Great Start to Quality
Self-Assessment Survey for Out-of-School Time Programs

Welcome to the Great Start to Quality Program Profile for Out-of-School Time Programs

This section will capture the basics about your program and staffing. Please provide as much detail as possible and double check your license number!

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* 1. Program Information

Program Name:

License Number:

Program Address (including city and zip code):

County:

Primary Contact Person:

Email:

Phone:

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* 2. Are you a Multi-Site Director or will you be filling out a Self-Assessment Survey for multiple programs?

Yes

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* 3. What type of care do you offer? Select all that apply.

Before and After School Care

Full Day

Half Day

Drop In Care

Emergency Care

Summer Care

Holiday Care

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* 4. Program Director/ Administrator/ Site Supervisor

Director/Administrator Name (First, Maiden, Last)

Director/Administrator Date of Hire

Director/Administrator Qualifcations

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* 5. What type of setting below best describes your program? Use the box below if none of the options accurately capture your program?

Stand-Alone Center, the building is mainly for the program or the program is associated with the organization that owns the building

Stand-Alone Center, the program uses a part of a building or uses most of a building that isn't associated with the organization that owns the building

School Building, Program operates in a school mostly in classrooms

School Building, Program operates in a school mostly in gym or cafeteria

Other (please specify)

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* 6. How many classrooms do you have?

7% of survey complete.