Family Questionnaire

Family Child Care Family Engagement Lesson 1 Apply Family Questionnaire Program Tool	WWW.VIRTUALLABSCHOOL.ORG ACTIVITY ID: 26386 Name Certifier Date
Please complete the following questionnaire about your child’s caregiver,_________________________. Your feedback on the questionnaire will provide information to your child’s caregiver about ways that they can improve their current practices and grow as a professional. The following questions relate to high quality practices demonstrated by caregivers. For each question, please rate your child’s caregiver on a scale of 1-3 (1=Needs improvement, 2=Competent, 3=Very Competent). My child’s caregiver: Provides a clean, safe, learning environment for my child. 1 2 3 Provides an environment that encourages healthy habits and good nutrition. 1 2 3 Provides materials, experiences and routines that support my child’s development and learning. 1 2 3 Provides activities and materials that support my child’s fine motor skills (i.e., writing, building with blocks, painting) and large muscles skills (climbing, dancing). 1 2 3 Provides activities and materials that support my child’s cognitive development (thinking, problem solving). 1 2 3 �Թ��s my child’s language development and provides materials and experience that encourage reading, writing and communication. 1 2 3 Provides experiences and materials that support my child’s creativity through music, art, and dance. 1 2 3 Helps my child build a positive self-concept and self-identity. 1 2 3 Respects my child’s culture and background and represents our family and culture in the environment. 1 2 3 Provides opportunities for my child to interact with peers and helps my child to get along with others. 1 2 3 Uses positive guidance strategies to help my child understand how to behave appropriately. 1 2 3 Establishes positive, collaborative relationship with my family. 1 2 3 Provides a well-organized environment and manages the classroom effectively. 1 2 3 Is respectful in their communication and interactions with my child can family. 1 2 3 Adapted from: The Child Development Associate National Credentialing Program and CDA competency standards: Family Child Care edition. (2021). (pp. 147-148). Washington, DC: Council for Professional Recognition.

Program Tool

WWW.VIRTUALLABSCHOOL.ORG

ACTIVITY ID: 26386

Name

Certifier

Date

Please complete the following questionnaire about your child’s caregiver,_________________________. Your feedback on the questionnaire will provide information to your child’s caregiver about ways that they can improve their current practices and grow as a professional.

The following questions relate to high quality practices demonstrated by caregivers. For each question, please rate your child’s caregiver on a scale of 1-3 (1=Needs improvement, 2=Competent, 3=Very Competent).

My child’s caregiver:

Provides a clean, safe, learning environment for my child.

1

2

3
Provides an environment that encourages healthy habits and good nutrition.

1

2

3
Provides materials, experiences and routines that support my child’s development and learning.

1

2

3
Provides activities and materials that support my child’s fine motor skills (i.e., writing, building with blocks, painting) and large muscles skills (climbing, dancing).

1

2

3
Provides activities and materials that support my child’s cognitive development (thinking, problem solving).

1

2

3
�Թ��s my child’s language development and provides materials and experience that encourage reading, writing and communication.

1

2

3
Provides experiences and materials that support my child’s creativity through music, art, and dance.

1

2

3
Helps my child build a positive self-concept and self-identity.

1

2

3
Respects my child’s culture and background and represents our family and culture in the environment.

1

2

3
Provides opportunities for my child to interact with peers and helps my child to get along with others.

1

2

3
Uses positive guidance strategies to help my child understand how to behave appropriately.

1

2

3
Establishes positive, collaborative relationship with my family.

1

2

3
Provides a well-organized environment and manages the classroom effectively.

1

2

3
Is respectful in their communication and interactions with my child can family.

1

2

3

Adapted from:

The Child Development Associate National Credentialing Program and CDA competency standards: Family Child Care edition. (2021). (pp. 147-148). Washington, DC: Council for Professional Recognition.

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