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					                                       Family Friendly Workplace Practices Survey




                                      Columbia Worksite Family Friendly Survey
1. Please Complete the Following Info:                         Name:
Industry:                                                      Company:
Years in Busienss:                                             E-mail Address:
                                                            Number of FTE Employees:
2. Check all practices currently implemented at your workplace. If uncertain, describe what you do in the variation box.
                                                                Currently            Not
                        Description                            Implemented       Implemented           Variation (Describe)
POLICY
Job sharing/flextime/part-time work schedules
Accrued sick time can be used for dependents or elderly
care
On site childcare or subsidies for childcare
Support groups for family issues
Health insurance available for employees and family
Employee assistance programs
Scholarships or education assistance
Enhanced childcare resources and referrals
Allows employees to call home or to call child care facility
Time off to attend educational activities
Part-time employees have access to healthcare benefits
Wellness programs
Compressed work weeks
Time off to take child/elderly to doctor
Adoption benefits
Provides continuing education opportunities
Paid time off to participate in community activities
Telecommuting
Flexible Work Hours
STUDENT SUPPORT
Job shadowing
Scholarships
Internships
Mentoring Programs
Entrepreneurial Program
Equipment Donation
Donation of books or newspapers
Adopt a family
Partners In Education
Tutoring Programs


3. Please list any of your organization's family friendly policies that were not mentioned above.




4. Additional Comments




5. Describe the value your company gains from your family friendly best practices.
                                 Columbia Chamber of Commerce Rating Scale
                                            Family Friendly Practices: Example Company
                                              Not                        Points
Family Friendly Practice Implemented                      Variation                                 Promotions Allowed
                                          Implemented                   Awarded
   Special Scheduling               0           0             0             0                           0-90 Points
   Accrued Sick Time                0           0           #REF!         #REF!
   On Site Child Care               0           0             0             0       * Window stickers
                                                                                    * Social media
   Paid Maternity Leave           #REF!       #REF!         #REF!         #REF!     * Posters/brochures
   Support Groups                   0           0             0             0
   Cafeteria Benefits             #REF!       #REF!           0           #REF!                        90-150 Points
   Health Insurance for Family      0           0             0             0
                                                                                    *    Window stickers
   Employee Assistance              0           0             0             0
                                                                                    *    Social media
   Scholarships                     0           0           #REF!         #REF!     *    Posters/brochures
                                                                                    *    Keychains
   Child-care Referrals             0           0           #REF!         #REF!     *    Bumper stickers
   Benefits to Part Time          #REF!       #REF!         #REF!         #REF!
   On Site Break Area             #REF!       #REF!           0           #REF!                       150-200 Points
   Company Special Events         #REF!       #REF!           0           #REF!     * Window stickers
                                                                                    * Social media
   Calls to Child Care or Home      0           0             0             0       * Posters/brochures           *"Best of" print
   Educational Time Off             0           0             0             0       * Keychains                      *Web site
                                                                                    features                                         *
   Child/Elder Health Time Off      0           0             0             0       Bumper stickers
   Compressed Workweeks             0           0             0             0
   Wellness Programs                0           0             0             0
   Adoption Benefits                0           0             0             0
   Continue Employee Education      0           0           #REF!         #REF!
  Total Rating Points             #REF!      #REF!         #REF!        #REF!                            #REF!
Areas for any additional consideration or added weight:

				
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