Child and Family Resources, Inc. is researching the child care trends and needs of local workers and employers. This survey will take under five minutes to complete and the results will help us better serve you.

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* 1. Address

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* 2. How many people does your company employ?

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* 3. How many of your employees need and use child care?

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* 4. During what days do your employees need/use child care? Check all that apply.

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* 5. During what hours do your employees need/use child care? Check all that apply.

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* 6. What are the most common reasons for employee absenteeism and/or lost time? Please rank the following on a scale of 1-5, 1 indicating most frequent cause.

  1 2 3 4 5
Employee illness
Child's illness
Child care needs
Personal time
Family issues

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* 7. Does your company provide information to employees about child care services offered within your community?

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* 8. What is the percentage of employee turnover per year?

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* 9. Does your company offer any of the following benefits? Check all that apply.

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* 10. Are you aware of the child care subsidy support options for families in your county?

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* 11. Is your company able to provide financial support to employees needing child care?

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* 12. In what County does the majority of your employees reside?

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* 13. Do you know of any needs related to child care that we can address?

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* 14. Which of the following services would you be interested in learning more about? Check all that apply.

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* 15. Are you aware that Child and Family Resources has a toll free line (1-800-881-5786) for free child care referrals for working families?

Thank you for taking time to fill out our survey!

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