COVID-19: Community Child Care Survey Looking for a way to make things a little easier for your staff whose needs for child care have changed during this crazy time? We can coordinate directly with you to find care for multiple employees, whether it's two or two hundred. Fill out our form below, and we'd be happy to connect! Question Title Contact Information: Name Company Address City/Town ZIP/Postal Code Email Address Phone Number Question Title Please indicate the number of child(ren) needing care in each age level: Infant (0-12 months) Toddler (13-36 months) Preschool (3-5 years) Kindergarten School Age (6-12 years) Question Title On which days of the week is child care needed? Please select all that apply. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Question Title What hours does your business have employees on site? Please select all that apply. Traditional Business Hours (8:00am-5:00pm) Morning Shift (7:00am-3:00pm) Afternoon Shift (3:00pm-11:00pm) Overnight Shift (11:00pm-7:00am) Other (please specify) Question Title Please indicate any special accommodations, requirements, or restrictions needed for any of the children or your working parents: Question Title Do any of your employees need a child care program that accepts CCDF vouchers? Yes No Do not know at this time Question Title If child care is needed in areas other than that of the business address, please list any additional zip codes below, separated by commas: Question Title Is there anything else you'd like us to know? Thank you for completing our survey. For more information and additional resources, please visit our website at www.childcareanswers.com. Submit