Provider/Teacher Survey

Appendix A-3:
Provider/Teacher Survey

Family and
Early Care and
Education Provider
Relationship Study

Teacher and Child Care Provider Survey

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OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

Provider Survey
Thank you for agreeing to participate in the Family and Early Care and Education Provider Relationship
Study. The results will help us develop surveys that teachers, child care providers, and policymakers can
use to improve children’s care and education.
This survey asks about you and your early education and child care program. We will also ask about the
parents and families of children whose learning and development you support. Some of these questions
will be about how you and the families of children in your care communicate and work together.
All information obtained from this study will be kept private. The report summarizing the findings will
not contain any names or identifying information.
Please follow these steps:
1. Complete the provider survey. It takes approximately 10 minutes.
Please use a black or blue pen to complete this form.
Mark

to indicate your answer.

If you change your answer, mark
right answer.

on the wrong answer, and mark

to indicate the

2. Use the self-addressed, postage-paid envelope, to mail the survey back to:
XXXXX XXXXXX
Westat
1600 Research Boulevard
Rockville, Maryland
20850-3129
3. As a token of our appreciation for your time and effort, you will receive a check for $50 within 2-3
weeks of our receipt of your completed questionnaire.

Public reporting burden for this collection of information is estimated to average 10 minutes per response, including the time for
reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not
conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
number.
The office of Management and Budget has approved the data collection under OMB #XXXX-XXXX. OPRE is authorized to conduct
this study under Section 649 of the Head Start Act, as amended by the Improving Head Start for School Readiness Act of 2007,
codified at 42 United States Code (U.S.C.) 9844.

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OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

1. Since September, how often have you talked to parents about the following regarding their
child?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Their child’s experiences in the education
and care setting ..........................................
b. Their child’s abilities .................................
c. Their child’s general behavior ...................
d. Problems their child is having in the
education and care setting ..........................
e. Goals parents have for their child ..............
f.

What to expect at each stage of their
child’s development ...................................

2. Since September, how often have you talked to parents about the following regarding
themselves?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Their personal relationship with a spouse
or partner ....................................................
b. Their employment status ............................
c. Their financial situation .............................
d. Their parenting styles.................................

3. Since September, how often have you talked to parents about the following regarding the
education and care their children receive?
[MARK ONE BOX IN EACH ROW.]
Never

a. Your expectations for the children in
your care ..................................................
b. The rules you have for children in your
care ...........................................................
c. How they feel about the education and
care you provide ......................................

2

Rarely

Sometimes

Very often

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

4. How often do you have difficulty communicating with parents because they have a strong
accent or speak a different language than you?
[MARK ONLY ONE BOX.]
Never..........................................................................................................
Rarely .........................................................................................................
Sometimes..................................................................................................
Very often ..................................................................................................

5. Listed below are some things families may or may not share with you. Thinking about the
children and families you serve, for how many children and their families do you know the
following?
I know…
[MARK ONE BOX IN EACH ROW.]
None

a. If children have siblings. ..........................
b. If children have other adult relatives
living in their households ..........................
c. Their parents’ schedules ...........................
d. The marital status of children’s parents ....
e. The employment status of children’s
parents ......................................................
f. Their financial situation ...........................
g. The role that faith and religion play in
children’s households ..............................
h. Their cultures and values .........................
i.

j.

What their families do outside of the
education and care setting to encourage
their children’s learning ...........................
How parents discipline their child ............

k. Changes happening at home .....................
l.

Health issues their children have such as
food allergies or asthma ............................

3

Some

Most

All

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

6. Since September how often have you been able to do the following?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Help children settle in when they are
dropped off.................................................
b. Share information with parents about their
children’s day.............................................
c. Offer parents books and materials on
parenting ....................................................
d. Suggest activities for parents and children
to do together ............................................

7. We would like to learn about how you and the families of children in your program work
together.
How often are you able to do the following?
[MARK ONE BOX IN EACH ROW.]
Never

Rarely

Sometimes

Very often

a. Answer parents’ questions when they
come up ......................................................
b. Work with parents to develop strategies
they can use at home to support their
child’s learning and development ..............
c. Set goals with parents for their child .........
d. Offer parents ideas or suggestions about
parenting ....................................................
e. Provide parents the opportunity to give
feedback about your performance..............

8. When planning activities for children in your program, how often are you able to take into
account the following?
[MARK ONE BOX IN EACH ROW.]
Never

a. Information parents share about their
children .......................................................
b. Families’ values and cultures ......................

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Rarely

Sometimes

Very often

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

9. Please indicate how much you agree or disagree with each of these statements.
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

Disagree

Agree

Strongly agree

a. Sometimes it is hard for me to support the
way parents raise their children ..................
b. Sometimes it is hard for me to support the
way parents discipline their children ..........
c. Sometimes it is hard for me to support the
goals parents have for their children ...........

10. People work in care and education settings for many reasons. Please indicate how much you
agree or disagree with the following statements:
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

a. I teach and care for children because I
enjoy it ..........................................................
b. I see this job as just a paycheck ....................
c. I teach and care for children because I like
being around children ...................................
d. If I could find something else to do to
make a living I would ...................................

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Disagree

Agree

Strongly agree

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

11. People vary in what they consider part of their job. Please indicate how much you agree or
disagree with the following statements.
Part of my job is to…
[MARK ONE BOX IN EACH ROW.]
Strongly
disagree

a.
b.
c.
d.
e.
f.
g.

Disagree

Agree

Strongly agree

Help families get services available in the
community ..................................................
Offer parents information about
community events such as fairs...................
Respond to issues or questions outside of
normal care hours ........................................
Change the care schedule in response to
parents’ work or school schedules ..............
Learn new ways to teach and care for
children........................................................
Change activities offered to children in
response to families’ feedback ....................
Talk to parents about how they raise their
children........................................................

12. In the last ten years, have you received training or coursework on how to recognize signs of:
[MARK ONE BOX IN EACH ROW.]
Yes

a.

Developmental delays in children. ......................................................................

b.

Child abuse and neglect. .....................................................................................

c.

Domestic violence ...............................................................................................

d.

Substance abuse ..................................................................................................

e.

Depression or mental health issues in parents .....................................................

f.

Hunger .................................................................................................................

No

13. If families have a question or a problem comes up during the day, how easy or difficult is it
for them to reach you?
[MARK ONLY ONE BOX.]
Very difficult ............................................................................................
Difficult ....................................................................................................
Easy ..........................................................................................................
Very easy..................................................................................................

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OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

14. Since September, have you personally helped families in any of the following ways:
[MARK ONE BOX IN EACH ROW.]
Yes

a.

Encouraged families to seek or receive services? ..........................................

b.

Made appointments or arrangements for families to receive services they need?

c.

Helped families find services they need? ......................................................

15.

Are you of Hispanic or Latino origin?
[MARK ONLY ONE BOX.]
Yes ..........................................................................................................
No ...........................................................................................................

16.

What is your race?
[MARK ALL THAT APPLY.]
White ......................................................................................................
Black or African American.....................................................................
American Indian or Alaska Native .........................................................
Asian Indian............................................................................................
Chinese ...................................................................................................
Filipino ...................................................................................................
Japanese ..................................................................................................
Korean ....................................................................................................
Vietnamese .............................................................................................
Other Asian .............................................................................................
Native Hawaiian .....................................................................................
Guamanian or Chamorro ........................................................................
Samoan ...................................................................................................
Other Pacific Islander .............................................................................

17.

Do you have a Child Development Associate (CDA) credential?
[MARK ONLY ONE BOX.]
Yes ..........................................................................................................
No ...........................................................................................................

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No

OMB No.: XXXX-XXXX
Expiration Date: XX/XXXX

18.  What is the highest level of education you have completed?
[MARK ONLY ONE BOX.]
Less than a high school diploma.............................................................
High school diploma or GED .................................................................
Some college, no degree .........................................................................
Associate’s degree ..................................................................................
Bachelor’s degree ...................................................................................
Graduate school degree ..........................................................................

END: THANK YOU FOR COMPLETING THIS SURVEY

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