Head Start Family Survey

We're working on making sure our Head Start services and community services match family needs. We need your help to figure out what is most important for families with young children.

Please fill out our survey to let us know what you think! It has 14 questions and takes just a few minutes. The survey will be open until December 15.

If you want, please fill out your name and phone number or email to be entered for one of two $25 gift certificates to Walmart. No one at Head Start will see your contact information and your answers will not be tied to your contact information.

Thank you for your help.

* 1. How many adults and children are in your household, including you?

* 2. Where do you live?

* 3. How are you and any other adults in your household employed?

  Full-time employment Part-time employment No paid employment
You
Spouse/partner
Other adults living with you

* 4. Where does your child/children attend Head Start? (Check all that any child has ever attended)

* 5. How do you get your child/children to preschool/child care or other activities?

* 6. How easy is it to get to children care/preschool or activities?

* 7. Which factors make a Head Start location more convenient? (Check all that apply)

* 8. What preschool and child care services have you used in the last year for your family? (Check all that apply)

* 9. How much would these things make it easier to use Head Start services?

  No difference A little easier Somewhat easier A lot easier
Longer hours
Fee-based child care services on site
Summer Head Start
Different hours
Ability to put child on bus
Ability to put child on bus at a different stop
Different site location

* 10. How useful are each of these services that Head Start currently provides for you and your family?

  Not useful A little useful Moderately useful Very useful Never used this service
Preschool
Child care
Parent classes
Services for children with special needs
Transportation to and from Head Start
Referrals to other services

* 11. How easy has it been to use community services that your family has needed? (Check the answer that fits best for each one)

  Could not access service Difficult to access needed service OK to access needed service Easy to access needed service Do not need this type of service
Child care
Early education services
Physical health services
Children's mental health services
Adult mental health services
Services for children with special needs
Services to address addiction/substance abuse
Services to address domestic violence
Food and nutritional assistance services
Housing assistance services (HUD, financial assistance, services for homelessness)
Transportation and transportation assistance
Availability of affordable phone and internet services
Financial assistance

* 12. What challenges have you had with making and serving healthy food for your family in the last year? (Check the answer which fits best for each one)

  No problem A little difficult Moderately difficult Very difficult
Being able to afford healthy foods
Being able to get to grocery store that has fresh fruit and vegetables
Being able to get to any place offering food
Having adequate cooking facilities to cook in
Knowing how to cook healthy foods
Having enough time to cook and eat healthy foods
Knowing which foods are healthy
Eating enough fruits and vegetables each day
Getting your kids or other family members to eat healthy foods
Food allergies and sensitivities

* 13. Would you be interested in opportunities to learn more about getting and preparing nutritious foods?

* 14. Optional: If you would like to be considered for our gift card drawing, please put in your name, email, and/or phone. This information is not connected to any of your answers on this survey or shared with anyone. Thank you for helping Head Start!

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