Child Care Resource and Referral Annual Update - Fiscal Year 21

Thank you for taking the time to update your contact information for the Partnership for Children and Families, Mesa County's Child Care Resource and Referral! Annual updates are essential to maintain accurate records for families in the community. This survey will take approximately 15 minutes. Please answer these questions to the best of your ability. 

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* 1. Today's date

Date

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* 2. Program Designated Name

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* 3. License Number

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* 4. What is your license type? (Can be found in the top, right corner of your license)

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* 5. Director of Program

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* 6. Name of person completing this form (if different from the director above)

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* 7. Director's Phone Number

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* 8. Other reported phone number (if applicable)

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* 9. Director or Authorized Email

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* 10. Link to program website (if applicable)

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* 11. Primary Language Spoken

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* 12. Do you give PCF and Mile High United Way permission to give out your program's information to families in need of child care?

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* 13. Does your program currently have a CCCAP (Colorado Child Care Assistance Program) agreement with local DHS?

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* 14. Youngest age authorized to serve - in weeks, months or years (example: 18 months)

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* 15. Oldest age authorized to serve - in weeks, months or years (example: 5 years)

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* 16. Your program accepts (check all that apply): 

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* 17. Is your program open year round?

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* 18. Normal days and hours of operation (example: Monday - Thursday, 7:30am - 5:30pm. Closed on Fridays.)

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* 19. My program is (check all that apply):

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* 20. Profit Facility

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* 21. Does your program have staff members fluent enough to TRANSLATE into other languages?

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* 22. Other languages SPOKEN by staff members?

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* 23. Extra Care Services - additional services the program offers outside of business hours (check all that apply):

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* 24. Environment - snapshot of the program (check all that apply):

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* 25. Meals - nutrition offered by your program (check all that apply):

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* 26. Philosophy

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* 27. Special Needs - provider has experience, training or expertise working with children with these special needs or is willing to support the need (check all that apply):

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* 28. Experience - How many years have YOU worked in Licensed Child Care?

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* 29. Education - Highest level of education achieved by the provider

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* 30. Affiliation - program is affiliated with or a member of the organization (check all that apply)

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* 31. Are you interested in becoming a member of the Partnership for Children and Families? Members volunteer their time to try to help us move our vision forward, collaborate with other stakeholders, help inform our strategic plan, and identify gaps and needs in each community. 

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* 32. Do you currently use a health consultant?

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* 33. Child care setting:

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* 34. Transportation (check all that apply):

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* 35. Child care licensing rules require licensed child care programs to have an Emergency Preparedness Plan. Does your program have this plan in place?

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* 36. For Level 1 Programs only: Most Level 2 - 5 programs are now benefiting from $2,100 - $10,000 in Colorado Shines state funds. Would you like more information? Camps and after school programs are not eligible.

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* 37. Comments: Is there any additional information regarding the program you'd like to share?

0 of 37 answered
 

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