ITS A CHILD'S WORLD FAMILY DAY HOME AGENCY
PARENT/ DAYHOME SURVEY

Question Title

* 1. How long have you been with your current Provider?

Less than 6 months

More than 6 months

1-2 yrs

2-3 yrs

More than 3 yrs.

Provider's Name

Question Title

* 2. Do you feel your provider is attentive to the development of your child?

Rarely

Sometimes

Usually

Always

Provide Comment

Question Title

* 3. Is the provider's home a place of comfort and safety for your child?

Rarely

Sometimes

Usually

Always

Provide Comment

Question Title

* 4. Does the provider interact with your child in a positive and caring manner?

Rarely

Sometimes

Usually

Always

Provide Comment

Question Title

* 5. Does the provider communicate to you on a daily basis about your child's day?

Rarely

Sometimes

Usually

Always

Provide Comment

ITS A CHILD'S WORLD FAMILY DAY HOME AGENCY
PARENT/ DAYHOME SURVEY

Question Title

* 1. How long have you been with your current Provider?

Question Title

* 2. Do you feel your provider is attentive to the development of your child?

Question Title

* 3. Is the provider's home a place of comfort and safety for your child?

Question Title

* 4. Does the provider interact with your child in a positive and caring manner?

Question Title

* 5. Does the provider communicate to you on a daily basis about your child's day?

Question Title

* 6. Do you have any other comments, questions, or concerns in regards to your dayhome?

Question Title

* 7. Has there been any changes to your personal information such as , phone #, email, work place etc?