Child Care Counts is a task force dedicated to stabilizing and increasing the number of available slots for high quality child care in Windham County. Recognizing that access to child care is a critical economic and workforce development issue, we seek to engage a broad range of partners invested in the issue.

We are seeking input from our community on your experiences as a worker and a caregiver. Your answers will assist the task force to prioritize our work in the coming months.  This survey should take about 10 minutes to complete. 

Thank you!

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* 1. Are you currently (check all that apply):

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* 2. Which best describes your work schedule?

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* 3. Work schedule

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* 4. What shift do you usually work?

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* 5. Do you receive:

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* 6. How much flexibility do you have in your work schedule to handle family responsibilities?

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* 7. If you are in school or a training program, what best describes your school/training?

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* 8. In the past month to what extent child care been a source of stress:

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* 9. Please describe child care stressors:

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* 10. Demographic information:

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* 11. Household Income:

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* 12. If you live alone please skip to question 18

What are the ages and relationships of the people who live in your household:

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* 13. What best describes your marital status:

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* 14. Is your spouse/partner employed?

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* 15. How many hours per week does your spouse/partner work?

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* 16. What shift does your spouse or spouse/partner work?

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* 17. How much flexibility does your spouse or partner have in his/her work schedule to handle child care responsibilities?

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* 18. Do you have children/stepchildren aged 18 and younger who do not live with you?

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* 19. Do you have children/step-children living outside the home for whom you provide financial support?

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* 20. Please check the one response that best describes your situation when your child is sick

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* 21. For all your children combined, how much on average, do you spend each month on child care expenses?

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* 22. How comfortable are you talking with co-workers and with your supervisor about your responsibilities for children? (check N/A if you do not have co-workers or a supervisor)

  Not at all Just a little Somewhat Very N/A
Coworkers
Supervisors

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* 23. In the past month, because of your responsibilities for children, how often have you had to, or chosen to (write the number of times):

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* 24. In the past month how often have you worked less effectively because you were concerned or upset about child care issues:

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* 25. Because of your child care responsibilities, in the past year, have you:

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* 26. Below is a list of workplace supports that have been offered by some employers. For each of these supports please indicate whether you currently use; would use if it were available and you needed it; or would probably not use even if it were available and needed.

  Currently use Would use Would not use
Flexible work hours
Job sharing
Option to work from home/telecommute
Unpaid leave
Personal time off or other paid leave
Program to set aside pre-tax dollars to pay for care
Subsidy for child care
On-site child care center
On-site support group for parents
On-site parent education program(s)
Employee assistance programs
Wellness program
Social/family activities

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* 27. Please add any comments about your experience as a working parent.

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* 28. If you would like to stay informed about Child Care Counts and local efforts to improve our early care and learning system , please feel free to include your contact information.

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