Head Start Survey - Community Needs
Community Assessment Survey - This survey was developed by Early Childhood Analytics (contact:
). It is intended for Head Start parents, staff and community partners.
Name and Contact information (optional)
Which community do you live in?
Are you a Head Start parent, staff or other?
What are the challenges, issues and struggles in the community where you live?
Please select those items that are issues, challenges and struggles for the community where you live.
Nutrition (education or poor eating habits)
Diabetes and obesity
Alcohol and drug use
Drinking and driving
Ethnic or racial conflict
Mental health problems
Filling out forms and applying for services
Lack of employment opportunities
Lack of child care
Lack of transportation services
Accessibility to health services
Accessibility to other services
What sources of stress relief do you regularly use (such as activities or services in the community)?
May your answers be cited in the Community Assessment and attributed to "a Head Start parent/staff/policy council member"?
May your answers be cited in the Community Assessment and attributed to the community in which you live?
May Head Start staff or consultants contact you with follow up questions or discussion about your responses?
Thank you so much for your participation in this Community Assessment survey! Your input is important to the Head Start program for planning future services.
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