English to Russian Medical Medical: Pharmaceuticals

Please indicate if is exposed to the following at HOME: 
11.
Smoke from cigarettes or other tobacco products
11a.
How often is the exposure?
DailyWeeklyMonthly
12.
Dogs, cats, and other furry animals?
12a.
How many pets?
Pets
13.
Does receive regular care (at least once a week) outside the home?
13a.
Are there children who are not siblings also present at the outside care site?
Does attend DAY CARE (at a daycare center)?
Please indicate if is exposed to the following at DAY CARE: 
14.
Smoke from cigarettes or other tobacco products?
14a.
15.
15a.
Does go to the HOME of a BABYSITTER or Other Regular Caregiver?