Needs Assessment Survey for Families Question Title * 1. How many children do you have between the ages of 0-12? 1-2 children 3-4 children 5+ children Question Title * 2. What are the age ranges of your children? (Select all that apply) Infants (0-12 months) Toddlers (1-3 years) Preschoolers (3-5 years) School-age children (5-12 years) Question Title * 3. Are you currently using any child care services? Yes No Question Title * 4. If you answered 'yes' to the above question, what type of child care do you use? Home-based care Center-based care Legally-exempt care Group-family care After-school programs Other (please specify) None of the above Question Title * 5. Do you face transportation barriers when accessing child care services? Yes No Question Title * 6. If you answered 'yes' to the question above, please explain: Question Title * 7. How much do you typically spend on child care each month? Less than $100 $100-$300 $301-$500 More than $500 Question Title * 8. What percentage of your monthly household income is spent on child care? Less than 10% 10-20% 21-30% More than 30% Question Title * 9. How satisfied are you with the child care services your child(ren) receive? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied Question Title * 10. What are the most important factors in choosing a child care provider? (Select up to 3) Cost Location Quality of care Curriculum or activities offered Safety measures Provider's experience or qualifications Cultural/linguistic relevance Other (please specify) Question Title * 11. Does your child have any special needs that require specialized care? Yes No Question Title * 12. If you answered 'yes' to the above question, how well do you feel the child care provider accommodates these needs? Very well Well Neutral Poorly Very poorly N/A Question Title * 13. If you answered 'yes' to question 11, what additional resources or support would be helpful in meeting your child's needs? Question Title * 14. Do you work non-traditional hours (e.g., evenings, weekends)? Yes No Question Title * 15. If you answered 'yes' to the above question, do you find it difficult to access child care during these hours? Yes No N/A Question Title * 16. What other child care options would be helpful for families working non-traditional hours? Question Title * 17. Does your child care provider offer services that meet your cultural or language preferences? Yes No Question Title * 18. If you answered 'no' to the above question, what additional services would be helpful? Done