NMCAA Exit Interview

Question Title

* 1. Name (optional):

Question Title

* 2. Job Title:

Question Title

* 3. Department:

Administration

Community Services

Early Head Start

Head Start

Senior Nutrition

Question Title

* 4. Original hire date:

Date

Date

Question Title

* 5. Start date in last position:

Date

Date

Question Title

* 6. Separation Date:

Date

Date

Question Title

* 7. Total length of service:

Question Title

* 8. Other position(s) held with NMCAA:

Question Title

* 9. Please describe the primary reason(s) why you are leaving your current position:

Question Title

* 10. Did dissatisfaction with any of the following factors influence your decision to leave?

	Yes	No
Type of work	Type of work Yes	Type of work No
Working conditions (setting schedule, travel, flexibility)	Working conditions (setting schedule, travel, flexibility) Yes	Working conditions (setting schedule, travel, flexibility) No
Pay	Pay Yes	Pay No
Supervisor	Supervisor Yes	Supervisor No
Location	Location Yes	Location No
Cost of living in area	Cost of living in area Yes	Cost of living in area No
Commute	Commute Yes	Commute No

Question Title

* 11. Please rate the following aspects of the job you are vacating. Use the 1-5 scale below:

	1 Poor	2	3 Average	4	5 Excellent
Type of work performed	Type of work performed 1 Poor	Type of work performed 2	Type of work performed 3 Average	Type of work performed 4	Type of work performed 5 Excellent
Fairness of workload	Fairness of workload 1 Poor	Fairness of workload 2	Fairness of workload 3 Average	Fairness of workload 4	Fairness of workload 5 Excellent
Pay	Pay 1 Poor	Pay 2	Pay 3 Average	Pay 4	Pay 5 Excellent
Working conditions	Working conditions 1 Poor	Working conditions 2	Working conditions 3 Average	Working conditions 4	Working conditions 5 Excellent
Tools and equipment provided	Tools and equipment provided 1 Poor	Tools and equipment provided 2	Tools and equipment provided 3 Average	Tools and equipment provided 4	Tools and equipment provided 5 Excellent
Training received	Training received 1 Poor	Training received 2	Training received 3 Average	Training received 4	Training received 5 Excellent
Co-workers	Co-workers 1 Poor	Co-workers 2	Co-workers 3 Average	Co-workers 4	Co-workers 5 Excellent
Supervision received	Supervision received 1 Poor	Supervision received 2	Supervision received 3 Average	Supervision received 4	Supervision received 5 Excellent
Level of input in decisions that affect you	Level of input in decisions that affect you 1 Poor	Level of input in decisions that affect you 2	Level of input in decisions that affect you 3 Average	Level of input in decisions that affect you 4	Level of input in decisions that affect you 5 Excellent

Question Title

* 12. Please rate the following aspects of NMCAA overall. Use the 1-5 scale below:

	1 Poor	2	3 Average	4	5 Excellent
Hiring process	Hiring process 1 Poor	Hiring process 2	Hiring process 3 Average	Hiring process 4	Hiring process 5 Excellent
New employee orientation	New employee orientation 1 Poor	New employee orientation 2	New employee orientation 3 Average	New employee orientation 4	New employee orientation 5 Excellent
Training opportunities	Training opportunities 1 Poor	Training opportunities 2	Training opportunities 3 Average	Training opportunities 4	Training opportunities 5 Excellent
Career development opportunities	Career development opportunities 1 Poor	Career development opportunities 2	Career development opportunities 3 Average	Career development opportunities 4	Career development opportunities 5 Excellent
Employee morale	Employee morale 1 Poor	Employee morale 2	Employee morale 3 Average	Employee morale 4	Employee morale 5 Excellent
Fair treatment of employees	Fair treatment of employees 1 Poor	Fair treatment of employees 2	Fair treatment of employees 3 Average	Fair treatment of employees 4	Fair treatment of employees 5 Excellent
Recognition for a job well done	Recognition for a job well done 1 Poor	Recognition for a job well done 2	Recognition for a job well done 3 Average	Recognition for a job well done 4	Recognition for a job well done 5 Excellent
Support of work/life balance	Support of work/life balance 1 Poor	Support of work/life balance 2	Support of work/life balance 3 Average	Support of work/life balance 4	Support of work/life balance 5 Excellent
Cooperation within the agency	Cooperation within the agency 1 Poor	Cooperation within the agency 2	Cooperation within the agency 3 Average	Cooperation within the agency 4	Cooperation within the agency 5 Excellent
Communication between management and employees	Communication between management and employees 1 Poor	Communication between management and employees 2	Communication between management and employees 3 Average	Communication between management and employees 4	Communication between management and employees 5 Excellent
Performance and development planning and evaluation	Performance and development planning and evaluation 1 Poor	Performance and development planning and evaluation 2	Performance and development planning and evaluation 3 Average	Performance and development planning and evaluation 4	Performance and development planning and evaluation 5 Excellent
Interest and investment in employees	Interest and investment in employees 1 Poor	Interest and investment in employees 2	Interest and investment in employees 3 Average	Interest and investment in employees 4	Interest and investment in employees 5 Excellent
Commitment to customer service	Commitment to customer service 1 Poor	Commitment to customer service 2	Commitment to customer service 3 Average	Commitment to customer service 4	Commitment to customer service 5 Excellent
Concern with quality and excellence	Concern with quality and excellence 1 Poor	Concern with quality and excellence 2	Concern with quality and excellence 3 Average	Concern with quality and excellence 4	Concern with quality and excellence 5 Excellent
Administrative policies and procedures	Administrative policies and procedures 1 Poor	Administrative policies and procedures 2	Administrative policies and procedures 3 Average	Administrative policies and procedures 4	Administrative policies and procedures 5 Excellent

Question Title

* 13. Please rate your supervisor on the following factors. Use the 1-5 scale below:

	1 Poor	2	3 Average	4	5 Excellent
Gave usable feedback	Gave usable feedback 1 Poor	Gave usable feedback 2	Gave usable feedback 3 Average	Gave usable feedback 4	Gave usable feedback 5 Excellent
Recognized accomplishments	Recognized accomplishments 1 Poor	Recognized accomplishments 2	Recognized accomplishments 3 Average	Recognized accomplishments 4	Recognized accomplishments 5 Excellent
Clearly communicated expectations	Clearly communicated expectations 1 Poor	Clearly communicated expectations 2	Clearly communicated expectations 3 Average	Clearly communicated expectations 4	Clearly communicated expectations 5 Excellent
Treated you fairly and respectfully	Treated you fairly and respectfully 1 Poor	Treated you fairly and respectfully 2	Treated you fairly and respectfully 3 Average	Treated you fairly and respectfully 4	Treated you fairly and respectfully 5 Excellent
Coached, trained and developed you	Coached, trained and developed you 1 Poor	Coached, trained and developed you 2	Coached, trained and developed you 3 Average	Coached, trained and developed you 4	Coached, trained and developed you 5 Excellent
Provided leadership	Provided leadership 1 Poor	Provided leadership 2	Provided leadership 3 Average	Provided leadership 4	Provided leadership 5 Excellent
Encouraged teamwork and cooperation	Encouraged teamwork and cooperation 1 Poor	Encouraged teamwork and cooperation 2	Encouraged teamwork and cooperation 3 Average	Encouraged teamwork and cooperation 4	Encouraged teamwork and cooperation 5 Excellent
Resolved concerns promptly	Resolved concerns promptly 1 Poor	Resolved concerns promptly 2	Resolved concerns promptly 3 Average	Resolved concerns promptly 4	Resolved concerns promptly 5 Excellent
Listened to suggestions and feedback	Listened to suggestions and feedback 1 Poor	Listened to suggestions and feedback 2	Listened to suggestions and feedback 3 Average	Listened to suggestions and feedback 4	Listened to suggestions and feedback 5 Excellent
Kept employees informed	Kept employees informed 1 Poor	Kept employees informed 2	Kept employees informed 3 Average	Kept employees informed 4	Kept employees informed 5 Excellent
Supported work/life balance	Supported work/life balance 1 Poor	Supported work/life balance 2	Supported work/life balance 3 Average	Supported work/life balance 4	Supported work/life balance 5 Excellent
Provided appropriate and challenging assignments	Provided appropriate and challenging assignments 1 Poor	Provided appropriate and challenging assignments 2	Provided appropriate and challenging assignments 3 Average	Provided appropriate and challenging assignments 4	Provided appropriate and challenging assignments 5 Excellent

Question Title

* 14. Would you work for NMCAA in the future?

Question Title

* 15. What did you like most about NMCAA?

Question Title

* 16. Are there any situations or deviations from policies that you feel we should be aware of?

Question Title

* 17. Do you have any questions or comments?