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* 1. This survey is complete by:

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* 2. Family Ethnicity

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* 4. The location of my Head Start center was convenient for my family's participation.

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* 5. Information provided by Head Start included materials for both fathers and mothers.

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* 6. The current program schedule met the needs of my family.

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* 8. Our family has a need for Early Head Start services (children under age of 3).

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* 9. Are you or a household member currently pregnant?

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* 10. Do you have literacy materials available at home? (books, magazines, newspapers, etc.)

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* 11. I am satisfied with the Head Start services my family receives from:

  Agree Neutral Disagree Don't Know
Classroom Staff
Administration
Family Service Workers

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* 12. Head Start has helped my child get ready for school by:

  Agree Neutral Disagree Don't Know
Becoming more independent
Learning basic concepts in language
Learning basic concepts in math
Learning to share and cooperate

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* 13. Head Start gives my child a:

  Agree Neutral Disagree Don't Know
Safe place to learn
Clean environment

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* 14. What would you identify as your needs for your child concerning our program? (Check all that apply)

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* 15. Head Start provides me with quality information through

  Agree Neutral Disagree Don't Know
Newsletters
Parent Handbook
Parent-Teacher Conferences and Home Visits
Home Visits Family Service Workers
Website and electronic messaging (Remind)
Flyers announcing upcoming events
Menus

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* 16. Head Start has told me about how to be involved with:

  Agree Neutral Disagree Don't Know
Policy Council
Parent Committee
Classroom Volunteering
Program events and family social nights
Fatherhood Events

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* 17. Head Start has provided me with informational support regarding:

  Agree Neutral Disagree Don't Know
Child development
Community Resources
Personal Relationships
Disabilities
Mental Health
Health and dental health
Nutrition

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* 18. Head Start has enabled me to:

  Agree Neutral Disagree Don't Know
Define my own life goals
Accomplish and pursue my goals
Understand and carry out my role as the primary educator for my child

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* 19. My child's teacher:

  Agree Neutral Disagree Don't Know
Worked with me to plan my child's learning and development
Planned activities around my child's individual needs
Helped me have a better understanding of my child's social and emotional development

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* 20. When I requested help for my child's social and emotional develop, it was:

  Agree Neutral Disagree Don't Know
Delivered in a timely manner
Useful and successful
Supportive of my family's values

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* 21. Head Start centers are friendly and inviting for families

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* 22. Head Start centers are friendly and inviting for fathers

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* 23. Head Start has provided me with information on disabilities.

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* 24. If yes, when I requested help for my child's disabilities, the services were:

  Agree Neutral Disagree Don't Know
Delivered in a timely manner
Useful and successful
Supportive of my family's values

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* 25. My child attends child care before or after Head Start.

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* 26. There was turnover in the people working with my child and family this year (e.g., teachers, teacher assistants, or family service worker).

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* 27. If yes, this turnover had what type of effect on my family's experience:

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* 28. My family's biggest stressors this year were: (Check all that apply)

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* 29. Do you agree with the home visits required by the program?

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* 30. My family receives the following services. (Check all that apply)

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* 31. My biggest concern for my family at this time is:

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* 32. How much time does your child spend watching television, playing video game or on a computer/tablet/phone?

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* 33. In the last 12 months did you or other adults in your household cut the size of meals or skip meals due to the lack of food?

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* 34. In the last year have you needed or received assistance from a food bank or food pantry.

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* 35. Do you have a need for the following services during the summer months for your children?

  Yes No
Early Head Start (0-2 yrs. Of age)?
Head Start Services (3-5 yrs.)?
Daycare Services

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* 36. Do you have any infant or toddler children not currently served at our KAF Program? 

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* 37. If you answer Yes to question 36, how many?

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* 38. My family’s biggest stressor for this year due to COVID-19 were: 
Check all that apply:

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* 39. Other comments I have:

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