ChildNet (Creole) Parent Satisfaction Survey

Question Title

2. Ki laj ou? (Required.)

Anba 18

18-29

30-49

50-64

65 ak plis

Question Title

3. Seks: (Required.)

Femel

Mal

Lot (Souple di ki sa):

Question Title

4. Gwoup Etnik: (Required.)

Question Title

5. Ras (Souple chwazi you-n): (Required.)

Question Title

6. Relijyon/Kilti ou afilye:

Question Title

7. Ki lang ou pale? (Required.)

Angle

Kreyol

Espayol

Lot:

Question Title

8. Souple ekri Vil ou: (Required.)

Question Title

9. Nan ki kategori lajan fanmi-w ye? (Required.)

Pi piti ke 10,000

$10,000 - $20,000

$21,000 - $40,000

$41,000 - $60,000

$61,000 - $80,000

$81,000 +

Question Title

10. Kouman Travaye Sosyal la patisipe nan ka/planifikasyon sevis yo? (Required.)

ZIP Code:

Toutan

Byen souvan

Kek fwa

Ditou

Question Title

11. Eske Travaye sosyal la ba-w opotinite pou bay reyaksyon/opinyon-w sou ka-w la ak bezwen fanmi-w yo? (Required.)

Toutan

Byen Souvan

Kek fwa

Ditou

Question Title

12. Eske yo te esplike-w pou kisa timoun timoun yo anba sipevizyon Childnet? (Required.)

Yon ti kras

Ditou

Question Title

13. Ki pwen out a bay tet ou sou jan ou fe sa ki ekri nan plan ka-a? (Required.)

Ekselan

Byen

Pasab

Mal

Question Title

14. Eske sevis yo ede ka-w la avanse? (Required.)

Mwen byen dako

Mwen dako

Yon tija dako

Mwen pa dako ditou

Question Title

15. Eske Travaye Soayal la ba-w nouvo enfomasyon sou chanjman ki fet nan ka-w la (Tankou chanjman nan kote yo mete timoun nan rete, chita tande nan Tribinal yo, rankont yo, reyinyon yo, elatriye.)? (Required.)

Toutan

Byen souvan

Kek fwa

Ditou

Question Title

16. Eske Travaye Sosyal fe-w patisipe nan desizyon kap pran sou santé mantal, edikasyon, ak bezwen santé fizik timoun nan? (Required.)

Toutan

Byen souvan

So Kek fwa

Ditou

Pa aplikab ( timoun nan ak mwen)

Question Title

17. Eske Travaye Sosyal la konsidere relijyon-a nan sevis lap ba-w yo? (Required.)

Toutan

Byen souvan

Kek fwa

Ditou

Pa gen pwoblem nan sa

Question Title

18. Eske-w patisipe nan desizyon kap pran pou timoun nan retounen lakay ou osinon jen yon lot kote pou timoun nan (yo) rete toutan? (Required.)

Toutan

Byen souvan

Kek fwat

Ditou

Pa aplikab (Timoun nan ak mwen)

Question Title

19. Eske-w satisfe ak kote yo mete timoun yo rete-a? (Required.)

Satisfe anpil

Yon tijan satisfe

Yon tijan pa satisfe

Pa satisfe

Pa aplikab (Timoun nan ak mwen)

Question Title

20. Eske-w gen vizit ak lot kalite kontak (apel telefon/mesaj elektronik) ak timoun ou yo? (Required.)

Toutan

Byen souvan

Kek fwa

Ditou

Pa aplikab (Timoun nan ak mwen)

Question Title

21. Eske satisfe ak vites ou resevwa sevis yo? (Required.)

Satisfe anpil

Yon tijan satisfe

Yon tijan pa satisfe

Pa satisfe

Question Title

22. Ki nivo satisfaksyon jeneral ak patisipasyon Childnet nan ka-w la? (Required.)

Satisfe anpil

Yon tijan satisfe

Yon tijan pa satisfe

Pa satisfe

Question Title

23. Ki sa-w pi pa renmen ak Travaye Sosyal ou-a?

Question Title

24. Kouman Childnet ka fe pi byen?

Question Title

25. Kouman ou te ranpli dokiman sa-a? (Required.)

Sou odinate

Sou papye

Telefon

Fas a fas

Question Title

* 1. Non (Si-w vle):

Question Title

* 2. Ki laj ou? (Required.)

Question Title

* 3. Seks: (Required.)

Question Title

* 4. Gwoup Etnik: (Required.)

Question Title

* 5. Ras (Souple chwazi you-n): (Required.)

Question Title

* 6. Relijyon/Kilti ou afilye:

Question Title

* 7. Ki lang ou pale? (Required.)

Question Title

* 8. Souple ekri Vil ou: (Required.)

Question Title

* 9. Nan ki kategori lajan fanmi-w ye? (Required.)

Question Title

* 10. Kouman Travaye Sosyal la patisipe nan ka/planifikasyon sevis yo? (Required.)

Question Title

* 11. Eske Travaye sosyal la ba-w opotinite pou bay reyaksyon/opinyon-w sou ka-w la ak bezwen fanmi-w yo? (Required.)

Question Title

* 12. Eske yo te esplike-w pou kisa timoun timoun yo anba sipevizyon Childnet? (Required.)

Question Title

* 13. Ki pwen out a bay tet ou sou jan ou fe sa ki ekri nan plan ka-a? (Required.)

Question Title

* 14. Eske sevis yo ede ka-w la avanse? (Required.)

Question Title

* 15. Eske Travaye Soayal la ba-w nouvo enfomasyon sou chanjman ki fet nan ka-w la (Tankou chanjman nan kote yo mete timoun nan rete, chita tande nan Tribinal yo, rankont yo, reyinyon yo, elatriye.)? (Required.)

Question Title

* 16. Eske Travaye Sosyal fe-w patisipe nan desizyon kap pran sou santé mantal, edikasyon, ak bezwen santé fizik timoun nan? (Required.)

Question Title

* 17. Eske Travaye Sosyal la konsidere relijyon-a nan sevis lap ba-w yo? (Required.)

Question Title

* 18. Eske-w patisipe nan desizyon kap pran pou timoun nan retounen lakay ou osinon jen yon lot kote pou timoun nan (yo) rete toutan? (Required.)

Question Title

* 19. Eske-w satisfe ak kote yo mete timoun yo rete-a? (Required.)

Question Title

* 20. Eske-w gen vizit ak lot kalite kontak (apel telefon/mesaj elektronik) ak timoun ou yo? (Required.)

Question Title

* 21. Eske satisfe ak vites ou resevwa sevis yo? (Required.)

Question Title

* 22. Ki nivo satisfaksyon jeneral ak patisipasyon Childnet nan ka-w la? (Required.)

Question Title

* 23. Ki sa-w pi pa renmen ak Travaye Sosyal ou-a?

Question Title

* 24. Kouman Childnet ka fe pi byen?

Question Title

* 25. Kouman ou te ranpli dokiman sa-a? (Required.)

1. Non (Si-w vle):

2. Ki laj ou? (Required.)

3. Seks: (Required.)

4. Gwoup Etnik: (Required.)

5. Ras (Souple chwazi you-n): (Required.)

6. Relijyon/Kilti ou afilye:

7. Ki lang ou pale? (Required.)

8. Souple ekri Vil ou: (Required.)

9. Nan ki kategori lajan fanmi-w ye? (Required.)

10. Kouman Travaye Sosyal la patisipe nan ka/planifikasyon sevis yo? (Required.)

11. Eske Travaye sosyal la ba-w opotinite pou bay reyaksyon/opinyon-w sou ka-w la ak bezwen fanmi-w yo? (Required.)

12. Eske yo te esplike-w pou kisa timoun timoun yo anba sipevizyon Childnet? (Required.)

13. Ki pwen out a bay tet ou sou jan ou fe sa ki ekri nan plan ka-a? (Required.)

14. Eske sevis yo ede ka-w la avanse? (Required.)

15. Eske Travaye Soayal la ba-w nouvo enfomasyon sou chanjman ki fet nan ka-w la (Tankou chanjman nan kote yo mete timoun nan rete, chita tande nan Tribinal yo, rankont yo, reyinyon yo, elatriye.)? (Required.)

16. Eske Travaye Sosyal fe-w patisipe nan desizyon kap pran sou santé mantal, edikasyon, ak bezwen santé fizik timoun nan? (Required.)

17. Eske Travaye Sosyal la konsidere relijyon-a nan sevis lap ba-w yo? (Required.)

18. Eske-w patisipe nan desizyon kap pran pou timoun nan retounen lakay ou osinon jen yon lot kote pou timoun nan (yo) rete toutan? (Required.)

19. Eske-w satisfe ak kote yo mete timoun yo rete-a? (Required.)

20. Eske-w gen vizit ak lot kalite kontak (apel telefon/mesaj elektronik) ak timoun ou yo? (Required.)

21. Eske satisfe ak vites ou resevwa sevis yo? (Required.)

22. Ki nivo satisfaksyon jeneral ak patisipasyon Childnet nan ka-w la? (Required.)

23. Ki sa-w pi pa renmen ak Travaye Sosyal ou-a?

24. Kouman Childnet ka fe pi byen?

25. Kouman ou te ranpli dokiman sa-a? (Required.)