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FY10 Universal Pre-Kindergarten(UPK) Classroom Quality Grant Renewal RFR Questionnaire
/ Introduction
Deadline:Your response to this questionnaire must be received by EEC by 4:30 pm on July 17, 2009. Applicants must choose only one method of submission, online or hard copy. Completing the survey online is strongly encouraged, but not required. Please refer to the FY10 Universal Pre-Kindergarten (UPK) Pilot Classroom Quality Grant Renewal RFR for instructions on submitting a hard copy (http://www.eec.state.ma.us/kr_grant_submit.aspx).
Please refer to the RFR posted on EEC’s website before completing this questionnaire. As described in the RFR, completion of this questionnaire is a required part of the renewal process. This data will help demonstrate your ongoing eligibility for the grant.
Please note: EEC does not plan to use this enrollment data to determine FY10 program award amounts; given the level of expected reductions in available funds, FY09 enrollment data will be used to calculate FY10 grant awards with across-the-board reductions subject to final budget appropriations. However, please enter complete and accurate data, as information collected may be used for planning purposes.
For questions about this questionnaire, please contact Kelly Schaffer at .

FY10 Universal Pre-Kindergarten (UPK) Classroom Quality Grant Renewal Questionnaire for Independent Family Child Care Providers

Provider Name: ______

Provider Program Number: ______

Provider Address: ______

Contact Person: ______

Title: ______

E-mail Address: ______

Phone Number: ______

Program Information

1.  As of May 1, 2009, is the program currently accredited by the National Association for the Education of Young Children (NAFCC)? ____ Yes ____ No

NAFCC Accreditation Number:

NAFCC Accreditation expiration date:

2.  Does the program or provider currently use the Guidelines for Preschool Learning Experiences to plan the curriculum and Early Childhood Program Standards for Three and Four Year olds (not applicable to family child care) to plan the curriculum and activities for preschool children?

____ Yes ____ No

3.  Which one of the four EEC approved assessment instruments is used to assess preschool children in the program?

____ Creative Curriculum Developmental Continuum

____ Work Sampling

____ High Scope COR

____ Ages & Stages

4.  When did the program start using this assessment tool? ______(mm/yyyy)

Please reply with information regarding the entire program at this site as of May 1, 2009, unless otherwise noted. Please note that if your agency has more than one grantee site, you will need to submit a separate questionnaire for each program site.

5.  Number of preschool children (2.9 years until Kindergarten eligible) enrolled at this site? ____

6.  Number of preschool children (2.9 years until Kindergarten eligible) at this site whose enrollment is funded through EEC Financial Assistance (vouchers or contracts), Head Start, or private scholarship*? Please only count each child once (by primary funding source).

* Please only count children with private scholarships with monthly incomes (for a family of three) at or below 85% of the state median income ($5,554/month) _____

7.  Does the program fund children through private scholarships? ____ Yes ____ No

Classroom Eligibility Information

8.  As of May 1, 2009, what is the total number of preschool classes in the program site?

Note: For purposes of this RFR, a classroom refers to a specific group of children. If there are separate morning and afternoon sessions, please enter each session as a distinct “classroom.” If you have questions about how your program’s information should be entered, please contact Kelly Schaffer at .

_____

9.  For how many preschool classrooms is the program requesting FY10 UPK Classroom Quality renewal funding? Question not applicable to independent family child care providers.

10.  Complete the following information for your family child care home.

UPK Funding Status: ____ Current UPK classroom

Provider Name: ______

EEC certification or DOE license number (if applicable): ______

Highest Degree obtained (please select the highest degree obtained): ___ HS diploma/GED ___CDA ___AA ___BA/BS ___Masters ___Doctorate ___No Degree

Number of hours per day that home operates: ____

Number of days per week that home operates: ____

Number of weeks per year that home operates: ____

EEC does not plan to use this enrollment data to determine FY10 program award amounts; given the level of expected reductions in available funds, FY09 enrollment data will be used to calculate FY10 grant awards with across-the-board reductions subject to final budget appropriations. However, please enter complete and accurate data, as information collected may be used for planning purposes.

Please list, as of the two weeks below, the FTE enrollment of preschool children in this classroom/home by funding source. If children are funded by more than one source, please list them only once, counting the primary funding source. Please enter 0 if zero is the correct response or your response will not be considered complete.

Please Note: FTE enrollment in a classroom or family child care homes for purposes of this questionnaire is defined as the sum of the proportion of time that each child in a classroom or home is enrolled during the specified weeks relative to the total number of hours that the classroom or home is in operation.

As examples, if classroom A is open 50 hours per week and includes 15 children enrolled full-day full-week and 5 children enrolled full-day for three days per week (or 60% time), the FTE enrollment is 15 + 0.6 (5) = 18. If classroom B is open 20 hours per week (5 days for 4 hours each day) and includes 10 children enrolled full-week and 10 children enrolled for two days per week (or 40% time), the FTE enrollment is 10 + 0.4 (10) = 14.

Week of Nov 3, 2008 / Week of Apr 6, 2009
1. / FTE home enrollment of preschool children: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
2. / FTE home enrollment of preschool children receiving EEC financial assistance (voucher or contract), Head Start or private scholarship*: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
3. / FTE home enrollment of preschool children receiving Head Start funding: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
4. / FTE home enrollment of preschool children receiving voucher funding: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
5. / FTE home enrollment of preschool children receiving contract funding: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
6. / FTE home enrollment of preschool children receiving private scholarship funding: / Invalid number Please enter number of children. / Invalid number Please enter number of children.
7. / As of May 1, 2009, what is the number of children in the home with IEP's: Invalid number Please enter number of children.

* Please only count children with private scholarships with monthly incomes at or below 85% of state median income for a family of three ($5,554/month).
Note: The total number of children receiving financial assistance (line 2) must be equal to the sum of children receiving financial assistance by type (lines 3,4,5 and 6).