JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
RC Community Needs Assessment Spring 2022
Hello!! You are receiving this survey because our records show you have one or more children on our Early Childhood census who are not yet in Kindergarten. Every year as part of our ongoing efforts to improve the services we offer to families, we conduct a community needs survey. Please take a moment to complete this form to provide us valuable feedback.
Your answers are anonymous and can not be connected to you unless you provide your name.
Thank you in advance for your participation!
Julie Thom - Early Childhood Program Coordinator
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please indicate the ages of the children who live in your home.
*
Check all that apply
Birth to 2 years old
3 to 5 years old
Kindergarten to 3rd Grade
4th - 6th Grade
7th - 12th Grade
Required
Please indicate which Early Childhood programs/services you have participated in over the past school year.
Check all that apply
Preschool at CE Jacobson Elementary
Preschool at another location
ECFE - Spring Session 2022
Early Childhood Screening at CE Jacobson Elementary
Early Childhood Screening in another school district
Early Childhood Special Education (ECSE)
In Home Daycare
Center Based Daycare
Have not participated in any Early Childhood program or service
Do you have any concerns about your child's development in any one or more of the following areas?
Check all that apply
Social Emotional or Behavior Development
Language/Literacy Skill Development
Speech (how well others can understand my child)
Attention/Memory Skills
Large Motor Skills (crawl, walk, run, jump, climb, etc)
Small Motor Skills (pick up small items, put puzzle together, hold crayon or marker, etc)
Vision
Hearing
No concerns in any area
Some EC classes include a parent component - would you be most likely to attend if this class met:
Check all that apply
Weekly, ongoing class - ONLINE
Weekly, ongoing class - IN PERSON
One-time class, specific topic - child care provided
One-time special event class, parent/child attends together
Recorded information/presentation, watch when I have time
One-on-one phone call with parent educator or other resource provider
Weekend offering
Other:
If you have questions about how to address a concern you have with your child's (behavior, development, etc.) where do you get this information?
*
Check all that apply
Friend/Family member
Website or Search Online
Podcast
Book or other printed material
Medical Doctor or other health professional
Chisago County Public Health
School District Teacher
Other:
Required
What type of information would be the most helpful to you as a parent?
Check all that apply
How to address my child's behavior.
What should my child be doing at his or her age?
How to build academic/school readiness skills.
How to increase my child's social emotional skills.
Other:
Do you feel there are populations that Rush City Early Childhood are NOT serving or needs of the community that we are not addressing?
Your answer
Next
Page 1 of 2
Clear form
Never submit passwords through Google Forms.
This form was created inside of ISD 139 Rush City Public Schools.
Report Abuse
Forms