School
Transportation Information
Please
list any schools for which transportation is
provided
To
School
From School
To School
From School
To School
From School
Center
Funding
Sources
of Funding (check
all that apply)
Head Start
State 4K
ABC Grant Recipient
First Steps Grant Recipient
Other
Operational
Information
Services
for Families (check
all that apply)
Preschool
Programs
5 Mornings a week
2-3 Mornings a week
Mothers Morning Out
After
School Programs
5 afternoons a week
5 Mornings a week
4 or fewer afternoons a week
4 or fewer mornings a week
Financial
Services for Families
Accept ABC Voucher
Sliding fee Scale
Multi-Child Discount
Employer Discounts
Scholarships
Languages
Spoken and / or Taught (check
all that apply)
English
Spanish
French
Other
Hours
of Operation
Monday -------- Open at
Close at
Tuesday ------- Open at
Close at
Wednesday -- Open at
Close at
Thursday ------ Open at
Close at
Friday -----------Open at
Close at
Saturday ------ Open at
Close at
Sunday -------- Open at
Close at
Do you accept children
Full-time
Part-time
Both
Program Duration
Full Year
School Year
Summer Only
Do
you provide for mildly ill children?
Yes
Even
if not enrolled?
Yes
No
No
Do you offer care for special schedules?
(check all that apply)
Drop-Ins
24 hour care
Weekends
Before School
After School
School Vacations / Holidays
Rotating Schedules
Shift Work
Temporary or Emergency Care
Additional
Fees
Registration
Fee
Late Pick Up Fee
Late Payment Fee
Other Fee(s)
Attributes
(Check all that apply)
I am interested in learning about accreditation
through the National Association for the education
of Young Children (NAEYC)
I am interested in learning about accreditation
through the National Association for Family
Child Care (NAFCC)
Please
make any other comments that you would like
parents to know about your program
Professional
Staff Development
Director
Information
Director Highest Level of Education
Completed:
Less than High School Diploma/GED
High School Diploma or GED
Associate Degree; Child Related
Associate Degree; Non Related
Bachelors Degree; Child Related
Bachelors Degree; Non Related
Masters Degree; Child Related
Masters Degree; Non Related
Ph. D Early Childhood or related field
Some Child-related Course Work
Director
Training (check all that apply)
15 Hours of DSS Credit
Family Childcare Home ABC
Child Care Credential
Childcare Center ABC Child Care Credential
Family Day Care Rating Scale
Infant/Toddler Environmental Rating Scale
Early Childhood Environmental Rating Scale
Child Development Association
SC Child Care Credential (ECD 101)
Teacher
Information
Number
of Teachers and Assistants
Important
Information -
for
Statistical Purposes Only
| Director
Yearly Earnings |
|
Less Than $15,000 |
$15,000 - $20,000 |
$20,000 - $25,000 |
|
$25,000 - $30,000 |
$30,000 - $35,000 |
$35,000 - $40,000 |
|
$40,000 - $45,000 |
$45,000 - $50,000 |
$50,000 + |
| Teacher
Yearly Earnings (average) |
|
Less Than $15,000 |
$15,000 - $20,000 |
$20,000 - $25,000 |
|
$25,000 - $30,000 |
$30,000 - $35,000 |
$35,000 - $40,000 |
|
$40,000 - $45,000 |
$45,000 - $50,000 |
$50,000 + |
| Assistant
Yearly Earnings (average) |
|
Less Than $15,000 |
$15,000 - $20,000 |
$20,000 - $25,000 |
|
$25,000 - $30,000 |
$30,000 - $35,000 |
$35,000 - $40,000 |
|
$40,000 - $45,000 |
$45,000 - $50,000 |
$50,000 + |
Benefits
Offered to Employees
(check
all that apply)
Health Insurance
Dental Insurance
Life Insurance
Child Care Discount
Tuition Reimbursement
Paid Holidays
Paid Sick Leave
Paid Vacation
Retirement Account
Other
Number
of employees who are Spanish/Hispanic/Latino
Mexican/Mexican-American/Chicano
Puerto Rican
Cuban
Other
Number
of employees whose race is
White
Black
American or Alaska Native. Tribe
Asian Indian
Native Hawaiian
Chinese
Filipino
Japanese
Vietnamese
Other Asian:
Guamanian or Chamarro
Samoan
Other Pacific Islander:
Other
English
Language Ability
Number employees who speak other than English
at home.
Language
How well do these employees speak
English (check all that apply)
Very Well
Well
Not Well
Not at All
I accept these conditions; I understand that
Child Care Resource & Referral (CCR&R)
only makes referrals, not recommedations, to
families. I agree to assist CCR&R in maintaining
up-to-date information on the Child Care availibility
by reporting changes in my facility when they
occur. I give CCR&R permission to release
the information in this form to parents seeking
Child Care services.
My Name (electronic signature) is
I
wish to be contacted for updates by (check all
that apply)
Telephone
Email
Fax
Mail
If
you have any questions, please contact CCR&R
at (843) 747-9000 or 1 (877) 227-3454 toll free
or email care4kids@tuw.org.
