Skip to content
Day Habilitation Survey
1.
Please state who you are (choose one that best applies):
A person with a disability receiving day habilitation services;
A family member of a person with a disability receiving day habilitation services
A professional guardian of a person receiving day habilitation services
An advocate or attorney for a person receiving day habilitation services
Any other member of the public
2.
Please state where you live (choose one that best applies):
Greater Boston;
Metro West;
North Shore or north of Boston;
South Shore or south of Boston;
Cape Cod or the Islands;
Central Massachusetts (Worcester County)
Western Massachusetts (Franklin, Hampshire, or Hampden Counties);
Berkshires
I live out of state;
3.
If
you
have a disability and attend day habilitation,
have a family member
with a disability who attends day habilitation or
serve as guardian
for a person with a disability who attends day habilitation, please describe the disability(ies) as best as possible. Please choose
ALL
that apply:
A person with an intellectual disability
A person with autism
A person with another type of developmental disability
A person who is non-verbal
A person who uses a wheelchair or another assistive mobility device or requires assistance ambulating
A person who is Deaf or Hard of Hearing
A person who is blind or has a visual impairment
A person with another type of physical disability
A person with a traumatic brain injury
A person who has mental health issues
A person who has behavioral issues
A person with another type of disability not mentioned above
4.
What provider agency runs the day habilitation program you attend?
5.
Do you receive day habilitation supplemental supports (also referred to as 1:1 or wrap funding)? Choose one that best applies:
Yes, for the whole day
Yes, for part of the day (less than 30 hours per week)
No
I do not know
6.
What other day or employment programs or supports do you participate in? Please choose
ALL
that apply:
Community based day supports (CBDS)
Group supported employment
Individual employment (job in the community with individual supports)
Time during the day with family or friends
None, I am in the day habilitation full time
Other (please specify)
7.
At your day habilitation program, during an average month, how many times do you usually have opportunities to go into the community? Choose one that best applies:
Never
One day per month
Two days per month
Four days per month (about one day per week)
Eight to twelve days per month (about two to three days per week)
Twenty days per month (about every weekday)
Other (please specify)
8.
When you leave your day habilitation to go into the community, please describe who is with you. Please choose one that best applies:
Only staff
One to two day habilitation participants, plus staff
Three to five day habilitation participants, plus staff
Five to seven day habilitation participants, plus staff
Other (please specify)
9.
If you could change or improve your day habilitation, what would you change? Please choose
ALL
responses that apply.
I would want to do more community activities or spend more time away from the day habilitation building
I would want to work or, if I am already working, I want to work more
I would want to attend Community Based Day Supports (CBDS) instead of day habilitation
I would have there be more staff or have better trained staff
I would change the day habilitation location to one closer to a city/town center
I would not change anything
Other (please specify)
10.
When you leave your day habilitation to do activities in the community, what statement best describe this experience? Choose one that best applies:
I am actively engaged and participating
I actively watch and observe
I am not engaged or participating because I am not interested in the activity
I am not engaged or participating because I do not have the staff support I need
Other (please specify)
11.
Please choose the statement below that best describes the understanding that day habilitation staff have about your disabilities and abilities and about the time you spend in the community. Choose the one that best applies:
Staff tend to be too guarded or protective in limiting me from being in the community
Staff are appropriately concerned, but could allow me to be in the community more with better staffing ratios or better trained staff
I agree with the perspective of my staff about how often I can and should be in the community
Staff should be more guarded or protective about how much time I can be in the community safely
Other (please specify)
12.
In an ideal situation, what general areas would you want addressed in the goals and objectives in your Day Habilitation Service Plan? Please choose
ALL
that apply.
Personal hygiene
Toileting
Activities of daily living
Social skills
Increasing skills or use of your communication device/system
Behavior
Safety awareness
Cooking skills
Money management
Academic
Physical exercise
Physical therapy related to ambulation or standing
Physical therapy related to range of motion
Occupational therapy related to fine motor skills
Occupation therapy related to sensory issues
Other (please specify)
13.
What do you think are the main barriers to you spending time in the community?
14.
Please think about any time you spend during the week outside where day habilitation staff help you be in the community. This includes time spent outdoors, at restaurants, shopping, social activities, volunteering, or recreational activities. Please describe how happy or unhappy you are with those opportunities. Please choose one that best applies.
Very unsatisfied
Mostly unsatisfied
Neutral
Mostly satisfied
Very satisfied
Not applicable, because my day habilitation staff do not bring me into the community, or do this only rarely.
Other (please specify)
15.
What do you think needs to change to increase or improve the time spent in the community for people in day habilitation?
Current Progress,
0 of 15 answered