwichoptions 5- Very Important Salad and sandwichoptions 4- Important Salad and sandwichoptions 3- Somewhat Important Salad and sandwichoptions 2- Not Very Important Salad and sandwichoptions 1- Not Important At All Ability to customize or"build your own meal" Ability to customize or"build your own meal" 5- Very Important Ability to customize or"build your own meal" 4- Important Ability to customize or"build your own meal" 3- Somewhat Important Ability to customize or"build your own meal" 2- Not Very Important Ability to customize or"build your own meal" 1- Not Important At All Fresh menu ingredients Fresh menu ingredients 5- Very Important Fresh menu ingredients 4- Important Fresh menu ingredients 3- Somewhat Important Fresh menu ingredients 2- Not Very Important Fresh menu ingredients 1- Not Important At All Taste of food Taste of food 5- Very Important Taste of food 4- Important Taste of food 3- Somewhat Important Taste of food 2- Not Very Important Taste of food 1- Not Important At All Appearance of food Appearance of food 5- Very Important Appearance of food 4- Important Appearance of food 3- Somewhat Important Appearance of food 2- Not Very Important Appearance of food 1- Not Important At All Question Title * 14. What would encourage you to participate in lunch more often? Shorter lines Different hot menu choices Different cold menu choices Other (please specify) Question Title * 15. Now for the same list rate how well your school cafeteria does for each. 5- Excellent 4-Very Good 3- Average 2- Fair 1- Poor Menu variety Menu variety 5- Excellent Menu variety 4-Very Good Menu variety 3- Average Menu variety 2- Fair Menu variety 1- Poor Ability to customize or"build your own meal" Ability to customize or"build your own meal" 5- Excellent Ability to customize or"build your own meal" 4-Very Good Ability to customize or"build your own meal" 3- Average Ability to customize or"build your own meal" 2- Fair Ability to customize or"build your own meal" 1- Poor Fresh menuitems/ingredients Fresh menuitems/ingredients 5- Excellent Fresh menuitems/ingredients 4-Very Good Fresh menuitems/ingredients 3- Average Fresh menuitems/ingredients 2- Fair Fresh menuitems/ingredients 1- Poor Taste of food Taste of food 5- Excellent Taste of food 4-Very Good Taste of food 3- Average Taste of food 2- Fair Taste of food 1- Poor Appearance of food Appearance of food 5- Excellent Appearance of food 4-Very Good Appearance of food 3- Average Appearance of food 2- Fair Appearance of food 1- Poor Place to learn abouthealthy eating habits Place to learn abouthealthy eating habits 5- Excellent Place to learn abouthealthy eating habits 4-Very Good Place to learn abouthealthy eating habits 3- Average Place to learn abouthealthy eating habits 2- Fair Place to learn abouthealthy eating habits 1- Poor Fun place toeat/socialize Fun place toeat/socialize 5- Excellent Fun place toeat/socialize 4-Very Good Fun place toeat/socialize 3- Average Fun place toeat/socialize 2- Fair Fun place toeat/socialize 1- Poor Conveniently locatedcafeteria Conveniently locatedcafeteria 5- Excellent Conveniently locatedcafeteria 4-Very Good Conveniently locatedcafeteria 3- Average Conveniently locatedcafeteria 2- Fair Conveniently locatedcafeteria 1- Poor Clean cafeteria Clean cafeteria 5- Excellent Clean cafeteria 4-Very Good Clean cafeteria 3- Average Clean cafeteria 2- Fair Clean cafeteria 1- Poor Question Title * 16. What is your overall satisfaction level with each of these items served in your school cafeteria? 5- Very Satisfied 4- Satisfied 3- SomewhatSatisfied 2- Not VerySatisfied 1- Not Satisfiedat all 0- I Don't Eat it Tacos/Burritos Tacos/Burritos 5- Very Satisfied Tacos/Burritos 4- Satisfied Tacos/Burritos 3- SomewhatSatisfied Tacos/Burritos 2- Not VerySatisfied Tacos/Burritos 1- Not Satisfiedat all Tacos/Burritos 0- I Don't Eat it Cold Sandwiches (deli,cold cuts, wraps etc.) Cold Sandwiches (deli,cold cuts, wraps etc.) 5- Very Satisfied Cold Sandwiches (deli,cold cuts, wraps etc.) 4- Satisfied Cold Sandwiches (deli,cold cuts, wraps etc.) 3- SomewhatSatisfied Cold Sandwiches (deli,cold cuts, wraps etc.) 2- Not VerySatisfied Cold Sandwiches (deli,cold cuts, wraps etc.) 1- Not Satisfiedat all Cold Sandwiches (deli,cold cuts, wraps etc.) 0- I Don't Eat it Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 5- Very Satisfied Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 4- Satisfied Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 3- SomewhatSatisfied Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 2- Not VerySatisfied Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 1- Not Satisfiedat all Hot Sandwiches (cheesesteak, grilled cheese,meatball subs etc.) 0- I Don't Eat it Burgers Burgers 5- Very Satisfied Burgers 4- Satisfied Burgers 3- SomewhatSatisfied Burgers 2- Not VerySatisfied Burgers 1- Not Satisfiedat all Burgers 0- I Don't Eat it Pizza Pizza 5- Very Satisfied Pizza 4- Satisfied Pizza 3- SomewhatSatisfied Pizza 2- Not VerySatisfied Pizza 1- Not Satisfiedat all Pizza 0- I Don't Eat it Pasta Dishes (mac ncheese, spaghetti,lasagna Pasta Dishes (mac ncheese, spaghetti,lasagna 5- Very Satisfied Pasta Dishes (mac ncheese, spaghetti,lasagna 4- Satisfied Pasta Dishes (mac ncheese, spaghetti,lasagna 3- SomewhatSatisfied Pasta Dishes (mac ncheese, spaghetti,lasagna 2- Not VerySatisfied Pasta Dishes (mac ncheese, spaghetti,lasagna 1- Not Satisfiedat all Pasta Dishes (mac ncheese, spaghetti,lasagna 0- I Don't Eat it Chicken nuggets/tenders Chicken nuggets/tenders 5- Very Satisfied Chicken nuggets/tenders 4- Satisfied Chicken nuggets/tenders 3- SomewhatSatisfied Chicken nuggets/tenders 2- Not VerySatisfied Chicken nuggets/tenders 1- Not Satisfiedat all Chicken nuggets/tenders 0- I Don't Eat it Chicken pattysandwiches Chicken pattysandwiches 5- Very Satisfied Chicken pattysandwiches 4- Satisfied Chicken pattysandwiches 3- SomewhatSatisfied Chicken pattysandwiches 2- Not VerySatisfied Chicken pattysandwiches 1- Not Satisfiedat all Chicken pattysandwiches 0- I Don't Eat it Salads Salads 5- Very Satisfied Salads 4- Satisfied Salads 3- SomewhatSatisfied Salads 2- Not VerySatisfied Salads 1- Not Satisfiedat all Salads 0- I Don't Eat it Question Title * 17. What is your favorite lunch item? Salads Cold sandwiches Hot sandwiches (hamburger, Chicken Patty) Pizza Pasta meals (Lasagna, Pasta & Meatballs, Mac & Cheese, Baked Ziti) Empanadas, Quesadilla, Tacos. Burritos Meat/Chicken (Chili, Salisbury Steak, BBQ Chicken,) Fish Meals (Baked Cajun Fish, Fish & Chips, Fish Nuggets) Teriyaki Meatballs, Tangerine Chicken, Asian Noodles Other (please specify) Question Title * 18. What is your favorite vegetable? (Check all that apply) Carrots Corn Lettuce Broccoli Green Beans Spinach Collard Greens Sweet Potatoes Peas Cauliflower Lima Beans Black Beans Chickpeas Lentils Celery Cucumbers Question Title * 19. What is your favorite fruit? (Check all that apply) Apple Orange Grape Pear Banana Peach Plum Question Title * 20. When you decide to whether or not to get breakfast or lunch at school, how important are each of thefollowing to your decision? 5-Very Important 4-Important 3-SomewhatImportant 2-Not VeryImportant 1-Not Important atAll Shorter lines Shorter lines 5-Very Important Shorter lines 4-Important Shorter lines 3-SomewhatImportant Shorter lines 2-Not VeryImportant Shorter lines 1-Not Important atAll Friendly cafeteria staff Friendly cafeteria staff 5-Very Important Friendly cafeteria staff 4-Important Friendly cafeteria staff 3-SomewhatImportant Friendly cafeteria staff 2-Not VeryImportant Friendly cafeteria staff 1-Not Important atAll Place to learn about healthy eating habits Place to learn about healthy eating habits 5-Very Important Place to learn about healthy eating habits 4-Important Place to learn about healthy eating habits 3-SomewhatImportant Place to learn about healthy eating habits 2-Not VeryImportant Place to learn about healthy eating habits 1-Not Important atAll Fun place to eat/socialize Fun place to eat/socialize 5-Very Important Fun place to eat/socialize 4-Important Fun place to eat/socialize 3-SomewhatImportant Fun place to eat/socialize 2-Not VeryImportant Fun place to eat/socialize 1-Not Important atAll Conveniently located cafeteria Conveniently located cafeteria 5-Very Important Conveniently located cafeteria 4-Important Conveniently located cafeteria 3-SomewhatImportant Conveniently located cafeteria 2-Not VeryImportant Conveniently located cafeteria 1-Not Important atAll Clean cafeteria Clean cafeteria 5-Very Important Clean cafeteria 4-Important Clean cafeteria 3-SomewhatImportant Clean cafeteria 2-Not VeryImportant Clean cafeteria 1-Not Important atAll Question Title * 21. Tell us how much you agree or disagree with the statements about school breakfast or lunch this year. Strongly Agree Agree Disagree Strongly Disagree Meals are preparedfresh. Meals are preparedfresh. Strongly Agree Meals are preparedfresh. Agree Meals are preparedfresh. Disagree Meals are preparedfresh. Strongly Disagree Meals are preparedfresh. Meals are tasty. Meals are tasty. Strongly Agree Meals are tasty. Agree Meals are tasty. Disagree Meals are tasty. Strongly Disagree Meals are tasty. I am willing to try foods I haven't tried before. I am willing to try foods I haven't tried before. Strongly Agree I am willing to try foods I haven't tried before. Agree I am willing to try foods I haven't tried before. Disagree I am willing to try foods I haven't tried before. Strongly Disagree I am willing to try foods I haven't tried before. The cafeteria staff ispolite and helpful. The cafeteria staff ispolite and helpful. Strongly Agree The cafeteria staff ispolite and helpful. Agree The cafeteria staff ispolite and helpful. Disagree The cafeteria staff ispolite and helpful. Strongly Disagree The cafeteria staff ispolite and helpful. Meal service by the staffis good. Meal service by the staffis good. Strongly Agree Meal service by the staffis good. Agree Meal service by the staffis good. Disagree Meal service by the staffis good. Strongly Disagree Meal service by the staffis good. Meals match what isindicated on the menu. Meals match what isindicated on the menu. Strongly Agree Meals match what isindicated on the menu. Agree Meals match what isindicated on the menu. Disagree Meals match what isindicated on the menu. Strongly Disagree Meals match what isindicated on the menu. I have enough time toeat. I have enough time toeat. Strongly Agree I have enough time toeat. Agree I have enough time toeat. Disagree I have enough time toeat. Strongly Disagree I have enough time toeat. Question Title * 22. Now for the same list rate how well your school cafeteria does for each. 5- Excellent 4-Very Good 3- Average 2- Fair 1- Poor Place to learn abouthealthy eating habits Place to learn abouthealthy eating habits 5- Excellent Place to learn abouthealthy eating habits 4-Very Good Place to learn abouthealthy eating habits 3- Average Place to learn abouthealthy eating habits 2- Fair Place to learn abouthealthy eating habits 1- Poor Fun place toeat/socialize Fun place toeat/socialize 5- Excellent Fun place toeat/socialize 4-Very Good Fun place toeat/socialize 3- Average Fun place toeat/socialize 2- Fair Fun place toeat/socialize 1- Poor Conveniently locatedcafeteria Conveniently locatedcafeteria 5- Excellent Conveniently locatedcafeteria 4-Very Good Conveniently locatedcafeteria 3- Average Conveniently locatedcafeteria 2- Fair Conveniently locatedcafeteria 1- Poor Clean Cafeteria Clean Cafeteria 5- Excellent Clean Cafeteria 4-Very Good Clean Cafeteria 3- Average Clean Cafeteria 2- Fair Clean Cafeteria 1- Poor Shorter lines Shorter lines 5- Excellent Shorter lines 4-Very Good Shorter lines 3- Average Shorter lines 2- Fair Shorter lines 1- Poor Friendly cafeteria staff Friendly cafeteria staff 5- Excellent Friendly cafeteria staff 4-Very Good Friendly cafeteria staff 3- Average Friendly cafeteria staff 2- Fair Friendly cafeteria staff 1- Poor Question Title * 23. Using stars from 1 to 10, where 1 is the worst school cafeteria possible and 10 is the best schoolcafeteria possible, how many stars would you give your school cafeteria? Done