2010 Satisfaction Survey for Family and/or Advocate Independent Living Programs

Exit this survey

 

1. Staff have increased their awareness and sensitivity of my family member/friends needs and wishes.

Staff have increased their awareness and sensitivity of my family member/friends needs and wishes.   Agree	Disagree	Not sure
What do we do well? What can we improve

2. MY family member/friend has more opportunities for involvement in daily activities.

MY family member/friend has more opportunities for involvement in daily activities.   Agree	Disagree	Not sure
What do we do well? What can we improve?

3. Individual choices and preferences are part of my family member/friend's daily life.

Individual choices and preferences are part of my family member/friend's daily life.   Agree	Disagree	Not sure
What do we do well? What can we improve?

4. I feel the program provides a safe and healthy environment.

I feel the program provides a safe and healthy environment.   Agree	Disagree	Not sure
What do we do well? What can we improve?

5. Steps are taken to identify and minimize health and safety risks.

Steps are taken to identify and minimize health and safety risks.   Agree	Disagree	Not sure
What do we do well? What can we improve?

6. My family member/friend is given opportunities for personal growth and new experiences.

My family member/friend is given opportunities for personal growth and new experiences.   Agree	Disagree	Not sure
What do we do well? What can we improve?

7. My famil member/friend is assisted to maintain contact with family and other important relationships.

My famil member/friend is assisted to maintain contact with family and other important relationships.   Agree	Disagree	Not sure
What do we do well? What can we improve?

8. My family member/friend is given opportunities to socialize.

My family member/friend is given opportunities to socialize.   Agree	Disagree	Not sure
What do we do well? What can we improve?

9. I am satisfied with the support my family member/friend is receiving from the NSDRC.

I am satisfied with the support my family member/friend is receiving from the NSDRC.   Agree	Disagree	Not sure
What do we do well? What can we improve?

10. Are there any architectural, environmental, attitudinal, financial, employment, communication, transportation, recreation, or educational/vocational areas that pose problems for your family member/friend?

Are there any architectural, environmental, attitudinal, financial, employment, communication, transportation, recreation, or educational/vocational areas that pose problems for your family member/friend?   Yes	No	Not sure
If yes please explain.