Exit this survey >> Services to Children and Families - Consumer Survey Question Title * 1. Which stakeholder group do you represent for the purpose of responding to this survey? (Choose one) Youth - age 6-10 Youth - age 11-14 Youth - age 15-18 Adult - age 18-21 Adult - over 21 Biological family member Extended family (grandparent, aunt/uncle, cousin, etc.) Adoptive family member Legal guardian Other (please specify) Question Title * 2. What is your county of residence? (Choose one) Adams Asotin Benton Chelan Clallam Clark Columbia Cowlitz Douglas Ferry Franklin Garfield Grant Grays Harbor Island Jefferson King Kitsap Kittitas Klickitat Lewis Lincoln Mason Okanogan Pacific Pend Oreille Pierce San Juan Skagit Skamania Snohomish Spokane Stevens Thurston Wahkiakum Walla Walla Whatcom Whitman Yakima Question Title * 3. In which county do you (or did you) typically receive services? (Choose one) Adams Asotin Benton Chelan Clallam Clark Columbia Cowlitz Douglas Ferry Franklin Garfield Grant Grays Harbor Island Jefferson King Kitsap Kittitas Klickitat Lewis Lincoln Mason Okanogan Pacific Pend Oreille Pierce San Juan Skagit Skamania Snohomish Spokane Stevens Thurston Wahkiakum Walla Walla Whatcom Whitman Yakima Question Title * 4. How long have you been involved with children & family services in Washington State? (Choose one) Less than 1 year 1 – 2 years 2 – 5 years 5 – 10 years More than 10 years Most recent year of involvement: Question Title * 5. Which groups best describe your race or ethnicity? (Choose all that apply) Asian / Pacific Islander Black / African American Hispanic Native American / Alaska Native White / Caucasian Other (please specify) Question Title * 6. During your most recent service experience, which state agency serving children and families were you involved with? (Choose one) Court-Administered Services Department of Commerce Department of Early Learning Department of Health DSHS: Children’s Administration DSHS: Economic Services Administration DSHS: Juvenile Rehabilitation Administration DSHS: Mental Health DSHS: Substance Abuse Health Care Authority Tribal Services Other (please specify) Question Title * 7. What challenges were you or your family facing that led to your involvement with this agency? (Choose all that apply) Unemployment or need for job training Need for respite care Basic needs (food, cash assistance, access to health care) Mental health concerns Difficulty managing disabilities or chronic illness Managing a child with complex needs Difficulties with parenting and home management Domestic violence Need for child care or pre-school Substance abuse issues Housing needs Legal issues Other (please specify) Question Title * 8. Which services did you or your family receive? (Choose all that apply) Domestic violence counseling Job training or unemployment support Medical assistance / access to health care Parenting classes or instruction Substance abuse treatment Assistance managing disabilities or chronic illness of a child Enrollment in child care or pre-school Cash assistance Food / nutrition Support from a caseworker Respite Care Counseling or other mental health services Housing assistance Legal assistance Other (please specify) Next/Save >>