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How often did you use child care?
 
Full Time
 
Part-Time
 
Drop In
 
 
 
Was the home enviroment clean?
 
All the time
 
Usually
 
Sometimes
 
Never
 
 
 
Do you feel your children were in a safe enviroment?
 
Yes
 
No
 
 
 
Are you comfortable with what your child(ren) have learned?

 
Yes
 
No
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Skills Child(ren) have learned
Physical care
Emotional care
Social care
Overall care
 
 
 
How long have you been at this child care?
   
 
 
 
Would you consider using our services again?
 
Yes
 
No
 
 
 
Do you feel the provider was friendly?
 
Yes
 
No
 
 
 
Do you feel that the Provder was professional)?
 
All the time
 
Sometimes
 
Most of the time
 
Never

 
 
 
Do we have permission to use your child(ren)photo or school work for public display? Ex: in home, websites, brochures, etc.
 
Yes
 
No
 
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