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* 1. Please enter your name and contact information

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* 2. Name of  Director/Owner/Person completing survey

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* 4. Are you  currently a registered Critical Care Site?

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* 5. If you answered  yes to Question 4, are you currently caring  for children?

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* 6. If you are a registered Critical Care Child Care site, how many tests will be needed to test each staff member (or household member, including you as the provider) at your site?

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* 7. If you are a registered Critical Care Child Care site, how many tests will be needed to test each child at your site?

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* 8. If you are a registered /licensed but currently closed  child care site, how many tests will be needed to test each staff member (or household member, including you as the provider) at your site?

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* 9. If you are a registered/licensed but currently closed  child care site, how many tests will be needed to test each child at your site?

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* 11. What supports do you need now to either keep your Critical Child Care site operating or reopening your child care program?

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* 12. If you need funding, please describe:  For what? For how long?  How much?

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* 13. If you need assistance with supplies,  please select all that apply

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* 14. Are you ready to call staff back to work?

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* 15. Is your program prepared to offer infant care?

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* 16. Is your program prepared to offer Toddler care?

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* 17. Is your program prepared to offer Preschool care?

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* 18. Is your program prepared to offer School Age care?

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* 19. If you indicated that you were unprepared to provide care in questions  15 - 18, please  select a reason from the below list. Choose any that apply.

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* 20. What else do we need to know about child care during this time to help you either as Critical Child Care Sites or to reopen when the time comes?

0 of 20 answered
 

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