Arts Education
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For Full, Well-Rounded Education for Child -
Need Arts Classes
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For Full, Well-Rounded Education for Child -
Need Arts Field Trips
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For Full, Well-Rounded Education for Child -
Need Professional Arts Teachers
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Asthma
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Access to Health Care
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Attention Deficit Disorder
(ADD)/Attention Deficit Hyperactivity Disorder
(ADHD)
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Autism
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Barriers to Accessing Health Care
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| Breastfeeding
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Child Care
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Child Care Type -
Cared for in Own Home
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Child Care Type -
Cared for in Someone Else's Residence
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Child Care Type -
Child Care Center, Preschool or Nursery
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Child Care Type -
Head Start
or State Preschool Program
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Child in Kindergarten
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Difficulty Obtaining
Child Care
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Licensed Family or Home Day Care Provider
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Reasons for Difficulty Obtaining Child Care
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Reasons for No Child Care
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| Child
Development/Disability |
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| Child Health Status
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| Child Routines/Daily Activities/Family Interaction
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Community |
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Demographics
- Child: Age, Race/Ethnicity, Place of Birth,
Citizenship
- Respondent: Age, Race/Ethnicity, Place of Birth, Marital
Status, Education, Employment,
- Household Composition
- Household Income (Federal Poverty Level )
- Language Used Most at Home
- Service Planning Areas/Health Districts
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| Dental Health
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Diabetes
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Ever
Diagnosed with Diabetes
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First 5 L.A.
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Ever Called First 5 L.A.
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Ever
Heard of First 5 L.A.
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From What Source Did You Hear of First 5 L.A.
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H1N1
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Child Had H1N1
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Child Had H1N1 - Asked to Cough in Elbow
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Child Had H1N1 - Kept Away From Siblings and Friends
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Child Had H1N1 - Kept Home From School
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Child Had H1N1 - Kept in Separate Bedroom
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Child Had H1N1 - Taken to See Doctor
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Child Had H1N1 Vaccine
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Child Had H1N1 Vaccine - Number of Doses (0-9 year
olds)
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Child Had H1N1 Vaccine - Where They Received Vaccine
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Parent Prefer to Have Child Vaccinated at School
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Health Insurance Coverage for Child
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Among Insured - Uninsured in Past Year
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Dental Insurance
- Yes
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Dental Insurance - No
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Type of Health Insurance
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Home Visits
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Frequency of Home Visits From Professional (eg.
Social Worker)
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Home Visit From Professional (eg. Social
Worker)
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Human papillomavirus (HPV)
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Ever Heard of HPV Vaccine
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Had Any HPV Shots (9+ year olds)
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Had Any HPV Shots ( Girls 13-17 year olds)
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How Many HPV Shots Did Child Receive (9+
year olds)
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Parent Planning on Having Child (9+
year old girls) Receive All 3 Shots
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To Child Top |
| Insurance Coverage for Child
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Medical Conditions
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Mental Health Care
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Nutrition |
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Parent Health
Risks/Behaviors
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Parent Involvement in School
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Attend School Events
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Volunteer in PTA, or Fundraisers for School
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School has Arts Education
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Parental Social Support
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Preconception/Prenatal Care
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Pregnancy Preparation - Information on Caring
for Gums and Teeth
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Pregnancy Preparation - Information on Dangers
of Tobacco Smoke Exposure
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Pregnancy Preparation - Information on Genetic
Screening
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Pregnancy Preparation - Information on Healthy
Weight for Pregnancy
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Pregnancy Preparation - Information on
Multi-Vitamin or Folic Acid Supplements
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Pregnancy Preparation - Information on Nutrition
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Physical Activity
- Average Days Gymnastics, Dance, Karate Classes
(per week)
- Average Days Playing or Practicing Team Sports
(per week)
- Average Days Playing Physically Interactive Games eg.
Dance Dance Revolution (per week)
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Average Days Walk, Bike, or Skateboard From
School (per week)
- Average Days Walk, Bike, or Skateboard To
School (per week)
- Time Spent in Gymnastics, Dance, Karate
Classes (per week)
- Time Spent Playing or Practicing Team
Sports (per week)
- Time Spent Playing Physically Interactive
Games eg. Dance Dance Revolution (per
week)
- Time Spent Walking, Biking, or
Skateboarding From School (per week)
- Time Spent Walking, Biking, or
Skateboarding To School (per week)
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Total Amount of Physical Activity
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Safe Park for Child
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Smoking
- Mother Smoked While Pregnant
- Mother Tried
to Quit Smoking When Pregnant
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Television Viewing
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TV Watching 0-23 Month Olds (0 Hours/Day)
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TV Watching 2-17 Year Olds (3+ Hours/Day)
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| Vaccination
Understanding
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Women, Infants and
Children (WIC)
- While Pregnant Participated in WIC
- Child
Participated in WIC
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