2021 Child Care Needs Assessment
1.

Which of the 5 towns do you live in? 

Clarkstown
Haverstraw
Orangetown
Ramapo
Stony Point
2.
What is your family composition? 
Mother, Single, Working
Mother, Single, Not working
Father, Single, Working
Father, Single, Not working
2 Parents/ guardians, both working
2 Parents/ guardians, 1 working
2 Parents/ guardians, neither working
3.
If you have children in the following age group, please indicate how many. 

Infant (0-17 months) 
 

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4.
If you have children in the following age group, please indicate how many. 

Toddler (18-36 months)

 

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5.
If you have children in the following age group, please indicate how many. 

Preschoolers (3-5 years)
 

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6.
If you have children in the following age group, please indicate how many. 

K-6th Grade 
 

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7.
If you have children in the following age group, please indicate how many. 

7th -9th Grade 
 

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8.
What is you current family income?
No income
Below $50,000
$50,001- $100,000
$100,001- $250,000
Above $250,001
9.
While your children were in care, did you have trouble paying? 
Always
Often
Sometimes
Rarely
Never
10.
In order to pay for care, did you: (check all that apply)
Borrow from family or friends?
Cut back on work hours
Cut back on basic household expenses
Cut back on child care hours
Have a friend/ relative watch your child/ children
11.
Do you receive assistance to pay for child care/ child care subsidy? 
Yes
No
12.
If you do receive assistance, do you have trouble paying your parent share fee/co-pay?
Yes
No
13.
What are the TWO Most important reasons you selected your current child care arrangements?
Quality
Location - close to home
Location- close to work
Cost
Caregiver is a relative
Children are happy in the program
Small adult/ child ratio
The program accepts subsidy
Good learning/educational program
Caregiver is trained and educated
How I was treated at the initial visit
Heard good things from other parents
My other child was enrolled in this program
Provider's experience with special needs children
Program nationally accredited
Other  
14.
Where is or has your child(ren) been cared for in the past 12 months (check all that apply):
Child Care Center
Licensed/Registered Child Care Home Program
Head Start/Early Head Start
Nanny/Babysitter in Home
Nursery School
Nursery School
Preschool
With older sibling
Care by parent
Care by friend/family
Camp
Before/After school program
Library
Other
15.

How much do you pay a week for child care?

 

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16.

How many days a week is your child in care?

 

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17.
Have you ever withdrawn your child from a provider/program for any of the following reasons (check all that apply)
Cost of care too high
Change in your work hours
Moved out of area of current child care
Provider cannot take my infant (or 2nd child)
Provider could be more nurturing
Frequent staff changes
Personal dissatisfaction (doesn't like the person, doesn't like another staff/household member, child isn't happy, but nothing is "wrong", etc.
Provider's business practices (won't provide tax information, documentation, etc.)
Environment (pets, air quality, safety, etc.)
OCFS Violations
My child was expelled/asked to leave
Other
Other  
18.
Have child care issues ever caused you to (check all that apply)
Call out of work
Feel distracted/unproducti-
ve at work
Leave work early
Arrive late
Cut back work hours
Quit your job
Lose your job
Change your job within the company (less responsibility)
Change jobs to another company
Receive disciplinary action
No issues
Other
Other  
19.
Does your employer offer (check all that apply)
Work from home
Dependent Care Assistance (DAP)
Resources to find child care
Child care at work site
Financial assistance for child care
Flexible schedule
Extended maternity/paternity leave
Allow you to bring child to work
Other
Other  
20.
If your employer offered any of the options above which TWO would be most helpful?
Work from home
Dependent Care Assistance (DAP)
Resources to find child care
Child care on work site
Financial assistance for child care
Flexible schedule
Extended maternity/paternity leave
Allow you to bring child to work
Other
Other  
21.
Have child care issues impacted your job? (check all that apply)
Child care not always reliable
Not always able to pay
Worried child isn't safe
Worried child isn't receiving best care
Did not have someone to watch child
No impact
Other  
22.
Are you aware of Child Care Resources of Rockland's services for children and families?
Yes
No, but I have heard of them
No, I have never heard about them
23.
Are you interested in any of the following?
Yes, send me the results of this survey
Yes, I would like to join your email list
No, I am not interested
24.
If you selected yes to receiving survey results and/or to joining our email list, please provide the following:

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Work Phone:
Email Address:
emailaddress@xyz.com