Adams County COVID-19 Child Care Pulse Survey

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* 1. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 2. What is your total household income?

Less than $20,000

$20,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 or More

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* 3. What is your gender?

Female

Male

Gender neutral/gender fluid/other

Prefer not to answer

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* 4. What is your race/ethnicity? Check all that apply

Black, African American, African

Hispanic, Latino/a

White, Caucasian, Euro-American, European

Middle Eastern, Arabic

Asian, Pacific Islander, Asian-American

Indigenous, Native American

Prefer not to answer

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* 5. What is your primary language?

English

Spanish

Prefer not to answer

Other (please specify)

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* 6. How old are your children?

Infant (0-18 months - walking)

Toddler (18 months -2.5 yrs)

Preschool (2.5-5 years old)

School-Aged Care (K-12 years old)

Older than 12 years old

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* 7. If your child/children are kindergarten and older, what school district do they attend

Adams 12 Five Star Schools

Adams County 14

Bennett 29J

Mapleton

School District 27J

Strasburg 31J

Westminster 50

Other (please specify)

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* 8. How do you pay for care? (Select all the apply)

Pay own tuition

Colorado Child Care Assistance Program (CCCAP)

School district funding

Headstart

Denver Preschool Program (DPP)

Temporary Assistance for Needy Families (TANF)

I am unaware of assistance options available

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* 9. What is your current, most often used means of childcare?

Childcare Center

Licensed in-home childcare provider

School age only program (BASE, before and after school, rec center, private company)

Residential Summer Camp

School District Preschool

Headstart

Nanny/Babysitter

At home with an adult providing care (for example- stay at home parent, another adult, family member)

At home with an older sibling

Children are old enough to stay home alone

Outside family member, neighbor, or friend

Other (please specify)

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* 10. Currently, do you have the child care that you need for your child/children? Please answer by age group for each of your children.

	Yes	No	N/A
Infant (0-18 months - walking)	Infant (0-18 months - walking) Yes	Infant (0-18 months - walking) No	Infant (0-18 months - walking) N/A
Toddler (18 months -2.5 yrs)	Toddler (18 months -2.5 yrs) Yes	Toddler (18 months -2.5 yrs) No	Toddler (18 months -2.5 yrs) N/A
Preschool (2.5-5 years old)	Preschool (2.5-5 years old) Yes	Preschool (2.5-5 years old) No	Preschool (2.5-5 years old) N/A
School-Aged Care (K-12 years old)	School-Aged Care (K-12 years old) Yes	School-Aged Care (K-12 years old) No	School-Aged Care (K-12 years old) N/A
Older than 12 years old	Older than 12 years old Yes	Older than 12 years old No	Older than 12 years old N/A

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* 11. Which of the following describe why you do not currently have the child care/school program that you need? Check all that apply

	Infant-preschool	School-aged (K-12)
Care provider/school program has closed or is permanently unavailable	Care provider/school program has closed or is permanently unavailable Infant-preschool	Care provider/school program has closed or is permanently unavailable School-aged (K-12)
Care provider/school program is temporarily closed due to COVID-19	Care provider/school program is temporarily closed due to COVID-19 Infant-preschool	Care provider/school program is temporarily closed due to COVID-19 School-aged (K-12)
Care provider/school program has reduced the number of children they serve	Care provider/school program has reduced the number of children they serve Infant-preschool	Care provider/school program has reduced the number of children they serve School-aged (K-12)
Care provider/school program has reduced the days or hours of operation	Care provider/school program has reduced the days or hours of operation Infant-preschool	Care provider/school program has reduced the days or hours of operation School-aged (K-12)
Do not feel it is safe to send our child/children to child care/school program	Do not feel it is safe to send our child/children to child care/school program Infant-preschool	Do not feel it is safe to send our child/children to child care/school program School-aged (K-12)
Cannot find available care when/where I need it	Cannot find available care when/where I need it Infant-preschool	Cannot find available care when/where I need it School-aged (K-12)
There are not care providers with options that accommodate my work schedule/situation	There are not care providers with options that accommodate my work schedule/situation Infant-preschool	There are not care providers with options that accommodate my work schedule/situation School-aged (K-12)
Can no longer afford child care	Can no longer afford child care Infant-preschool	Can no longer afford child care School-aged (K-12)

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* 12. Rank each of the following childcare/school program concerns from lowest concern to highest concern (1 being of highest concern and 8 being of lowest concern):

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* 13. As a result of COVID-19, has anyone in your household experienced a change in their work situation? Check all that apply

Yes, I or someone else in my household switched to working remotely or at home

Yes, I or someone else in my household am/are working fewer hours

Yes, I or someone else in my household was laid off or furloughed

No, no one in my household has experienced a change

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* 14. Since the beginning of the pandemic, has your household income:

Stayed the same

Increased

Decreased

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* 15. To what extent does your current situation impact your ability to ensure care for your children?

A great deal

A lot

A moderate amount

A little

None at all

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* 16. (Optional) Describe how your situation has impacted your ability to ensure care for your children?

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* 17. Are you enrolled in any school or education program?

Yes full time

Yes part time

No- I had to stop due to lack of childcare

No-reasons unrelated to childcare

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* 18. Are you a student at Front Range Community College Westminster Campus?

Yes

N/A

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* 19. If not, are you a student at any of the following?

Another Community College (please specify)

A University (please specify)

A Technical School (please specify)

A High School/GED program (please specify)