Child Care Referral Service Evaluation Name(Required) First Last Email(Required) County(Required)MonroeLivingstonWayneHave you made a decision about your child's care?(Required)Please selectFound care, new arrangementKeeping former arrangementDecided not to use care at this timeDon't need care yet / No decisionWhat kind of child care program did you choose?(Required)Please selectCenter based careFamily day care (non-relative)Informal provider (non-relative)Provider in child's home (non-relative)Playgroup, parent exchange, etc.Nursery school, Head Start, Wee ProgramBefore / After programRelativeStill looking / have not chosenDid you find child care as a direct result of the list of referrals we provided you?(Required) Yes No Did you have any problems in your child care search?(Required) Yes No Check all that apply: Cost too prohibitive No openings for age of my child Program Lack of quality care Type of care does not exist Care not available in needed time period Problems with distance/transportation Funding not available Any comments about the child care referrals we provided?Were you satisfied with the service the referral specialist provided?(Required) Yes No Any comments about the service we provided?Did contact with our service increase your knowledge or understanding of the indicators of quality child care?(Required) Yes No Any comments about your contact with us?How long did it take to receive child care options that met your needs?(Required)Please select1 business day2 business days3 business days4-7 business daysDid you use our website?(Required) Yes No Was it user-friendly?(Required) Yes No Any comments about our website?Did you read the information in the referral packet you received?(Required) Yes No Was it user-friendly?(Required) Yes No Any comments about the referral packet?If you need to make a new child care arrangement, would you use our referral service again?(Required) Yes No Please share any other comments or suggestions.Additional Info I would like to be contacted in response to my feedback. I’m still looking for care and would like more referrals.
