ArcNCR Family/Caregiver Satisfaction Survey for Supported Living
 

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THE ARC NORTHERN CHESAPEAKE REGION: SURVEY OF FAMILY/CAREGIVER SATISFACTION WITH SUPPORTED LIVING
Purpose and Instructions: The purpose of this survey is to help The Arc Northern Chesapeake Region to determine the quality of its Support Living services operations and how best to improve them.

Rating Items: Please rate each item and give each item only one rating.

1. The opportunities that your family member in Supported Living gets to meet people and make friends?

2. The opportunities that your family member in Support Living gets to engage in leisure and recreational activities at home?

3. The opportunities that your family member in supported Living gets to engage in leisure and recreational activities outside of his/her home?

4. The opportunities that your family member in Supported Living gets to try out and learn new things based upon his/her interests?

5. The opportunities that your family member gets to be actively engaged in everyday life activities in his/her home (e.g., planning and preparing meals, housecleaning and maintenance, planning and scheduling activities, etc.)?

6. The support that your family member gets from Supported Living staff in making choices and decisions that give your family member control over his/her life (e.g., who s/he spends time with, who s/he lives with, where s/he lives, etc.)?

7. The support that your family member gets from Supported Living staff with respect to meeting his/her medical, health, and personal care needs?

8. The respect shown to your family member by our Supported Living Staff?

9. The support that your family member gets from Supported Living staff with respect to managing his/her financial affairs?

10. The responsiveness of Supported Living staff to your calls, concerns, and requess for information?

11. The respect shown to you by Supported Living staff in their interactions with you?

12. The physical appearance and upkeep of the home in which your family member lives?

13. Your overall satisfaction with the Supported Living services provided to your family member by The Arc Northern Chesapeake Region?

Questions: Please answer each of the questions below.

14. What do you like most about the Supported Living supports provided to your family member by The Arc Northern Chesapeake Region, and why?

15. What do you like least about the Supported Living supports provided to your family member, and why?

16. What should Supported Living staff do to improve the nature and quality of the services and supports that they provide to your family member and/or other persons in Supported Living? Please be as specific as you can in your answer.