17-18 SSD Homebound Services Survey

Please take a moment to provide us with feedback about your experience with Homebound Services from Special School District.

Thanks, your input helps us to work towards improving our level of service!

Question Title

* 1. Please tell us your role (check all that apply.)

Special Education IEP Casemanager

Special Education Teacher

Special Education Area Coordinator

Special Education Director

General Education Counselor

General Education Teacher

District Liaison/Administrator

Other (please specify)

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* 2. Please check the homebound student's district:

Affton

Bayless

Brentwood

Clayton

Ferguson/Florissant

Hancock

Hazelwood

Jennings

Kirkwood

Ladue

Lindbergh

Maplewood Richmond Heights

Mehlville

Normandy

Parkway

Pattonville

Ritenour

Riverview

Rockwood

University City

Valley Park

Webster Groves

Other (please specify)

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* 3. IMPORTANT NOTE FOR SCHOOLS: Homebound students must continue to remain enrolled in schools and the school must maintain teacher(s) of record for the purpose of providing curriculum and assigning grades and credits. The Homebound Department is not a school and does not maintain permanent records. Student's academic progress must be determined and recorded by the school.

Please indicate your understanding of whether or not your student(s) received grades and credits for the work they completed during the time they were receiving homebound services.

Yes, the student received grades, credits for the work they completed.

No, the student did not receive grades/credits for the work they completed.

No, the student did not complete enough work to receive grades/credits.

I do not know whether they received grades/credits.

Other (please specify)

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* 4. Please rate your understanding of the following Homebound Issues:

	1 Very clear	2	3 Average	4	5 Very Unclear	6 Not applicable
My understanding of the Homebound process	My understanding of the Homebound process 1 Very clear	My understanding of the Homebound process 2	My understanding of the Homebound process 3 Average	My understanding of the Homebound process 4	My understanding of the Homebound process 5 Very Unclear	My understanding of the Homebound process 6 Not applicable
Knowing where to find the Homebound Application paperwork	Knowing where to find the Homebound Application paperwork 1 Very clear	Knowing where to find the Homebound Application paperwork 2	Knowing where to find the Homebound Application paperwork 3 Average	Knowing where to find the Homebound Application paperwork 4	Knowing where to find the Homebound Application paperwork 5 Very Unclear	Knowing where to find the Homebound Application paperwork 6 Not applicable
Understanding the required components of the Homebound Application	Understanding the required components of the Homebound Application 1 Very clear	Understanding the required components of the Homebound Application 2	Understanding the required components of the Homebound Application 3 Average	Understanding the required components of the Homebound Application 4	Understanding the required components of the Homebound Application 5 Very Unclear	Understanding the required components of the Homebound Application 6 Not applicable
The "user friendliness" of the Homebound Webpage and the supporting documentation	The "user friendliness" of the Homebound Webpage and the supporting documentation 1 Very clear	The "user friendliness" of the Homebound Webpage and the supporting documentation 2	The "user friendliness" of the Homebound Webpage and the supporting documentation 3 Average	The "user friendliness" of the Homebound Webpage and the supporting documentation 4	The "user friendliness" of the Homebound Webpage and the supporting documentation 5 Very Unclear	The "user friendliness" of the Homebound Webpage and the supporting documentation 6 Not applicable

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* 5. Please rate the level of support you received from the Homebound office:

	1 Polite and Helpful	2	3 Average	4	5 Rude and unresponsive	6 Not applicable
The administrative staff	The administrative staff 1 Polite and Helpful	The administrative staff 2	The administrative staff 3 Average	The administrative staff 4	The administrative staff 5 Rude and unresponsive	The administrative staff 6 Not applicable
The secretarial staff	The secretarial staff 1 Polite and Helpful	The secretarial staff 2	The secretarial staff 3 Average	The secretarial staff 4	The secretarial staff 5 Rude and unresponsive	The secretarial staff 6 Not applicable

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* 6. Please rate the contact/communication from the Homebound teacher(s):

	1 Excellent	2	3 Average	4	5 Very poor	6 Not applicable
Timeliness of initial contact	Timeliness of initial contact 1 Excellent	Timeliness of initial contact 2	Timeliness of initial contact 3 Average	Timeliness of initial contact 4	Timeliness of initial contact 5 Very poor	Timeliness of initial contact 6 Not applicable
Arrangements for exchange of student assignments and completed work	Arrangements for exchange of student assignments and completed work 1 Excellent	Arrangements for exchange of student assignments and completed work 2	Arrangements for exchange of student assignments and completed work 3 Average	Arrangements for exchange of student assignments and completed work 4	Arrangements for exchange of student assignments and completed work 5 Very poor	Arrangements for exchange of student assignments and completed work 6 Not applicable
Amount and quality of student work that was returned to school	Amount and quality of student work that was returned to school 1 Excellent	Amount and quality of student work that was returned to school 2	Amount and quality of student work that was returned to school 3 Average	Amount and quality of student work that was returned to school 4	Amount and quality of student work that was returned to school 5 Very poor	Amount and quality of student work that was returned to school 6 Not applicable
Quality and timeliness of Monthly Progress Reports	Quality and timeliness of Monthly Progress Reports 1 Excellent	Quality and timeliness of Monthly Progress Reports 2	Quality and timeliness of Monthly Progress Reports 3 Average	Quality and timeliness of Monthly Progress Reports 4	Quality and timeliness of Monthly Progress Reports 5 Very poor	Quality and timeliness of Monthly Progress Reports 6 Not applicable
Professional attitude of Homebound Teacher	Professional attitude of Homebound Teacher 1 Excellent	Professional attitude of Homebound Teacher 2	Professional attitude of Homebound Teacher 3 Average	Professional attitude of Homebound Teacher 4	Professional attitude of Homebound Teacher 5 Very poor	Professional attitude of Homebound Teacher 6 Not applicable

17-18 SSD Homebound Services Survey

Question Title

* 1. Please tell us your role (check all that apply.)

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* 2. Please check the homebound student's district:

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* 4. Please rate your understanding of the following Homebound Issues:

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* 5. Please rate the level of support you received from the Homebound office:

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* 6. Please rate the contact/communication from the Homebound teacher(s):

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* 7. Please list any positive feedback (PLUS+). What was good about your experience with Homebound services?

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* 8. Please list any negative feedback (DELTA-) What did you NOT like about your experience with Homebound Services?

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* 9. Please give us any additional suggestions (=IMPROVE!) What would you suggest we could do to make our services better?