July 17, 2010
Shannon Walker
SIA Foundation, Inc.
P.O. Box 6479
Lafayette, IN 47903
Dear Ms. Walker,
We write to ask the SIA Foundation’s support for the Witham Family YMCA located in the
Boone County seat of Lebanon, Indiana. Your support would come through a grant of
$8,715.00, which will fund the purchase of equipment for the Child Watch program.
To promote our mission of putting Christian principles into practice through programs that
enhance personal growth and improve health of spirit, mind, and body for all, we realize some
members may need the extra support to meet those goals. The purpose of this grant is to help
meet the goals of guardians/parents with small children. Often guardians/parents will forgo their
own personal growth and healthy lifestyle choices such as exercising because they do not have
reliable child care. The Witham Family YMCA seeks to lessen the burden of its community and
members by providing a safe, reliable, child care option. A detailed description and projected
costs of providing this service is included in the following proposal.
We are asking you, the SIA Foundation, for support because we have similar goals for our
community. We both want to improve the quality of life and meet the needs of our residents.
This grant money will be used as a capital investment in the areas of health and welfare and will
be used within one year of receiving funds.
Please note we have included all necessary documentation required by your foundation. If
further information is necessary, please contact us and we will oblige your request. Also, if you
have any questions or would like to meet with us, please don’t hesitate to call or email us at
ckline@tds.net.
Thank you for your time and consideration of our request.
Sincerely,
Carrie M. Kline
Volunteer Grant Writer
cc: Lora Pennington
Cindy Moore
Volunteer Grant Writer
A Proposal for Funding
Child Watch Program at the Witham YMCA
To the SIA Foundation
Amount Requested: $ 8175.00
November 18, 2010
Or when available
Carrie Kline
Cindy Moore
Volunteer Grant Writers
Witham YMCA
1025 N. Jameson St
Lebanon, IN 46052
765.482.5960
2
Table of Contents
For
Child Watch Program at the Witham YMCA
Executive Summary ........................................................................................................................ 4
Statement of Need ........................................................................................................................... 6
Project Description ......................................................................................................................... 8
Evaluation ..................................................................................................................................... 11
Sustainability ................................................................................................................................ 11
Organization Information ............................................................................................................. 12
Conclusion .................................................................................................................................... 14
Appendices.................................................................................................................................... 15
3
Executive Summary
The Witham YMCA is requesting a capital grant to purchase the necessary equipment to furnish
the Child Watch room at a state of the art facility that is currently being constructed.
The Boone County YMCA has been serving Boone County for more than forty years without a
central facility to house its programs and services. The population in Boone County has grown
over the past decade, resulting in more residents and particularly more families in need of
services offered by the YMCA. The Boone County YMCA established a partnership with
Witham Hospital to build a new facility on the Witham Hospital campus. The name of Witham
YMCA will be used throughout the proposal as the new name for the Boone County YMCA.
Construction began in October, 2009 for a 35,000 sq. ft. facility that is anticipated to be
completed by November, 2010.
The new facility is designed to serve 4,000-5,000 people within the first year, and more in
subsequent years which will impact the health and wellness of the community in a positive
manner. Due to the large number of families in Boone County, many of the programs offered by
the YMCA are designed for children and youth. The need for childcare for families while using
the YMCA facilities was made evident through surveying our existing members. Most families
with young children are not able to exercise on a regular basis due to limited childcare options
for their children. The cost of childcare is also prohibitive for many families for activities other
than work.
One of the services provided by the YMCA is the Child Watch program, which is a child care
program for families with young children. The Child Watch program offers free child care in a
safe, educational environment while parents participate in individual or group exercise programs
within the facility. Parents can also utilize Child Watch while away from the facility for up to
two hours per day for a small additional fee. The Child Watch program has its own 965 square
foot room within the YMCA. The request of this proposal is for funding for the equipment to
furnish this room.
The room will include many items that will provide a fun, yet educational environment for
children ages 6 weeks to 10 years. Age appropriate toys and equipment are needed prior to the
4
opening of the facility in November, 2010. Having various accessories and activities available to
children in the center will encourage learning, social interaction, and new discoveries within a
safe environment. The Child Watch room will begin serving the community as soon as the
YMCA is available for public use. The total amount requested to fund this proposal is $8175.00.
An itemized list of equipment will be included in the appendices of this proposal.
Those impacted most by this project will be the children and parents that utilize the Child Watch
program. Children will experience stimulating play experiences and social interaction with other
children. The child care program will allow parents time to enhance their personal growth by
improving their own health of spirit, mind, and body.
5
Witham Family YMCA Child Watch Program
Statement of Need
For more than forty years the independent Boone County YMCA has been changing lives and
strengthening our community by promoting values like caring, honesty, and responsibility.
Recently the Boone County YMCA joined forces with the YMCA of Greater Indianapolis. This
has allowed greater potential and support for fundraising efforts for the building of the facility.
An ongoing partnership will provide support and resources to the now called Witham Family
YMCA, strengthening its ability to serve the residents of the community.
Currently, the Witham Family YMCA provides programs and services for 1,000- 2,000 people,
utilizing various facilities throughout the community. Coordinating and overseeing programs in
various locations has restricted the number and types of programs we have been able to offer.
The need to provide services to more people within the community has prompted the building of
a new facility that will serve all residents of Boone County. One central location is needed to
provide the most comprehensive programming in the most efficient manner.
As of the census of 2000, there were 46,107 people, 17,081 households, and 12,810 families
living in Boone County. The population density was 109 people per square mile. The 2008
population density was 133 per square mile. The total number of housing units in 2008 was
estimated to be 22,148. By 2009, the population had grown to 56,287 which is an increase of
22.1%. The projected growth over the next five years, as determined by the U.S. Census Bureau,
is that the census will be 62, 958 by 2015.
The households with parents who are married with children comprise 31.4% of the households.
Those married without children comprise 33.1%, single parent households 6.6%, and people
living alone 21.2%. Owner occupied homes account for 75% of the housing units in Boone
County with a median value of $131,000. Renter occupied units make up 11% with a median
rent of $545, based on U.S. Census Bureau statistics from 2000. 1
1
Information found on World Wide Web on June 14, 2010.
http://www.stats.indiana.edu/profiles.asp?scope...
6
The rapid growth in the past ten years and projected growth demonstrates a growing need for
community services. The age span of the population creates a need for programs that meet the
need of all age groups, from babies to seniors. The YMCA has a strong history of providing ageappropriate, educational and enriching programming to the communities it serves.
The YMCA Board of Directors and staff established a unique partnership with Witham Hospital
to build a facility that would meet the medical and health needs of the community. The
partnership will allow the YMCA and Witham Hospital to create more opportunities to serve
more people in one convenient and safe location. Construction began in October 2009 on a
35,000 sq. ft. YMCA facility on the Witham Hospital campus. The new facility will reflect the
partnership with the hospital and will be named the Witham Family YMCA. It is a state of the art
facility that will serve all residents of Boone County. The facility will be a place for people to
pursue healthier lifestyles by accessing the most modern workout equipment, nutrition
counseling and supportive staff. The synergy of programs and services will give both
organizations many new opportunities to serve more people than either could on their own. It
will also provide ways to save the community money by reducing overlapping services while
sharing space and operational costs.
The YMCA provides young people with opportunities to explore their options, reach their
potential, develop a positive self-image, appreciate good health, adopt a positive value system
and grow spiritually. The YMCA is committed to being open and accessible to all serving men,
women, and children of all ages, faiths, background, abilities and income levels helps the YMCA
realize its mission: To put Christian principles into practice through programs that build healthy
spirit, mind and body for all.
One of the needs within the YMCA is the need for child care while parents are exercising or
participating in a program within the facility. The Child Watch was designed to provide a safe,
interactive play area for young children ages 6 wks-10 yrs. This program is offered to parents at
no extra cost for up to two hours while they work out. Parents can also utilize Child Watch for up
to two hours a day while they are away from the facility for a nominal fee.
7
Project Description
Research has shown that exercise is an important step in a healthy lifestyle. However,
occasionally families will not participate in this important step because of the lack of adequate
child care. The YMCA will provide the solution for parents that lack adequate childcare for their
children while they exercise or run errands outside of the YMCA. The Child Watch room is a
965 square foot facility. This facility will include many items that will provide the safe and fun
environment for the children. The kinds of equipment in a child watch center can play a crucial
role in the development of a child. Having various accessories in the center can fuel discoveries
and open doors to more learning and fun. An itemized but not exclusive description of equipment
is described below. The Child Watch room will begin serving others as soon as the YMCA is
available for public use.
Furniture
Mobile storage unit with shelves
Information board
Locking Cabinets
Pick a book stand
Cribs (2)
Child table and chairs
Toys/Entertainment
Tracks and trains
Child rocking chair
Toy garage with cars/trucks
Adult rocking chair
Workbench with tools
Infant swing
Kitchen center
Diaper pail (2)
Writing center
Facilities/Safety
First Aid Kit
Coat Hooks
Clocks (2)
Phone
Trash can
Puppets
Dolls/cradles/strollers/etc.
Musical instruments
CD player with assorted music
Books for many ages
Miscellaneous items
Information about the child care benefit will be released within various media outlets. It will be
included in all seasonal program guides and new member packets. Flyers will be available
describing the services offered outside of the Child Watch area, located in high traffic areas.
8
Local advertising whether on the radio, TV, internet, mailings or newspapers will also provide
information about the Child Watch program. All staff and volunteers will be trained to answer
basic questions about the service.
Project Timeline
1. Continue to release statements of progress in the community about the opening of the
new facility, Witham Family YMCA. Promote the benefits of having a YMCA in their
community and how they can help.
2. Current employees have been assigned to research and purchase the equipment needed to
create the Child Watch area. The Witham Family YMCA has a line of credit with Chase
Bank.
3. A tentative scheduled Grand Opening Date is November 18, 2010.
Staffing
Staffing for the Child Watch Area at Witham Family has not been completely implemented at
this time. Below are tentative positions. Positions are currently open to Greater Indianapolis
YMCA employees. The positions will be open to the general public in September 2010. The
number of volunteers/employees for each position will be determined at a later date. Employee
wages are paid out of the YMCA’s general fund.
Volunteers-Child Watch Aides
Play games and read with children. All volunteers must complete the Volunteer Contact Form
to be connected with the Volunteer Champion at the YMCA branch.
Child Care Aide - Child Watch
Assist Child Watch Team Lead with daily activities, which include interacting with children,
parents, & staff, maintaining feeding/diapering schedules following all safety guidelines for
YMCA assist with transition to next shift.
Applicants must be at least 16 years old and have experience working with children. Child Care
9
Aides must have a high regard for safety, basic knowledge of child development, good
communication skills and the ability to obtain required YMCA training (CPR & First Aid
certifications, Child Abuse Prevention, Safety & Risk Management and YMCA Child
Care/Youth Development training) and TB Test. Days and times may vary.
Day/Evening Lead Child Watch Attendant
Child Care - Part Time
Must enjoy working with children and is dedicated to making a difference in their lives by being
a good role model. Attendants should be dedicated and hardworking individuals, who are
problem solvers, have good communication skills, have a sense of humor and enjoy being a part
of a team. Flexibly and reliability and willing to work weekends is a must. Attendants may be
working in our Parents’ Night Out program.
Lead Attendants must be at least 18 years of age with a high school diploma. At least two years
of experience working with children. They will ensure that proper procedures are being followed
in all areas of Child Watch. They also act as point of contact for parents and staff for a specific
shift, handling any problems or issues that may arise in a positive and professional manner.
Oversees and monitors Child Watch staff during specific time shift and ensures that staff are
monitoring and interacting with children at an acceptable and appropriate level. Communication
to the Program Coordinator on all Child Watch issues on a regular basis. All Attendantes must
have a high regard for safety, basic knowledge of child development, good communication skills
and the ability to obtain required YMCA training (CPR & First Aid certifications, Child Abuse
Prevention, Safety & Risk Management and YMCA Child Care/Youth Development training)
and TB Test.
Program Coordinator- Child Watch
Under the direction and supervision of the Youth and Family Life Director, the Program
Coordinator is responsible for the staff and children in Child Watch, ensuring a healthy, safe and
loving environment. The Coordinator will demonstrate Caring, Honesty, Respect and
Responsibility while providing for children’s social, physical, spiritual and mental well-being
and will interact positively with parents to develop a trusting relationship.
10
Must be at least 21 years old, have a high school diploma or its equivalent and have at least one
year of experience working directly with children, preferably in an early childhood setting (2-3
years preferred). They must have an understanding of the stages of child development, meeting
the needs of the children using the Child Watch area and experience in supervising staff and
handling conflict situations with members and staff. Capability of establishing and maintaining
positive relationships with staff, members, program participants, and with the general public is
also required. Must have the ability to obtain CPR and First Aid certifications, Child Abuse
Prevention training, Safety and Risk Management Training, New Employee Orientation and
other training required for YMCA youth workers. Days and times may vary. 2
Evaluation
The Child Watch program will be evaluated by various means.
1. Success will be indicated by the number of members that use the service. If 50% of the
members that fall into the demographic criteria use the Child Watch., it will be
considered a success. The number of families with age appropriate children will be
obtained from the Membership Database.
2. Comment Cards/Drop Off Box are available to all members of the YMCA. These are
general comment cards for the whole campus.
3. Child Watch evaluations are sent to a random group of parents that utilize the Child
Watch service on a monthly basis. Central Office then compiles and summarizes results.
A summary report is then put together and released to employees. See Appendix D.
4. Both Child Watch employees/volunteers will be encouraged to submit their ideas to the
Program Coordinator for evaluation.
Sustainability
This grant will enable the Witham Family YMCA to purchase equipment needed for the startup
of the Child Watch Program. After the initial start up costs, the costs of maintaining the facility
2
Information found on World Wide Web on June 17, 2010.
http://www.indymca.org/jobs/positiondetail.asp?id=2876
11
should be minimal. Income to support the Child Watch will come from the nominal fee that is
charged to parent members when they leave the premises. Income to support the program will
also come from the organizational wide annual fundraising drive, member fees, and any
additional fundraising events to help sustain the program.
One specific fundraising event planned is the hosting of a toy party with Discovery Toys. This
party will be open to the public. Attendees will be given the opportunity to buy toys for their
own household or buy a toy as a donation to the YMCA. A percentage of the sales from this
party will go to the Child Watch Program of the Witham Family YMCA. Those proceeds will be
used to buy any equipment as needed. If successful, this fundraiser may be help on an annual
basis.
Organization Information
The organization known as the YMCA originated in London, England in 1844, and came to
Indiana in 1854. The organization has continued to maintain a rich tradition of building “strong
kids, strong families and strong communities”. Throughout the Indianapolis area, our twelve
YMCA branches serve more than 185,000 people from diverse communities--providing over $7
million in scholarships, program subsidies, and underwritten programs among low-income
communities. We want to do more than serve the people in our community—we want to help
them thrive. Our mission is to put Christian principles into practice through programs that
enhance personal growth and improve health of spirit, mind, and body for all.
The YMCA provides young people with opportunities to explore their options, reach their
potential, develop a positive self-image, appreciate good health, adopt a positive value system
and grow spiritually. The YMCA is committed to being open and accessible to all. Serving men,
women, and children of all ages, faiths, backgrounds, abilities and income levels helps the
YMCA realize its mission: To put Christian principles into practice through programs that build
healthy spirit, mind and body for all.
The YMCA adds lasting value to the lives of children and families by helping people begin and
maintain healthy lifestyles, providing a positive, safe place for children and helping teens
12
develop leadership skills and succeed in school. We teach character-building values to youth and
provide a place that strengthens families. Programs for seniors enrich their social and physical
well-being. The programs offered include all age groups, which results in the YMCA enriching
the lives of individuals, families, and the community.
The Boone County YMCA has been in existence for forty years, and has operated its programs
without a central facility. It is a not-for-profit 501c3 community service organization. The
YMCA has provided programs and services for more than 1,000 people each year utilizing
various facilities throughout the community. Most recently, the Boone County YMCA has joined
the YMCA of Greater Indianapolis Association which has allowed us to share resources and
strengthen our position in Boone County. The association has also provided fundraising
initiatives and support to help us realize our goal of a YMCA facility in Boone County. It is
projected that the new YMCA will serve 4,000 to 5,000 people in its first year of operation.
The YMCA has formed a unique partnership with Witham Hospital and the new facility that is in
construction is located on the Witham medical complex. Since the facility will be utilized by
both organizations, the name of Witham YMCA was chosen. A new name for a new facility
seemed appropriate, and the choice ties it to the community, giving name recognition.
The Witham YMCA is governed by a Board of Directors representing the diversity of the
community. See Appendix C for a detailed list of the board members. Board members are chosen
by their talents and their desire to fulfill the YMCA mission. An application is completed, and
they are interviewed and voted on at the board meetings. The board members contribute through
time, talents, and in financial ways. They are asked to attend at least 70% of the board meetings
and to be active on a committee. They participate in all campaigns and in special events as they
are able.
The staff leadership team is composed of an executive director, two program coordinators, and
one program director. The executive director, Lora Pennington, oversees the current programs
and services offered by the YMCA and is actively involved in the decision-making for the
construction of the new facility. She is working closely with the builders to determine the budget
13
based on the needs of the programs to be offered. The program director oversees all programs
currently offered and is forecasting what services will be added when the new facility opens. The
two coordinators provide day to day support for the executive director and for members,
providing information and enrolling members.
The volunteers are a vital part of the staffing mix and are utilized in many programs. The
summer camps have volunteers assisting with many activities and providing hands-on interaction
with the campers. These volunteers are adults and older youth who have received training in
working with younger children. Volunteers can offer their time on a regular basis or for special
events. The variety of skills offered by the volunteer group has enhanced the quality of the
programs offered. Volunteers also help with fund-raising events, membership drives, and
donations. We have a well-established core of volunteers who are actively involved in investing
in the future of Boone County.
Conclusion
The Witham Family YMCA in Lebanon, Indiana is a resource that will enhance personal growth
and improve the health and spirit of all those that participate in its programs. There is a
commitment to accomplish a relationship building atmosphere. Those relationships are based on
the core values of caring, honesty, respect and responsibility. To give the families with young
children the same opportunity to build those relationships, a Child Watch Center will be
constructed within the YMCA. This center will provide child care for children up to the age of
ten years old while their parent(s) participate in the relationship building activities. These
activities are not only for themselves, but also as building block for a community.
Witham Family YMCA has been very proactive in raising the funds needed to build a new
facility and we have secured funding through Chase Bank to cover additional. The SIA
Foundation Grant for $8175.00 will lessen the burden of the loans and enable us to provide more
services to our members and the community. We appreciate your time and request your support
for our children and the Child Watch Center.
14
Appendices
For
Child Watch Program at the Witham YMCA
15
Item
Witham Family YMCA of Greater Indianapolis
Costs Related to Child Watch Center
Retail Cost
# of Units
Appendix A
Projected Total
Furniture
Mobile storage unit with shelves
Pick a book stand
Cribs
Childs table and chairs
TV/DVD
Child rocking chair
Adult rocking chair
Infant swing
High Chairs
Diaper Pail
$400
1
$400.00
$250
1
$250.00
$200
2
$400.00
$150
2
$300.00
$1,000
1
$1,000.00
$100
3
$300.00
$300
2
$600.00
$37.50
2
$75.00
$150
2
$300.00
$12.50
2
$25.00
$30
1
$30.00
$500
1
$500.00
$150
2
$300.00
$20
1
$20.00
$100
1
$100.00
$150
1
$150.00
$350
1
$350.00
$375
1
$375.00
$450
1
$450.00
$150
1
$150.00
$100
3
$300.00
$400
1
$400.00
$300
1
$300.00
$350
1
$350.00
$250
1
$250.00
$500
1
$500.00
$8,175.00
Facilities/Safety
First Aid Kit
Information board
Locking Cabinets
Trash Can
Toys/Entertainment
Tracks and trains
Toy garage with cars/trucks
Workbench with tools
Kitchen center
Writing center
Puppets
Art Station
Dolls/cradles/strollers/etc.
Musical instruments
CD player with assorted music
Books for many ages
Miscellaneous items
Total
16
Appendix B
17
Appendix C
2010 Witham Family YMCA Board Members
Committee
#
Name
Chair
Company
Address 1
City
Zip
4607
1
4605
2
4605
2
4605
2
4605
2
4605
2
4605
2
4614
7
4605
2
4605
2
4605
2
(765) 3252494
(765) 4850587
(765) 4820462
4605
2
4605
2
(765) 4827784
(765) 4829280
Farmer's Bank
3024 W. Blubaugh
Avenue
Thorntow
n
2
Baird, Yvonne
Bennington,
Jerry
Witham Hospital
2421 Golfside Drive
Lebanon
Finance
Christian
Mission
Building and
Grounds
3
Boatright, Jack
Financial - Retired
2324 Elmwood Drive
Lebanon
4
Bradley, Pam
Boone REMC
920 Jackson St
Lebanon
5
Brand, John
BFS Engineering
129 Ulen Blvd.
Lebanon
Executive
Building and
Grounds
6
Burtron, Michael
Jackson-McCormick Ins.
2025 Elizaville Road
Lebanon
7
Davenport, Joe
Sales Exec. - Retired
2946 S. 200 E.
Progam
8
Emmert, Abby
Western Boone-Student
5056 W. 300 S.
Lebanon
Jamestow
n
Finance
Honan, Paul
Honan Eye Care
202 East Drive
Lebanon
Progam
Board
Development
9
1
0
1
1
Lebanon City Police
903 Glendale Drive
Lebanon
Isenhower, Pat
Witham Health Services
4860 E. 100 N.
Lebanon
Finance/Emeritu
s
Financial
Development
1
2
1
3
Kruse, Paul (Past
-President)
Meyer, Mary
Francis
Parr, Richey, Obremskey,
& Morton, Attorneys
628 North Lebanon
Street
Lebanon
104 Ulen Blvd.
Lebanon
Financial
Development
Building and
Grounds
18
1
Hood, Scott
Chair
Chair
Chair - E
Chair of
Fundraisin
Home
Phone
(765) 4826007
(765) 4824041
(765) 4839551
(765) 6765161
(765) 4823944
(765) 4820692
(765) 4823939
g
Financial
Development
Building and
Grounds
Financial
Development
Board
Development
Board
Development
Finance/Executiv
e
Board
Development
1
4
1
5
1
6
1
7
1
8
1
9
2
0
Board
Development
2
1
2
2
2
3
Finance
Program
Financial
Development
19
2
4
Ameritech - Retired
245 S. Murifield
Circle
Lebanon
Veternarian- Retired
215 Essex Drive
Lebanon
Morton Farms
Principal, Lebanon High
School
2645 E. SR 47
Lebanon
2347 Ulen Overlook
Western Boone - Reitred
705 S. Pearl Street
Lebanon
Thorntow
n
Kramer Lumber
219 East Drive
Lebanon
Samson, Casey
Student-LHS
411 N Jameson St
Lebanon
Schaller, Heather
McConnell,
Anna
Remax
2323 Elmwood Drive
115 N Muirfield
Circle
Lebanon
4799 W 200 S
2205 Terrace Lane
Milburn, Allen
Chair of
SKC
Miller, Devon
Morton, George
Chair of
CC
O'Rourke, Kevin
Chair
Parker, Larry
Ransom, Mark
(Board Chair)
Chair
CPA, Katz,Sapper, Miller
Teacher, New Hope
Church
Dale, Elizabeth
Taylor, Jocelyn
Co-Chair
of
Fundraisin
g
Teacher, Harney
Elementary
4605
2
4605
2
4605
2
4605
2
4607
1
4605
2
4605
2
(765) 4827212
(765) 3350163
(765) 3252615
(765) 4831587
(765) 4367884
(765) 4827155
(765) 4852224
Lebanon
4605
2
4605
2
4605
2
Lebanon
4605
2
(765) 4831936
Lebanon
765-482-1235
765-676-5525
YMCA Child Watch Parent Survey 3
Appendix D
2010
Please take a few minutes to answer the questions below. Your answers are anonymous and will be used
to help us improve your child's program. Thank you for your cooperation.
1. Overall, how would you rate the YMCA child care program? Please check only one box.
□ Excellent
□ Good
□ Fair
□ Poor
2. How would you rate the program on each of the following?
Good
Fair
Poor
Not
applicable or
don't know
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
Planned activities (such as arts and crafts,
games, interest centers)
Discipline practices
□
□
□
□
□
□
□
□
□
□
Opportunity for unstructured play
□
□
□
□
□
Facilities
Safety and security
Cleanliness
Convenience of location
Supplies/toys/games
Play equipment
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
Excellent
Staff
Overall caregiver quality
Staff warmth and friendliness
Staff communication with parents
Staff communication with children
Program
General
Meals/snacks
Affordability
Registration/enrollment process
Written information about the program or
activities
3. Does your child appear to be happy at the center?
□ Always
□ Usually
3
□ Sometimes
□ Never
Modified from original found at www.clevelandymca.org/childcare/2008SchoolAgeChildCareParentSurvey.doc on July 12, 2010.
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4. Please indicate how much you feel the YMCA child care program has helped your child:
Learn to get along with others
Learn to appreciate other
cultures
Learn to appreciate similarities
and
differences in others
Understanding the core values of
the YMCA (Caring, Honesty,
Respect, Responsibility)
Learn to follow rules (such as
putting away toys)
A lot
□
Somewhat
□
A little
□
Not at all
□
Not
applicable or
don't know
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
□
5. Does your participation in this program make you feel confident that your child is in a safe, supportive
and nurturing environment?
□ A lot
□ Somewhat
□ A little
□ Not at all
□ Don't know/not applicable
6. Does your participation in this program enable you to exercise without worrying about what your child is
doing?
□ A lot
□ Somewhat
□ A little
□ Not at all
□ Don't know/not applicable
7. How long has your child been with the YMCA child watch program?
□ Less than 1 year
□ 1 year
□ 2 years
□ 3-5 years
8. How did you first hear about the child watch program? (check one only)
□ School
□ Telephone book
□ Other
□ Mail
□ YMCA staff
9. Why did you choose this program?
□ Convenience
□ Had heard it was good
□ Fees
10. Would you recommend this program to other
parents?
□ Other
□ Yes
11. Have you received information on other YMCA programs
available?
12. Do you or your children participate in any other YMCA programs?
□ Yes
□ No
If yes, which program(s)?_______________________________
13. Are you
□ Single, divorced, widowed
14. How old is your
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□ Married
□ No
□ Yes
□ Uncertain
□ No
child?
15.
Is your child
□ Male
□ Female
16. The Y is committed to serving people regardless of their ability to pay. We need to know whether we are
reaching all income levels. Could you please indicate your total annual household income, before taxes?
(optional)
□ $0 - $9.999
□ $15,000 - $19,999
□ $30,000 or more
□ $10,000 - $14,999
□ $20,000 - $29,999
17. The Y is committed to reaching out to all races and ethnicities. Could you please indicate your race or
ethnicity? (optional)
□ American Indian or Alaskan Native □ Black or African American
□ Caucasian/White
□ Asian or Pacific Islander
□ Hispanic/Latino
□ Other
18. Please share with us any suggestions for improvement or additional comments you might have.
__________________________________________________________________________________________
Please return your completed survey to your child’s center or mail to your local YMCA
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