CYFS Follow-Up Questionnaire

Thank you for calling CYFS for information on child care providers. Please take a moment in the next few days to give us your feedback. We rely on this information to improve your services to parents and child care providers. Thank you in advance for taking the time to fill out this form.


Zip Code:
Client ID:
Follow-Up Date:

Please select the answer that best describes your child care selection experience:

1. Quality of care options available
Very Satisfied Satisfied Somewhat Satisfied Not Satisfied Not Sure N/A

2. Satisfaction with quality of care chosen
Very Satisfied Satisfied Somewhat Satisfied Not Satisfied Not Sure N/A

3. What type of child care did you choose? (Check all that apply)
Child Care Center Family Home Provider In My Home (Nanny) Relative/Friend Head Start Program Preschool Progam Before School After School Still Looking Decided not to use Child Care Found Care not from Referrals

4. Did you have any problems finding child care to meet the needs of your family?
Yes No N/A

5. If yes, what problems did you encounter during your search?
Cost No Openings Available Hours Location Transportation Quality of Care Available Other

6. Which of the following quality indicators did you use in choosing child care? (Check all that apply)
Caregiver/Teacher Qualifications Activities/Curriculum Setting/Environment Adult/Child Interactions Other:

Please rate your experience with our agency staff:

7. Quality of Counseling/Knowledge of Staff
Excellent Very Good Good Fair Poor Not Sure N/A

8. Courtesy and Customer Service of Staff
Excellent Very Good Good Fair Poor Not Sure N/A

9. Response Time - When did you receive the requested information?
Excellent (Same Day) Very Good (1-2 Days) Good (3-5 Days) Fair (6-7 Days) Poor (More than a Week) Not Sure N/A

10. Accuracy of Child Care Information
Excellent Very Good Good Fair Poor Not Sure N/A

11. Quality of Information/Materials
Excellent Very Good Good Fair Poor Not Sure N/A

12. How did you access the service?
Yes No Not Sure

13. Were you able to make a better decision regarding child care based on our services and information?
Yes No Not Sure

14. Did your understanding of available resources such as financial assistance, child health insurance or other community resources increase?
Yes No Not Sure

15. Would you ever use our services again?
Yes No Not Sure

16. Would you recommend our services to others?
Yes No Not Sure

17. Would you be interested in being contacted for advocacy efforts? If yes, please include your phone, email and contact information.
Yes No Not Sure
Name:
Phone:
E-mail:

18. What could we do to improve our services to families?


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