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* 1. Where do you live?

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* 2. For what reasons do you need/use child care:

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* 4. What services do you want to be included in a child care program:

  Least Important Medium Importance Most Important
Educational Skills Tutoring
English language tutoring
Social interaction for child
Cultural learning
Activities (sports, crafts, etc.)
Homework help
Having a nurse in the program
Toys/equipment provided
Healthy food choices
Flexible service hours
Mother time

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* 5. Have you have experienced any of these child care problems?

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* 6. Do you use child care (does someone care for your children when you are at work or not at home)?

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* 8. Are you satisfied with your current child care arrangements?

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* 9. Do you pay for child care?

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* 10. How much do you pay per child per week for childcare?

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* 11. How many kids do you have currently in childcare?

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* 12. What are your main concerns when deciding what child care to use?

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* 13. Would you like to have a job working in a child care center?

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* 14. Would you like to have a job caring for children in your home?

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* 15. How many people live in your immediate family household (ex. you, husband and children; do not include relatives or friends)? 

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* 16. Please estimate the annual income range for your household?

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