Care 4 Kids Provider Orientation

To translate this survey, scroll to the bottom of the page and select your preferred language in the drop-down. (Para traducir esta encuesta, desplázate hasta la parte inferior de la página y selecciona tu idioma preferido en el menú desplegable.)

What kind of child care provider are you?(Required)

Licensed

Unlicensed

Other

Have you considered becoming licensed?

Yes

No

Other

For more information about becoming licensed, please visit Licensing – CT Office of Early Childhood

I found the information about child development beneficial.

I found the information about health & safety beneficial.

Do you understand the importance of 'Back to Sleep”?

Yes

No

Somewhat

What further information or support would help you feel more comfortable understanding the importance of "Back to Sleep"?

Did you find the resources (handouts, brochures) helpful?

Yes

No

What further resources would be helpful?

What specifically did you learn today that you plan to implement in your work?

Your feedback helps us to improve the services we provide. What can we do to make these sessions more valuable?

Help Us Spread the Word about 211 Child Care!

Have you heard of 211 Child Care?

Yes

No

Have you, your colleagues or families you know used 211 Child Care?

Yes

No

How would you rate your experience?

Please share 2-3 sentences about your experience with 211 Child Care:

We would like other families to know about the help, support, and resources 211 Child Care provides, and positive testimonials tell the story powerfully. May we contact you to gather more information about your 211 Child Care experience?

Yes

No

Would you like more information about 211 Child Care?

Yes

No

Name(Required)

First Last

City Town(Required)

Email(Required)

Phone(Required)

What is the best way to contact you?(Required)

Phone

Email