Protective Factors Family Survey

 
1. PROTECTIVE FACTOR #1: Access to Basic Needs
What is your housing status?
2. Are you employed?
3. How do you feel about your job?
4. How have your life experiences prepared you for fiscal hardship?
5. PROTECTIVE FACTOR #2: Parent Resiliency
How would you rate your physical health?
6. How would you rate your emotional health?
7. Which of the following best describes your outlook on life?
8. When you look back on your life so far, how does it make you feel?
9. PROTECTIVE FACTOR #3: Social Connections
Which of the following best describes your family friendships?
10. How involved is your family in local clubs and events?
11. Which of the following is most similar to the personal support in your life?
12. Who are your mentors or role models?
13. PROTECTIVE FACTOR #4: Parent Knowledge of Child Development
Which best describes your understanding of optimal early development?
14. Describe the optimal social emotional skills you want your child acquire.
15. Describe the source of most of your parenting knowledge
16. What parenting philosophy do you hope to pass on to your child?
17. PROTECTIVE FACTOR #5: Child Development Services
What level of educational opportunity will you expose your child to?
18. What kind of care are you able to provide for your child?
19. What level of personal education did you achieve?
20. Which best describes your family's home habits?