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Follow up survey for services received from 211 Child Care
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Thank you for using 211 Child Care Referral Assistance for First Responders. We hope that we were able to assist you to learn about child care options in your community and become aware of resources for your family. Please take a moment to let us know how we did by filling out a brief survey. Your participation is much appreciated.
Name
First
Last
Email
Occupation
Overall, how satisfied are you with the services you received from 211 Child Care?
(Required)
Excellent
Pretty good
Neutral
Not so great
Terrible
How would you rate the phone manner of the person you spoke with when you called 211 Child Care.
(Required)
Excellent
Pretty good
Neutral
Not so great
Terrible
In terms of their knowledge of Child Care programs, regulations and quality indicators, the 211 Child Care Referral Specialist was
(Required)
Very knowledgeable
Somewhat knowledgeable
Not knowledgeable
Other
Please explain other
In terms of their response to your specific questions and needs, would you say the referral specialist was...
(Required)
Very responsive
Somewhat responsive
Not responsive
other
Please explain "other"
Were you able to find child care and enroll your child into a program?
Yes
No
Care no longer needed.
Haven't decided yet.
If you did not enroll your child, what factors contributed to you not enrolling (check all that apply)
(Required)
No spaces
Cost
Hours not available
Type of care
Unsatisfactory interview with child care program
Changed my mind about work schedule.
Will use a family member.
Other
Would you like to explain?
How satisfied were you with the packet of information sent to you?
Very Satisfied
Somewhat Satisfied
Not Satisfied
Other
Would you like to explain why you were not satisfied with the packet of information or other?
Are you in need of any additional services? (If yes, we will follow up with you)
Yes
No
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