Cheyenne-Kiowa-Lincoln Early Childhood Council

Fun Tote Program Parent/Caregiver Survey

Please complete this survey to enter a drawing to receive a special prize! The continued funding for the program relies on your feedback! We are currently funded by the Buell Foundation. Thank you in advance for completing this survey!

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Date

Community where you reside

Location you received tote

Are you a parent, caregiver, or home child care provider?

ParentCaregiverHome Child Care Provider

What are the ages of your children or child?

Infant1 year old2 years old3 years old4 years old5 years old6 years old7 years old8 years old9 years old or older

Which totes did you check out?

Do you feel that using the tote increased the one-on-one time you, as a parent or caregiver, spent with your child or children?

YesNo

Did you notice a difference in your child's development or the development of a new skill after using the tote?

YesNoPlease Specify:

If improvement was seen, please rate the improvement by a number on the following scale
of 1-41 - I did not see much change but the child/children enjoyed the activities2 - I did see a small change and would use the tote again3 - There was definite improvement in the child/children's development4 - The child/children's development was greatly improved and he/she mastered the activities associated with this tote

Do you feel that your community/county has adequate health services for your children (dental, medical, social/emotional health)? If not, what services would you like to see become available?

YesNo

Early childhood social/emotional health is an extremely important part of your child’s development.
Are you aware of the providers in your community supporting social/emotional health?

YesNo

Do you have any suggestions on improving the program or any additional feedback you
would like to provide the Cheyenne, Kiowa and Lincoln Early Childhood Council?

YesNo

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form.

Programs

Universal Pre-k
Fre

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Cheyenne-Kiowa-Lincoln Early Childhood Council (CKLECC)
Julie Witt, Council Coordinator (719) 775-8622
355 D Ave. PO Box 235 Limon, CO 80828

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