Appendix D: Nutrition and Wellness Data Collection Instruments
D.1a Provider Web Survey
LOGO
OMB
Control No: 0584-XXXX OMB
Approval Expiration Date: XX/XX/XXXX
Study of Nutrition and Activity in Child Care Settings (SNACS)
Provider Web Survey
Child
Care Center ID
Interviewer ID #: | | | | | | | |
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXX .The time required to complete this information collection is estimated to average 56 minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. |
About the Study. The Study of Nutrition and Activity in Child Care Settings is intended to study nutrition and activity in child care centers, family day care homes, afterschool programs, and at-risk programs participating in the Child and Adult Care Food Program (CACFP) and some not participating in the CACFP. More than 1,500 child care providers in over 20 states were selected to be part of the study. Abt Associates is conducting this study for the USDA Food and Nutrition Service (FNS). Participation in the study by selected sponsors and child care providers who receive CACFP funds is required under Section 305 of the Healthy, Hunger-Free Kids Act of 2010 (HHFKA).
Data Collection Activity. The Provider Survey will gather information about foods served by the provider, types of foods served, wellness policies, menu planning practices, food purchasing practices, food service practices, and additional program characteristics. The Provider Survey is divided into eleven sections. The survey will take approximately 60 minutes tocomplete.
Protecting Privacy. All information gathered from child care sponsors, child care centers, family day care homes, child care administrators and staff, and families participating in this study is for research purposes only and will be kept private to the full extent allowed by law except for your general community location. Responses will be grouped with those of other study participants, and no individual participants, program administrators, program staff, parents, or children will be identified in any study report.
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Questions. If you have any questions about the study please call our toll-free study number at 1-844-808-4777 or email [email protected]. We will be happy to answer your questions and to help you in any way we can.
Thank you for participating in the Study of Nutrition and Activity in Child Care Settings.
Online Provider Survey Instructions
Thank you for taking part in our important study. The purpose of this survey is to learn about food and physical activity practices at child care facilities. Each section in the survey deals with a specific topic:
1) Center Directors/Family Child Care Owner
2) Menu Planning
3) Food Purchasing
4) Food Preparation and Food Safety
5) Food/Beverage Serving Practices
6) Food Allergies and Food Intolerances
7) Water
8) Physical Activity
9) Infant Feeding and Infant Physical Activity Section
10) Nutrition and physical activity promotion/education practices
11) Barriers to CACFP participation
The survey can be accessed by more than one person at your program, and you can save portions of the survey to return to it later. After Section 1 is completed, the remaining sections do not have to be completed in order. Please have the person at your program most familiar with a given topic respond to the section on that topic. In order to complete this survey, please [click on the link provided] which will take you to the online survey and then enter your login information.
If you have any questions about the study or this survey, please feel free to call our toll-free number at 1-844-808-4777 or email [email protected].
Online Survey of Providers
Section 1
Center Directors/Family Child Care Owner
The questions in this section ask about the number and ages of children you serve, and whether you participate in federal food programs. Please have the person most familiar with these topics at your program respond to this section.
M1.1. Does your program participate in CACFP* (Child and Adult Care Food Program), which provides reimbursement for foods served that meet specific meal pattern requirements?
Yes
No
[Hover definition] *The CACFP provides a variety of public or private nonprofit child care centers, Head Start programs, outside-school-hours care centers, and other licensed day care providers with cash reimbursement for eligible meals and snacks served to enrolled children. Snacks and meals must meet Federal guidelines.
M1.2 . Does your child care site participate in the School Breakfast Program (SBP)*?
Yes
No
[Hover definition] *The School Breakfast Program is a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. Participating school districts and schools offer free or reduced price lunches to eligible children, and receive cash subsidies from the USDA for each meal served that meets Federal requirements.
M1.3 Does your child care site participate in the National School Lunch Program (NSLP)*?
Yes
No
[Hover definition] *The National School Lunch Program is a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. Participating school districts and schools offer free or reduced price breakfasts to eligible children, and receive cash subsidies from the USDA for each meal served that meets Federal requirements. School districts and schools may also receive cash subsidies or snacks served to children in afterschool educational or enrichment programs.
M1.4. Which of the following describes your program? (Choose all that apply)
Sponsored Child Care Center or other Preschool
Independent Child Care Center or other Preschool
Head Start
State Run Preschool
Family Day Care Home
Afterschool program
Other
M1.5 How would you describe the area in which your program is located – urban, suburban, small town, rural, or tribal community?
Urban
Suburban
Small town
Rural
Tribal community
M1.6 How long has your child care program been open for operation?
Less than 6 months
6 months up to 1 year
1 year up to 3 years
3 years up to 5 years
5 or more years
[ASK IF M1.4. NE 5]
M1.7a What is your job title or role? If your job title is not included on the list, please select the title that most closely matches your current role. (Please answer this question for the person who answered most of the questions in this survey.)
Director or Site Supervisor/Manager [Hover definition]
Assistant Director [Hover definition]
Food Service Director or Manager/Cook [Hover definition]
Teacher [Hover definition]
Graduate Assistant [Hover definition]
Teacher Aid or Volunteer [Hover definition]
None of the above
[Hover Definitions]:
Director or Site Supervisor/Manager: The person responsible for running a childcare program or a site.
Assistant Director: The person who is second in command running a childcare program or site.
Food Service Director or Manager/Cook: The person responsible for the meal program at your child care or afterschool facility. Responsibilities can include menu planning and meal preparation, as well as purchase and inventory of foods, food quality, nutrition, productivity standards, management of food service staff, food safety, and managing the food service budget.
Teacher: The person who works directly with children at your child care center or afterschool program, and also plans curriculum and activities, and has daily management/oversight of the classroom.
Graduate Assistant: A person completing their graduate degree in education who is gaining practical experience in the classroom through working with children or in a classroom at your site.
Teacher Aid or Volunteer: A person who helps the main teacher or staff person in the classroom, may work directly with children, set up activities, clean up, etc.
[ASK IF M1.4.=5; FAMILY DAY CARE]
M1.7b What is your job title or role? If your job title is not included on the list, please select the title that most closely matches your current role. (Please answer this question for the person who answered most of the questions in this survey.)
Owner/Co-Owner/Operator
Assistant
Teacher
Volunteer
None of the above
M1.8. Does your program offer full-day child care for at least nine months out of the year?
Yes
No
M1.9. Does your program offer half-day child care for at least nine months out of the year?
Yes
No
M1.10. Do you serve children who are in kindergarten or older?
Yes
No
[ASK IF M1.10=1; OTHERWISE SKIP TO M1.11]
M1.10.a. Do you offer before school care?
Yes
No
M1.10.b. Do you offer afterschool care?
Yes
No
[ASK IF M1.10.b=1; OTHERWISE SKIP TO M1.11]
M1.10.b.i. Do you participate in the CACFP Afterschool Meal Program?
Yes
No
M.1.10.b.ii. Do you participate in the CACFP At-Risk Afterschool Meal Program*?
Yes
No
[Hover definition] * The at-risk afterschool meals component of the Child and Adult Care Food Program (CACFP) offers Federal funding (reimbursement) to afterschool programs that serve a meal or snack to children up to age 18 in low- income areas. Snacks and meals must meet Federal guidelines and may be served after school, on weekends, and during vacations.
M1.11. What was your total enrollment as of September 30, 2015 for children of each of the following ages? (Choose all that apply)
[PROGRAMMING: ALLOW NUMERIC RESPONSE FROM 0 – 500; IF OPTION IS NOT SELECTED, PROGRAM AS 0]
0-5 months: number of children___________
6-11 months: Number of children: ________
12-17 months: Number of children: ________
18-23 months: number of children: __________
24-35 months: number of children__________
3-5 years: number of children _________
Older than 5 years: number of children_________
[PROGRAMMING NOTE:
CREATE VARIABLE INFANTNUMBER SUMMING RESPONSE FROM 0-5 MONTHS AND 6-11 MONTHS
CREATE VARIABLE TODDLERNUMBER SUMMING RESPONSE 12-17 MONTHS AND 18-23 MONTHS
CREATE VARIABLE PRESCHOOLNUMBER SUMMING 24-35 MONTHS AND 3-5 YEARS]
Section 2
Menu Planning
The questions in this section ask about menu planning and menu cycling. Please have the person most familiar with menu planning/menu cycling at your program help to respond to this section.
M2.1. Are the meals/snacks you serve analyzed for their nutritional content?
Yes
No
Don’t know
[ASK IF M2.1=1; OTHERWISE SKIP TO M2.5]
M2.2. Who is responsible for analyzing the nutritional content of menus? (Choose all that apply)
Sponsoring agency
Center or home child care provider [Hover definition]
Director or Site Supervisor [Hover definition]
Child care center corporate office [Hover definition]
Cook or Chef [Hover definition]
Dietitian/Nutritionist [Hover definition]
Other (specify): ____________
Don’t know
[Hover Definitions]:
Sponsoring agency: A public or non-profit organization that is responsible for the administration of CACFP in family day care homes, child care centers, or a combination of child care facilities. Sponsors must ensure compliance with Federal and State regulations, provide training and process claim forms for meal reimbursements.
Center or home child care provider: The person who supervises and takes care of the children on a daily basis
Director or Site Supervisor: The person responsible for running a childcare program or a site.
Child care Center corporate office: In a multisite or chain/franchise childcare program, the corporate office is headquarters for all sites. The corporate office is also responsible for the overall success of the business or corporation. May also be called headquarters, the main office, national office, or regional office.
Cook or Chef: The person who prepares meals and snacks for your program.
Dietitian/Nutritionist: A dietitian is a food and nutrition expert with a profession credential (R.D. or Registered Dietician). R.D.s may also be licensed by the state in which they operate. A nutritionist has typically completed an undergraduate or graduate degree in the field of nutrition, but does not have the R.D. credential.
M2.3. How often is the nutritional analysis of menus completed?
3 times or more per year
Once or twice each year
Once every other year
Less than once every other year
Don’t know
M2.4. How are the menus analyzed for the nutritional content? (Choose all that apply)
Software:
[PROGRAMMER NOTE: COLLAPSE UNLESS OPTION IS SELECTED]
Name of software: _____________________________ Don’t know
Other (specify): ___________________________________________________
Don’t know
M2.5. Do you use cycle menus, such as menus that repeat every week or month?
Yes
No
Don’t know
[ASK IF M2.5=1; OTHERWISE SKIP TO M2.7]
M2.6. What is the frequency of the cycle?
1 week cycle (same menu repeated weekly)
2 week cycle (same menu repeated every two weeks)
3 week cycle (same menu repeated every three weeks)
4 week cycle (same menu repeated every four weeks)
5 week cycle (same menu repeated every five weeks)
6 week cycle (same menu repeated every six weeks)
7 week cycle (same menu repeated every seven weeks)
8 week cycle (same menu repeated every eight weeks)
Longer than 8-week cycle
Don’t know
M2.7. When planning your menus, which of the following factors do you consider? (Choose all that apply)
Access to sample menus or menus used in the past
Ease of preparing menu items
Time needed to prepare menu items
Access to foods / beverages
Prices of foods / beverages
Seasonality of produce (e.g. more fruit in summer)
Availability of preparation equipment
Cooking or food preparation skills of food preparer / cook
Kitchen/food preparation space
Food storage capacity (e.g. freezer space or pantry space)
Menu planning software
Child preferences (including allergies)
Parent preferences
CACFP meal patterns
Nutritional quality of food
Other (please describe):___________________________
Don’t know [Display only if respondent tries to skip question.]
M2.7a. Of the responses selected above, what are the top three factors you consider when planning your menu?
[PROGRAMMING NOTE: DISPLAY ALL OPTIONS FROM M2.7 AND ALLOW RESPONDENT TO RANK FROM 1 – 3.]
M2.8. Who plans the menus for your program? (Choose all that apply)
Sponsoring agency
Center or home child care provider [Hover definition]
Director or Site Supervisor [Hover definition]
Child care center corporate office [Hover definition]
Cook or Chef [Hover definition]
Dietitian/Nutritionist [Hover definition]
Teacher
Other (specify): ____________
Don’t know
M2.9 Are you the person who plans menus for your program?
Yes
No
[ASK M2.10 – M2.12 IF M2.9=1]
M2.10. How many years of menu planning experience to do you have?
less than 2 years
2-5 years
6-10 years
More than 10 years
M2.11. Do you have any of the following degrees or certifications? (Choose all that apply)
High school diploma or GED
Associate degree
Baccalaureate degree
Master’s degree
Doctoral degree
Registered dietitian
Other:___________________
No degree or certification
[ASK IF M2.11=2 – 5]
M2.12. What was the area of study? (Choose all that apply)
Early childhood education
Family child studies
Child development
Business administration
Food service management
Food and nutrition/dietetics
Other:___________________
Section 3
Food Purchasing
The questions in this section ask where and how often you purchase various types of food for your child care program, and how you keep track of food purchases. Please have the person most familiar with food purchasing at your program help to respond to this section.
M3.1. Who purchases the foods and beverages for your program? (Choose all that apply)
Sponsoring agency
Center or Home Child Care Provider [Hover definition]
Director or Site Supervisor [Hover definition]
Cook or Chef [Hover definition]
Dietitian/Nutritionist [Hover definition]
Teacher
Parent Volunteer
Other: ____________
Don’t know [Display only if respondent tries to skip question.]
[PROGRAMMING NOTE: SHOW INITIAL QUESTION (WHERE DO YOU BUY FOOD/BEVERAGES…)IF OPTION IS SELECTED, SHOW SUBSEQUENT QUESTIONS]
M3.2. The next few questions ask about how and where you purchase food/beverages for your child care program. From which of the following venues do you purchase foods/beverages for your program?
For each venue where you buy food for your program, please select how the items are chosen, which type(s) and how often the items are purchased.
Where do you buy food/beverages for your program? (choose all that apply) |
How do you order your foods/ beverages? (choose all that apply) |
How does the food arrive at your site? (choose all that apply) |
Which of the following types of items do you purchase at this location? (choose all that apply) |
How often do you buy any foods/beverages from this source? |
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(Co-op) or Community Supported Agriculture (CSA) |
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M3.3. Who is responsible for tracking or documenting food/beverage purchases? (Choose all that apply)
Sponsoring agency
Center or home child care provider
Director or Site Supervisor
Child care corporate office
Cook or Chef Dietitian/Nutritionist
Teacher
Other (specify): ____________
Don’t know
[PROGRAMMER NOTE: ONLY DISPLAY FOLLOW UP QUESTION IF OPTION IS SELECTED]
M3.4. How are food/beverage purchases tracked or documented? (Choose all that apply)
Financial software/program:
Name of software/program: _______________________ Don’t know
Food purchasing software/program
Name of software/program: __________________________ Don’t know
Spreadsheet software (e.g. Microsoft Excel)
Paper records
Other (specify): _________________
Don’t know
M3.5. Do you use any tools or resources from any of the following entities to help you in your selection and purchasing of healthier foods? (Choose all that apply)
Child care corporate office
State health department
USDA (including online resources or technical assistance from personnel)
Sponsoring agency
Resource & referral agency
Internet/ online resources (specify)________________________
Other (specify):_________________________________
None of the above
M3.6. What additional tools or resources would be helpful in the selection and purchasing of healthier foods for your program?
Menu planning tools for child care programs
Food Buying Guide calculator for child care programs
Healthy standardized recipe resources for child care programs
Reading food labels resources/calculator for child care programs
Model nutrition and food purchasing policies for child care programs
Other (specify)________________________________________________
Don’t know
M3.7. What are the barriers to purchasing and serving healthier foods for your program? (Choose all that apply)
Cost of healthier foods
Time needed to prepare healthier meals and snacks
Preference of children in program
Parental preferences, including those related to culture
Lack of knowledge about nutrition guidelines
Limitations with kitchen space and/or equipment
Lack of staff knowledge/skills required to prepare nutritious meals and snacks
Lack of staff knowledge on how to read a nutrition facts label
Access to nutritious food and beverage options
Convenience of using processed and pre-prepared foods
Staff resistance because of personal food preferences
Other:____________________
No barriers to purchasing and serving healthier foods
Don’t know
M3.7.a Of the responses selected above, what are the top three barriers to purchasing and serving healthier foods for your program?
[PROGRAMMING NOTE: DISPLAY ALL OPTIONS FROM M3.7 AND ALLOW RESPONDENT TO RANK FROM 1 – 3.]
M3.8. How well prepared do you feel at selecting healthier foods for your program?
Very prepared
Somewhat prepared
Not too prepared
Not at all prepared
Don’t know
M3.9. How would you rate your knowledge of nutrition?
Very knowledgeable
Somewhat knowledgeable
Not too knowledgeable
Not at all knowledgeable
Don’t know
[ASK M3.10 – M3.11 IF M1.1=1; OTHERWISE SKIP TO M4.1]
M3.10. Who is responsible for compiling meal counts for claims for CACFP reimbursement? (Choose all that apply)
Sponsoring agency
Center or Home Child care Provider
Director or Site Supervisor
Cook or Chef
Dietitian/Nutritionist
Teacher
Other (specify):____________
Don’t know
M3.11. How are meal counts documented? (Choose all that apply)
Meal tracking software:
[PROGRAMMER NOTE: COLLAPSE UNLESS OPTION IS SELECTED]
Name of software: ___________________________ Don’t know
Microsoft Excel or other spreadsheet
Microsoft Access or other database
Paper form
Other (specify):_________________________________
Section 4
Food Preparation and Food Safety
The questions in this section ask about food preparation and food safety. Please have the person most familiar with food preparation and food safety at your program help to respond to this section.
M4.1. How are the snacks and meals you serve prepared (cooked, heated, or plated)? (Choose all that apply)
Prepared onsite, or at the same location where children are
Prepared at an onsite central kitchen operated by child care center(s)
Prepared at an offsite central kitchen operated by child care center(s)
Prepared by school food service department for child care center
Prepared by and purchased from independent food service company/vendor
Other (specify): ____________
Don’t know [Display only if respondent tries to skip question.]
[ASK IF M4.1=1; PREPARED ONSITE; OTHERWISE SKIP TO M4.3]
M4.2. Which of the following are available in your on-site food preparation area? (Choose all that apply)
Refrigerator
Freezer
Cabinets, pantry, or shelving for dry goods
Microwave
Oven
Stove
Hot plate or other alternative heating element
Toaster oven/ toaster
Blender
Dishwasher
Sink
Hot water source
Don’t know [Display only if respondent tries to skip question.]
M4.3. Do you have any policies about food safety (e.g., preparing food safely, preventing choking)?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M4.4. Are staff required to complete a food safety training course?
Yes
No
Don’t know
[ASK IF M4.4=1; OTHERWISE SKIP TO M4.5]
M4.4.a Are staff required to be certified for food safety?
Yes
No
Don’t know
M4.5. Do you have a plan in place to allow for a food product to be identified and removed from your kitchen during a recall?
Yes
No
Don’t know
M4.6. Who prepares snacks and meals for your program? (Choose all that apply)
Sponsoring agency
Center or Home Child care Provider [Hover definition]
Director or Site Supervisor [Hover definition
Cook or Chef [Hover definition]
Dietitian/Nutritionist [Hover definition]
Teacher
Other: ____________
Don’t know
M4.7. Are you the person who prepares snacks and meals for your program?
Yes
No
[ASK M4.8 – M4.10 IF M4.7=1; OTHERWISE SKIP TO M5.1]
M4.8. How many years of food preparation experience to do you have?
0-1 year
2-5 years
6-10 years
More than 10 years
M4.9. Do you have any of the following degrees or certifications? (Choose all that apply)
High school diploma or GED
Associate degree
Baccalaureate degree
Master’s degree
Doctoral degree
Registered dietitian
Other:___________________
No degree or certification
[ASK IF M4.9=2-5, OTHERWISE SKIP TO M5.1]
M4.10. What was the area of study? (Choose all that apply)
Early childhood education
Family child studies
Child development
food and nutrition/dietetics
Other:___________________
Section 5
Food/Beverage Serving Practices
The questions in this section ask about the types of meals and snacks you serve, and about various practices or policies you have about food eaten by children during the day. Please have the person most familiar with food/beverage serving practices at your program respond to this section.
M5.1. For each of the following meal or snack times, please indicate whether you provide food, require food to be brought from home, and/or allow food to be brought from home. Check all that apply
[If “Not served at our site” is checked, no other response may be checked for that meal or snack. If “We allow parents to send food from home” is checked, then “We do not allow parents to send food from home” cannot be checked]
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We provide food |
We allow parents to send food from home |
We require parents to send food from home |
We do not allow parents to send food from home |
Not served at our site at all |
Breakfast |
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Morning snack |
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Lunch |
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Afternoon snack |
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Dinner/Supper |
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Evening snack |
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Other : ___________ |
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[IF M5.1=“Do not allow food from home” for all responses (except other) skip to M5.3]
M5.2. Is there a policy that describes the types of food/beverages that can be brought from home for meals and snacks? (This does not include food allergy or food safety policies)
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.3. Is there a policy that describes the types of food/beverages that can be brought from home for onsite celebrations that include children? (This does not include food allergy or food safety policies)
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.4 Do you have a policy in place that describes how staff should introduce new foods to children?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.5. Do you have a policy in place that describes what staff should do when children decline food that is served to them?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.6. Do you have a policy regarding additional or second servings of food or beverages for children?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.7. For which of the following food/beverages are second servings allowed? (Choose all that apply)
Any food
Fruit
Vegetables
Meat/Meat alternate (eg. chicken, beef, beans, nuts)
Mixed foods (e.g. chili, lasagna, taco)
Cereal
Grain/Bread (e.g. rice, pasta, roll)
Milk
Dairy (e.g. cheese, yogurt)
100% juice
Water
Other beverages
Salty snack (e.g. chips, crackers)
Sweet snack/dessert (e.g. cookies, cakes)
Second servings are not allowed
Don’t know
[ASK IF TODDLERNUMBER+PRESCHOOLNUMBER>0]
M5.8 Do you have a policy on serving juice to children 1 – 5 years old?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
[ASK IF TODDLERNUMBER+PRESCHOOLNUMBER>0]
M5.9 Do you have a policy on serving sugar sweetened beverages to children 1 – 5 years old?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M5.10. Does your program follow best practices for nutrition from any of the following organizations?
USDA
State Agency
Sponsoring Agency
Caring for our Children
CACFP Sponsor Association
CACFP Provider Association
Other_______________
Do not follow any best practices for nutrition
Don’t know
Section 6
Food Allergies and Food Intolerances
The questions in this section ask about your practices or policies for children who have allergies or intolerances to specific foods or types of foods. Please have the person most familiar with these topics at your program respond to this section
M6.1. Do you have a policy on managing special dietary needs (e.g., food allergies, diabetes)?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M6.2. Do you require students with food allergies or special dietary needs to bring documentation from a medical provider?
Yes
No
Don’t know
M6.3. How does your program serve meals and snacks to children with food allergies? (Choose all that apply)
Children with an allergy are required to bring their food from home
Children with an allergy are given meals/snacks at a different time
Children with an allergy are given meals/snacks at another table/in another room
Children with an allergy are allowed to bring their food from home
We provide alternative food/beverages to those children with an allergy
Other (specify):______________________
Don’t know
[ASK IF M6.3=5; PROVIDE ALTERNATIVE FOOD/BEVERAGES; OTHERWISE SKIP TO M7.1]
M6.4. Are the alternative foods/beverages your program provides to children with an allergy readily available at your usual shopping venues?
Very available
Somewhat available
Not too available
Not at all available
Don’t know
M6.5. Does the purchase of these alternative foods/beverages have an impact on food costs for your program?
Yes, alternative foods are very expensive to purchase.
Yes, somewhat of an impact, alternative foods are somewhat expensive to purchase.
Yes, but not too much of an impact, alternative foods are not too expensive to purchase.
No impact at all, alternative foods do not cost more than regular foods used in meals and snacks.
Don’t know
Section 7
Water
The questions in this section ask about water availability to children during the day. Please have the person most familiar with this topic at your program respond to this section
M7.1. Does your child care program have a policy on the availability and serving of water throughout the day?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M7.2. Do teachers encourage children to drink water throughout the day?
Yes
No
Don’t know
M7.3. Is water available to children when they are in outside play spaces? (Choose all that apply)
Yes, available for self-serve
Yes, given to children on request
Yes, only during designated water breaks
No, not available outside (skip to M7.5)
M7.4. How is drinking water made available to children outside? (Choose all that apply)
Non-refrigerated drinking fountain/faucet
Refrigerated drinking fountain/faucet
Filtered drinking fountain/faucet
Unfiltered drinking fountain/faucet
Individual sized disposable (single use) water bottles
Individual sized reusable water bottles
Large water bottles coolers, dispensers (like in office buildings)
Serving pitchers/large Thermos
Other:______________________________________
M7.5. Is water available to children when they are inside? (Choose all that apply)
Yes, available for self-serve
Yes, given to children on request
Yes, only during designated water breaks
No, not available inside
[ASK IF M7.5<4; OTHERWISE SKIP TO M7.7]
M7.6. How is drinking water made available to children inside (Choose all that apply)
Non-refrigerated drinking fountain/faucet
Refrigerated drinking fountain/faucet
Filtered drinking fountain/faucet
Unfiltered drinking fountain/faucet
Individual sized disposable (single use) water bottles
Individual sized reusable water bottles
Large water bottles coolers, dispensers (like in office buildings)
Serving pitchers/ large Thermos
Other (write in): __________________________________________________________________
M7.7. How often is drinking water served during meals or snacks?
All of the time
Most of the time
Some of the time
Rarely or never
M7.8. During meals or snacks, how is water served (for example, in pitchers, cups, or bottles for children to drink)? (choose all that apply)
Provided at the table with meals
Provided at the table with snacks
Provided only after child finishes milk or juice
Provided only after child finishes meal or snack
Children allowed only one serving
Children allowed to self-serve as much as want
Provided only upon request by child
Not provided at the table at meals or snacks
Section 8
Physical Activity
The questions in this section ask about the different ways that children play indoors and outdoors at your program. Please note that some of these questions ask about a specific age group of children. Please have the person most familiar with physical activity at your program respond to this section.
Please read each activity below and check ONE answer choice for each row (More than once a day, Once a day, A few times per week, A few times per month, A few times per year, Never (but available at site), Not available at site).
M8.1. How frequently do you use the following physical activity equipment or activities?
This question applies to all children in your care between the ages of 1 and 5.
[ASK IF TODDLERNUMBER+PRESCHOOLNUMBER>0]
Type of Physical Activity or Equipment |
More than once a day |
Once a day |
A few times per week |
A few times per month |
A few times per year |
Never (but available at site)
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Not available at site |
Organized group games or activities: dance, ball games, parachute games, running games, aiming games, sports play, jumping games, instruction games, balance games |
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Free play |
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Ball play and striking equipment (balls, bean bags, noodles, rackets) |
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Floor play equipment (mats, portable tunnels, etc.) |
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Jumping play equipment (jump ropes, hula hoops, trampoline) |
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Parachute |
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Push-pull toys (wagons, wheelbarrows, big dump trucks, shopping carts, doll strollers, etc.) |
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Riding toys (tricycles, cars, etc.) |
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Rocking and twisting toys (rocking horse, sit-n-spin, etc.) |
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Sand/water play toys (buckets, scoops, shovels) |
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Twirling play equipment (ribbons, scarves, batons, etc.) |
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Balancing surfaces (balance beams, boards, etc) |
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Basketball hoop |
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Climbing structures (jungle gyms, ladders, etc) |
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Dramatic play structure (playhouse) |
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Merry-go-round |
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Pool |
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Sand box |
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See-saw |
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Slides |
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Swinging equipment (swings, rope, etc.) |
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Tricycle track |
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Tunnels |
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Other activities:_____________ |
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Other equipment:____________________ |
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[ASK IF TODDLERNUMBER>0; OTHERWISE SKIP TO M8.3]
M.8.2. Thinking about your schedule, on a typical day this week how many sessions of physical activity are provided to young children (between the ages of 12 and 23 months) on average per day, about how many minutes does each session last, and is each session indoors or outdoors? [RANGE 0-60?]
[CAN SELECT MULTIPLE OPTIONS, BUT CANNOT SELECT 2 IF 1 IS NOT SELECTED; ETC. IF “NOT OFFERED” IS SELECTED, CANNOT SELECT ANY OTHER OPTION]
Session 1: Minutes: ___________________ Indoors Outdoors
Session 2: Minutes: ___________________ Indoors Outdoors
Session 3: Minutes:___________________ Indoors Outdoors
Session 4: Minutes: ___________________ Indoors Outdoors
Session 5: Minutes: ___________________ Indoors Outdoors
Session 6: Minutes: ___________________ Indoors Outdoors
Not offered
[ASK IF PRESCHOOLNUMBER>0; OTHERWISE SKIP TO M8.4]
M8.3. Thinking about your schedule, on a typical day this week, how many sessions of physical activity are provided to children (2-5 years of age) per day, about how many minutes on average does each session last, and is each session indoors or outdoors? [RANGE 0-60?]
[CAN SELECT MULTIPLE OPTIONS, BUT CANNOT SELECT 2 IF 1 IS NOT SELECTED; ETC. IF “NOT OFFERED” IS SELECTED, CANNOT SELECT ANY OTHER OPTION]
Session 1: Minutes: ___________________ Indoors Outdoors
Session 2: Minutes: ___________________ Indoors Outdoors
Session 3: Minutes:___________________ Indoors Outdoors
Session 4: Minutes: ___________________ Indoors Outdoors
Session 5: Minutes: ___________________ Indoors Outdoors
Session 6: Minutes: ___________________ Indoors Outdoors
Not offered
[ASK IF TODDLERNUMBER+PRESCHOOLNUMER>0]
M8.4. Do you take children (1 -5 years of age) to any offsite facility or area for physical activities (e.g., park, pool, playground, gym)
Yes
No
[ASK IF TODDLERNUMBER+PRESCHOOLNUMER>0 AND M8.6=1; OTHEWISE SKIP TO M8.6]
M8.5 How often do you take children (1 -5 years of age) to an offsite facility or area for physical activities?
Multiple times a day (Specify number of times per day)______________________
Once a day
Two or three times per week
Once a week
Once every two weeks
Once a month
Other ______________________________________
M8.6. Which of the following describe the outdoor play space at your site? (Choose all that apply)
Space for all activities, including jumping, running, and rolling
Separate play areas for each age group
Areas that allow play for individuals, pairs, small groups, and large groups
Full access for children with special needs
All of our play space is indoors; we do not have any outdoor play space
Other (Specify) ___________________
Don’t know
[ASK IF TODDLERNUMBER+PRESCHOOLNUMER>0]
M8.7. How often is portable play equipment *offered to children (1 -5 years of age) during free play time?
At least a few items are always available
Often
Sometimes
Rarely or never
[Hover definition] *Portable play equipment is any equipment that is not fixed in place, such as: balls, bean bags, rackets, floor mats, portable tunnels, jump ropes, trampoline, parachute, wagons, shopping carts, tricycles, rocking horses, sand and water play toys, ribbons and batons.
[ASK IF TODDLERNUMBER+PRESCHOOLNUMER>0]
M8.8. Is active play ever restricted for children (1 -5 years of age) as a disciplinary action for misbehavior?
Yes
No
M8.9. What is the role of child care providers/teachers during children’s physically active playtime?
They supervise only, to ensure safety
They supervise and verbally encourage physical activity
They supervise, verbally encourage, and sometimes join in
They supervise, verbally encourage, and often join in
M8.10. How often do child care providers incorporate physical activity into routines, transitions, and planned activities*?
Each time they see an opportunity
Often
Sometimes
Rarely or never
[Hover definition] Physical activity during routines, transitions, and planned activities can include playing Simon Says or other movement games while children wait in line or transition between activities, or using movement during circle time or story time.
[ASK IF TODDLERNUMBER>0; OTHERWISE SKIP TO M8.12]
M8.11. Outside of meal and nap time, what is the longest that children (12 – 23 months of age) are asked to remain seated at any one time?
30 minutes or more
20-29 minutes
15-19 minutes
Less than 15 minutes
[ASK IF PRESCHOOLNUMBER>0; OTHERWISE SKIP TO M8.13
M8.12. Outside of meal and nap time, what is the longest that children (2 -5 years of age) are asked to remain seated at any one time?
30 minutes or more
20-29 minutes
15-19 minutes
Less than 15 minutes
[ASK IF TODDLERNUMBER>0; OTHERWISE SKIP TO M8.14]
M8.13. How often do young children between the ages of 12 – 23 months old watch television (including educational programs, and videos)?
Daily, 2 hours or more per day
Daily, 1-2 hours per day
Daily, less than 1 hour per day
Daily, less than 30 minutes per day
A few times a week (but not every day)
A few times a month
Once a month
Never
[ASK IF PRESCHOOLNUMBER>0; OTHERWISE SKIP TO M8.15]
M8.14. How often do children between the ages of 2-5 years old watch television (including educational programs, and videos)?
Daily, 2 hours or more per day
Daily, 1-2 hours per day
Daily, less than 1 hour per day
Daily, less than 30 minutes per day
A few times a week (but not every day)
A few times a month
Once a month
Never
[ASK IF TODDLERNUMBER>0; OTHERWISE SKIP TO M8.16]
M8.15. How often do young children between the ages of 12 – 23 months old use a computer, tablet, smart phone, or video game time (including educational games/programs and videos)?
Daily, 2 hours or more per day
Daily, 1-2 hours per day
Daily, less than 1 hour per day
Daily, less than 30 minutes per day
A few times a week (but not every day)
A few times a month
Once a month
Never
[ASK IF PRESCHOOLNUMBER>0; OTHERWISE SKIP TO M8.17]
M8.16. How often do children between the ages of 2-5 years old use a computer, tablet, smart phone, or video game time (including educational games/programs and videos)?
Daily, 2 hours or more per day
Daily, 1-2 hours per day
Daily, less than 1 hour per day
Daily, less than 30 minutes per day
A few times a week (but not every day)
A few times a month
Once a month
Never
M8.17. When children are watching television, using a computer, tablet, smart phone, or video game time, what is the primary purpose of this activity?
Education
Entertainment
Both education and entertainment
Don’t know
[PROGRAMMER NOTE: PROGRAM WITH FIRST QUESTION VISIBLE (CHOOSE STAEMENTS THAT APPLY…) AND THEN 2ND TIER OF QUESTIONS ONLY VISIBLE ONCE A RESPONSE IS SELECTED]
M8.18. What makes it hard for children in your program to get physical activity? (choose all that apply)
Please choose statement(s) that apply to your child care program (Choose all that apply) |
How much would you say this decreases the amount of time spent doing physical activity? |
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M8.19. Below are some topics your site may or may not have policies or guidelines on.
Please read each topic below and indicate whether your site has a policy on these topics. Check ONE answer choice for each row (Written policy, Informal policy (spoken but not written), No policy, Don’t know).
Topic |
Yes, written policy* |
Yes, informal policy** |
No policy |
Don’t know |
Policy on amount of time provided each day for indoor and/or outdoor physical activity |
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Policy on amount of time children are seated during activities |
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Policy on weather (temperature/air quality) for outdoor play time |
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Policy on protective clothing or sunscreen application |
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Policy on withholding physical activity as discipline |
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Policy on amount of time children can watch television. |
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Policy on amount of time children use computer, tablet, smart phone, or other devices with screens |
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[Hover definition] A written policy can include any written guidelines about your program’s operations or expectations for teachers, staff, children, or families. Policies can be included in parent handbooks, staff manuals, and other documents.
[Hover definition] ** An informal policy can include any spoken guidelines about your program’s operations or expectations for teachers, staff, children, or families.
8.20. Does your program follow best practices for physical activity from any of the following organizations? (Choose all that apply)
USDA
State Agency
Sponsoring Agency
Caring for our Children
CACFP Sponsor Association
CACFP Provider Association
Other_______________
Do not follow any guidelines on best practices for nutrition
Don’t know
Section 9
[ASK IF INFANTNUMBER>0; OTHERWISE SKIP TO M10.1]
Infant Feeding and Infant Physical Activity Section
The questions in this section refer to infants under the age of 1 year (less than 12 months old). Please have the person most familiar with infant feeding and physical activity at your program respond to this section.
M9.1. Which of the following best describes the timing of infant feedings in your program?
Feedings always take place at fixed, scheduled times
Somewhat flexible to infants showing they are hungry*, but feedings are mostly at fixed times
Mostly flexible to infants showing they are hungry*, but feedings are sometimes at fixed times
Feedings only take place when infants show they are hungry*
Don’t know
[Hover definition] *Infants can show they are hungry by rooting, sucking on fingers or fist, licking or smacking lips, fussing or crying, or making excited arm and leg movements
M9.2. When feeding infants, how often do staff use responsive feeding techniques?*:
Always
Often
Sometimes
Rarely or never
Don’t know
[Hover definition] *Responsive feeding techniques include making eye contact, speaking to infants, responding to infants’ reactions during feedings, responding to hunger and fullness signals, and feeding only one infant at a time.
M9.3. How do staff determine the end of infant feedings?
Only by the amount of breast milk, formula, or food left
Mostly by the amount of milk, formula, or food left, but partly by infants showing they are full*
Mostly by infants showing they are full*, but partly by the amount of milk, formula, or food left
Only by infants showing they are full*
Don’t know
*Infants show they are full by slowing the pace of eating, turning away, becoming fussy, and spitting out or refusing more food.
M9.4. Does your program provide 100% juice to infants?
Yes
[DISPLAY ONLY IF M9.4=YES]
a. Starting at what age?
Younger than 6 months
Between 6 months and 12 months
Other (specify): ______________
No
Don’t know
M9.5. Are sugar sweetened beverages served to infants? (sugar sweetened beverages include soda, lemonade, or other juice drinks that are not 100% juice)
Yes
No
Don’t know
M9.6 Do you have a policy on serving juice to infants?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M9.7 Do you have a policy on serving sugar sweetened beverages to infants?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M9.8. At what age, on average, does your program introduce solid foods to infants with parent permission?
Younger than 4 months
At least 4 months but younger than 6 months
At 6 months
Older than 6 months
Do not give infants solid foods
Don’t know
M9.9. Do staff feed infants breast milk while at the site? )
Yes
[DISPLAY ONLY IF M9.7=YES]
M9.7.a. How many infants under 6 months are currently fed exclusively breast milk while at your site? ________
Don’t know
M9.7.b. How many infants under 6 months are currently fed any breast milk in combination with formula or solid foods while at the site? ________
Don’t know
M9.7.c. How many infants between 6-12 months are currently fed any breast milk while at the site? _________
No
Don’t know
M9.10. Do you allow mothers to breastfeed infants on site?
Yes
[DISPLAY ONLY IF M9.8=YES]
M9.8.a. Do you have a private room or area at your site where mothers can breastfeed their infants?
Yes
No
No (Skip to M9.9)
Don’t know
M9.11. Are mothers allowed to store their pumped breast milk at your site overnight?
Yes [DISPLAY ONLY IF M9.11=YES]
M9.11.a. Where is the breast milk stored? (Choose all that apply)
Refrigerator
Freezer
Shelf
Insulated cooler
No, mothers must bring in new bottles every morning
Don’t know
M9.12. How are breast milk and formula warmed? (Choose all that apply)
Under running warm tap water
By placing in a container of water no warmer than 120 degrees F
Electric bottle warmer
In our microwave
Other (specify): ________________
Don’t warm breast milk or formula
Don’t know
[Display only if M1.8 = 1]
M9.13.a. How often do you offer tummy time* to non-crawling infants in full day care?
1 time per day or less
2 times per day
3 times per day
4 times per day or more
[Display only if M1.9 = 1]
M9.13.b. How often do you offer tummy time* to non-crawling infants in half-day care?
3 times per week or less
4 times per week
1 time per day
2 times per day or more
[Hover definition] *Tummy time is supervised time when an infant is awake and alert, lying on her/his belly.
M9.14. How many times per day are infants taken outside (when the weather is appropriate)?
More than 3 times per day
2-3 times per day
Once per day
Less than once per day
M9.15. Do infants spend time in any of the following when they are not sleeping?
Cribs
Playpens
Car seats
Bouncy seats
Swings
Stationary entertainers (for example, Exersaucers)
None of the above
Don’t know
M9.16. Do you have a policy or guideline about infants spending time in cribs when they are not sleeping?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M9.17. Do you have a policy or guideline about the amount of time infants spend in seats, swings, or stationary entertainers (for example, ExerSaucers) at any one time?
Yes, we have an informal policy (spoken but not written)
Yes, we have a written policy
No, we do not have a policy
Don’t know
M9.18. On average, how much time do infants spend in front of a television, computer, video game, tablet, smart phone or other screen (including educational programs and videos)?
Daily, 2 hours or more per day
Daily, 1-2 hours per day
Daily, less than 1 hour per day
Daily, less than 30 minutes per day
A few times a week (but not every day)
A few times a month
Once a month
Never
M9.19. Do you have a policy or guideline about the amount of time infants spend in front of a television, computer, video game, tablet, smart phone, or other screen (including educational programs and videos)?
Yes, we have a written policy
Yes, we have an informal policy (spoken but not written)
No, we do not have a policy
Don’t know
Section 10: Nutrition and physical activity promotion/education practices
The questions in this section ask nutrition and physical activity promotion and education at your program. Please have the person most familiar with physical activity at your program respond to this section.
M10.1. Does your program’s collection of materials that promote healthy eating include any of the following? (CHOOSE ALL THAT APPLY)
Books about healthy eating habits
MyPlate posters
Pictures of fruits and vegetables
Healthy play foods or food models
Fruit or vegetable garden areas
No materials promoting healthy eating at my program
Don’t know
M10.2. Do child care providers/teachers incorporate planned nutrition education* into their classroom routines?
1 time per week or more
2–3 times per month
1 time per month
Rarely or never
Don’t know
[Hover definition] *Planned nutrition education can include circle time lessons, story time, stations during center time, cooking activities, and gardening activities.
M10.3. Do child care providers/teachers talk with children informally about healthy eating?
Each time they see an opportunity
Often
Sometimes
Rarely or never
Don’t know
M10.4. How often are families offered education* on child nutrition?
Every week or more
Every month
Several times a year
Once or twice a year
Never
Don’t know
[Hover definition] *Education can be offered through in-person educational sessions, brochures, tip sheets, or your program’s newsletter, website, or bulletin boards.
[ASK IF M10.4<4]
M10.5 Does education for families on child nutrition include any of the following topics? (choose all that apply)
Food and beverage recommendations for children
Serving sizes for children
Importance of variety in the child diet
Creating healthy mealtime environments
Using positive feeding practices
Policies on child nutrition at my childcare program
Recipes
Cooking techniques/ how to cook healthy foods
Shopping for healthy foods
Other:_______________________________________
Don’t know
M10.6. How often do child care providers/teachers talk with children informally about the importance of physical activity?
Each time they see an opportunity
Often
Sometimes
Rarely or never
Don’t know
M10.7. Does your program’s collection of materials that promote physical activity include any of the following? (CHOOSE ALL THAT APPLY)
Books about physical activity
Physical activity posters
Pictures of physical activity
No materials promoting physical activity at my program
Don’t know
M10.8. How often are families offered education on children’s physical activity?
2 times per year or more
1 time per year
Less than 1 time per year
Never
Don’t know
[ASK IF M10.8<4; OTHERWISE SKIP TO M10.10]
M10.9. Does education for families on children’s physical activity include any of the following topics? (choose all that apply)
Recommended amounts of daily physical activity for young children
Encouraging children’s physical activity
Limiting long periods of seated time for children
Children’s motor skill development
Policies on physical activity at my childcare program
Other:__________________________________
Don’t know
M10.10. How is information about nutrition and physical activity for children communicated to parents? (choose all that apply)
No nutrition information provided
No information on physical activity provided
Fliers or handouts
Newsletters/ Updates (including email)
Conversations between staff and parents
Menus
Health fairs
Parent workshops
Posters, bulletin boards, displays
Parent-teacher conference
Family events
Other (Please Specify):__________________________________________
Don’t know
Section 11 Barriers to CACFP participation
M11.1. Below are some difficulties which providers may face as participants in the CACFP. For each, please indicate whether this has been a major challenge, minor challenge, or not a challenge to your participation in the CACFP.
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Major challenge |
Minor challenge |
Not a challenge |
Meal reimbursement is not enough to cover food expenses |
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Not enough children in my program are eligible for higher reimbursement |
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Paperwork to receive meal reimbursement is difficult (including recordkeeping and meal claim submission) |
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Paperwork for child enrollment is difficult |
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Nutrition requirements are difficult |
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Requirements for site eligibility are difficult |
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Monitoring by the state or sponsor is time consuming |
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Lack of support from sponsor |
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Other, specify |
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M11.2. In your opinion, what changes might help child care centers and FDCHs who are not currently participating in the CACFP decide to participate? (choose all that apply)?
Offer more nutrition training for child care program staff
Require less monitoring
Require less accountability
Increase meal reimbursement rate
Provide more support to complete paperwork
Provide assistance with writing menus
Offer electronic enrollment and paperwork options
Other (specify: ________________________________)
END. You have completed all the sections. Thank you for your time on this important survey.
Provider
Web Survey, p.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Tara Wommack |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |