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* 1. My facility is a(n):

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* 2. In what zip code is your facility located?

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* 3. What is your current role?  Please select all that apply.

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* 4. What type(s) of program(s) does your facility offer?  Please check all that apply.

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* 5. Is your facility currently enrolled in the USDA Child and Adult Care Food Program?

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* 6. What is your current licensed capacity?  Please specify number of spaces permitted by age group.

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* 7. What is your current enrollment?  Please specify number of children by age group.

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* 8. If your current enrollment is less than your licensed capacity for any age group, please specify why.  If not applicable, please type N/A.

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* 9. Do you currently have a wait list?

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* 10. If you currently have a wait list, please specify how many children are on it, and how long the current wait time is in months.  If not applicable, please type N/A.

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* 11. Do you currently serve children with professionally documented special needs?

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* 12. If you currently serve children with professionally documented special needs, please specify the type(s) of special needs.  If not applicable, please type N/A.

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* 13. What are your current full-time rates?  Please specify by age.  If not applicable, please type N/A.

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* 14. On average, for the full-time rates specified in question 13, how many hours does a full-time child spend in your care?  If not applicable, please type N/A.

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* 15. What are your current part-time rates?  Please specify by age.  If not applicable, please type N/A.

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* 16. On average, for the part-time rates specified in question 15, how many hours does a part-time child spend in your care?  If not applicable, please type N/A.

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* 17. How many positions, by type, do you currently have?  If not applicable, please type N/A.

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* 18. How many new staff, by position type, have been hired within the past year?  If not applicable, please type N/A.

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* 19. How many staff, by position type, have left employment within the past year?  If not applicable, please type N/A.

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* 20. How many vacancies, by position type, do you currently have?  If not applicable, please type N/A.

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* 21. What is the average hourly wage for staff at your facility?  Please specify by position type.  If not applicable, please type N/A.

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* 22. Do you provide benefits to staff at your facility?  Please check all that apply.

  All Staff Full-time Staff Part-time Staff None
Health Insurance - Employee
Health Insurance - Family
Vacation
Sick Leave
Tuition Assistance
Retirement
Transit Subsidy
Parking Subsidy
Other

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* 23. If you chose "Other" in question 22, please specify the type of benefit and who is eligible to receive it.  If not applicable, please type N/A.

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* 24. Is your facility currently enrolled in Virginia Quality (Virginia's voluntary Quality Rating and Improvement System)?

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* 25. Is your facility accredited by the National Association for the Education of Young Children (NAEYC)?

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* 26. If your facility is not enrolled in Virginia Quality or NAEYC accredited, does it have an alternative accreditation or certification?

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* 27. If your facility has, is working towards, or has had an alternative accreditation or certification in the past, please specify which accreditation or certification.  If not applicable, please type N/A.

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* 28. If your facility does not currently have, and is not working towards, any type of accreditation or certification, please specify why.  If not applicable, please type N/A.

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* 29. Are you in need of training for your current employees?

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* 30. If you answered yes to question 29, please choose from the following types of training.  Check all that apply.

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* 31. Do you have children in your facility whose care is paid (at least in part) by subsidy payments or some other type of assistance?

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* 32. Are you willing to serve children receiving a child care subsidy or some other type of assistance?

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* 33. If you answered no to question 32, please specify why.  If not applicable, please type N/A.

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* 34. Would you use the following services or programs if they were available?  Please check all that apply.

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* 35. Does your facility's physical interior space currently meet your needs?

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* 36. Does your facility's physical exterior space currently meet your needs?

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* 37. Does your facility currently have any future plans for expansion?

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* 38. What is your current lease cost per square foot?  If not applicable, please type N/A.

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* 39. What is your lease maximum per square foot?  If not applicable, please type N/A.

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* 40. What is the most pressing need faced by your facility?

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* 41. OPTIONAL: Please enter your facility name, address, and contact information.  If you wish to remain anonymous, please type N/A.

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