Parent Survey

Parent Survey

Name of Child:

School:

Child's Grade

How many years has your child been in the after-school program at this school?

Less than one

3 or more

What do you think of your child's after-school Program?

(Your answers will help make the program better for all families)

How would you rate your child's after-school program in the following areas?

	Poor	Fair	Good	Excellent	Don't Know
1. The overall after-school program.
2. The safety of your child while he/she is at the after-school program.
3. The atmosphere and comfort of the room(s) in which the after-school program operates.
4. The snacks that are served to your child on a daily basis.
5. The hours of operation.
6. The transportation provided, if any. None Provided

To what extent do you agree or disagree with the following statements about the program?

	Strongly Disagree	Disagree	Agree	Strongly Agree	Don't Know
7. I am satisfied with the kinds of programs and activities offered at the after-school program.
8. There is adequate quiet time for my child to complete homework.
9. The after-school program has helped my child get his/her homework done on time.
10. There is adequate opportunity for physical activity.

How many days per week of after-school would be ideal for your child?

To what extent do you agree or disagree with the following statements describing your child's experience in the after-school Program?

My Child...	Strongly Disagree	Disagree	Agree	Strongly Agree	Don't Know
11. Enjoys attending the after-school program.
12. Feels comfortable with the after-school staff.
13. Seems happier or less stressed since participating in the after-school program.
14. Has friends in the after-school program.
15. Completes homework with greater ease.
16. Has a better attitude towards school.

To what extent do you agree or disagree with the following statements about the after-school staff?

	Strongly Disagree	Disagree	Agree	Strongly Agree	Don't Know
17. I am comfortable talking with the staff.
18. The staff welcomes suggestions from parents.
19. The staff keeps me informed about my child's day at the after-school program.
20. The staff welcomes parents who wish to observe
21. I am comfortable with how the staff handles discipline problems
22. The staff encourages positive interactions among the children.
23. I am satisfied with the number of adult staff available to work with the students.
24. I am satisfied with the manner adult staff interact with the students.
25. The staff has clearly informed me about how to contact them during the after-school program.
26. I am satisfied with the overall performance of the after-school staff.

Please Check all that apply:

27.	Why does your child attend the after-school program?	28.	What would your child be doing after-school if he/she were not attending this program?
	Student needs after-school supervision		Attending a private daycare center
	Student is interested because friends are attending		Be cared for by neighbors or relatives
	Student is interested because of the enrichment activities offered		Staying home with adult supervision
	Parent is interested in enrichment programs		Staying home alone
	Teacher recommended program		Attending a variety of places during the week
	Student needs homework assistance		List additional after-school options:
	Additional reasons for attending program:		List additional after-school options:

29. What do you like best about the after-school program?

30. What are some things you would like to see changed?

31. How many times have you had a chance to observe the after-school program?

32. Have you been involved as a volunteer in the after-school program?

Yes

If yes, how do you participate?

	Northwest Regional Educational Laboratory
	101 SW Main Street, Suite 500
	Portland, Oregon 79212