Quality Assurance & Compliance Customer Service Survey Question Title * 1. What services did you receive from Charles County DSS? Child Support Emergency Services (Burial, Utilities) Homeless Services Family Involvement Meeting TDAP TCA Foster Care Medical Assistance In-Home Services Child Protective Services Scheduled Interview Other (please specify) Question Title * 2. Were you treated with respect? Yes No Question Title * 3. If you came into the agency, was the lobby comfortable? Yes No N/A Question Title * 4. What could we do to improve our lobby? (Check all that apply) More Comfortable Chairs More Privacy Improved Check-in Process Paint/Decorations TV WIFI Toys for Children Magazines/Books Other (please specify) Question Title * 5. How long was your wait time? 0 – 15 mins 15 mins – 1 hour 1 hour – 3 hours 3 hours – 5 hours 5 hours – 8 hours Question Title * 6. How did you hear about us? Family / Friend Internet Community Provider Other (please specify) Question Title * 7. Were your needs met? Yes No I am not sure Question Title * 8. Did we answer your question(s) or address your concern(s)? Yes No Question Title * 9. Were you eligible for the services that you applied for? Yes No N/A Question Title * 10. Did we direct you to additional resources and/or information? Yes No N/A Question Title * 11. Did your caseworker provide you with additional information about community services? Yes No N/A Question Title * 12. Was your caseworker knowledgeable about the program you came in for today? Yes No N/A Question Title * 13. How satisfied are you with the service that you received at Charles County Department of Social Services? Very Satisfied Satisfied Neither Satisfied Nor Unsatisfied Dissatisfied Very Dissatisfied Question Title * 14. How can we serve you better? Question Title * 15. Please tell us about your experience at Charles County DSS: Question Title * 16. Name of the caseworker that you met with: Question Title * 17. What is your client ID or case number: Question Title * 18. Would you like to be contacted about this survey or your experience while at Charles County DSS? If so, please provide your name, phone number and/or email address. Done
