CHILDCARE SURVEY OF ACTIVITY AND WELLNESS
(C-SAW) QUESTIONNAIRE
Childcare Survey of Activity and Wellness (C-SAW)
IMPORTANT:
In this survey, the term “childcare center” refers to all of the early care and education services for children ages 0-5 offered at (center address will be programmed in). This refers to centers that are stand alone facilities and programs co-located in another building, such as a school.
When answering the questions, DO NOT INCLUDE any children in kindergarten or higher grades who also receive services at this address.
You will need a hardcopy or electronic version of the full menu of foods and beverages served at this center last week (Monday-Friday or every day the center was open last week).
You will need a hardcopy or electronic version of your center’s written guidelines, rules or policies.
If you don’t know the answer to a question, please contact the appropriate person to try to get the information. Thanks in advance for doing so!
A. ABOUT THIS CHILDCARE CENTER
A1. Do children of the following ages attend this childcare center?
(Mark  one box per row)
| 
				 | Yes | No | 
| a. Children less than 1 year of age |  |  | 
| b. Children who are 1 year old |  |  | 
| c. Children who are 2 years old |  |  | 
| d. Children who are 3 to 5 years old and not yet in kindergarten |  |  | 
A2. On a typical day, about how many children who are not yet in kindergarten are cared for at this childcare center?
 
Number of children
A3. Is this childcare center located in the same building as a public or private school?
 Yes
 No
A4. The organization that administers this childcare center is:
(Mark  one box)
 For profit
 Non-profit
 Don’t know
A5. The organization that administers this childcare center …
(Mark  one box)
 Administers childcare only at this site
 Is a franchise, part of a chain or corporately owned
 Administers childcare at multiple sites, but is not a chain or corporately owned
 Don’t know
A6. How would you describe the organization that administers this childcare center?
(Mark  all that apply)
 Religious organization
 Public school or local public education agency
 Military
 Non-military government agency
 College or university
 Tribal agency
 Worksite
 Social service or family and youth organization
 A business
 Other
 
(Specify)
A7. How many days per week is this childcare center usually open?
 
Number of days open each week
A8. Counting both full-time and part-time positions, how many paid staff (such as paid teachers and teacher’s aides) work in this childcare center’s classrooms serving children ages 0-5 years but not yet in kindergarten?
 
Total number of paid classroom staff
A9. For children not yet in kindergarten, does this childcare center offer…
(Mark  one box per row)
| 
				 | Yes | No | 
| a. Full-day (6 or more hours per day) programming? |  |  | 
| b. Half-day (less than 6 hours per day) programming? |  |  | 
A10. The early childhood program at this childcare center is:
(Mark  one box)
 Licensed as a childcare center by state, local, or tribal organization
 Legally exempt from licensing as a childcare center
 Don’t know
A11. Which of the following sources provide funding for this childcare center?
(Mark  one box per row)
| 
				 | Yes | No | 
| a. Public pre-kindergarten programming? |  |  | 
| b. Head Start or Early Head Start? |  |  | 
| c. The Child and Adult Care Food Program (also called CACFP or “the food program”) or the National School Lunch Program (NSLP)? |  |  | 
| d. Public childcare subsidies targeted for working and low-income families (including childcare vouchers/certificates, and state contracts)? |  |  | 
NOTE 1
If Question A11 = Yes (CACFP or NSLP is a funding source), GO TO NOTE 2.
A11aa. Have you ever heard of the Child and Adult Care Food Program (also called CACFP or “the food program”)?
 Yes  GO TO QUESTION A11bb
 No  GO TO NOTE BEFORE QUESTION A11cc
A11bb. What are the reasons your childcare center is not participating in CACFP?
(Mark  all that apply)
 Do not know much about CACFP
 The paperwork requirements are too difficult
 The nutrition requirements are too difficult to meet
 The childcare center does not have enough eligible children
 The meal reimbursement is not enough to cover food expenses
 The benefit does not seem worth the effort
 Our sponsoring agency or organization does not support participation
 Children don’t like the types of foods the program requires
 Other
 
(Specify)
NOTE 2
If Question A11d = No (Public childcare subsidies are not a funding source), GO TO QUESTION A12.
A11cc. For about what percent of the children does this childcare center receive public childcare subsidies?
(Mark  one box)
 1% - 25%
 26% - 50%
 51% - 75%
 76% - 100%
A12. Does this childcare center participate in [state name for QRIS] quality rating improvement system?
 Yes
 No
A13. Does this childcare center have accreditation from a national, state-level, and/or local organization (such as NAEYC, Montessori, or a state or local accreditation)?
 Yes  GO TO QUESTION A13a
 No  GO TO SECTION B, NUTRITION
A13a. Please enter the name of all national, state, local, or tribal organizations that have accredited this childcare center:
 
| B. NUTRITION | 
NOTE 3
If this childcare center ONLY serves children less than 1 year old, GO TO QUESTION B19.
B1. Do children ages 1 to 5 years old eat any meals or snacks at your childcare center?
 Yes  GO TO QUESTION B2
 No  GO TO QUESTION B11
B2. For children ages 1 to 5 years old, when the following meals and snacks are eaten at this childcare center, who usually provides the food?
(Mark  one box per row)
| Meal or Snack | Usually brought from home by parents or guardians | Usually provided by center | N/A- Not usually eaten at the center | 
| a. Breakfast |  |  |  | 
| b. Mid-morning snack |  |  |  | 
| c. Lunch |  |  |  | 
| d. Mid-afternoon snack |  |  |  | 
| e. Dinner |  |  |  | 
| f. Evening snack |  |  |  | 
NOTE 4
If all meals are usually brought from home or not usually eaten at the center, GO TO QUESTION B15.
B3. Not including food brought from home, where are this childcare center’s meals usually prepared?
(Mark  one box)
 All meals prepared on-site
 All meals prepared off- site (such as catered)
 Some meals prepared on-site and some prepared off-site
B4. Who usually develops the menus for this childcare center?
(Mark  all that apply)
 Childcare center director
 Onsite food service manager/food manager/cook
 A meal planning service or software (such as Minute Menu or procurement software)
 A corporate office, sponsor organization, or school food service
 A food vendor
 Other
 
(Specify)
B5. Does this childcare center have paid staff whose primary job is dedicated to foodservice-related tasks, such as ordering or shopping for food, preparing food, or cooking food?
 Yes
 No
NOTE 5
Questions B6 to B15 ask how often during the last week different types of foods and beverages were included in meals and snacks provided for children ages 1 to 5 years old at this childcare center.
IMPORTANT: To answer these questions, you will need to look at the menu of foods and beverages served at this childcare center last week
B6. How many days was this childcare center open last week?
 
Number of days open last week
B7. During the last week, how often were children ages 1 to 5 years old served 100% fruit juice, such as apple, grape, or orange juice?
(Mark  one box)
 Served some days, but not every day
 Served every day, usually 1 time per day
 Served every day, usually 2 times per day
 Served every day, usually 3 or more times per day
 Not served at all last week
B8. During the last week, how often were children ages 1 to 5 years old served sweet drinks that are not 100% juice, such as Hi-C, lemonade, Kool-Aid, Capri Sun, Sunny Delight, Hawaiian Punch, sweet teas, sport drinks, or sodas?
(Mark  one box)
 Served some days, but not every day
 Served every day, usually 1 time per day
 Served every day, usually 2 times per day
 Served every day, usually 3 or more times per day
 Not served at all last week
B9. During the last week, how often were children ages 1 to 5 years old served flavored milk, such as chocolate, vanilla, or strawberry?
(Mark  one box)
 Served some days, but not every day
 Served every day, usually 1 time per day
 Served every day, usually 2 times per day
 Served every day, usually 3 or more times per day
 Not served at all last week
B10. During the last week, how often were children ages 1 to 5 years old served fruit, including fresh, canned, dried, and frozen?
(Mark  one box)
 Served some days, but not every day
 Served every day, usually 1 time per day
 Served every day, usually 2 times per day
 Served every day, usually 3 or more times per day
 Not served at all last week
B11. During the last week, how often were children ages 1 to 5 years served vegetables, including fresh, canned, and frozen? Please do not count white potatoes.
(Mark  one box)
 Served some days, but not every day
 Served every day, usually 1 time per day
 Served every day, usually 2 times per day
 Served every day, usually 3 or more times per day
 Not served at all last week
B12. During the last week, how often were children ages 1 to 5 years served fried or pre-fried potatoes, such as French fries, tater tots, and hash browns? Please include types that are sold frozen and then baked in the oven, or prepared from scratch.
(Mark  one box)
 Served 1 time last week
 Served 2 times last week
 Served 3 times last week
 Served 4 or more times last week
 Not served at all last week
B13. During the last week, how often were children ages 1 to 5 years old served fried, pre-fried or breaded meats such as chicken nuggets, chicken strips, fish sticks, or corn dogs? Please include types that are sold frozen and then baked in the oven, or fried meats prepared from scratch.
(Mark  one box)
 Served 1 time last week
 Served 2 times last week
 Served 3 times last week
 Served 4 or more times last week
 Not served at all last week
B14. During the last week, how often were children ages 1 to 5 years old served sweet baked goods such as cakes, pastries, pies, muffins, pop tarts, brownies, donuts, sweet rolls, cupcakes, and cookies? Please do not include graham crackers.
(Mark  one box)
 Served 1 time last week
 Served 2 times last week
 Served 3 times last week
 Served 4 or more times last week
 Not served at all last week
B15. During the last week, how often were children ages 1 to 5 years old served salty snacks such as chips, crackers, popcorn, or pretzels?
(Mark  one box)
 Served 1 time last week
 Served 2 times last week
 Served 3 times last week
 Served 4 or more times last week
 Not served at all last week
B16. Are parents and guardians allowed to bring in food such as cakes, pastries, brownies, donuts, cupcakes, and cookies for special occasions, such as holidays or birthday celebrations?
 Yes
 No
B17. How often do you and other staff at this childcare center see children who do not appear to be getting enough food to eat at home?
(Mark  one box)
 Never
 Rarely
 Sometimes
 Often
 Very often
B18. During the past 12 months, did this childcare center…
(Mark  one box per row)
| 
 | Yes | No | 
| a. Grow fruits, vegetables, and/or herbs (on- or off-site)? |  |  | 
| b. Have agriculture or nutrition education activities (e.g., taste tests at the center, cooking demonstrations, farmer visits or field trips to a farm/garden, learning about how food grows or where it comes from)? |  |  | 
NOTE 6
If this childcare center does not serve children less than 1 year old, GO TO SECTION C, PHYSICAL ACTIVITY.
B19. Is there a space available at this center for mothers to breastfeed?
 Yes  GO TO QUESTION B19a
 No  GO TO SECTION C
B19a. Is that space private?
 Yes
 No
C. PHYSICAL ACTIVITY
NOTE 7
If this childcare center only serves children less than 1 year old, GO TO QUESTION C8.
This section asks about physical activity opportunities for children ages 1 to 5 years old. When answering the questions, consider all children, including those with special needs.
Physical activity includes the type of play where children are breathing harder and their hearts are beating faster than when at rest.
Examples: dancing, jumping, hopping, running, yoga
Physical activity does not include sedentary play, where children might be sitting and playing with blocks, toys, or puzzles.
NOTE 8
If this center provides ONLY half-day care, GO TO QUESTION C3.
C1. For children ages 1 and 2 years old about how much total time is usually provided each day for physical activity? Please include indoor and outside time, and self-directed and adult led activity.
(Mark  one box)
 None
 Less than 15 minutes
 At least 15 minutes, but less than 30 minutes
 At least 30 minutes, but less than 1 hour
 At least 1 hour, but less than 1.5 hours
 At least 1.5 hours, but less than 2 hours
 At least 2 hours, but less than 2.5 hours
 At least 2.5 hours
 We do not have any children ages 1 and 2 years old at this childcare center
C2.	For
children ages 3 to 5 years old, about how much total
time is usually provided each day for physical activity? Please
include indoor and outside time, and self-directed and adult led
activity? 
(Mark 
one box)
 None
Less than 15 minutes
 At least 15 minutes, but less than 30 minutes
 At least 30 minutes, but less than 1 hour
 At least 1 hour, but less than 1.5 hours
 At least 1.5 hours, but less than 2 hours
 At least 2 hours, but less than 2.5 hours
 At least 2.5 hours
 We do not have any children ages 3 to 5 years old at this childcare center
NOTE 9
If this center provides ANY full-day care, GO TO QUESTION C5.
C3. For children ages 1 and 2 years old about how much total time is usually provided each day for physical activity? Please include indoor and outside time, and self-directed and adult led activity.
(Mark  one box)
 None
 Less than 15 minutes
 At least 15 minutes, but less than 30 minutes
 At least 30 minutes, but less than 1 hour
 At least 1 hour
 We do not have any children ages 1 and 2 years old at this childcare center
C4. For children ages 3 to 5 years old, about how much total time is usually provided each day for physical activity? Please include indoor and outside time, and self-directed and adult led physical activity.
(Mark  one box)
 None
 Less than 15 minutes
 At least 15 minutes, but less than 30 minutes
 At least 30 minutes, but less than 1 hour
 At least 1 hour
 We do not have any children ages 3 to 5 old at this childcare center
C5. About how many times each day are children ages 1 to 5 years old usually taken outdoors for physical activity?
(Mark  one box)
 1 time per day
 2 times per day
 3 or more times per day
 We do not have daily scheduled outdoor physical activity time
C6. About how many times each day are children ages 1 and 2 years old provided with an adult-led physical activity, either indoors or outdoors? Examples include dancing, yoga, music and movement, gross motor skills activities, or physically active adult-led games.
(Mark  one box)
 We do not have any children ages 1 and 2 years old at this childcare center
 1 time per day
 2 times per day
 3 or more times per day
 We do not have daily scheduled adult-led physical activity time
C7. About how many times each day are children ages 3 to 5 years old provided with an adult-led physical activity, either indoors or outdoors? Examples include dancing, music and movement, motor skills activities, or physically active adult-led games.
(Mark  one box)
 We do not have any children ages 3 to 5 years old at this childcare center
 1 time per day
 2 times per day
 3 or more times per day
 We do not have daily scheduled adult-led physical activity time
NOTE 10
If the center does not serve children less than 1 year old, GO TO SECTION D, SCREEN TIME.
C8. About how many times each day are infants who are not yet crawling placed on their stomachs for supervised "tummy time"?
(Mark  one box)
 1 time per day
 2 times per day
 3 or more times per day
 Infants do not have daily tummy time
C9. Does this center have written guidelines, rules, or policies about the amount of time infants may be placed in devices that constrain movement, such as swings or infant seats?
 Yes
 No
| D. SCREEN TIME | 
The next few questions ask about screen time while children are at your center. Screen time includes any time spent watching shows or videos, or playing games (including active video games) on a screen.
Screens include:
TV, videos, DVDs
Projections on a wall or big screen (e.g. projected from a computer)
Desktop, laptop or tablet computers
Electronic games
Smart phones or other hand held devices
Do not include the following as part of screen time:
Using e-books or tablet computers to read children stories
Using Smart Boards for interactive instruction
Using any video conferencing program (like Skype)
D1. While at this childcare center, about how much daily screen time do children under 2 years old usually have? IMPORTANT: Screen time includes any time watching shows or videos, or playing games (including active video games) on a screen.
(Mark  one box)
 We do not have any children under 2 years old at this childcare center
 We have screen time for this age group, but not every day
 Less than 30 minutes per day
 More than 30 minutes but less than 60 minutes per day
 1-2 hours per day
 More than 2 hours per day
 We never have screen time for children under 2 years old
D2. While at this childcare center, about how much time do children ages 2 to 5 years old usually spend in front of any types of screens? IMPORTANT: Screen time includes any time watching shows or videos, or playing games (including active video games) on a screen as defined at the top of this section. Screen time does not include teachers using e-books or tablet computers to read children stories, using Smart Boards for interactive instruction, or connecting with families through Skype or videoconferencing programs.
(Mark  one box)
 We do not have any children ages 2 to 5 years old at this childcare center  GO TO QUESTION D3
 We have screen time for this age group, but not every day
 Less than 30 minutes per day
 More than 30 minutes but less than 60 minutes per day
 1-2 hours per day
 More than 2 hours per day
 We never have screen time for children ages 2 to 5 years old  GO TO QUESTION D3
D2a. For children ages 2 to 5 years old, what is the purpose (or purposes) of this screen time?
(Mark  all that apply)
 Educational
 Entertainment
 Engagement in physical activity
 Other
 
E. STAFF TRAINING
This section asks about staff training. Training only includes the following types of activities:
classes,
workshops,
conference sessions, and
any activities that count as continuing education hours.
E1. During the past 12 months, have you or your assistant director/curriculum director had training on the following topics?
(Mark  one box per row)
| Training Topic | Yes | No | 
| a. Child nutrition (other than food safety and food program guidelines) |  |  | 
| b. Infant nutrition |  |  | 
| c. Supporting breastfeeding or the storage and handling of breast milk |  |  | 
| d. Using responsive feeding techniques for children, such as paying attention to when children are hungry, or not pressuring children to clean their plate when full |  |  | 
| e. Engaging young children in physical activity |  |  | 
E2. During the past 12 months, what portion of the classroom childcare staff at this center has had training on each of the following topics?
(Mark  one box per row)
| Training Topic | All | Most | Some | None | 
| a. Child nutrition (other than food safety and food program guidelines) |  |  |  |  | 
| b. Infant nutrition |  |  |  |  | 
| c. Supporting breastfeeding or the storage and handling of breast milk |  |  |  |  | 
| d. Using responsive feeding techniques for children, such as paying attention to when children are hungry, or not pressuring children to clean their plate when full |  |  |  |  | 
| e. Engaging young children in physical activity |  |  |  |  | 
| f. Positive behavioral interventions |  |  |  |  | 
| g. Child development and approaches to learning |  |  |  |  | 
| h. Stress management and mental health promotion for providers |  |  |  |  | 
| F. ACTIVITIES TO IMPROVE THIS CHILDCARE CENTER’S NUTRITION AND PHYSICAL ACTIVITY OFFERINGS | 
F1. During the past 12 months, has this childcare center…
(Mark  one box per row)
| Activity | Yes | No | 
| a. Participated in an assessment to review the center’s nutrition and physical activity practices, such as the Nutrition and Physical Activity Self-Assessment for Childcare (NAP SACC), Let’s Move Checklist, or [state assessment tool]? |  |  | 
| b. Used a curriculum or lesson series whose primary focus is healthy eating or getting the children moving? |  |  | 
| c. Earned a special designation for the center’s nutrition and physical activities practices and policies, such as a healthy childcare facility, a breastfeeding friendly childcare facility, or a state specific designation? |  |  | 
| G. TRACKING DEVELOPMENTAL PROGRESS | 
G1. During the past 12 months, for what portion of the children did this childcare center do developmental screening using a validated screening tool (such as the Ages and Stages Questionnaire) within 3 months of program enrollment?
(Mark  one box)
 All
 Most
 Some
 None
G2. During the past 12 months, for what portion of the children did this childcare center engage in ongoing assessment of their developmental progress, including cognitive skills, language, social-emotional skills, and physical development?
(Mark  one box)
 All
 Most
 Some
 None
G3. During the past 12 months, what portion of families received information on a regular basis from this childcare center about their child’s development and learning? This could be through in-person or telephone conferences or via written communication.
(Mark  one box)
 All
 Most
 Some
 None
| H. DISCIPLINE | 
H1. During the past 12 months, which of the following has this childcare center done to deal with child behaviors such as hitting, kicking, biting, tantrums, or disobeying?
(Mark  one box for each row)
| Disciplinary Action | No | Yes | If Yes, For How Many Children? | 
| a. Asked a parent/caregiver to pick up a child early because of behavior problems. |  |   | 
				 | 
| b. Sent a child home for one day or more because of behavior problems. |  |   | 
				 | 
| c. Told a parent/caregiver their child can no longer attend your center because of behavior problems. |  |   | 
				 | 
| I. WHO COMPLETED THE SURVEY | 
This section should be completed by the person mostly responsible for completing this survey.
I1. What is your primary role at this childcare center?
(Mark  one box)
 An administrative role such as director center supervisor/manager, assistant director or principal
 A teaching role such as teacher, assistant teacher or some other direct service role
 Both an administrative role and a teacher/direct service role
 
 Other
(Specify)
We would appreciate it if you would provide us with a copy of the menu(s) you used when answering the questions about the foods and beverages served at your childcare center last week. Please click the “Browse” button below to find your menu file(s). Once found, highlight each file and click “Upload”.
If you do not wish to provide the menu, please click here .
J. FEEDBACK ON PILOT QUESTIONNAIRE
Since this is a pilot study, your responses to the three remaining questions will provide us with feedback that will help us learn about the survey.
J1. How difficult or easy was it for your center to complete this survey?
 Very Difficult
 Somewhat Difficult
 Somewhat easy
 Very Easy
J2. How much time did it take you to complete the survey?
 Less than 15 minutes
 15-30 minutes
 30-45 minutes
 45-60 minutes
 More than one hour
J3. Is there any other feedback you’d like to provide about this survey?
THANK YOU VERY MUCH FOR COMPLETING THIS SURVEY!
	
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Mary Dingwall | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-11 |