Upbring Head Start Community Survey
Parents/Guardian: We would love to hear your feedback on how we can better serve your community. This survey asks for your feedback about the need for a Head Start program in your community. Your responses are completely CONFIDENTIAL and will be used solely to assist in the evaluation and improvement of the program.
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How did you find out about Head Start?
Are you the child's :
Do you share housing with relatives or other adults?
Are you :
How many children under the age of 5 live with you?
How old are each of the children?
Do you have a child diagnosed with a disability?
Clear selection
If yes, what is that disability?
Do you know of any families in the community that have a child with a disability that need preschool/childcare services?
Clear selection
If yes, how can we reach them?
Are there any barriers that prevent you from receiving needed services for your child?
Clear selection
If yes, what are some of those barriers?
To help us better plan for the future, what Head Start program option would best meet your needs?
Do you regularly use child care?
How much do you spend in child care? (per month)
How many hours per week is child care needed?
What community services have you used outside of Head Start? Please check all that apply.
Where there any services that you needed, but did not receive?
What were the barriers to receiving services? Please check all that apply.
Overall, how open are you to having a Head Start program in your community?
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