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The Role of Families and Guardians in Safeguarding Human Rights

1. Have you been informed of the following regarding the human rights of your family member, or person for whom you support decision-making?

  Yes No
a. Family member's human rights and your role in providing for and protecting them?
b. The role of a human rights officer?
c. The role of a human rights coordinator?
d. The role of a human rights committee?
e. The role of a human rights specialist?

2. Which of the following describes your role as a family member or guardian in the DDS Human Rights System?

3. Are DDS Area Office personnel you have relationships with accessible and responsive to your concerns/questions regarding human rights issues?

4. Which, if any, of the following groups or persons has been helpful in answering human rights questions or concerns? (please check all that apply)

5. Are there human rights questions or concerns you have tried to convey that have not been attended to?

6. Do you feel sufficiently informed about the various DDS and community resources you can use to address concerns regarding safety, suspicions of abuse/neglect or other human rights issues?

7. Do you find human rights personnel and activities are culturally sensitive and user friendly in:

  Yes No No experience with this
a. communication methods
b. presentations
c. trainings

8. If your family member has communication challenges, do you feel staff (including human rights personnel), are well trained in and use appropriate and effective means of communication with him/her?

9. Do you feel your family member's choices and/or preferences are respected when selecting services and/or service providers?

10. Are you satisfied with the provider staff's responses to your family member's needs in the following areas?

  Yes No
a. Medical
b. Dental
c. Behavioral
d. Nutritional

11. Do you feel direct care staff are sufficiently trained to appropriately convey health issues and report incidents, as well as on-going needs, to the health care providers your family member sees?

12. Overall, do you feel that DDS adequately addresses your questions and concerns regarding your family member's human rights and your role in protecting those rights?

13. Which region does the person you safeguard receive services from?

14. What is your status regarding the person you are safeguarding? (Please check the one that applies)