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* 1. How many children are you parent or guardian for that live in your household (aged 5 or younger only)?

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* 2. What childcare arrangements do you have for your children between the ages 0 - 5 years old?

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* 3. If you have school age children, where do they stay for after school care?

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* 4. How many days per week do your children or children under your care normally need daycare?

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* 5. Are you currently in need of childcare?

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* 6. Rank these answers as to what your main priority is when seeking childcare?

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* 7. What is your weekly cost of care for your children in each age group?

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* 8. What is your overall satisfaction with your current care arrangements for your child?

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* 9. Would you be likely to change your current childcare arrangements if a more convenient option was available?

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* 10. Would you be likely to change your current childcare arrangements if a more affordable option was available?

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* 11. Would you be likely to use a formal childcare center for back-up when your other childcare was unavailable?  (Back-up care is often used when your regular caregiver is unavailable due to vacation, illness, weather...)

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* 12. In the last 3 months have you had to leave/miss work to manage childcare issues (such as caregiver unavailability) not related to illness?

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* 13. Do you prefer your childcare to be closer to your home or work?

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* 14. Which school district do you live in?

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* 15. How flexible is your employer with respect to childcare responsibilities?

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* 16. Have you ever quit a job because you couldn't find adequate childcare?

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* 17. If you are currently unemployed, would having adequate/affordable childcare available make you likely to seek employment?

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* 18. Would you be in need of night shift childcare (between 6 pm and 7 am)?

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* 19. Please provide any additional comments regarding your needs or opinions about childcare or potential childcare issues and concerns.

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