Survey and Needs Assessment
Parent Information
First Name
Last Name
Survey Information
1. State Regulations and Policies: Were you informed of the local and state rules and regulations that govern our facility?
Yes
No
2. Family Involvement: Were you told about and how you can be involved with the center program events or volunteer opportunities?
Yes
No
3. Security/Health & Safety/Cleanliness: Were you informed about the safety policies, and cleanliness of the center?
Yes
No
4. Our Classroom & Curriculum: Were you informed about your child's potential classroom and the program curriculum? Funshine Express
Yes
No
5. Our Staff Members: Were you informed about our friendly staff members and how we are here to assist you?
Yes
No
6. Food & Nutrition: Were you informed about our program food service policy and shown where the menu is posted?
Yes
No
7. ASQ Screening tool: Were you informed about our ASQ policy, and this step is madatory in the enrollment process?
Yes
No
8. Communication Policy: Were you informed about our communication tools? ProCare Connect & ProCare
Yes
NO
9. Visitation & Open Door Policy: Were you informed about how we handle visitation and our open door policy?
Yes
No
10. Our Enrollment Process: Were you informed about the four steps of the enrollment process?
Yes
No
11. Our ECAP/Redding Program: Were you provided information about our State funded program, and provide a flier?
Yes
No
12. Parent Rights To Know Form: Was this form explained to you and then signed
Yes
No
13. What did you enjoy about your tour?
14. Was there anything else you wanted to know, or we did not cover?
15. What is your next step after your tour?
Choose one
Purchase of Care Packet
Private Pay Packet
Place me on the waiting list
No longer interested
16. Additional Document Requests:
Medical/Religious Form
Cultural Food Restrictions Form
Medication Form
Infant Form
No Forms Required
Needs Assessment
Message
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