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Customer Satisfactory Survey

We are pleased to have been able to assist you in your recent child care search. A follow up is important for several reasons. It enables us to determine the status of your search and to offer further assistance if you are still looking for child care. It also affords us the opportunity to evaluate your experience and solicit any suggestions you might have that would help us improve our service. Thank you for filling out this form. Please Note: If you are looking for child care, fill out the Child Care Request Form. 

First Name:

Last Name:

Address:

City: State:          

Zip Code:

Home Phone:

Email:

Date you used the service:

Please check the most appropriate response.

1. Based on the referrals provided to you, did you encounter any of the following problems while searching for child care?

On waitlists Location   Type of careSchedule Transportation  Too expensive  No openings  Quality of care  No problems  Other

2.  How would you rate the quality of care that you are currently using?

Very high  High  Good  Satisfactory   Poor

3.  If you had a phone consultation with an information and referrals specialist, how helpful was it?  Non-Applicable

Very helpful  Helpful  Somewhat helpful  Not helpful

4.  Based on the consultation your received from the information and referral specialist, how much did your knowledge about how to look for quality child care increase?  Non-Applicable

Large amount Moderate amount  Small amount  Not at all 

5.  How accurate was the child care program information that you received?

Very accurate  Accurate  Somewhat accurate  Not accurate                    

6.  Did the child care program information that you received match the criteria that you requested?

Matched very well Most referral criteria matched Some referral criteria matched  Referrals did not match Less than 3 referrals given

7. Overall, how would you rate the referrals service?

Excellent        Good          Satisfactory         Poor        

8. If you found care, what type of care did you select?

Relative/friend/neighbor   School age program Camp        Child care centerFamily child care  Nanny  Other

9.  How long did it take you to find child care?

Less than 1 week   2 weeks  3 to 4 weeks  5 to 6 weeksMore than 6 weeks

10.  Did you find child care?

Yes, I found care  No decision/still looking Did not find care Decided not to look for careKept former 

11.  How did you find child care?   

 Through Child Care ConnectionThrough a friend/family Through a providerThrough another agencyOther

12. Would you use the service again in the future if you needed to choose child care?

Yes       No       Not sure

13.  Any comments or suggestions: 

Thank you for taking the time to complete this form. Please click the Submit button to send us your information. 

 

  
     
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