Satisfaction Survey for Families of People Receiving Supports

By completing this survey, you will assist Community Living Essex County to provide the best possible service experience to you and your family member. This survey should take 10-15 minutes to complete. We thank you for your time and valued input.

Please read the following statements and pick the answer that best applies to you and your family member’s experience.  

The deadline date for survey completion is by the end of the day on Friday, May 28, 2021. 

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* 1. What is your relationship with the person supported by Community Living Essex County?

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* 2. What type(s) of support does your family member receive? (Select all that apply)

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* 3. How are these supports paid for? (Select all the apply)

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* 4. Community Living Essex County employees are positive, friendly, helpful, and respectful.

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* 5. Community Living Essex County is open to suggestions and comments.

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* 6. Progress is being made to support my family member’s achievement of their goals and dreams.

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* 7. Community Living Essex County does a good job in developing and delivering programs and services to support my family member.

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* 8. Community Living Essex County is able to change the supports provided when the needs of my family member changes.

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* 9. Please provide any feedback or other comments that will help us enhance our supports.

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* 10. My family member has an opportunity to make meaningful decisions about each day.

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* 11. My family member to his/her best capability directs important decisions in their life.

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* 12. Please provide any feedback or comments that will help enhance your family member’s ability to direct their supports.

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* 13. Community Living Essex County Employees that work with my family member are well trained.

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* 14. My family member’s home is well maintained and safe.

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* 15. I am confident that my family member’s possessions are protected and maintained.

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* 16. The employees are able to meet the needs of my family member and can provide any needed support.

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* 17. The agency has responded appropriately and followed required safety measures during the pandemic.

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* 18. I have been well informed about the agency's responses, subsequent adjustments to supports and actions taken during the pandemic.

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* 19. Please provide any feedback, comments or suggestions you may have regarding supports during the pandemic.

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* 20. Please provide any feedback or comments that will help Community Living Essex County enhance the safety of your family member.

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* 21. My family member has opportunities to connect with the important people who are in their life in any way possible (phone, email, Skype, Zoom, in person when permissible due to COVID related restrictions).

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* 22. I feel welcomed when I phone or visit at my family member’s home in spite of times where visits are  restricted due to COVID.

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* 23. Employees keep me well informed about the care and activities of my family member.

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* 24. Community Living Essex County acts on suggestions and comments if I have concerns or feedback.

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* 25. Please provide any feedback or comments that will enhance family member/friends connections.

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* 26. I am satisfied with my family member’s opportunities to engage in a variety of activities taking into consideration that COVID restrictions have really limited the availability of activities.

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* 27. My family member has opportunities to meaningfully participate in their community taking into consideration that the pandemic has restricted your son/daughter from doing most of their activities they usually do and enjoy.

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* 28. I am satisfied with the transportation and support provided to ensure my family member can do the activities they would like to do.

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* 29. Please provide feedback or comments on how we can enhance your family member’s/friends involvement in their community.

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* 30. If you have any specific concerns and you would like us to follow-up with you, please provide your name and contact information.

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