IHSS Timesheet Survey IHSS Timesheet Survey Note: Your responses will be kept confidential. Identifying information is only being collected to follow up with those who would like additional help and information. Question Title * 1. First Name Question Title * 2. Last Name: Question Title * 3. (Optional): Home Phone Number Question Title * 4. (Optional): Cell Phone Number Question Title * 5. Optional Yes! I want to receive text message and phone call updates from UDW. Standard data rates apply. Question Title * 6. What county do you work in? Alpine Butte El Dorado Imperial Kern Madera Mariposa Merced Mono Nevada Orange Placer Plumas Riverside San Diego San Luis Obispo Santa Barbara Sierra Stanislaus Sutter Tuolumne Question Title * 7. What is your gender? Male Female Other Question Title * 8. What is your age range? 18 - 25 26 - 30 31 - 40 41 - 50 51 - 60 61 - 70 71 - 75 76 - 80 81 and older Question Title * 9. How many hours do you work per week? less than 10 hours 10 - 15 hours 15 - 20 hours 20 - 25 hours 25 - 30 30 - 35 35 - 40 40 or more hours Other (please specify) Question Title * 10. How many clients do you take care of? 1 2 3 or more Question Title * 11. Do you live with your client? Yes No Other (please specify) Question Title * 12. What is your race/identity? (Select all that apply) White African America/Black Hispanic/Latino Asian Pacific Islander Middle Eastern Native American Other (please specify) Question Title * 13. What is your primary language? English Spanish Korean Cambodian Chinese (Cantonese) Chinese (Mandarin) Farsi Armenian Russian Vietnamese Hmong Tagalog Other (please specify) Question Title * 14. How would you rate the current timesheet submission system? Very unsatisfied Unsatisfied Neutral Satisfied Very satisfied Question Title * 15. When you receive information about IHSS from the state and/or county, how easy is it to understand? Very easy to understand Easy to understand Sometimes difficult to understand Very difficult to understand Question Title * 16. Does your paycheck go through Direct Deposit? Yes No Question Title * 17. If you do NOT have Direct Deposit, would you like information/help in setting it up? Yes No Maybe Other (please specify) Question Title * 18. How long does it take to fill out your timesheet? Question Title * 19. Where do you usually fill out your timesheet (e.g. home, county office)? Home County office Other (please specify) Question Title * 20. In the past 3 months, how many times was your paycheck delayed? 0 - never 1 - once 2 - two times 3 - three times 4 or more Other (please specify) Question Title * 21. In the past 3 months, how many times was your timesheet returned because of an error? 0 - never 1 - once 2 - twice 3 - three times 4 or more Other Question Title * 22. If you had a timesheet returned because of errors, what were the errors? Question Title * 23. Do you have internet access? Yes No Question Title * 24. If yes, how do you access the internet? Home computer Library School Devises - iPhone, Android, Blackberry, and others UDW office Workplace Other Question Title * 25. Do you trust sending your timesheet electronically? Yes No Maybe Question Title * 26. If you could submit your timecard online, how likely do you think you are to do so? Never All the time Sometimes Most of the time Other (please specify) Question Title * 27. Do you like the idea of being able to access and print your wage statement/pay stub electronically? Yes No Maybe Other (please specify) Question Title * 28. Would you like to receive your timesheets (regular and replacement) electronically? Yes No Maybe Other (please specify) Question Title * 29. Would you like to participate in a pilot/test program Yes No Maybe Other (please specify) Question Title * 30. Have you had trouble paying bills due to a late or delayed IHSS paycheck? Yes No Question Title * 31. Should setting up online IHSS timesheet submission be a priority campaign for our union? Yes No Question Title * 32. (Optional): Please share any ideas you have to improve the IHSS paycheck and timesheet system. Question Title * 33. (Optional): Yes! I am interested in joining a committee with other providers to make improvements to the IHSS payroll system. Done