Child Development Services - Part B 619 - Parent SurveyChild Development Services - Part B 619

1. Please indicate which CDS site you deal with

	CDS SITES (Drop Down Menu)
PLEASE SELECT FROM DROP DOWN MENU	Please indicate which CDS site you deal with PLEASE SELECT FROM DROP DOWN MENU CDS SITES (Drop Down Menu)

2. Please rate the following:

	Never	Rarely	Often	Always
I was offered the help I needed so I could participate in Individual Education Plan (IEP) meetings and in the development of the Individual Education Program (IEP).	*Please rate the following: I was offered the help I needed so I could participate in Individual Education Plan (IEP) meetings and in the development of the Individual Education Program (IEP). Never	I was offered the help I needed so I could participate in Individual Education Plan (IEP) meetings and in the development of the Individual Education Program (IEP). Rarely	I was offered the help I needed so I could participate in Individual Education Plan (IEP) meetings and in the development of the Individual Education Program (IEP). Often	I was offered the help I needed so I could participate in Individual Education Plan (IEP) meetings and in the development of the Individual Education Program (IEP). Always

3. Please rate the following:

	Never	Rarely	Often	Always
My concerns and recommendations were considered in the development of the IEP.	*Please rate the following: My concerns and recommendations were considered in the development of the IEP. Never	My concerns and recommendations were considered in the development of the IEP. Rarely	My concerns and recommendations were considered in the development of the IEP. Often	My concerns and recommendations were considered in the development of the IEP. Always

4. Please rate the following:

	Never	Rarely	Often	Always
I have been asked for my opinion about how well early intervention services are meeting my child's needs.	*Please rate the following: I have been asked for my opinion about how well early intervention services are meeting my child's needs. Never	I have been asked for my opinion about how well early intervention services are meeting my child's needs. Rarely	I have been asked for my opinion about how well early intervention services are meeting my child's needs. Often	I have been asked for my opinion about how well early intervention services are meeting my child's needs. Always

5. Please rate the following:

	Never	Rarely	Often	Always
Any written information I receive is written or explained to me in a way I understand.	*Please rate the following: Any written information I receive is written or explained to me in a way I understand. Never	Any written information I receive is written or explained to me in a way I understand. Rarely	Any written information I receive is written or explained to me in a way I understand. Often	Any written information I receive is written or explained to me in a way I understand. Always

6. Please rate the following:

	Never	Rarely	Often	Always
CDS staff treat me as a team member.	*Please rate the following: CDS staff treat me as a team member. Never	CDS staff treat me as a team member. Rarely	CDS staff treat me as a team member. Often	CDS staff treat me as a team member. Always

7. Please rate the following:

	Never	Rarely	Often	Always
Those involved in my child’s IEP meetings seek out my input.	*Please rate the following: Those involved in my child’s IEP meetings seek out my input. Never	Those involved in my child’s IEP meetings seek out my input. Rarely	Those involved in my child’s IEP meetings seek out my input. Often	Those involved in my child’s IEP meetings seek out my input. Always

8. Please rate the following:

	Never	Rarely	Often	Always
I received a copy of my rights and was told who to call if I didn't understand something.	*Please rate the following: I received a copy of my rights and was told who to call if I didn't understand something. Never	I received a copy of my rights and was told who to call if I didn't understand something. Rarely	I received a copy of my rights and was told who to call if I didn't understand something. Often	I received a copy of my rights and was told who to call if I didn't understand something. Always

9. Please rate the following:

	Never	Rarely	Often	Always
I know who to call with questions regarding my child's early intervention.	*Please rate the following: I know who to call with questions regarding my child's early intervention. Never	I know who to call with questions regarding my child's early intervention. Rarely	I know who to call with questions regarding my child's early intervention. Often	I know who to call with questions regarding my child's early intervention. Always

10. Please rate the following:

	Never	Rarely	Often	Always
The CDS site communicates with me regarding my child's progress on IFSP goals.	*Please rate the following: The CDS site communicates with me regarding my child's progress on IFSP goals. Never	The CDS site communicates with me regarding my child's progress on IFSP goals. Rarely	The CDS site communicates with me regarding my child's progress on IFSP goals. Often	The CDS site communicates with me regarding my child's progress on IFSP goals. Always

11. Please rate the following:

	Never	Rarely	Often	Always
The CDS site offers me training about early intervention issues.	*Please rate the following: The CDS site offers me training about early intervention issues. Never	The CDS site offers me training about early intervention issues. Rarely	The CDS site offers me training about early intervention issues. Often	The CDS site offers me training about early intervention issues. Always

12. Please rate the following:

	Never	Rarely	Ofrten	Always
The CDS site helps me to play an active role in my child's early intervention.	*Please rate the following: The CDS site helps me to play an active role in my child's early intervention. Never	The CDS site helps me to play an active role in my child's early intervention. Rarely	The CDS site helps me to play an active role in my child's early intervention. Ofrten	The CDS site helps me to play an active role in my child's early intervention. Always

13. Please rate the following:

	Never	Rarely	Often	Always
The CDS site explains what options I have if I disagree with a decision.	*Please rate the following: The CDS site explains what options I have if I disagree with a decision. Never	The CDS site explains what options I have if I disagree with a decision. Rarely	The CDS site explains what options I have if I disagree with a decision. Often	The CDS site explains what options I have if I disagree with a decision. Always

14. Please rate the following:

	Never	Rarely	Often	Always
I feel welcome by administration and staff from the CDS site.	*Please rate the following: I feel welcome by administration and staff from the CDS site. Never	I feel welcome by administration and staff from the CDS site. Rarely	I feel welcome by administration and staff from the CDS site. Often	I feel welcome by administration and staff from the CDS site. Always

15. Please rate the following:

	Never	Rarely	Often	Always
CDS staff have helped me get the services that my child needs.	*Please rate the following: CDS staff have helped me get the services that my child needs. Never	CDS staff have helped me get the services that my child needs. Rarely	CDS staff have helped me get the services that my child needs. Often	CDS staff have helped me get the services that my child needs. Always

16. Please rate the following:

	Never	Rarely	Often	Always
CDS staff have helped me communicate more effectively with the people who work with my child.	*Please rate the following: CDS staff have helped me communicate more effectively with the people who work with my child. Never	CDS staff have helped me communicate more effectively with the people who work with my child. Rarely	CDS staff have helped me communicate more effectively with the people who work with my child. Often	CDS staff have helped me communicate more effectively with the people who work with my child. Always

17. Please rate the following:

	Never	Rarely	Often	Always
CDS staff have helped me know about my child's and my rights concerning special education services.	*Please rate the following: CDS staff have helped me know about my child's and my rights concerning special education services. Never	CDS staff have helped me know about my child's and my rights concerning special education services. Rarely	CDS staff have helped me know about my child's and my rights concerning special education services. Often	CDS staff have helped me know about my child's and my rights concerning special education services. Always

18. Please rate the following:

	Never	Rarely	Often	Always
My input regarding the transition needs that focus on my child’s transition-to-school goals are considered in the development of the IEP.	*Please rate the following: My input regarding the transition needs that focus on my child’s transition-to-school goals are considered in the development of the IEP. Never	My input regarding the transition needs that focus on my child’s transition-to-school goals are considered in the development of the IEP. Rarely	My input regarding the transition needs that focus on my child’s transition-to-school goals are considered in the development of the IEP. Often	My input regarding the transition needs that focus on my child’s transition-to-school goals are considered in the development of the IEP. Always

19. Please rate the following:

	Never	Rarely	Often	Always
The CDS site assists me in understanding what outside agencies can assist my child in realizing his/her education goals.	*Please rate the following: The CDS site assists me in understanding what outside agencies can assist my child in realizing his/her education goals. Never	The CDS site assists me in understanding what outside agencies can assist my child in realizing his/her education goals. Rarely	The CDS site assists me in understanding what outside agencies can assist my child in realizing his/her education goals. Often	The CDS site assists me in understanding what outside agencies can assist my child in realizing his/her education goals. Always

20. What is your current involvement with CDS

What is your current involvement with CDS My child has only been referred to CDS

My child has been determined to be eligible for services

We are currently waiting for services to begin

We are receiving services